Purpose: Several studies have explored the relationship between level of education and medication adherence, as well as the relationship between level of education and cognitive function. However, there have been few studies on the relationships between level of education, cognitive function, and medication adherence. This study aimed to explore whether cognitive function has a mediating effect between level of education and medication adherence in patients with schizophrenia. Patients and Methods: A total of 329 participants were included in this study. Cognitive function was assessed using the Brief Assessment of Cognition in Schizophrenia, and medication adherence using the Medication Adherence Questionnaire. The relationships between the clinical factors and cognitive function that contributed to medication adherence were tested through multivariable linear regression analysis. The mediating effect of medication adherence was tested using the bootstrapping approach with the PROCESS macro. Results: Family history, insight and executive function were associated with medication adherence in individuals with schizophrenia, and executive function had a mediating effect between level of education and medication adherence. Conclusion: Adopting specific education programs that promote cognitive development as well as actively intervening in executive function might be conducive to improve medication adherence in patients with schizophrenia.

Introduction Mild cognitive impairment (MCI) is an intermediate phase between normal cognitive ageing and dementia and poses a serious threat to public health worldwide; however, it might be reversible, representing the best opportunity for secondary prevention against serious cognitive impairment. As a non-pharmacological intervention for those patients, interventions that combine physical exercise and cognitive training, whether delivered simultaneously or sequentially, may have superior effects on various cognitive domains, including global cognition, memory, executive function and attention. The supportive evidence remains incomplete. This study aims to assess the effectiveness of a combined exercise and cognitive intervention in Chinese older adults with mild cognitive impairment (COGITO), empowered by digital therapy and guided by the Health Action Process Model and the Theory of Planned Behaviour (HAPA-TPB theory) in a home-based setting. Methods and analysis This study is a randomised controlled, assessor-blinded multi-centre study. Four parallel groups will include a total of 160 patients, receiving either a combined exercise and cognitive intervention, an isolated exercise intervention, an isolated cognitive intervention or only health education. These interventions will be conducted at least twice a week for 50 min each session, over 3 months. All interventions will be delivered at home and remotely monitored through RehabApp and Mini-programme, along with an arm-worn heart rate telemetry device. Specifically, supervisors will receive participants’ real-time training diaries, heart rates or other online monitoring data and then provide weekly telephone calls and monthly home visits to encourage participants to complete their tasks and address any difficulties based on their training information. Eligible participants are community-dwelling patients with no regular exercise habit and diagnosed with MCI. The primary outcome is cognitive function assessed by the Alzheimer’s Disease Assessment Scale-Cognitive (ADAS-Cog) and Community Screening Instrument for Dementia (CSI-D), with baseline and three follow-up assessments. Secondary outcomes include quality of life, physical fitness, sleep quality, intrinsic capacity, frailty, social support, adherence, cost-effectiveness and cost-benefit. Ethics and dissemination The study was approved by the Institutional Review Board of Peking University. Research findings will be presented to stakeholders and published in peer-reviewed journals and at provincial, national and international conferences. Trial registration number ChiCTR2300073900.

Background: Nonsuicidal self-injury (NSSI) is prevalent and harmful among adolescents with major depressive disorder (MDD), threatening mental and physical health. This study aims to elucidate the poorly understood neural mechanisms underlying NSSI behaviors and motivations in this group. Methods: 133 adolescent participants were recruited, comprising 45 MDD with NSSI, 46 MDD without NSSI, and 42 age- and sex-matched healthy controls. All underwent resting-state functional MRI, from which low-frequency amplitude fluctuations (ALFF) were assessed and regions showing group differences were used as seeds for functional connectivity (FC) analyses. Associations between ALFF/FC values and NSSI behaviors and motivations were then evaluated via a cross-validation prediction method for robustness and generalizability. Results: Adolescents with MDD who engaged in NSSI showed increased ALFF in the left precuneus, significantly associated with NSSI behaviors, and increased left precuneus–left cuneus FC, significantly associated with behaviors and intrapersonal negative reinforcement motivations. Prediction analyses confirmed the robustness of these associations, with ALFF ( r _{(predicted, observed)} = 0.653, p = 0.001) and FC ( r _{(predicted, observed)} = 0.601, p = 0.001; r _{(predicted, observed)} = 0.587, p = 0.001). Conclusion: Our study identified key alterations in brain activity associated with NSSI behaviors and motivations in adolescents with MDD, providing neural markers for NSSI prediction and diagnosis and targets for precision interventions.