IntroductionThe COVID-19 pandemic increased perinatal mental health needs and disrupted routine obstetric care, disproportionately affecting Black and economically disadvantaged communities. Michigan’s Perinatal Collaborative Care Model (Peri CoCM), a publicly funded virtual program, launched during the pandemic and continued after the public health emergency. This qualitative study examined participant experiences with Peri CoCM, including perceived usefulness, acceptability, and barriers/facilitators to engagement, particularly among marginalized perinatal people to inform post-COVID service delivery.MethodsEligible participants were pregnant or up to one year postpartum Peri CoCM patients recruited from a May–July 2025 referral cohort. Nine women ages 27–42 completed one-hour, semi-structured Zoom interviews between August and September 2025; the sample intentionally overrepresented self-identified Black women. Interviews were recorded, transcribed, verified against audio, and analyzed by a coding team using grounded-theory–informed thematic analysis with constant comparison.ResultsParticipants reported positive experiences with Peri CoCM across four thematic areas: (1) Pathways to care, (2) Perceived impacts of program, (3) Importance of culturally responsive care, and (4) Recommendations for program optimization. Trusted referrals from obstetric and other providers facilitated entry into care, often for anxiety, depression, grief, or first-time mental health support. Participants described Peri CoCM as accessible, supportive, and valuable during pregnancy and postpartum. Virtual options, flexible scheduling, compassionate behavioral health clinicians, and consistent follow-up reduced barriers and promoted openness. The short-term model helped some transition to longer-term therapy, while clinicians supported insurance navigation, medication decisions, and community resource connections. Participants gained coping skills, validation, and self-understanding. They emphasized culturally responsive provider fit and recommended longer continuity, broader wraparound services, and sustained no-cost access to reduce stress and improve engagement.ConclusionMichigan’s Peri CoCM was perceived as a low-barrier, relationship-centered, culturally responsive virtual pathway supporting perinatal wellbeing and systems navigation in the post-COVID era. Cost transparency and flexible delivery were central to acceptability and expanded access to equitable care.
Problematic Reliance on Generative AI in an Anxious Young Adult: Case Report
Generative Artificial Intelligence (AI) tools are increasingly integrated into daily life, offering cognitive support across domains such as writing, decision-making, and social interpretation. While beneficial, excessive reliance may contribute to diminished confidence in one’s own thinking. This report describes a woman in her mid-20s with Generalized Anxiety Disorder and Major Depressive Disorder who developed a pattern of functional dependence on generative AI tools- specifically ChatGPT. She historically had strong social, academic and occupational functioning. Psychiatric consultation did not suggest the presence of a personality disorder, and although she was a high-achieving individual, clinically significant perfectionistic traits were not evident. Despite this, she increasingly relied on AI for routine cognitive and interpersonal tasks including composing emails, interpreting social interactions, predicting the future and making decisions and felt increasingly uncomfortable completing such tasks independently. This case highlights the potential danger of generative AI tools in reassurance seeking behavior and how it might compound anxiety. These behaviors were observed across both professional and personal contexts, suggesting that AI use was not limited to task-specific assistance but reflected a generalized strategy for managing uncertainty and self-doubt. This behavioral pattern is characterized in this case by cognitive offloading, reduced confidence in independent judgment, and reinforcement of externalized thinking processes. This led to the subjective belief of declining skill and compromised functional autonomy. The Interaction of Person-Affect-Cognition-Execution (I-PACE) model was used to describe this pattern of behavior. While repeatedly turning to a family member or friend for validation and reassurance might lead to interpersonal fatigue, AI tools have no such limits and are infinitely accessible. This might ultimately worsen a patient’s ability to tolerate uncertainty. Given the ubiquity of AI tools and the prevalence of anxiety disorders, clinicians may need to be aware of the role AI tools potentially play in reassurance seeking and thus perpetuation of anxiety.
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Transcutaneous auricular vagus nerve stimulation targets the brain-gut axis to treat functional dyspepsia: a scoping review of clinical evidence and mechanistic research
BackgroundFunctional dyspepsia (FD) is a common gut–brain interaction disorder with suboptimal response to pharmacotherapy. Transcutaneous auricular vagus nerve stimulation (taVNS), a non-invasive neuromodulation targeting the vagus nerve, has emerged as a promising brain–gut axis therapy. This scoping review (PRISMA-ScR, JBI methodology) synthesizes clinical and preclinical mechanistic evidence on taVNS for FD.MethodsPubMed, Embase, Web of Science, and Cochrane Library were searched up to December 20, 2025, following PRISMA-ScR. Using PICOS (adults with FD; taVNS; sham/non-vagal/active controls; symptoms, gastric function, psychological outcomes, biomarkers; RCTs/clinical trials and controlled animal studies), two reviewers independently screened, extracted data, and assessed bias (RoB2 for RCTs, SYRCLE for animal studies). A narrative synthesis was performed due to heterogeneity.ResultsFour RCTs (n = 480) and eight preclinical rodent studies met inclusion. All RCTs showed significant improvements in dyspeptic symptoms, gastric accommodation, slow-wave normalization, and comorbid anxiety, depression, sleep disturbance versus sham/non-vagal control, sustained for 4–12 weeks. Stimulation parameters varied (10–30 Hz; 0.5–10 mA; 2–4 weeks); risk of bias low-moderate. Preclinical rodent evidence supported five interconnected candidate mechanisms: (i) autonomic balance and cholinergic modulation; (ii) α7nAChR/NF-κB anti-inflammatory pathway with duodenal barrier restoration; (iii) NGF/TrkA/PLC-γ/TRPV1-mediated visceral hypersensitivity suppression; (iv) HPA axis inhibition; (v) rebalancing of brain-gut peptides (motilin, CCK, GLP-1).ConclusionThis review characterizes taVNS as a safe, well-tolerated, mechanistically plausible non-invasive neuromodulation for FD acting on multiple brain–gut axis nodes. However, the small number of trials, parameter heterogeneity, and limited follow-up constrain definitive conclusions. Adequately powered, multicenter RCTs with standardized protocols and long-term follow-up are needed to confirm efficacy and define optimal regimens.
Investigation of psychiatric symptoms, dissociative experiences, and childhood trauma in allergic rhinitis, and evaluation of the clinical relationship between these factors
BackgroundIn this study, we aimed to evaluate levels of depression and anxiety symptoms, childhood trauma, and dissociative experiences in patients with allergic rhinitis (AR) and compare them with healthy controls. Additionally, investigate the association between childhood trauma, depressive symptoms, and dissociative experiences in AR patients.MethodsThe study sample consisted of 152 adults (76 AR patients and 76 healthy controls) who presented to the otorhinolaryngology outpatient clinic. Data were collected using a personal information form and standardized self-report scales for childhood trauma (Childhood Trauma Questionnaire – CTQ-28), anxiety and depression (Hospital Anxiety and Depression Scale – HADS), and dissociative experiences (Dissociative Experiences Scale – DES).ResultsSignificant differences were found between the patient and control groups in terms of all parameters (p<0.05). The patient group showed significantly higher levels of childhood trauma, anxiety and depressive symptoms, and dissociative experiences. Correlation analyses revealed a significant correlation between childhood trauma and both depressive symptoms and dissociative experiences in AR patients. Furthermore, regression analysis showed that childhood trauma significantly contributed to the severity of depression in AR patients, while the presence of dissociative symptoms further increased the risk of depression.ConclusionsThis study presents evidence of a positive association between childhood trauma, depression, and dissociative experiences in allergic rhinitis, highlighting their potential roles as risk factors for the condition. Therefore, psychiatric evaluation is crucial and necessary for treatment success in AR patients.
Association between perceived school climate and employment anxiety among medical undergraduates: the mediating role of intentional self-regulation and the moderating role of perceived employability
BackgroundEmployment anxiety is an important psychological concern for medical undergraduates during the transition from university to work. This study examined the association between perceived school climate and employment anxiety and evaluated the roles of intentional self-regulation and perceived employability in this association.MethodsA cross-sectional survey was conducted among 3,857 undergraduate students from four medical universities in Heilongjiang Province, China, between September and December 2025. Participants completed measures of perceived school climate, intentional self-regulation, perceived employability, employment anxiety, and demographic and academic characteristics. Hierarchical regression, indirect-association analysis, and moderated mediation analysis with 5,000 bootstrap resamples were performed. Multivariable models included university fixed effects and were adjusted for demographic and academic covariates.ResultsA more positive perceived school climate was associated with lower employment anxiety and stronger intentional self-regulation. Intentional self-regulation statistically accounted for part of the association between perceived school climate and employment anxiety. Perceived employability moderated the association between intentional self-regulation and employment anxiety: the negative association, and consequently the conditional indirect association, was stronger among students with lower perceived employability and weaker among those with higher perceived employability. However, the incremental magnitude of the moderation effect was modest.ConclusionsSupportive perceived school climate was associated with lower employment anxiety partly through intentional self-regulation, with a modest moderating role of perceived employability. Integrating school-climate improvement, self-regulation training, and targeted career support may strengthen psychological adaptation during the school-to-work transition.
Emotion regulation difficulties and experiential avoidance in adolescents with non-suicidal self-injury: a latent profile and moderation analysis
BackgroundNon-suicidal self-injury (NSSI) represents a significant clinical concern among adolescents. Although emotion regulation difficulties (ERD) and experiential avoidance are associated with NSSI, how these regulatory vulnerabilities co-occur within individuals and whether experiential avoidance influences the ERD–NSSI association remain unclear. This study aimed to characterize regulatory vulnerability profiles based on ERD and experiential avoidance and examine the moderating role of experiential avoidance in adolescent NSSI.MethodsThe study included 456 adolescent psychiatric inpatients with NSSI (Mage = 15.30, SD = 1.66). Participants completed self-report measures assessing ERD, NSSI, and experiential avoidance, including the Difficulties in Emotion Regulation Scale (DERS), Adolescent Non-suicidal Self-Injury Assessment Questionnaire (ANSAQ), and Acceptance and Action Questionnaire-II (AAQ-II). Anxiety and depressive symptoms were assessed using clinician-administered Hamilton Anxiety Rating Scale-14 (HAMA-14) and Hamilton Depression Rating Scale-17 (HAMD-17) ratings conducted by trained psychiatric clinicians. Latent profile analysis was conducted to identify profiles based on ERD and experiential avoidance. The Bolck-Croon-Hagenaars (BCH) method was used to compare depressive symptoms, anxiety symptoms, and NSSI severity across profiles. Moderation analysis was conducted to examine whether experiential avoidance modified the strength of the association between ERD and NSSI.ResultsLPA identified three profiles characterized predominantly by low (23.25%), moderate (42.54%), and high (34.21%) levels of regulatory vulnerability. BCH analysis identified significant profile differences in NSSI, depression, and anxiety. NSSI and anxiety showed graded differences across profiles, while depressive symptoms were elevated in both Moderate and High profiles. Experiential avoidance showed a modest moderating effect on the association between ERD and NSSI (B = 0.005, 95% CI = [0.001, 0.008]), indicating that the strength of this association differed across levels of experiential avoidance.ConclusionLatent profiles of ERD and experiential avoidance were identified among adolescents with NSSI, with differences in clinical burden across profiles. Experiential avoidance modestly moderated the association between ERD and NSSI, with the magnitude of this association varying across levels of experiential avoidance. These findings provide complementary person-centered and variable-centered perspectives on regulatory vulnerability among adolescents with NSSI.
STAT+: Definium’s LSD therapy eased anxiety in second large trial
Definium Therapeutics said Monday that its LSD therapy helped patients with anxiety in a second late-stage trial, setting up the company to seek the first approval of a psychedelic drug for anxiety.
In the 12-week trial, patients taking a 100-microgram dose of the drug, called DT120, experienced a 9.8-point drop on a test called the Hamilton Anxiety Rating Scale, while those on placebo experienced a 4.7-point drop. The difference of 5.1 points is similar to what was seen in Definium’s first late-stage anxiety study and larger than what’s been observed with many other anxiety therapies, though it’s difficult to compare results across studies.
Definium is among the first wave of biotechs nearing regulatory approval for psychedelic therapies, a class of treatments that may be especially attractive to patients since they appear to exert rapid benefits. (In the latest trial, Definium said patients experienced changes as early as the second day after dosing.) In contrast, the effects of traditional options like antidepressants take weeks to kick in.
Screening and Monitoring of Mental Health in Educational Settings: Programme for Detection, Psychoeducation and Self-help
Conditions: Anxiety; Depression Disorder; Bullying; Addiction; Suicide; Self Harm; Psychosis; Eating Disorders
Interventions: Other: program for the detection, referral, and psychoeducation in adolescents
Sponsors: Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz; Hospital Universitario Rey Juan Carlos; Hospital Universitario Infanta Elena; Universidad Carlos III de Madrid; Centro de Investigación Biomédica en Red de Salud Mental
Completed
Interventions: Other: program for the detection, referral, and psychoeducation in adolescents
Sponsors: Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz; Hospital Universitario Rey Juan Carlos; Hospital Universitario Infanta Elena; Universidad Carlos III de Madrid; Centro de Investigación Biomédica en Red de Salud Mental
Completed
Recovery-phase symptoms after COVID-19 infection and anxiety levels among college students
ObjectiveThis study examines the relationship between physical symptoms during the recovery phase after COVID-19 infection and anxiety levels among college students, with the aim of providing empirical evidence for post-pandemic mental health screening and health management in universities.MethodsThe study used online survey data collected from college students in March 2023. After excluding straight-line responses, 394 valid questionnaires were retained. Among 372 students with a clear infection status, we examined the association between confirmed COVID-19 infection and anxiety. Among 298 students with confirmed infection, we further analyzed the associations of the number of physical symptoms during recovery, recovery time, and specific physical symptoms with anxiety.ResultsConfirmed COVID-19 infection itself was not significantly associated with a higher anxiety level. Among infected students, however, the number of physical symptoms during recovery was positively associated with higher anxiety levels, whereas recovery time was not significantly associated with anxiety level. Analyses of specific symptoms showed that memory decline and chest pain were significantly associated with higher anxiety levels.ConclusionPost-infection mental health screening in universities should not focus only on whether students have been infected. Greater attention should be paid to the burden of physical symptoms during recovery. Symptom count, cognitive changes, and chest discomfort may serve as useful supplementary indicators for post-infection follow-up and psychological risk identification.
Renaclic for Chronic Kidney Disease Self-Management: Formative User-Centered Co-Design Study
Background: Chronic kidney disease (CKD) affects over 850 million individuals worldwide and requires sustained patient education, shared decision-making, and self-management support. Digital health platforms may facilitate these needs; however, many lack comprehensive, user-centered design and fail to address practical and psychosocial patient concerns. Objective: This study aimed to describe the formative co-design of Renaclic, a digital platform developed with patients and health care professionals (HCPs) to support CKD education and self-management in the French health care context. Methods: A three-stage user-centered design (UCD) study was conducted between April and August 2021. Stage 1 included benchmarking of 10 French-language CKD platforms and semistructured interviews with 8 stakeholders (3 HCPs: 1 nephrologist, 1 general practitioner, 1 nurse; 5 patients: 2 novice and 3 expert users). Stage 2 consisted of two virtual co-design focus groups incorporating card-sorting and interface design activities. Stage 3 translated identified needs into structured content categories and a low-fidelity prototype. Qualitative data were analyzed thematically. Results: Benchmarking revealed fragmented educational content, limited practical guidance on home dialysis logistics, insufficient coverage of lifestyle and psychosocial concerns, and minimal interactive features. Interviews identified five main themes: need for reliable centralized information, anxiety during care transitions, demand for practical lifestyle guidance, importance of reassuring language, and value of moderated peer exchange. More than 30 thematic content items were generated and organized through card-sorting into five consolidated content categories that structured the platform’s information architecture. Co-design sessions informed mobile accessibility, simplified navigation pathways, and integration of educational, symptom-tracking, and community-oriented functionalities. Conclusions: This formative study demonstrates how participatory UCD with diverse CKD stakeholders can generate a structured, context-sensitive digital platform framework. Renaclic provides a replicable model for early-stage co-design of digital health interventions in chronic disease management. Future research will evaluate usability, engagement, and implementation in real-world settings.
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