Adverse childhood experiences (ACEs) are associated with physical and mental health difficulties in adulthood. This study examines the associations of ACEs with functional impairment and life stress among military personnel, a population disproportionately affected by ACEs. We also evaluate the extent to which the associations of ACEs with functional outcomes are mediated through internalizing and externalizing disorders.

The sample included 4,666 STARRS Longitudinal Study (STARRS-LS) participants who provided information about ACEs upon enlistment in the US Army (2011–2012). Mental disorders were assessed in wave 1 (LS1; 2016–2018), and functional impairment and life stress were evaluated in wave 2 (LS2; 2018–2019) of STARRS-LS. Mediation analyses estimated the indirect associations of ACEs with physical health-related impairment, emotional health-related impairment, financial stress, and overall life stress at LS2 through internalizing and externalizing disorders at LS1.

ACEs had significant indirect effects via mental disorders on all functional impairment and life stress outcomes, with internalizing disorders displaying stronger mediating effects than externalizing disorders (explaining 31–92% vs 5–15% of the total effects of ACEs, respectively). Additionally, ACEs exhibited significant direct effects on emotional health-related impairment, financial stress, and overall life stress, implying ACEs are also associated with these longer-term outcomes via alternative pathways.

This study indicates ACEs are linked to functional impairment and life stress among military personnel in part because of associated risks of mental disorders, particularly internalizing disorders. Consideration of ACEs should be incorporated into interventions to promote psychosocial functioning and resilience among military personnel.

Individuals with schizophrenia experience significantly higher rates of chronic physical health conditions, driving a 20-year reduction in life expectancy. Poor diet quality is a key modifiable risk factor; however, owing to side-effects of antipsychotic medication, cognitive challenges and food insecurity, standard dietary counselling may not be sufficient for this population group.

To evaluate the feasibility, acceptability and preliminary effectiveness of two dietary interventions – pre-prepared meals and meal kits – for individuals with schizophrenia.

The Schizophrenia, Nutrition and Choices in Kilojoules (SNaCK) study is a 12-week, three-arm, cross-over, randomised controlled trial. Eighteen participants aged 18–64 years diagnosed with schizophrenia or schizoaffective disorder will be recruited from community mental health services in Australia. Participants will be randomised to receive pre-prepared meals, meal kits or a supermarket voucher as a control, crossing-over at the end of weeks 4 and 8, so that all participants experience all three study arms. Primary outcomes include feasibility (recruitment rate and retention, number of days participants use pre-prepared meals or meal kits, adherence to meals as prescribed, difficulty in meal preparation and meal wastage) and acceptability (meal provision preference ranking and implementation) of the nutrition interventions. Secondary outcomes include the effects of the intervention on metabolic syndrome components, dietary intake, quality of life and food security measures.

Feasible, acceptable and effective dietary interventions for people with schizophrenia are urgently needed. Findings from this trial will inform future larger randomised controlled trials that have the potential to influence policy and improve health outcomes for this vulnerable population.

To investigate the effect of physical exercise intensity on state anxiety symptoms and affective responses.

Twenty-one healthy women (mean age: 23.6 ± 5.4 years) participated in three sessions: self-selected intensity exercise, moderate-intensity prescribed exercise, and a nonexercise control session. Before each session, participants were exposed to unpleasant stimuli. State anxiety symptoms and affective responses were assessed pre- and post-stimulus exposure and pre- and post-sessions. A two-way repeated measures ANOVA tested state anxiety, while the Friedman test analyzed affective responses.

Time significantly affected state anxiety symptoms [F (2,0) = 25.977; P < 0.001; η2p = 0.565]. Anxiety increased post-stimulus (P < 0.001) and decreased after all sessions. No significant differences were found between exercise and control conditions. Time also significantly influenced affective responses [χ² (8.0) = 62.953; P < 0.001; Kendall’s W: 0.375]. Affective responses decreased post-stimulus (P = 0.029) and significantly increased after both exercise sessions (P < 0.001) but remained unchanged in the control session (P = 0.183).

Although state anxiety increased after unpleasant stimuli in all conditions, reductions following exercise sessions were comparable to the nonexercise session. However, both exercise sessions uniquely improved affective responses, highlighting their potential for emotional recovery after unpleasant stimuli.

Mentalizing defines the set of social cognitive imaginative activities that enable interpretation of behaviors as arising from intentional mental states. Mentalization impairments have been related to childhood trauma (CT) and are widely present in people suffering from mental disorders. Nevertheless, the link between CT exposure, mentalization abilities, and related psychopathology remains unclear. This study aims to systematically review the evidence in this domain.

A Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA)-compliant systematic review of literature published until December 2022 was conducted through an Ovid search (Medline, Embase, and PsycINFO). The review was registered in the Prospective Register of Systematic Reviews (PROSPERO) (CRD42023455602).

Twenty-nine studies were included in the qualitative synthesis. Twenty studies (69%) showed a significant negative correlation between CT and mentalization. There was solid evidence for this association in patients with psychotic disorders, as almost half the studies focused on this population. The few studies focusing on unipolar depression, personality disorders, and opioid addiction also reported a negative impact of CT on mentalization. In contrast, evidence for post-traumatic stress disorder was inconsistent, and no evidence was found for bipolar disorder. When stratifying for subtypes of CT, there was solid evidence that neglect (physical and emotional) decreased mentalization capacity, while abuse (physical, emotional, or sexual) was not associated with mentalization impairments.

Although causality cannot be established, there was substantial evidence that CT negatively affects mentalization across various psychiatric disorders, particularly psychotic disorders. These findings highlight the potential of targeting mentalization impairments in prevention and treatment strategies aiming to reduce the incidence and the social functioning burden of mental illness.

Loneliness and social isolation pose significant public health concerns globally, with adverse effects on mental health and well-being. Although the terms are often used interchangeably, loneliness refers to the subjective feeling of lacking social connections, whereas social isolation is the objective absence of social support or networks.

To investigate the prevalence of loneliness and social isolation and their associations with psychiatric disorders.

This study used data from the Republic of Korea National Mental Health Survey 2021, a nationally representative survey. A total of 5511 adults aged 18–79 residing in South Korea participated in the survey. Loneliness and social isolation were assessed using the Loneliness and Social Isolation Scale, whereas psychiatric disorders were evaluated using the Korean version of the Composite International Diagnostic Interview. Multivariate logistic regressions were performed after adjustment for sociodemographic variables.

Among the participants, 11.8% reported experiencing loneliness, 4.3% reported social isolation and 3.4% reported both. Co-occurrence of loneliness and social isolation was significantly associated with psychiatric disorders (adjusted odds ratio (AOR) 7.59, 95% CI: 5.48–10.52). Loneliness alone was associated with greater prevalence and higher probability of psychiatric disorders (AOR 3.12, 95% CI: 2.63–3.71), whereas social isolation did not show any significant association (AOR 0.88, 95% CI: 0.64–1.22).

The co-occurrence of loneliness and social isolation is particularly detrimental to mental health. This finding emphasises the need for targeted interventions to promote social connection and reduce feelings of isolation.

The mental health of incarcerated individuals is a widely recognized public health issue, but little is known about the mental health status of the incarcerated individuals upon release. This study aimed to measure the prevalence of psychiatric disorders and substance use disorders (SUDs) among incarcerated men scheduled to be released from jail soon.

We conducted a cross-sectional national survey from September 2020 to September 2022 across 26 jails (selected at random) in France. Each participant was interviewed within 30 days prior to their release via a structured questionnaire, including the Mini International Neuropsychiatric Interview.

A total of 579 individuals were included in the analysis (participation rate: 66.2%). The prevalence of mood disorders, anxiety disorders, post-traumatic stress disorder, and psychotic episodes were 30.7% (95% confidence interval [CI]: 27.1%–34.6%), 28.7% (95% CI: 25.1%–32.5%), 11.1% (95% CI: 8.8%–13.9%), and 10.5% (95% CI: 8.3%–13.3%), respectively. Additionally, almost half of the individuals had an SUD, and dual disorders were identified in 21.9% (95% CI: 18.8%–25.5%) of the cases. The analysis of mental health care pathways raised questions about access to certain types of care, such as full-time psychiatric hospitalization while in prison, as well as questions about the continuity of care upon release.

This study shows that the mental health of incarcerated men who are scheduled to be released soon is precarious. Complex mental health problems, particularly dual disorders, are common and require better coordination between mental health care systems in prisons and the community.

To examine the risk of perinatal mental illness, including new diagnoses and recurrent use of mental healthcare, comparing women with and without traumatic brain injury (TBI), and to identify injury-related factors associated with these outcomes among women with TBI.

We conducted a population-based cohort study in Ontario, Canada, of all obstetrical deliveries to women in 2012–2021, excluding those with mental healthcare use in the year before conception. The cohort was stratified into women with no remote mental illness history (to identify new mental illness diagnoses between conception and 365 days postpartum) and those with a remote mental illness history (to identify recurrent illnesses). Modified Poisson regression generated adjusted relative risks (aRRs) (1) comparing women with and without TBI and (2) according to injury-related variables (i.e., number, severity, timing, mechanism and intent) among women with TBI.

There were n = 12,724 women with a history of TBI (mean age: 27.6 years [SD, 5.5]) and n = 786,317 without a history of TBI (mean age: 30.6 years [SD, 5.0]). Women with TBI were at elevated risk of a new mental illness diagnosis in the perinatal period compared to women without TBI (18.5% vs. 12.7%; aRR: 1.31, 95% confidence interval [CI]: 1.24–1.39), including mood and anxiety disorders. Women with a TBI were also at elevated risk for recurrent use of mental healthcare perinatally (35.5% vs. 27.8%; aRR: 1.18, 95% CI: 1.14–1.22), including mood and anxiety, psychotic, substance use and other mental health disorders. Among women with a history of TBI, the number of TBI-related healthcare encounters was positively associated with an elevated risk of new-onset mental illness.

These findings demonstrate the need for providers to be attentive to the risk for perinatal mental illness in women with a TBI. This population may benefit from screening and tailored mental health supports and treatment options.

Folate and cobalamin deficiency or impaired function due to genetic variants in key enzymes have been associated with neuropsychiatric symptoms. The aim of this study was to compare folate and cobalamin status in patients admitted to an acute psychiatric unit to patients from primary health care in order to reveal factors which may be important in the follow-up of patients with mental disorders.

Anonymous blood samples tested for folate, cobalamin, the metabolic marker total homocysteine (tHcy), creatinine and glomerular filtration rate as well as age and gender in patients admitted to a psychiatric acute unit (n = 981) and patients from primary health care (controls) (n = 32,201) were reviewed retrospectively.

Median serum folate was 18% lower and median serum cobalamin was 11% higher in patients with mental disorders compared to controls. Folate deficiency was associated with 54% higher median tHcy levels among patients with mental disorders compared to controls. The prevalence of folate deficiency was 31% and of cobalamin deficiency 6% in patients admitted to a psychiatric acute unit in a Norwegian hospital in 2024.

Folate, but not cobalamin deficiency, was prevalent in Norwegian patients with mental disorders. The higher tHcy levels in folate-deficient patients with mental disorders indicate an impaired folate metabolism, which might be related to genetic factors, such as polymorphisms in the methylenetetrahydrofolate reductase (MTHFR) gene. Ensuring a serum folate concentration above 15 nmol/L and a serum cobalamin above 250 pmol/L might improve symptoms in patients with mental disorders.

Most information about the association between childhood maltreatment (CM) and subsequent psychiatric morbidity is based on retrospective self-reports. Findings from longitudinal studies using prospective reports to statutory agencies may be subject to attrition. We therefore compared the prevalence to age 30 of inpatient psychiatric diagnoses in those who experienced agency-reported CM with those of the rest of the cohort using administrative data to minimise loss to follow-up.

We used linked administrative data for two birth cohorts of all individuals born in Queensland, Australia in 1983 and 1984 (N = 83,050) and followed to age 30 years. This was the entire cohort aside from 312 people who died. Information on CM came from statewide child protection data and psychiatric diagnoses from all public and private hospital admissions in Queensland.

On adjusted analyses, the 4,703 participants (5.7%) who had been notified to the statewide child protection authority had three to eight times the odds of being admitted for any of the following psychiatric diagnoses by age 30 years old: schizophrenia-spectrum disorders, bipolar affective disorders, depression, anxiety and post-traumatic stress disorders (PTSD). There were similar findings for all the CM subtypes. Associations were especially strong for PTSD with between a seven – and nine-fold increase in the odds of admission.

This is one of the largest studies of the long-term effects of CM, covering an entire jurisdiction. All types of maltreatment are significantly related to a range of psychiatric disorders requiring hospitalisation. Early identification, intervention and providing appropriate support to individuals who have experienced CM may help mitigate the long-term consequences and reduce the risk of subsequent mental health problems.

Mental disorders and physical-health conditions frequently co-occur, impacting treatment outcomes. While most prior research has focused on single pairs of mental disorders and physical-health conditions, this study explores broader associations between multiple mental disorders and physical-health conditions.

Using the Norwegian primary-care register, this population-based cohort study encompassed all 2 203 553 patients born in Norway from January 1945 through December 1984, who were full-time residents from January 2006 until December 2019 (14 years; 363 million person-months). Associations between seven mental disorders (sleep disturbance, anxiety, depression, acute stress reaction, substance-use disorders, phobia/compulsive disorder, psychosis) and 16 physical-health conditions were examined, diagnosed according to the International Classification of Primary Care.

Of 112 mental-disorder/physical-health condition pairs, 96% of associations yielded positive and significant ORs, averaging 1.41 and ranging from 1.05 (99.99% CI 1.00–1.09) to 2.38 (99.99% CI 2.30–2.46). Across 14 years, every mental disorder was associated with multiple different physical-health conditions. Across 363 million person-months, having any mental disorder was associated with increased subsequent risk of all physical-health conditions (HRs:1.40 [99.99% CI 1.35–1.45] to 2.85 [99.99% CI 2.81–2.89]) and vice versa (HRs:1.56 [99.99% CI 1.54–1.59] to 3.56 [99.99% CI 3.54–3.58]). Associations were observed in both sexes, across age groups, and among patients with and without university education.

The breadth of associations between virtually every mental disorder and physical-health condition among patients treated in primary care underscores a need for integrated mental and physical healthcare policy and practice. This remarkable breadth also calls for research into etiological factors and underlying mechanisms that can explain it.

The objective of this study was to determine what factors are associated with behavioral health in veterinary disaster responders.

An online cross-sectional survey was distributed via snowball sampling. Results were analyzed using chi-square analyses.

Responses from 237 veterinarians were analyzed. Being involved in more than 1 disaster event was associated with higher anxiety and/or depression (43.4% vs 28.6%, respectively), difficulty with relationships (28.1% vs 14.3%, respectively), and a greater prevalence of sleep problems (44.6% vs 28.0%, respectively) compared to only being involved in 1 event. Veterinarians that were deployed longer than 2 months had the highest prevalence of anxiety and/or depression (43.9%) and sleep problems (50.0%). Veterinarians that received behavioral health training before deployment had lower rates of anxiety and/or depression (27.8% vs 42.9%, respectively) compared to those who did not receive training. Respondents involved with depopulation had the highest rates of anxiety and/or depression (66.7%) and sleep problems (58.1%).

Factors associated with behavioral health outcomes included the number and length of deployments, receiving behavioral health training, and being involved in depopulation. To reduce the risk of behavioral health outcomes, interventions such as time-off and behavioral health support are needed.

Previous studies have indicated associations between maternal mental disorders and adverse birth outcomes; however, these studies mainly focus on certain types of mental disorders, rather than the whole spectrum.

We aimed to conduct a broad study examining all maternal mental disorder types and adverse neonatal outcomes which is needed to provide a more complete understanding of the associations.

We included 1 132 757 liveborn singletons born between 1997 and 2015 in Denmark. We compared children of mothers with a past (>2 years prior to conception; n = 48 646), recent (2 years prior to conception and during pregnancy; n = 15 899) or persistent (both past and recent; n = 10 905) diagnosis of any mental disorder, with children of mothers with no mental disorder diagnosis before the index delivery (n = 1 057 307). We also considered different types of mental disorders. We calculated odds ratios and 95% CIs of low birthweight, preterm birth, small for gestational age, low Apgar score, Caesarean delivery and neonatal death.

Odds ratios for children exposed to past, recent and persistent maternal mental disorders suggested an increased risk for almost all adverse neonatal outcomes. Estimates were highest for children in the ‘persistent’ group for all outcomes, with the exception of the association between persistent maternal mental disorders and neonatal death (odds ratio 0.96, 0.62–1.48).

Our study provides evidence for increased risk of multiple adverse neonatal outcomes among children of mothers with mental disorders, highlighting the need for close monitoring and support for women with mental disorders.