The nasal cycle is a normal physiological process involving alternating congestion and decongestion of the nasal cavities, yet patient awareness of this phenomenon is poorly understood. The objective of this study was to assess patient awareness of the nasal cycle and its association with nasal symptom perception and anxiety.

This prospective observational study included 120 adult ENT outpatients. A structured questionnaire assessed awareness of the nasal cycle, perception of alternating nasal obstruction and anxiety. Nasal symptom severity was measured using the Nasal Obstruction Symptom Evaluation score, and nasal airflow dominance was assessed with the cold spatula test.

Only 28.3 per cent of patients were aware of the nasal cycle. Although 51.7 per cent perceived alternating nasal obstruction, most considered it abnormal. Poor awareness was associated with higher Nasal Obstruction Symptom Evaluation scores (p = 0.01) and increased anxiety (p = 0.003).

Limited awareness of the nasal cycle leads to misinterpretation of normal physiology. Simple counselling may reduce symptom related anxiety.

Radiotherapy for head and neck cancer (HNC) requires a thermoplastic immobilisation mask, which can heighten anxiety, yet this remains poorly recognised and inconsistently measured. Virtual reality (VR)-based rehearsal has been proposed as a preparatory strategy, but patient receptivity is unknown. This study examined the prevalence of state anxiety at mask fabrication, the practicality of administering the six-item State-Trait Anxiety Inventory (STAI Y-6) in a busy pre-treatment workflow and patient interest in VR-based preparation.

In this cross-sectional study, 39 consecutively recruited adults with HNC at a tertiary cancer centre completed a 10-item questionnaire before their first CT simulation: the STAI Y-6 plus four study-specific items covering mask-specific anxiety, general treatment anxiety and interest in a guided VR rehearsal of the procedure. Associations between STAI Y-6 caseness and supplementary items were assessed using Monte Carlo-simulated chi-squared tests.

Recruitment was 93% (39/42), completion 100% and median completion time 3.6 minutes. The mean pro-rated STAI Y-6 score was 43.3 (SD 14.1, range 20–77). Seventeen participants (44%, 95% CI 29–59%) scored ≥41, the threshold for clinically meaningful state anxiety. Participants with elevated anxiety more often reported at least some mask-specific anxiety (71% vs 32%; p = 0.025) and more often expressed uncertainty about VR (p = 0.027).

Nearly half of participants reported clinically meaningful anxiety at mask fabrication, and the STAI Y-6 was quick and acceptable to administer. Larger, multi-site studies with repeated assessment are needed to confirm prevalence and test targeted preparation such as VR.

Family caregivers of terminal cancer patients often experience substantial emotional burden. This study assessed depression, anxiety, stress, and coping–distress associations among caregivers in Eastern India to inform culturally sensitive interventions.

A cross-sectional survey was conducted among 100 adult caregivers of terminal cancer patients at a tertiary care hospital in Kolkata. Participants were recruited via systematic random sampling and interviewed using a structured proforma, the 21-item Depression, Anxiety and Stress Scale (DASS-21) and the Brief-COPE inventory. Descriptive statistics summarized demographics and caregiving characteristics. Spearman’s rank correlation was used to assess associations between psychological distress and coping domains, with p < 0.05 considered statistically significant.

Caregivers (median age 43 years; 70% male) were predominantly the patient’s children (67%). Median DASS-21 scores indicated moderate depression (16), anxiety (14), and stress (16). Coping scores indicated low-to-moderate use of problem-focused (1.875 ± 0.321), emotional (1.871 ± 0.269), and avoidant coping (1.865 ± 0.266). Emotional coping correlated significantly with anxiety (ρ = 0.301, p = 0.002), depression (ρ = 0.317, p = 0.001), and stress (ρ = 0.293, p = 0.003). Depression also correlated with stress and problem-focused coping, while stress correlated with avoidant coping.

Caregivers experienced considerable psychological burden, with emotional coping consistently linked to distress. These associations likely reflect reactive adaptation rather than inherent maladaptiveness. Results highlight an urgent need to recognize caregiver distress within oncology settings and to develop culturally informed psychosocial interventions in palliative care, particularly in low-resource environments. Such efforts could enhance both caregiver well-being and quality of end-of-life care.

The World Health Organization (WHO) developed an assessment for healthy aging termed intrinsic capacity (IC). However, the association between IC and depression/anxiety remains poorly understood, with limited understanding of the underlying metabolic mechanisms.

This prospective cohort study comprised 212,033 UK Biobank participants recruited between 2006 and 2010. We calculated a UK Biobank-adapted four-domain IC deficit score using seven functional status indicators across psychological, sensory, vitality, and locomotor domains. Elastic net regression was employed to derive a metabolic signature that represented IC status. Polygenic risk scores (PRS) for depression and anxiety were computed from associated risk variants.

Compared with a 0 IC deficit score, participants with a 4+ score had higher risk, with hazard ratios (HRs) (95% CIs) of 3.96 (3.72–4.21) for depression and 3.03 (2.82–3.25) for anxiety. The metabolic signature of IC comprised 59 metabolites, with mediation effects of 1.007 (1.005, 1.008) for depression and 1.006 (1.004, 1.007) for anxiety. The highest hazards were observed in participants with high PRS and 4+ IC score; the HRs were 4.36 (3.70–5.13) for depression and 3.46 (2.87–4.17) for anxiety.

IC is associated with a higher risk of depression and anxiety, possibly mediated by its metabolic signature, with enhanced effects in genetically susceptible individuals.

This analysis aimed to examine past 20-year prevalence trends of multiple mental health outcomes by age and sex, using repeated cross-sectional survey data from the Canadian household population.

Age- and sex-stratified bootstrap-weighted prevalence estimates were calculated from available Canadian Community Health Survey datasets between 2002 and 2024. Categorizations for age included adolescents and young adults (12–29 years), middle-aged adults (30–64 years) and older adults (65+ years). Mental health outcomes included self-reported professionally diagnosed mood and anxiety disorder, depression survey scales (Composite International Diagnostic Interview Short Form for Major Depression /9-item brief Patient Health Questionnaire) and fair/poor self-perceived mental health. Stratified prevalence estimates from each year were combined and assessed for heterogeneity using random-effects meta-analysis. In the instance of heterogeneity, meta-regression models were applied to generate predicted prevalence trends over time for each mental health outcome, by age and sex categories.

The prevalence of all mental health outcomes increased from 2002/2003 to 2024, in all age groups of both sexes. For example, in adolescent and young adult males, the weighted prevalence of diagnosed mood disorder increased from 2.37% (95% confidence interval [CI]: 2.03, 2.78) in 2003 to 12.58% (95% CI: 10.37, 15.19) in 2024, while prevalence in females of this age group increased from 5.23% (95% CI: 4.76, 5.74) in 2003 to 21.49% (95% CI: 18.97, 24.24) in 2024. Generally, young males saw the greatest relative increases in prevalence, while young females had the greatest absolute increases. Middle-aged and older adults also saw notable increases in their prevalence of poor mental health. Quadratic survey year terms were statistically significant in meta-regression analysis for all outcomes, age and sex groups (excluding mood disorder trends in65+-year-old adults), suggesting curvilinear trends. Male age categories showed more similar trends over time when compared to age-specific estimates of females.

The broad identification of increasing prevalence across various outcomes, age and sex groups has not been highlighted by prior research. Though prevalence increases in young females remain distinct, this finding aligns with previous literature. Consistency of trend patterns between diverse mental health outcomes indicates that multiple dimensions of mental health may be changing similarly over time. Future analyses are critical in understanding the potential factors contributing to these trends and should look to include broad population samples, rather than limiting analyses to specific age/sex groups.

Recent studies indicate that anxiety is one of the most prevalent mental health challenges faced by children and adolescents diagnosed with autism spectrum disorder (ASD).

For young individuals with concurrent Intellectual disability disorder, these rates are projected to be significantly elevated.

Despite the estimated high prevalence of anxiety among young individuals with co-occurring ASD and intellectual developmental disorder (IDD), significant uncertainty remains in the field about the most effective methods for identifying, diagnosing, and treating anxiety in this distinct group.

The main objective of this narrative review is to examine the current literature on effective strategies and adjustments for evaluating and treating anxiety in children and adolescents who have co-occurring ASD and IDD, aiming to support professionals engaged with this significantly neglected group.

Prior research shows that humans adjust their learning rate based on environmental volatility. This adaptation has been shown to be reduced in individuals with high levels of anxious-depression, but past studies have been cross-sectional, making it unclear whether this adaptation is trait-like or responsive to treatment. There are also questions about the basic replicability of this effect with recent studies failing to find robust associations.

In the Precision in Psychiatry study, we examined changes in learning rate adaptation in a points-loss task, following four weeks of treatment in two patient groups receiving either internet-based cognitive behavioral therapy (n = 677) or antidepressants (n = 95), compared to a group of healthy participants (n = 95).

All groups showed increased learning rates in volatile environments at baseline, but against our prediction, learning rate adaptation was not cross-sectionally associated with individual differences in anxious-depression. There was also no evidence that learning rate adaptation changed post-treatment, despite symptom improvements. However, in the antidepressant group, symptom reductions correlated with learning rate adaptation. This finding should be interpreted cautiously as we found that the key outcome measure had poor test–retest reliability.

Overall, our results suggest that associations between learning rate adaptation and anxious-depression, if present, are likely modest, depend on task characteristics, may not be present in treatment-seeking adults, and do not improve following treatment.

This study aimed to examine the relationships between post-earthquake trauma, anxiety, stress, and stress coping strategies among university students who survived the Kahramanmaraş earthquakes.

This cross-sectional study included 384 university students who survived the Kahramanmaraş earthquakes. Data were collected using a personal information form and standardized scales assessing post-earthquake trauma, anxiety, stress, and stress coping strategies. Descriptive statistics, group comparisons, and correlation analyses were performed.

Among the participants, 35.7% had lost a relative, 47.8% had lost a friend, 10.0% reported that their homes were destroyed, 54.0% reported home damage, and 3.1% had been trapped under rubble. A strong positive correlation was found between post-earthquake trauma and anxiety scores (r = 0.714). Participants who had lost a family member, relative, or friend had significantly higher trauma and anxiety scores than those who had not. Trauma scores were also significantly higher among those who were injured, trapped under rubble, or involved in rescue efforts. Significant relationships were found between post-earthquake trauma, anxiety, stress, and stress coping strategies.

Earthquake-related experiences were associated with increased trauma, anxiety, and stress and with stress coping strategies. Early psychological assessment and psychosocial support may help reduce the psychological effects of earthquakes on university students.

Although a relationship between body fat and mental health problems has been established, sex-based differences in this association remain insufficiently understood.

To investigate the association of whole-body and regional fat mass indices with anxiety symptoms in men and women.

A nationwide sample of 3856 men and 5010 women was analysed. Fat mass of the whole body, trunk, arm and leg was measured using a bioelectrical impedance analyser, and fat mass indices (kg/m2) were derived by dividing fat mass by height squared. Symptoms of anxiety were determined using the Generalized Anxiety Disorder-7. Logistic regressions were used to investigate the association of each fat mass index with anxiety symptoms. Sex-stratified analyses were conducted to assess sex-related differences.

The prevalence of anxiety symptoms was 3.3% among men and 5.5% among women. Among female participants, a one-standard deviation increase in whole-body, trunk, arm or leg fat mass index was associated with 1.20-fold (95% CI: 1.04–1.39), 1.21-fold (95% CI: 1.04–1.41), 1.19-fold (95% CI: 1.04–1.35) and 1.19-fold (95% CI: 1.03–1.38) increases in odds of anxiety symptoms, respectively. By contrast, no clear association was observed between fat mass indices and anxiety symptoms in men.

Our analysis demonstrated sex differences in the relationship between body fat and anxiety, with high whole-body and regional fat mass indices positively associated with anxiety symptoms in women.

Reinforcement motivation, particularly heightened punishment sensitivity and its imbalance relative to reward sensitivity (“motivational bias”), can predict outcomes in anorexia nervosa (AN). However, previous studies did not account for affective symptoms, which are intertwined with reinforcement processes and illness trajectory. This study examined whether affective symptoms explain outcomes beyond reinforcement motivation.

Adolescent girls and young women with AN (n = 192; Mage = 16.33 years, SD = 2.61) completed self-report measures of punishment/reward sensitivity, depressive symptoms, and trait anxiety at treatment admission and at 1-year follow-up. Outcomes included ED symptoms, body mass index, and multidimensional recovery (Morgan–Russell outcome assessment schedule). Cross-sectional comparisons included long-term recovered individuals (n = 154) and healthy controls (n = 440); longitudinal associations were tested using nested linear regression.

Patients with AN and recovered individuals showed elevated punishment sensitivity (η2ₚ = 0.19) and stronger motivational bias (punishment>reward; η2ₚ = 0.17). At baseline, reinforcement motivation and affective symptoms showed limited predictive utility. Longitudinally, shifts in motivational bias were associated with ED symptoms and multidimensional outcomes (|β| > 0.248, pFDR < .002), whereas changes in affective symptoms were the most robust and consistently associated predictors (|β| > 0.173, pFDR < .017).

Depressive symptom improvement emerged as the key predictor of outcome, showing stronger associations with follow-up ED symptoms and psychosocial functioning than reinforcement motivation. While changes in reinforcement motivation accompanied ED outcomes, affective symptom change was more predictive across outcomes. These findings emphasize the importance of prioritizing affective processes within developmentally tailored AN treatment frameworks.