Current Psychiatry Research and Reviews

Background: Autistic Spectrum Disorder (ASD) is a disorder associated with genetic and neurological components leading to difficulties in social interaction and communication. According to statistics of WHO, the number of patients diagnosed with ASD is gradually increasing. Most of the current studies focus on clinical diagnosis, data collection and brain images analysis, but do not focus on the diagnosis of ASD based on machine learning. Objective: This study aims to classify ASD data to provide a quick, accessible and easy way to support early diagnosis of ASD. Methods: Three ASD datasets are used for children, adolescences and adults. To classify the ASD data, we used the k-Nearest Neighbours method (kNN), the Support Vector Machine method (SVM) and the Random Forests method (RF). In our experiments, the data was randomly split into training and test sets. The parts of the data were randomly selected 100 times to test the classification methods. Results: The final results were assessed by the average values. It is shown that SVM and RF are effective methods for ASD classification. In particular, the RF method classified the data with an accuracy of 100% for all above datasets. Conclusion: The early diagnosis of ASD is critical. If the number of data samples is large enough, we can achieve a high accuracy for machine learning-based ASD diagnosis. Among three classification methods, RF achieves the best performance for ASD data classification.

The continual deterioration of the structure and function of the nervous system is a major global health problem associated with neurodegenerative disorders. Gut-brain axis plays a significant role in linking gut microbiota to neurological function. Live microorganisms that benefit the host's health are called probiotics. These probiotics are increasingly recognized as beneficial for treating neurodegenerative diseases. This review investigates the impact of probiotics on neurodegenerative disorders, specifically focusing on conditions like Alzheimer's, Parkinson's, and amyotrophic lateral sclerosis. According to studies, probiotics have the power to alter the host's neuroimmune response, lower inflammation, and modify the composition of the gut microbiota. Studies have indicated a potential relationship between the stomach and the brain by connecting variations in the gut microbiota to neurodegenerative diseases. Probiotics can influence the gut flora, which leads to a reduction in neuroinflammation, oxidative stress, and other pathological processes linked with these conditions. This review also discusses how probiotics impact the central nervous system through mechanisms such as altered blood-brain barrier function, neurotrophic factor regulation, and neurotransmitter production. Based on preclinical and clinical data, probiotics are also highlighted as an adjunctive or prophylactic treatment for neurodegenerative diseases. More research is needed to find the exact strains, dosages, and duration of probiotic therapies required to have the greatest neuroprotective effects, despite the good results thus far. It is also acknowledged that translating findings from animal studies to human applications can be challenging. With the ability to reduce the neuropathological features of Parkinson's and Alzheimer's diseases, probiotics provide a novel therapeutic approach for neurodegenerative illnesses.

The correlation between elevated levels of amyloid-β and phosphorylated tau (p-tau) protein and AD is widely recognized. A rise in pTau and amyloid- β levels aids in separating AD from other neurodegenerative conditions. In this study, we have assessed the correlation between cognitive impairment and peripheral biomarkers, tau and amyloid-β levels, in AD patients with mild Alzheimer's disease in order to develop protein-based markers in a more useful way. An enzyme-linked immunosorbent assay has been used to determine the levels of tau and p-tau in the serum of the different groups and it has revealed their levels to be noticeably greater in AD compared to mild AD and even higher compared to elderly controls. Based on the cutoff levels for tau, p-tau, and amyloid-β in patients with AD and mild AD, having high sensitivity and specificity, which have been described in numerous studies by respective International Research Groups (with the greatest number of pieces of available evidence), the plasma concentration of these proteins can be used as a diagnostic indicator for AD and mild AD. These levels may also offer a practical guide to their implementation in the clinical routine.

Background: Multiple sclerosis (MS) is a chronic disease that affects the central nervous system. Depression, anxiety and stress are the most common psychiatric comorbidities in MS, which can have adverse consequences. The aim of this study was to determine the effect of relaxation (Jacobson and Benson) technique on depression, anxiety and stress in MS patients. Methods: This clinical trial was conducted since December 2016 to March 2017 in the Multiple Sclerosis Association and the Neurology Clinic of Farshchian Hospital (Sina) in Hamadan. Sixty patients with multiple sclerosis were randomly assigned to two experimental (n=30) and control (n=30) groups. The control group received routine care and experimental group received the relaxation technique (Jacobson and Benson) in 8 sessions of 60-minute twice a week for 4 weeks in addition to receiving routine care. The DASS-21 scale was completed by samples before and after the intervention. Results: Results of the study showed that in the intervention group, the scores of depression, anxiety and stress after using relaxation (Jacobson and Benson) was decreased significantly (P<0.05), while in the control group no significant decrease was observed (P<0.05). Conclusion: The results of this study showed that relaxation (Jacobson and Benson) is effective in reducing depression, anxiety and stress in patients with multiple sclerosis. Therefore, in addition to prescribing medication, it is suggested that complementary therapies be performed for these patients.

Background: The most common psychological problem in hemodialysis patients is low hope. Hope is an important source of adaptation for the survival of the patients with a chronic disease. Objective: This study aimed to evaluate the effect of spiritual care on hope in patients undergoing hemodialysis. Methods: In this randomized controlled trial conducted in Iran in 2017, 60 hemodialysis patients with ending-stage of renal disease under hemodialysis treatment were randomly assigned into two experimental (n=30) and control (n=30) groups. The spiritual care program consisting of protectionist care, supporting the patient's rituals and using support systems was administered in four sessions of 60 minutes individually, twice a week, morning or evening in hemodialysis ward. Snyder’s Hope Questionnaire was completed before and after the intervention in both groups. Data were analyzed in SPSS software version 16. Results: Prior to the intervention, there was no significant difference between the experimental and control groups (p=0.262); however, following the intervention, the difference was statistically significant with regard to the mean scores of hope in the experimental (36.43 ± 3.37) and control (35.20 ± 7.00) groups (p=0.04). Conclusion: According to the findings of the present study, spiritual care promotes hope in Muslim patients undergoing hemodialysis; therefore, nurses can adopt the spiritual care to this end.

Background: The combined oral contraceptive pill (OC), containing synthetic estrogens and progestins, is used by millions of women worldwide, yet little is known about its effects on cognition or on psychiatric disorders. The progestin component of OCs determines their androgenicity, i.e. whether the OC has androgen binding components with masculinising effects or antiandrogenic components with feminising effects. Objective: The present review discusses the literature surrounding OC use and cognition in healthy women. Given the important role that sex hormones play in psychiatric disorders, we also consider the influence of OCs on symptoms of schizophrenia, post-traumatic stress disorder, depression, bipolar disorder, anxiety disorders and indirectly, sleep quality. Results: Research has shown that while there are no differences between OC users and non-users, androgenic OCs enhance visuospatial ability and anti-androgenic OCs enhance verbal fluency. Little is known about OCs effects on other cognitive domains, such as memory and executive function. There is little research examining OC use in schizophrenia, post-traumatic stress disorder, bipolar disorder and anxiety disorders. There is some evidence that OC use is associated with depression, however the exact causality of this association remains to be verified. Conclusion: We maintain that future studies need to address several methodological limitations, such as separating OCs based on androgenicity to avoid the masking effects that occur when various OCs are considered as one group. As this review highlights several significant effects of OC use on the brain, the implications of OC use needs to be considered in future research.

Background: Depression is the most common mental health problem among students. International students are more vulnerable and have shown an increased percentage of depression, but no review on the prevalence of depression among international students is available. Objective: To explore the documented prevalence of depression among international students studying in universities and what are the associated factors of depression that are stated in the article mentioning the prevalence of depression. Methods: Various online databases were used to identify research articles related to the prevalence of depression among international students published between January 2010 and April 2020. Ten articles were included in this review based on the selection criteria. Results: Overall, the prevalence of depression ranges from 22.6% to 45.3% among international students and ranges from 34.2% to 46.5% in males and 33.2% to 54.1% in females. Academic stress, English proficiency, cultural shock, burnout, distress, acculturative stress, social isolation, living alone, and lack of social connectedness predicted the depression among international students. Conclusion: The prevalence of depression is higher among international students compared to domestic students and the general population. A thorough psychological and social assessment would be beneficial to screen for mental health problems, including depression.

Background: Mental illness remains a global public health concern, affecting millions of individuals worldwide. However, barriers such as limited access to mental healthcare, stigma, and resource constraints hinder effective interventions and treatment. The fourth industrial age, marked by the integration of artificial intelligence technologies, offers innovative solutions to revolutionize mental health counseling and support. Method: This review explores the challenges faced in traditional mental healthcare and proposes the integration of AI-generated health counseling as a transformative approach. AI-powered chatbots and virtual assistants present accessible, cost-effective alternatives that overcome geographical barriers and combat stigma. These chatbots employ natural language processing and machine learning to engage users in personalized and interactive conversations. Chatbots also offer continuous support, psychoeducation, and coping strategies. Virtual Reality Therapy leverages AI to create realistic simulations for exposure therapy, proving effective in treating anxiety disorders and PTSD. AI-driven voice assistants and virtual coaches enhance mental health counseling by delivering behavioral therapy and improving symptoms of depression and anxiety. Results: They enhance accessibility, provide 24/7 support, and reduce stigma, offering personalized support tailored to individual needs. Integrating AI-generated health counseling in mental healthcare can bridge treatment gaps, improve accessibility, and strengthen the patient-provider relationship. Conclusion: AI serves as a valuable supplement, working collaboratively with human therapists to provide comprehensive care. Embracing AI technologies responsibly holds promise for the future of mental health counseling and offers transformative possibilities to address the global burden of mental illness.

Introduction: Vaginismus includes some psychological conditions such as fear of pain and avoidance from penetration. There is little knowledge about the effects of vaginismus. Objective: The present study aims to present the bio-psychosocial consequences of vaginismus in women life. Methods: The method of the present study is a review, which is conducted on the available resources. All relevant studies were included to present effects of vaginismus on the women. Results: Women who have vaginismus have many problems with self-identity, psychological and reproductive lives. Most of the effects of vaginismus lead to another deep effect on women. Women with vaginismus mostly describe themselves negatively. This negative self-perception affects women’s self-esteem levels which cause psychiatric disorders. The psychiatric disorders have been associated with vaginismus as a reason and result. It is stated in the studies that the general anxiety and, penetration specific anxiety are related to vaginismus. This result reflects that women with vaginismus have more anxiety about penetration. Women with vaginismus encounter reproductive problems, who are more likely to encounter increased cesarean section and fertility problems, they are reluctant to seek health care services, especially due to fear of the gynaecological examination. Conclusion: Although vaginismus is a common problem, there is little information about the effects of vaginismus on women. Vaginismus causes psychiatric disorders and reproductive problems. The researchers should examine how women live with vaginismus. It is also suggested that psychotherapy techniques should include couples interventions and, researchers should examine psychological health of women deeply.

Objectives: The psychological impact of violent video games remains controversial. This study, therefore, investigated the effect of playing violent versus nonviolent video games on aggression and irritability, examining the roles of gender and gameplay duration. Methods: A repeated-measures experimental design was employed. The final sample consisted of 210 participants (102 boys, 108 girls), who were assessed before and after playing either a violent (Counter-Strike) or a non-violent (Candy Crush Saga) game for three different durations (20, 40, 60 minutes). Aggression was measured using the Buss-Perry Aggression Questionnaire (BPAQ) and irritability using the Caprara Irritability Scale (CIS). Results: Analysis revealed a significant association between playing violent video games and heightened aggression and irritability. A significant main effect of gender was observed, with male students scoring higher on both aggression and CIS dimensions following exposure than female students (F(1, 206) = 21.897, p < .001, η²p = .096), indicating a moderate effect size. Furthermore, extended gameplay time was also associated with a stronger rise in aggression levels (χ²(1) = 46.787, p < .001, Cramér's V = .472). Discussion: The findings of this work suggest that exposure to violent video gaming is significantly linked to enhanced aggression and irritability in college students. These effects increase with the duration of time spent gaming. In addition, the effect was more pronounced among male participants than females, indicating greater susceptibility in males. Conclusions: Compared to nonviolent video games, violent video games increase aggressive behavior in college students.

Abstract: Attention-Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental condition that mostly affects children and mainly includes inattention, hyperactivity, and impulsivity. Although the etiology of ADHD remains elusive, it encompasses a variety of genetic, individual, environmental, neurological, and psychological factors along with some associated disorders like Fragile X syndrome, anxiety, etc. Dysregulated dopaminergic and noradrenergic neurotransmitters are largely linked to ADHD. ADHD's pathophysiology is complex and polygenic, making it challenging to identify the genes responsible for the disorder. Various pharmacological and nonpharmacological treatments are currently in use to manage ADHD. An emerging area in the treatment of ADHD includes the use of antioxidants, machine learning, transcranial electric current stimulant technique, and telemedicine along with virtual, augmented, and mixed reality technologies, which are important for improving disease outcomes, addressing unmet needs, and providing individuals with more options for managing their symptoms.

Background: Successful breastfeeding is influenced by both physiological and psychosocial factors. Postpartum Depression (PPD) and perceived social support have been shown to affect breastfeeding outcomes, partly through their association with Breastfeeding Self-Efficacy (BSE). However, evidence on the interrelationships among these variables in Iranian postpartum women remains limited. Methods: This descriptive cross-sectional study was conducted in Hamadan, Iran, between March and September 2024. A total of 240 postpartum women within six months after delivery were selected using multistage cluster sampling. Data were collected using a demographic-obstetric questionnaire, the Breastfeeding Self-Efficacy Scale–Short Form (BSES-SF), the Edinburgh Postnatal Depression Scale (EPDS), and the Multidimensional Scale of Perceived Social Support (MSPSS). Data were analyzed using descriptive statistics, independent-samples ttests, and Pearson correlation coefficients. Results: The mean age of participants was 29.77 ± 5.85 years. The mean BSE score was 37.53 ± 6.07 (range: 18–57). Based on the EPDS cutoff (≥12), 90.0% of participants screened positive for depressive symptoms. BSE was negatively correlated with EPDS scores (r = −0.507, p < 0.001). Family support showed a positive correlation with BSE (r = 0.212, p = 0.001). No statistically significant correlation was found between overall perceived social support and EPDS scores. Discussion: Lower breastfeeding self-efficacy was associated with higher depressive symptom scores, highlighting the psychological vulnerability of postpartum women. Family support appeared to play a particularly important role in supporting maternal confidence in breastfeeding. Recent studies emphasize that enhanced social support can mitigate PPD risks and boost BSE, particularly in cultural contexts where family involvement is key. Conclusion: The findings suggest that breastfeeding self-efficacy is closely associated with postpartum depressive symptoms and perceived family support. Interventions aimed at strengthening family-based social support may help improve maternal mental health and breastfeeding confidence during the postpartum period.

Introduction/Objective: The aim of the study was to explore the latent profiles of the psychological resilience of Chinese college students and analyze the influencing factors of different subgroups. Methods: Using a convenience sampling method, 334 college students from three colleges were surveyed in May 2025. The Connor-Davidson Resilience Scale (CD-RISC) was used for psychological resilience assessment. Through latent profile analysis (LPA) and multivariate logistic regression analysis, the heterogeneity of psychological resilience and its influencing factors is discussed. Results: The study revealed two psychological resilience profiles: the low psychological resilience group (48.80%) and the high psychological resilience group (51.20%). Marital status, sibling status, family economic situation, family relationships, alcohol use, frequency of staying up late, self-rated health, academic stress, and family functioning are all significant predictors for distinguishing different resilience profiles (p < 0.05). Taking the high psychological resilience group as the reference group, multivariate analysis shows that those without siblings (adjusted OR=1.91) and those who report academic pressure (adjusted OR=1.92) are significantly more likely to belong to the low psychological resilience group. In contrast, better family functioning (i.e., lower APGAR scores indicating less dysfunction) was associated with high resilience classification (adjusted OR=0.58). Discussion: Findings show that the psychological resilience level of college students exhibits a bimodal distribution, and some individuals may face pressure and adaptation difficulties. Academic pressure is an important factor, while good family functioning is associated with a protective effect. Lifestyle factors, including sleep patterns and drinking habits, may indicate a decline in psychological resilience and deserve further attention. Conclusion: Academic stress and family functioning are associated with resilience profile membership. Strengthening the family support system and improving stress management resources may be related to higher psychological resilience levels. These measures could be considered in similar student populations.

Introduction/Objective: Neuroimaging-based artificial intelligence for ASD risk screening holds considerable promise as an objective, scalable complement to behavioral assessment; however, most existing studies are limited by poor generalizability, absence of external validation, and inadequate model interpretability. This study aims to address these limitations by developing a robust, interpretable, and externally validated neuroimaging-only framework for ASD risk screening using restingstate functional magnetic resonance imaging (rs-fMRI) and graph neural networks. Methods: Functional connectivity matrices were derived from rs-fMRI data and modelled as undirected brain graphs, in which each region of interest (ROI) is a node and pairwise connectivity strength defines the edge weights. A graph-based connectome encoder with an attention-aware pooling layer was employed to generate subject-specific neurobiological representations, followed by a calibrated classification layer producing probabilistic ASD risk scores. Brain parcellation was performed using the AAL-116 atlas (116 ROIs). Model training and internal validation followed a nested crossvalidation protocol on the ABIDE I dataset (871 subjects after quality control; 403 ASD, 468 TD), with independent external validation on ABIDE II (834 subjects; 378 ASD, 456 TD) without retraining or parameter adjustments. Results: The proposed framework achieved an AUROC of 0.83 (95% CI: 0.80–0.86) on ABIDE I and 0.79 (95% CI: 0.76–0.82) on ABIDE II, outperforming all baseline models including SVM, MLP, and standard GNN architectures. The Expected Calibration Error (ECE) was 0.048 on ABIDE I and 0.061 on ABIDE II, indicating reliable probabilistic risk estimates. Site-wise robustness analysis demonstrated low AUROC variance (SD = 0.018) across acquisition sites, confirming generalizability across heterogeneous multi-site data. Attention-based attribution identified discriminative connectivity patterns within the Default Mode Network, Social Brain Network, and Salience Network, consistent with established ASD neurobiological findings. Discussion: The minimal performance gap between ABIDE I and ABIDE II validation results demonstrates that the graph-based connectome encoding approach captures intrinsic neurobiological signal rather than dataset-specific artefact. The integration of GNNExplainer-based attribution maps bridges the gap between predictive performance and neurobiological interpretability, addressing a key barrier to clinical adoption of deep learning models in neurodevelopmental screening. Importantly, ABIDE datasets are retrospective and research-grade; the reported metrics reflect statistical generalization across research cohorts and do not constitute clinical diagnostic validation, which would require prospective evaluation in real-world clinical populations. Conclusion: This study presents a robust, interpretable, and externally validated neuroimaging-only framework for ASD risk screening that demonstrates strong generalization across multi-site rs-fMRI datasets. The framework provides calibrated probabilistic risk estimates alongside neurobiologically grounded explanations, positioning it as a promising computational support tool for clinicians. Prospective validation in clinically recruited, early-childhood populations remains a necessary step toward translational deployment.

Introduction/ Objectives: Substance use is a major global public health challenge and is closely associated with psychiatric illness. Patterns of use are shaped by sociodemographic and cultural factors, with men, younger individuals, and those with lower education at greater risk. Among psychiatric patients, substance use complicates treatment and worsens outcomes. This study aimed to (i) estimate the prevalence and patterns of substance use, (ii) examine sociodemographic factors associated with substance use, and (iii) explore associations between specific substances and psychiatric diagnoses among psychiatric outpatients at a tertiary hospital in Tshwane, South Africa. Methods: A hospital-based cross-sectional survey was conducted among 405 psychiatric outpatients. Substance use was assessed using the WHO Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST v3.1), and sociodemographic data were collected using a questionnaire. Descriptive statistics, Pearson Chi-square tests, logistic regression, and multinomial logistic regression were applied to examine associations. Results: Participants had a mean age of 38.4 years; most were Black (98.5%), male (52.4%), and single (85.4%). Schizophrenia was the most common diagnosis (32.6%). Lifetime prevalence of substance use was high (70.1%), with alcohol (60.5%), tobacco (49.9%), and cannabis (26.4%) most frequently reported. Logistic regression showed higher odds of substance use among males (OR=1.96, 95% CI: 1.25–3.09), single individuals (OR=2.24, 95% CI: 1.21–4.16), and those with a family history of substance use (OR=1.98, 95% CI: 1.27–3.09). Multinomial regression revealed significant associations between tobacco use and schizophrenia (RRR=2.01, 95% CI: 1.05–3.81), and cannabis use and psychosis (RRR=7.04, 95% CI: 2.95–16.80). Discussion: Substance use is strongly linked to psychotic disorders, particularly schizophrenia and psychosis, and is further shaped by sociodemographic vulnerabilities such as male sex, single marital status, and family history of substance use. These findings underscore the need for integrated mental health and substance use interventions in South Africa and point to the importance of nationally representative studies to clarify causal pathways and inform policy. Conclusion: Substance use is highly prevalent among psychiatric outpatients and is significantly associated with psychotic disorders. Addressing these challenges requires integrated care approaches that combine psychiatric and substance use services, alongside evidence-informed policies to reduce the burden of comorbidity and improve long-term outcomes.

Autism Spectrum Disorder (ASD) is a lifelong neurodevelopmental condition characterized by deficits in social communication and the presence of restricted or repetitive behaviors and interests. Increasing prevalence rates underscore the importance of early identification and timely intervention. This review examines current and emerging diagnostic and management approaches to ASD. Standardized diagnostic frameworks, such as the DSM-5 criteria, remain central to clinical assessment. Recent advances in screening tools have enhanced early detection. Due to the heterogeneity of clinical presentations, individualized care is necessary. Management strategies commonly integrate behavioral and developmental interventions, educational support, family involvement, and, when appropriate, pharmacological treatment for associated symptoms. Functional outcomes are further improved by strategies, such as executive function training, occupational therapy, technology-assisted therapies, and caregiver-mediated programs. Research indicates that extensive family involvement and coordinated, interdisciplinary care lead to improved long-term outcomes. To maximise functioning, engagement, and quality of life, the existing literature generally supports a comprehensive, flexible, and person-centred approach that takes into account each person's unique needs and strengths.

Introduction/Objective: People with borderline personality disorder have high rates of self-harm and suicide attempts and often present in crisis, yet many cannot access consistent inperson care. Telemedicine may expand timely, less-stigmatized treatment. To map and synthesize the available evidence on the effectiveness, safety, acceptability, and implementation characteristics of telemedicine interventions for adults with borderline personality disorder and suicide risk Methods: We conducted a scoping review in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR). We searched MEDLINE, Embase, PsycINFO, Web of Science, Cochrane Library, and Scopus from inception to 30 June 2025 using combinations of keywords related to borderline personality disorder, BPD, telemedicine, telepsychiatry, telepsychotherapy, digital mental health, suicide, suicidal ideation, self-harm, and non-suicidal self-injury. An updated search was conducted from 1 July 2025 to 1 May 2026, using the same databases and search strategy, to identify newly published eligible studies before resubmission. We included studies on adults with diagnosed or probable borderline personality disorder that evaluated clinician-led, cliniciansupported, or adjunctive digital/telephone interventions delivered via video, telephone, secure messaging, mobile applications, web-based psychoeducation, internet-based self-management tools, or blended digital formats, and reported outcomes on suicidality, non-suicidal self-injury, crisis service use, treatment engagement, or functioning. A total of 19 studies met the inclusion criteria. The updated search did not identify additional studies meeting the eligibility criteria. Methodological quality and study limitations were examined using design-appropriate appraisal tools. Results: Across the included studies, clinician-led telemedicine interventions showed promising but heterogeneous findings for suicidal ideation, non-suicidal self-injury, treatment engagement, and crisis-related outcomes. Several studies reported reductions in suicidal ideation or self-harm, while others showed comparable outcomes to in-person or usual care. Because numerical effect estimates were available only for a subset of studies and outcome measures varied substantially, the findings should be interpreted cautiously. Therapeutic alliance, adherence and satisfaction were generally acceptable and, in some comparative studies, broadly comparable to face-to-face care when core treatment components were preserved, and between-session coaching was available within steppedcare pathways with explicit safety procedures. Discussion: These findings indicate that telemedicine can support core components of borderline personality disorder care, including skills training, structured crisis follow-up and between-session support, when delivered within structured, safety-focused pathways with explicit crisismanagement protocols. However, the certainty of the evidence is limited by heterogeneous study designs, small samples, short follow-up and inconsistent outcome reporting, so telemedicine is best regarded as a promising complement to, rather than a replacement for, in-person care. Conclusion: Telemedicine may represent a feasible and promising component of care for adults with borderline personality disorder and elevated suicide risk when implemented within structured, safetyfocused pathways. Its clinical relevance depends on explicit crisis-management protocols, routine verification of patient location, predefined emergency procedures, and coordination with local services when acute risk escalates. Larger, longer-term trials with standardized self-harm outcomes and explicit attention to digital equity, clinician workload, and cross-context applicability are needed.

Introduction: The primary characteristic of panic disorder is persistent unanticipated panic attacks along with a relentless attitude and changes in behavior (American Psychiatric Association, 2022). Anxiety may also indicate unresolved issues associated with autonomy, liability, and value congruity, as suggested by existential perspectives. To operationalize value reconstruction and responsibility integration, a methodical, empirical intervention was designed, known as Self-Core Value Empowerment Therapy (SCVET). Therefore, this study aims to analyze the impact of SCVET in the clinical context for panic disorder treatment within a Saudi cultural context. Case Presentation: This case report applied a single intrinsic case study design. A Saudi woman aged 30-years diagnosed with panic disorder according to the DSM-5-TR criteria. She received eight sessions of SCVET twice a week for four months. A structured clinical evaluation was utilized for monitoring of psychological changes and symptom severity. Panic frequency and intensity were reduced in the post-treatment findings, in conjunction with boosted adaptability, value congruity, and integration of responsibility. Conclusion: In this case report, symptom reduction was observed through utilization of structured empirical value work. For future to determine generalizability controlled research is required

Background: Major depressive disorder (MDD) is a prevalent psychiatric condition with limited biological markers to guide diagnosis and treatment. While reduced brain creatine concentrations have been implicated in MDD pathophysiology, the role of circulating creatine remains unclear. Objective: To examine whether circulating creatine concentrations differ between individuals with MDD and non-MDD comparators in a large, population-based cohort, and to explore demographic correlates of systemic creatine status. Methods: We conducted a cross-sectional exploratory analysis within the All of Us Research Program, an NIH-led cohort of U.S. adults. MDD cases were identified from electronic health records using standardized OMOP concept identifiers. Circulating creatine concentrations were extracted from curated laboratory data, and participants with end-stage renal disease were excluded. Group comparisons were performed using Welch’s t-test, and associations with age and sex were evaluated. Results: Circulating creatine concentrations did not differ significantly between individuals with MDD and non-MDD participants. Of the 63,162 individuals diagnosed with MDD, creatine measurements were available for 94, and 81 participants were included in the final analysis after excluding those with renal pathology (mean age: 53.7 ± 13.8 years; 54% male). Mean creatine concentrations in the MDD group (1.02 ± 0.36 mg/dL) were similar to those in the non-MDD reference group (n = 121; mean age: 52.4 ± 15.4 years; 1.01 ± 0.40 mg/dL; P = 0.86). Within the MDD group, creatine concentrations were not significantly correlated with age (r = 0.18, P = 0.12). However, serum creatine levels were significantly higher in men than in women (1.16 ± 0.36 mg/dL vs. 0.81 ± 0.24 mg/dL; P < 0.0001). Conclusions: In this population-based exploratory analysis, circulating creatine concentrations were comparable between individuals with and without MDD but showed pronounced sex-related differences. These findings highlight the importance of considering sex as a biological variable in creatine research and underscore the need for longitudinal and mechanistic studies to clarify the relationship between peripheral and central creatine homeostasis in depression.