Early adverse life events are thought to have lasting effects on mental health, yet evidence in humans remains largely correlative. This study investigated whether the timing of maternal separation in rats differentially affects anxiety-related behaviour and neuropeptide levels in adulthood.

Male Wistar rats were subjected to short-term (ST, 15 min) or long-term (LT, 180 min) maternal separation during one of three postnatal windows: PND 2–6, PND 8–9, or PND 10–14. In adulthood, anxiety-like behaviour was assessed using the elevated plus maze (EPM). Brains were subsequently analysed for neuropeptide Y (NPY) and neurokinin A (NKA) levels across discrete brain regions.

LT separation produced markedly time-dependent and opposing effects on both behaviour and neurochemistry. Separation during PND 8–9 reduced time spent on the open arms of the EPM and decreased hippocampal NPY levels, whereas separation during PND 10–14 produced the opposite pattern in both measures. LT separation at PND 8–9 also induced more widespread alterations in neuropeptide levels compared to the other time windows. ST separation produced no significant behavioural or neurochemical effects.

The LT consequences of early maternal separation are critically dependent on the precise timing of the stressor, with a narrow postnatal window around PND 8–9 appearing particularly sensitive. These findings underscore the importance of considering developmental timing when studying the impact of early life adversity, with potential translational relevance for understanding stress-related psychopathology in humans.

Test anxiety affects up to 40% of university students and is associated with academic failure, depression and suicidal ideation, yet clinical screening and high-frequency research designs remain hampered by the burden of 20-item instruments such as the Test Anxiety Inventory (TAI). Although brief measures exist (e.g. the ten-item Westside Test Anxiety Scale and the five-item TAI), a validated, gender-invariant hierarchy of ultra-short forms tailored to contemporary undergraduates is lacking.

To develop and validate a hierarchy of brief TAI versions (ten-item Short Form, five-item Ultra-Short Form and three-item Micro Form) suitable for systematic screening and ecological monitoring in student mental health contexts.

A large sample of Israeli undergraduates (N = 1803) completed the Hebrew TAI. Items were selected based on exploratory factor analysis loadings. Structural validity and gender measurement invariance were confirmed via confirmatory factor analysis.

The five-item Ultra-Short Form showed excellent fit (comparative fit index (CFI) = 0.995, root mean square error of approximation (RMSEA) = 0.05) and the three-item Micro Form exhibited strong standardised factor loadings (≥0.79). Strict scalar invariance was established across genders for all versions. All versions maintained high internal consistency (α ≥ 0.85) and strong correlations with the full scale (r ≥ 0.88). Selected items prioritised somatic over cognitive distress, suggesting contemporary students experience test anxiety as a visceral, physiological ‘survival threat’ rather than cognitive rumination.

These validated brief measures offer a promising toolkit for ‘agile assessment’ in student mental health settings, enabling early identification of at-risk students, pending external criterion validation and independent replication.

Placebos have historically been used as comparative tools in randomised controlled trials (RCTs), but their therapeutic effect, particularly in psychiatric conditions, warrant a more detailed exploration to improve research design and clinical practice.

This systematic review and meta-analysis examines the factors influencing placebo treatment effects across major psychiatric disorders, including depression, anxiety disorders, obsessive–compulsive disorder (OCD) and post-traumatic stress disorder (PTSD).

This PROSPERO registered systematic review and meta-analysis followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify RCTs with at least one placebo and one medication arm (citalopram or escitalopram), across four major groups of psychiatric conditions. Data extraction focused on study characteristics, methodology, target condition, participant demographics and outcome measurements. Cohen’s d effect sizes for placebo and medication groups were calculated, with random-effects model meta-analyses performed to assess heterogeneity and their correlates.

The review included 80 studies with 312 outcome measures, involving 19 776 participants (7 to 91 years old). A large placebo response was observed (effect size: 1.01; 95% CI: 0.93–1.10) with significant heterogeneity (I2: 99.61%). Significant differences in placebo responses were noted across clinical conditions, independent of the medication type. PTSD and depressive disorders exhibited the highest placebo effect size (1.14 and 1.02, respectively), whereas OCD showed the lowest (effect size: 0.62, P < 0.01). Anxiety disorders displayed a moderately large placebo effect size (0.86), with significant variability among anxiety disorder subclasses, specifically noting the lowest placebo effect size in specific phobia (0.23, P < 0.01). The medication effect size (1.43) also demonstrated considerable heterogeneity (I2: 99.76%) but was not significantly different across psychiatric conditions (P = 0.61). Placebo response magnitude was larger in studies with more study arms (b: 0.181, P < 0.01) and younger mean age of the participant (b: −0.010, P < 0.01). Moreover, clinician-rated outcomes versus patient self-reports (effect size: 1.07 v. 0.76, P < 0.01), multicentre studies (p < 0.01) and using intention-to-treat data (effect size: 1.08 v. 0.86, P = 0.01) were associated with larger placebo effect size.

This study used a unique approach to examine placebo responses from the same interventions across multiple major psychiatric disorders. We found substantial placebo responses across psychiatric conditions and significant heterogeneity, influenced by a range of study-related and demographic factors. The findings underscore the complexity of placebo responses and highlight the importance of considering these variances in both research design and clinical translation.

Cognitive behavioural therapy (CBT) is the first-line treatment for anxiety and related disorders. Limited research has explored long-term outcomes following CBT for anxiety-related disorders in naturalistic settings, particularly for generalized anxiety disorder (GAD), social anxiety disorder (SAD), and post-traumatic stress disorder (PTSD).

This study examined long-term outcomes and attrition after group CBT for GAD, SAD, and PTSD in a naturalistic sample. Across disorders, it was hypothesized that gains would be maintained long-term, with a gradual return of clinically relevant symptoms observed at later follow-up points.

Data were collected from individuals completing CBT at a tertiary anxiety treatment clinic. Symptom changes pre- to post-treatment and over a 2-year follow-up were examined, as well as the influence of baseline depressive symptoms on change over time. Worry, social anxiety, and post-traumatic stress symptoms were assessed at pre- and post-treatment and 3, 6, 9, 12, and 24 months.

On average, symptom improvements were maintained over the 2-year follow-up for all disorders. Higher pre-treatment depression was associated with greater symptom severity throughout the study but generally did not affect the magnitude of symptom change. The exception was PTSD, where baseline depression was also associated with changes in symptom severity across the whole study period. This effect was not observed for those with SAD and GAD. Attrition was high across the follow-up period.

This study provides preliminary evidence for the long-term efficacy of CBT in a naturalistic setting. It also highlights challenges with retaining clients in long-term follow-up in naturalistic settings.

Anxiety disorders are highly prevalent yet lack objective biomarkers. Whereas threat-related attentional biases are well documented, less is known about broader eye movement alterations that may characterise anxiety.

To characterise multi-paradigm eye movement profiles in anxiety disorders and evaluate their potential as behavioural markers for disorder differentiation.

Eye movements were recorded in 91 patients with anxiety disorders, 118 with depressive disorders and 98 healthy controls during free viewing of neutral-stimuli, smooth-pursuit and fixation-stability tasks. Principal component analysis was applied to derive latent eye movement dimensions, which were then tested for group differences, associations with symptom severity and classification performance.

Compared with both patients with depression and healthy controls, patients with anxiety disorders exhibited hyper-scanning during free viewing, characterised by increased saccade frequency and path length, and hyper-pursuit during smooth pursuit, reflected in increased velocity gain, fewer intrusive saccades and more catch-up saccades. Principal component analysis identified six latent components, among which active visual exploration, pupillary arousal and smooth-pursuit control demonstrated robust group differences. Machine learning models trained on 6 components yielded areas under the receiver operating characteristic curve of 0.82 for anxiety versus healthy controls, 0.83 for depression versus healthy controls and 0.61 for anxiety versus depression.

Hyper-scanning and hyper-pursuit emerge as defining eye movement signatures of anxiety, linking core mechanisms of vigilance and prediction with measurable behavioural markers. These insights position eye-tracking as a promising behavioural modality for mechanism-informed differentiation across affective disorders.

To examine the impact the COVID-19 pandemic in Ireland on symptoms and functioning in individuals across a range of mental health disorders.

A systematic bibliographic search of case reports, cross-sectional and longitudinal studies was conducted between March 12th, 2020, and December 20th, 2024, among studies evaluating the impact of the COVID-19 pandemic on symptoms and functioning for individuals with pre-existing mental health disorders and for those who presented with self-harm or died by probable suicide in the Republic of Ireland. Studies were independently screened by two reviewers according to inclusion and exclusion criteria, with selected variables extracted and summarised. Risk of bias assessments and narrative synthesis of included studies were conducted.

Twenty-eight studies met inclusion criteria. Findings were heterogeneous and disorder specific. An increase in presentations of self-harm, anxiety disorders, and eating disorders to child and adolescent mental health services and emergency departments was noted, with relative stability of symptoms in other cohorts including bipolar disorder and treatment-resistant schizophrenia. Significant symptom deterioration, with poor quality of life and functioning was demonstrated in individuals with emotionally unstable personality disorder both cross-sectionally and longitudinally.

Most people with pre-existing mental disorders did not experience significant exacerbation associated with the pandemic, with exception of those with eating disorders and EUPD.

Journalists covering war are exposed to grave risk which can cause mental health difficulties.

To determine the long-term psychiatric health of journalists who covered wars in Afghanistan and the Middle East between September 2001 (following 9/11) and 2013 (waning of the Arab Spring uprisings).

Observational, qualitative study involving journalists from CNN, The New York Times, the Washington Post, the Associated Press and National Public Radio. Data collected via study website and Zoom interviews. Of 324 journalists identified, 202 (62.3%) were traceable. Of these, 16 (4.9%) were deceased, 156/186 (83.9%) consented and 30/186 (16.1%) declined participation. Of 156 journalists who provided psychometric data, 99 (63.4%) agreed to interview. Duration of exposure to and severity of risk were recorded. Psychometric data included the General Anxiety Disorder seven-item scale, the nine-item Patient Health Questionnaire, the PTSD Checklist for DSM-5 and the Structured Clinical Interview Schedule for DSM-5 to elicit 12-month and lifetime prevalence of psychiatric diagnoses.

One hundred and twelve (71.8%) were male, mean age was 57.0 (s.d. = 9.75) years and 77/156 (49.4%) spent more than 3 years in war zones. Time in a war zone correlated with risk severity (r = 0.476, p < 0.001). Lifetime and 12-month prevalence of post-traumatic stress disorder (PTSD) 27%/6%; major depression 34%/8%; any anxiety disorder 28%/11%; alcohol use disorder 34%/4%; acute stress disorder 6%/0%; dissociative disorder 2%/0%. Severity of risk predicted lifetime PTSD only (odds ratio 2.55, 95% CI: 1.27–5.14, p = 0.009). Counselling was available to 63/156 (40.4%) journalists while covering conflict.

Journalists who covered wars in Afghanistan, Iraq and elsewhere that began after 9/11 have a high lifetime prevalence of PTSD, major depression, any anxiety disorder and alcohol use disorder; 12-month prevalence for PTSD and any anxiety disorder remains elevated, albeit less so. War journalism is hazardous, and risk severity predicts PTSD, highlighting the importance of therapy availability.

Parental prenatal mood and anxiety disorders (PMADs) are linked to child neurodevelopmental disorders (NDDs), but evaluations of the magnitude and mechanisms of this association are limited. This study estimates the strength of the association and whether it is impacted by genetic and environmental factors.

A systematic search of PubMed, CENTRAL, PsycINFO, OVID, and Google Scholar was performed for articles published from January 1988 to September 2025. Of 2,420 articles screened, 74 met the inclusion criteria. Meta-analyses were conducted on 21 studies, and 53 were included in the narrative synthesis. We conducted random-effects meta-analyses, along with tests for heterogeneity (I2) and publication bias (Egger’s test). The review followed PRISMA and MOOSE guidelines.

Maternal PMADs were associated with a significantly increased risk of attention-deficit/hyperactivity disorder (ADHD; odds ratio [OR] 1.91, 95% confidence interval [CI] 1.45–2.52) and autism spectrum disorder (ASD; OR 1.75, 95% CI 1.43–2.14) in children. Paternal PMADs were also associated with the risk of NDDs, with combined odds for ASD and ADHD (OR = 1.23, 95% CI 1.14–1.33). Several studies suggested that the link between parental PMADs and offspring NDDs might be impacted by both genetic and environmental factors, including the impact of ongoing parental depression on child behavior.

Parental PMADs are associated with increased risk of NDDs in children. These findings likely reflect a combination of inherited liability and environmental processes; clarifying mechanisms will require genetically informed designs. Regardless of mechanism, offering optional, family-centered developmental support may help promote child well-being in families where a parent is experiencing PMADs.

Children displaced by armed conflict are at high risk of experiencing psychological distress. The ongoing war in Gaza has resulted in widespread trauma among Palestinian youth, yet limited data exist on their mental health following displacement. This study assessed the prevalence and correlates of anxiety and depressive symptoms among war-displaced Palestinian refugee children and adolescents resettled in Qatar.

To estimate the prevalence of clinically significant anxiety and depressive symptoms and to identify psychosocial and trauma-related factors associated with symptom severity in this population.

A cross-sectional study was conducted among 350 Palestinian children (aged 8–17 years) residing in a residential compound in Qatar. Symptoms of anxiety and depression were measured using the Screen for Child Anxiety Related Emotional Disorders-Child Version and the Short Mood and Feelings Questionnaire-Child Version, respectively. A Resilience and Demographic Questionnaire was devised to assess trauma exposure and psychosocial variables. Multiple linear regression identified factors associated with symptom severity.

Clinically significant anxiety and depressive symptoms were found in 70.9 and 46.0% of participants, respectively. Separation anxiety was the most common subtype. Female gender, witnessing death, physical injury and disrupted caregiving were significantly associated with worse outcomes.

This study highlights the urgent need for trauma-informed, culturally sensitive mental health services for displaced Palestinian children and young people. While clinical interventions are vital, a sustainable resolution to the conflict is essential to mitigate further psychological harm.

An increase in mental disorders has been suggested, but the interpretation of such trends remains unclear. This study examines changes in the 12-month prevalence of anxiety and mood disorders over 12 years and evaluates whether clinical characteristics or sociodemographic, vulnerability and health-lifestyle risk factors contributed to these trends.

To assess trends in the 12-month prevalence of anxiety disorders (i.e. panic disorder, agoraphobia, social anxiety disorder or generalised anxiety disorder) and mood disorders (major depressive disorder, dysthymia or bipolar disorder) and explore whether changes in clinical profiles or risk factors influenced these trends.

Data from 11 615 respondents (mean age 43.5 years, 53.5% female) in the Netherlands Mental Health Survey and Incidence Studies (NEMESIS) were analysed, covering 2007–2009 (NEMESIS-2, n = 6646) and 2019–2022 (NEMESIS-3, n = 4969). Diagnoses were determined using the Composite International Diagnostic Interview 3.0.

The 12-month prevalence of all anxiety and mood disorders was significantly higher in 2019–2022 compared to 2007–2009, with relative increases across disorders ranging from approximately a half to more than double their previous rates. Any anxiety or mood disorder increased from 10.2 to 16.7%. Clinical profiles were equally severe in 2019–2022; rather, there was increased mental health care use, a higher number of comorbid disorders and earlier onset. Examination of 14 risk factors showed no consistent evidence of greater prevalence or increased relative impact over time.

There was a consistent rise in the 12-month prevalence of anxiety and mood disorders over 12 years. This increase was not explained by changes in risk factors or less severe disorder reporting. Instead, these findings suggest a concerning decline in public mental health, highlighting the need for effective prevention strategies, timely interventions and better mental health resource allocation to address growing clinical demands.

People with severe COVID anxiety have significant fears of contagion, physiological symptoms of anxiety in response to a COVID stimulus and employ often disproportionate safety behaviours at the expense of other life priorities.

To characterise the long-term trajectory of severe COVID anxiety, and the factors that influence recovery.

This prospective cohort study followed 285 people with severe COVID anxiety in the UK over 18 months. A nested randomised feasibility trial tested an online cognitive–behavioural therapy (CBT)-based intervention (no. ISRCTN14973494). Descriptive statistics and linear regression models identified factors associated with change in COVID anxiety over 18 months.

Most participants experienced major reductions in COVID anxiety over time (69.8% relative cohort mean decrease, P < 0.001), but a quarter of people (23.7%, 95% CI: 17.8–30.1) continued to worry about COVID every day, and for 13% symptoms remained severe even after the ending of all public health restrictions. Increasing age, being from a minority ethnic background that confers greater risk from COVID-19, and the persistence of high levels of health anxiety and depressive symptoms, predicted slower improvements in severe COVID anxiety after adjusting for other clinical and demographic factors. Neither a trial CBT-based intervention, nor contextual factors including daily case rates, vaccination status or having contracted COVID-19, appeared to affect the trajectory of severe COVID anxiety.

For most people severe COVID anxiety improves significantly with time. However, interventions treating depression and health anxiety, and targeting older people and those from greater-risk minority backgrounds, warrant further investigation in future pandemics.