Psychiatry Int., Volume 6, Issue 4 (December 2025) – 12 articles

Background: Poisoning is a frequent cause of emergency department (ED) visits. The COVID-19 pandemic may have influenced its epidemiology and clinical profile. Objective: To analyze and compare the characteristics of poisonings treated in the ED before and after the COVID-19 pandemic. Methods: A retrospective observational study was conducted including all patients who attended for acute poisoning in a Spanish tertiary hospital from January 2018 to December 2022. Sociodemographic variables, toxic agents, clinical features, psychiatric history, intentionality, and outcomes were analyzed. Results: A total of 170 cases were recorded. Medicinal agents were the most frequent toxicants, followed by ethanol. After the onset of the pandemic, there was an increase in poisonings due to medicinal agents and in cases with psychiatric comorbidity, particularly intentional overdoses. Hospital admissions and ICU referrals also increased, although mortality remained low. Conclusions: The COVID-19 pandemic was associated with relevant changes in the epidemiology and clinical profile of poisonings treated in the ED, highlighting the growing importance of intentionality and psychiatric disorders. Full article

We tested the longitudinal invariance of seven short versions of the Center for Epidemiological Studies Depression Scale (CES-D) in maternal caregivers, following recent analytic recommendations for ordered categorical responses. Data for this study were drawn from the Longitudinal Studies in Child Abuse and Neglect (LONGSCAN) consortium, based on responses from 427 maternal caregivers across five waves corresponding to their children’s ages: 4, 6, 12, 14, and 16 years. We employed a comprehensive approach using differences in two approximate fit indices (CFI and RMSEA), the chi-square difference test (χ²), and a sensitivity analysis based on predicted response differences. Only one version demonstrated full invariance across all levels, while the others showed only partial evidence for loading or threshold invariance. These findings highlight concerns regarding the use of brief CES-D versions in longitudinal research, particularly over extended time periods. They also underscore the need to reassess whether item content aligns with current definitions of depressive syndrome. Our results suggest that evaluating the longitudinal invariance of short depression measures is essential to ensure the validity of conclusions about changes over time. Full article

The global prevalence of type 2 diabetes is alarmingly high, and a considerable proportion of diabetes patients suffer from anxiety and depression. The presence of anxiety and depression worsens the prognosis of diabetes; it increases non-compliance to the treatment and mortality rate. A cross-sectional study of adults ages 20 years or older was conducted in 24 districts of Khyber Pakhtunkhwa (KP). Individuals diagnosed by a certified medical doctor with type 2 diabetes were recruited using multistage stratified cluster sampling. The Agha Khan University Anxiety and Depression Scale (AKUADS) was used for assessment. Chi-square and logistic regression were used to assess the association between depressive disorder and characteristics of the study participants. The results showed that 31.64% of type 2 diabetic patients suffered from anxiety and depression. Prevalence was higher in individuals aged ≤40 years (37.75%), females (40.58%) compared to males (26.48%), individuals without formal education (38.48%), and underweight participants (55%). Anxiety and depression were also prevalent among housewives (38.04%), rural residents (34.76%), and current smokers (43.14%). Multivariate logistic regression indicated significantly higher odds of anxiety and depression among individuals with primary education (OR = 4.73, p-value = 0.03), underweight individuals (OR = 4.46, p-value = 0.001), and those reporting pain (OR = 2.82, p-value < 0.001). The high prevalence of anxiety and depression in the known diabetic population in the KP province of Pakistan requires the development of strategies for screening, awareness related to the contributing factors, and treatment of co-morbid depression at community level. Full article

Mental health issues and insufficient physical activity (PA) among students pose significant public health concerns. This study aimed to examine the prevalence of depression, anxiety, and stress symptoms, alongside PA levels, among Croatian medical students, with a focus on sex-specific differences and associations between these variables. A cross-sectional study was carried out during May and June 2025 among medical students at the University of Osijek, Croatia. Participants completed a self-reported questionnaire consisting of three sections: sociodemographic characteristics, the Depression, Anxiety, and Stress Scale-21 (DASS-21), and the International Physical Activity Questionnaire-Short Form (IPAQ-SF). The study included 244 students (70 males, 174 females) with a median age of 21 years (IQR: 20–23). Symptoms of depression, anxiety, and stress were reported by 33.1%, 48.4%, and 42.6% of participants, respectively. According to IPAQ-SF, 39.7% of students reported PA levels below current recommendations. Female students reported significantly higher depression (p = 0.009), anxiety (p < 0.001), and stress scores (p < 0.001), lower levels of moderate (p = 0.009) and vigorous PA (p < 0.001), and more time spent sitting (p = 0.006) compared to their male counterparts. Furthermore, significant positive correlations were identified between sitting time and depression (ρ = 0.17, p = 0.01), anxiety (ρ = 0.18, p = 0.006), and stress (ρ = 0.26, p < 0.001). Conversely, higher PA—particularly vigorous activity—was associated with lower levels of depression (ρ = −0.21, p = 0.001) and anxiety (ρ = −0.15, p = 0.018). Croatian medical students demonstrated a substantial prevalence of depression, anxiety, and stress symptoms, combined with inadequate levels of PA. These findings highlight the importance of implementing strategies aimed at supporting mental health and fostering regular PA among future healthcare professionals. Full article

This study investigated the impact of maternal psychological factors—specifically anxiety and depression—on breastfeeding outcomes in women with high-risk and low-risk pregnancies. A total of 157 postpartum women were assessed using the State-Trait Anxiety Inventory (STAI) and the Edinburgh Postnatal Depression Scale (EPDS) at multiple time points: 3–4 days, 3 months, and 6 months postpartum. Breastfeeding duration and exclusivity were the primary outcomes. Correlation analyses showed significant negative associations between STAI scores and breastfeeding duration in both groups, with stronger effects in the low-risk group (e.g., r = −0.546, p < 0.001 at 3 months). Similarly, EPDS scores were inversely correlated with breastfeeding duration, particularly at 3 and 6 months postpartum (r = −0.272, p < 0.001 and r = −0.248, p = 0.001, respectively, in the high-risk group). Logistic regression identified EPDS scores at 3 months (p = 0.046, Exp(B) = 0.844) and STAI scores at 3–4 days postpartum (p = 0.006, Exp(B) = 0.861) as significant predictors of early breastfeeding cessation. The model explained 64.9% of the variance in the low-risk group. These findings highlight the significant influence of postpartum anxiety and depressive symptoms on breastfeeding outcomes and suggest that early screening and support for these specific psychological factors may enhance breastfeeding duration and exclusivity, particularly after high-risk pregnancies. Full article

Background: Physical activity is essential for good health and human well-being, yet one-third of adults worldwide fail to achieve the recommended weekly physical activity. Buddhist Walking Meditation (BWM), Walking Meditation (WM), or Mindful Walking (MW) is a mindfulness practice characterized by mind–body interaction, seeking to promote people’s well-being. Therefore, this systematic review aimed to examine the effect of Buddhist Walking Meditation, Walking Meditation, or Mindful Walking on health in adults and older adults. Methods: This systematic review (PROSPERO: CRD42024581286) followed PRISMA guidelines. A literature search was conducted in PubMed, SciELO, Web of Science, and Scopus to identify studies that used BWM, WM, or MW as interventions in adults and older adults. The methodological quality was assessed using the PEDro scale, and the risk of bias was evaluated using the Cochrane RoB 2 tool. Results: Ten studies met the inclusion criteria, with intervention durations ranging from 4 to 24 weeks. Most were rated as “good” quality. Positive effects were reported in ankle proprioception, balance, functional fitness, psychological outcomes (e.g., reductions in stress, anxiety, or depression), and selected cardiometabolic markers (HbA1c, blood pressure, and arterial stiffness) in specific subgroups. However, several studies showed a moderate-to-high risk of bias. Conclusions: BWM, WM, and MW are safe and potentially effective PA strategies to enhance physical and mental health in adults and older adults. Their simplicity, low impact, and high adherence rates make them suitable for sedentary or clinically vulnerable populations. Full article

Background: Insomnia is strongly associated with stimulant use across various populations and for a wide range of substances. It represents a significant clinical problem among individuals with stimulant use disorders, yet treatment guidelines for this specific population are limited. This gap underscores the need for a systematic review to analyze the pharmacological and non-pharmacological treatments for insomnia in individuals with stimulant use disorders. The aim of this review is to determine the efficacy, safety, and limitations of these approaches and their impact on psychiatric symptoms, stimulant use, and adverse events. Methodology: A systematic review was conducted through January–July 2025 using PubMed, Scopus, and Web of Science. The review focused on the management of chronic insomnia associated with stimulant use, including substances such as amphetamines, methylphenidate, nicotine, caffeine, and cocaine. The systematic review was structured in accordance with the PRISMA guidelines, and identified studies were assessed by title/abstract and full-text evaluation. Results: A total of twenty studies were included in the systematic review. Seven studies examined pharmacological interventions, including modafinil, naltrexone/buprenorphine-naloxone, varenicline, combination NRT, and ramelteon. Thirteen studies investigated non-pharmacological approaches, including Cognitive Behavioral Therapy (CBT), Repetitive Transcranial Magnetic Stimulation (rTMS), Electrical Vestibular Nerve Stimulation (VeNS), maximal strength training, electroacupuncture (EA), and probiotics. The majority of interventions demonstrated positive outcomes in reducing insomnia severity, with some participants achieving non-clinical levels. Commonly reported clinical symptoms related to insomnia included difficulty initiating or maintaining sleep, early morning awakening, and sleep dissatisfaction. Conclusions: Both pharmacological and non-pharmacological interventions showed promise. However, the lack of validated guidelines underscores the need for integrated therapeutic approaches that address the complex comorbidity of insomnia, stimulant use, and co-occurring psychiatric conditions. Full article

The main characteristics of attention deficit hyperactivity disorder (ADHD) are associated with inattention, impulsivity, and/or hyperactivity. Those diagnosed with this neurodevelopmental disorder present with executive function and motor difficulties, which have repercussions in educational, occupational, or social areas. On the other hand, it has been evidenced that the regular practice of physical activity or exercise or sport could produce improvements in areas with difficulties. It is for this reason that the objective of the present review was to describe and analyze the effects of the practice of physical activity, exercise, or sport on executive functions in adults diagnosed with ADHD through the scientific literature (registry: INPLASY202530105). The articles indexed in PubMed (1145), Scopus (43), and WoS (2910) were searched using the following keywords: “Adult” OR “Adults” AND “Attention-Deficit/Hyperactivity Disorder” OR “Attention-Deficit with Hyperactivity Disorder” AND “Physical activity” OR “Exercise” OR “Sports” OR “Sport” AND “Executive Function”. In addition, four articles were identified using other search engines. A total of 10 articles met the selection criteria. TESTEX was used to assess the quality of the articles, and TIDierR was used to report the results. Of the ten included studies, nine mention an improvement in inhibitory control, six in selective attention, three in cognitive flexibility, and one in working memory (all p < 0.05). It was concluded that the practice of physical activity, exercise, or sport has a positive and significant effect on the executive functions of adults with ADHD, specifically on selective attention, inhibitory control, and cognitive flexibility. Furthermore, benefits were observed in depression, brain activation, and stability. Among the limitations is the lack of a meta-analysis, which makes it difficult to quantify and recommend which intervention is most effective for this population. Furthermore, the various types and degrees of ADHD were not considered. Full article

Climate change poses a growing threat to the mental health of children and adolescents. This narrative review synthesizes global, interdisciplinary research on the psychological impacts of climate disruption during critical developmental stages, with attention to marginalized populations. We explore three key pathways of harm: direct exposure to environmental disasters, chronic disruption of ecological and social systems, and existential distress such as eco-anxiety. Drawing on eco-social theory and developmental psychopathology, the review highlights how these impacts are shaped by age, geography, identity, and systemic inequities. It identifies both risk and protective factors, emphasizing the importance of caregiving relationships, cultural practices, education, and youth climate engagement. While activism can foster resilience and purpose, it may also incur emotional burdens that require clinical and policy attention. We argue that child and adolescent mental health must be recognized as central to climate justice and adaptation, and we offer urgent recommendations for integrated action across sectors. Full article

Smartphone addiction has emerged as a significant public health concern, particularly among adolescents and young adults. This narrative review, conducted in line with the ANDJ checklist, synthesizes evidence from 25 systematic reviews and meta-analyses, complemented by randomized controlled trials and clinical studies, to provide a structured overview of the field. The study selection flow and publication trends reveal a rapidly expanding research landscape, with most evidence produced in the last decade, reflecting both the ubiquity of smartphones and increasing awareness of their health impacts. The synthesis highlights converging findings across reviews: excessive smartphone use is consistently associated with psychosocial, behavioral, and academic challenges, alongside sleep disturbances and mental health symptoms. Common messages include the recognition of smartphone addiction as a multidimensional phenomenon, while emerging themes point to heterogeneity in definitions, tools, and methodological approaches. Comparative analysis of reviews underscores both shared risk factors—such as emotional dysregulation and social isolation—and differences in study designs and target populations. Importantly, this review identifies critical gaps, including the lack of standardized definitions, limited longitudinal evidence, and scarce cross-cultural validation. At the same time, promising opportunities are noted, from lifestyle-based interventions (e.g., physical activity) to educational and policy-level strategies fostering digital literacy and self-regulation. The post-pandemic context further emphasizes the need for sustained monitoring and adaptive responses. Overall, this review calls for youth-centered, multi-sector interventions aligned with WHO recommendations, supporting coordinated, evidence-based action across health, education, and policy domains. Full article

Instagram is a hugely popular social media site; however, it has also been cited in many times as being a source of low self-esteem, unhappiness, and body dissatisfaction. Despite this, there is potential to use Instagram as a self-care delivery system and create positive changes in users’ mental health by showing them a specific type of image. In this paper, we use Stress Reduction Theory to demonstrate that viewing images of nature on Instagram can improve well-being (H1), by increasing feelings of connectedness with nature (H2). Furthermore, we posit this same influence will elicit more altruistic behaviour from users (H3). In a laboratory experiment, participants accessed images using either the #naturephotography hashtag, or a control hashtag (#bookshelves). Analyses showed that, in line with the proposed positive effects of SRT, viewing natural images improved well-being and positive emotions, and this was at least partially mediated by increased connectedness to nature. Future studies that use a more longitudinal approach, and examine how images can be presented within a more robust psychiatric intervention are then discussed. Full article

Background and Objective: Postpartum depression (PPD) is a prevalent psychiatric condition with significant consequences for maternal, paternal, and infant well-being. In Saudi Arabia, some reported prevalence rates exceed global averages. This narrative review synthesizes the current literature on the prevalence, risk factors, awareness, and quality-of-life impact of PPD in Saudi Arabia. The aim is to identify methodological inconsistencies, highlight the risk factors, and guide future research and policy. Method: A comprehensive literature search was conducted using PubMed, Scopus, Web of Science, and Google Scholar. Studies published between 2010 and May 2025 were included if they addressed PPD in Saudi Arabia and the inclusion criteria were met. 38 articles were selected for full-text analysis and incorporation in the study. Results: PPD prevalence in Saudi Arabia ranges from 5.1% to 75.7%, with regional variation attributed to inconsistent methodologies, screening instruments, and diagnostic cutoffs. Risk factors encompass psychiatric history, marital conflict, limited social support, low income, cesarean delivery, unplanned pregnancy, anemia, and sleep disturbance. Nutritional and newborn-related predictors were inconsistently reported. Awareness among the public and healthcare professionals remains limited, and paternal postpartum depression is underrecognized. PPD exerts a pronounced negative impact on maternal quality of life, spanning physical, psychological, and social domains. Conclusions: PPD poses a substantial public health burden in Saudi Arabia. Routine screening with validated tools, integrated perinatal mental health services, and targeted public education campaigns may help address diagnostic delays and stigma. Future studies must adopt standardized diagnostic criteria and longitudinal designs to generate nationally representative prevalence estimates and evaluate preventive strategies. Full article