The aim of this study is to determine the prevalence and type of mental disorders associated with pathological gambling/gambling disorder (GD) in the general population.

Systematic review and meta-analysis of adult population-based studies reporting on psychiatric comorbidity of GD according to International Classification of Diseases (ICD-10/ICD-11), Diagnostic and Statistical Manual of Mental Disorders (DSM-IV/DSM-5) criteria, or widely used assessment instruments. PubMed, Scopus, and Web of Science databases were searched for relevant studies in English. The study’s protocol was preregistered in PROSPERO (CRD42024574210).

Of 454 articles published between 1993 and 2024, 12 met the inclusion criteria. Most studies used DSM-IV or DSM-5 criteria (only two ICD-10 criteria), and were evenly distributed across Europe, North America, and Southeast Asia. The weighted average prevalence of any mental disorder in individuals with GD was 82.2%. High comorbidity rates were found for substance use disorders (SUDs) (34.2%), mood disorders (30.9%), and anxiety disorders (29.9%), followed by personality (14.3%) and psychotic (5.9%) disorders. Meta-analysis indicates that individuals with GD are 10.7 (95% confidence interval [CI]: 5.7;20.1) times more likely to develop any mental disorder than the general population. The odds ratio for mental disorders associated with GD were 5–12 times higher for nicotine dependence, drug use disorder, alcohol use disorder, and SUD, and 3–4 times higher for anxiety and mood disorders.

These findings add weight to the view that GD is associated with a significantly increased risk for addictive behaviors, mood, and anxiety disorders.

A better mechanistic understanding of schizophrenia spectrum disorders is crucial to developing efficient treatment approaches. Therefore, this study investigated longitudinal interrelations between clinical outcomes, brain structure, and somatic health in post-acute individuals from the schizophrenia spectrum.

A sample of 63 post-acute patients from two independent physical exercise studies was included in the final analyses. Demographic, clinical, cognitive, and somatic data were acquired at baseline and follow-up, as were structural magnetic resonance imaging scans. Multivariate cross-lagged panel modeling including mediators was used to study the mutual interrelations over time between the clinical, neural, and somatic levels.

A higher baseline global gray matter volume and larger regional gray matter volumes of the hippocampal formation, precuneus, and posterior cingulate predicted improved clinical outcomes, such as daily-life functioning, negative symptoms, and cognition. Increases in white matter volume from baseline to follow-up resulted in significantly reduced positive symptoms and higher daily-life functioning.

Our findings suggest that stimulating neuroplasticity, especially in the hippocampal formation, precuneus, and posterior cingulate gyrus, may represent a promising treatment target in post-acute schizophrenia spectrum disorders. Physical exercise therapies and other lifestyle interventions, and brain stimulation approaches reflect potential treatment candidates. Given the exploratory character of the statistical analysis performed, these findings need to be replicated in independent longitudinal imaging cohorts of patients with schizophrenia spectrum disorders.

Psychosocial interventions are vital in treating severe mental illness, yet their use remains limited, and patients often lack adequate information about them. Patient-focused versions of clinical guidelines are designed to enhance mental health literacy and inform patients about available treatments, but these resources are underutilized. This study evaluated the impact of implementing a patient-focused psychosocial intervention guideline on empowerment, knowledge, and use of psychosocial interventions among individuals with severe mental illness.

Multicentre, cluster-randomised trial. The study population comprised adult patients with a severe mental disorder. The intervention group received a multimodal, structured, and protocol-led patient-focused guideline implementation, whereas the control group received treatment as usual. Data were analysed using hierarchical linear models. The primary outcome was the change in patients’ empowerment.

There was no significant intervention effect on empowerment (effect size=0.13, p=0.605), which increased slightly in both groups. The number of psychosocial interventions familiar to patients increased significantly more in the intervention group. Exploratory analyses suggest that patient empowerment could have been influenced by COVID-19-related stress, patient age, the severity of functional impairment, and migration background. The improvement in the utilisation of psychosocial interventions did not differ significantly between the intervention group (M=1.1, SD=2.5) and the control group (M=1.3, SD=2.4).

The implementation of a patient-focused psychosocial intervention guideline failed to enhance empowerment among service users. However, our analyses indicate that the intervention led to an improvement in patient knowledge with respect to guideline content. The availability of psychosocial interventions may have been significantly constrained by the COVID-19 pandemic.

Despite the high prevalence of mental disorders, knowledge about mental health, its promotion, prevention, and pathways to care in the general population remain limited. Mental Health First Aid (MHFA) seeks to increase mental health literacy in the general population and enable individuals to support others with mental health problems until professional help is available. This study aimed to investigate the feasibility and initial effects of MHFA training on (i) mental health literacy, (ii) stigmatizing attitudes toward individuals with mental health problems, (iii) social distance, (iv) trainees’ mental health, and (v) quality of life.

In an uncontrolled pilot study, individuals aged 18–75 years who participated in MHFA courses in Germany were recruited. Outcomes were assessed at baseline, post-training, and 6-month follow-up.

In total, 362 participants (mean age 43 years, 78% female) enrolled in the study at baseline. Retention was about 50% for post-training and 60% for follow-up assessment. At post-training, mental health literacy was increased (adjΒ = 6.77, 95% CI = 5.69 to 7.84) and social distance (adjΒ = −2.30, 95% CI = −2.73 to −1.87) and stigmatizing attitudes (adjΒ = −2.61, 95% CI = −3.25 to −1.97) were reduced. These effects were also evident at 6-month follow-up. There were no effects on trainees’ mental health. At the 6-month follow-up, 89% of trainees had talked to someone with mental health problems at least once, and 65% of trainees were quite or very confident in offering help.

Our findings suggest initial beneficial effects of MHFA training as implemented in Germany. A randomized controlled trial of MHFA in Germany is now warranted.

Little is known about the interrelationships among adverse childhood experiences (ACEs), post-traumatic stress disorder (PTSD), dissociative disorders, depression, and dementia risk. We sought to investigate associations of ACEs, PTSD, dissociative disorders, and depression with incident dementia and explore whether these associations may be interrelated through mediation.

This prospective cohort study used population-based UK Biobank data, including 502 355 participants recruited at 22 assessment centres who completed questionnaires, an interview, and physical assessments at baseline (2006–2010). Data are linked to participants’ electronic health records from primary care, hospital admissions, and death registers through November 30, 2022, and to the results of the UK Biobank online mental health survey (2016–2017). Cox regression and g-formula-based mediation analyses were used to examine associations between self-reported ACEs, self-reported PTSD symptoms, diagnosed PTSD, dissociative disorders, depression, and dementia.

In the final sample (n = 434 215, mean (SD) age 56.58 (8.07) years), ACEs (hazard ratio (HR)1point: 1.10; 95% CI 1.02–1.20), diagnosed PTSD (HR: 2.09; 95% CI 1.38–3.18), dissociative disorders (HR: 3.96; 95% CI 2.55–6.15), depression (HR: 2.17; 95% CI 2.05–2.30), and self-reported PTSD symptoms (HR1point: 1.09; 95% CI 1.06–1.11) were associated with increased dementia risk, after adjusting for sociodemographic characteristics. Self-reported PTSD symptoms explained 75.26% (P < .001) of the excess dementia risk associated with ACEs. Depression explained 4.51% (P = .02) of the ACEs-dementia link, 8.42% (P < .001) of the diagnosed PTSD-dementia link, and 10.29% (P < .001) of the dissociative disorders-dementia link.

Individuals with ACEs, PTSD, dissociative disorders, or depression appear to be at increased risk of dementia, potentially through both shared and unique associations. However, these findings should be interpreted with caution due to potential limitations in statistical power.

Adverse childhood experiences (ACEs) can cause morphological brain alterations across the lifespan, contributing to increased vulnerability to mental and physical disorders. Despite extensive research on ACEs-related brain alterations, the protective or augmenting role of modifiable lifestyle factors such as physical activity has been largely underexplored, representing a key gap in our understanding of trauma-related neuroplasticity. To close this gap, we aimed to investigate how lifetime physical activity (LPA) influences the relationship between ACEs and morphological brain alterations.

Moderation analyses using Hayes’ PROCESS macro examined the interaction between ACEs and LPA on the volume of limbic system-related regions – hippocampus, amygdala, anterior cingulate cortex (n = 81).

While LPA showed no moderating effect on hippocampal or anterior cingulate volume, the model concerning the volume of the amygdala was significant. This model explained 8.1% of the variance in amygdala volume (p = 0.002) and the interaction of LPA and ACEs contributed 7.9% of this variance, with a significant effect (β = −0.221 p ≤ 0.001). That indicated LPA moderates ACEs-related structural changes in the amygdala, a key component of the central circuitry of emotion and stress sensitization. Notably, only in individuals with low physical activity were ACEs associated with increased volume of amygdala.

Our findings underscore the behavioral dependency of the structural adaptations of the amygdala following childhood adversities. These results emphasize the therapeutic potential of incorporating physical activity into interventions for trauma-exposed individuals, offering a behavioral approach to mitigating stress-related neurobiological changes.