روانپزشکی
مقالهها، منابع و پژوهشهای تازه حوزه روانپزشکی
ورود به زیرشاخهنقشه موضوعی
جستوجوی دقیقسلامت روان
روانپزشکی، روانشناسی، اعتیاد و سلامت روان جامعه
زیرشاخهها
برای رسیدن به فهرست متمرکزتر، یک مسیر تخصصی را انتخاب کنید.
روانشناسی بالینی
مقالهها، منابع و پژوهشهای تازه حوزه روانشناسی بالینی
ورود به زیرشاخهروانپزشکی کودک و نوجوان
مقالهها، منابع و پژوهشهای تازه حوزه روانپزشکی کودک و نوجوان
ورود به زیرشاخهاعتیاد و سوءمصرف مواد
مقالهها، منابع و پژوهشهای تازه حوزه اعتیاد و سوءمصرف مواد
ورود به زیرشاخهرواندرمانی
مقالهها، منابع و پژوهشهای تازه حوزه رواندرمانی
ورود به زیرشاخهپیشگیری از خودکشی
مقالهها، منابع و پژوهشهای تازه حوزه پیشگیری از خودکشی
ورود به زیرشاخهسلامت روان جامعه
مقالهها، منابع و پژوهشهای تازه حوزه سلامت روان جامعه
ورود به زیرشاخهتازهترین رکوردها
شواهد سلامت روان
PubMed2026
[THE EPISTEMOLOGY OF PSYCHIATRY: DISPOSITIF OF KNOWLEDGE AND PROFESSIONAL WORK].
The article offers systematic consideration of epistemology of psychiatry as section of medicine which examination permits to analyze dispositif of science successfully implementing conceptual theoretical constructs in everyday practice. The various versions and trends in this area are considered, from traditional history of medicine with its positive or negative models of development of psychiatry to historical epistemology and history of ideas striving to create conceptualized picture of permanent scientific revolution or explosive evolution of psychiatry. The number of key moments are marked representing crystallization points of epistemology of psychiatry as systematic form of research: 1) the question about area of knowledge that is provide space for research in this direction; 2) creation of space of reflexive thinking where internal problematization of psychiatric theory and practice will be possible, excluding development of general theory of psychiatry that is externally imposed on it as general guidelines; 3) problematization of modus of openness of psychiatry to related areas of knowledge and public practice, minimizing interference of non-professionals in professional activities of psychiatrists.
PubMed2026
Parallel Parent-Child Mindfulness Intervention for Migrant Families' Adaptation: A Randomized Controlled Trial.
Parent and child sociocultural adaptation is essential to migrant family well-being, and community-based mindfulness training may support this process. However, evidence on mindfulness interventions for migrant families remains scarce, particularly those engaging parent and child simultaneously. This study evaluates a parallel parent-child mindfulness intervention targeting sociocultural adaptation, psychological adjustment, and family relationships among Chinese new-arrival families in Hong Kong. In a randomized controlled trial, 116 parent-child dyads were assigned to an 8-week mindfulness intervention or routine community services. Outcomes were assessed at baseline, post-intervention, and 6-month follow-up. Compared with controls, the intervention significantly improved parents' sociocultural adaptation, with attenuated effects at follow-up. It also increased parent life satisfaction and reduced parenting stress at posttest. Child outcomes were largely nonsignificant, except for short-term improvements in social interaction and life satisfaction at posttest. Indirect effects of the intervention through parent sociocultural adaptation were nonsignificant, with estimates in the hypothesized direction for parent life satisfaction (B = 0.94, 95% CI [-0.02, 1.90]) and psychological distress (B = -1.42, 95% CI [-2.89, 0.04]). No mediation effects were observed among children. Subgroup analyses indicated that effects on parent adaptation and life satisfaction varied by child sex and family length of residence, with sustained effects observed only among parents of boys and families residing in Hong Kong for less than 2 years. Findings suggest that parallel parent-child mindfulness interventions may support specific aspects of migrant families' adaptation, with more consistent and sustained effects for parents than for children.
PubMed2026
Perceived discrimination, coping, and psychosocial adjustment: A mixed methods study of Chinese internal migrant youth.
Studies of identity-based discrimination among Chinese youth attending vocational schools and working in urban areas are scarce. To contribute to the global understanding, we adopted an explanatory sequential mixed-methods design with 204 Chinese internal migrant youth (Aged 16-24, 68.1% male, Mage = 20.17 years, SD = 1.57) to examine the associations between perceived discrimination and psychological adjustment, and the moderating roles of coping and perceived social support. In the first phase, participants completed self-report measures, and in the second phase, we interviewed a subsample of 47 youth to contextualize our quantitative trends. Quantitative findings showed that perceived discrimination was negatively linked to self-esteem and positively to depressive symptoms, whereas active-approach coping and social support were positively related to self-esteem and negatively with depressive symptoms. Expressive-evading coping covaried positively with depressive symptoms. We also found that passive-avoidant coping exacerbated the associations between discrimination and depressive symptoms. The roles of active coping and social support in relation to self-esteem varied by age. Qualitative data showed that migration status, rural origin, and regional dialects were the most cited reasons for experiencing discrimination, occurring most frequently in immediate neighborhoods and schools by locals and classmates. Most youth turned to close friends for emotional support, rather than parents, teachers, or classmates. Many would ignore or distract themselves from the experiences, and sometimes would actively cope with the stress. Both quantitative and qualitative findings reveal the unique challenges Chinese migrant youth encounter and distinct pathways of resilience in adapting to urban settings.
PubMed2026
Perceived Utility of Combining Atypical Long-Acting Injectable Antipsychotics With Psychosocial Interventions: An Exploratory Survey of Mid-Career Psychiatrists in Japan.
AIMS: Although combining long-acting injectable antipsychotics (LAIs) with psychosocial treatments for schizophrenia is important, psychiatrists' attitudes toward this approach remain underexplored. We investigated Japanese psychiatrists' perceptions of combining atypical LAIs with psychosocial interventions. METHODS: An anonymous cross-sectional web-based survey was administered to 1038 mid-career Japanese psychiatrists, of whom 69 provided complete responses. Participants' general attitude toward recommending atypical LAIs was dichotomized as positive or negative/neutral, and they rated on a 4-point scale the usefulness of combining atypical LAIs with five psychosocial interventions: (1) psychosocial treatment (e.g., psychoeducation), (2) day/night care, (3) community care, (4) financial/employment support, and (5) housing support. RESULTS: Thirty-nine respondents held a positive attitude toward recommending atypical LAIs, whereas 30 held a negative/neutral attitude. A positive attitude was significantly associated with perceiving the combination as useful for psychosocial treatment (p = 0.038), financial/employment support (p = 0.015), and housing support (p = 0.041), but not for day/night care (p = 0.090) or community care (p = 0.079). Free-text rationales most commonly cited improved adherence and relapse prevention, enhanced illness insight, and synergistic effects as reasons for valuing the combination. CONCLUSIONS: This exploratory study suggests that mid-career Japanese psychiatrists, particularly those with a favorable attitude toward atypical LAIs, perceive the combination of LAIs with psychosocial support not merely as an adherence tool but as a synergistic strategy promoting broader functional recovery. Because respondents represent a small, predominantly male, self-selected sample, the generalizability of the findings is limited.
PubMed2026
Geographic variation in access to Medicare-subsidised psychotherapy.
OBJECTIVE: Within Australia, evidence is limited regarding how access to mental health care varies across geographical regions, and which areas experience the lowest levels of service use. This study aimed to provide new population-level evidence on the geographic variation in the use of Medicare-subsidised psychotherapy over the past decade and identify regions with the lowest service use. METHODS: We used administrative data from the Medicare Benefits Schedule to identify 2.7 million adults aged 25-54 years across mainland Australian states with a new mental health treatment plan from a general practitioner between 2014 and 2023. State-level trends were examined by calculating the proportion of individuals who accessed Medicare-subsidised psychotherapy within 3 months of receiving their mental health treatment plan in each state per year. We then examined variation in the use of psychotherapy across regions in 2023 (Statistical Area Level 4), and assessed how this psychotherapy use was associated with area-level socioeconomic disadvantage. RESULTS: Between 2014 and 2023, psychotherapy use among adults with a mental health treatment plan declined substantially across all states, from approximately 60% of adults in 2014 to <50% in 2023. Psychotherapy use also varied markedly across sub-state regions (Statistical Area Level 4s) in 2023, with uptake ranging from 36% in Sydney's Outer South West to 60% in Perth's inner suburbs. Access was generally lower in non-metropolitan regions and in areas with higher socioeconomic disadvantage. CONCLUSIONS: The results highlight the need for system supports that make psychological services more accessible, particularly in socioeconomically disadvantaged areas. Addressing access gaps will require coordinated efforts across general practice, service delivery and policy settings. Prioritising support and policies towards regions with the poorest access can assist with designing a more equitable mental health system.
PubMed2026
'No Dumping!' Threshold Work in Voluntary Sector Mental Healthcare in Inner-City London.
This paper examines the sociomaterial dynamics of mental healthcare by following metaphors circulating among voluntary sector providers that they were becoming 'dumping grounds' within a system in crisis. In the United Kingdom, the voluntary sector has long been called upon to deliver flexible, community-based care that reduces pressure on primary and secondary services. Under chronic conditions of austerity, however, providers have been stretched beyond their capacity. Drawing on ethnographic research across three voluntary sector mental health sites in inner-city London, I analyse how providers made and maintained places of care while grappling with expanding and shifting demands. Taking a sociomaterial approach, I propose the analytic concept of 'threshold work' to complicate the dumping metaphor and to reconceptualise how material thresholds of place and immaterial thresholds of mental health need are co-constituted with care practices. I identify three interrelated modes of threshold work through which providers manage the limits of inclusion, revealing how diagnostic boundaries of need and spatial arrangements of care move together, shaping the terms and conditions of care in the city.
PubMed2026
Associations Between Pain Severity and Opioid Agonist Treatment Among People With Drug Injection Experience in Australia.
INTRODUCTION: Pain is highly prevalent among people with opioid use disorder (OUD), yet it is often undertreated. Whether opioid agonist treatment (OAT) improves pain outcomes is unknown among this target population. This research aimed to explore associations between pain severity and current OAT status in a longitudinal cohort of people who inject drugs. METHODS: Data were drawn from the Melbourne Injecting Drug User Cohort Study (SuperMIX), comprising individuals with a drug injection history recruited from areas across Greater Melbourne and Geelong, Australia, between 2008 and 2024. Eligible participants were adults who reported ever being in OAT for at least one time point. Participants were classified into four groups based on their self-reported pain level (from none to severe). Multilevel ordinal logistic regression with a participant-level random intercept examined the association between pain severity and current OAT status, comparing current OAT (methadone or buprenorphine) with no current OAT as the reference category. Current OAT status was treated as a time-varying exposure, with methadone and buprenorphine examined separately in sensitivity analyses. Models were adjusted for demographic and clinical characteristics and substance use history. RESULTS: A total of 1328 participants were eligible for inclusion. At baseline, most were male (67.7%), on government income support (81.9%), and had pain at any level in the past 4 weeks (66.0%), with a mean age of 36.7 (SD 10.6) years. No association between pain severity and current OAT status was observed, while several other factors associated with higher pain severity were identified, such as older age, poorer overall health and the use of other opioids. DISCUSSION AND CONCLUSIONS: While OAT status was not associated with pain severity in this study, several other factors associated with higher pain severity were identified. These findings highlight the multifactorial nature of pain in this population and the importance of considering broader physical and emotional health when managing pain.
PubMed2026
Clinical effectiveness and safety of metadoxine in the management of acute alcohol intoxication: A single-center retrospective cohort study.
BACKGROUND: Acute alcohol intoxication (AAI) is a common emergency with no specific antidote. Metadoxine has shown potential but lacks sufficient real-world evidence, particularly in Chinese populations. OBJECTIVES: To evaluate the clinical efficacy and safety of metadoxine in patients with acute alcohol intoxication. METHODS: This single-center retrospective cohort study included 124 patients with AAI admitted to an emergency department between January and December 2024. Patients were divided into metadoxine plus conventional treatment (n=62) or conventional treatment alone (n=62) after propensity score matching. Primary outcomes were time to consciousness recovery (Glasgow Coma Scale ≥14) and treatment effectiveness rate (symptom improvement within 6 hours without treatment escalation). Secondary outcomes included time to symptom relief, emergency stay, time to vital sign stabilization, blood ethanol decline rate, adverse reactions, and liver function changes. RESULTS: Metadoxine significantly shortened consciousness recovery time (3.05±1.45 vs. 5.65±1.58 hours, mean difference -2.60 hours, 95% CI: -3.14 to -2.06, p < 0.001) and improved treatment effectiveness rate (93.5% vs. 77.4%, OR=4.04, 95% CI: 1.30-12.56, p = 0.011). All secondary outcomes were significantly better in the metadoxine group (p < 0.001 for time-related outcomes and blood ethanol decline). No significant differences were observed in adverse reactions (9.68% vs. 6.45%, p = 0.510) or post-treatment liver enzyme abnormalities (12.90% vs. 16.13%, p = 0.610). Subgroup analysis showed a significant interaction by initial Glasgow Coma Scale (p = 0.037), indicating greater efficacy in patients with moderate-to-severe impairment. CONCLUSION: Metadoxine, when added to conventional supportive therapy, significantly accelerates consciousness recovery and improves clinical outcomes in acute alcohol intoxication without increasing short-term adverse events. The benefit appears more pronounced in patients with lower Glasgow Coma Scale scores.
PubMed2026
Clinicians' Perspectives and Experiences of Barriers, Enablers and Implementation of a Child and Adolescent Mental Health Crisis Service: A Qualitative Evaluation of the Safeguards Team Program.
BACKGROUND: Presentations of children and young people (CYP) to Emergency Departments (ED) for acute mental health (MH) issues have increased globally and in Australia. The Safeguards Teams Program (STP) was implemented to provide acute, rapid response, recovery-focused, trauma-informed brief intervention. This study aims to explore clinicians' perspectives and experiences implementing the STP, including barriers, facilitators and suggestions for programme improvement. METHODS AND MATERIALS: This study used a qualitative approach by employing in-depth interviews. Participants were recruited using purposive sampling. The interview transcripts were coded and analysed thematically. RESULTS: Key themes included perceived barriers to implementation, programme enablers and suggestions for improvement. Enablers of successful implementation included structures that supported clinicians' outreach and service accessibility, a centralised and flexible referral model that clinicians perceived facilitated timely care, and opportunities for clinicians' capacity building and collaboration. Clinicians also perceived that the STP supported children and young people experiencing MH crises who may not meet the intake criteria for other services, thereby addressing an important service gap. Perceived barriers included high demand, which increased workload, and challenges associated with the model of care (MoC) in its early stages of implementation. Suggestions for programme improvement emphasised the need for greater contextualisation of services through co-design, a more flexible MoC as part of STP service delivery, and a structured and formalised referral process. Participants also recommended including clinicians with specific skills and cultural awareness, enhancing community awareness, and strengthening integration efforts. CONCLUSIONS: Clinicians perceived the STP as a valuable crisis-response service with the potential to address an important service gap for CYP who need rapid outreach specialist MH crisis response. Findings relating to clinicians' experiences and perceptions of implementing the STP may inform the development, refinement and implementation of similar crisis-response models. Further quantitative research is needed to evaluate clinical outcomes, service utilisation and consumer perspectives associated with the STP.
PubMed2026
Effects of Aromatherapy on Stress and Anxiety Among Intensive Care Unit Nurses: A Systematic Review.
BACKGROUND: Nurses working in intensive care units (ICU) are at high risk for stress and anxiety. Aromatherapy stands out as a non-pharmacological and easily implementable complementary approach for alleviating these symptoms. To our knowledge, this is the first systematic review specifically examining the effects of aromatherapy on stress and anxiety among ICU nurses. AIMS: This systematic review aimed to evaluate the effects of aromatherapy on stress and anxiety among ICU nurses and to assess the methodological quality of the evidence. STUDY DESIGN: In this systematic review, a literature search was conducted in the Scopus, PubMed, Web of Science and Cochrane Library databases without any time restrictions. The review includes randomised controlled, experimental and quasi-experimental studies evaluating the effects of aromatherapy interventions on stress and/or anxiety among ICU nurses. The selection of studies, data extraction and assessment of methodological quality were conducted independently by two researchers. RESULTS: This systematic review included five studies involving a total of 254 participants. Two of these studies are randomised controlled trials, and three are quasi-experimental studies. The studies included in the review demonstrate that aromatherapy is administered using various essential oils and application methods (inhalation, topical application, etc.). The findings suggest that aromatherapy interventions may reduce stress among ICU nurses, whereas evidence regarding anxiety reduction is mixed and less consistent across studies. CONCLUSION: Aromatherapy may have potential benefits for reducing stress among ICU nurses, whereas evidence for anxiety reduction remains limited and inconsistent. Further high-quality studies are needed before firm conclusions or routine clinical implementation can be recommended. RELEVANCE TO CLINICAL PRACTICE: Aromatherapy may be considered as an optional supportive intervention within staff well-being programs, provided that safety, scent sensitivity, infection-control procedures and individual preferences are taken into account. However, standardised protocols and further high-quality evidence are required to support its routine clinical use.
PubMed2026
Environmental Context and Reporting Completeness of Event-Based Ecological Momentary Assessment in Cigarette and Cannabis Use.
INTRODUCTION: Ecological momentary assessment (EMA) allows researchers to capture substance use as it occurs in daily life, but participants may not report every use event. Little is known about whether the environments where people spend time affect the completeness of these reports. METHODS: We examined how consistently young adults reported cigarette and cannabis use through event-based EMA and whether reporting differed by the social vulnerability of places they visited. We analysed 30 days of GPS-enabled EMA and daily diary data from 34 young adults in California (730 participant days). We compared daily cigarette and cannabis use events reported through EMA with those reported in the following day's diary and classified EMA reports as lower than, matching, or higher than the diary. Using GPS data and the Social Vulnerability Index, we measured the social vulnerability of participants' daily activity spaces relative to home. RESULTS: Bayesian multilevel multinomial logistic regression showed that higher social vulnerability in daily activity spaces relative to home was associated with greater odds of reporting fewer use events through EMA than in the daily diary for cigarettes (aOR 1.55, 95% CrI 1.25-1.93) and cannabis (aOR 1.28, 95% CrI 1.06-1.55). The association for cigarettes was also observed in a larger independent dataset. DISCUSSION AND CONCLUSIONS: These findings suggest that the completeness of real-time substance use reporting may depend partly on where participants spend their time. Researchers using event-based EMA should consider environmental context when interpreting incomplete reports and designing studies to improve data completeness.
PubMed2026
Experiences of mothers with borderline personality disorder following an intervention to support mother-infant relationships: "more tools in my toolbox".
Motherhood is inherently demanding, and some of these demands may be amplified for women with borderline personality disorder (BPD). The exacerbation of BPD symptoms from parenting-related stressors can have adverse impacts on mother-infant relationships and infant development. This qualitative study explores Australian mothers' views of the impacts of mother-infant dialectical therapy plus (MI-DBT+). MI-DBT+ is an innovative therapeutic intervention which integrates mother-infant dialectical behavior Therapy (MI-DBT), a known effective intervention for the mental health of mothers with BPD, with attachment and biobehavioral catch-up (ABC) therapy. Specifically, eight mothers completed semi-structured interviews about their experiences of intervention following completion of the MI-DBT+ program. A thematic analysis of this interview data found that mothers appreciated learning more skills to enhance their understanding of their infants' needs, behaviors and emotions. Mothers also reported improved reflective functioning and better control of their emotional responses. These skills assisted in managing emotional distress at both the individual and dyadic level. The study was limited due to available demographic data, with only maternal and child age available. Discussion also focuses on the fit between DBT and ABC, longer term developmental concerns and sustainability.
PubMed2026
Personality Disorder Diagnoses in Outpatient Forensic Mental Health: A Comprehensive Prevalence Study in the Netherlands.
Personality disorders (PDs) are associated with significant clinical and societal consequences and are highly comorbid with other psychiatric conditions. In forensic mental health settings, PD diagnoses are particularly relevant because they are linked to antisocial behavior, recidivism risk, and specific treatment needs. However, empirical knowledge about the prevalence of PD diagnoses in outpatient forensic mental health (OFMH) care is limited. We aimed to conduct a comprehensive study of the prevalence of PD diagnoses in OFMH institutions and to describe the demographic, clinical, and legal characteristics of individuals with PD diagnoses. Data were collected from OFMH institutions across the Netherlands for all adult individuals who received treatment in 2023. Fifteen institutions provided usable data, resulting in a total sample of 10,560 individuals. Descriptive analyses were conducted to estimate the prevalence of PD diagnoses and to examine differences across individual characteristics and treatment variables. Overall, 19.3% of all individuals were diagnosed with at least one PD. PD was the primary diagnosis in 12% of all individuals and an additional diagnosis in 7.3%, which seems to indicate that PD diagnoses are under-recognized. The most frequently recorded specific PD diagnoses were other specified or unspecified PD, followed by borderline PD and antisocial PD. PD diagnosis prevalence was higher among female individuals, middle-aged individuals, individuals receiving voluntary treatment, and those involved in more serious violent offenses. These findings provide large-scale prevalence data on PD diagnoses in Dutch OFMH and highlight the importance of systematic assessment of personality pathology in forensic outpatient populations.
PubMed2026
Real-Time Neurofeedback Training to Modulate Glutamate-Glutamine Concentration Using Functional Magnetic Resonance Spectroscopy.
Neurofeedback training is a procedure in which participants learn to modulate brain activity through their own efforts. Here, we designed a real-time neurofeedback training using functional magnetic resonance spectroscopy (fMRS) to modulate the concentration of glutamate, a major excitatory neurotransmitter, and its precursor glutamine (collectively referred to as Glx) in a volume-of-interest (VOI) located in the occipital lobes. During an induction phase participants employed a self-selected strategy to increase or decrease Glx concentration relative to a reference concentration measured prior to neurofeedback training. Participants were informed about their performance after the induction phase by displaying a disk in green for success or red for failure. The disk size indicated the magnitude of success or failure. The procedure was repeated over the course of 30 trials. Participants were randomly assigned to experimental and control groups (15 participants per group). The experimental group received veridical feedback about their success or failure in the induction phase. The control group received random feedback. Glx concentration in the VOI was measured using 2-s-long consecutive Point RESolved Spectroscopy (PRESS) scans in a 3-Tesla MRI scanner. The results showed that depending on group assignment, participants in the experimental group learned to increase or decrease Glx concentration over the course of training. No significant changes in Glx concentration were observed in the control group. These findings suggest that, with the help of veridical performance feedback, participants learned to modulate Glx concentration in the VOI in the desired direction over a relatively short period of time. fMRS-based neurofeedback training may complement existing neurofeedback approaches by targeting neurotransmitter-related processes.
PubMed2026
The Impact of Heterogeneity in Individual Characteristics and Motivation to Quit Heroin Use on Contingency Management and Opioid Agonist Treatment Response: A Latent Class Analysis.
INTRODUCTION: Contingency Management (CM) involves the systematic application of positive reinforcement (financial incentives) to promote behaviour change, to improve treatment outcomes for individuals with opioid use disorder (OUD). To better understand patient heterogeneity, this study sought to identify meaningful subgroups/classes underlying the population based on characteristic groupings, followed by determining whether CM effectiveness varied between these subgroups. METHODS: Baseline characteristics (evidenced/theorised to impact CM effectiveness) of participants with OUD from the PRAISe trial (N = 552) were empirically examined using latent class analysis. Model selection was based on fit statistics and interpretability. Class was then evaluated as a potential moderator of CM effectiveness on abstinence from heroin using a mixed effects model (consistent with the PRAISe trial analysis). RESULTS: A four-class solution best described the population: (1) Less clinically complex/low alcohol dependence/high motivation to quit heroin (N = 115); (2) More clinically complex/low alcohol/high motivation (N = 287); (3) More clinically complex/high alcohol/high motivation (N = 73); and (4) More clinically complex/moderate alcohol/low motivation (N = 77). CM for Attendance, previously shown to increase heroin abstinence in the overall study sample, was more effective than no CM for participants in class (1) and (2) exclusively (OR = 5.21; 95% CI 1.25, 21.78 and OR = 1.87; 95% CI 1.03, 3.40, respectively). CM targeted at abstinence, previously shown to not be effective compared to no CM overall, was not effective in any class. DISCUSSION AND CONCLUSIONS: CM targeted at attendance is more effective for two subgroups of the OUD population characterised by either less complex clinical presentation and/or low dependence on alcohol. Individual differences may therefore inform a targeted CM treatment approach.
PubMed2026
The Role of Emotional Intelligence in Intensive Care Nursing: A Scoping Review.
BACKGROUND: Emotional intelligence (EI) is critical in intensive care unit (ICU) nursing, where nurses face high stress, clinical instability and emotionally demanding situations. EI helps nurses manage emotions, improve communication and support clinical performance. It has also been linked to lower burnout and more adaptive coping among ICU nurses. AIM: This scoping review aimed to map the available evidence on emotional intelligence among nurses working in ICUs, including its key dimensions, associated professional outcomes and current knowledge gaps. STUDY DESIGN: A scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A structured search was conducted in MEDLINE, CINAHL, PubMed and Scopus for studies published in the past 10 years in Portuguese, English or Spanish. RESULTS: In total, this review included nine studies. The evidence highlights the crucial role of EI in emotional regulation, communication and clinical performance among ICU nurses. Key dimensions of emotional intelligence, including empathy, emotional clarity and self-regulation, were consistently identified as important. Training programmes demonstrated significant improvements in EI and reduced burnout symptoms, and EI was also associated with more adaptive coping strategies and improved professional performance. CONCLUSIONS: Emotional intelligence is an important competency in ICU nursing and has been linked to improved communication, clinical decision-making and lower burnout among nurses. Despite these benefits, research still shows gaps, particularly in standardising EI assessment tools and in the need for longitudinal studies. Targeted emotional intelligence training programmes may strengthen ICU nurses' emotional resilience and enhance care quality. RELEVANCE TO CLINICAL PRACTICE: Integrating EI development into ICU nursing education and institutional policies can help reduce burnout, improve communication with patients and families, and enhance overall clinical performance, thereby supporting a healthier work environment and strengthening nurses' communication and professional performance in intensive care settings.
PubMed2026
Trends in Hepatitis D Virus Prevalence Among HBsAg-Positive Individuals With and Without HIV in Italy: A Converging Epidemiology.
BACKGROUND AND AIMS: Hepatitis D virus (HDV) infection has historically been more prevalent among people with HIV (PWH) due to shared transmission routes. Whether HIV status still identifies a subgroup at higher risk of HDV in contemporary settings remains unclear. METHODS: We performed two cross-sectional analyses assessing anti-HDV prevalence among HBsAg-positive PWH enrolled in the ICONA cohort in 2009-2012 and 2019-2023, compared with HIV-negative individuals from the MASTER and PITER cohorts. RESULTS: Anti-HDV prevalence among PWH declined from 19.1% to 12.5%, converging with that observed in HIV-negative individuals (12.7%). Injection drug use markedly decreased over time among PWH and remained the strongest determinant of HDV infection. In multivariable analyses, HDV seropositivity was associated with age, injection drug use, and birth outside Italy, but not with HIV infection in the contemporary period. CONCLUSION: These findings indicate that HIV infection is no longer independently associated with HDV infection in this setting and support universal HDV screening strategies.
PubMed2026
When Guidelines Are Not Enough: Clinician Hesitation to Diagnose Borderline Personality Disorder in Adolescents as a Barrier to Timely Evidence-Based Care.
A recent review of 11 international clinical guidelines for borderline personality disorder (BPD) and its features in adolescents, found broad agreement on core recommendations: structured assessment, psychotherapy as first-line treatment and family involvement. This is a meaningful step forward. But it raises a question the guidelines themselves do not answer: If clear recommendations exist, why are so many adolescents still not receiving a timely diagnosis? This commentary focuses on that gap. Clinicians frequently hesitate to diagnose BPD in young people, often out of concern about stigma or a belief that the diagnosis is premature or harmful. The evidence does not support these concerns. BPD features in adolescence are stable, clinically significant and respond to targeted treatment. When clinicians avoid the diagnosis, adolescents tend to receive fragmented, symptom-focused care that misses the underlying presentation. There is a real paradox here: The attempt to protect young people from a label ends up denying them access to the treatment that label would unlock. This commentary argues that future guideline development must go beyond describing what good care looks like and start addressing why clinicians struggle to provide it.
PubMed2026
The convergent roles of metabolic dysfunction, alcohol, and iron in steatotic liver disease: a review.
Steatotic liver disease (SLD) encompasses a broad spectrum of disorders influenced by metabolic dysfunction, alcohol use, and other cofactors. The updated classification of metabolic dysfunction-associated steatotic liver disease (MASLD) and alcohol-associated liver disease (ALD), along with the recognition of the overlapping entity MetALD, allows for better identification of patients at increased risk of progressive liver injury. While iron dysregulation is known to worsen both MASLD and ALD, its role within MetALD remains poorly defined. Understanding how iron contributes to this combined phenotype may provide new insight into why these patients experience more severe disease outcomes. This review synthesises current evidence linking iron to MASLD, ALD, and their intersection in MetALD. It introduces the concept of Fe-MetALD, a "triple-hit" phenotype where metabolic dysfunction, alcohol, and iron overload act together to accelerate liver injury. Mechanistically, these insults share common pathways involving oxidative stress, mitochondrial dysfunction, endoplasmic reticulum stress, inflammation, and hepatic stellate cell activation, collectively promoting fibrosis progression and potentially increasing the risk of cirrhosis and hepatocellular carcinoma. Experimental studies suggest that the combination of these insults produces more severe liver injury than any individual factor alone. Emerging therapies that target iron pathways, including hepcidin mimetics, ferroportin inhibitors, and iron-reduction strategies like venesection or chelation, may offer therapeutic potential, although current evidence remains largely preclinical. Recognising Fe-MetALD as a high-risk phenotype supports incorporating iron markers into diagnosis and developing therapies targeting metabolic, alcohol-related, and iron-mediated injury. Understanding this triple-hit interaction may improve risk stratification and guide future therapies for SLD.
PubMed2026
Co-creating and testing a bibliotherapy e-storybook for children coping with parental complex post-traumatic stress disorder.
Background: Children living with a parent with complex post-traumatic stress disorder (CPTSD) may struggle to understand and respond to parental behaviours, increasing their risk of distress and mental health difficulties. Despite this, few evidence-informed narrative resources exist to support these children.Method: A free bibliotherapy e-storybook was co-created with over 30 participants from the affected communities and partners, including individuals with lived experience, service providers, clinicians, and an international interdisciplinary research team. Public feedback on a draft version informed further refinement. A cross-sectional online survey of additional community members and partners assessed the e-storybook. Twenty-two additional participants completed closed-ended and six open-ended survey questions.Results: Findings indicated that the co-creation approach was effective in developing a targeted and relevant resource for children.Conclusion: The e-storybook was perceived as a useful bibliotherapy tool to support child and family outcomes and to facilitate meaningful conversations about family experiences.
PubMed2026
Efficacy of technology-based psychosocial interventions on quality of life and psychological outcomes in adolescent and young adult survivors of childhood cancer: a systematic review and meta-analysis of randomized controlled trials.
PURPOSE: Adolescent and young adult (AYA) survivors of childhood cancer remain at risk of psychological distress and reduced quality of life (QoL). We evaluated the efficacy of technology-based psychosocial interventions on QoL and psychological outcomes in this population. METHODS: PubMed, CINAHL, Cochrane Library, PsycINFO, Embase, Scopus, and Web of Science were searched for randomized controlled trials (RCTs) published between 2015 and 2025. Outcomes were QoL, anxiety, depression, distress, and emotional well-being. Risk of bias was assessed with RoB 2. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were pooled with random-effects models (RevMan Web); heterogeneity (I2), subgroup analyses by assessment timing and leave-one-out sensitivity analyses were performed (PROSPERO: CRD420251248328). RESULTS: Ten RCTs (747 participants) were included. Technology-based interventions were associated with a small but statistically significant improvement in overall QoL (SMD = 0.24, 95% CI 0.09 to 0.39, p = 0.001); the effect was not significant post-intervention but was small-to-moderate at 6-24-month follow-up (SMD = 0.36, 95% CI 0.11 to 0.60, p = 0.004). A small-to-moderate reduction in anxiety was observed (SMD = - 0.35, 95% CI - 0.65 to - 0.05, p = 0.02), whereas effects on depression (SMD = - 0.31), distress (SMD = - 0.04), and emotional well-being (SMD = 0.20) were not statistically significant. CONCLUSION: Technology-based psychosocial interventions were associated with modest but statistically significant improvements in QoL and anxiety among AYA survivors of childhood cancer, with evidence of sustained benefits over time. Effects on broader psychological domains were more variable; larger, theory-driven trials with standardized outcomes are needed.
PubMed2026
Mental health struggles and coping strategies of individuals facing terminal illness of a loved one: A survey in a tertiary care hospital of Kolkata, West Bengal.
OBJECTIVES: Family caregivers of terminal cancer patients often experience substantial emotional burden. This study assessed depression, anxiety, stress, and coping-distress associations among caregivers in Eastern India to inform culturally sensitive interventions. METHODS: A cross-sectional survey was conducted among 100 adult caregivers of terminal cancer patients at a tertiary care hospital in Kolkata. Participants were recruited via systematic random sampling and interviewed using a structured proforma, the 21-item Depression, Anxiety and Stress Scale (DASS-21) and the Brief-COPE inventory. Descriptive statistics summarized demographics and caregiving characteristics. Spearman's rank correlation was used to assess associations between psychological distress and coping domains, with p < 0.05 considered statistically significant. RESULTS: Caregivers (median age 43 years; 70% male) were predominantly the patient's children (67%). Median DASS-21 scores indicated moderate depression (16), anxiety (14), and stress (16). Coping scores indicated low-to-moderate use of problem-focused (1.875 ± 0.321), emotional (1.871 ± 0.269), and avoidant coping (1.865 ± 0.266). Emotional coping correlated significantly with anxiety (ρ = 0.301, p = 0.002), depression (ρ = 0.317, p = 0.001), and stress (ρ = 0.293, p = 0.003). Depression also correlated with stress and problem-focused coping, while stress correlated with avoidant coping. SIGNIFICANCE OF RESULTS: Caregivers experienced considerable psychological burden, with emotional coping consistently linked to distress. These associations likely reflect reactive adaptation rather than inherent maladaptiveness. Results highlight an urgent need to recognize caregiver distress within oncology settings and to develop culturally informed psychosocial interventions in palliative care, particularly in low-resource environments. Such efforts could enhance both caregiver well-being and quality of end-of-life care.
PubMed2026
Early interventions for primary care patients with stress-related mental ill health: a randomised controlled non-inferiority trial of a nurse-led collaborative care intervention versus cognitive behavioural therapy.
BACKGROUND: Stress-related mental ill health is highly prevalent, and most individuals first seek help in primary care where access to psychological support is often limited. OBJECTIVE: To test whether nurse-led collaborative care (CC) is non-inferior to cognitive behavioural therapy delivered as psychologist-guided self-help (GSH-CBT) in reducing stress for adult primary care patients with stress-related mental ill health. METHODS: A randomised controlled non-inferiority trial where 172 adult primary care patients with mild to moderate stress-related mental ill health were allocated to nurse-led CC or GSH-CBT (1:1). The primary outcome was the Perceived Stress Scale-10 administered every 3 weeks during the 12-week treatment phase. The a priori non-inferiority margin was 0.3 d, requiring the one-sided 95% CI of the effect size to fall within this bound. Secondary outcomes were symptoms of exhaustion, sleep problems, depressive symptoms, general anxiety and quality of life. FINDINGS: In both conditions, participants showed large, significant within-group improvements on the primary outcome and all secondary outcomes. The primary outcome showed a small between-group difference (d=0.22), favouring GSH-CBT, with the CI upper bound (0.52) exceeding the non-inferiority margin. For secondary outcomes, GSH-CBT led to a greater reduction in exhaustion (d=0.28; 95% CI 0.64 to 0.002). No other between-group differences were observed. CONCLUSIONS: Nurse-led CC was not non-inferior to GSH-CBT. Effect differences were small, but improvements were slightly larger in GSH-CBT. CLINICAL IMPLICATIONS: Given that nurse-led CC is safe, easy to administer, and that significant within-group improvements were observed across all measures, this intervention could be a viable option in primary care settings where psychologist-delivered treatment is limited.
PubMed2026
Economic instability and substance use among adults in 10 US states: Evidence from a population-based study.
BACKGROUND: Economic instability may shape substance use (i.e., cigarette use and cannabis use) among the adult population. However, their relationship remains poorly understood. This study estimated the prevalence of economic instability indicators (i.e., employment instability, received food stamps, food insecurity, housing insecurity, and threatened utility shutoffs), exclusive cigarette use (TU), exclusive cannabis use (CU), and cigarette-cannabis co-use (TCU), and investigated the associations between economic instability indicators and these distinct substance use patterns among adults aged ≥18 years. METHODS: This study used cross-sectional population-based data from the 2023 Behavioral Risk Factor Surveillance System (BRFSS) Marijuana Use and Social Determinants and Health Equity modules, administered in 10 US states. The 2023 BRFSS achieved a response rate of 44.7%. The sample included (unweighted n = 50,481; weighted N = 24,896,969) adults ≥18 years. The outcome variables were TU, CU, and TCU. Indicators of economic instability included employment instability, receipt of food stamps, food insecurity, housing insecurity, and threats of utility shutoffs. Weighted descriptive statistics and multivariable multinomial logistic regression analyses were conducted. RESULTS: Overall, 48.6% of the participants were aged ≤50 years, 52.6% were women, and 64.4% self-identified as non-Hispanic White. The prevalences of TU, CU, and TCU were 8.1%, 11.1%, and 3.6%, respectively. Participants experiencing employment instability, housing insecurity, or threats of utility shutoffs were more likely to engage in CU compared to TU or TCU (P ≤ 0.01). All economic instability indicators were significantly associated with TCU, with the strongest association observed for those who received food stamps (aRRR = 2.27, 95% CI: 1.75-2.94), which was also significantly associated with TU (aRRR = 1.55, 95% CI: 1.24-1.93). Threats of utility shutoffs (aRRR = 1.37, 95% CI: 1.10-1.70) and housing insecurity (aRRR = 1.27, 95% CI: 1.04-1.55) were significantly associated with CU. CONCLUSIONS: Economic instability indicators are significantly associated with cigarette and cannabis use, as well as their co-use patterns among US adults residing in the 10 participating states. Effective, targeted public health interventions to mitigate substance use risk in economically precarious populations are needed. Healthcare providers should routinely screen for economic instability to identify individuals at high risk for substance use and provide them with social services and behavioral health interventions.
PubMed2026
Effects of opioids and stimulants on the respiratory system.
Drug overdose remains an urgent public health concern as it is a leading cause of fatal injury in the United States, with approximately 90% being attributed to opioid-induced respiratory depression from synthetic opioids. This statistic is primarily driven by the rise in the use of fentanyl, a potent synthetic opioid and its increased use in combination with stimulant drugs. The rise in the combined use of opioids and stimulants raises questions about pharmacological and physiological interactions, and its implication for the treatment of their addictive consequences and of overdoses. Though opioid-related fatalities are due to respiratory depression and stimulant fatalities predominantly from cardiac disruption, co-use creates interactions that remain under studied. Similarly, how medications designed to treat opioid use disorder impact respiration has been mostly neglected. Here, we review preclinical and clinical studies on the effects of opioids and stimulants on respiration, focusing on brainstem respiratory nuclei, and explore implications for advancing prevention and treatment strategies for drug-related overdose.
PubMed2026
From Innovation to Impact: The CREATE Framework as a Blueprint for Large Language Model Adoption in Opioid Treatment Programs.
Large language model (LLM)-based systems have tremendous potential to improve patient-centered health care, especially for medically underserved populations. However, realizing this potential requires careful consideration of the socio-technical contexts in which LLMs are used. The design of such systems should consider the vulnerabilities of any medically underserved group that the system intends to support, and provide trustworthy evidence for its use. This viewpoint reports the lessons learned from our experience and research with the CREATE (Culture, Respect, Education, Advancement, Trust, and Expertise) framework for engaging multiple stakeholders to guide the integration of LLM-based systems for improved health care delivery. We propose an extension of the traditional hierarchy of evidence model and identify key junction points in clinical workflows at which LLM-based systems can potentially be used to improve patient care. The key messages can be summarized as follows: (1) users of AI technologies, such as LLM-based tools, must be aware of the strengths, limitations, and impact of these technologies on health care delivery workflows and on the quality of generated evidence on which health care recommendations are based; (2) users must also be aware of the impact of data quality on AI outputs and on the evidence generated from the use of these systems; (3) the evidence pyramid provides a framework that facilitates the evaluation of the output generated by AI systems; (4) the CREATE framework facilitates the engagement of a variety of stakeholders. We propose concrete approaches for its validation and implementation; (5) any system designed to support people with opioid use disorder (OUD) needs to consider the overall lack of trust and stigmatizing experiences of this population with the health care system, and we discuss various aspects of the evaluation process necessary to build trust; (6) to discuss research directions that need to be addressed before LLM-based systems can be integrated usefully in patient health care.
PubMed2026
The role of coping strategies and psychological resilience in shaping academic stress levels.
The period of university studies is associated with numerous stressors that can negatively affect the psychological functioning of young adults. This study aimed to investigate the relationship between perceived stress levels, preferred coping strategies, and psychological resilience. The analysis focused on resilience as a potential moderator of the relationship between coping strategies and stress intensity. The study included 607 Polish students. A significant part of the group was medical students (61.72%). The study employed the Perceived Stress Scale (PSS-10), the Coping Inventory (Mini-COPE), the Resilience Scale (SPP-25), and used an author-developed questionnaire to collect sociodemographic information. The respondents exhibited moderate stress intensity (M = 22.54; SD = 7.04) and a moderately high level of general resilience (M = 59.39; SD = 15.37). Among coping strategies, acceptance (M = 1.94) and active coping (M = 1.85) were chosen most frequently, while turning to religion and helplessness were chosen least frequently. Analysis of personal resources showed the highest scores in openness to experience and sense of humor. Interaction effects rarely reached statistical significance. The study group showed a profile of students who were stressed but had functional coping resources. The moderation analysis results indicate the complex nature of the relationships among the variables studied-although psychological resilience is a key resource, its role as a moderator of the relationship between coping strategies and stress is not universal and emerges only in specific areas of functioning. The data obtained suggest that psychological interventions should focus on strengthening existing resources (such as active coping) and developing resilience, which may serve as a buffer against the negative effects of academic stress.
PubMed2026
Business Associates' Involvement in US Health Care Data Breaches: Longitudinal Analysis.
BACKGROUND: Health care organizations increasingly rely on business associates (BAs) to provide clinical, administrative, and technology services that require access to protected health information. While the Health Information Technology for Economic and Clinical Health (HITECH) Act and the Health Insurance Portability and Accountability Act (HIPAA) Omnibus Rule extended legal liability to BAs, the frequency and characteristics of data breaches involving BAs have not been systematically tracked across the entire post-HITECH reporting era. Understanding these trends is critical for health information managers and cybersecurity professionals who are directly responsible for managing third-party risk. OBJECTIVE: The author examined the longitudinal trends in BA involvement in health care data breaches reported to the US Department of Health and Human Services (HHS) Office for Civil Rights (OCR) from 2009 to 2025, including changes in frequency, breach mechanisms, breach locations, and severity profiles of BA-involved incidents across 3 regulatory periods. METHODS: The author conducted a retrospective longitudinal analysis of health care data breaches (N=6612) reported to the HHS OCR breach portal between October 2009 and December 2025. The author operationalized BA involvement as breaches reported by BA entities or flagged as BA-related. Using logistic regression models, the author estimated annual trends in BA involvement, breach mechanism, and breach location. Chi-square tests assessed associations between BA status and breach characteristics across 3 regulatory periods: pre-Omnibus (2009-2013), post-Omnibus (2014-2019), and 2020-2025. Proportion tests compared BA-involvement rates across periods. RESULTS: BA-involved breaches accounted for 1950 of 6612 (29.5%) incidents and 285,718,494 (48.8%) of all affected individuals. The annual BA-involvement rate increased from 22.1% in the pre-Omnibus period to 36.6% in the 2020-2025 period (z score=8.29, P<.001). Logistic regression confirmed an 8% annual increase in the odds of BA involvement (odds ratio [OR] 1.08, 95% CI 1.07-1.10; P<.001). Hacking/IT incidents shifted from a minority of incidents to the dominant breach mechanism (OR 1.41 per year, 95% CI 1.39-1.44; P<.001), and the odds of network server breaches increased by 29% per year (OR 1.29, 95% CI 1.26-1.31; P<.001). BA-involved breaches were significantly more concentrated in hacking (1282/1950, 65.7% vs 2351/4662, 50.4%) and network server locations (1084/1950, 55.6% vs 1435/4662, 30.8%) compared with non-BA breaches (P<.001). The proportion of mega breaches (≥100,000 individuals) also increased annually (OR 1.16, 95% CI 1.13-1.19; P<.001), with BA-involved breaches exhibiting a significantly higher rate of mega breaches (12.4% vs 8.2%; χ21=28.44; P<.001). CONCLUSIONS: Building on prior evidence linking BA involvement to breach severity, this study demonstrates that BA-involved health care data breaches accelerated substantially across the post-HITECH reporting era, with the steepest increase beginning in 2020. The concurrent growth of hacking and the concentration of breaches on network servers coincided with digital transformation, cloud migration, and the ransomware epidemic, which may have amplified third-party risk exposure. Health information managers and cybersecurity professionals should prioritize BA risk management strategies that account for the evolving threat landscape, including enhanced vendor security assessments and data compartmentalization requirements.
PubMed2026
Comparative Efficacy and Acceptability of Transdiagnostic Psychotherapies for Emotional Disorders: Protocol for a Network Meta-Analysis of Randomized Controlled Trials.
BACKGROUND: Emotional disorders-primarily anxiety and unipolar depressive disorders-are highly prevalent, disabling, and frequently comorbid. Disorder‑specific cognitive behavioral therapy (DS‑CBT) is considered a gold standard treatment, yet it can be inefficient in the context of high comorbidity and service constraints. Transdiagnostic psychotherapies that target shared maintaining mechanisms (eg, emotion dysregulation and neuroticism) have been developed, including the Unified Protocol, transdiagnostic behavior therapy, emotion regulation therapy, and various transdiagnostic internet-delivered cognitive behavioral therapy protocols. Recent meta-analyses suggest that transdiagnostic interventions are effective or likely effective, but a comprehensive comparative evaluation across different transdiagnostic protocols, DS‑CBT, other evidence‑based psychotherapies, and control conditions is lacking. OBJECTIVE: This study aims to conduct a network meta-analysis (NMA) to compare the efficacy and acceptability of various transdiagnostic therapies (eg, the Unified Protocol, transdiagnostic behavior therapy, and emotion regulation therapy), DS-CBT, other evidence-based active therapies (eg, acceptance and commitment therapy, behavioral activation, and mindfulness-based cognitive therapy), and control conditions (waitlist or care as usual) in improving symptoms in adults with anxiety and/or depressive disorders and generate a probabilistic ranking of their efficacy. METHODS: This meta-analysis will include randomized controlled trials from PubMed, Embase, PsycInfo, and the Cochrane Library, complemented by existing meta‑analytic research domain databases for depression and anxiety. Eligible participants are adults (≥18 years) with a principal diagnosis of anxiety and/or unipolar depressive disorder according to established diagnostic classification systems (eg, any version of the Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases, 10th or 11th revisions) or scoring above a validated cutoff on anxiety or depression scales. Primary outcomes are continuous measures of anxiety and depressive symptom severity at the posttreatment time point; secondary outcomes include study dropout (acceptability) and response or remission where available. We will perform random-effects network meta-analyses within a frequentist framework using the netmeta package in R to estimate relative treatment effects and P scores for treatment rankings and examine transitivity and consistency. We will conduct additional Bayesian NMAs as sensitivity analyses using the surface under the cumulative ranking curve for ranking. RESULTS: As of September 2026, the literature search has been completed, and title and abstract screening is ongoing. Data analysis will be conducted in late 2026. We expect the meta-analysis to be completed and submitted for publication by the end of 2026, with results expected to be published in early 2027. CONCLUSIONS: This NMA will provide comprehensive comparative evidence on the efficacy and acceptability of transdiagnostic psychotherapies for emotional disorders, which can inform clinical decision-making and guideline development. TRIAL REGISTRATION: OSF Registries osf.io/p8957; https://osf.io/p8957/overview. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/104791.
PubMed2026
Early Exposure to a Parent's Alcohol Use Disorder as an Adverse Childhood Experience: Neurobiological and Clinical Consequences in Adulthood.
Adverse childhood experiences (ACEs) are a significant determinant of health across the life course and exhibit a dose-dependent relationship with the risk of mental and physical disorders in adulthood. One common yet under-recognized ACE is growing up in a family with an alcohol problem. The objective of this study was to review current data on the neurobiological mechanisms and clinical consequences of early exposure to parental alcohol use disorder, considered an ACE, along with implications for medical practice. A review was conducted of the literature on ACEs, with a particular focus on exposure to parental alcohol use disorder, the co-occurrence of other developmental adversities, and health outcomes in adulthood. Data on ACE screening and the trauma-informed care approach were also included. Parental alcohol use disorder often co-occurs with violence, neglect, and mental health disorders among caregivers, increasing overall stress exposure. Chronic developmental stress is associated with hypothalamic-pituitary-adrenal axis dysregulation and persistent inflammation, as well as an increased risk of depression, anxiety disorders, posttraumatic stress disorder, and substance use disorders. Somatic consequences are also described, including a higher risk of type 2 diabetes and cardiovascular disease, as well as a poorer response to treatment in individuals with ACE exposure. The term adult children of alcoholics is descriptive in nature and does not constitute a diagnostic entity. Early exposure to a parent's alcohol use disorder as an ACE is associated with multidimensional health consequences in adulthood. Further research is needed on the efficacy and safety of ACE screening and the implementation of trauma-informed care.