Substance use is a rising public health concern among University students. Nowadays, most university students use substances for different purposes, but it has negative impacts on university students, ranging from social, economic, psychological, and mental problems. This impact, in turn, results in poor academic performance or dropping out of university. There were limited qualitative study designs that explored substance use among university students in Ethiopia, which were used to understand why most students use those substances. So, this study aimed to explore the reasons for substance use among Wollega University undergraduate students, Wollega, western Ethiopia, 2025. An exploratory qualitative study design was employed from March 25, 2025 to May 2, 2025. Exponential discriminatory snowball sampling and purposive sampling method were used to sample study population. Semi-structured in-depth interview and key informant interview guides in English were created to standardize data gathering by referencing a variety of previously published works. Data were audio-recorded, transcribed verbatim, and imported into qualitative data analysis software, Open Code version 4.03, for coding and analysis. Twenty participants were included, with 13 in-depth interviews and 7 key informant interviews. About six themes emerged about the reasons why the majority of Wollega University students take substances, including: due to sociocultural reasons, educational factors, to alleviate psychological distress, university-related factors, laws, and environmental considerations. The study revealed that most of Wollega university students use substances due to socio-cultural factors, educational reasons, psychological problems, laws, and university-related factors, and environmental factors. Therefore, given the potential for far-reaching consequences, immediate and effective prevention and control strategies are urgently needed to address substance use among students.

College students are vulnerable to depressive symptoms, suicidal ideation, sleep disturbance, and stress-related psychological problems. Aerobic exercise and repetitive transcranial magnetic stimulation (rTMS) have each shown therapeutic potential in affective disorders, but evidence on their combined application in college students at suicide risk remains limited, particularly when neurophysiological outcomes are considered. To evaluate the feasibility, safety, and preliminary effects of aerobic exercise combined with rTMS on suicidal ideation, depressive symptoms, sleep, and prefrontal functional activation in college students at suicide risk. This prospective single-centre non-randomised controlled pilot study will enrol students aged 18-21years who are identified as being at suicide risk by the Xinhai University Crisis Intervention System. At-risk participants will enter one of three groups: active rTMS plus aerobic exercise, sham rTMS plus aerobic exercise, or standardised group psychological intervention/usual support. A separately recruited healthy reference cohort will complete the same assessment schedule without active treatment. Active rTMS will be delivered over the left dorsolateral prefrontal cortex at 10Hz and 120% of the individual motor threshold once daily for 2weeks. Aerobic exercise will be prescribed at a target heart-rate zone of 135-164 beats/min for 30-60min per session every 2days for 2weeks, with heart rate and adherence objectively monitored. The primary outcomes are changes in the Self-rating Idea of Suicide Scale (SIOSS) total score and Self-rating Depression Scale (SDS) standard score from baseline to week 4. Secondary outcomes include SIOSS and SDS dimensions, total sleep time, task-related and resting-state functional near-infrared spectroscopy (fNIRS) measures, adherence, concomitant care, and adverse events. The study was approved by the Ethical Review Committee of Yancheng First People's Hospital (Approval No. 2023-K-230) and the Ethics Committee of INTI International University (Approval No. INTI-IU/FHLS-RC/BTCMI/AUGUST2022/003). Findings will be disseminated through peer-reviewed publications and academic conferences. Chinese Clinical Trial Registry, ChiCTR2400079723.

Khat use is an increasing public health concern in Somaliland, linked to various mental, physical, social, and psychological problems. This study examined the effect of khat consumption on work performance among small business employees in the City-Center Market, Hargeisa, Somaliland. A quantitative cross-sectional design was employed, with purposive sampling of 150 male respondents. Data were collected through a structured Likert-scale questionnaire measuring khat consumption patterns and work performance. Reliability was confirmed using Cronbach's alpha, and multiple linear regression analysis was applied to assess the predictive effect of khat consumption on work performance. Demographic and occupational variables (education level, marital status, employment type, type of khat commonly chewed, and age categories) were included as controls. Regression analysis showed khat consumption was significantly associated with work performance (B = 0.774, β=0.879, t=15.062, p<0.001). Higher levels of khat use were associated with lower work performance, while other variables including education level (p=0.281), marital status (p=0.548), employment type (p=0.902), type of khat (p=0.700), and age (p=0.429) showed no statistically significant effects. The study suggests that khat consumption may negatively influence employee productivity, while demographic and occupational factors appear to have limited influence. These findings highlight the importance of workplace awareness and policy measures aimed at reducing the potential adverse impact of khat use on work performance.

To explore workplace violence (WPV) amongst Latvian undergraduate nursing students during clinical placements. Workplace violence has profound consequences. Nursing students on placement are often victims of non-verbal and verbal abuse, physical or sexual violence, causing psychological problems, hindering their professional identity and causing them to leave the nursing profession. Numerous studies indicate the problem's extent, yet reporting in the Baltic region has been absent in the literature. Cross-sectional survey. This study, conducted October to December 2023, was based on similar studies in Australia and the UK, using a validated 4-point Likert scale with 24 questions assessing WPV. Questions were uploaded to a commercial internet survey provider, distributed across three universities providing nursing programs in Latvia. Ethical approval was obtained from the University of Latvia's Ethics Committee. Participation was voluntary, involving 119 students (21% from three universities). STROBE checklist: cross-sectional studies. The majority of nursing students (52.9%) on placement experienced bullying (n = 63). Perpetrators included registered nurses and patients. Exposure included negative non-verbal behaviour (69.8%, n = 83), being ignored (55.5%, n = 66), neglected (52.1%, n = 62), and unfairly criticized (51.3%, n = 61). Only 13.4% (n = 16) reported these episodes. There was a significant association between bullying and students considering leaving the nursing profession. Latvian nursing students experience various forms of WPV, including emotional bullying (e.g., negative non-verbal behaviour, being ignored, neglected, unfairly criticized, verbally abused), physical abuse (e.g., being pushed), sexual harassment (e.g., inappropriate touching, sexist remarks). The lack of reporting may result in unresolved issues for both students and nursing profession. Clinical nurses working directly in healthcare settings and academic facilitators/lecturers involved in teaching and training should collaborate on implementing targeted training programs addressing WPV. This ensures that both practical and theoretical WPV-handling aspects are covered comprehensively. None.

To examine the Tanner stage-specific patterns of psychological and behavioural problems in girls with central precocious puberty (CPP) and to identify clinical predictors of clinically significant psychological impairment. This retrospective cross-sectional study included 116 girls with CPP treated between January 2020 and December 2024. Clinical data were extracted from electronic medical records. Pubertal development was classified by breast Tanner staging into stage II (n = 32), stage III (n = 42) and stages IV-V (n = 42). Psychological outcomes were evaluated using the age-standardised Child Behavior Checklist (CBCL) T-scores. For participants aged ≥7 years, depressive and anxiety symptoms were assessed using the Children's Depression Inventory and the Screen for Child Anxiety Related Emotional Disorders. The independent predictors of clinically significant psychological problems were identified through logistic regression analysis, defined as CBCL Total Problems T-score of ≥64, and model performance was assessed using receiver operating characteristic curve analysis. The mean CBCL Total Problems T-score was 58.6 ± 12.4, and 50 girls (43.1%) had clinically significant psychological problems. Psychological burden increased across Tanner stages. The CBCL Total T-scores were 52.4 ± 10.8 in stage II, 58.6 ± 11.6 in stage III and 65.8 ± 13.2 in stages IV-V (p < 0.001). The prevalence of clinically significant problems increased from 21.9% to 40.5% and 61.9% (p = 0.002). Internalising symptoms showed a stronger stage-related pattern than externalising symptoms. Early age at onset was associated with increased symptom severity (r = -0.385, p < 0.001). Multivariable analysis identified Tanner stages IV-V versus stage II (odds ratio [OR] = 2.94, 95% confidence interval [CI]: 1.44-5.99, p = 0.003), younger age at onset (OR = 0.72, 95% CI: 0.55-0.94, p = 0.016), higher peak luteinising hormone (LH) (OR = 1.45, 95% CI: 1.08-1.95, p = 0.014) and family history of early puberty (OR = 2.18, 95% CI: 1.26-3.77, p = 0.005) as independent predictors. The prediction model showed good discrimination (area under the curve = 0.812, 95% CI: 0.738-0.886). Girls with CPP experience substantial psychological burden, and risk increases with pubertal stage. Advanced Tanner stage, earlier pubertal onset, increase in peak LH and family history are indicators for enhanced psychological monitoring and support.

BackgroundEarthquakes present significant threats to community mental health, yet post-disaster resource limitations and high demand restrict access to care. The 2023 Türkiye–Syria earthquakes affected millions, increasing psychological problems and highlighting the urgent need for scalable interventions.AimsThis study assessed (a) the feasibility of procedures prior to a fully powered randomised controlled trial (RCT) and (b) the potential effectiveness of Problem Management Plus (PM+), a scalable psychological intervention, in reducing common mental health problems among Turkish earthquake survivors.MethodA two-arm, single-blind pilot RCT was conducted with survivors residing in temporary housing in Türkiye. Participants were randomly allocated (1:1) to PM+ (n = 38) or enhanced care-as-usual (E-CAU; n = 38) and assessed at baseline, 1 week post intervention and at the 1-month follow-up. The primary outcome was depression (Patient Health Questionnaire, PHQ-9); secondary outcomes were self-identified problems (Psychological Outcome Profiles, PSYCHLOPS), functional impairment (World Health Organization Disability Assessment Schedule, WHODAS 2.0), psychological distress (Kessler-10 Psychological Distress Scale, K-10), anxiety (Generalised Anxiety Disorder Scale, GAD-7) and post-traumatic stress (Post-traumatic Stress Disorder Checklist, PCL-5). The trial was prospectively registered (NCT06026306).ResultsRecruitment, retention (74%) and treatment adherence (79%) supported feasibility. At post-assessment, PM+ showed greater reductions than E-CAU across all outcomes: PHQ-9 (adjusted mean difference −5.91, 95% CI –8.23 to –3.58), PSYCHLOPS (−6.94, –8.88 to –5.01), WHODAS 2.0 (−8.77, –12.50 to –5.03), K-10 (−9.66, –13.35 to –5.97), GAD-7 (−4.31, –6.39 to –2.24) and PCL-5 (−18.72, –25.97 to –11.47). At follow-up, improvements remained significant for psychological distress and self-identified problems.ConclusionsFindings provide preliminary evidence that PM+ is a feasible and potentially effective intervention for alleviating common mental health problems among Turkish earthquake survivors.

ABSTRACTBackgroundCannabinoid hyperemesis syndrome (CHS) is characterized by episodes of severe nausea, vomiting, and abdominal pain among those with heavy cannabis use. We estimated differences between those reporting CHS symptoms and those who use cannabis daily and less frequently on drug use, psychiatric problems, other health problems, antisocial behavior, and personality.MethodsThe National Firearms, Alcohol, Cannabis, and Suicide survey was administered to 7034 US adults (3427 male, 3607 female) in 2025. Survey items assessed substance use, common psychiatric symptoms, personality traits, and symptoms of CHS.ResultsThose with CHS symptoms reported the highest rates and greatest variety of drug use compared to others who used cannabis. Those with CHS symptoms reported higher rates of other drug use than those who used cannabis daily without CHS symptoms across a variety of drug classes, including opioids, hallucinogens, and sedatives, higher rates of drug overdoses, and greater use of all drug classes than those with less-than-daily cannabis use. Those with CHS symptoms also reported more depression, anxiety, sleep problems, chronic pain, antisocial behavior, intimate partner violence, and disinhibited personality traits than those who used daily (meand= 0.58) and less frequently (meand= 0.69) and those with no cannabis use in the past 12 months (meand= 0.99).ConclusionsThose with CHS symptoms exhibit a variety of psychological and behavioral problems including higher rates of other drug use, psychiatric symptoms, antisocial behavior, and dysfunctional personality traits. Results highlight the importance of understanding and addressing the broader psychosocial challenges faced by people experiencing CHS symptoms.

The article substantiates the possibility and necessity of the conjunction of theology, science, and practice as distinctive features of the anthropological approach to solving psychological and pedagogical problems. The relevance is due to the increasing number of arbitrary interpretations of the conceptual core of the approach, the distortion of its methodological foundations and its value-meaning vertical. The specificity of the anthropological approach is concretized in the form of a tripartite model integrating the theological aspect (Orthodox anthropology), the scientific aspect (co-existential psychology and co-image pedagogy), and the practical aspect (professional psychological and pedagogical activity aimed at solving the anthropological super-task — the inculturation of man). The source, language, and contribution of each sphere to the tripartite model are revealed. Three pairwise conjunctions are identified (theology — science, theology — practice, science — practice) and the central area of their intersection — the space of anthropopractice in its entirety. The model serves as a tool for distinguishing authentic anthropological work from its imitations.

The use of social media has been associated with various effects on mental health and addiction to these platforms, especially among university students. The aim of the study was to analize the impact of Instagram, Facebook, WhatsApp, and TikTok on social media addiction and mental health, considering the mediating role of the latter. The study was conducted with a sample of 684 university students. Through Model 4 of the PROCESS macro for SPSS, direct and indirect relationships were evaluated between platform use (independent variables), mental health problems (mediating variable), and social media addiction (dependent variable). Regression analyses and bootstrapping with 10,000 samples were applied to estimate confidence intervals of indirect effects. The findings revealed Instagram and TikTok showed significant direct effects on social media addiction as well as indirect influences through mental health problems. These visually intensive platforms are associated with increases in psychological problems, which in turn contribute to higher levels of addiction. In contrast, Facebook and WhatsApp did not show significant direct or indirect effects on mental health or social media addiction. The findings highlight that platforms such as Instagram and TikTok pose significant risks to mental health and social media addiction among university students, underscoring the need for targeted interventions to mitigate these effects. On the other hand, Facebook and WhatsApp appear to have limited impact. This study fills gaps in the literature by differentiating psychological effects by platform and emphasizes the importance of considering social media design in digital well-being strategies.

An integrated systemic approach to chronic primary pain from epigenome to brain: a narrative review.

The COVID-19 pandemic led to an increased prevalence of psychological disorder in population-based studies, but the effect on the ability to work has been less well studied, except in health workers. This study aimed to assess whether there has been an increase in the number of people seeking assistance for psychological problems from the Sheffield Occupational Health Advisory service in the UK since the COVID-19 pandemic. The study used routinely collected data at Sheffield Occupational Health Advisory Service (SOHAS) to compare the proportion of all new referrals presenting with psychological problems for 3 years prior to (2017-2019) and following the pandemic (2022-2024). Statistical differences were assessed using the chi-square test. Psychological problems were the most common health problem presenting among those seeking advice at SOHAS both before (57.9%) and after the pandemic (61.5%); this was a small, but significant, difference (P < 0.01). In the post-COVID period, phone consultations largely replaced face-to-face appointments, and the patients were slightly younger, less likely to be referred by a GP and less likely to be off work through illness. The advice given post-COVID was more likely to include employment law and disability discrimination. The observed increase in people seeking advice with psychological problems was minor and bore no resemblance to the reported increase in mental health problems in the UK population since the COVID-19 pandemic. There was no evidence that GPs are detecting and referring more patients with psychological problems affecting work performance.

Previous studies have largely emphasized the adverse effects of overnutrition on mental health. However, undernourished adolescents are also likely to experience social prejudice and exclusion, which may negatively correlate to psychological well-being. However, evidence showing associations between undernutrition and mental health remains limited. In this study, we examine the relationship between nutritional status and psychological sub-health (PSH) among Chinese adolescents and investigate a mediating role for perceived discrimination. In this cross-sectional study, a total of 2,699 adolescents from three provinces in China participated in this questionnaire-based study. Analysis of variance, logistic regression, and restricted cubic spline (RCS) analyses were conducted to examine nutritional status and perceived discrimination associations with PSH. Structural equation modeling was used to examine pathways linking body mass index (BMI), perceived discrimination, and PSH across different nutritional status subgroups, while some covariates (such as gender, sleep duration, and alcohol consumption) were adjusted. Overall, 461 adolescents (17.08%) exhibited PSH. Both undernutrition (Odds ratio (OR) = 1.57, 95% Confidence interval (CI) = 1.08-2.27, P = 0.017) and overnutrition (OR = 1.67, 95% CI = 1.32-2.12, P < 0.001) were associated with an increased risk of PSH, indicating a U-shaped nonlinear dose-response relationship (χ² = 15.37, P for nonlinearity < 0.001). Perceived discrimination significantly mediated the association between BMI and PSH in undernourished (β = -0.069, P = 0.012) and overnourished (β = 0.037, P = 0.010) adolescents. Additionally, overnutrition was directly associated with a higher PSH risk among male adolescents (β = 0.118, P = 0.007). A significant nonlinear association between BMI and PSH was observed in Chinese adolescents, with perceived discrimination playing an important mediating factor in both undernourished and overnourished groups. These findings provide clues to the causes of psychological sub-health problems among adolescents with different nutritional statuses and also point out the direction for future research on developing targeted mental health promotion strategies tailored to adolescents with different nutritional statuses.

Elevated emotional distress is common in patients with type 1 diabetes mellitus (T1DM), and alleviating psychological problems is important as they may interfere with adherence to T1DM treatment regiments and poor glycaemic regulation. One way to understand and treat emotional distress is to formulate them as linked to self-regulatory strategies and their underlying metacognitive beliefs as proposed by the Self-regulatory Executive Functioning (S-REF) model. We aimed to evaluate the role of dysfunctional metacognitions in diabetes-related emotional distress beyond general emotional distress and to test the statistical fit of a metacognitive model in a sample consisting of 218 adults with T1DM. Dysfunctional metacognitive beliefs were significantly and positively associated with emotional distress symptoms. Beliefs about the need to control thoughts and cognitive self-consciousness showed a unique association with diabetes-related emotional distress even when controlling for general emotional distress symptoms. A metacognitive model specified by dysfunctional metacognitive beliefs, metacognitive strategies (brooding), and general and diabetes-related emotional distress fitted the data well. The metacognitive model of psychological disorders is relevant to formulate and possibly treat different types of emotional distress symptoms in patients with T1DM with the implication that a feasibility trial of metacognitive therapy is warranted.

Precocious puberty: An overview of pathogenesis, clinical presentation, and management.

This qualitative study was conducted to determine feelings of nurses caring for children affected by earthquake, and their efforts to manage the disaster using a phenomenological approach. Data were collected through one-on-one in-depth interviews and audio recordings. The data obtained from audio recordings were evaluated using qualitative content analysis method. As a result of the analysis, two main and seven sub-themes were created as Emotional Responses (Anxiety, Fear, and Helplessness), Inadequacy in Disaster Management (Inability to reach children and families, Inability to meet the needs of children and families, Inability to create safe areas, Inadequacy of knowledge and skills). These research findings have demonstrated the importance and necessity of providing psychosocial support to nurses caring for children affected by disasters, given the psychological problems they experience. At the same time, it is necessary to develop preventive strategies regarding negative situations related to the management of children in disaster.

Loneliness is an unpleasant subjective experience associated with significant psychological and physical health problems. With increasing urbanization and aging populations, loneliness is becoming a global public health concern. Thus, understanding the neural correlates of loneliness is crucial for developing targeted intervention approaches. In the current study, we collected resting-state fMRI data from 238 young adults (ages 17-26; 59 males, 179 females) and used fractional amplitude of low-frequency fluctuations (fALFF) and functional connectivity (FC) analyses to investigate the neural correlates of loneliness. Results revealed that loneliness was negatively correlated with fALFF in the right posterior precuneus. Functional connectivity analyses showed that loneliness was positively correlated with connectivity between the right posterior precuneus and right superior frontal gyrus, and negatively correlated with connectivity between the right ventromedial prefrontal cortex and a network including the right cerebellum, left fusiform gyrus, and right superior occipital gyrus. These findings reveal neural correlates of loneliness, including distinct patterns of intrinsic activity in the posterior precuneus and specific functional connectivity patterns involving regions associated with social cognition and emotional regulation. The results provide neural evidence for understanding individual differences in loneliness and could potentially inform future research on neurostimulation and cognitive-behavioral interventions targeting these specific brain networks.

Given that cancer survivors often face psychological problems, this study explores the effect of acceptance and commitment therapy (ACT) to improve death anxiety (DA), experiential avoidance (EA), meaning in life (MIL), and quality of life (QoL). The study was conducted from June to November 2023, encompassing recruitment, an 8-week intervention (July-August 2023), and follow-up to 3months post-intervention at a tertiary cancer hospital in China. A total of 50 cancer survivors were randomized (25 per group). The weekly intervention was delivered through in-person, one-on-one sessions over 8weeks. Each session (approximately 35-45min) was structured to cover distinct thematic modules of ACT. The primary outcome was DA and other secondary outcomes included EA, MIL, as well as QoL. Data were collected at T0 (pre-intervention), T1 (post-intervention), T2 (1month post-intervention), and T3 (3months post-intervention). The intervention effects were estimated using generalized estimating equation models. Participants had various cancer types, primarily head and neck (28%), lung (28%), and breast (24%). Cancer stages included I-II (54%), III (44%), and IV (2%). Participants in the ACT group revealed significantly greater reductions on DA than those in the wait-list control group at T1 (95% CI: -3.449 to -2.631), T2 (95% CI: -4.899 to -3.821), and T3 (95% CI: -5.311 to -3.969), as well as on EA and the symptom domain of quality of life at three time points. In addition, the intervention demonstrated significantly greater improvements on MIL, the functional domain and global health status of quality of life at T1, T2, and T3. In this study with a wait-list control group rather than an active comparator, the in-person ACT-based intervention reduced death anxiety, experiential avoidance, and symptom-related quality of life impairments while enhancing meaning in life, functional quality of life, and global health status in cancer survivors. These benefits were sustained for up to 3months post-intervention, though generalizability may be limited by the sample's cancer types and stages. Chinese Clinical Trial Registry (ChiCTR2300074472). https://www.chictr.org.cn/.

Background &amp; Objective: Anxiety is a common psychological problem among the elderly that can reduce quality of life if left unmanaged. Dhikr therapy is a non-pharmacological spiritual intervention that may help alleviate anxiety. Methode: This study aimed to determine the effect of dhikr therapy on anxiety levels among elderly individuals at UPT PSTW Husnul Khotimah, Riau Province. A quantitative pre-experimental one-group pretest–posttest design was used with 61 elderly respondents selected through purposive sampling. Anxiety levels were measured using the Indonesian version of the Zung Self-Rating Anxiety Scale (ZSAS). Dhikr therapy was administered for three consecutive days, and data were analyzed using the Wilcoxon Signed Rank Test. Result: The results showed a significant reduction in anxiety levels after the intervention (p &lt; 0.05). Conclusion: In conclusion, dhikr therapy is effective in reducing anxiety among the elderly and can be applied as a non-pharmacological nursing intervention in elderly care settings.

Brain structural and functional alterations in adolescents with borderline personality disorder: A systematic review and a research agenda.

Background:Premature ejaculation (PE) is the most common male sexual dysfunction, which often causes significant psychological problems. Although botulinum toxin A (Botox) has shown promise for delaying ejaculation through chemodenervation, the optimal anatomical target remains uncertain. This study evaluated the efficacy and safety of Botox injection into the penile prepuce and subcoronal region as a novel approach for lifelong PE.Methods:A prospective case series was conducted in 7 adult men (mean age 54.7 ± 6.5 years) diagnosed with lifelong PE (intravaginal ejaculatory latency time <1 minute, PEDT ⩾11). Participants received a single 100-unit Botox injection, administered subcutaneously into the prepuce and subcoronal region. The Premature Ejaculation Diagnostic Tool (PEDT) and Male Sexual Health Questionnaire (MSHQ) were completed before, 4 weeks, and 6 months after treatment to assess the efficacy.Results:Seven patients were included in the analysis. No significant changes were observed in PEDT scores at 4 weeks (18.00 ± 0.9; P = .7358) or at 6 months (17.71 ± 0.4; P = .762) compared with baseline. Similarly, MSHQ erection scores (5.00 ± 2.0 at 4 weeks; 4.85 ± 2.2 at 6 months), ejaculation scores (23.43 ± 3.8 at 4 weeks; 23.42 ± 3.1 at 6 months), and satisfaction scores (10.71 ± 4.07 at 4 weeks; 10.14 ± 3.5 at 6 months) did not differ significantly from baseline values (P > .05 for all comparisons). No adverse events or treatment-related side effects were reported throughout the study period.Conclusions:Subcoronal Botox injection was safe and well-tolerated, but it did not show significant improvements in ejaculatory control or sexual function scores. The findings suggest that sensory-targeted Botox administration alone is insufficient to enhance the ejaculatory reflex.