Hybrid care is increasingly used for chronic disease management, yet how patients are allocated to these modalities in routine practice remains poorly understood.

To characterize baseline factors associated with physician-driven allocation to hybrid versus in-person care and examine three-year clinical outcomes.

This retrospective observational cohort included adults with hypertension, type 2 diabetes, and/or dyslipidemia enrolled in a programme in Alma Mater Hospital of Antioquia, Medellín, Colombia (2019–2025). Care modality was determined by treating physicians. Associations between baseline clinical, functional–behavioural, and psychosocial characteristics, care allocation, and follow-up outcomes were examined using logistic regression and interpreted as associational rather than causal.

Among 638 participants (319 hybrid; 319 in-person), higher baseline glycated haemoglobin (HbA1c) (adjusted odds ratio [aOR] 2.68 per 1% increase; 95% CI 2.17–3.31) and inadequate medication adherence (aOR 1.96; 95% CI 1.17–3.28) were associated with hybrid care allocation, whereas higher educational attainment was inversely associated (middle vs low: aOR 0.43; 95% CI 0.25–0.72; high vs low: aOR 0.19; 95% CI 0.10–0.33). A strong gradient was observed in the secondary complexity analysis. Hybrid care was associated with higher three-year therapeutic goal attainment (OR 7.34; 95% CI 4.96–10.86) and lower chronic disease-related emergency department utilization (OR 0.53; 95% CI 0.36–0.79).

Hybrid care allocation was systematically associated with baseline clinical and contextual characteristics. Outcome differences should be interpreted cautiously given clinician-driven allocation and baseline differences.

Psychosocial factors represent modifiable targets relevant to alleviate depression risk. While individual psychosocial risks are well-documented, their combined status across multiple life domains is underexplored. We aimed to construct a novel multidimensional composite score of psychosocial status and explore its association with incidence of depression.

A total of 336,922 individuals (mean age 56.21 years) without depression at baseline from the UK Biobank were included. Psychosocial status was assessed across four dimensions (recent stressful events, current psychiatric symptoms, social contact and socio-economic status) using 18 factors. A composite psychosocial score was constructed by weight effect of each factor, with higher values indicating lower level of psychosocial status. Using Cox proportional hazards models to evaluate the associations between individual psychosocial factor, psychosocial score and the risk of depression.

During a median follow-up of 13.60 years, 14,806 depression cases were identified. Low household income, recent depressive symptoms, loneliness and financial difficulties emerged as the most significant predictors of depression across four domains, with hazard ratios (HRs) of 3.82 (95% confidence intervals [CIs]: 3.43–4.26), 3.09 (2.99–3.19), 2.46 (2.37–2.54) and 1.96 (1.88–2.04), respectively. Each one-point increase in the psychosocial score was associated with a 42% higher depression risk. Compared to individuals with high psychosocial status, those in the medium- and low-level groups had an adjusted HR of 1.71 (95% CI: 1.62–1.81) and 4.36 (95% CI: 4.15–4.58), respectively.

These findings highlight that psychosocial factors collectively represent modifiable targets for preventing depression, with interventions addressing the combined status of these domains likely offering greater impact than focusing on isolated factors.

Psychotic-like experiences (PLEs) are common in adolescence and often associated with later mental health difficulties. Although many psychosocial factors are related to PLEs, little is known about how these factors interact over time. Longitudinal network analysis allows examination of the stability of symptom associations and identification of potential intervention targets. This study investigated the structure and temporal stability of PLE networks in a large community-based adolescent cohort.

Adolescents aged 13–19 years (N = 605 with complete data across all time points) completed assessments at baseline, 12 months, and 24 months. Measures included positive and negative PLEs, cognitive biases, depression, anxiety, trauma, and interpersonal sensitivity. Networks were estimated at each time point, and permutation-based tests were used to compare network structure and overall connectivity across time. Centrality stability was assessed using bootstrapping procedures.

Network structures were stable across the 2-year period, with no significant differences in overall organization or connectivity between time points. Depression consistently showed the highest centrality, followed by anxiety and attributional bias. Positive PLEs were most strongly associated with anxiety, while negative PLEs showed their strongest associations with depression. Attributional bias remained centrally positioned and was strongly linked to trauma. All networks showed robust accuracy and high stability.

Despite considerable developmental change during adolescence, the psychosocial architecture of PLEs remained notably stable. Depression, anxiety, and attributional biases emerged as consistent key nodes, highlighting them as promising targets for prevention and early intervention in adolescents at risk for persistent PLEs.

Psychotic-like experiences (PLEs), especially for persistent PLEs, are highly predictive of subsequent mental health problems. Hence, it is crucial to explore the psychopathological associations underlying the occurrence and persistence of PLEs. This study aimed to explore the above issues through a longitudinal dynamic network approach among PLEs and psychological and psychosocial factors.

A total of 3,358 college students completed two waves of online survey (from Oct 2021 to Oct 2022). Socio-demographic information was collected at baseline, and PLEs, depressive and anxiety symptoms, and adverse life events were assessed in both waves. Cross-lagged panel network analyses were used to establish networks among individuals with baseline PLEs as well as those without.

At baseline, 455(13.5%) students were screened positive for PLEs. Distinct dynamic network structures were revealed among participants with baseline PLEs and those without. While ‘psychomotor disturbance’ had the strongest connection with PLEs in participants with baseline PLEs, ‘suicide/self-harm’ was most associated with PLEs in those without. Among all three subtypes of PLEs, bizarre experiences and persecutory ideation were the most affected nodes by other constructs in participants with baseline PLEs and those without, respectively. Additionally, wide interconnections within the PLEs construct existed only among participants without baseline PLEs.

The study provides time-variant associations between PLEs and depressive symptoms, anxiety symptoms, and adverse life events using network structures. These findings help to reveal the crucial markers of the occurrence and persistence of PLEs, and shed high light on future intervention aimed to prevent and relieve PLEs.

A large and accumulating body of evidence shows that loneliness is detrimental for various health and well-being outcomes. However, less is known about potentially modifiable factors that lead to decreased loneliness.

We used data from the Health and Retirement Study to prospectively evaluate a wide array of candidate predictors of subsequent loneliness. Importantly, we examined if changes in 69 physical-, behavioral-, and psychosocial-health factors (from t0;2006/2008 to t1;2010/2012) were associated with subsequent loneliness 4 years later (t2;2014/2016).

Adjusting for a large range of covariates, changes in certain health behaviors (e.g. increased physical activity), physical health factors (e.g. fewer functioning limitations), psychological factors (e.g. increased purpose in life, decreased depression), and social factors (e.g. greater number of close friends) were associated with less subsequent loneliness.

Our findings suggest that subjective ratings of physical and psychological health and perceived social environment (e.g. chronic pain, self-rated health, purpose in life, anxiety, neighborhood cohesion) are more strongly associated with subsequent loneliness. Yet, objective ratings (e.g. specific chronic health conditions, living status) show less evidence of associations with subsequent loneliness. The current study identified potentially modifiable predictors of subsequent loneliness that may be important targets for interventions aimed at reducing loneliness.

Love of life as a positive evaluation of one‘s own life plays an important role in developing a person’s positive outlook on their own wellbeing.

Our goal is to define the nature of interrelations between manifestations of love of life and some psychosocial factors of health in university students.

Using the English version of the Love of Life Scale (Ahmed M. Abdel-Khalek) and the Sociocultural Health Questionnaire (E. Nikolaev), we carried out an online survey of 136 university students of both genders. A correlation analysis helped to define the interrelations.

We established that a high level of the overall rate of Love of Life, on the one hand, corresponds to high self-evaluation of a person’s health (r=.31, p<.05) and happiness (r=.47, p<.05). On the other hand, it correlates with a high level of anti-suicidal barrier (r=.20, p<.05) and low frequency of headaches (r=-.18, p<.05). Students’ desire for a long life, which would enable to achieve everything they have been dreaming of, correlates with low weight (r=-.18, p<.05). A low level of stress is connected with a greater feeling of love in life (r=-.22, p<.05) and its perception as something beautiful and fascinating (r=-.29, p<.05). Better understanding of life correlates with lower frequency of smoking (r=-.19, p<.05).

A psychological construct of Love of life, due to its negative correlations with the health risk factors has a great positive potential for a personality development and their health. It can serve as a target for a psychological impact in interventions.

No significant relationships.

The present study aimed to investigate the outcomes of psychiatric symptoms and family functions on treatment adherence in children, in addition to sociodemographic characteristics and clinical factors related to the disease.

The research sample consisted of 43 children who were followed up with rheumatic heart disease diagnosis during the study. Clinical features were obtained from the patient files. The family assessment device evaluating family functioning and the strengths and difficulties questionnaire scale to screen emotional and behavioural problems in children were used.

Considering the regularity of treatment in our patients, there were 31 (72%) patients adherent to secondary prophylaxis regularly, 7 (6.9%) patients were partially adherent, and 5 (11.6%) patients non-adherent. Patients were divided into treatment adherent (Group 1) and non-adherent (Group 2). There was no statistically significant impact on treatment adherence whether the patients receive enough information, lifestyle, fear of developing adverse effects, fear of addiction, lack of health insurance, difficulties in reaching the drug or hospital. However, the fear of syringes on treatment adherence had an effect statistically significantly (p = 0.047). Forgetting to get a prescription and/or take the drug when the time comes was statistically higher in the non-adherent group (p = 0.009). There was no statistically significant effect of psychosocial factors on treatment adherence between groups.

Providing an effective active recall system, involving primary care workers, providing training on the disease and its management, and a comprehensive pain management programme can improve the process, especially for cases where secondary prophylaxis is missed.

A proportion of patients with bipolar disorder (BD) manifests with only unipolar mania (UM). This study examined relevant clinical features and psychosocial characteristics in UM compared with depressive-manic (D-M) subgroups. Moreover, comorbidity patterns of physical conditions and psychiatric disorders were evaluated between the UM and D-M groups.

This clinical retrospective study (N = 1015) analyzed cases with an average of 10 years of illness duration and a nationwide population-based cohort (N = 8343) followed up for 10 years in the Taiwanese population. UM was defined as patients who did not experience depressive episodes and were not prescribed adequate antidepressant treatment during the disease course of BD. Logistic regression models adjusted for relevant covariates were used to evaluate the characteristics and lifetime comorbidities in the two groups.

The proportion of UM ranged from 12.91% to 14.87% in the two datasets. Compared with the D-M group, the UM group had more psychotic symptoms, fewer suicidal behaviors, a higher proportion of morningness chronotype, better sleep quality, higher extraversion, lower neuroticism, and less harm avoidance personality traits. Substantially different lifetime comorbidity patterns were observed between the two groups.

Patients with UM exhibited distinct clinical and psychosocial features compared with patients with the D-M subtype. In particular, a higher risk of comorbid cardiovascular diseases and anxiety disorders is apparent in patients with D-M. Further studies are warranted to investigate the underlying mechanisms for diverse presentations in subgroups of BDs.

The growing prevalence of severe cognitive impairment in populations, the involvement of a significant number of people of working age in the medical, psychological and social problems associated with dementia, the insufficiency and inconsistency of information about the mechanisms of formation of these disorders actualize a comprehensive social study of dementia.

the psychosocial mechanisms of the formation of clinical, functional disorders in dementia, to develop comprehensive medical and psychosocial programs to help patients with dementia and those involved in caring for them, based on the proposals of the psychosocial model of dementia

A selective observational comparative dynamic study of 315 people with Alzheimer’s dementia and 214 people who care for the patients was carried out.

Changes in family-role and social parameters, a high level of “expressed” emotions of caregivers have an adverse effect on the development of psychotic (r = 0.618), affective (r = 0.701), behavioral (r = 0.837) dementia disorders. The degree of adherence to anti-dementia therapy by the caregiver is one of the important factors determining the amount of care received by the patient (r = 0.698). Agitation / aggression (r = 0.761), anxiety (r = 0.562), sleep disturbances (r = 0.521) contribute to increased compliance. The low satisfaction of the caregiver with premorbid (r = 0.698) and current (r = 0.653) relationships with the patient leads to a decrease in the compliance of the caregiver.

The mechanism of psychopathological symptoms, functional disorders is heterogeneous, depending on the biological causes and psychosocial conditions of functioning of patients.

No significant relationships.

To assess ultra-processed food (UPF) consumption and its socio-demographic, psychosocial and behavioural correlates in a general population of Italian children, adolescents and adults.

Cross-sectional telephone-based survey

Italy, 2010–2013.

In total, 9078 participants (5–97 years) from the Italian Nutrition & Health Survey. Dietary intakes were collected by a 1-d 24-h dietary recall. UPF was defined by the NOVA classification and expressed as percentage of total energies.

Average energy intake from UPF (95 % CI) was 17·3 % (17·1 %, 17·6 %) among adults and 25·9 % (24·8 %, 27·0 %) in children/adolescents. Top sources of UPF were processed meats (32·5 %) and bread substitutes (16·7 %). Among adults, age (β = −3·10; 95 % CI (−4·40, −1·80) for >65 years v. 20–40 years; βs are dimensionless) and residing in Southern Italy (β = −0·73; 95 % CI (−1·32, −0·14) v. Northern) inversely associated with UPF. Screen view during meals was directly linked to UPF, as well as poor self-rated health (β = 5·32; 95 % CI (2·66, 7·99)), adverse life events (β = 2·33; 95 % CI (1·48, 3·18)) and low sleep quality (β = 2·34; 95 % CI (1·45, 3·23)). Boys consumed two-point percent more UPF of the total energy than girls (β = 2·01; 95 % CI (0·20, 3·82)). For all ages, a Mediterranean diet was inversely associated with UPF (β = −4·86; 95 % CI (−5·53, −4·20) for good v. poor adherence in adults and (β = −5·08; 95 % CI (−8·38, −1·77) for kids).

UPF contributes a modest proportion of energy to the diets of Italian adults while being one-quarter of the total energies in children/adolescents. UPF was associated with several psychosocial factors and eating behaviours. Increased adherence to Mediterranean diet would possibly result in lower UPF consumption.

Depressive disorders (DD) in adolescence are often misdiagnosed and under-recognised. A major clinical problem regards the high rate of co-morbidity with other disorders, namely substance abuse. The aim of this study was to assess the discriminative power of the Beck Depression Inventory II (BDI-II) to characterise specific social–demographic variables related to DD in adolescence.

A Portuguese version of the BDI-II and a social–demographic questionnaire were administered to 775 Portuguese adolescents (312 males, 463 females; mean age: 16.9 years); 83 adolescents performed a clinical interview following DSM-IV criteria.

Mean BDI-II Portuguese version (BDI-II-P) total score was 10.31 (standard deviation: 8.4), with females reporting more depressive symptoms than males (P < 0.001). Low academic achievement, sleep disturbances, and alcohol consumption were consistently associated with depressive symptoms for both genders. Higher tobacco consumption was significantly associated with depressive symptoms in females. Familial factors did not appear to be associated with depressive symptoms in males. However, a higher frequency of siblings, having separated parents as well as a more extreme perception of the mother's educational style were consistently associated with depressive symptoms in females.

The BDI-II-P showed discriminative power to characterise social–demographic variables related to DD especially in adolescent females.

Little is known about the precursors of suicide risk among primary-care patients. This study aimed to examine suicide risk in relation to patterns of clinical consultation, psychotropic drug prescribing, and psychiatric diagnoses.

Nested case-control study in the Clinical Practice Research Datalink (CPRD), England. Patients aged ⩾16 years who died by suicide during 2002–2011 (N = 2384) were matched on gender, age and practice with up to 20 living control patients (N = 46 899).

Risk was raised among non-consulting patients, and increased sharply with rising number of consultations in the preceding year [⩾12 consultations v. 1: unadjusted odds ratio (OR) 6.0, 95% confidence interval (CI) 4.9–7.3]. Markedly elevated risk was also associated with the prescribing of multiple psychotropic medication types (⩾5 types v. 0: OR 62.6, CI 44.3–88.4) and with having several psychiatric diagnoses (⩾4 diagnoses v. 0: OR 31.1, CI 19.3–50.1). Risk was also raised among patients living in more socially deprived localities. The confounding effect of multiple psychotropic drug types largely accounted for the rising risk gradient observed with increasing consultation frequency.

A greater proportion of patients with several psychiatric diagnoses, those prescribed multiple psychotropic medication types, and those who consult at very high frequency might be considered for referral to mental health services by their general practitioners. Non-consulters are also at increased risk, which suggests that conventional models of primary care may not be effective in meeting the needs of all people in the community experiencing major psychosocial difficulties.

Weight self-perceptions, or how a person perceives his/her weight status, may affect weight outcomes. We use nationally representative data from 1988–1994 and 1999–2008 to examine racial/ethnic disparities in weight self-perceptions and understand how disparities have changed over time.

Using data from two time periods, 1988–1994 and 1999–2008, we calculated descriptive statistics, multivariate logistic regression models and predicted probabilities to examine trends in weight self-perceptions among Whites, Blacks, US-born Mexican Americans and Mexican immigrants to the USA.

National Health and Nutrition Examination Survey (NHANES) III (1988–1994) and continuous NHANES (1999–2008).

Adult NHANES participants aged 18 years and older (n 37 050).

The likelihood of self-classifying as overweight declined between 1988–1994 and 1999–2008 among all US adults, despite significant increases in mean BMI and overweight prevalence. Trends in weight self-perceptions varied by gender and between racial/ethnic groups. Whites in both time periods were more likely than racial/ethnic minorities to perceive themselves as overweight. After adjustment for other factors, disparities in weight self-perceptions between Whites and Blacks of both genders grew between survey periods (P<0·05), but differences between overweight White women and Mexican immigrants decreased (P<0·05).

Weight self-perceptions have changed during the obesity epidemic in the USA, but changes have not been consistent across racial/ethnic groups. Secular declines in the likelihood of self-classifying as overweight, particularly among Blacks, are troubling because weight self-perceptions may affect weight-loss efforts and obesity outcomes.