Search Results (257)

Introduction: Mental health problems in children and adolescents are a growing public health concern. Aerobic physical activity has been identified as a promising, accessible, and low-cost intervention to promote psychological well-being. Methods: This systematic review and meta-analysis was conducted following PRISMA 2020 guidelines and a pre-registered PROSPERO protocol. We searched PubMed, Scopus, Web of Science, and CINAHL for randomized controlled trials published until December 2024, with no language restrictions. Eligibility criteria included interventions based on aerobic physical activity among children and adolescents (5–18 years) reporting outcomes on mental health (e.g., depression, anxiety, self-esteem, mood, resilience). Methodological quality was assessed with the PEDro scale. Results: From 828 initial records, 21 studies met the inclusion criteria and 19 were included in the meta-analysis. The trials, conducted in diverse countries and settings, applied structured aerobic interventions (e.g., running, dancing, cycling, active games) with durations of 6–30 weeks. The pooled results showed significant improvements in depression, anxiety, self-esteem, and stress, with the largest effects observed in stress reduction and self-esteem enhancement. Conclusions: Aerobic physical activity appears to be an effective and feasible strategy to improve mental health in children and adolescents. Its integration into school and community programs is recommended as a preventive and complementary approach to traditional treatments. Full article

Estrogen-dependent conditions, such as endometriosis, adenomyosis, lipedema, polycystic ovary syndrome, and breast cancer, are intimately involved with hormonal changes related to estrogen and their receptors. These conditions can be expressed mainly during hormonal changes such as pregnancy, puberty, and menopause. They are associated with alterations in estrogen function and inflammatory mechanisms, leading to significant discomfort and a marked decrease in self-esteem in women. Resveratrol has been studied in the treatment of inflammatory diseases like obesity, metabolic syndrome, and endometriosis. The research suggests potential pathways through which resveratrol may also be beneficial in treating metabolic and estrogen-dependent conditions. We reviewed 63 articles from 2000 to 2025, prioritizing systematic reviews, meta-analyses, and randomized controlled trials in the PubMed, ScienceDirect, and SciELO databases. Our results suggest that resveratrol may benefit metabolic and estrogen-dependent conditions by modulating anti-inflammatory factors that regulate estrogen receptor activity, increasing lipolysis, decreasing insulin resistance, and mitigating oxidative stress. Future research should evaluate the long-term safety and potential therapeutic effects of resveratrol in metabolic conditions. Full article

Background: Chronic stress in childhood and adolescence leads to excessive cortisol secretion, adipokines production and obesity with all the negative mental and physical effects on the health of individuals and adulthood. Objectives: The aim of the present non-randomized controlled trial was to investigate the effect of a stress management protocol with diaphragmatic breathing (DB) and physiotherapy exercise on stress, body composition, cardiorespiratory and metabolic markers of children and adolescents with morbid obesity. Methods: The study included 31 children and adolescents (5–18 years old) with morbid obesity (22 in the intervention arm and 9 controls). All participants completed anxiety questionnaires and a self-perception scale. Forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), blood pressure (BP) and SpO₂ were measured. Fasting glucose, uric acid, triglycerides, HbA1c, (AST/SGOT), (ALT/SGPT), HDL, LDL, insulin, ACTH, cortisol, HOMA-IR, 17-OH, S-DHEA, SHBG were assessed, and anthropometric measurements were also performed. Results: In the intervention group, 4 months after the treatment, an improvement was noted in the BMI, BMI z-score, waist-to-height ratio, FEV1, SpO₂, pulse and systolic BP. HDL increased, ALT/SGPT and insulin resistance improved. Positive changes were observed in temporary and permanent stress and self-esteem of children in the intervention group, including anxiety, self-perception, physical appearance, etc. Conclusions: A combined exercise and DB protocol has a positive effect on stress, by improving body composition, reducing insulin resistance, and ameliorating physical and mental health and quality of life of pediatric patients with morbid obesity. Full article

Background/Objectives: Obstructive sleep apnea (OSA) is a highly prevalent disorder that significantly impacts quality of life and daily functioning. While continuous positive airway pressure (CPAP) therapy is effective, long-term adherence remains a challenge. This single-arm observational study aimed to evaluate clinical outcomes and adherence patterns during telemedicine-supported CPAP therapy and identify distinct phenotypic response clusters in Romanian patients with OSA. Methods: This prospective observational study included 86 adults diagnosed with OSA, treated with ResMed Auto CPAP devices at “Victor Babeș” University Hospital in Timișoara, Romania. All patients were remotely monitored via the AirView™ platform and received monthly telephone interventions to promote adherence when necessary. Clinical outcomes were assessed through objective telemonitoring data. K-means clustering and t-distributed stochastic neighbor embedding (t-SNE) were employed to explore phenotypic response patterns. Results: During telemedicine-supported CPAP therapy, significant clinical improvements were observed. The apnea–hypopnea index (AHI) decreased from 42.0 ± 21.1 to 1.9 ± 1.3 events/hour. CPAP adherence improved from 75.5% to 90.5% over six months. Average daily usage increased from 348.4 ± 85.8 to 384.2 ± 65.2 min. However, post hoc analysis revealed significant concerns about the validity of self-reported psychological improvements. Self-esteem changes showed negligible correlation with objective clinical measures (r < 0.2, all p > 0.1), with only 3.3% of variance being explained by measurable therapeutic factors (R² = 0.033). Clustering analysis identified four distinct adherence and outcome profiles, yet paradoxically, patients with lower adherence showed greater self-esteem improvements, contradicting therapeutic causation. Conclusions: Telemedicine-supported CPAP therapy with structured monthly interventions was associated with substantial clinical improvements, including excellent AHI reduction (22-fold) and high adherence rates (+15% after 6 months). Data-driven phenotyping successfully identified distinct patient response profiles, supporting personalized management approaches. However, the single-arm design prevents definitive attribution of improvements to telemonitoring versus natural adaptation or placebo effects. Self-reported psychological outcomes showed concerning patterns suggesting predominant placebo responses rather than therapeutic benefits. While the overall findings demonstrate the potential value of structured telemonitoring for objective CPAP outcomes, controlled trials are essential to establishing true therapeutic efficacy and distinguishing intervention effects from measurement bias. Full article

A psoriasis vulgaris flare is characterized by a rapid intensification of symptoms, which is often triggered by various factors that can worsen the condition. The risk factors for these exacerbations are numerous and include obesity, antihypertensive drugs, and psychological stress. Moreover, links have been documented between type II diabetes, hypertension, and psoriasis vulgaris. The present case report describes a 52-year-old female patient who presented at the clinic with disseminated erythematous-squamous plaques and patches covered by thick, white-pearly, easily detachable scales, along with stress, fatigue, anxiety, severe pruritus, irritability, insomnia, and decreased self-esteem. Her past medical regimen included various conventional topical options, including calcipotriol combined with betamethasone, clobetasol, betamethasone combined with salicylic acid, and betamethasone combined with gentamicin, yet the condition remained refractory, with periodic flare-ups. The integrated and personalized therapeutic approach aimed to target both the dermatological issues and the associated systemic and psychological factors contributing to the condition. The therapeutic strategy implemented in this case combined psychological counseling sessions, a very low-calorie ketogenic diet, oral supplementation with anti-inflammatory and antioxidant vitamins and minerals, topical treatments utilizing urea and Dead Sea-mineral-based formulations, and rosemary extract-based scalp care, without requiring additional conventional treatment. This comprehensive approach led to significant improvement, ultimately achieving complete remission of the patient’s psoriasis. The associated comorbidities were well controlled with the specified medication, without any further complications. Thus, the importance of alternative options was emphasized, particularly in the context of an incurable disease, along with the need for continued research to improve the ongoing therapeutic management of psoriasis vulgaris. Such approaches are essential to reducing the risk of flare-ups and to achieving better management of associated risk factors. Full article

Background/Objectives: Cochlear implants (CIs) and hearing aids (HAs) have enhanced auditory rehabilitation in elderly individuals, yet limitations in musical perception and psychosocial integration persist. This systematic review aimed to evaluate the effects of music therapy (MT) on the quality of life (QoL), self-esteem, auditory perception, and cognition in older CI and HA users. Methods: A comprehensive search of PubMed was conducted up to March 2022 following PRISMA guidelines. Studies involving participants aged ≥ 60 years with CIs and/or HAs were included. Ten studies (n = 21,632) met eligibility criteria. Data were extracted and assessed using the Newcastle–Ottawa Scale. Results: MT led to improved sound quality, with HISQUI19 scores rising from 60.0 ± 21.8 to 74.2 ± 27.5. Early MT exposure was associated with significantly better MUMU outcomes (p = 0.02). Bilateral CI users showed enhanced stereo detection (52% to 86%), and CI + HA users achieved CNC scores exceeding 95%. Postlingual CI users outperformed prelingual peers in musical discrimination (9.81 vs. 3.48; p < 0.001). Long-term HA use was linked to better a QoL and reduced loneliness. Conclusions: While music therapy appears to support auditory and psychosocial functioning in hearing-impaired older adults, the absence of randomized controlled trials limits causal inference regarding its effects. These results support its integration into hearing rehabilitation strategies for older adults. Full article

Background and Objectives: Polycystic ovary syndrome (PCOS) is associated with an elevated risk of impaired mental health and psychiatric disorders, such as depression and anxiety. Physical factors like weight and hirsutism, as well as psychological factors, such as self-esteem and coping strategies, are all known to have an influence on mental health status. Aim: To assess psychological symptoms in women with and without PCOS, by use of the well-established, validated self-report questionnaire: Symptom Checklist-90-Revised (SCL-90); to determine the reliability of the SCL-90 for assessment of PCOS patients. Design: Prospective case-control study. Methods: Psychological symptoms were assessed using the German version of the SCL-90 in 31 PCOS women and 31 healthy controls. To test the impact of various parameters on numerical outcome parameters, correlation analyses were conducted. Results: PCOS women revealed significantly increased SCL-90 scores in seven out of the nine subscales (hostility subscale, anxiety subscale, depression subscale, paranoid ideation subscale, psychoticism subscale, somatization subscale, interpersonal sensitivity subscale, obsessive compulsive subscale), as well as in all three global indices (p < 0.05). SCL-90 scores were significantly positively correlated with perceived total stress and perceived helplessness and significantly negatively correlated with perceived self-efficacy (p < 0.05). Conclusions: PCOS women experienced higher levels of psychological symptoms including depressive and anxiety symptoms. Higher perceived stress, higher perceived helplessness and lower self-efficacy were associated with more psychological symptoms. Hence, there is a need to support PCOS women with their emotional regulation and coping strategies. Full article

Background/Objectives: Anorexia nervosa (AN) is a severe disorder with limited treatment efficacy. This interim analysis aimed to assess the preliminary efficacy and safety of transcranial direct current stimulation (tDCS) in reducing core AN symptoms, stress, depression, low self-esteem, and BMI in adolescent females, to determine the rationale for continuing the study. Methods: A single-center, randomized, double-blind, placebo-controlled trial included 20 adolescent females with AN assigned to an active tDCS group (n = 10) or a sham group (n = 10). The intervention involved 30 sessions over three weeks, targeting the dorsolateral prefrontal cortex. Outcomes were assessed at baseline, post-treatment, and follow-up using the Eating Attitudes Test (EAT-26) for eating disorder symptoms, the Perceived Stress Scale (PSS-10) for stress, the Beck Depression Inventory (BDI) for depression, the Rosenberg Self-Esteem Scale (SES) for self-esteem, and body mass index (BMI) measurements. Safety and tolerability were assessed using the tDCS Side Effects Questionnaire. Results: Eating disorder symptoms significantly decreased in the active tDCS group at study end (p = 0.003) and follow-up (p = 0.02), while no significant changes were observed in the sham group. Although BMI increased more in the active group (13.78%) than in the sham group (7.31%), this difference was not statistically significant (p = 0.10). Conclusions: Adverse effects were mild and transient, with no serious safety concerns reported. Based on the results of this interim analysis, the study will proceed due to promising efficacy outcomes and good treatment tolerability. Full article

Studies commonly measure the effects of media narratives on the self immediately following exposure. We explored whether these effects on viewers’ self-esteem, self-efficacy and motivation are confined to the immediate post-exposure period and examined how they are related to the audience’s identification with the protagonist. In Study 1, participants watched movie clips that included inspiring narratives depicting protagonists who succeeded in accomplishing their goals. Implicit self-esteem was significantly higher immediately after watching than after a short break. Unexpectedly, identification was positively correlated only with delayed self-esteem. In Study 2 we changed the control condition and added explicit measures. The reduction in implicit self-esteem between the two measurement times was replicated in the no-treatment control group. Moreover, self-efficacy and motivation were higher than in the control group and were stable over time, and identification was positively related only to delayed implicit self-esteem and motivation. We conclude that the effect of inspiring narratives on the self extends beyond the immediate time of exposure, and identification with the characters contributes to this persistent effect. The findings are explained by theories of contrast and assimilation, identification and inspiring narratives. Full article

Background: The widespread use of smartphones and the internet has transformed communication, but excessive use has raised concerns about smartphone and internet addiction, which can lead to psychological, physical, and social issues. The objective of this literature review is to explore the relationship between smartphone and internet addiction and physical activity, particularly focusing on whether physical exercise, especially sports, can serve as a protective factor against addiction. The review aims to examine how physical activity can reduce the negative impacts of addiction and improve overall mental health. Methods: This review synthesizes empirical research on smartphone and internet addiction and its connection to physical activity. It examines studies exploring how addiction leads to physical inactivity and how participation in physical activities, especially sports, can counteract this effect. The review also evaluates research on psychological mechanisms, such as self-esteem, self-control, and emotional resilience, that mediate the relationship between physical activity and addiction. Additionally, it discusses how sociodemographic and contextual factors influence this relationship. Conclusions: The findings consistently show an inverse relationship between smartphone and internet use and physical activity, with physical activity acting as a protective factor against addiction. Sports and other physical activities have been linked to reduced addictive behaviors, enhanced psychological well-being, and improved emotional resilience. Promoting physical activity, particularly sports, along with psychological interventions, appears to be an effective strategy for preventing and treating smartphone and internet addiction. Future research should focus on developing tailored interventions and studying diverse populations to optimize addiction prevention. Full article

Background/Objectives: Work engagement is essential for quality care and workforce retention in professional nursing. While job demands–resources theory has guided extensive research on job-related antecedents, personal resources have received comparatively less empirical attention, primarily focusing on self-efficacy, self-esteem, and optimism. This study examined the unique association between ikigai—the Japanese concept of life purpose—as a novel personal resource and work engagement in professional nursing practice, controlling for established job resources, demands, and personal resources. Methods: An analytical cross-sectional study was conducted with vocational nursing trainees in Germany (N = 166). Data were collected via online questionnaire using validated instruments to assess ikigai, job resources (autonomy, interpersonal relations, professional resources), job demands (work overload, lack of formal rewards), other personal resources (self-efficacy, organization-based self-esteem, optimism), and work engagement. Hierarchical multiple linear regression examined ikigai’s unique association with work engagement. Results: The final model explained 40.3% of variance in engagement, with ikigai accounting for a statistically significant increase in explained variance (ΔR² = 0.033, p < 0.01). Ikigai demonstrated a unique positive association with work engagement (β = 0.24, p < 0.01), comparable in strength to job resources and other personal resources. Conclusions: Findings support ikigai as a distinct personal resource associated with work engagement among nursing trainees. This extends the job demands–resources model by highlighting the relevance of existential constructs. Supporting ikigai development may offer a complementary strategy for promoting engagement in professional nursing. Full article

Background: Borderline Personality Disorder (BPD) is a growing health concern, characterized by emotional dysregulation, impulsivity, and unstable interpersonal relationships. One of the core features of BPD is self-harm, which has significant implications for clinical management, risk assessment, and treatment planning. Accurate assessment tools are essential in evaluating symptom severity and identifying individuals at high risk of self-injurious behaviors, thereby guiding clinical interventions effectively. This study aimed to assess the psychometric properties, factor structure, and diagnostic utility of the Greek version of the Borderline Personality Disorder Severity Index-IV (BPDSI-IV), providing preliminary evidence for its reliability and validity. Methods: A total of 128 individuals with BPD and 32 healthy controls were assessed using the BPDSI-IV together with the Brief Symptom Inventory-53 (BSI-53), the BPD Checklist, the Rosenberg Self-Esteem Scale, the WHOQOL-BREF, and the Defense Style Questionnaire-40 (DSQ-40). BPD diagnoses were confirmed using the Structured Clinical Interview for DSM-5 Personality Disorders (SCID-5-PD). Internal consistency, confirmatory factor analysis (CFA) of previously suggested models, exploratory and confirmatory bifactor modeling, and validity assessments were conducted. Results: The BPDSI-IV showed strong internal consistency (α = 0.92, ωt = 0.96), with most subscales demonstrating adequate reliability. Exploratory bifactor analysis using the Schmid–Leiman transformation supported a model with a dominant severity factor (ωh = 0.69), reinforcing the dimensional nature of BPD. CFA supported this bifactorial approach. BPDSI-IV scores significantly discriminated BPD patients from controls (p < 0.001). Strong correlations with measures of psychopathology and self-esteem, and correlations with quality of life further supported its validity. Conclusions: The Greek BPDSI-IV demonstrated strong reliability and validity indicators. Structured assessment tools, such as the BPDSI-IV, can enhance early intervention and research on the course of borderline personality disorder symptoms. Full article

Purpose: This study evaluated the effectiveness of a school-based experiential self-management program for children with atopic dermatitis (AD) based on Roy’s adaptation theory. Design and Methods: Data were collected from June to August 2021, with 33 children in the experimental group and 32 in the control group. Participants were 10- to 11-year-old elementary school children who reported having AD symptoms within the past year and were able to complete self-report questionnaires. The program consisted of seven weekly school-based sessions that included disease education, symptom management techniques, skin care practices, nutritional guidance, and self-esteem enhancement activities. Outcomes, including AD severity, disease-related knowledge, adaptive behavior, self-esteem, and quality of life, were measured at baseline, post-intervention, and four weeks post-intervention using Generalized Estimating Equation analysis. Results: The experimental group showed significant improvements in AD severity (SCORAD: 22.80 ± 3.18 to 17.75 ± 2.24), disease-related knowledge (10.64 ± 2.00 to 13.64 ± 1.39), adaptive behavior (3.55 ± 1.70 to 10.58 ± 2.45), self-esteem (26.18 ± 4.76 to 31.55 ± 3.46), and quality of life (90.24 ± 11.07 to 100.27 ± 9.76), while the control group remained unchanged. Improvements were sustained four weeks post-intervention. Conclusions: This program effectively reduced AD severity and enhanced knowledge, adaptive behavior, self-esteem, and quality of life in children with AD. Practice Implications: School-based self-management programs effectively enhance disease knowledge, adaptive behaviors, and quality of life in children with AD. Full article

Background/Objectives: There is scientific evidence showing that body- and/or body weight-related blaming, guilting, and shaming continue to be both promoted and tolerated in many societal contexts, including schools and healthcare settings. A deeply ingrained belief still prevails among many individuals that inducing these negative emotions can serve as a motivator for children and adolescents to engage in obesity treatment. Therefore, the aim of this systematic review is to examine these emotions (blame, guilt, shame) in relation to body weight and their impact on psychological functioning within the pediatric population affected by overweight and obesity. Methods: Articles were searched up using PubMed and Web of Science in June 2023 and March 2025. The search was conducted without limiting the years of publication. The inclusion criteria included the following: (1) pediatric samples, (2) full text available, and (3) original research articles. Articles were excluded if they were editorials, letters, replies from authors, review articles, and articles without a full text. Results: The initial search returned 199 results. A total of 16 articles were included in the study. Analysis of the collected records revealed associations between body- or weight-related blame, guilt, and shame and various aspects of psychological functioning in the pediatric population such as (a) interpersonal context (e.g., social stigma, bullying, teasing history, social connectedness, weight-related language used by parents in conversations with children and adolescents; (b) intrapsychic context—relationship with eating and food (e.g., binge eating, dietary restraint, emotional eating, and the risk of developing eating disorders); (c) intrapsychic context—self-perception (e.g., self-esteem, feelings of worthlessness, self-compassion, self-efficacy, perceived control); (d) intrapsychic context—emotional functioning (e.g., emotional distress, anxiety, depression, emotion regulation strategies); and (e) intrapsychic context—additional psychological factors (e.g., mindfulness, quality of life, willingness to seek help, and motivation for both help-seeking and sustaining successful lifestyle changes). Conclusions: Understanding the dynamics of body- and/or weight-related blame, guilt, and shame among children and adolescents with overweight and obesity is essential for developing effective support systems that enhance their well-being and psychological resilience in both the prevention and treatment of obesity. Further research is needed to explore the relationships between body- and weight-related blame, guilt, and shame and psychological functioning in pediatric populations with overweight and obesity, including the dynamics of child–parent–healthcare provider interactions, the context of parenting skills and attitudes that support the child during obesity treatment, the long-term consequences of body- and weight-related blame, guilt, and shame, the relationship between healthcare providers’ tendencies to engage in body- and weight-related shaming or blaming and their communication skills and mental well-being (e.g., levels of professional burnout, emotion regulation skills, and personality traits), as well as the influence of social media on body- and weight-related shame, guilt, and blame. Full article

Introduction: Overweight and obesity among children and adolescents are a growing public health problem. The aim of this study was to determine the impact of overweight and obesity on the psychosocial functioning and physical activity levels of children and adolescents. Methods: This study was conducted among 100 children and adolescents aged 9–18 from three institutions in the Podkarpackie Province: a primary school, a hospital ward, and a health resort. An original questionnaire was used, containing questions about body image, emotions related to eating, self-esteem, and physical activity. All participants were classified into appropriate BMI categories based on anthropometric data. Results: The analysis showed that 48% of respondents admitted to eating meals in secret, and 5% did so every day for a month. As many as 65.82% of participants stated that their body shape affects the way they think about themselves, and more than two-thirds felt frustrated with their figure. Statistically significant differences were observed in the perception of one’s own body and the level of its acceptance depending on the BMI category. In addition, 58.58% of respondents did not engage in physical activity to control their weight. Conclusions: The results of this study confirm that overweight and obesity in children and adolescents are associated with a negative body image, low self-esteem, unhealthy eating habits, and low levels of physical activity. The obtained results can be used by medical personnel, educators, and educational institutions to develop effective prevention programs aimed at counteracting the negative consequences of overweight and obesity in children and adolescents. Full article