IntroductionChildhood adversities disrupt the healthy development of children and often have long-term effects on their physical and mental health in adulthood. Identifying them is essential; however, the majority of the existing tools do not adequately capture their diversity and complexity. Moreover, although the age at which adversities occur and their subjective impacts are known to be important, many instruments fail to assess these dimensions.MethodsTo address these gaps, a new scale was developed based on a review of 300 client files from individuals diagnosed with dissociative identity disorder (DID). The scale items were derived from types of childhood adversity commonly associated with the formation of alternate identities. Psychometric evaluation was conducted using data from three independent samples.ResultsExploratory factor analysis (EFA) with the first sample (n = 338) indicated that a single factor explained more than half of the total variance, supporting a unidimensional structure for the 59-item scale. Confirmatory factor analysis (CFA) with the second sample (n = 413), refined using modification indices, demonstrated good model fit. Convergent validity was evaluated in a third sample (n = 125) using the Adverse Childhood Experiences (ACE) scale. A significant positive correlation was found between the Childhood Adversity Scale (CAS) and ACE, indicating strong convergent validity.DiscussionThis suggests that CAS is a reliable and valid tool that both clinicians and researchers can use for a comprehensive assessment of childhood adverseness.
Revolution’s aftermath: population based cross-sectional study to understand the intergeneration mental health and wellbeing following the 2024 student-led uprising
BackgroundBangladesh was confronted with a nationwide student uprising in July 2024, that exposed both participants and observers to widespread unrest and traumatic events. To better understand the kind of support the population will need, it is important to understand its immediate impact on mental wellbeing.AimAim was to examine the prevalence of trauma symptoms among the Bangladeshi general population, aged 15+, within three-months following revolution.MethodsThis cross-sectional survey using the Post Traumatic Stress Disorder (PTSD) Checklist for DSM-5 (PCL-5, five-point Likert scale), was combined with a one-off online workshop to sensitise this population on mental health, trauma, and resilience. Associations between sociodemographic factors and PCL-5 scores were examined with multiple linear regression (ANOVA/ANCOVA). Probable PTSD (PCL-5 ≥ 31) was assessed using log-binomial regression. We estimated Population Attributable Fractions (PAF), Absolute Risk Reduction (ARR) to estimate the proportion of high PTSD attributable to each exposure, and applied min–max normalisation of Likert scales for cross-item comparison.ResultsMore than half of the surveyed participants (n=207; mean age 27.6 ± 9.7 years; 72% Gen Z) had clinically suggestive PTSD. This was more common among women (53.7%), and respondents from Chattogram (57.4%) and Khulna (66.7%). Adjusted analyses suggested modestly higher prevalence among Millennials (PR 1.23, 95% CI 0.87-1.74). PAF estimates indicated small contributions from age groups (Millennials +6.5%, GenX/Boomers -3.6%), and gender (men -3.1%). Under hypothetical elimination of exposure, absolute PTSD reduction was greatest among Millennials. Symptom clusters varied: women, and older adults showed consistently higher scores, while Gen Z reported more negative thoughts/feelings.ConclusionThe study underscores the potential higher prevalence of probable PTSD following large-scale demonstrations and confrontations, and recommends targeted culturally appropriate mental health interventions. Further research involving a representative sample from the population and longitudinal data is recommended to monitor long-term psychological impacts in Bangladesh.
Comparative efficacy of non-pharmacological therapies in adolescents with subthreshold depression: a systematic review and network meta-analysis
BackgroundSubthreshold depression (SD) is highly prevalent in adolescents and young adults aged 11–25 years, leading to impaired psychosocial functioning and a high risk of progression to major depressive disorder (MDD). Non-pharmacological therapies are the mainstay of intervention for adolescent SD, yet the comparative efficacy of different interventions remains unclear. This study aimed to compare the relative effectiveness of various non-pharmacological interventions for adolescent SD via network meta-analysis (NMA).MethodsWe initially retrieved 5,297 records from six databases (PubMed, Embase, Web of Science, Cochrane, PsycINFO, CINAHL) for randomized controlled trials (RCTs) of non-pharmacological interventions for SD in individuals aged 11–25 years who did not meet the DSM-IV/ICD-10 diagnostic criteria for MDD or depressive episode. The control groups received waitlist control or usual care, and the primary outcome was depressive symptoms assessed by validated scales (BDI-II, CES-D, CDI, HAMD). Two reviewers independently conducted study selection, data extraction and risk of bias assessment (RoB 2.0). Heterogeneity was analyzed using the I² statistic; NMA was performed under a Bayesian framework with consistency assessment, and the CINeMA tool was used to grade the certainty of evidence. This study was registered in PROSPERO (CRD42023456264) and reported in accordance with the PRISMA 2020 statement.ResultsA total of 30 RCTs involving 3,471 participants were included. Traditional meta-analysis showed that non-pharmacological interventions significantly improved depressive symptoms in adolescents with SD (pooled SMD = −0.93, 95% CI: −1.20 to −0.66, P < 0.0001), with high heterogeneity across studies (I² = 92%) driven by intervention type, delivery mode, intervention duration and participant age. NMA results indicated that behavioral activation (BA) was the most effective intervention (SMD = −3.45, 95% CI: −4.89 to −2.02), followed by physical exercise intervention (PEI) (SMD = −1.34, 95% CI: −2.68 to −0.03) and light therapy (LT) (SMD = −1.24, 95% CI: −2.17 to −0.31). No significant overall inconsistency was detected in the study (χ²=6.72, df=9, P = 0.651).ConclusionsNon-pharmacological interventions are effective for adolescents with SD, and BA is recommended as the first-line clinical option. Clinical selection of interventions should take into account individual patient characteristics and intervention features. This study has several limitations, including high heterogeneity across studies, single-study evidence for some interventions (e.g., LT, PEI), a broad age range of participants and the lack of long-term follow-up data. Further large-scale, multi-center RCTs are needed to validate these findings.
RESCUE- expected usefulness and willingness to participate in a trauma-informed group intervention for coping with traumatic work experiences in the emergency medical services
Emergency Medical Services personnel (EMS) are confronted with potentially highly stressful and traumatic occupational experiences, placing them at high-risk for mental disorders. Avoidant coping mechanisms, internalized and occupational stigma not only impede disclosure of and processing the incident-related stress but also weaken the overall resilience of the EMS. Effective interventions are needed that operate both at the individual and group level. The aim of this study was to investigate the expected usefulness and willingness to participate in a trauma-informed intervention (Facts derived from Narrative Exposure Therapy, NETfacts). A total of 256 German EMS (67.19% men, 32.81% women) participated in the online survey. We assessed the expected usefulness and willingness to participate in NETfacts, critical incident-related stress (EMS Critical Incident Inventory EMS-CII), burnout symptoms (Professional Quality of Life ProQOL), age and work experience. Overall, about half of the EMS expected NETfacts to be at least somewhat useful, and reported a generally willingness to participate. Expected usefulness was neither associated with critical incident-related stress nor burnout symptoms. Younger participants (<35 years) showed a generally higher willingness to participate than older participants. However, the willingness is across both age groups positively associated with higher levels of critical incident-related stress. Nevertheless, burnout symptoms and the willingness are negatively associated among participants age 35 and older, while remaining stable among their younger colleagues. Early, trauma-informed and age-sensitive prevention programs are needed to mitigate the adverse effects of critical incidents among EMS. Our study presents EMS preferred circumstances to enhance employees’ uptake of such a program.
Editorial: Case reports in psychopharmacology, volume IV
Harnessing the power of biomarkers for diffuse intrinsic pontine gliomas
Nature Medicine, Published online: 12 May 2026; doi:10.1038/s41591-026-04399-2
The BIOMEDE trial, although negative for its primary endpoint, illustrates the utility of adaptive trial designs and biopsy-informed tumor profiling in guiding treatment decisions and patient counseling — and provides mechanistic evidence that can inform future therapeutic strategies.
Brazil’s big bet on mosquitos
Nature Medicine, Published online: 12 May 2026; doi:10.1038/s41591-026-04388-5
As Brazil takes its modified mosquito program from pilot to practice at national scale, what will it take to beat dengue?
Genomic epidemiology of the 2025 mpox epidemic in Sierra Leone
Nature Medicine, Published online: 12 May 2026; doi:10.1038/s41591-026-04385-8
A phylogenetic analysis examined the origins of the first mpox outbreak in Sierra Leone and found evidence of an emerging lineage (G.1) that has likely descended from the Nigerian epidemic and emerged in Sierra Leone months before first detection.
Data-Driven Decision Support in Obesity Management Commission: enabling more equitable and personalized obesity care
Nature Medicine, Published online: 12 May 2026; doi:10.1038/s41591-026-04363-0
Announced in this Comment and in collaboration with Nature Medicine is the convening of the Data-Driven Decision Support in Obesity Management Commission, to promote adequate scientific evidence to support obesity management across global populations.
CRISPR−Cas9 CD33-deleted allogeneic hematopoietic cell transplantation with gemtuzumab ozogamicin maintenance in AML: a phase 1/2 trial
Nature Medicine, Published online: 12 May 2026; doi:10.1038/s41591-026-04362-1
In a first-in-human trial combining the transplantation of CD33-negative CRISPR-edited hematopoietic cells with the CD33-targeted antibody–drug conjugate gemtuzumab ozogamicin, all transplanted patients achieved primary engraftment, and the treatment was well tolerated.