Withania somnifera (WS) is considered an adaptogen agent with reported antistress, cognition facilitating and anti-inflammatory properties, which may be beneficial in the treatment of mental disorders.

This systematic review investigated the efficacy and tolerability of Withania somnifera for mental health symptoms in individuals with mental disorders.

The protocol of this review was registered with PROSPERO (CRD42023467959). PubMed, Scopus, PsycINFO, CINAHL, Embase and CENTRAL were searched for randomised controlled trials comparing Withania somnifera to any comparator, in people of any age, with any mental disorder. The meta-analyses were based on standardised mean differences (SMDs) and odds ratios with 95% confidence intervals, estimated through frequentist and Bayesian-hierarchical models with random-effects.

Fourteen studies, corresponding to 360 people treated with Withania somnifera and 353 controls were included. Anxiety disorders were the predominant diagnostic category. Thirteen trials administered Withania somnifera orally (median dose 600 mg/day), one with Shirodhara therapy. The median follow-up time was 8 weeks. Although limited by the small number of studies, substantial between-study heterogeneity, and outlier effects, our investigation showed Withania somnifera effectiveness in improving anxiety (outlier-corrected SMD: −1.13 (95% CI: −1.65; −0.60), pooled SMD: −1.962 (95% CI: −2.66; −0.57)), depression (SMD: −1.28 (95% CI: −2.40; −0.16) and stress (SMD: −0.95 (95% CI: −1.46; −0.43) symptoms and sleep quality (SMD: −1.35 (95% CI: −1.79; −0.91). The effect size was confirmed using the Bayesian for anxiety but not for depression. No significant difference between Withania somnifera and the comparators was found for safety and tolerability.

We found evidence supporting the effectiveness of Withania somnifera in treating anxiety symptoms. Future trials should replicate this finding in larger samples and further clarify a possible Withania somnifera role in depression and insomnia treatment.

Previous research has demonstrated that the COVID-19 pandemic led to a global increase in mental distress. However, few studies have examined the impact of the pandemic on mental health stigma.

To investigate changes in measures of mental health stigma, including knowledge, attitudes and behavioural intentions, in 2021 and 2023 in Hong Kong; to examine the mediating role of attitudes on the relationship between knowledge and behavioural intentions; and to explore how disclosure of mental illness contributes to enhanced overall well-being.

Data were collected as part of a larger research project focusing on mental well-being in Hong Kong. A total of 1010 and 1014 participants were surveyed in 2021 and 2023, respectively. The participants were Hong Kong residents aged 18 years and above.

Our findings demonstrate that all measures of mental health stigma showed increases in severity between 2021 and 2023. In addition, our mediation analyses observed both full and partial mediation effects of attitudes on the relationship between knowledge and behavioural intentions. The results also showed that mental illness disclosure was associated with higher well-being; however, despite these benefits, there was a decrease in willingness to disclose in 2023 compared with 2021.

This study highlights the ongoing issue of mental health stigma in Hong Kong. Future mental health programmes and interventions should aim to address various facets of mental health knowledge, including symptom recognition, access to support resources and the deleterious consequences of mental health stigma.

Identifying key areas of brain dysfunction in mental illness is critical for developing precision diagnosis and treatment. This study aimed to develop region-specific brain aging trajectory prediction models using multimodal magnetic resonance imaging (MRI) to identify similarities and differences in abnormal aging between bipolar disorder (BD) and major depressive disorder (MDD) and pinpoint key brain regions of structural and functional change specific to each disorder.

Neuroimaging data from 340 healthy controls, 110 BD participants, and 68 MDD participants were included from the Taiwan Aging and Mental Illness cohort. We constructed 228 models using T1-weighted MRI, resting-state functional MRI, and diffusion tensor imaging data. Gaussian process regression was used to train models for estimating brain aging trajectories using structural and functional maps across various brain regions.

Our models demonstrated robust performance, revealing accelerated aging in 66 gray matter regions in BD and 67 in MDD, with 13 regions common to both disorders. The BD group showed accelerated aging in 17 regions on functional maps, whereas no such regions were found in MDD. Fractional anisotropy analysis identified 43 aging white matter tracts in BD and 39 in MDD, with 16 tracts common to both disorders. Importantly, there were also unique brain regions with accelerated aging specific to each disorder.

These findings highlight the potential of brain aging trajectories as biomarkers for BD and MDD, offering insights into distinct and overlapping neuroanatomical changes. Incorporating region-specific changes in brain structure and function over time could enhance the understanding and treatment of mental illness.

Chronic pain (CP) and mental disorders often coexist, yet their relationship lacks comprehensive synthesis. This first hierarchical umbrella review examined systematic reviews and meta-analyses, also observational studies and randomized controlled trials (where reviews are currently lacking) to report CP prevalence, risk factors, and treatment across mental disorders.

We searched MEDLINE, PsycINFO, Embase, Web of Science, and CINAHL, identifying 20 studies on anxiety, depression, bipolar disorder, schizophrenia, ADHD, autism, or dementia, and CP. Quality was assessed using AMSTAR and Newcastle-Ottawa Scale.

Prevalence varied widely—23.7% (95% CI 13.1–36.3) in bipolar disorder to 96% in PTSD—consistently exceeding general population rates (20–25%). Risks were elevated, with bidirectional links in depression (OR = 1.26–1.88). Risk factors included female gender, symptom severity, and socioeconomic disadvantage, though data were limited beyond PTSD and depression. Treatment evidence was sparse: cognitive behavioral therapy showed small effects on pain (SMD = 0.27, 95% CI -0.08–0.61), acupuncture with medication improved pain (MD = -1.06, 95% CI -1.65–-0.47), and transcranial direct current stimulation reduced pain in dementia (d = 0.69–1.12). Methodological issues were evident, including heterogeneous designs and inconsistent pain definitions.

This review confirms CP as a significant comorbidity in mental disorders. Clinicians should prioritize routine pain screening and multimodal treatments. Researchers need longitudinal studies with standardized assessments to clarify causality and improve interventions. Taken together, this work highlights an urgent need for integrated psychiatric care approaches, emphasizing that addressing CP could enhance mental health outcomes and overall patient well-being.