Background/Objectives: The concepts of trust and distrust in health systems during health crises are significantly related to public adoption of health behaviors and health outcomes. The aim of this review is to examine trust and mistrust during times of health crisis, such as periods of viral pandemics and epidemics, and how these concepts relate to public health behaviors and, by extension, affect health outcomes. Methods: A focused search was conducted in PubMed and Scopus using a Boolean expression to identify relevant articles written in the English language and published between 2003 and 2023. The research methods comprised content analysis, thematic analysis, and a word cloud visualization to identify frequent themes related to trust and mistrust in healthcare systems. Results: The analysis included 57 studies and revealed that trust in healthcare systems, institutions, and professionals plays a significant role in shaping public health behaviors during health crises. The study also highlighted how mistrust leads to negative health outcomes, such as increased belief in conspiracy theories, vaccine hesitancy, and non-compliance with public health measures. Conclusions: The review emphasizes the importance of building and maintaining trust in healthcare systems to ensure better public health outcomes during crises. It calls for further research to better understand the nuances of trust and mistrust, aiming to inform public health strategies and interventions that could lead to more effective crisis management and improved health outcomes.

Expressed emotion (EE) is an established prognostic factor for relapse in schizophrenia. Through critical comments (CC), hostility (H) and emotional overinvolvement (EOI), a relative can be rated as high or low EE, but the role of warmth should also be evaluated in order to consider the influence of a positive affect within the family context. In this study, EE was assessed in a sample of 48 relatives of patients with schizophrenia using the Camberwell Family Interview (CFI). Questionnaires assessing coping (brief-COPE), their wellbeing (World Health Organization Well-Being Index WHO-5) and the socio-demographic variables were also administered. Relatives who expressed a higher level of warmth were found to make fewer CC (5.2 ± 4.6 vs. 8.4 ± 4.6, p = 0.009) and have, on average, higher EOI scores (3.2 ± 1.0 vs. 1.9 ± 1.1, p = 0.002) than those who expressed no or very little warmth. High EE was found to be associated with having fewer family members (p = 0.035), while relatives with a higher level of education expressed less warmth (p = 0.007). Relatives with a low level of warmth had higher maladaptive coping scores and tended to score worse for their overall wellbeing in comparison to relatives who showed a higher level of warmth (28.4 ± 5.0 vs. 24.1 ± 5.2, p = 0.006 and 39.1 ± 20.4 vs. 51.3 ± 22.0, p = 0.073, respectively). Since the role of warmth is important, it should be taken into account when designing family interventions, independently from lowering EE. Customized interventions to promote warmth and the routine screening of relatives are recommended.

Involuntary hospitalizations have come to the fore due to growing concerns that Europe may be in the throes of reinstitutionalization. In Greece, the topic is of sheer importance in light of the incomplete deinstitutionalization process. In this context, the aim of the study is to explore differences in the rates and determinants of involuntary hospitalizations between a psychiatric and a general hospital. A total of 600 patients participated in the study. Information about their socio-demographic and clinical characteristics as well as previous contact with mental health services was garnered from their clinical record and through patient and physician interviews. Symptom severity was assessed with HoNOS. Overall, 60.7% of admissions were involuntary: 63.1% in the psychiatric hospital and 52.5% in the general hospital. In the general hospital, number of previous involuntary admissions and level of aggression constituted risk factors for detention; whereas previous hospitalization amid the last month was the only protective factor. In the psychiatric hospital, no contact with mental health services during the last month was the only risk factor for detention and suicidality the only protective. There is imperative need to design interventions geared towards curbing compulsory admissions. Psychiatric hospitals and other contextual factors should be prioritized.

Background/Objectives: Breast reconstruction (BR) following mastectomy plays a critical role in post-cancer care by offering both physical and psychological benefits. Despite advancements in techniques and shared decision-making (SDM), BR uptake remains inconsistent. This systematic review aims to synthesize evidence on objective (medical and socioeconomic) and subjective (psychological and personal) factors influencing BR decision-making among women undergoing mastectomy for breast cancer. Methods: A systematic search was conducted across PubMed, ScienceDirect, OVID, and Google Scholar, identifying peer-reviewed studies published between January 2013 and 25 July 2024. Eligible studies examined determinants of BR decisions in women undergoing therapeutic mastectomy, excluding perspectives of non-patient stakeholders and post-decision outcomes. The risk of bias and study quality were assessed using the Quality Appraisal for Diverse Studies (QuADS) tool. This review was registered in PROSPERO (CRD42023456198) and followed PRISMA guidelines. Results: Twenty-seven studies comprising 994,528 participants across 16 countries met the inclusion criteria. The objective factors included age, comorbidities, insurance coverage, physician recommendations, and healthcare access. The subjective factors encompassed body image concerns, self-esteem, fear of recurrence, and emotional readiness. Younger age, private insurance, and active physician counseling were associated with increased BR uptake, while older age, lack of information, and financial or logistical barriers reduced uptake. Regional disparities were noted across healthcare systems. Conclusions: BR decisions are influenced by complex, interrelated clinical, psychological, and systemic factors. Integrating SDM tools, enhancing patient education, and addressing healthcare inequities are essential for supporting informed and equitable BR decision-making. Future research should prioritize longitudinal studies and policy interventions to improve access to and patient satisfaction with BR outcomes.

Background: In recent decades there has been an increasing interest in cognitive deficits in schizophrenia. However, only a few studies have examined the impact of psychosocial support on the prevention of cognitive deterioration in patients who suffer from schizophrenia. Aim: The aims of the present study are: (1) to confirm the presence of cognitive deficits among patients with schizophrenia; (2) to explore any correlations between such deficits and a range of clinical and/or demographic characteristics of the patients; and (3) to investigate any association between cognitive deficits and psychosocial support. Method: A total of 118 patients with schizophrenia (the patient group) and 102 healthy volunteers (the control group) had a cognitive assessment using a battery of neuropsychological tests. The patients were allocated to one of the following groups: (1) patients under routine outpatient follow-up; or (2) patients receiving or having recently received intensive psychosocial support, in addition to follow-up. This included daily participation in vocational and recreational activities provided by dedicated mental health day centers. The findings of the neuropsychological testing of individuals in all groups were compared, after controlling for clinical or demographic factors. Results: The scores in the neuropsychological tests were lower overall in the patients group compared to healthy volunteers. Within the patients group, those receiving/having received psychosocial support had higher scores compared to those on routine follow-up alone. There were no significant differences between patients currently receiving psychosocial support and those having received it in the past. Lower education, age and illness duration (but not severity of positive or negative symptoms) were factors associated with lower test scores. Conclusions: The study provides some evidence that psychosocial support may be beneficial for the cognitive functioning of patients with schizophrenia and this benefit may be a lasting one.

Background/Objectives: Schizophrenia is associated with cognitive deficits that may compromise everyday functioning, including driving. This review systematically examined recent original research (2015–2025) on driving performance in individuals with schizophrenia with a focus on neuropsychological factors, applying a narrative synthesis given the heterogeneity of designs and outcomes, while no quantitative meta-analysis was feasible. Methods: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a structured search of PubMed and Scopus was conducted on 4 May 2025. The inclusion criteria were original studies involving individuals diagnosed with schizophrenia, published between 2015 and 2025. Studies on animals, other psychiatric or neurological conditions, and healthy populations were also excluded. Critical appraisal was performed using the Joanna Briggs Institute (JBI) tools. Extracted data included sample demographics, cognitive deficits, neuropsychological assessments, brain imaging, and the main findings. A narrative synthesis was then performed. Results: Six high-quality studies met the inclusion criteria. Findings were grouped into three categories: (1) driving behavior: fitness to drive varied widely across individuals, (2) cognitive deficits and brain activity: poorer driving-related performance was consistently associated with specific impairments in cognition and brain structure, and (3) medication effects: individuals taking certain atypical antipsychotics demonstrated better driving performance compared to those on other types of medication, while extrapyramidal symptoms negatively influenced driving fitness. Conclusions: Driving in schizophrenia is shaped by cognitive, clinical, and pharmacological factors. These findings highlight the clinical relevance of individualized evaluations, integration into personalized care and targeted rehabilitation to promote driving autonomy and community inclusion. This area remains under-researched, as only six studies met the inclusion criteria, which restricts the robustness and generalizability of the conclusions. Funding: This review received no funding from any external sources. Registration: The review protocol was submitted to PROSPERO (International Prospective Register of Systematic Reviews) under registration number CRD420251060580.