IntroductionAlthough both hypochondriasis and suicidality are common in psychiatric patients and related to anxiety and depression, their association in psychiatric patients remains unclear. This study investigated the direct association of hypochondriasis with suicidality and the indirect associations via anxiety and depression in psychiatric patients.MethodsClinical records of 5484 psychiatric outpatients were reviewed. Hypochondriasis, Suicidality, Anxiety, and Depression were evaluated using the hypochondriasis item of the Hamilton Depression Rating Scale, the suicidality item of the 17-item Hamilton Depression Rating Scale (HAM-D17), the Hamilton Anxiety Rating Scale (HAM-A), and the 6-item subscale of the Hamilton Depression Rating Scale (HAM-D6), respectively. The associations among Hypochondriasis, Suicidality, Anxiety, and Depression were examined using a parallel mediation model. The model was estimated using the lavaan package in R with 10, 000 bootstrap resamples, adjusted for age and sex. Moderation by age and sex was also investigated.ResultsSignificant positive indirect associations via Anxiety (point estimate = 0.05, 95% CI [0.03, 0.06]) and Depression (point estimate = 0.17, 95% CI [0.15, 0.19]) were observed between Hypochondriasis and Suicidality. Conversely, the direct association between Hypochondriasis and Suicidality was also significant but in a negative direction (B = −0.16, p <.001). As the total indirect association was stronger than the direct association, the total association of Hypochondriasis with Suicidality was significantly positive (B = 0.05, p = 0.002). The negative direct association of Hypochondriasis with Suicidality was significantly stronger in younger patients (interaction term = 0.004, p <.001).ConclusionAnxiety and depression mediated the association between hypochondriasis and increased suicidality. In contrast, hypochondriasis was associated with decreased suicidality after accounting for the mediators. As the indirect association was stronger than the direct association, hypochondriasis was associated with increased suicidality overall. The direct association between hypochondriasis and decreased suicidality was stronger in younger patients.
Gut microbiota profiles in anorexia nervosa: associations with disease severity, BMI, and history of childhood trauma
Study objectivesEmerging evidence suggests a possible link between anorexia nervosa (AN) and alterations in the gut microbiota. This study aimed to characterize the gut microbiota profile in a cohort of Chinese female patients with AN.MethodA comparative analysis of the gut microbiota was conducted between 30 female patients with AN and 30 sex- and age-matched healthy controls (HCs). Fecal samples were collected for 16S rRNA gene sequencing analysis. All participants were assessed using the Eating Disorder Inventory (EDI) and the Childhood Trauma Questionnaire (CTQ). Bioinformatics analysis was performed using QIIME2, and statistical analyses were carried out with SPSS 26.0 and R software. Correlations between microbiota differences and body mass index (BMI), EDI, and CTQ were further investigated.ResultsThe analysis revealed differences in beta diversity and the abundances of specific microbial taxa between the two groups; however, no significant differences were observed in alpha diversity nor in the associations between gut microbiota and BMI, disease severity, or childhood trauma.ConclusionsThis study identified limited differences in the gut microbiota composition between patients with AN and HCs. Critically, no robust associations between gut microbiota and clinical features were found after rigorous multiple comparison correction. While nominal (uncorrected) correlations were observed between the specific microbiota and psychological traits, these results are exploratory and should be considered hypothesis-generating. They highlight a potential avenue for future research but require validation in larger, longitudinal cohorts to determine their reproducibility and biological significance.
Editorial: Assessment and management of addictive disorders in sexual and racial minorities
Preoperative anxiety and depression symptoms are associated with poorer clinical outcomes following corrective surgery for adult equinocavovarus foot
PurposeThis study aimed to investigate the preoperative psychological status of adult patients with equinocavovarus foot deformity and to examine the association between preoperative anxiety/depressive symptoms and the clinical outcomes of corrective surgery in this population.MethodsA retrospective analysis was conducted on 103 adult patients who underwent corrective surgery for equinocavovarus foot at Xi’an Honghui Hospital between March 2014 and July 2023. Baseline data were collected. Patient psychological status, ankle-hindfoot function, pain, and quality of life were assessed preoperatively and at the final follow-up using the Hospital Anxiety and Depression Scale (HADS), the American Orthopedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, the Visual Analog Scale (VAS), and the 36-Item Short Form Health Survey (SF-36). Based on preoperative HADS scores, patients were categorized into an anxiety/depression group (Group A) and a non-anxiety/depression group (Group B). The two groups were compared with respect to baseline characteristics (gender, age, disease duration, BMI, follow-up duration), clinical outcomes, and the degree of improvement in all assessment metrics.ResultsA total of 83 patients completed the follow-up, among whom 38 (45.78%) exhibited preoperative anxiety/depression symptoms. No significant differences were found in baseline characteristics between the two groups (all P > 0.05). At the final follow-up, both groups showed significant improvement in VAS, AOFAS, SF-36 (PCS/MCS), and HADS (A/D) scores compared to their preoperative baselines (all P < 0.001). Intergroup comparisons revealed that Group A had significantly lower AOFAS and SF-36 (PCS/MCS) scores, and significantly higher VAS and HADS (A/D) scores than Group B, both preoperatively and at the final follow-up (all P < 0.001). Regarding the degree of improvement, Group A demonstrated a smaller magnitude of improvement in VAS (P < 0.01), AOFAS (P < 0.01), and SF-36 PCS (P < 0.001) compared to Group B. Conversely, Group A showed a greater improvement in SF-36 MCS and HADS (A/D) scores (all P < 0.001).ConclusionsWhile surgery improved all outcomes, patients with preoperative anxiety/depression exhibited persistently worse clinical scores. Their improvement profile was distinct: smaller gains in pain and physical function but greater mental health improvement. Addressing preoperative psychological status may optimize comprehensive outcomes.
The conversing military chaplain: time allocation, task salience, and competencies among Swedish military chaplains
Military chaplaincy is an established yet multifaceted practice within military organizations and is exposed to particular stressors such as the use of violence, ethical dilemmas, loss, and existential vulnerability. This study examines how a Swedish normative framework for Military Soul Care (ACCES: advisory role, command and crisis support, ceremonies, education, and soul care conversations) interacts with Swedish military chaplains’ own experiences of what they perceive as most important and meaningful in their mission. The empirical material consists of qualitative questionnaire data collected in 2025 from 50 military chaplains. The material was analyzed using an abductive approach and organized thematically. The results show that conversations constitute the task to which the greatest amount of time is devoted across both main categories of military chaplains, and that conversations are understood broadly, ranging from informal everyday interactions to confidential individual soul care conversations. Various forms of ceremonies and crisis support related to death and grief were experienced as particularly meaningful and reflect a clearly articulated priestly identity. Educational tasks varied between categories, with time constraints and organizational priorities limiting opportunities depending on context. A central finding is that presence within the organization, aimed at building relationships and trust, emerges as a decisive prerequisite and contributes to many chaplains working beyond their contracted hours. The importance of presence is not explicitly articulated in the ACCES framework but rather permeates the mission implicitly. Against the backdrop of a changed security environment, the findings illustrate that ecclesial priestly competencies related to crisis response, death, grief, and funeral expertise constitute a particularly vital resource in situations of crisis and war.
Artificial allosteric protein switches with machine-learning-designed receptors
Nature Biotechnology, Published online: 15 April 2026; doi:10.1038/s41587-026-03081-9
Allosteric biosensors are constructed by combining reporter proteins with machine-learning-designed receptor domains.
Inducible, split base editors for in vivo cancer functional genomics
Nature Biotechnology, Published online: 15 April 2026; doi:10.1038/s41587-026-03077-5
Inducible base editors enhance cancer genomic screens in vivo.
Structure-centric searching enables global mapping of the public metabolome
Nature Biotechnology, Published online: 15 April 2026; doi:10.1038/s41587-026-03082-8
StructureMASST enables pan-repository MS/MS searches using a chemical name or structure.
Rapid expansion of genotype D1.1 A(H5N1) influenza viruses in wild birds across North America during the 2024 migratory season
Nature Medicine, Published online: 15 April 2026; doi:10.1038/s41591-026-04300-1
Using active and passive genomic surveillance, researchers observed the rapid spread of high pathogenicity avian influenza H5N1 D1.1 viruses in wild birds during the 2024 migratory season, which coincided with detection in humans, but did not identify mammalian adaptive markers in viruses from wild birds.
Closing the gap on antifungal resistance
Nature Medicine, Published online: 15 April 2026; doi:10.1038/s41591-026-04334-5
Drug-resistant fungal disease must be addressed in the 2026 update to the Global Action Plan on Antimicrobial Resistance