Electroconvulsive therapy (ECT) has been well discussed in psychiatry as one of the oldest, yet still enduring and effective treatments for several psychiatric disorders, including depression, catatonia, mania, and psychoses. However, the intellectual history of ECT is much less known in the field of epilepsy, in spite of the fact that the therapy's origins are squarely in epilepsy neuropathology. Therefore, this historical review's primary aim is to retrace the scientific roots of ECT from a uniquely epilepsy-focused perspective. We focus on the key contributions of a neuropathologist studying epilepsy, László Meduna, who was the first to wonder if seizures may be beneficial in certain psychiatric disorders. In addition, we highlight the controversies surrounding his initial results, the transition from chemoconvulsants to electrical seizure induction, and that, despite the long-standing clinical use of ECT, it is still not well understood in mechanistic terms why inducing a seizure could relieve symptoms of certain psychiatric illnesses. The history of ECT for epileptologists is particularly insightful not only because it chronicles how an idea originating from studies focusing on seizures has come to have such an enduring impact on clinical care in an area outside of epilepsy but also because it highlights how bold testing of innovative hypotheses stemming from seemingly disconnected observations can lead to tangible breakthroughs in translation.

PurposeTo assess the feasibility and acceptability of the "Naru" Program, a Reiki-informed meditative intervention for first-year nursing students, and to estimate pre-post change in distress and well-being.DesignSingle-group pretest-posttest pilot feasibility study.MethodsInformed by Transitions Theory and holistic nursing, a seven-session hybrid program combined the spiritual precepts of Reiki with Joshin Kokyu Ho breathing meditation and guided imagery; five mental health nurses appraised its content. Of 413 students invited, 61 were screened, 29 eligible, 22 started, and 12 completed. Feasibility outcomes were uptake, retention, adherence, and acceptability; distress and well-being were assessed with the Depression Anxiety Stress Scales - 21 and the Psychological Well-Being Manifestation Measure Scale, with Wilcoxon signed-rank tests.FindingsThe program was delivered as designed and well received: participants reproduced the meditation independently, some during clinical placements. Uptake was 14.8% and retention 54.5%; attrition concentrated at year-end. Distress decreased and well-being increased on all retained subscales, with large effect sizes and bootstrap intervals excluding zero for all but one measure; reliable improvement was most frequent in well-being and happiness.ConclusionsDelivery and acceptability were established; recruitment and retention were not, and require changes to timing and recruitment before a controlled trial. Efficacy cannot be inferred.

Adolescents of mothers with a history of depression are at increased risk for developing depression themselves. These adolescents may have been especially vulnerable to depression under conditions of stress, such as the beginning of the COVID-19 pandemic. To understand the complex processes involved in the transmission of maternal depression risk to adolescent offspring in the context of stress, we examined potential mediating and moderating factors that link maternal depression history and offspring depressive symptoms, including resting-state functional connectivity (rs-FC) and mothers' depressive symptoms, in 85 adolescents during the pandemic. Adolescents' prepandemic rs-FC between the posterior and anterior cingulate cortices (PCC-ACC) moderated the association between maternal depression history and adolescents' symptoms during the pandemic, such that maternal depression history predicted adolescents' symptoms only in youths with heightened PCC-ACC rs-FC. Mothers' depressive symptoms during the pandemic mediated and moderated the link between maternal depression history and adolescents' symptoms. Mothers with a history of depression had greater depressive symptoms early during the pandemic, which were further associated with offspring depressive symptoms. Additionally, maternal depression history predicted depressive symptoms in adolescents whose mothers had lower depressive symptoms during the pandemic. Findings speak to the mediating and moderating processes in the transmission of maternal depression risk to adolescent offspring in the context of the pandemic.

Traditional symptom validity tests (SVT) are crucial yet costly components of routine evaluations. Embedded overreporting SVT cutoffs in commonly used psychopathology screeners exist, but it is unclear how multiple elevations across these measures impact detection accuracy. This study explored if the convergence of elevations across three embedded SVTs, Beck Depression Inventory-Second Edition, Beck Anxiety Inventory, and Posttraumatic Stress Disorder Checklist for DSM-5, improves invalidity detection accuracy using preselected and sample-derived cutoffs. Individual screeners demonstrated high specificity but low sensitivity, and each screener uniquely predicted validity status. Using conservative/preselected cutoffs, elevating ≥2 embedded SVTs significantly improved specificity to >99% with modest sensitivity (32%), while ≥3 elevations using liberal/sample-derived cutoffs resulted in 98% specificity but an improved sensitivity of 41%. Multiple elevations across embedded SVTs can identify noncredible responding/symptom endorsement on psychopathology screeners, thus signaling that more robust validity testing can be discontinued. However, given the lower sensitivity of this approach, these embedded SVTs may better rule in rather than rule out noncredible responding when elevated.

Family instability and involvement in interparental conflict have long been identified as risk factors for adolescent depression; however, adolescent perceptions may be an underexamined measure of family instability which could produce cascading effects toward depressive symptoms. Altered perceptions due to cognitive maturation and puberty may make adolescents particularly attuned to deviations in the stability of the family system. Moreover, their involvement in parents' conflicts may further amplify their vulnerability to these stressful environmental experiences and increase their likelihood of depression. Therefore, perceived family instability, involvement in interparental conflict, and depressive symptoms were examined in 296 adolescents (50.3% female, mostly White) across three annual waves starting at age 13 years. Using autoregressive latent trajectory modeling, between-person results showed that adolescents with higher initial levels of perceived family instability tended to show higher initial depression levels, and some adolescents' involvement in their parents' disputes increased faster than others over this three-year period. Within-person results indicated that adolescents experiencing higher-than-usual perceived family instability at age 14 exhibited significantly higher depressive symptoms at age 15, pointing to the unfolding emotional cost of instability for early-to-middle adolescents. Findings emphasize modeling enduring vulnerabilities and intra-individual fluctuations in family and emotional processes during adolescence.

Social withdrawal in late childhood and adolescence is linked to long-term developmental challenges, yet its unique impact on adult adaptive functioning remains understudied. This TRAILS study (N = 1,798 in the population cohort, M (SD) age at T1: 11.1 (0.6), 49% boys, 86.5% ethnically Dutch, M (SD) age at T7: 28.9 (0.6); N = 405 in the high-risk cohort, M (SD) age at T1: 11.1 (0.5), 66% boys, 97.6% ethnically Dutch, M (SD) age at T7: 29.6 (0.7)) examined whether social withdrawal during the ages of 11 to 16 predicted the achievement of developmental milestones by age 29, including romantic competence, residential autonomy, friendship satisfaction, work competence, and financial competence. Higher levels of social withdrawal consistently predicted lower likelihood of having achieved these milestones by age 29 (median OR = 0.76 in both cohorts), even after controlling for peer victimization, cognitive abilities, and family background measured in early adolescence. These effects were consistent across cohorts and gender. Sensitivity analyses that accounted for genetic confounding and clinical conditions (e.g., autism, depression) further supported the findings. These results highlight social withdrawal as a critical risk factor for developmental disadvantages, urging early interventions to foster social engagement and mitigate long-term maladjustment.

ObjectiveDigital sleep interventions offer scalable early mental health support for youth. This study evaluated the feasibility and preliminary impact of Sleep Ninja, a self-guided Cognitive Behavioural Therapy for Insomnia (CBT-I) app, on insomnia and depression symptoms among adolescents in Aotearoa, New Zealand.MethodParticipants aged 16-18 (n = 47, 11% Māori, n = 5) with a self-reported desire to improve sleep were recruited via social media and snowball sampling. Users engaged with the app for 30 days. Online assessments of insomnia, depression, and well-being occurred at baseline, post-intervention (30 days), and follow-up (90 days). App acceptability and feasibility were explored via the User Version of the Mobile Application Rating Scale (uMARS) and qualitative interviews (n = 7).ResultsQuantitative results showed high app acceptability (uMARS) and feasibility, with participants engaging for an average of 17 days. Significant improvements in insomnia and depression symptoms and well-being were observed at 30 days, with some effects sustained at 90 days. Qualitative interviews further supported acceptability; participants emphasised the importance of cultural relevance and suggested incorporating Te Reo Māori to enhance engagement.ConclusionsSleep Ninja is acceptable to adolescents in Aotearoa, New Zealand. Preliminary results suggest improvements in insomnia, depression, and well-being, supporting further evaluation in a larger trial.