Magical thinking (MT) involves beliefs that thoughts or actions can influence events in unrealistic ways. While MT is integral to obsessive compulsive disorder, and reflected in the cognitive features of schizophrenia, it is observable across the general population in various forms. Given its prevalence and potential relevance to a range of psychiatric conditions, understanding more about what may predispose an individual to MT, and how it may in some cases culminate in psychological distress or dysfunction would be helpful. This paper reports a systematic review of studies investigating MT, encompassing both magical ideation and thought-action fusion specifically, across the disciplines of psychiatry and psychology, to shed further light on the likely predisposing factors and behavioural consequences of MT, its potential neurobiological underpinnings, and role in psychiatric symptomatology. After exclusions, 191 studies were identified that explored MT in association with a diverse array of secondary topics, from gambling compulsions to childhood trauma, within both clinical and non-clinical samples, across a range of cultural contexts. On an intra-individual level, MT demonstrates numerous cognitive and emotional correlates, and on a societal level it may influence both social custom and religious tradition. A synthesis of the available evidence uncovers unexplored relationships with social cognition and mental health, and future research investigating its emerging relationships with stress, mood and social connection, may uncover functions beyond those exhibited by a simple marker of psychopathology.
Sleep quality and its associated factors among women of reproductive age in Ethiopia: a systematic review and meta-analysis
BackgroundQuality sleep is vital for women’s health during reproductive years, affecting both physical and mental well-being. In Ethiopia, socio-economic and cultural factors worsen sleep issues, but data on this demographic are scarce. This systematic review and meta-analysis assesses the prevalence of poor sleep quality among Ethiopian women and identifies contributing factors, aiming to inform interventions and policies to improve sleep health in low-resource settings.MethodThis systematic review followed PRISMA guidelines and searched PubMed, Scopus, and Web of Science for observational studies. We included studies utilizing the Pittsburgh Sleep Quality Index (PSQI), as it is the most widely validated tool for assessing subjective sleep quality across diverse populations. Reviewers independently screened articles using Rayyan and assessed study quality with the Joanna Briggs Institute tools. Data were analyzed using Stata version 17. To account for potential clinical and methodological variability across studies, a random-effects model was employed to pool results, with heterogeneity assessed using statistics and the Cochrane’s Q test. Publication bias and sensitivity analyses were also performed.ResultNine studies involving 4,376 women of reproductive age (15–49 years) in Ethiopia were included. The pooled prevalence of poor sleep quality was 49.17% (95% CI: 35.29, 63.08). Significant predictors of poor sleep quality included intimate partner violence (OR: 3.24), depression (OR: 3.37), unplanned pregnancy (OR: 2.71), multigravidity (OR: 2.61), and substance use (OR: 2.24).ConclusionA systematic review indicates that nearly half of Ethiopian women of reproductive age experience poor sleep quality. Key factors include unplanned pregnancies, substance use history, intimate partner violence, previous depression, stress, being in the third trimester, and comorbidities; these need urgent attention and the implementation of screening and preventive measures. Future research should focus on effective interventions to improve sleep quality in these populations.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42023455867.
Group-based psychosocial interventions reduce internalized stigma in psychiatric disorders: ISMI-focused systematic review
BackgroundInternalized stigma negatively impacts recovery outcomes, quality of life, and self-concept among individuals with psychiatric diagnoses. Group-based psychosocial interventions have been proposed as effective stigma-reduction strategies, but their impact across diverse populations remains under-evaluated.ObjectiveThis systematic review synthesizes global evidence on the effectiveness of group-based interventions in reducing internalized stigma in adult psychiatric populations, with a focus on studies using the Internalized Stigma of Mental Illness (ISMI) scale.MethodsFollowing PRISMA 2020 guidelines, we searched PubMed, PsycINFO and Web of Science, and additionally screened full-text platforms (SpringerLink, ScienceDirect, SAGE Journals, and Wiley Online Library), for studies published between 2003 and 2025. Inclusion criteria required adult psychiatric populations, group-based interventions, and internalized stigma as a primary outcome. Study selection, risk of bias assessment, and data extraction were performed independently by two reviewers (US and GOC).ResultsTen studies [n= 1,088], across five countries, met inclusion criteria, including randomized controlled trials and pre-post designs. Most studies reported significant reductions in ISMI scores post-intervention, particularly in the domains of stereotype endorsement and social withdrawal. Culturally adapted interventions in China, Poland, and Spain demonstrated feasibility and impact, though subscale reliability varied regionally.ConclusionGroup-based psychosocial interventions may help reduce internalized stigma in psychiatric populations within an ISMI-based evidence base. The ISMI scale is, to this day, among the most frequently used instrument, though cultural adaptation of subscales such as stigma resistance remains a concern.
Detecting bipolarity using the Lebanese Arabic hypomania checklist (HCL-32): validation of shortened HCL versions
IntroductionDue to the under diagnosis of bipolar disorder, screening instruments such as the hypomania checklist 32 items (HCL-32) is used to differentiate between Bipolar Disorder (BD) and Major Depressive Disorder (MDD). However due to its lengthy format, efforts were done to validate a shorter alternative without compromising its ability to differentiate between BD and MDD. We aimed to shorten the HCL-32 and assess the screening performance of the three Lebanese Arabic abbreviated HCL versions (HCL-20, -16, and -8) relative to the full HCL-32 in a sample of clinically diagnosed patients with BD and MDD in Lebanon.MethodsIn a sample of 760 patients (BD-I=29, BD-II=142, MDD=589) clinically diagnosed with BD and MDD, the screening performance of the three Lebanese Arabic abbreviated HCL versions (HCL-20, -16, and -8) as well as the full HCL-32, was assessed, looking at the reliability, sensitivity, and specificity.ResultsAll the shortened HCL versions showed strong reliability (a=0.78-0.90.) They also demonstrated good screening ability (AUC=0.8520- 0.8835) in differentiating BD from MDD. For the sensitivities across the shortened versions, they were consistently higher in BD-II vs MDD compared to BD-I vs MDD across all scales showing that the shortened versions have the ability to detect BD-II cases much more effectively.DiscussionThis study is the first to validate the shortened HCL versions in an Arabic speaking population. The HCL- 16 appears to be the most optimal shortened scale for distinguishing between BD versus MDD. However, these findings should be interpreted in light of the study’s limitations including the use of retrospective data collection and item interdependence of the HCL-32.
Novel antivenoms bite back
Nature Biotechnology, Published online: 20 May 2026; doi:10.1038/s41587-026-03157-6
New approaches to antivenoms for snakebite lean on cutting-edge techniques, but can they successfully be brought to market?
Directed evolution of small RNA-stabilizing motifs that improve prime-editing efficiency
Nature Biotechnology, Published online: 20 May 2026; doi:10.1038/s41587-026-03123-2
Prime editing is improved with engineered RNA-stabilizing motifs.
An AI framework for multi-disease detection via retinal imaging
Nature Medicine, Published online: 20 May 2026; doi:10.1038/s41591-026-04424-4
Using large-scale retinal images from community and tertiary hospitals, we developed Reti-Pioneer, a quality-aware, multi-task framework for multi-disease detection. Diverse external validation confirmed its generalizability. Furthermore, a prospective silent trial and clinical pilot study demonstrated its time efficiency, real-world feasibility, and potential for integration into clinical workflows.
Unintended consequences of legacy oversight in digital medicine
Nature Medicine, Published online: 20 May 2026; doi:10.1038/s41591-026-04417-3
Unintended consequences of legacy oversight in digital medicine
Pathogenic germline variations and cancer risks in pediatric patients referred for genetic testing
Nature Medicine, Published online: 20 May 2026; doi:10.1038/s41591-026-04423-5
Analyses of sequencing data from 75,602 children referred for genetic testing from 2016 to 2025 provide insights on the association between pathogenic germline variants and childhood cancer.
Considering biological limitations of lesion network mapping
Nature Neuroscience, Published online: 20 May 2026; doi:10.1038/s41593-026-02319-8
Lesion network mapping (LNM), or atrophy network mapping, has become a widely adopted tool for linking focal brain lesions or neurodegenerative brain clusters, respectively, to distributed functional networks associated with cognitive or clinical deficits. Recent insights, however, suggest that LNM primarily captures elementary topological properties of the normative connectome rather than disorder-specific circuits. Independent clinical evidence supports these methodological concerns, reflecting a deeper biological issue. LNM is inherently unable to capture the higher-order disconnection effects and non-linear connectivity changes that characterize the brain response to a broad range of neurological conditions. Brain injuries can induce widespread changes in distal regions not directly affected by the damage, as well as complex patterns of pathological hyperconnectivity and hypoconnectivity that evolve over time and whose functional significance remains uncertain. These phenomena represent a central challenge in clinical neuroscience. LNM is intrinsically limited in capturing these dynamics, with important implications for clinical translation and neuromodulation.