Formal social support from healthcare professionals is critical in facilitating the transition to parenthood and may contribute to parental self-efficacy. However, its association with parent-infant bonding remains unclear, and evidence to guide clinical practice is scarce, especially during the postpartum hospital stay. This study aimed to (a) explore associations between formal social support during the postpartum stay, parenting self-efficacy, and parent-infant bonding; and (b) investigate the role of depressive symptoms and other confounding factors. A cross-sectional survey was conducted from April 2023 to August 2024 in five hospitals in French-speaking Switzerland. 420 first-time parents (298 mothers and 122 partners). First-time mothers and co-parents completed a cross-sectional survey. Variables were measured using the Hospital Anxiety and Depression Scale, the Birth Satisfaction Scale-Revised, the FOCUS-Postpartum Scale, the Perinatal Infant Care Social Support Scale, the Parenting Expectations Survey, and the Mother-Infant Bonding Scale. Descriptive statistics, correlation analyses, and regression analyses were performed. A total of 298 mothers and 122 partners answered the survey. Parents reported low satisfaction with the information received during the postpartum hospital stay. In bivariate analyses, formal social support was positively associated with maternal self-efficacy (rho = 0.18, p = 0.004) but not with partners' self-efficacy (rho= -0.07, p = 0.45) or parent-infant bonding. After adjustment for confounding factors, the association between formal social support and maternal self-efficacy was no longer significant. In the maternal regression model, satisfaction with informal general support was significantly associated with maternal self-efficacy (β = 0.62, p = 0.002). Non-exclusive breastfeeding was associated with higher maternal bonding difficulties (β = 0.34, p = 0.008). Partners with a secondary education level reported lower parenting self-efficacy (β = -35.49, p = 0.005) and lower bonding quality (β = 0.7, p = 0.019) than those with an apprenticeship education. Depressive symptoms were negatively associated with parental self-efficacy (mothers β = -2.44, p = 0.015; partners β = -4.57, p < 0.001) and bonding (mothers β = 0.08, p < 0.001; partners β = 0.07, p = 0.002). Higher satisfaction with informal support was linked to maternal self-efficacy, while depressive symptoms consistently undermined both parental self-efficacy and bonding for both parents. Together with parents' low satisfaction with information received, these findings underscore the need for tailored support and the importance of clear and consistent communication from healthcare professionals for both mothers and partners.

Efficacy of scalp cooling system versus chemical cooling cap in preventing chemotherapy-induced alopecia in breast cancer (COHAIR Study): a prospective randomized trial.

Quality of life after out-of-hospital cardiac arrest: age matters.

Undergraduate students are at risk for developing emotional disorders, which have exacerbated during the coronavirus disease 2019 (COVID-19) pandemic. Auricular acupuncture is a complementary and integrative therapy that may help manage these conditions. This study aimed to compare the effects of semipermanent needle acupuncture and low-level laser auricular acupuncture for the treatment of emotional disorders in undergraduate students post-COVID-19. This was an open-label, multicenter, randomized, parallel-group, superiority clinical trial. Following the CONSORT statement recommendations, 397 participants were randomized to either the semipermanent needle auricular acupuncture group or the low-level laser auricular acupuncture group. Data were collected at three time points: before the first session (baseline), after the last session (final), and seven days after the end of the treatment (follow-up). The Perceived Stress Scale, Hospital Anxiety and Depression Scale, digital algometer, glucometer, and salivary α-amylase biosensor were used for data collection. Generalized estimating equation models were applied to examine the associations between interventions and outcomes. Semipermanent needle auricular acupuncture was more effective than low-level laser auricular acupuncture in reducing stress levels. Both groups showed significant reductions in anxiety, depression, and stress levels over time. Furthermore, the semipermanent needle auricular group showed an increased pressure pain threshold in the trapezius muscle between baseline and follow-up, while the low-level laser auricular acupuncture group presented a reduction in stress-related capillary glucose between baseline and the final assessment. Regarding safety, low-level laser auricular acupuncture group was associated with fewer and milder adverse reactions. Symptoms of stress, anxiety, and depression improved over time in both groups, with semipermanent needles showing a greater reduction in stress levels compared to laser. Both modalities demonstrated comparable clinical performance and high participant satisfaction. Low-level laser acupuncture presented a superior safety profile with fewer and milder adverse reactions. RBR-8cxnvr2 (Brazilian Registry of Clinical Trials – ReBEC))/ UTN: U1111-1284-7974. • Both needle and laser auricular acupuncture reduced anxiety and depression symptoms. • No significant differences were found between the two auricular modalities. • Semipermanent needle was more effective than laser in reducing stress. • The low-level laser group experienced fewer and milder adverse reactions.

Lower extremity nerve decompression (LEND) for painful diabetic peripheral neuropathy (PDPN) remains controversial, and evidence regarding its long-term effectiveness in real-world clinical practice is limited. This retrospective real-world cohort study included patients with PDPN treated with LEND or medical therapy alone between 2008 and 2011. Ultra-long-term outcomes were assessed after > 10 years of follow-up. Pain intensity was evaluated using the visual analogue scale (VAS). Composite pain burden and functional impact were assessed with the Brief Pain Inventory for Diabetic Peripheral Neuropathy (BPI-DPN). Psychological symptoms were measured using the Hospital Anxiety and Depression Scale (HADS), and analgesic medication burden was quantified by the Medication Quantification Scale III (MQS-III). Exploratory prognostic factor and subgroup analyses based on pain distribution were performed. Seventy-six patients in the LEND group and 31 patients in the medical group were available for ultra-long-term analysis. Compared with medical management, LEND was associated with greater long-term pain relief (mean VAS change - 5.63 ± 2.16 vs - 1.03 ± 1.92; p < 0.001) and higher responder rates (≥ 50% pain reduction: 65.8% vs 9.7%; p < 0.001). Significant long-term improvements were also observed in BPI-DPN pain severity and pain interference (both p < 0.001), anxiety and depression symptoms (both p < 0.001), and medication burden (MQS-III p < 0.001). Within the LEND cohort, younger age at surgery and lower body mass index were independently associated with greater long-term pain improvement. Both focal and diffuse pain subgroups demonstrated significant improvements in pain and functional outcomes after surgery, with no meaningful differences at ultra-long-term follow-up. Diabetic foot ulcer events occurred less frequently after LEND (0% vs 32.3%; p < 0.001). LEND demonstrated long-term efficacy in alleviating pain and concurrently improving the pain-related interference and psychological status of patients with PDPN. A Graphical Abstract is available for this article. This study was retrospectively registrated in Chinese Clinical Trial Registry chictr.org. cn (ChiCTR2500099348), https://www.chictr.org.cn/bin/project/edit?pid=266042 .

How useful is the expanded disability status scale to neuropsychiatrists?

Effective self-management is vital for improving outcomes in middle-aged and younger adults receiving maintenance hemodialysis. However, their self-management behaviors vary widely and remain understudied. This cross-sectional study included 458 individuals to identify distinct self-management profiles and related influencing factors. Participants completed a self-management behavior scale and the Hospital Anxiety and Depression Scale. Latent profile analysis revealed three profiles: Skill Deficiency Type (n = 157), Emotional Disorders Type (n = 190), and Comprehensive Self-manager (n = 111). Education level, dialysis duration, dialysis frequency, anxiety, and depression levels differed significantly between groups (p < 0.05). Multivariate logistic regression confirmed these as key predictors of profile membership. Findings highlight the heterogeneity of self-management in this population, influenced mainly by educational background, dialysis experience, and psychological health. Tailored interventions addressing both behavior and emotional support are recommended to enhance patient outcomes.

Although the incidence of Painful-Diabetic Peripheral Neuropathy (Painful-DPN) is higher in women, the underlying reasons for this are not known. This study investigated sex differences in pain and neurological phenotypes in 2 cohorts of patients with Painful-DPN. Two cohort analyses were performed in this retrospective analysis of participants with Painful-DPN recruited to cross-sectional studies: (1) Patient-Reported Outcomes Measures Cohort analysis (n = 184), which assessed neuropathic pain intensity (Numeric Rating Score), neuropathic symptoms (Neuropathic Pain Scale), mood (Hospital Anxiety and Depression Scale), quality of life (Norfolk QoL-DN), and sleep (Medical Outcomes Sleep Study); (2) Neurological Phenotyping Cohort analysis (n = 100), which assessed large- (Neuropathy Impairment Score of the Lower Limb plus Seven Neurophysiological Tests) and small-nerve fibre function. Participants were also divided into irritable (IR) and nonirritable nociceptor phenotypes. In the first cohort analysis, women reported greater neuropathic pain symptom burden, poorer sleep, and higher anxiety prevalence than men. In the second cohort analysis, men had greater large-nerve fibre impairment, whereas women exhibited more severe small-fibre dysfunction. In addition, IR nociceptor phenotypes were more prevalent in women. Women with Painful-DPN experience a greater disease burden, increased small-fibre impairment, and are more likely to have the IR nociceptor phenotype, suggesting potential sex-specific disease mechanisms.

Examining the association between social appearance anxiety and perceived social support in adolescents with butane explosion-induced burns.

Fear of COVID-19 over the first year of the pandemic: Effect on anxiety, depression, and substance use, taking mental health support into account.

This cross-sectional study examines the effects of multidimensional social support on anxiety and depression symptoms in colorectal cancer patients, with particular focus on the mediating role of psychological resilience in this association. We recruited patients from the Shantou Central Hospital between October 2023 and December 2024 using consecutive recruitment. Participants completed validated instruments: the Perceived Social Support Scale (PSSS), Connor- Davidson Resilience Scale (CD-RISC), and Hospital Anxiety and Depression Scale (HADS). Structural equation modeling (SEM)-based path analysis with maximum likelihood estimation was performed to analyze the mediation pathways after establishing bivariate correlations through Pearson's analysis, using composite scores of the scales (rather than latent variables). We recruited 268 Chinese colorectal cancer patients (51.49% male, mean age predominantly 45-65 years, 34.33% at Stage Ⅲ and 31.72% at Stage Ⅳ) who received surgery alone or combined with chemotherapy/radiotherapy. The cohort demonstrated moderate resilience levels (58.62 ± 12.14), with mean perceived social support scores of 42.38 ± 10.72 and HADS scores of 22.40 ± 7.62. Significant correlations emerged: social support positively correlated with resilience (r = 0.62, P < 0.01) and negatively with anxiety/depression (r=-0.54, P < 0.01), while resilience showed inverse associations with anxiety/depression (r=-0.67, P < 0.01). The SEM revealed excellent model fit (CFI = 0.97, RMSEA = 0.04). Social support was associated with lower anxiety/depression both directly (β=-0.41, P < 0.001) and indirectly via an association with greater resilience enhancement (β=-0.29, P < 0.01), with resilience accounting for 29.17% of the variance in the social support-anxiety/depression relationship. Our findings suggest psychological resilience acts as a partial mediator in the pathway between perceived social support and mental health among colon cancer patients. The results highlight the importance of integrating psychosocial interventions that simultaneously strengthen external support systems and cultivate internal resilience capacities.

Irritable Bowel Syndrome (IBS) is a common functional gastrointestinal disorder marked by chronic abdominal discomfort and altered bowel habits, including constipation, diarrhea, or a combination of both. It significantly impacts quality of life and is often linked to psychological stress and dietary factors. Given the scarcity of multi-university data from Jordan, this study aimed to determine the prevalence of IBS among medical students across three Jordanian universities and to identify associated lifestyle, psychological, and demographic risk factors using validated instruments. A cross-sectional survey was conducted among medical students from the University of Jordan, Mutah University, and Jordan University of Science and Technology across all academic levels. The Rome III criteria were employed to diagnose IBS. Sleep quality was evaluated using the SATED (Satisfaction, Alertness, Timing, Efficiency, and Duration) scale, and mental health status was assessed using the Hospital Anxiety and Depression Scale (HADS). A total of 572 students completed the questionnaire. IBS was identified in 33.74% of respondents. Among those with IBS, 31.1% had the constipation-predominant subtype, 18.1% had the diarrhea-predominant subtype, and 50.8% experienced mixed symptoms. Binary logistic regression revealed that a family history of IBS significantly increased the likelihood of having the disorder (OR: 1.95; 95% CI: 1.34-2.83). Other significant risk factors included smoking (OR: 1.43; 95% CI: 1.08-2.40) and anxiety borderline anxiety (OR: 1.76; 95% CI: 1.11-2.80; p = 0.01). Established anxiety (OR: 1.53; p = 0.06) did not reach statistical significance. Sixth-year students were found to be at highest risk (OR: 5.16; 95% CI: 1.84-14.41), possibly due to greater academic pressure. Regular physical activity was associated with lower IBS odds, though this did not reach statistical significance (OR: 0.6; p = 0.07). No significant association was found with gender, BMI, sleep quality, junk food consumption, or depression. IBS is prevalent among Jordanian medical students and is associated with both genetic predisposition and lifestyle factors. These findings underscore the importance of targeted mental health and lifestyle interventions - particularly for sixth-year students - and highlight the need for longitudinal research to establish causal pathways. To our knowledge, this is the first multi-university study in Jordan to simultaneously assess psychological, sleep, and lifestyle correlates of IBS in medical students using validated instruments, providing a foundation for evidence-based student health policy in the region.

Friedreich ataxia is a debilitating multisystem neurodegenerative disorder. Depression is more prevalent in individuals with Friedreich ataxia (14%-36%) than in the general European population (8.5%). While psychological resilience is known to influence mental health in other chronic conditions, its role in Friedreich ataxia remains underexplored. We aimed to compare psychological resilience between individuals with Friedreich ataxia and healthy controls, assess associations with clinical or demographic characteristics, depression, and anxiety, and explore changes in resilience longitudinally. Participants were drawn from the Aachen site of the European Friedreich Ataxia Consortium for Translational Studies (EFACTS) registry. Resilience was measured using the Wagnild and Young RS-25 questionnaire. Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale and Beck's Depression Inventory II. Student's t-tests were used to compare groups. Pearson correlations assessed associations between resilience, depression, and anxiety scores. Univariate and multiple linear regressions were conducted to identify factors associated with resilience. Longitudinal resilience trends were evaluated graphically, and a within-person analysis was conducted using paired-T-tests in participants with available data. Missing data were imputed in 10% of cases. Overall, 61 participants (43 with Friedreich ataxia, 18 controls) were followed for up to six years. Median age was 30 years for individuals with Friedreich ataxia and 28 years for controls; 58.1% and 61.1% were female, respectively. At baseline, resilience scores were significantly lower in individuals with Friedreich ataxia (135.1 ± 25.3) than in controls (151.5 ± 12.2; p < 0.05). Resilience was strongly negatively correlated with depression (r = -0.85, p < 0.001) and moderately with anxiety (r = -0.65, p < 0.001). We observed an apparent decline in resilience in patients during the COVID-19 pandemic albeit not statistically significant in the within-person subgroup analysis (pre-COVID-19 143.1 vs 131.2 post COVID-19; p = 0.07, n = 18), possibly due to low sample size. Individuals with Friedreich ataxia display reduced resilience compared to healthy controls, which is associated with greater levels of depression and anxiety. Resilience remained stable over the disease course but appeared to decline during the COVID-19 pandemic, underlining the importance of strengthening resilience and mental well-being in this population.

This study aimed to examine the sequential mediating roles of nutritional status and depressive symptoms in the relationship between frailty and cognitive function in breast cancer patients. A cross-sectional study was conducted with 425 middle-aged and older breast cancer patients. Frailty was assessed using the FRAIL Scale. Nutritional status was measured with the MiniNutritional Assessment-Short Form. Depressive symptoms were evaluated using the depression subscale of the Hospital Anxiety and Depression Scale. Cognitive function was assessed with the Mini-Mental State Examination. Data were analyzed using the PROCESS macro for SPSS to test a sequential mediation model. Frailty was significantly associated with poorer cognitive function. A significant sequential indirect pathway was identified in which frailty was significantly associated with poorer nutritional status, and poorer nutritional status was significantly associated with more severe depressive symptoms, which were further associated with lower cognitive scores. The standardized indirect effect was β = -0.437, 95% CI [- 0.669, - 0.218], accounting for 43.4% of the total effect. A direct effect of frailty on cognition remained. The association between frailty and cognitive function in breast cancer patients was partly explained by nutritional status and depressive symptoms within the sequential mediation model, highlighting the connection between physical and mental health. For breast cancer survivors with frailty, integrated care that addresses both nutritional deficits and depressive symptoms may be key to reducing cognitive decline and maintaining quality of life.

Chair-based versus standard home exercise programs in people with COPD: A randomized controlled trial.

Purpose We examined walking ability, fatigue, health-related quality of life, anxiety, depression, cognitive, and physical function as correlates of self-reported sedentary behavior in adults with multiple sclerosis (MS). Methods 465 adults with MS completed surveys including the Marshall Sitting Questionnaire (MSQ), Multiple Sclerosis Walking Scale (MSWS-12), Fatigue Severity Scale (FSS), Hospital Anxiety and Depression Scale, Short Form Health Survey-12 physical and mental (SF-12 PCS and MCS), along with clinical characteristics and demographics surveys (e.g., MS type, patient-determined disease steps). Zoom-based assessments of the California Verbal Learning Test II [CVLT-II], the Symbol Digit Modalities Test, and the 30-second Sit-to-Stand were completed. Statistical analyses included bivariate correlations and a multivariable linear regression that identified correlates of sedentary behavior in MS. Results The bivariate analyses indicated weak, but significant associations among MSQ and FSS (r = .092), SF-12 MCS (r = −0.111), and CVLT-II (r = −0.092). The multivariate regression demonstrated that SF-12 MCS scores entered the model in Step 1 (b = −0.111, p < .05), and CVLT-II entered the model in Step 2 (b = −0.090, p > .05). Conclusion We identified FSS, SF-12 MCS, and CVLT-II as correlates of sedentary behavior in adults with MS. SF-12 MCS was the strongest predictor of sedentary time.

While yoga is known to benefit depression in breast cancer patients, its efficacy as an adjunct to diverse treatment regimens remains unclear. This study evaluated yoga's efficacy in alleviating depression during varied breast cancer therapies and supports its clinical integration as a complementary intervention. Following PRISMA 2020 guidelines, we systematically searched for RCTs in English and Chinese. Literature quality was assessed using the Cochrane Risk of Bias tool. Data were analyzed with Review Manager 5.4.1, including subgroup analyses by treatment type and assessment scale. Analysis of 21 studies showed yoga significantly reduced depression levels [SMD = -0.58, 95% CI (-0.83, -0.32), P < 0.00001]. Subgroup analyses revealed a significant combined mean difference among the surgery group [SMD: -1.04], the postoperative radiotherapy group [SMD: -2.47], and the postoperative chemotherapy group [SMD: -0.46]. The group receiving postoperative radiotherapy demonstrated a significantly greater improvement in depression. Subgroup analyses of scale-assessed effects confirmed the validity of the Beck Depression Inventory (BDI), the Center for Epidemiologic Studies Depression Scale (CESD), the Hospital Anxiety and Depression Scale (HADS), and the Zung Self-Rating Depression Scale (SDS). The HADS demonstrated a greater effect size [SMD = -1.19, 95% CI (-2.13, -0.24), P = 0.01]. The impact varied among those undergoing different treatment regimens. Notably, the degree of improvement in depression appeared to be greater in the postoperative radiotherapy group. HADS is a practical self-assessment scale that has demonstrated considerable improvement and is recommended for use in breast cancer patients with depression.

Objective:Subjective idiopathic tinnitus is characterized by the subjective perception of sound in the absence of an external source, significantly impairing quality of life. Studies have found that a considerable number of tinnitus patients experience comorbid negative emotional states such as anxiety disorders, while emotional dysregulation can, in turn, exacerbate the perceived tinnitus, indicating a close interrelationship. A systematic bibliometric summary in this field is currently lacking. This study aims to employ bibliometric methods to reveal the research dynamics, collaborative networks, and emerging trends in the tinnitus-anxiety disorder association field.Methods:A total of 773 publications related to tinnitus and anxiety/mood disorders from 2014 to 2025 were retrieved from the Web of Science Core Collection (WoSCC). After screening, 262 valid publications were included. Bibliometric and visual analyses of countries/regions, authors, institutions, journals, keywords, and references were performed using VOSviewer (v1.6.20), CiteSpace (v6.4.R2), Scimago Graphica, R-bibliometrix (R 4.5.1; Massimo Aria & Corrado Cuccurullo, University of Naples Federico II), and Microsoft Excel.Results:The United States produced the most publications (58) and maintained extensive international collaborations. The University of Nottingham was the most prolific institution (24 publications). Frontiers in Neurology was the most popular journal, publishing the most articles (13). LARYNGOSCOPE was the most cited journal (314 citations). Gerhard Andersson was the leading contributor, being the most prolific author (11 publications) and the most cited (1145 citations). Keyword co-occurrence analysis identified “Tinnitus, anxiety, depression, prevalence, severity, association, hospital anxiety” as core research hotspots. Co-cited reference analysis indicated that the tinnitus handicap inventory, the hospital anxiety and depression scale, alongside investigations into tinnitus mechanisms and treatment strategies, received the most significant attention.Conclusion:This bibliometric study provides a comprehensive overview of the research landscape concerning subjective idiopathic tinnitus and anxiety disorders. It identifies the most influential countries/regions, institutions, and authors, and delineates the current research hotspots and emerging trends. The findings offer theoretical guidance for future research into the shared mechanisms and treatment strategies for tinnitus comorbid with emotional disorders.

ObjectivesTo evaluate the feasibility, acceptability and potential efficacy of the culturally adapted Educate, Nurture, Advise Before Life Ends (ENABLE) programme in Singapore for patients with heart failure (HF) and their family caregivers.DesignNon-blinded randomised wait-list controlled pilot study, using Simon’s randomised phase II trial design.SettingSpecialist outpatient clinics in a tertiary cardiac centre in Singapore.ParticipantsPatients had a diagnosis of American Heart Association Stage C or D HF, were symptomatic with New York Heart Association functional class 2 and above symptoms, had a prognosis of 6 months, a hospitalisation in prior 6 months and were on disease-directed HF management. Patients already known to palliative care (PC) were excluded. Recruited caregivers were family caregivers of patients.InterventionENABLE integrates PC early into HF care. It starts with a comprehensive PC assessment with a PC physician and nurse. This is followed by a series of nurse coach-led health coaching sessions for both patients and caregivers. After the completion of health coaching, participants would receive follow-up phone calls to review their coping up to 6 months post-enrolment.Outcome measuresFeasibility was defined by the proportion of approached patient-caregiver dyads who consented to participate and the proportion of participants who completed health coaching. Acceptability was defined by a score of at least 12 out of a maximum of 16 for the Client Satisfaction Questionnaire 4-Item Survey. Primary efficacy outcome measure was the change in patient quality of life (QOL) at 6 months as measured by Kansas City Cardiomyopathy Questionnaire (KCCQ) total score, with the target effect size (Cohen’s d) being at least 0.25 SD in favour of ENABLE. Other secondary outcomes included patient/caregiver anxiety and depression scores on the Hospital Anxiety and Depression Scale, spirituality scores on the Functional Assessment of Chronic Illness Therapy-Spiritual Wellbeing Scale and caregiver QOL on the Singapore Caregiver Quality of Life Scale.ResultsFeasibility: recruitment was carried out from February 2022 to October 2023. We approached 164 patient-caregiver dyads and 60 patient-caregiver dyads (36.6%) consented. A total of 48 patients and 44 caregivers started on health coaching, of which 44 patients (91.7%) and 43 caregivers (97.7%) completed health coaching.Acceptability: patients’ satisfaction was high, at 85.7% and 87.5% in the intervention and wait-list arm, respectively. Caregivers were similarly satisfied, at 100% and 87.5% in the two arms, respectively.Efficacy: intervention-arm patients had a higher mean total KCCQ score at 6 months than wait-list-arm patients (difference in means=12.4; 95% CI 0.9 to 24.0; Cohen’s d=0.43). There was no difference in caregiver QOL changes between trial arms at 3 months and 6 months. Both patients and caregivers had improvements in anxiety at 3 months and sustained improvements in depression and spirituality at 6 months.ConclusionsProportion of participants who completed health coaching was high, though proportion of approached participants who consented was lower than expected. Our acceptability and efficacy targets were met. Further phase III testing is planned.Trial registration numberNCT05211882.

Longitudinal trajectories of anxiety and depression in patients with endometrial cancer or atypical endometrial hyperplasia undergoing fertility-sparing treatment.