Functional Outcome Prediction in Young Adults With Mental Health Symptoms Using Machine Learning and Large Language Models: Longitudinal Observational Study

Background: Functional impairments associated with mental health conditions are on the rise. Predicting functional outcomes may improve the targeting of preventive interventions. While prognostic models have primarily focused on psychosis, early recognition services require a transdiagnostic approach. Objective: This study aimed to predict global functioning within a 2-year follow-up using baseline clinical and structural magnetic resonance imaging (MRI) data in a population-based sample of young, help-seeking individuals presenting with affective and anxiety symptoms as well as attention-deficit hyperactivity disorder. Methods: We classified 357 help-seeking individuals aged 18‐35 years recruited from 9 sites as “impaired” (Global Assessment of Functioning [GAF] ≤60; n=228) or “nonimpaired” (GAF>60; n=129) at year 1 and/or year 2 follow-up. GAF classification group status at follow-up was predicted using linear support vector machine (SVM), decision tree, and large language model (LLM) Llama-3 using clinical assessments and/or structural MRI. Leave-one-site-out (SVM) or external sample (LLM) was used for validation. Results: SVM achieved balanced accuracy of 69.2% using clinical features only. Items related to baseline occupational functioning, interpersonal relationships, cognitive functioning, psychotic and affective symptoms, as well as the presence of anxiety disorder, were most predictive. The decision tree further reduced the feature set to 5 predictive items, achieving balanced accuracy of 76.6%. Although amygdala and hippocampal subregions achieved balanced accuracy of 57.1%, structural MRI did not improve the overall prediction. Llama-3 performed comparably well to SVM (balanced accuracy of 72.6%). Conclusions: Machine learning demonstrated good performance in predicting global functioning. Interestingly, the out-of-the-box LLM performed comparably well without being trained or fine-tuned, highlighting the potential of leveraging free-text data for mental health prognosis.

Gene Therapy Restores Brain Function and Behavior in Fragile X Syndrome

A University of California, Riverside-led research team has developed a gene therapy that restored production of a missing brain protein, corrected abnormalities in brain circuitry, and improved behavior in a mouse model of Fragile X syndrome (FXS). The study, published in the journal Molecular Therapy Nucleic Acids, tested an adeno-associated virus (AAV)-based therapy carrying a normal human version of the FMR1 gene to produce the Fragile X messenger ribonucleoprotein (FMRP) and found that early treatment normalized several measures of brain activity while improving social behavior, exploratory behavior, and cognitive flexibility.

“In a typical brain, FMRP acts like a brake or a volume control,” said senior author Iryna Ethell, PhD, a professor of biomedical sciences at the UC Riverside School of Medicine. “Without it, neural circuits become overactive and less efficient, which contributes to many of the developmental and behavioral challenges associated with FXS.”

FXS is the most common single-gene cause of autism spectrum disorder. According to the researchers, the disorder typically manifests from expansion of CGG repeats in the 5′ untranslated region of FMR1. The mutation causes methylation and silencing of the gene, leading to a major reduction or complete loss of FMRP, an RNA-binding protein that regulates numerous messenger RNAs involved in synapse formation, maturation, and function. Loss of the protein can lead to abnormal synaptic activity and increased cortical hyperexcitability.

FXS can produce sensory hypersensitivity, seizures, anxiety, intellectual disability, developmental delays, repetitive behaviors, and social communication difficulty. Current treatments for this syndrome don’t seek to cure it, rather they are aimed at managing the associated symptoms of anxiety, hyperactivity, irritability, aggression, depression, and seizures.

The therapy developed by the research team was designed to replace missing FMRP rather than repair the original mutation. To do this, the researchers used an AAV9 viral vector to deliver human FMR1 isoform 7, one of the most abundant forms of the protein found in the brain. The therapy was tested in newborn mice lacking FMRP via intracerebroventricular injections at either a low or high doses.

The work built on earlier research that explored the potential of AAV-mediated restoration of FMRP in rodent models. These prior studies used a range of viral serotypes, promoters, delivery routes, and FMRP isoforms and showed they could partially or completely correct specific biochemical, physiological, and behavioral abnormalities. The researchers noted that studies involving mouse and rat FMRP homologs had shown that restoring the protein could improve a range of Fragile X-related deficits.

The current study showed that high-dose treatment produced the strongest positive effects in the mouse models. Electroencephalography showed normalization of baseline gamma power, improvements in responses to sound, reduced background neural activity, and improved habituation to repeated auditory stimuli. The therapy also restored abnormal patterns of brain-wave coupling that have been associated with Fragile X-related dysfunction.

Behavioral testing showed that these improvements persisted into adulthood. Mice receiving the higher dose displayed normalized exploratory behavior, improved social preference, and better performance in probabilistic reversal learning, a measure of cognitive flexibility that requires adapting when previously rewarded behaviors stop producing rewards.

“Fragile X mice tend to persist with an old solution even after the rules change,” Ethell said. “After treatment, they became much better at adapting, performing similarly to mice with normal FMR1 function.”

The researchers noted that their work showed the importance of delivering at therapy for FXS early in its development. They said that widespread distribution of the potential new gene therapy throughout the brain was necessary to achieve a therapeutic benefit. There was a clear relationship between the proportion of neurons expressing the therapeutic gene and the degree of functional recovery, which indicated that restoring FMRP in a sufficient number of cortical cells is critical for correcting any behavioral deficits.

While a promising step, the investigators said that the work was a preclinical study and that future research will now focus on developing delivery methods that can of have broad distribution across the human brain. The team also believes their approach could have broader applications.

“Beyond FXS, the findings may provide a roadmap for treating other genetic neurodevelopmental disorders caused by the loss of a single critical protein,” Ethell said. “Our study shows it may be possible to restore function across complex brain networks by replacing a missing gene. That gives us reason to be optimistic about the future of genetic medicine.”

The post Gene Therapy Restores Brain Function and Behavior in Fragile X Syndrome appeared first on Inside Precision Medicine.

When OCD Is Loud, Trust Your Higher Power

by Annabella Hagen, LCSW

When I met Marie, she shared how faith and her connection with a Higher Power had always been important in her life. Her parents taught her that faith could be an anchor during hard times.

But Marie also had a genetic predisposition to obsessive compulsive disorder (OCD). When doubts and fears began to take over, she slowly lost confidence that she could ever feel peace again. Without knowing it, the more she tried to reason with the thoughts, fight them, or seek reassurance, the stronger they became.

Her OCD changed themes as she grew up. The voice within whispered different fears at different times:

“You may hurt the kids you’re babysitting.”
“You caused your granny’s pneumonia because you didn’t wash your hands well enough.”
“Am I going blind?”
“Why do these ugly images come into my head in sacred places? I must stop them.”

She tried to “fix” her doubts. But the more she focused on them, the more they grew. They distracted her from what mattered most — including her relationship with her Higher Power. She blamed herself for not feeling close to God. She felt ashamed and spiritually broken.

Many people with OCD blame themselves for their unwanted thoughts. They panic.

“Why would I think this?”
“What does this say about me?”
“Am I a terrible person?”

No matter what Marie did, she could not find certainty. She could not get enough reassurance. She wished she could control her thoughts and feelings. Because she couldn’t, she became very hard on herself. Her self-compassion slowly disappeared.

But here is something important: every human being — whether they have OCD or not — experiences disturbing thoughts, images, or impulses at times. Research going back decades, including studies like Rachman and de Silva (1978), shows that intrusive thoughts are common in the general population.

The difference is not the content of the thoughts. The difference is how often they come, how intense they feel, and how much distress they cause.

When someone without OCD has a strange thought, they may feel uncomfortable and say, “That was weird,” and move on.

But someone with OCD feels a strong need to solve the doubt. They may analyze it, argue with it, pray repeatedly, seek reassurance, or try to push it away. Without realizing it, these efforts make the thoughts louder and more frequent. This is how the OCD cycle grows.

Understanding this can bring hope. It means the problem is not your faith. It is the pattern.

And the good news is that OCD is not only genetic or neurological. It is also behavioral. That means you can learn to respond differently!

Thoughts and feelings are like the weather. They come and go. When we fight them or try to control them, they often stay longer.

You can learn to let them be.

Through Exposure and Response Prevention (ERP), you can practice moving toward what matters most — your faith, your family, your values — even when doubt is present. Instead of trying to silence the thoughts, you can choose not to follow the urge to fix them.

The first step is awareness.

You may already notice the unwanted thoughts. But can you notice how you respond?

Ask yourself gently:

  • Do I try to get rid of emotional pain right away?
  • Do I avoid situations because they trigger anxiety and doubts?
  • When I feel an urge, do I automatically act on it?
  • Can I see that thoughts are just thoughts, not facts?

These small moments of awareness begin to weaken the cycle.

As you practice new responses, you can begin shaping new pathways in your brain. Slowly, you can move closer to the connection with your Higher Power that you have been longing for.

Thoughts come and go. What matters most is what you choose to do.

You can act in faith and trust your Higher Power, even when the OCD voice is loud. That voice feels powerful, but it is not your identity. It does not define your relationship with God.

Change takes time. It takes practice. But it is possible. And it is worth it!

And you can find your way back!

Remember, OCD may try to use your faith as a weapon, your faith is not the problem—the disorder is. OCD is a health condition that seeks certainty where faith invites trust.

If you find yourself in a cycle of “loud” thoughts and repetitive compulsions—like over-praying, seeking constant reassurance, or fearing you’ve lost your connection to the divine—know that healing is possible.

To help more individuals like Marie navigate these challenges, the International OCD Foundation has released a comprehensive new brochure specifically for people of faith.

Download the “OCD is Not What You Think It Is” Brochure here or visit the Faith & OCD Resource Page to find more specialized support and information.

The post When OCD Is Loud, Trust Your Higher Power appeared first on International OCD Foundation.

Brain-Infiltrating T Cells Linked to Social Deficits in Autism Mouse Model

The prevalence of autism spectrum disorder (ASD) is roughly one in 36 people, with a male-to-female ratio of 4:1. The disorder is known to be influenced by multiple factors, both genetic (gene mutations and copy number variations) and environmental, such as infections during pregnancy. However, the role of immunity in genetic ASD remains unclear.

One area of interest lies in lymphocytes—cells that are known to shape neurodevelopment and behavior. But their roles in neurodevelopmental disorders are not well defined.

Now, new research shows that a subset of T cells—γδ T cells—can infiltrate the brain and contribute to changes in social behavior in a genetic mouse model that mimics behavioral features of ASD. Depleting these cells from the brain increased sociability, suggesting that targeting abnormal immune function during neurodevelopment may offer interventions for ASD.

This work is published in Science Immunology in the paper, “CXCL16-mediated recruitment of γδ T cells to the brain reduces sociability in mice.”

Infections during pregnancy can induce the release of interleukin-17A (IL-17A) from T helper 17 cells and γδ T cells. Prior research has linked this type of maternal immune activation to neurodevelopmental disorders, but there is a lack of evidence connecting IL-17A and social behaviors in genetic mouse models.

To investigate this further, a team of researchers from the Division of Allergy and Immunology in the Medical Institute of Bioregulation at Kyushu University, in Fukuoka, Japan, studied 15q11-13 duplication (15q dup) mice—a mouse model that mimics a chromosome duplication found in some humans with ASD. These mice also demonstrate reduced social interactions, behavioral inflexibility, and increased anxiety-like behaviors.

The team analyzed immune cell populations in the brains of the 15q dup mice. Their findings suggest an increase in γδ T cells in the developing brains when compared with wild-type mice.

Using single-cell RNA sequencing (scRNA-seq), the team uncovered that this was most likely due to microglia in the brain expressing the chemokine CXCL16, which promotes immune cell migration. CXCL16 was highly expressed in the brains of 15q dup mice and contributed to increased infiltration of γδ T cells.

In addition, experiments revealed that deleting IL-17A–producing γδ T cells or blocking them with antibodies after birth increased sociability and reduced anxiety-like behaviors in the 15q dup mice.

Taken together, the authors note that these findings suggest that “immune dysregulation contributes to social behavior deficits in 15q dup mice, consistent with observations in maternal immune activation models, and may represent a potential target for interventions for ASD-associated differences in social behavior.”

The post Brain-Infiltrating T Cells Linked to Social Deficits in Autism Mouse Model appeared first on GEN – Genetic Engineering and Biotechnology News.

Psychological distress and caregiver burden among informal caregivers of patients with earthquake-related and stroke-related dependency: a comparative study

ObjectiveThis study aimed to compare the psychological burden of informal caregivers of patients with earthquake-related dependency and those caring for patients with stroke-related dependency following the 6 February 2023 Türkiye–Syria earthquakes.MethodsA total of 90 informal caregivers of dependent patients were included in this comparative study: 60 caregivers of stroke patients and 30 caregivers of patients with earthquake-related dependency. Participants were assessed using the Beck Depression Inventory, Beck Anxiety Inventory, Beck Hopelessness Scale, Caregiver Burden Scale, and the PTSD Checklist for DSM-5 (PCL-5).ResultsCaregiver burden was significantly higher among male caregivers (p=0.026). Caregivers of patients with earthquake-related dependency more frequently reported receiving external support than caregivers of stroke patients (p=0.004). Overall, caregiving was perceived as a moderate burden in both groups. The distributions of depressive symptoms, anxiety symptoms, and hopelessness levels did not differ significantly between the groups (p=0.172, p=0.172, and p=0.834, respectively). Among caregivers of stroke patients, PTSD symptoms and caregiver burden showed moderate positive correlations with depression, anxiety, and hopelessness (all p<0.05). In caregivers of patients with earthquake-related dependency, caregiver burden was associated only with hopelessness (p=0.045).ConclusionInformal caregivers of patients with earthquake-related and stroke-related dependency experienced comparable levels of psychological distress, despite differences in caregiving context and disaster-related adversity. The higher frequency of external support among caregivers of patients with earthquake-related dependency may be associated with this pattern, suggesting that family and social support may be relevant to caregiver psychological outcomes in post-disaster settings.

Cognitive-attitudinal factors predict CBT-I enrollment willingness in Chinese sleep clinic patients: a knowledge-attitudes-practices survey

BackgroundDespite strong evidence for cognitive behavioral therapy for insomnia (CBT-I), uptake remains constrained by poorly understood cognitive, attitudinal, and practical barriers. This study examined determinants of willingness to enroll in sleep improvement programs among adults at risk of sleep disorders—including insomnia, obstructive sleep apnea, and comorbid psychological distress—attending a tertiary sleep clinic in China.MethodsA cross-sectional knowledge-attitudes-practices survey was conducted among 2,661 adults attending the sleep and behavioral medicine outpatient clinic at Ganzhou Hospital-Nanfang Hospital, Southern Medical University, Ganzhou, Jiangxi, China, between February 2022 and June 2025. Willingness to enroll in a structured sleep improvement program was assessed alongside sleep health knowledge, perceived need, CBT-I versus medication effectiveness beliefs, telehealth acceptability, clinical severity (Insomnia Severity Index, Epworth Sleepiness Scale, STOP-Bang), psychological symptoms (PHQ-2, GAD-2), perceived barriers, and sociodemographic characteristics. Multivariable logistic regression identified independent predictors of willingness to enrollment, with secondary analyses evaluating model discrimination and testing prespecified interactions.ResultsAmong 2,661 participants (median age 45 years, 56.5% female, median ISI = 13), 1,386 (52.1%) expressed willingness to enroll. Univariable comparisons showed no significant differences between willing and not-willing groups across demographics, clinical characteristics, or barriers (all p>0.05). However, multivariable modeling revealed that when considered simultaneously, cognitive-attitudinal factors emerged as significant independent predictors, suggesting complex interactions rather than simple bivariate associations. In multivariable models, perceived need (OR = 1.20, 95% CI: 1.16–1.25, p<0.001), beliefs that CBT-I is more effective and durable than sleep medication (OR = 1.12, 95% CI: 1.08–1.16, p<0.001), sleep health and treatment knowledge (assessed by a six-item knowledge score) (OR = 1.09, 95% CI: 1.05–1.13, p<0.001), and anxiety symptoms (OR = 1.07, p=0.005) positively predicted willingness. Paradoxically, depression symptoms (OR = 0.94, p<0.001) and insomnia severity (OR = 0.93, p<0.001) inversely predicted willingness. Model discrimination was modest (AUC = 0.543, 95% CI: 0.504–0.590). Time (mean 3.54) and cost (3.44) were most severe barriers but showed no independent association with willingness (p>0.05).ConclusionCognitive-attitudinal factors (perceived need, CBT-I beliefs, knowledge) independently predicted enrollment willingness, whereas demographics and practical barriers did not. Depression and insomnia severity paradoxically reduced willingness, creating an inverse care law. However, poor model discrimination and measurement of stated willingness rather than actual enrollment limit conclusions. Prospective validation and motivational enhancement strategies for patients with depression are needed.

Case Report: Subacute combined degeneration misdiagnosed as a primary affective disorder: diagnostic pitfalls and clinical red flags

BackgroundSubacute combined degeneration (SCD) of the spinal cord is a progressive neurological disorder caused by vitamin B12 deficiency. When initial symptoms present as nonspecific fatigue, dizziness, and affective distress, the condition is frequently misattributed to primary psychiatric disorders. This “diagnostic overshadowing” leads to critical delays in administering definitive therapy, risking irreversible axonal damage.Case presentationA 39-year-old male presented with a nine-month history of progressive paresthesia, dizziness, and emotional distress. Initial medical workups (including brain CT and EEG) were unremarkable, leading to a diagnosis of Somatic Symptom Disorder and anxiety. Despite treatment with multiple psychotropic agents, his condition deteriorated, eventually manifesting as lower limb weakness and significant gait ataxia. Subsequent evaluation at a tertiary center revealed absent patellar reflexes and impaired vibratory sensation. Psychometric testing (SCL-90) showed a high somatization factor (3.00). Investigations confirmed a critically low serum vitamin B12 level (<37 pmol/L) and characteristic longitudinally extensive T2-weighted hyperintensities in the dorsal columns from C3 to T12. Following intramuscular and oral vitamin B12 replacement, supplemented by escitalopram for residual distress, the patient achieved significant recovery. At five-month follow-up, he was fully ambulatory with near-normalization of psychometric scores.ConclusionThis case illustrates the risk of misinterpreting organic neurological deficits as psychogenic somatization. A discrepancy between subjective psychiatric complaints and emerging objective neurological signs-such as absent reflexes or ataxia-should trigger an immediate search for underlying organic etiologies and the initiation of targeted treatment.

Virtual reality based attentional bias modification training for patients with obsessive-compulsive disorder: a feasibility study

BackgroundAttentional bias modification (ABM) training is employed to modulate attentional bias and alleviate clinical symptoms in obsessive-compulsive disorder (OCD) patients. This study aimed to develop a novel, ecologically valid ABM paradigm based on virtual reality (VR). The intent was to enhance the efficacy of traditional computerized ABM and to preliminarily examine its feasibility in patients with contamination-based obsessive-compulsive disorder (OCD).Method15 patients with OCD who were currently receiving pharmacotherapy were recruited and allocated to either an ABM group, which received VR-ABM training twice weekly for four weeks (eight sessions in total), or a TAU group, which continued their routine outpatient treatment, including pharmacotherapy, psychotherapy, and physical therapy.Result5 patients in ABM group and 5 patients in TAU group completed the 4-week follow-up. VR-ABM paradigm effectively elicited target symptoms, with virtual scenarios inducing moderate levels of obsessive-compulsive symptoms and anxiety. Notably, all participants in the VR-ABM group reported the program to be appropriately challenging, effectively eliciting obsessive-compulsive symptoms and improving subjective concentration.ConclusionThese preliminary findings support the feasibility of the novel VR-ABM training in OCD and warrant further investigation in larger, controlled trials to rigorously evaluate its therapeutic efficacy.