Background: Comprehensive geriatric assessment (CGA) is a widely recommended, multidimensional approach for guiding clinical decision-making and management in older adults. However, its implementation remains limited by a shortage of geriatric specialists, the complexity of geriatric care, and the increasing demands of an aging population. Mobile self-administered tools offer a potential strategy to expand access to multidimensional geriatric evaluation, particularly in resource-limited settings. Objective: This study aimed to evaluate the feasibility and agreement of a mobile self-administered CGA screening tool compared with geriatrician-administered assessments among inpatient and outpatient older adults in Brazil. Methods: This cross-sectional study included 80 older adults recruited from inpatient and outpatient geriatric clinics in Brasília, Brazil. Participants completed a mobile CGA, which incorporated validated instruments covering functional status (Vulnerable Elders Survey–13 [VES-13]), cognition (Cognitive Change Questionnaire–8 [CCQ-8]), depressive symptoms (5-item Geriatric Depression Scale [GDS-5]), nutritional status (Mini Nutritional Assessment [MNA]), frailty (G8 screening tool), social support (Gijón Scale), falls, and vision and hearing. Within 48 hours, a geriatrician independently performed a geriatrician-administered CGA using the same instruments. Agreement between the 2 assessment methods was evaluated using Wilcoxon signed-rank tests, Spearman correlation coefficients, intraclass correlation coefficients (ICCs), and Cohen κ coefficients for categorical variables. Results: Participants had a mean age of 70 (SD 7) years; 58.8% (47/80) were female, and 65% (52/80) had ≤8 years of education. The mean completion time for the self-administered CGA was 18.5 (SD 7.5) minutes. Most participants rated the tool as easy or very easy to use (65/80, 81.3%) and reported satisfaction with the assessment process (n=79, 98.8%). High concordance was observed between the self-administered and geriatrician-administered CGA versions for most domains. Cohen κ coefficients demonstrated strong agreement for falls (κ=0.878; <.001), hearing impairment (κ=0.826), and vision impairment (κ=0.634). No significant differences were observed between the 2 assessment methods for functional status (VES-13), frailty screening (G8), depressive symptoms (GDS-5), and cognition (CCQ-8). Nutritional status and social vulnerability showed lower concordance than other CGA domains. Among inpatients, significant discrepancies were identified in both nutritional scores and Gijón social risk scores (≤.05), with participants reporting greater perceived vulnerability. For outpatients, significant differences were observed for nutritional status (MNA; P=.02) and frailty screening (G8; P=.046). Conclusions: A mobile self-administered CGA demonstrated good feasibility, high user satisfaction, and substantial agreement with geriatrician-administered assessments across multiple geriatric domains. The tool may support geriatric screening and triage in settings with limited specialist availability, particularly when used as a complement to comprehensive clinical assessment.
Background: Rejoyn (CT-152) is a prescription digital therapeutic (DTx) adjunct to antidepressive medication authorized for patients with major depressive disorder. To better understand the patient benefit of DTx and other treatment modalities, current regulatory standards support the use of modern psychometric methods to interpret the clinical meaningfulness of treatment effects for patients. In the primary analysis of Rejoyn from the pivotal phase 3 Mirai trial (NCT04770285), Rejoyn showed a broad risk-to-benefit profile as demonstrated on multiple clinician- and patient-rated scales, including the primary efficacy outcome measure, the Montgomery-Åsberg Depression Rating Scale (MADRS). These findings supported US Food and Drug Administration authorization of Rejoyn as a prescription DTx. However, the clinical relevance of these changes in the MADRS score is not immediately interpretable in clinical practice. Here, we present the results from several post hoc analyses of the Mirai trial data to support the interpretation of clinically meaningful treatment differences on clinician- and patient-reported change in depressive symptoms. Objective: This study had two main objectives: (1) establish threshold parameters that allow for clinically meaningful interpretation of the Mirai results in clinical practice, based on the clinical trial end points of change from baseline in depressive symptoms, and (2) apply this threshold in a responder and sensitivity analysis in the intent-to-treat (ITT) population (which is more frequently reported in pharmacological trials) to further support the interpretation of change in unblinded analysis of the Mirai results. Methods: For the Mirai meaningful within-patient change (MWPC) analysis, anchor-based methods were used to define an MWPC threshold by exploring the associations between the MADRS and the clinician-rated Clinical Global Impression-Severity Scale (CGI-S) and the patient-reported Patient Health Questionnaire 9-Item Scale (PHQ-9). Additional post hoc efficacy analyses (including that of responders) are reported for the ITT population. Results: Using the MWPC thresholds of 8 and 10 points (derived with the CGI-S and PHQ-9 as anchor measures, respectively), the distribution of MADRS responders favored the Rejoyn group over the sham group, and the Rejoyn group had 24%‐47% higher odds of meaningful improvement on the MADRS. Post hoc ITT analyses also favored the Rejoyn group over the sham group for response rates and PHQ-9 and CGI-S score change from baseline. Conclusions: Results are consistent with the primary findings of the Mirai trial, supporting the efficacy of Rejoyn as an adjunctive treatment to antidepressive medication monotherapy for adults with major depressive disorder. The MWPC analyses offered a measure of meaningful change on the MADRS, providing a framework of clinical meaningfulness for the Mirai trial findings.
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Hello there and welcome to a new week. STAT reporter Andrew Joseph here in London filling in for Mr. Pharmalot for the day. Before we get to the headlines, an extra dose of encouragement to check out all the great pieces that STAT has to offer today, from Reed Jobs opining on the NIH budget to our new trust-in-science reporter Nick Florko outlining his own experience grappling with, as he puts it, “how frustrating it is to realize that modern medicine does not have all the answers.” Now to those headlines. …
Novo Nordisk is seeking to assure investors that it can regain its momentum in the coming years, outlining plans to expand its pipeline and find new products that it could sell more like consumer goods than traditional medicines, building off what’s occurring with its obesity treatments, STAT shares. At the company’s capital markets day in London, CEO Mike Doustdar said Novo would launch at least five multi-blockbusters by 2030 and deliver revenue growth on par with other major pharma firms. He also presented a strategy that involved investing more in disease areas outside diabetes and obesity and said the company “will be more active within business development,” an acknowledgment of investors’ concerns that Novo was too reliant on its landmark GLP-1 drugs and needed to develop other products.
Drugs called orexin agonists have been hailed for their ability to treat rare sleep disorders, but with new data, Alkermes is showing for the first time that the new class of therapies may benefit people with ADHD, STAT writes. In a randomized Phase 1 study, the company’s new drug, called ALKS 7290, was well tolerated and showed a signal of efficacy. Participants in the study started with a median score of 39 on a diagnostic known as the Adult ADHD Investigator Symptom Rating Scale, indicating that they had moderate to severe symptoms. After two weeks, those taking a high dose of 50 milligrams of ALKS 7290 experienced a 19-point reduction on the scale, indicating that their symptoms had become mild.
By Emma Beckwith, 2026 Youth Mental Health Academy Intern, Child Mind Institute
As mental health care, education, and research for youth advances, it is important to remember that in order to best serve young people, we must listen to their lived experience. They know better than anyone what conversations and changes need to happen to improve child and adolescent mental health care around the world. Therefore, they must be included in this discussion as co-creators and leaders of transformation.
Building on the momentum of last year’s inaugural Global Summit on Youth Mental Health, the Stavros Niarchos Foundation (SNF) Global Center for Child and Adolescent Mental Health at the Child Mind Institute will host the second edition of the annual event on September 21-24 in New York City.
Anna Laura Praxedes, Director, Young Peacebuilders (left) with Felipe Neto, Founder of the Felipe Neto Institute, and João Pedro Schroder, Member of the SNF Global Center Youth Council in Brazil, during the inaugural Global Summit on Youth Mental Health in New York, 2025
Led by the SNF Global Center’s Global Youth Advisory Council (GYAC), the event is set to unite young people from around the world to discuss the issues impacting their mental health. Additionally, clinicians, researchers, and policymakers will participate in various sessions. The hope is that youth and adult experts can work together to enact necessary changes in child and adolescent mental health care.
The GYAC, consisting of members from the Global Center’s Child and Adolescent Mental Health Initiatives (CAMHI) in Greece, Brazil, and South Africa, took on a leading role in organizing the summit. In every step of the process, they have had input on what they want the summit to look like, new features they want to include, the key topics that will be discussed, as well as the theme for this year’s summit: “Redefining Mental Health Care: Youth Perspectives in a Changing World.” They will also serve as moderators of discussion panels, with each GYAC member leading conversations on topics they feel passionate about.
“Nothing About Us Without Us”
The youth are the present and future and deserve to be the lead contributors in this work. This year, the summit aims to center their voices through three thematic sessions:
“Meeting Young People Where They Are” will examine how to make school systems safer places for identity expression and mental health education. And they’ll discuss how to make digital spaces safer, including ways to communicate the impact online spaces have on mental wellness to young people.
“What Young People Care About” will consist of breakout sessions where, in small groups, young people will discuss the modern youth experience in how topics such as climate change, economic instability, and political polarization affect their mental health.
“Setting Young People Up for the Future” will include a Q&A with experts where youth can learn how to take care of their mental wellness in a changing world.
During last year’s summit, young participants came together to document key takeaways and actionable items for implementation and global change through a published youth-led report. This year, the goal is to increase youth involvement even more, with more youth attendees, speakers, and leaders. After all, this event isn’t just for the betterment of youth and adolescent mental health, but a space for people around the world who have a shared passion and care about this issue to connect and unify in order to enact positive change.
As a young person myself, what I would like to see come out of this year’s summit is action. The event is already an amazing starting point, where both young people and adults have shown their care for improving child and adolescent mental health. Now, we need to take actionable steps to implement the changes needed as voiced by youth, so that the talk doesn’t just stay within the event but becomes a reality. While there is no doubt that it will take time, I have hope that with the continuation of these annual summits, more global experts, changemakers, policymakers, clinicians, researchers, and caretakers will take what they’ve learned into their spaces of work to enact real change.
As Nelly Serdari, a member of the Youth Engagement Scheme (YES) with CAMHI in Greece, stated at last year’s summit, “The only way that we can try to break down barriers is if older generations try to get on our level.”
Now, it is up to the adults to break down the barriers that we youth cannot.
Brain disorders impose a major global health burden, yet current pharmacological and neuromodulation therapies are often constrained by invasiveness, limited spatial precision, poor access to deep brain structures, or insufficient long-term efficacy. Non-invasive ultrasound neuromodulation has emerged as a promising approach combining high spatial resolution, deep tissue penetration, and reversible modulation. Its biological effects arise from multiscale mechanotransduction involving membrane deformation, mechanosensitive ion channels, intracellular calcium signaling, glial regulation, and neurovascular coupling. Together, these processes modulate neuronal excitability, synaptic plasticity, network connectivity, neuroinflammation, and cerebral perfusion. Preclinical studies support its therapeutic potential across neurological and psychiatric disorders, while early clinical studies indicate short-term tolerability and preliminary target engagement in Alzheimer’s disease, Parkinson’s disease, and depression. Emerging approaches, including individualized treatment planning, closed-loop stimulation, and sonogenetics, may further improve the precision and cellular specificity of ultrasound neuromodulation. This review summarizes the physical principles and cellular mechanisms of ultrasound neuromodulation, evaluates its therapeutic and clinical applications, and discusses key challenges and future directions, including personalized stimulation, closed-loop systems, sonogenetics, and disease-modifying strategies.
One of the main challenges in clinical psychotherapy is disseminating effective psychological treatments to the millions who need them but lack access. Transdiagnostic interventions, particularly those delivered online, can help bridge this treatment gap. However, these interventions, often provided as a “one-size-fits-all” approach, do not tailor to individual patient needs. Therefore, it is essential to identify which patients benefit from these treatments and who require more intensive interventions. This randomized controlled trial (RCT) aims to evaluate the effects of an Internet-based transdiagnostic intervention (UJI Online Transdiagnostic Protocol/Transversal) for emotional disorders, adapted to patients’ response. Three hundred sixty-six adults with clinically significant symptoms of anxiety and depression (ODSIS ≥ 7 and/or OASIS ≥ 8) and without suicidal ideation or a severe mental disorder participated. After having completed the first three modules, patients will be randomized based on their symptomatic response. Early responders will either continue with the original intervention—12 self-administered modules—or discontinue treatment. Non-early responders will receive a blended format—including two therapist-led videoconference sessions—or continue with the original intervention. Multilevel models will be used to analyze the data. The primary expected result is that the blended format will improve treatment outcomes for non-early responders compared to the self-applied format. Moreover, it is expected that discontinuing treatment for early responders will be as effective as continuing it until completion. The findings are expected to inform clinical practice by highlighting the importance of assessing symptomatic response throughout treatment, especially in its early phases, to better tailor interventions to the needs of different patient groups.Clinical trial registrationhttp://www.chictr.org.cn, identifier NCT07051148.
BackgroundShared reading supports early child development, but parental depressive symptoms may reduce its frequency and quality. Most previous studies assumed linear relationships with small samples. This large cross-sectional study examined linear and non-linear associations between parental depressive symptoms and shared reading practices in Chinese preschoolers.MethodsWe recruited 21,366 parent-child dyads (children aged 3–6 years) from 189 kindergartens in western China. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D). Shared reading was assessed using the StimQ READ subscale. Multivariable linear regression, piecewise linear regression with threshold estimation, and natural spline analysis were performed, adjusting for sociodemographic covariates.ResultsHigher CES-D scores were linearly associated with lower total reading scores (adjusted β = –0.074 per point, 95% CI: –0.081 to –0.067). Piecewise regression identified a significant estimated breakpoint at CES-D score = 19.0 (95% CI: 11.9–26.1), below this threshold the slope was steeper (β = –0.085) than above (β = –0.051). Natural spline analysis confirmed non-linearity (P = 0.026) and located the point of maximum curvature at CES-D score = 10.9, indicating the most rapid change in slope occurred at subclinical symptom levels. The association was consistent across all subgroups (after Bonferroni correction).ConclusionsParental depressive symptoms are negatively associated with shared reading in a non-linear, breakpoint-dependent manner. Even subclinical symptoms (CES-D score≈ 11) are associated with steeper declines, while the association attenuates at higher levels (CES-D score ≈ 19). Interventions targeting parental mental health, especially at subclinical to moderate symptom levels, may help preserve high-quality home literacy environments.
BackgroundObesity in older adults is associated with significant medical, functional, and psychological consequences, including body image dissatisfaction and maladaptive eating behaviors such as emotional eating. Although these associations have been extensively studied in younger populations, limited evidence is available in older adults with obesity. This study aimed to examine differences in body dissatisfaction by age and weight status and its association with emotional eating in adults and older adults with obesity.Methods108 participants were included and divided into four subgroups based on age and weight status. Body dissatisfaction was assessed using the Body Uneasiness Test (BUT-A). Emotional eating was evaluated using the Emotional Eating subscale of the Dutch Eating Behaviour Questionnaire (EE-DEBQ). Two-way ANOVAs were conducted to examine the effects of age, weight status, and their interaction on body dissatisfaction, while Pearson correlations were used to assess associations between body dissatisfaction and emotional eating.ResultsThe analysis showed significant main effects of both age and weight status on global body dissatisfaction, with higher BUT-GSI scores observed in adults than in older adults and in participants with obesity compared with normal-weight individuals. Across all BUT dimensions, participants with obesity reported higher levels of body image concerns, avoidance, compulsive self-monitoring, and depersonalization. Significant age × weight status interactions emerged for weight phobia and body image concerns. Age significantly affected body image concerns and avoidance. Positive correlations between body dissatisfaction and emotional eating were found in adults with obesity (r=0.443, p=0.024) and older adults with obesity (r=0.480, p=0.004), as well as in normal-weight adults (r=0.573, p=0.001).ConclusionThe findings highlight the significant role of both ageing and obesity in shaping body image experiences.
BackgroundSelf-harm (SH) is common, but its severity varies. Severe cases may involve extensive hospitalization and high suicide risk. Although SH is associated with post-traumatic stress disorder (PTSD), personality disorder (PD), and complex cases of PD-PTSD comorbidity, factors related to SH severity are sparsely researched.AimsThe study aims to investigate how SH severity relates to PTSD symptoms and different domains of personality functioning. The study also aims to explore indirect associations of interpersonal functioning, PTSD symptoms and SH severity.MethodsIn a multicenter cross-sectional design, the study included outpatients admitted for personality disorder treatment (n = 361) and psychiatric inpatients (n = 42) with frequent (>5) or long (>4 weeks) admissions in the previous year due to SH (Ntotal = 403, period 2019–2022). Patient self-reports included current (last 6 months) SH and suicide attempts, PTSD symptoms, and self and interpersonal domains of personality functioning.ResultsMore severe PTSD symptoms and poorer self-functioning (self-control and identity integration) were significantly and independently associated with greater SH severity. The association between PTSD symptoms and increasing SH severity was partially mediated by greater impairment of self-control and identity integration. Interpersonal domains were not associated with SH severity.ConclusionThis study highlights post-traumatic stress and personality problems as common clusters of symptoms among patients with increasingly severe SH. Further exploration indicated personality functioning self-domains as potential drivers of the association between post-traumatic symptoms and SH severity. Results support integrated, individualized treatment addressing SH in light of both trauma burden and personality functioning.
