This study investigated the architecture and neural activity of white matter functional networks (WMFNs) in individuals with opioid use disorder (OUD) after prolonged abstinence, compared with healthy controls (HCs).

Blood oxygen level-dependent signals in white matter were analyzed using a data-driven k-means clustering approach across individuals with OUD at baseline (OUD1), the same individuals after prolonged abstinence at follow-up (OUD2), and HCs.

In OUD1, the deep frontoparietal network was fragmented into the superior longitudinal fasciculus network and anterior corona radiata network; this organization partially recovered in OUD2, becoming more similar to HCs. OUD1 also showed hyperactivation in the deep frontal network and hypoactivation in the frontotemporal-parietal network, with frontotemporal-parietal activity negatively correlated with years of opioid use.

OUD is associated with disrupted architecture of WMFNs and altered neural activity, whereas prolonged abstinence may promote partial network restoration. These findings highlight the neuroplastic potential of WMFNs during recovery and provide insights into the neural mechanisms underlying OUD and abstinence-related rehabilitation.

Exposure to stress is a well-established risk factor for psychotic experiences, yet the cognitive mechanisms underlying this association remain insufficiently understood. This study examined whether longitudinal changes in cognitive biases mediate the relationship between stress exposure and changes in psychotic-like experiences (PLEs) in the general population sample of adults aged 18–40 years.

Adults without a history of psychiatric treatment were assessed at baseline and at 12-month follow-up. Change-score mediation models with bootstrap confidence intervals were estimated, adjusting for age, gender, and education.

Of 5,126 adults who completed the baseline assessment, 2,290 (44.7%) participated in the follow-up. Greater stress exposure predicted increases in PLEs, negative, and depressive symptoms. After correction for multiple testing, significant indirect effects consistent with mediation by cognitive biases were observed for PLEs, but not for negative or depressive symptoms. These effects were significant for changes in belief inflexibility, safety behaviors, external attribution, and subjective cognitive and social cognitive problems, but not for attention to threat or jumping to conclusions. Reverse mediation models indicated consistently smaller indirect effects. In parallel multiple-mediator models, no individual bias showed a unique indirect effect on PLEs, yet the total indirect effect remained significant, suggesting mediation through interrelated biases. Social cognitive problems emerged as the only bias with a specific indirect effect on negative and depressive symptoms.

Longitudinal changes in cognitive biases might represent an indirect pathway to the association between stress exposure and increases in PLEs. These findings highlight cognitive biases as potential targets for preventive interventions.

Population-based longitudinal evidence using administrative healthcare registries remains limited. We aimed to estimate the burden and temporal trends of major depressive disorder (MDD) among individuals aged ≥65 in Lombardy, Italy, 2013 to 2023.

We conducted a retrospective population-based longitudinal study using multi-source administrative healthcare registries (Lombardy region, Italy), including an open cohort of individuals aged ≥65 years. Incident and prevalent MDD cases were identified from 2013 to 2023, through an algorithm combining hospital discharge records, administrative exemptions, long-term care facility admissions and community psychiatric services. Age-standardised incidence rates per 100,000 person-years and annual prevalence (%) were estimated overall, by sex and age, using the age-truncated (≥65) WHO standard population. Annual percent changes (APCs) and 95% confidence intervals (CIs) were estimated by Poisson regressions.

We identified 19,851 incident MDD cases during the study period. Age-standardised incidence declined from 126.5/100,000 person-years (95% CI 121.7–131.3) in 2013 to 50.6 (47.6–53.7) in 2023, with an APC of 10.8% (−11.8 to −9.7). Age-standardised annual prevalence decreased from 0.94% (0.93–0.95) in 2013 to 0.63% (0.62–0.64) in 2023, corresponding to an annual decline of 3.0% (−4.7 to −1.3). Rates were higher among females. Burden and trends did not differ significantly by sex but across age groups, with the largest reductions among individuals aged 80 years or older.

Administrative data capture clinically diagnosed MDD within the healthcare system, rather than the broader burden in the community. Comparable epidemiological estimates are needed to interpret trends across different settings.

People with severe mental illness (SMI) experience significant health inequalities, but long-term trajectories of physical multimorbidity and their association with mortality remain poorly understood.

To identify distinct trajectories of physical comorbidity burden within people with SMI and evaluate their associated mortality risks.

This retrospective cohort study included 64 962 patients with a first recorded SMI diagnosis in primary care, followed for up to 10 years. Joint latent class modelling was applied to jointly model annual Charlson Comorbidity Index (CCI) measurements and all-cause mortality, identifying latent trajectory groups with distinct comorbidity burden progression and survival profiles. Subsequently, multivariable Cox regression was used to estimate adjusted mortality risks across identified trajectories, and multinomial logistic regression was used to identify baseline clinical indicators of trajectory membership.

Over a median follow-up of 4.75 years (interquartile range 2.50–8.45 years), there were 5932 deaths (9.1%). Four distinct trajectory groups were identified: ‘increase stable’ (2.6%), ‘persistent high’ (5.1%), ‘persistent low’ (89.9%) and ‘rapid increase’ (2.5%). Compared with the persistent-low reference group, adjusted hazard ratios for mortality were 4.11 (95% CI 3.75–4.50) for the increase-stable group, 2.83 (95% CI 2.62–3.07) for the persistent-high group and 11.33 (95% CI 10.54–12.18) for the rapid-increase group. Older age (≥65 years) and the use of medications for hypertension, diabetes and obstructive airway disease were strong indicators of belonging to the higher-risk trajectories, with the multinomial regression model showing good discrimination of trajectory membership (overall area under the curve 0.78).

Patients with SMI in primary care exhibit heterogeneous trajectories of CCI-defined comorbidity burden, with each trajectory associated with a different mortality risk. Routinely collected primary care indicators may support early identification of patients likely to follow higher-risk trajectories; however, prospective validation remains essential before implementing risk-stratified interventions in practice.

Gaming disorder (GD), i.e., persistent problematic gaming with clinically significant impairment, is a growing concern; however, estimates of GD in representative adolescent samples are limited. This study aimed to examine GD prevalence, incidence, persistence, and risk factors for different epidemiological parameters across 6 years, covering pre- to post-COVID-19 pandemic.

Population-based longitudinal data, including 3358 German adolescents, were collected annually from 2019 to 2024 using online surveys. GD prevalence estimates were assessed by standardized International Classification of Diseases (ICD-11)-based self-report questionnaires. Between-wave persistence and incidence of GD, sociodemographic data, gaming time, and stress perception were measured. Risk factors for incidence and persistence of GD were examined using generalized-estimating equation (GEE) models.

GD prevalence doubled from 2.9% in 2019 to 6.5% in 2023 and remained above prepandemic levels in 2024 (3.9%). Males showed higher prevalence estimates compared to females across most waves, and prevalence peaked in 2023 (8%). For females, GD prevalence doubled between 2019 (1.7%) and 2020 (3.4%), peaked in 2022 (6.1%), and declined thereafter. The incidence of GD increased during the pandemic. According to GEE models, male sex, higher perceived stress, and longer gaming times were risk factors for GD incidence; older age and higher education were protective factors. The persistence of GD reached its peak in 2020 (36.2%). Significant risk factors for GD persistence were higher stress perception and longer gaming time.

Prevalence and incidence rates indicate that GD continues to be a significant concern, and pandemic-related increases affected both males and females. Prevention and intervention programs should target identified risk groups.

Longitudinal investigation of brain alterations in children putatively at risk of developing schizophrenia may identify early markers of pathophysiology associated with vulnerability for the disorder.

Children aged 9–12 years with multiple antecedents of schizophrenia (psychotic-like experiences; speech and/or motor delays; and social, emotional, and/or behavioral difficulties; ASz, n = 31), with a family history of schizophrenia/schizoaffective disorder (FHx, n = 21), and typically developing children (TD, n = 35) were recruited through community screening using questionnaires. T1-weighted structural MRI scans were obtained at baseline and after approximately 2 and 4 years of follow-up, and processed using the FreeSurfer longitudinal pipeline. Across these 3 assessment waves, total gray matter (GM) and white matter (WM) volume, and regional GM volumes in 12 regions of interest, were compared among the groups using linear mixed models.

Children were aged 11.21 (±1.61) years at baseline and the average lapse-of-time between each assessment was 1.76 (±0.36) years. The ASz group exhibited consistently higher total WM volume (b = 29.45) compared to the TD group, with no statistically significant time-related volumetric WM or GM differences in any region. The FHx group also demonstrated higher total WM volume (b = 36.49), and time-related total and regional GM volume changes were observed; however, these effects were attenuated after correction.

Global and regionally specific brain abnormalities distinguished children with different risk profiles for schizophrenia relative to their typically developing peers. Follow-up is required to determine how these changes may relate to later schizophrenia.

The COVID-19 pandemic raised concerns about the mental health of an already burdened healthcare workforce. This study examined mental health trajectories among healthcare workers (HCWs) across the pandemic and identified personal and employment factors associated with different symptom patterns.

Longitudinal data were drawn from the NHS CHECK cohort, including clinical and non-clinical staff from 18 NHS Trusts in England (April 2020–April 2023). Growth curve and growth mixture models identified latent classes of HCWs characterized by distinct trajectories of probable common mental disorders. Secondary outcomes included anxiety, depression, alcohol misuse, and post-traumatic stress symptoms. Logistic regression examined associations between baseline personal and employment characteristics and class membership.

The analytical sample included 22,764 participants. For each outcome, growth mixture models identified two latent classes. Approximately 31% of HCWs experienced persistently high symptoms of probable common mental disorders, while 69% experienced persistently low symptoms. Similar patterns were observed for secondary outcomes, with small subgroups demonstrating worsening symptoms followed by improvement. Logistic regression analyses showed that being female, younger, single, working as a nurse, or having a pre-existing mental health diagnosis increased the odds of belonging to a high symptom class. Perceived support from colleagues and managers was protective.

While many HCWs reported consistently low mental health symptom levels, almost a third belonged to a latent class characterized by persistently high symptoms across all time points. These findings underscore the need for mental health support for vulnerable HCW groups, embedded within routine NHS practice rather than limited to crisis periods.

Parental alcohol supply in early childhood may increase the risk of alcohol use in late adolescence. This study examined its longitudinal impact and the distinct roles of mothers’ and fathers’ drinking.

We studied 1,891 mother–child pairs from the Czech European Longitudinal Study of Pregnancy and Childhood. Mothers reported parental alcohol supply at ages 3, 5, 7, and 11 years, while adolescent alcohol use was reported by mothers, pediatricians, and youth at ages 18 and 19 years. Structural equation modeling assessed the longitudinal link between early alcohol supply (three classes: none, occasional, and frequent) and adolescent alcohol use, accounting for parental drinking and covariates, including the child’s sex, mother’s education, and family structure.

Alcohol supply began in early childhood, with 14% of children exposed by age 3 and around 20% by age 11. By age 19, one-third of individuals reported frequent alcohol use. Adolescents’ alcohol use was associated with concurrent mothers’, but not fathers’ alcohol use (β = .24, p < .001). Early alcohol supply predicted higher adolescent use for both occasional (β = .14, p = .041) and frequent (β = .22, p = .005) classes. Mothers’ and fathers’ alcohol use at 6 months was associated with frequent alcohol supply, and fathers’ alcohol use was also associated with occasional alcohol supply. Significant indirect effects were found from early parental drinking to adolescent use via these classes.

Public health messaging should emphasize the risks of early alcohol consumption, including its potential harm to the developing brain.

Depression is often comorbid with alcohol use problems, and sex differences may further complicate this interplay.

We conducted a longitudinal study using a large European adolescent cohort assessed at ages 14 (baseline, BL), 16 (follow-up 1, FU1), 19 (follow-up 2, FU2), and 23 (follow-up 3, FU3). Depression and alcohol use were measured using standardized behavioral scales. Cross-lagged analysis, improved Mendelian randomization (MR) analysis, and mediation analysis were conducted to infer the causal interplay.

2110 adolescents were included at baseline (49% male). Depression and alcohol consumption demonstrated a significant positive correlation (rBL = 0.094, pBL = 1.58E-05, 95% CI = [0.052, 0.137]), which gradually diminished over time and eventually became significantly negative. Depression and alcohol use problems remained strongly correlated across three timepoints (r > 0.074, p < 6.76E-03). Cross-lagged analysis suggested that depression predicted future alcohol use problems: βBL-FU1 = 0.058, p = 0.021, 95% CI = [0.009, 0.108]; βFU2-FU3 = 0.142, p = 8.34E-07, 95% CI = [0.113, 0.263]. MR analyses confirmed this causal interplay (rmean = 0.043, longitudinal ppermuation < 0.001). Interestingly, MR analyses also indicated that alcohol consumption might alleviate depression (rmean = −0.022, longitudinal ppermutation = 0.043), particularly in females at FU3, of which the anxiety status and the personality trait neuroticism largely mediated the effect. These findings were validated in an independent matched sample (N = 562) from Human Connectome Project.

Depression may predict future alcohol use problems, whereas moderate alcohol consumption might alleviate depressive symptoms, especially in females.

While prenatal exposure to tobacco has been associated with adolescent suicide attempt, little is known about the mechanisms explaining this association. This study aims to explore the mediating roles of internalizing symptoms, externalizing behaviors, and peer problems across childhood in the association between prenatal exposure to tobacco and adolescent suicide attempt.

We analyzed data from N = 8,861 participants from the Millennium Cohort Study followed from ages 9 months to 17 years. Binary logistic regression models were used to investigate the total association between exposure to tobacco in pregnancy and suicide attempt, and mediation analyses were conducted using structural equation models to investigate the direct and indirect associations.

In models adjusted for key covariates, we found a significant association between prenatal tobacco exposure and increased risk of adolescent suicide attempts (odds ratio = 2.08, 95% confidence interval = [1.68, 2.56]), partly mediated through internalizing problems, externalizing behaviors, and peer problems from ages 3 to 14 years (accounting for 37% of the total association, that is, 16%, 12%, and 9%, respectively).

These findings suggest that interventions targeting mental health symptoms and peer problems may maximize suicide prevention efforts among children who were prenatally exposed to tobacco, thus potentially reducing the long-term risk of suicide attempt.

Attention-deficit hyperactivity disorder (ADHD) in childhood is associated with various adverse long-term outcomes.

We aimed to examine the independent associations between ADHD symptoms at age 14–16 years and long-term mental health and psychosocial functioning outcomes in a 40-year birth cohort study.

Study members from the Christchurch Health and Development Study, a population-based New Zealand birth cohort study (N = 1265 at birth) were followed to age 40 years. Generalised estimating equations were used to model associations between ADHD symptoms at age 14–16 years and outcomes at age 18–40. Adjusted models were fitted to account for confounding by antecedent individual and familial risk factors, and coexisting symptoms of conduct disorder or oppositional defiant disorder.

Adolescents in the highest quartile for ADHD symptoms at age 14–16 years were at elevated risk of substance use disorder, depression, suicidal ideation, criminal offending and unemployment across early adulthood. They also had lower income, home ownership, relationship stability and living standards. The size of these associations attenuated after adjusting for confounding factors and the effect of coexisting conduct disorder and oppositional defiant disorder. However, in adjusted models, ADHD symptoms remained associated with elevated odds of substance use and criminal offending outcomes, with odds ratios ranging from 1.4 to 1.6.

Higher levels of adolescent ADHD symptoms are associated with substance use problems and criminal offending in adulthood. Long-term secondary prevention activities are needed to detect and manage coexisting problems among adults with a history of ADHD.

The COVID-19 pandemic has placed unprecedented strain on global health systems, significantly affecting both the physical and emotional well-being of populations. Nursing students represent a particularly vulnerable group due to the pandemic’s impact on their mental health and academic progression. This study aims to assess the level of resilience among Spanish university nursing students during the pandemic.

A longitudinal study was conducted with 361 nursing students from March to October 2020. Self-report questionnaires measured emotional intelligence, resilience, anxiety, depression, optimism, and self-efficacy during the first and second COVID-19 waves. Analyses included descriptive statistics, Spearman’s correlations, and hierarchical multiple regression.

Resilience slightly decreased from March to October 2020, while anxiety increased and depression remained stable. Resilience was positively correlated with optimism, self-efficacy, and emotional intelligence, particularly emotion regulation. Higher resilience was predicted by not living alone, greater optimism, and stronger emotion regulation skills.

Spanish nursing students showed variable resilience during COVID-19, positively associated with optimism, self-efficacy, emotional intelligence, and mental health factors like anxiety and depression. Findings highlight the psychological impact of the pandemic and support resilience-focused interventions in nursing education.

Financial strain is increasingly recognised as a contributor to psychological distress, which may in turn elevate the risk of developing mental disorder. However, few large-scale longitudinal studies have investigated its predictive role using diagnostic outcomes among higher education students.

To examine whether financial strain predicts a major depressive episode (MDE) one year later among Norwegian students, and whether associations are explained by sociodemographic factors or baseline psychological distress.

Data were drawn from the national Students’ Health and Wellbeing Study 2022 (SHoT2022) survey (N = 53 362), with a diagnostic follow-up one year later (N = 10 460) using the self-administered Composite International Diagnostic Interview version 5.0 (CIDI 5.0). Inverse probability weighted Poisson regression with robust standard errors estimated the risk of 30-day DSM-5-defined MDE for each financial indicator.

Financial strain was widespread: 6% reported frequent financial difficulties, 27% were unable to cover an emergency expense of 5000 Norwegian kroner (NOK; approximately €450/$500, and 35% spent 60% or more of their income on housing. Several indicators significantly predicted later MDE. Students frequently experiencing financial difficulties had a 3.55-fold increased risk (95% CI:2.97–4.22), attenuating to 1.53 (1.28–1.83) after full adjustment. Similar patterns emerged for most indicators. Associations were largely unaffected by sociodemographic adjustment, but were substantially reduced after accounting for baseline psychological distress.

Financial strain was associated with increased risk of MDE one year later, although much of the association was explained by baseline distress. Policies should address both financial and psychological vulnerabilities through strengthened financial support, alignment with living costs and targeted measures such as financial counselling and housing assistance.