Search Results (547)

Background: In the social context characterized by digitization and population aging, empty-nest older individuals have emerged as a particularly vulnerable group. This study examines the impact of digital finance on the mental health of empty-nest older individuals using data from the China Health and Retirement Longitudinal Study (CHARLS) spanning 2011 to 2018 and investigates its underlying mechanisms through the three dimensions of active aging. Results: The findings suggest that digital finance is associated with reduced likelihood and degree of depression among empty-nest older individuals. The beneficial effect of digital finance on depression is more pronounced among empty-nest older individuals with lower educational attainment, without supplementary pensions, and residing in rural areas. Furthermore, mechanism analysis shows that digital finance relates to better health outcomes, greater security, and increased social participation among empty-nest older individuals. Conclusions: These findings underscore the potential of digital finance to facilitate active aging among empty-nest older individuals. Full article

The pandemic spared most children and adolescents in Ghana from severe clinical disease, but it exposed long-standing gaps in services and protection methods. Methods: We conducted a desk-based narrative review of peer-reviewed studies, national and international reports, and grey literature from January 2020 to May 2025. The evidence was organised across eight domains of child and adolescent well-being. Across mental health, gambling and other risky behaviours, access to health services, economic hardship and child labour, nutrition, education, early childhood development, and WASH, the pandemic disrupted essential services and social safety nets. Examples include declines in routine care and immunisation, wider digital exclusion during remote learning, a rise in child labour linked to income loss, and persistent hygiene constraints. Preparedness in Ghana should focus on mental health, digital inclusion, early childhood services, and strong social protection. Ghana’s specific empirical data are uneven, so we triangulate peer-reviewed evidence with official reports, appraised the grey literature, and calibrated claims to the strength of sources. Full article

Background: Telepsychiatry expanded rapidly during the COVID-19 pandemic, yet patient experience data from mixed urban and rural areas in Saudi Arabia remain scarce. Objective: We aimed to quantify the perception of telepsychiatry among adults with major depressive disorder [MDD] in Madinah City, the KSA, and to identify associated demographic and clinical factors. Methods: A cross-sectional survey was conducted at Madinah Mental Health Hospital between December 2024 and March 2025. Eligible participants were Arabic-speaking adults [≥18 years] with a clinician-confirmed diagnosis of major depressive disorder [MDD] according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [DSM-5], following a scheduled video- or audio-based telepsychiatry consultation. Perception of telepsychiatry was assessed using the validated 10-item Arabic version of the Telehealth Satisfaction Scale [TeSS], which evaluates audiovisual quality, communication, and support. Variables associated with perception at p < 0.20 in the bivariable analyses were entered into a multiple linear regression model to identify independent predictors. Results: Of the 218 eligible patients, 207 participated [response rate = 95%], with similarly high participation rates being reported in comparable telepsychiatry surveys [e.g., 90–91%]. The majority were male [59%], with a mean [SD] age of 38.4 [11.2] years. The mean satisfaction score was 32.3 ± 6.3, and 36% of participants were classified as highly satisfied. In the multivariable analysis, higher satisfaction was independently associated with male gender [B = 3.0, 95% CI: 1.3–4.7], intermediate versus elementary education [B = 4.3, 95% CI: 1.1–7.6], and the presence of a chronic illness [B = 2.1, 95% CI: 0.3–3.8]. Conclusions: Telepsychiatry is generally well-accepted among adults with depression in Madinah. However, women and individuals with lower educational attainment report lower satisfaction. Targeted interventions such as improving privacy, offering digital literacy support, and tailoring communication may help improve the telepsychiatry experience for underserved groups. Full article

The rising prevalence of CKD, particularly within aging populations, demands effective and accessible self-management strategies. Three middle-aged and older adult inpatients (one female, two males; mean age 58.6 years ± 23) with CKD and preserved cognitive capacity (Mini-Mental State Examination) participated. A multiple case study was conducted in a Portuguese nephrology unit between November 2024 and February 2025, utilizing baseline assessments that included the Braden, Barthel, and Morse scales, as well as the KDQOL-SF. A targeted educational program addressed key CKD management aspects: disease understanding, vascular access care, medication regimens, and dietary restrictions. Pre- and post-intervention assessments measured knowledge gains. Results indicated improvements in participants’ knowledge and self-management capabilities across several domains. These included enhanced understanding of the disease process, vascular access for hemodialysis, dietary requirements, and fluid restrictions. Participants also demonstrated improved self-assessment of support systems, coping mechanisms, and family involvement. A 15% average increase in knowledge scores post-intervention was observed. This study provides preliminary evidence supporting the efficacy of a structured educational nursing program in improving CKD self-management. The significant improvements in knowledge and self-reported confidence suggest that targeted education is a valuable component of comprehensive CKD care. Future research should incorporate larger, more diverse samples and explore the long-term impact of the intervention. Furthermore, the integration of technological tools, such as personalized learning platforms and digital health, holds a significant promise for enhancing the accessibility and effectiveness of such educational programs. Full article

As the world’s population of older adults continues to grow rapidly, combating loneliness and social isolation has become an emerging health concern for this group. Though there has been increasing interest within the scientific community in exploring digital games as an intervention for loneliness, research on gaming as an intervention is a relatively new field of study. This scoping review examines the current state of research on the impact of digital gaming on loneliness in the older adult population and was conducted in accordance with the 2018 Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A total of 317 potentially relevant studies were identified through database searches, and of these, 278 studies were excluded due to failure to meet inclusion criteria. The full texts of 39 articles were assessed for eligibility, resulting in 9 articles being included in this scoping review. Some important findings from our study include the central role of social interaction in addressing loneliness and the potential for interventions targeting both physical and mental well-being to have a more significant impact on alleviating loneliness. We also found that while many studies reported positive effects of gaming interventions, some findings were contradictory, suggesting that the relationship between gaming and loneliness is complex and moderated by multiple factors. Recommendations for future research include expanding investigations to outside of East Asia (where the majority of existing studies were conducted) to the United States, Africa, India, or Europe. Full article

Recent years have witnessed a concerning rise in early-onset eating disorders (EDs), prompting a re-evaluation of their etiology, diagnosis, and treatment within pediatric populations. This perspective article synthesizes emerging evidence on the multifactorial origins of EDs in children, emphasizing a biopsychosocial framework that integrates genetic, epigenetic, psychological, and environmental factors. While early manifestations often diverge from adolescent or adult profiles—marked by somatic complaints, selective eating, and ritualistic behaviors—the disorders significantly interfere with developmental milestones. The COVID-19 pandemic has further exacerbated vulnerabilities, acting as a catalyst for disordered eating behaviors through increased familial stress, isolation, and disrupted routines. Central to this framework is the role of parental psychopathology and parent–child feeding interactions, which profoundly shape children’s emotional regulation and attachment patterns. Recent studies also underscore genetic susceptibilities—especially variants in the DRD4 and DAT1 genes—and epigenetic modifications that may mediate the transmission of risk across generations. The article reviews evidence from observational and genomic studies, highlighting how altered gene expression linked to early environmental stress contributes to the heterogeneity of EDs. Finally, it evaluates prevention and intervention strategies, including family-based treatments, digital health tools, and school-based programs. These strategies are essential for timely detection, individualized care, and reducing long-term impairment. Overall, the paper advocates for a nuanced understanding of EDs in children—recognizing their complex origins and developmental implications—to inform clinical practice, public health policy, and future research in pediatric mental health. Full article

Background: Burnout is a prevalent issue among mental health nurses. While various interventions have been implemented to address burnout, their effectiveness and sustainability remain unclear in specialised mental health settings. This systematic review aims to clearly evaluate the effectiveness of interventions specifically designed to reduce burnout among mental health nurses, focusing on intervention types, their impact, and the sustainability of results. Methods: A comprehensive search of databases (Embase, CINAHL, Medline, PubMed, Scopus, and Web of Science) identified studies on burnout reduction interventions for mental health nurses. Inclusion criteria focused on mental health nursing populations with pre- and post-intervention burnout measures. Methodological quality was assessed using JBI Critical Appraisal Tools. A narrative synthesis guideline was used to analyse data. Results: Among 2502 studies retrieved, only 4 met the inclusion criteria after a rigorous screening process. These studies explored specific intervention types, including a two-day burnout prevention workshop, an eight-week group-based psychoeducational programme, a twelve-week mindfulness-based psychoeducational intervention, and an eight-week guided self-help mindfulness programme delivered via a digital platform. Significant reductions in burnout were observed across these studies; however, the sustainability of these effects varied. Interventions of greater duration, such as the 12-week mindfulness-based programme and the 8-week group psychoeducational intervention, yielded more enduring improvements. In contrast, shorter interventions, like a two-day workshop, showed transient benefits that diminished over time. Conclusions: This review highlights a critical gap in research on burnout interventions for mental health nurses. While the reviewed interventions showed promise in reducing burnout, the findings underscore the need for sustainable, adaptable interventions and more robust research. Full article

Background: Undergraduate nursing students (UNSs) often enter clinical training just as they are still mastering the emotional labor of the profession. In Nepal, where teaching hierarchies discourage upward dialogue and hospitals routinely struggle with overcrowding, supply shortages, and outward nurse migration, these learners confront a distinct, under-documented burden of psychological distress. Objective: This study examines how UNSs interpret, negotiate, and cope with the mental health challenges that arise at the intersection of cultural deference, resource scarcity, and migration-fueled uncertainty. Methods: A qualitative design employing reflexive thematic analysis (RTA), guided by the Reflexive Thematic Analysis Reporting Guidelines (RTARG), was used. Fifteen second-, third-, and fourth-year Bachelor of Science in Nursing students at a major urban tertiary institution in Nepal were purposively recruited via on-campus digital flyers and brief in-class announcements that directed students (by QR code) to a secure sign-up form. Participants then completed semi-structured interviews; audio files were transcribed verbatim and iteratively analyzed through an inductive, reflexive coding process to ensure methodological rigor. Results: Four themes portray a continuum from silenced struggle to systemic constraint. First, Shrouded Voices, Quiet Connections captures how students confide only in trusted peers, fearing that formal disclosure could be perceived as weakness or incompetence. Second, Performing Resilience: Masking Authentic Struggles describes the institutional narratives of “strong nurses” that drive students to suppress anxiety, adopting scripted positivity to satisfy assessment expectations. Third, Power, Hierarchy, and the Weight of Tradition reveals that strict authority gradients inhibit questions in classrooms and clinical placements, leaving stress unvoiced and unaddressed. Finally, Overshadowed by Systemic Realities shows how chronic understaffing, equipment shortages, and patient poverty compel students to prioritize patients’ hardships, normalizing self-neglect. Conclusions: Psychological distress among Nepalese UNSs is not an individual failing but a product of structural silence and resource poverty. Educators and policymakers must move beyond resilience-only rhetoric toward concrete reforms that dismantle punitive hierarchies, create confidential support avenues, and embed collaborative pedagogy. Institutional accountability—through regulated workloads, faculty-endorsed wellbeing forums, and systematic mentoring—can shift mental health care from a private struggle to a shared professional responsibility. Multi-site studies across low- and middle-income countries are now essential for testing such system-level interventions and building a globally resilient, compassionate nursing workforce. Full article

Substance use during pregnancy is an increasingly important yet under-recognized threat to maternal and child health. This narrative review synthesizes the current evidence available on the epidemiology, pathophysiology, clinical management, and policy landscape of prenatal exposure to alcohol, tobacco, opioids, benzodiazepines, cocaine, cannabis, methamphetamines, and other synthetic drugs. All major psychoactive substances readily cross the placenta and can remain detectable in breast milk, leading to a shared cascade of obstetric complications (hypertensive disorders, placental abruption, pre-term labor), fetal consequences (growth restriction, structural malformations), and neonatal morbidities such as neonatal abstinence syndrome and sudden infant death. Mechanistically, trans-placental diffusion, oxidative stress, inflammatory signaling, and placental vascular dysfunction converge to disrupt critical neuro- and cardiovascular developmental windows. Early identification hinges on the combined use of validated screening questionnaires (4 P’s Plus, CRAFFT, T-ACE, AUDIT-C, TWEAK) and matrix-specific biomarkers (PEth, EtG, FAEE, CDT), while effective treatment requires integrated obstetric, addiction, and mental health services. Medication for opioid use disorders, particularly buprenorphine, alone or with naloxone, confers superior neonatal outcomes compared to methadone and underscores the value of harm-reducing non-punitive care models. Public-health strategies, such as Mexico’s “first 1 000 days” framework, wrap-around clinics, and home-visiting programs, demonstrate the potential of multisectoral interventions, but are hampered by structural inequities and punitive legislation that deter care-seeking. Research gaps persist in polysubstance exposure, culturally tailored therapies, and long-term neurodevelopmental trajectories. Multigenerational, omics-enabled cohorts, and digital longitudinal-care platforms represent promising avenues for closing these gaps and informing truly preventive perinatal health policies. Full article

Anxiety and depression affect millions worldwide, yet stigma and long wait times often delay access to care. Mobile mental health apps can decrease these barriers by offering on-demand screening and support. Nevertheless, many machine and deep learning methods used in such tools perform poorly under severe class imbalance, yielding biased, poorly calibrated predictions. To address this challenge, this study proposes MCoG-LDPSNet, a brain-inspired model that combines dual, orthogonal encoding pathways with a novel Loss-Driven Parametric Swish (LDPS) activation. LDPS implements a neurobiologically motivated adaptive-gain mechanism via a learnable β parameter driven by calibration and confidence-aware loss signals that amplifies minority-class patterns while preserving overall reliability, enabling robust predictions under severe data imbalance. On a benchmark mental health corpus, MCoG-LDPSNet achieved AUROC = 0.9920 and G-mean = 0.9451, outperforming traditional baselines like GLMs, XGBoost, state-of-the-art deep models (CNN-BiLSTM-ATTN), and transformer-based approaches. After transfer learning to social media text, the MCoG-LDPSNet maintained a near-perfect AUROC of 0.9937. Integrated into the EmotiZen App with enhanced app features, MCoG-LDPSNet was associated with substantial symptom reductions (anxiety 28.2%; depression 42.1%). These findings indicate that MCoG-LDPSNet is an accurate, imbalance-aware solution suitable for scalable mobile screening of individuals for anxiety and depression. Full article

Mental health conditions affect many young people in sub-Saharan Africa (SSA), where stigma is high and access to care is limited. Digital tools accessible on basic mobile phones offer a scalable way to promote mental health, but evidence on their effectiveness in SSA is limited. This study evaluated the reach, feasibility, acceptability, and knowledge outcomes of Digital MindSKILLZ, an interactive voice response (IVR) mental health intervention implemented in the Democratic Republic of Congo, Ghana, Nigeria, Rwanda, Uganda, and Zambia. Over seven months, 700,138 people called the platform, and 425,395 (61%) listened to at least one message. Of these users, 63.6% were under 25 and 68.3% were from rural areas. The three content branches—mental health information, mental health skills, and soccer quizzes—were accessed by 36.5%, 46.4%, and 50.9% of users, respectively. Among users who accessed the mental health branch of the intervention, the mean number of messages completed was 7.6 out of 18 messages. In a follow-up survey, 91% of users understood the content, 85% would recommend the intervention, and 38% found the mental health content most helpful. Average knowledge scores were 62%, with lower scores on common disorders and stigma. The intervention showed strong reach and acceptability, but content and implementation improvements are needed to boost engagement and retention. Full article

Psychological distress remains a significant public health concern, particularly among youth. With the growing integration of mobile and wearable technologies into daily life, digital phenotyping has emerged as a promising approach for early self-detection and intervention in psychological distress. Objectives: The study aims to determine how behavioral and device-derived data can be used to identify early signs of emotional distress and to develop and evaluate a prototype system that enables users to self-detect these early warning signs, ultimately supporting early intervention and improved mental health outcomes. Method: To achieve this, this study involved a multi-phase, mixed-method approach, combining literature review, system design, and user evaluation. It started with a scoping review to guide system design, followed by the design and development of a prototype system (ESFY) and a mixed-method evaluation to assess its feasibility and utility in detecting early signs of psychological distress through digital phenotyping. Results: The results demonstrate the potential of digital phenotyping to support early self-detection for psychological distress while highlighting practical considerations for future deployment. Conclusions: The findings highlight the value of integrating active and passive data streams, prioritizing transparency and user empowerment, and designing adaptable systems that respond to the diverse needs and concerns of end users. The recommendations outlined in this study serve as a foundation for the continued development of scalable, trustworthy, and effective digital mental health solutions. Full article

Background: Eco-anxiety and solastalgia are psychological responses to environmental degradation and climate change. This study examines how these concepts are represented in Spanish-language digital media, considering both emotional dimensions and the profiles of content producers. Methods: We conducted an inductive qualitative content analysis of 120 Spanish-language items (online news articles and selected posts from digital platforms) published between October 2023 and March 2024. Items were identified using a Boolean search strategy and initially filtered by LIWC to detect high emotional-and-anxiety term density; final coding followed grounded-theory procedures, resulting in four thematic categories. Results: The most frequent theme was environmental activism (41%), followed by catastrophic thinking (29%), coping strategies (25%), and loss of meaningful places (6%). Among content producers, citizen participants represented 40%, youth activists 25%, and scientists 15%. Digital media function both as sources of anxiety-inducing content and as spaces for awareness-raising and support. Conclusions: While eco-anxiety is not a clinical diagnosis, it exerts a significant psychological impact—particularly on youth and vulnerable groups. Spanish-language digital platforms play an ambivalent role, amplifying distress yet enabling resilience and collective action. Future interventions should leverage these channels to foster environmental awareness, emotional resilience, and civic engagement. Full article

Background: China is confronted with the dual challenges of deeply interwoven population aging and the digitalization process. The digital integration and mental health issues of the elderly group are becoming increasingly prominent. Objectives: The present study aimed to analyze the pathways through which individual, family, and social factors influence Internet use in the elderly through a multi-level analysis framework, to examine the association between Internet use and mental health with a view to providing empirical evidence for digital technology-based mental health intervention programs for the elderly, and to promote the scientific practice of the goal of healthy aging. Methods: Based on the data of the 2021 China General Social Survey (CGSS) and provincial Internet development indicators, a mixed cross-sectional dataset was constructed. Logistic hierarchical regression and OLS regression methods were adopted to systematically investigate the multi-level factors associated with Internet use among the elderly group and its association with mental health. Results: The results indicate that individual resources (younger age, higher education level, and good health status) and family technical support (family members’ Internet access) are strongly associated with Internet usage among the elderly, while regional Internet penetration rate appears to operate indirectly through micro-mechanisms. Analysis of the association with mental health showed that Internet use was related to a lower score of depressive tendency (p < 0.05), and this association remained robust after controlling for variables at the individual, family, and social levels. Conclusions: The research results provide empirical evidence for the health promotion policies for the elderly, advocating the construction of a collaborative intervention framework of “individual ability improvement–intergenerational family support–social adaptation for the elderly” to bridge the digital divide and promote the digital integration of the elderly population in China. Full article

Background and Objectives: With the widespread integration of digital media into daily life, social media addiction (SMA) has become a growing concern for university students’ mental health. Based on attachment theory, this study examined how attachment anxiety and avoidance influence SMA through fear of negative evaluation (FNE) and loneliness. Methods: A sample of 400 Chinese university students completed the 16-item short version of the Experiences in Close Relationships Scale (ECR), the 8-item Brief Fear of Negative Evaluation Scale (BFNE), the 6-item Revised UCLA Loneliness Scale–Short Form (RULS-6), and the 6-item Bergen Social Media Addiction Scale (BSMAS). Using the PROCESS macro (Model 6), a chained mediation model was tested. Results: Attachment anxiety positively predicts SMA (β = 0.42); the chained mediation pathway through FNE and loneliness accounts for ab = 0.06 of this effect, alongside additional single-mediator paths. In contrast, attachment avoidance shows a weaker total effect (β = −0.08) and a small negative chained mediation effect (ab = −0.02), offset by opposing single-mediator paths via FNE (negative) and loneliness (positive), resulting in a nonsignificant total indirect effect. Discussion: These findings suggest that in the Chinese cultural context, where social evaluation and belonging are emphasized, insecure attachment may heighten emotional reliance on social media. This study elucidates the socio-emotional mechanisms underlying SMA and extends the application of attachment theory to the digital media environment. Full article