Background: The nursing profession is recognized as a high-risk occupation, with the emotional toll on healthcare workers reaching a critical point. A complex interplay of anger and cynicism, often stemming from systemic pressures and chronic moral injury, seems to increasingly affect nurses’ professional and personal lives. This psychological strain does not end when the shift ends; rather, it often manifests as insomnia and nightmare distress, creating a vicious cycle of exhaustion and emotional instability. This article explores how anger, cynical distrust, nightmare distress and insomnia are interrelated and jeopardize the well-being of nursing staff and what these “invisible” symptoms reveal about the current state of healthcare by confirming their prevalence rates. Methods: This cross-sectional study was conducted online in October 2025 and included 441 hospital nurses who completed the Dimensions of Anger Reactions-5 (DAR-5), the 8-item Cynical Distrust scale (CDS-8), the Nightmare Distress Questionnaire (NDQ) and the Athens Insomnia Scale (AIS). Results: The prevalence rates of anger, nightmare distress and insomnia were 41.5%, 6.6%, and 62.1%, respectively. Based on the CDS-8 scores, a notable proportion (20.9%) of nurses fell within the highest quartile of CDS-8 scores (CDS-8 > 29), indicating relatively elevated cynical distrust within this sample; this threshold is sample-derived and does not correspond to a validated clinical cut-off. Hierarchical multiple regression analysis indicated that the DAR-5 explained 22.1% of the variance in AIS, while an additional 10.2% was explained by NDQ and another 1.5% by the CDS-8. Both cynical distrust and nightmare distress displayed a chain mediation pattern in the association between anger and insomnia; however, given the cross-sectional design, the temporal order of these variables cannot be confirmed. Conclusions: Anger exhibited significant direct and indirect associations with insomnia, with cynical distrust and nightmare distress acting as serial mediators in this cross-sectional model. Findings from this cross-sectional study tentatively suggest that future intervention efforts targeting insomnia in nurses might benefit from addressing anger alongside nightmare distress and cynical attitudes; however, experimental studies are needed to confirm whether such interventions would be effective.

Background: Among healthcare personnel, longitudinal studies have shown high levels of stress before, during and after the pandemic. The aim of this study was to examine the relationship between stress, psychological resilience, and sense of coherence in healthcare professionals. Subjects and Methods: In total, 203 healthcare professionals (63 physicians and 140 nurses) completed the Perceived Stress Scale (PSS), the Brief Resilience Scale (BRS), and the Sense of Coherence Questionnaire (SOC-13). The age, sex, and profession of the participants were recorded. Results: Women exhibited higher levels of perceived stress compared to males (18.450 ± 7.232 vs. 15.116 ± 5.662, t-test p < 0.05), as well as lower scores on the sense of coherence scale (57.525 ± 13.716 vs. 65.535 ± 12.481, t-test p < 0.05). No differences were observed with respect to profession. High levels of stress were recorded in 12.3% of workers and moderate values in 58.7%. The PSS demonstrated a negative correlation with both the SOC-13 and the BRS. The BRS showed a positive correlation with the SOC-13 (Pearson p < 0.01). Age showed no significant correlation. Linear regression analysis indicated that 49% of the variance in PSS was explained by SOC-13 and 3% by BRS. We subsequently investigated the hypothesis that the BRS may function as a mediator in the relationship between SOC-13 and PSS. Mediation analysis revealed that the BRS acts as a mediator in the relationship between SOC-13 and PSS. The indirect effect of BRS was statistically significant [b = −0.0770, 95% CI (−0.1312, −0.0216), p ≤ 0.01]. Furthermore, even in the presence of BRS mediation, the direct effect of SOC-13 on PSS remained significant [b = −0.2796, 95% CI (−0.3450, −0.2142), p ≤ 0.001]. Conclusions: High rates of stress, particularly in women healthcare professionals, appear to be intrinsically associated with the healthcare profession. It is likely that sense of coherence and psychological resilience can reduce stress, with resilience acting as a mediator.

Background/Objectives: Schizophrenia has been associated with increased inflammatory and metabolic disturbances. Perceived family support potentially affects inflammatory and metabolic biomarkers. The aim of this study was to determine the interrelations between family support, C-reactive protein (CRP) and Body Mass Index (BMI) in a sample of outpatients with schizophrenia. Importantly, this study sought to elucidate the effect of perceived family support on inflammatory processes among patients with schizophrenia. Methods: In this cross-sectional correlation study, 206 outpatients with schizophrenia in clinical remission completed a standardized self-report questionnaire that assessed family support (Family Support Scale—FSS). Sociodemographic, clinical and laboratory data were also recorded. Results: Among the participants, 49.5% had detectable CRP values (≥0.11 mg/dL), whereas 14.6% had positive CRP levels (>0.6 mg/dL). There was a significant difference in CRP levels among the different BMI groups (normal weight/overweight vs. obese). For obese patients, the crude odds ratios (ORs) for detectable and positive CRP values were 1.980 (95% confidence interval (CI) [1.056, 3.713]) and 27.818 (95% CI [6.300, 122.838]), respectively. Significant positive correlations were observed among CRP, BMI and illness duration, while scores on the FSS were negatively associated with these variables. The results of binary logistic regression analysis indicated that both BMI and family support were significant factors in determining the likelihood of having positive CRP levels, with each unit increase in the BMI associated with a 17% (95% CI [0.025, 0.337]) increase in the odds, and with each unit increase in family support leading to an 8.6% (95% CI [0.018, 0.15]) decrease. A moderation analysis revealed that the association between family support and the probability of having positive CRP levels depends on the BMI value, but only for obese patients did the protective effect of family support significantly decrease the magnitude of the risk of having positive CRP (b = −0.1972, SE = 0.053, OR = 0.821, p = 0.000, 95% CI [−0.3010, −0.0934]). Conclusions: The effect of perceived family support on inflammatory responses becomes evident in cases where beyond metabolic complications, inflammatory processes have already been established. Increased perceived family support seems to protect against inflammation and, notably, the association between low perceived family support and increased inflammation is even stronger. Establishing the role of family involvement during the treatment of patients with schizophrenia through inflammatory processes is a novelty of this study, emphasizing the need to incorporate family therapy into psychiatric treatment plans. However, primary interventions are considered necessary for patients with schizophrenia in order to maintain their BMI within normal limits and avoid the subsequent nosological sequelae.

Schizophrenia has been associated with increased inflammatory and metabolic disturbances. Perceived family support possibly effectuates changes in inflammatory and metabolic biomarkers. The aim of the present study was to determine the associations between family support, C-reactive protein (CRP) and Body Mass Index (BMI) in a sample of schizophrenic outpatients. In this cross-sectional correlation study 206 schizophrenic outpatients in clinical remission completed the standardized self-report questionnaire that assessed family support (family support scale-FSS). Sociodemographic, clinical and laboratory data were also recorded. 49.5% of the participants had detectable CRP values (≥0.11mg/dl), whereas 14.6% had positive CRP levels (>0.6mg/dl). There was a significant difference in CRP levels across the different BMI groups (normal-weight/ overweight vs. obese). For obese patients, the crude odds ratio (OR) for detectable CRP values was 1.980 with 95% confidence interval (CI) [1.056, 3.713] and for positive CRP values the OR was 27.818 (95% CI [6.300, 122.838]). Significant positive correlations were observed among CRP, BMI and illness duration, while scores on FSS were negatively associated with these variables. Results from the binary logistic regression analysis indicated that both BMI and family support were significant factors in determining the likelihood of having positive CRP levels, with each unit increase in the BMI associated with a 17% (95% CI [0.025, 0.337]) increase in the odds and with each unit increase in family support leading to a 8.6% (95% CI [0.018, 0.15]) decrease. The moderation analysis revealed that the association between family support and the probability of having positive CRP levels depends on BMI values, but the magnitude of the decreased risk for positive CRP associated with the protective effect of family support is significant (b=-0.1972, SE=0.053, OR=0.821, p=0.000, 95% CI [-0.3010, -0.0934]) only for obese patients. The effect of perceived family support on inflammatory responses becomes evident in cases where beyond metabolic complications inflammatory processes have already been established. However, primary interventions are considered necessary for schizophrenic patients in order to maintain BMI within normal limits and avoid the subsequent nosological sequelae.

Background: Post-traumatic growth (PTG) refers to positive psychological changes resulting from the struggle with highly challenging or traumatic life events. Psychosocial interventions have demonstrated efficacy in promoting psychological well-being in the aftermath of traumatic experiences. Cognitive Behavioral Therapy (CBT) is among the most extensively studied such interventions, aligning with the PTG model’s prerequisites for growth. Objective: The aim of this systematic review was to assess the efficacy of CBT and CBT-based interventions in promoting PTG. Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching PubMed, Scopus, and Google Scholar databases from inception to December 2024. Eligibility criteria included: (a) the inclusion of a CBT or CBT-based intervention, (b) measurement of PTG using the Post-Traumatic Growth Inventory (PTGI), (c) study participants having experienced traumatic life events, and (d) articles written in English. Risk of bias was assessed independently by two reviewers. Due to the heterogeneity of included studies, a qualitative narrative synthesis approach was adopted. Risk of bias was assessed using the RoB-2 tool for RCTs, ROBINS-1 for quasi-experimental studies and Newcastle–Ottawa scale for cohort studies. Certainty of evidence, assessed using the GRADE framework, is considered low. Results: A total of 19 studies were included (13 randomized controlled trials, 3 quasi-experimental, and 3 longitudinal studies). While traditional CBT produced mixed results in fostering PTG, CBT-based therapeutic protocols—particularly those explicitly designed to target PTG or incorporating structured cognitive–emotional techniques—demonstrated more consistent benefits. Limitations of the included studies include measurement of PTG as a secondary outcome, small sample sizes, and the presence of confounding variables. Conclusions: Further high-quality, multicenter randomized controlled trials with standardized protocols are needed to clarify the role of CBT in promoting growth after trauma.

Chronic Obstructive Pulmonary Disease (COPD) is a progressive respiratory condition commonly caused by prolonged exposure to harmful particles or gases. The literature on COPD patients is rich in reports of psychological symptoms such as anxiety and depression, which often co-occur with the physical manifestations of the disease. The primary aim of this study was to investigate the role of the sense of coherence and family support in depressive symptomatology among patients with COPD. A total of 143 patients (107 men and 32 women) participated, completing the Beck Depression Inventory (BDI), the Sense of Coherence-13 scale (SOC), and the Family Support Scale (FSS). Among the participants, 46.8% exhibited no depressive symptoms (BDI≤9), 29.5% had mild symptoms (BDI 10–15), 16.5% had moderate symptoms (BDI 16–23), and 7.2% had severe depressive symptoms (BDI≥24). Multiple regression analysis revealed that SOC accounted for 35.2% of the variance in BDI scores, with FSS contributing an additional 3.6%. Mediation analysis was conducted with BDI as the outcome variable, FSS as the mediator, and SOC as the predictor. The analysis confirmed the mediating role of family support in the SOC–BDI relationship, with the model explaining 10.3% of the variance in depressive symptoms. Based on these findings, future studies may benefit from exploring interventions that enhance perceived family support in COPD patients.