Category: 8. Health

The prevalence of irritable bowel syndrome (IBS) and chronic idiopathic constipation among US adults rose significantly during the COVID-19 pandemic, with a near doubling of the national rate of IBS over 2 years, a study has found.

The uptick is probably due to not only the direct impact of SARS-CoV-2 infection on the gastrointestinal tract but also to the psychological stress associated with pandemic life, the study team said. 

“COVID infection itself can definitely cause gastrointestinal symptoms like diarrhea, nausea, and abdominal pain — and for some people, those symptoms can linger and lead to chronic conditions like IBS,” Christopher V. Almario, MD, MSHPM, lead author and gastroenterologist at Cedars-Sinai Medical Center, Los Angeles, California, told Medscape Medical News. 

“But the stress of living through the pandemic — lockdowns, fear, isolation — also likely played a major role as well in the increased prevalence of digestive disorders. Both the infection itself and the psychological toll of the pandemic can disrupt the gut-brain axis and trigger chronic digestive disorders like IBS,” Almario said. 

The study was published in Neurogastroenterology & Motility.

Growing Burden of Gut Disorders 

Disorders of gut-brain interaction (DGBIs) are a heterogeneous group of conditions in which gastrointestinal symptoms occur without any detectable structural or biochemical abnormalities in the digestive tract. They include IBS, functional dyspepsia, and chronic idiopathic constipation, among others. 

DGBIs are highly prevalent. Research has shown that nearly 40% of people in the US meet Rome IV criteria for at least one DGBI. 

Almario and colleagues assessed trends in prevalence of these conditions during the COVID-19 pandemic. Starting in May 2020 through May 2022, they conducted a series of online surveys with more than 160,000 adults aged 18 or older using validated Rome IV diagnostic questionnaires. 

Results showed that during the pandemic, IBS prevalence rose from 6.1% in May 2020 to 11.0% by May 2022, an increase of 0.188% per month (adjusted P < .001). 

Chronic idiopathic constipation showed a smaller but statistically significant increase, from 6.0% to 6.4% (0.056% per month; adjusted P < .001). 

Within the IBS subtypes, mixed-type IBS showed the largest relative increase (0.085% per month), followed by IBS with constipation (0.041% per month) and IBS with diarrhea (0.037% per month). 

There were no significant changes in the prevalence of other DGBIs, such as functional bloating, functional diarrhea, or functional dyspepsia, during the study period. 

Almario told Medscape only about 9% of those surveyed reported a positive COVID test at the time of the surveys, but that figure probably underrepresents actual infections, especially in the early months of the pandemic. “Most of the survey responses came in during the earlier phases of the pandemic, and the percentage reporting a positive test increased over time,” he explained. 

Almario also noted that this study did not directly compare digestive disorder rates between infected and uninfected individuals. However, a separate study by the Cedars-Sinai team currently undergoing peer review addresses that question more directly. “That study, along with several other studies, show that having COVID increases the risk of developing conditions like IBS and functional dyspepsia,” Almario said. 

Taken together, the findings “underscore the increasing healthcare and economic burden of DGBI in the post-pandemic era, emphasizing the need for targeted efforts to effectively diagnose and manage these complex conditions,” they wrote. 

“This will be especially challenging for healthcare systems to address, given the existing shortage of primary care physicians and gastroenterologists — clinicians who primarily manage individuals with DGBI,” they noted. 

Support for this study was received from Ironwood Pharmaceuticals and Salix Pharmaceuticals in the form of institutional research grants to Cedars-Sinai. Almario has consulted for Exact Sciences, Greenspace Labs, Owlstone Medical, Salix Pharmaceuticals, and Universal DX.

Disrupted care during the covid-19 pandemic led to sharp increases in other non-covid causes of illness and death, particularly mental health disorders, malaria in young children, and stroke and heart disease in older adults, finds a study published by The BMJ today.

For example, new cases of depressive disorders rose by 23% in 5-14 year-olds and malaria deaths rose by 14% in children under five years old from 2020-2021.

The researchers say future responses to potential pandemics or other public health emergencies of international concern “must extend beyond infection control to address long term, syndemic health impacts.”

Most healthcare services were severely affected during the pandemic, hindering efforts to prevent and control many conditions. Yet an in-depth analysis of the pandemic’s impact on other causes of illness and death is still needed.

To address this, researchers in China used data from the Global Burden of Disease Study 2021 to simulate the burden of 174 health conditions in 2020 and 2021 across various regions, age groups, and sexes.

A total of 204 countries and territories were included in the analysis. The main measures of interest were incidence (number of new cases), prevalence (number of people living with a condition), deaths, and disability adjusted life years (DALYs) – a combined measure of quantity and quality of life.

Depressive and anxiety disorders, along with malaria, were the most notably affected, with a significant rise in disease burden compared with other causes.

For example, age standardised DALY rates for malaria rose by 12% (to 98 per 100,000). DALY rates for depressive and anxiety disorders also rose by 12% (to 83 per 100,000) and 14% (to 74 per 100,000), respectively, especially among females.

Age standardised incidence and prevalence rates for depressive disorders rose by 14% (to 618 per 100,000) and 10% (to 414 per 100,000), respectively, while anxiety disorders saw a 15% rise (to 102 and 628 per 100,000).

Prevalence rates for heart disease also saw notable increases, particularly among individuals aged 70 and above (169 per 100,000 for ischaemic heart disease and 27 per 100,000 for stroke). 

There was also a significant (12%) increase in the age standardised death rate due to malaria, particularly among children under five years old in the African region.

The researchers acknowledge that their methods may not fully capture the complexity and variation of pandemic-related disruptions, and say factors such as uneven quality of data across regions, potential underreporting, and delayed diagnoses during the pandemic, may have affected the accuracy of their results.

However, they say their analysis offers broader scope than previous studies and provides actionable, policy relevant recommendations to improve health system preparedness.

As such, they conclude: “These findings underscore the urgent need to strengthen health system resilience, enhance integrated surveillance, and adopt syndemic-informed strategies to support equitable preparedness for future public health emergencies.”

This study highlights how data can guide smarter recovery to ensure that future health crises disrupt lives less and afflict populations more evenly, say researchers in a linked editorial.

By integrating these insights into post-pandemic plans, countries can improve resilience, they write. Concrete steps include allocating budgets for essential services in emergencies, reinforcing primary health care, expanding disease surveillance networks, and prioritising universal health coverage with a focus on disadvantaged or marginalised communities.

“Ultimately, recognising and planning for the pandemic’s indirect toll will save lives and leave health systems stronger and fairer for future public health emergencies,” they conclude.

Researchers at McMaster University, Cleveland Clinic and Case Comprehensive Cancer Center have uncovered how a protein long associated with Alzheimer’s disease helps lung cancer spread to the brain – a discovery that offers hope that existing Alzheimer’s drugs could be repurposed in preventing cancer’s spread.

The study, published in Science Translational Medicine on July 2, 2025, details how the protein (BACE1) is instrumental in the development of brain metastases – tumours that spread to the brain from cancers originating elsewhere in the body – in people with lung cancer. These tumours occur in up to 40 per cent of patients with non-small cell lung cancer.

We’ve always associated BACE1 with Alzheimer’s disease, so to find it playing a major role in lung cancer brain metastases is an important discovery. It’s a reminder that cancer can hijack biological pathways in ways we don’t yet fully understand.”

Sheila Singh, senior author, director of McMaster’s Centre for Discovery in Cancer Research and professor with the Department of Surgery

To make the discovery, researchers used a cutting-edge gene activation technique known as a genome-wide in vivo CRISPR activation screen. The technique allowed researchers to systematically activate thousands of genes one by one in lung cancer cells and put the modified cells into mice. When BACE1 was switched on, the cancer cells were far more likely to invade the brain.

BACE1 has long been linked to Alzheimer’s disease, the most common form of dementia. In people with Alzheimer’s, BACE1 cuts a protein called APP, triggering the formation of sticky plaques in the brain.

Currently, there are limited therapies available once cancer has spread to the brain. However, researchers say the discovery of BACE1 does offer hope as a drug developed for Alzheimer’s could be repurposed.

The therapy uses a drug called Verubecestat that blocks BACE1 activity. Researchers found that mice given Verubecestat had fewer and smaller tumours, and also lived longer. The drug had shown promise in Alzheimer’s patients but a Phase 3 clinical trial was discontinued in 2018 after a committee determined it was unlikely that positive benefit/risk could be established.

“The discovery of BACE1 opens the door to repurposing existing treatments like Verubecestat to potentially prevent or slow the spread of lung cancer to the brain, where treatment options are currently very limited,” Singh says.

The team say more research is needed to better understand the effectiveness of the therapy in preventing the spread of lung cancer to the brain.

“This study highlights how interdisciplinary partnerships can lead to breakthroughs in understanding and treating devastating diseases like brain metastases,” said Shideng Bao, a researcher in Cleveland Clinic’s Department of Cancer Biology, a corresponding author on the paper. “By identifying BACE1 as a key player in the spread of lung cancer to the brain, we’ve uncovered a promising new avenue for therapeutic intervention that could ultimately improve outcomes for patients.”

The Sheila Singh Lab collaborated with Cleveland Clinic and Case Comprehensive Cancer Center on the research. Singh and her colleagues are world leaders in brain cancer research, previously discovering a pathway used by cancer cells to infiltrate the brain, as well as new therapeutic approaches.

The study was supported by funding from the Boris Family Fund for Brain Metastasis Research, the Canadian Cancer Society, the Canadian Institute of Health Research, the Cancer Research UK Lung Cancer Centre of Excellence the Cleveland Clinic Foundation and Lerner Research Institute, and a Sir Henry Wellcome Fellowship.

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A team of researchers from Japan has developed a method for generating alveolar epithelial type 2 (AT2)-like cells from mouse embryonic fibroblasts without using stem cell technology. Remarkably, this process, which typically takes a month with conventional stem cell differentiation, has been reduced to just 7 to 10 days.

The new approach, published in npj Regenerative Medicine, may have significant implications for the treatment of respiratory diseases such as interstitial pneumonia and chronic obstructive pulmonary disease (COPD), which currently have limited treatment options. AT2 cells are critical for lung health, as they produce surfactant and help in alveolar repair. In severe lung diseases, these cells can be depleted or impaired, underscoring the potential therapeutic value of regenerating AT2 cells.

New approach to generating AT2-like cells

Induced pluripotent stem cell (iPSC)-based methods have enabled the creation of AT2 cells, but this process is expensive and time-consuming, inspiring researchers to search for faster alternatives.

“The advent of the induced pluripotent stem cell (iPSC) technology in 2006 has enabled the generation of AT2 cells in approximately one month, but this method is costly and carries risks of tumor formation and immune rejection,” explained Professor Makoto Ishii of Nagoya University Graduate School of Medicine.

“To overcome these disadvantages, we focused on direct reprogramming instead. The direct reprogramming approach produces AT2-like cells in just 7 to 10 days, with lower tumor risk and potential for autologous use,” Ishii said.

The researchers focused on reprogramming mouse fibroblasts to produce AT2-like cells, known as induced pulmonary epithelial-like cells (iPULs), in a significantly shorter period.

First, the researchers identified 14 candidate genes associated with lung development. By studying expression levels of the AT2 cell marker, surfactant protein-C (Sftpc), they were able to determine a combination of four genes with the highest reprogramming efficiency – Nkx2-1, Foxa1, Foxa2 and Gata6 – that were most effective in inducing AT2-like cells.

These genes were introduced into a 3D culture of mouse fibroblasts expressing green fluorescent protein (GFP) in response to Sftpc. Approximately 4% of the cells exhibited GFP positivity in 7 to 10 days, indicating the successful induction of iPULs.

Transplantation into mouse lungs

Following this, the researchers isolated the GFP-positive cells using flow cytometry and analyzed them. The purified iPULs displayed lamellar body-like structures, which are characteristic of normal AT2 cells. A transcriptomic analysis revealed that the gene expression profiles of the iPULs closely resembled those of native AT2 cells.

To test the functionality of these iPULs, the researchers transplanted them into mice with interstitial pneumonia. After 42 days, the transplanted cells successfully engrafted into the alveolar region. Notably, some of the cells differentiated into alveolar epithelial type 1 (AT1)-like cells, which are vital for lung tissue regeneration.

With the successful demonstration of the reprogramming of fibroblasts into AT2-like cells in mice, the researchers say that their next step will be to explore the potential for using this technology in human cells. The ultimate goal is to develop a safe regenerative therapy using a patient’s own fibroblasts, Ishii added.

Reference: Morita A, Ishii M, Asakura T, et al. Direct reprogramming of mouse fibroblasts into self-renewable alveolar epithelial-like cells. npj Regen Med. 2025;10(1):30. doi: 10.1038/s41536-025-00411-4

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X-rays of the ankle showed swelling in the soft tissue but without some signs of infection. The doctors wondered if the man had osteomyelitis, an infection in the bone, which can be a complication in people with diabetic ulcers. The large size and duration of the ulcer matched with a bone infection, as well as some elevated inflammatory markers he had on his blood tests.

To investigate the bone infection further, they admitted the man to the hospital and ordered magnetic resonance imaging (MRI). But the MRI showed only a soft-tissue defect and a normal bone, ruling out a bone infection. Another MRI was done with a contrast agent. That showed that the man’s large arteries were normal and there were no large blood clots deep in his veins—which is sometimes linked to prolonged standing, as the man did at his laundromat job.

As the doctors were still working to root out the cause, they had started him on a heavy-duty regimen of antibiotics. This was done with the assumption that on top of whatever caused the ulcer, there was now also a potentially aggressive secondary infection—one not knocked out by the previous round of antibiotics the man had been given.

With a bunch of diagnostic dead ends piling up, the doctors broadened their view of possibilities, newly considering cancers, rare inflammatory conditions, and less common conditions affecting small blood vessels (as the MRI has shown the larger vessels were normal). This led them to the possibility of a Martorell’s ulcer.

These ulcers, first described in 1945 by a Spanish doctor named Fernando Martorell, form when prolonged, uncontrolled high blood pressure causes the teeny arteries below the skin to stiffen and narrow, which blocks the blood supply, leading to tissue death and then ulcers. The ulcers in these cases tend to start as red blisters and evolve to frank ulcers. They are excruciatingly painful. And they tend to form on the lower legs, often over the Achilles’ tendon, though it’s unclear why this location is common.

Aberrations in fibroblast growth factor receptors FGFR2/3 are major drivers of many cancers—including intrahepatic cholangiocarcinoma, endometrial, breast, gastric, and bladder cancers. However, the development of selective inhibitors targeted FGFR2/3 has long been challenged by the high sequence and structural similarity among FGFR family members, particularly the binding pocket homology among FGFR1, FGFR2, and FGFR3 exceeds 95%.

Currently approved pan-FGFR inhibitors lack selectivity and often inhibit FGFR1/4 as well, leading to dose-limiting toxicities such as hyperphosphatemia and diarrhea, reduced treatment efficacy. Compounding these challenges, the emergence of resistance-conferring mutations in FGFR2/3 frequently diminishes the effectiveness of current drugs.

To address this challenge, the Insilico team employed advanced molecular modeling techniques in combination with the company’s proprietary generative AI-based chemistry engine, Chemistry42, to efficiently design highly selective FGFR2/3 inhibitors featuring a novel core structure. This research, recently published in the Journal of Medicinal Chemistry , provides an innovative approach for the discovery and development of next-generation cancer therapies targeting FGFR2/3.

The process began with structural analysis and molecular modeling, which identified the hinge-binding region (core A) as a key contributor to FGFR2/3 binding. Based on these insights, the researchers defined a pharmacophore model that retained essential hydrogen bond donors and acceptors, as well as relevant features for selectivity and potency.

The Chemistry42 platform was then leveraged to generate a library of approximately 10,000 molecules with diverse core structures and linkers, prioritizing those predicted to exhibit strong protein-ligand interactions (as measured by PLI score) and favorable drug-like properties. Based on the generated amide-based scaffold, we found that flexible binding to the kinase hinge region can better accommodate various types of resistance mutations. By filtering for optimal molecular characteristics and high PLI scores, the team identified core3 (C3) as a structural motif likely to deliver high potency and selectivity for FGFR2/3.

Further ADMET prediction and Alchemistry—the free energy calculations module of Chemistry42—were subsequently used to rank and optimize the candidate molecules. This process ultimately led to the identification of ISM7594, a covalent dual FGFR2/3 inhibitor distinguished by its unique hinge-binding motif and novel core structure.

In the validation studies, ISM7594 exhibits nanomolar inhibitory activity against FGFR2 and FGFR3, with over 100-fold selectivity relative to FGFR1/4. It maintained strong efficacy against clinically relevant FGFR2/3 mutants associated with therapeutic resistance. In cancer cell lines harboring FGFR2/3 alterations, ISM7594 showed robust antiproliferative effects, while exhibiting minimal impact on cells without FGFR aberrations. In preclinical animal models, ISM7594 displayed favorable pharmacokinetic properties, significant tumor growth inhibition, and a reduced toxicity profile compared to less selective FGFR inhibitors.

“Our study not only demonstrates the speed and precision of AI-enabled drug design but also the importance of rigorous experimental validation to translate in silico discoveries into real, clinically relevant therapies,” said Xiao Ding, PhD, Head of Chemistry & DMPK and Senior Vice President of Medicinal Chemistry at Insilico Medicine.

In February 2025, Insilico published a research paper in the Journal of Medicinal Chemistry entitled “Discovery of Pyrrolopyrazine Carboxamide Derivatives as Potent and Selective FGFR2/3 Inhibitors that Overcome Mutant Resistance,” further demonstrating the process of core structure optimization for novel, highly selective FGFR2/3 inhibitors.

Since its founding in 2014, Insilico Medicine has published more than 200 peer-reviewed papers. Leveraging sustained scientific breakthroughs at the intersection of biotechnology, artificial intelligence, and automation, Insilico Medicine secured a position among the Top 100 global corporate institutions for biological sciences and natural sciences publications, and ranked 43rd among global corporate institutions in the USA across all-subject output.

Reference

[1] Wang, Y. et al. (2025) ‘Rational design and identification of ISM7594 as a Tissue-Agnostic FGFR2/3 inhibitor,’ Journal of Medicinal Chemistry [Preprint]. https://doi.org/10.1021/acs.jmedchem.5c00928 .

About Insilico Medicine

Two studies led by researchers at Imperial College London (ICL) have identified structural brain changes and blood biomarkers linked to dementia in former professional rugby players. 

The findings provide the first prospective evidence of physical brain and blood abnormalities in this group. 

Previous research had already shown that elite rugby players face a higher risk of neurodegenerative diseases later in life. The studies examined links between repeated head impacts in rugby and conditions such as Alzheimer’s disease and chronic traumatic encephalopathy (CTE).

Post-mortem examinations of former players have shown neuropathologies consistent with repetitive brain trauma.

Traumatic brain injury, already a known risk factor for neurodegeneration, contributes to an estimated 3%-15% of dementia cases in the general population.

While recent advances in fluid and imaging biomarkers have transformed dementia diagnosis, these techniques have not been systematically applied to rugby players previously exposed to multiple head impacts.

Study Cohort and Methods

The research involved 200 ex-professional rugby players aged 30 to 61 (median age, 44), all of whom had self-referred with brain health concerns but had no dementia diagnosis at baseline. At least one previous concussion while playing was reported by 193 (96.5%) of the former players, with a median of seven concussions.

The rugby group was compared with 33 age- and sex-matched healthy controls with no evidence of previous head trauma or dementia onset. 

Participants were 90% male. The median rugby career lasted 10.5 years, with 63% playing as forwards and 37% as backs.

Mental Health and Behavioural Symptoms

The former players scored higher on self-rated scales of depression, anxiety, and post-concussion symptoms than those in the control group, though not on sleep quality.

These symptoms, along with behaviour ratings of executive dysfunction and neuropsychiatric symptom severity, were more prevalent among individuals who had experienced a greater number of self-reported concussions. However, this was unrelated to the number of years played, or position of play. 

Despite frequent subjective memory complaints, the performance of players in cognitive testing did not differ significantly from that of the control group. However, 24 former players, particularly those who had played as forwards and those who had reported more concussions, met the research criteria for CTE syndrome based on neurobehavioural disturbance. This was determined with low provisional levels of certainty: 21 were classed as ‘suggestive’, three as ‘possible’, and none as ‘probable/definite’. Seven of the 24 had cognitive impairment, 12 had neurobehavioral dysregulation, and five had both.

Imaging Findings

3T MRI imaging showed the presence of cavum septum pellucidum in 24% of players, compared with 12% of controls. This was more common in those who had experienced more concussions. They also showed reduced volumes in the frontal and cingulate cortices, with reduced white matter and lower hippocampal volume associated with longer career durations. 

Only 4.6% showed trauma-associated white matter changes on diffusion tensor imaging.

Elevated Blood Biomarkers

Using ultrasensitive digital enzyme-linked immunosorbent assays, researchers analysed fluid biomarkers associated with neurodegeneration. 

Key findings included:

• Phospho-tau217 levels were 17.6% higher in former players
• 23.1% had elevated phospho-tau217
• 9.0% had raised plasma neurofilament light

While levels were lower than in late-onset Alzheimer’s patients, players with elevated markers had more severe neuropsychiatric symptoms, including depression and anxiety.

Frontal brain volumes correlated negatively with neurofilament light, and hippocampal volumes correlated negatively with phospho-tau217.

The findings were published simultaneously in two papers in the journal Brain.

Professor David Sharp, director of the UK Dementia Research Institute Centre for Care Research & Technology at ICL, who co-led the work, said: “We didn’t see any cases of early dementia in this group of former players, which is reassuring. However, the changes in blood biomarkers and brain imaging abnormalities show some long-term effects of repeated head impacts on the brain.”

The studies are set to continue for a further 4 years.

Calls for Action on Player Safety

“Nearly half of dementia cases are linked to known health and lifestyle risk factors, including traumatic brain injury from contact sports like rugby,” said Dr Jacqui Hanley, head of research at Alzheimer’s Research UK. While not much is known about how such injuries cause changes to the brain, “deepening our understanding could ultimately help lower dementia risk for professional sportspeople”.

Hanley called for stronger efforts to reduce head injury in contact sports, stating: “Reducing traumatic brain injury in contact sports is critical to help prevent brain damage and minimise dementia risk for the players.”

The Alzheimer’s Society echoed the concern, noting that professional rugby players face approximately twice the risk of dementia. They called for accurate data on injury patterns and their long-term effects. However, they also stressed that physical activity remains one of the most effective ways to reduce dementia risk.

The Dementia Trust has warned that repeated tackles, scrums, and collisions can contribute to CTE among rugby players, and noted a rise in early-onset dementia among retired professional players. 

In 2023, a group of 260 former professionals launched a lawsuit against World Rugby, the Welsh Rugby Union, and the Rugby Football Union. They alleged negligence in failing to protect players from the risk of neurodegenerative diseases. 

Dr Sheena Meredith is an established medical writer, editor, and consultant in healthcare communications, with extensive experience writing for medical professionals and the general public. She is qualified in medicine and in law and medical ethics. 

The fourth annual virtual conference of the Society for Digital Mental Health (SDMH), June 9-10, 2025, featured presentations and panel discussions on innovative online therapeutics, and on policy affecting their approval, access, and application.

Investigations by students and young researchers were also presented, with these 5 recognized by the organizing committee as best of conference.

Assessing Acceptance in Minorities

While digital therapeutics has the potential to increase access to mental health care, 3 of the featured studies examined how access to, as well as acceptance of, the technology can be problematic for minority groups.

Sigdha Kamarsu, Anxiety Research, Treatment, and Technology (ARTT) Lab, Georgia State University, Atlanta, GA, presented their investigation¹ into whether sexual and gender minority groups encounter additional or different barriers than majority group peers. The investigators applied standardized, self-report measures of attitudes towards psychological online intervention with internet based cognitive behavioral therapy (iCBT) and perceived barriers to psychological treatment. The cohort of 632 participants was grouped into women, men, and gender-queer categories, with sexual orientation categorized as heterosexual, lesbian/gay/bisexual (LGB), and other sexual minority identities (OSMI).

Kamarsu reported that concerns about lack of personal contact when using iCBT were greater for gender-queer individuals compared with men and women, and greater for OSMI compared with heterosexual individuals. OSMI individuals indicated greater confidence in the effectiveness of iCBT than LGB individuals.

“Our results corroborate our hypothesis that sexual and gender minority individuals experience greater negative attitudes, greater attitudinal barriers, and greater practical barriers than their majority group peers,” Kamarsu indicated.

Taylor Myers-Brower, Program for Anxiety, Cognition and Treatment (PACT) Lab, University of Virginia, Charlottesville, described their efforts to culturally tailor MindTrails, a cognitive bias modification program targeting anxious thinking patterns, for Latinx Spanish-speaking individuals.

Eleven treatment-seeking participants provided feedback on a Spanish version of the app over a course of 3 interviews. Factors considered in the interviews varied from technical issues, sources of confusion and the domain of discrimination, to variables affecting engagement and suggestions on personalizing content. The investigators used the feedback to guide iterative changes to the app.

“Early findings suggest positive impressions of a culturally-tailored MindTrails app and highlight potential enhancements to better address the needs of the target audience,” Myers-Brower reported.

Olive Chung-Hui Huang, Department of Psychology, University of Windsor, Ontario, Canada reported on a single arm clinical trial³ conducted with the Center for Addiction and Mental Health (CAMH), Toronto, Ontario that investigated how adoption and acceptability of mindfulness-based apps are affected by social determinants of health such as race, gender, and education.

A mindfulness-based app was provided to a cohort of 183 treatment-seeking adults (65% women, 38.5% sexual minority, 36.1% Black, indigenous, or People of Color [BIPOC], and 35.5% without college education).In the 1-month trial and 3-month follow-up, adoption was indicated by completion of any in-app exercises, acceptability of the app was assessed by questionnaire, engagement was reflected in the number of app exercises completed and the number of minutes in meditation, and attrition was determined from the number of assessments left uncompleted.

Huang reported finding that women, sexual minorities, and below-college educated individuals were more likely to engage with a mindfulness app, and BIPOC persons tended toward less engagement. She anticipates that their future research will “evaluate how mindfulness apps meet the needs of BIPOC or non-binary individuals, and the capacity for apps to be more gender-, trauma-, or culturally-informed.”

Adopting AI and ML

Tyler Schmitt, University of Pittsburgh, reported progress on a project⁴ utilizing a youth research collaborative to validate machine learning (ML) classifiers of social media content. Their goals included identifying social media interactions that expose youth to loneliness and social isolation and developing a mitigating algorithm to improve connectedness and social support.

“Loneliness and perceived isolation are linked to disproportionately higher rates of mental health problems in marginalized youth,” Schmitt related. “These youth may use social media to seek support and connectedness that they cannot find offline.”

The youth collaborative of 14 participants was constituted in partnership with 3 Pittsburgh-based community organizations serving Black, Latinx, and LGBTQ+ youth. The youth held monthly meetings, alternating between in-person and online, that focused on the 4 key concepts of loneliness, social isolation, connectedness, and social support.

“Our youth research partners married research-informed theory and their personal experiences to create working definitions of mental health risk and protective factors that they will use to validate ML classifiers of social media content,” Schmitt explained.

The project is ongoing, with 11 meetings held as of the presentation, of which 9 directly focused on the stated goals. To this point, the project has established consensus on which parts of the working definitions were accurate and identified gaps in the working definitions to be further analyzed in building ML parameters.

Steven Siddals, King’s College London, London, UK, described the experiences of 19 study⁵ participants using generative AI chatbots, like ChatGPT, for mental health issues ranging from symptoms of anxiety and depression to distress over romantic relationships, dealing with loss, and resolving stress and conflict. Siddals et al compared experiences of participants using rule-based chatbots to those using generative AI chatbots and between generative AI chatbots and therapist-guided treatment.

Utilizing semi-structured interviews and reflexive thematic analysis, the investigators derived 4 themes from the reported experiences: emotional sanctuary (validating, nonjudgmental); insightful guidance (valued advice, new perspectives); joy of connection (human-like companionship beyond traditional apps); and “AI Therapist” (augmented therapy, creative new uses). Within these 4 themes, the investigators noted caveats: for emotional sanctuary, appropriate guardrails could be absent; for insightful guidance, there could be insufficient challenge; for joy of connection, it could have been more accessible; and the “AI Therapist” did not lead the process.

In comparing the reported experiences with rule-based vs generative AI chatbots, Siddals related that the former was perceived “more predictable,” “more explainable,” and to have lower risk of bias; while the latter appeared to have “better engagement,” “deeper understanding,” “more flexibility,” and to offer “better quality advice.”

Comparing the experiences with generative AI chatbots to those with clinician-guided treatment, the former was valued by users for around-the-clock availability, lower cost, feeling “less judgmental,” and offering “creative new uses.” In comparison to the bot, the human clinician could lead the process and provide real human connection, and was appreciated for providing “deeper empathy” and “sense of commitment.”

In an earlier published report⁶ on this study, the investigators addressed the safety concern with generative AI chatbots accessed by users in crisis. They relate that several of the study participants experienced meaningful crisis support from generative AI, and they advocate for its use in these circumstances as long as guard rails remain in the algorithm.

While acknowledging that early generative AI chatbots had tragically supported users in dying by suicide, Siddals and colleagues argue against “underestimating the capabilities of generative AI to respond to crisis, and…limiting those capabilities at the times that matter most.”

Dr Bender reports on medical innovations and advances in practice and edits presentations for news and professional education publications. He previously taught and mentored pharmacy and medical students, and he provided and managed pharmacy care and drug information services.

References

1. Quirk HD, Anderson PL. Do sexual and gender minority (SGM) groups endorse different barriers and attitudes toward mental health treatment than majority group peers. Presented at annual conference of the Society of Digital Mental Health, June 9-10, 2025.

2. Taylor L, Myers-Brower E, Englander-Fuentes E, et al. User perceptions of a culturally tailored digital cognitive bias modification for interpretation program for anxious Hispanic individuals. Presented at annual conference of the Society of Digital Mental Health, June 9-10, 2025.

3. Huang O, Patel A, Daros A, et al. Social determinants of health are associated with differences in acceptability and engagement with a mindfulness app: Moderation by gender, sexual orientation, race/ethnicity, educational attainment. Presented at annual conference of the Society of Digital Mental Health, June 9-10, 2025.

4. Schmitt TN, Win E, Sreenivasan L, et al. Establishing a youth research collaborative to validate machine learning classifiers of social media content: Leveraging human centered design and youth research partnership. Presented at annual conference of the Society of Digital Mental Health, June 9-10, 2025.

5. Siddals S, Torous J, Coxon A. ChatGPT for mental health? Start by listening to real-life stories. Presented at annual conference of the Society of Digital Mental Health, June 9-10, 2025.

6. Siddals S, Torous J, Coxon A. “It happened to be the perfect thing”: experiences of generative AI chatbots for mental health. Npj Ment Health Res. 2024;3(1):48.