Neuropeptide Y (NPY) has been implicated in stress resilience and depression, yet findings on circulating levels in major depressive disorder (MDD) remain inconsistent, possibly due to confounders such as age, sex, and body mass index (BMI). This study assessed NPY concentrations in individuals with MDD and in matched controls from the Danish PRISME cohort of public-sector employees.

We investigated plasma NPY (p-NPY) concentrations in 77 adults with a current ICD-10 diagnosis of MDD and 77 age- and sex-matched controls. Plasma samples were analysed using a commercial ELISA kit. A general linear model examined the effects of group, age, sex, and BMI, including a sex-by-group interaction. Plasma NPY values were log10-transformed prior to analysis.

p-NPY concentrations did not differ significantly between MDD and controls (p = 0.785). No main effect of sex or sex-by-group interaction was observed (all p > 0.17), and BMI was unrelated to p-NPY (p = 0.917). By contrast, age was a strong predictor (β = 0.38, p < 0.001), explaining 13% of the variance.

In this community-based sample of high-functioning individuals with MDD, we found no evidence of altered p-NPY concentrations compared with matched controls. Instead, age emerged as a robust determinant of circulating NPY levels, independent of depression status and BMI, after adjustment for sex. These findings suggest that peripheral NPY variation may be more strongly related to demographic factors than to depression per se in this type of cohort.

Estimating the prevalence of use of substances such as heroin remains a challenge. The aim of this study is to identify the scientific publications in Spain that have used surveys to investigate heroin use, to describe their methodology and to contrast the formulation of the questions with users’ input on key aspects associated with use.

A scoping review was conducted until November 2024 in MEDLINE (Ovid), EMBASE and Web of Science. The review included questionnaire-based research studies assessing heroin use in Spain. Information on study, population, data collection and consumption characteristics was compiled from each included study. In addition, in-depth interviews were conducted with Spanish heroin current users and ex-users.

Twenty-nine questionnaire-based research studies assessing heroin use in Spain were identified; none of them were specifically oriented to estimate and characterise heroin use at the population level. Most of the studies focused on specific population groups, mainly drug users, students, or inmates. The majority addressed lifetime, past-year, and past-month use, although users found the past 3 or 6 months more relevant. Few studies explored other use characteristics; however, interviews with heroin ex-users highlighted the importance of factors like route of administration and age of first use.

The studies identified in this review vary in terms of target population, geographic scope, reference time frame, and data collection methods. Moreover, questionnaires rarely address additional characteristics of use that are considered relevant by former users. This review identifies areas for improvement to guide future studies and refine methodological approaches.

Electroconvulsive therapy (ECT) is an established treatment for schizophrenia. Oxidative stress has been implicated in its pathophysiology, and Thiobarbituric acid reactive substances (TBARS) are widely used markers of lipid peroxidation. However, the effect of ECT on TBARS levels remains unclear.

To compare changes in TBARS levels in schizophrenia inpatients receiving ECT plus pharmacotherapy versus pharmacotherapy alone and to examine associations between TBARS levels and clinical variables.

Thirty-eight inpatients with schizophrenia were included (ECT + pharmacotherapy: n = 18; pharmacotherapy only: n = 20). Serum TBARS levels were measured at admission and discharge. Clinical severity was assessed using the Clinical Global Impression and Positive and Negative Syndrome Scale. Non-parametric analyses and multiple linear regression were conducted.

TBARS levels did not significantly change from admission to discharge in either the ECT group (median 756.5 vs. 768.5 nmol/L) or the pharmacotherapy group (median 644.0 vs. 693.5 nmol/L). Percentage changes were comparable between groups (9.64% vs. 15.34%). TBARS levels were negatively correlated with age (ρ = −0.441) and illness duration (ρ = −0.333). Regression analysis showed that suicide history was the only significant predictor of TBARS levels (β = −0.402), while treatment modality was not associated with TBARS change.

ECT was not associated with statistically significant changes in TBARS levels; however, these findings should be interpreted cautiously given the exploratory nature of the study, the small sample size, and methodological limitations. The observed associations with clinical variables suggest that oxidative stress markers may have relevance in specific patient subgroups, warranting further investigation.

Physical neglect constitutes an experience of deprivation characterised by the absence of care, supervision, and stimulation, which may affect cognitive development during adolescence and hinder the learning of strategies to cope with demands. This study aimed to analyse coping styles and cognitive performance in adolescents in residential care with physical neglect as the predominant form of maltreatment, as well as to examine the association between both dimensions.

This observational, cross-sectional study included 45 adolescents in residential care, aged between 12 and 16 years, with physical neglect as the predominant type of maltreatment. The instruments used were the Adolescent Coping Scale (ACS), the Stroop Color and Word Test (SCWT), the Behavioural Assessment of the Dysexecutive Syndrome for Children (BADS-C), and the Digit Span and Coding subtests of the Wechsler Intelligence Scale for Children (WISC-V).

Participants showed a predominance of the non-productive coping style, together with lower-than-expected scores for their age and educational level in selective attention, processing speed, working memory, planning, cognitive flexibility, and inhibition. Lower cognitive and executive performance was related to greater use of the non-productive coping style. In addition, linear regression analyses showed that the global cognitive performance index was significantly associated with the non-productive coping style, even after statistically controlling for sex, age, and polyvictimization.

These findings suggest the importance of jointly considering coping styles and cognitive performance in adolescents in residential care with physical neglect, as well as the potential value of interventions that integrate emotion regulation, executive functions, and problem-solving.

Glucagon-like peptide-1 (GLP-1), indicated in the treatment of type 2 diabetes mellitus, influences reward processing, integral to disparate mental disorders. Emerging evidence suggests that GLP-1 receptor mono-agonists (GLP-1RAs) are potential treatment strategies for select mental disorders. Herein, we systematically review preclinical research documenting how GLP-1 and GLP-1RAs may impact reward function.

Relevant studies were identified through Web of Science, OVID (MedLINE, Embase, PsycInfo), and PubMed from database inception to June 28, 2026. Preclinical research investigating the association between GLP-1 and select GLP-1RAs and reward function was included. Reward functions assessed were food-, drug-, and sexual-related reward.

A total of 66 studies met inclusion and were synthesised herein. Taken together, results indicate that GLP-1 and GLP-1RAs affect measures of food-related, drug-associated, and sexual behaviours. GLP-1 administration was associated with a reduction in food intake and gross locomotor activity with respect to approaching and engaging in reward-seeking behaviours. When locally administered in selected brain regions of evaluated animal models, exenatide was associated with reduced substance use, food seeking, and sexual behaviours (p < 0.05). Similarly, liraglutide was observed to attenuate substance and food-related rewards (p < 0.05). In addition, semaglutide was demonstrated to reduce substance and sucrose intake, while dulaglutide is reported to reduce substance intake (p < 0.001).

Extant preclinical findings demonstrate a trend toward reductions in reward-associated behaviours following GLP-1RA administration. Our findings can also provide rationale and impetus for evaluating GLP-1RAs in the treatment of psychiatric disorders characterised by disturbance in hedonic function and behaviours.

In this cross-sectional analysis, we examined associations between socioeconomic status (SES), body mass index (BMI), inflammation, diet, and cognitive performance. While low SES is associated with lower cognitive scores, the present study investigated whether these variables – specifically BMI, inflammatory biomarkers, and dietary intake – statistically mediate this relationship.

The final sample included 109 young adults (mean age = 21.31; 65% female; 45% white). Analyses utilized a comprehensive neuropsychological battery, including the NIH Cognitive Toolbox and Kaufman Brief Intelligence Test, alongside biomarkers of inflammation (Interleukin (IL)-1β, IL-6, and tumor necrosis factor-α (TNF-α)), and self-reported dietary intake via the National Cancer Institute’s Diet History Questionnaire – Third Edition. A pre-registered analysis using bootstrapped standard errors across 5,000 bootstrapped replications in ‘lavaan’ tested whether (i) associations between SES and executive functioning and episodic memory were statistically mediated by a higher BMI and (ii) associations between BMI and executive functioning and episodic memory were statistically mediated by elevated inflammation and sugar or fat intake.

BMI did not account for the association between SES and cognition; however, BMI, fat intake, and sugar intake were inversely correlated with cognitive functioning. Sugar intake mediated the association between BMI and cognition, though this finding was not significant after adjusting for covariates. Inflammation did not mediate the relationship between BMI and cognition.

These results provide support for a link between BMI and cognitive performance and preliminary evidence of a mediating role of sugar intake. Further longitudinal and experimental research is needed to extend these findings and characterize underlying mechanisms.

In recent years, artificial intelligence (AI) and its applications have become a compelling topic in psychiatry. This study aimed to investigate whether the AI chatbot ChatGPT is useful for patient education by evaluating the quality, reliability, and readability of its responses to patient questions about repetitive transcranial magnetic stimulation (rTMS).

Twenty-five frequently asked questions about rTMS were separately queried to ChatGPT-4 with no follow-up questions. Responses were reviewed by three psychiatrists by using the Global Quality Scale (GQS), DISCERN tool, and Journal of the American Medical Association (JAMA) Benchmark Criteria. Readability was evaluated by the Flesch-Kincaid Grade Level and the Gunning Fog, Coleman-Liau, and Simple Measure of Gobbledygook Indexes.

Overall, the quality of ChatGPT responses was moderate to good, with a mean GQS score of 3.69. The mean DISCERN score was 35.33, which is considered poor, and the JAMA Benchmark Criteria score was 0 for all questions. The mean readability score was high (mean grade level, 10.98).

Our results show that ChatGPT responses to patient questions about rTMS are of acceptable quality and usefulness. However, the reliability and accuracy of the responses are limited, and a high reading level is required to understand them. Although ChatGPT can support patient education about rTMS, it should be used with caution and under guidance from healthcare professionals.

Bipolar disorder (BD) is marked by recurrent mood episodes and functional impairment. Growing evidence implicates mitochondrial dysfunction, oxidative stress, and metabolic disturbances as important to its pathophysiology, affecting neuronal signalling, synaptic plasticity, and inflammatory pathways.

This review synthesises current evidence linking energetic metabolism to BD, integrates neuroimaging and peripheral biomarker findings, and discusses emerging therapeutic strategies targeting mitochondrial and metabolic dysfunction.

A systematic search following PRISMA guidelines was conducted across PubMed, MEDLINE, EMBASE, Scopus, and Cochrane Library using ‘bipolar disorder’, ‘energetic metabolism’, and ‘mitochondria’. Inclusion criteria comprised peer-reviewed human studies, original research, and meta-analyses; paediatric, non-English, dietary, genetic, or comorbidity-focused studies were excluded. Additional manual searches targeted biomarker-specific studies.

Evidence consistently shows impaired oxidative phosphorylation, reduced ATP and phosphocreatine, altered NAD+/NADH ratios, and increased oxidative and inflammatory markers in BD. Neuroimaging demonstrates reduced PCr/ATP ratios, elevated lactate, and decreased TCA cycle intermediates, indicating cerebral energy deficits. Peripheral biomarkers: including decreased ETC complex activity, increased MDA and 8-OHdG, altered purinergic enzymes, and elevated mtDNA reflect systemic bioenergetic stress. Emerging interventions targeting mitochondrial cofactors (creatine, CoQ10, carnitine, NAC), metabolic strategies (ketogenic diet), and immunomodulatory or purinergic pathway modulators show promise.

Emerging evidence suggests that systemic bioenergetic dysregulation may contribute to the pathophysiology of BD. Integrating mitochondrial, metabolic, and inflammatory biomarkers with neuroimaging may enable biologically informed patient stratification and precision therapeutics aimed at restoring energetic homeostasis. Large, standardised multicenter studies are required to translate these findings into clinical practice.

Staff attire may influence patient perceptions of staff in healthcare settings. However, little is known about how this applies to psychiatric services. To address this gap, we examined whether different types of attire influence patient approval of staff in psychiatric settings.

Adult patients receiving treatment in the Psychiatric Services of the Central Denmark Region were invited to participate in an electronic survey. Respondents were randomly allocated to one of five groups shown photographs of a: I. Doctor wearing personal clothes, II. Doctor wearing white coat over personal clothes, III. Doctor wearing white coat over scrubs, IV. Nurse wearing personal clothes, or V. Nurse wearing scrubs. Each participant answered seven ‘approval’ question items on a Likert-like scale (range 0–10) covering competence, credibility, empathy, trustworthiness, willingness to follow recommendations, willingness to approach the staff member and perceived professionalism. Composite approval scores were compared across the doctor and nurse groups, respectively, using pairwise t-tests.

Of the 9310 eligible patients, 1431 (15.4% response rate) completed the full questionnaire. Mean composite approval scores (range 0–70) were highly similar and did not differ statistically significantly across the doctor groups (I. 52 ± 14, II. 53 ± 14 and III. 52 ± 14, respectively; all p ≥ 0.244), nor between the nurse groups (IV. 52 ± 14 and V. 52 ± 15, respectively; p = 0.826).

In this randomised survey experiment, approval ratings were highly similar across psychiatric staff attire. Given this apparent parity, and the advantages in terms of hygiene and correct identification of staff, we believe that more consistent use of uniforms should be considered.