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Introduction and purpose: Endometriosis is a gynecological disease that affects about 10% of women worldwide. Women suffering from endometriosis are susceptible to mental health disorders, such as depression and anxiety. It is essential to highlight the psychological struggles of women with endometriosis in order to integrate physical and psychological care and subsequently enhance the treatment outcomes. Materials and Methods: Medical databases such as Pubmed, Embase, Google Scholar were searched for scientific papers on endometriosis and its relationship with the symptoms of depression and anxiety. Research outlined the influence of endometriosis treatment, social stigmatization and non-medicinal approach. State of knowledge: The prevalence of depression and anxiety among women with endometriosis is significant. The symptoms of the disease influence daily struggles, relationship with partners and family, education and career responsibilities, subsequently lowering the quality of life. Women with endometriosis experience social stigmatization manifested not only from society members but also from healthcare professionals. The approach to the medical treatment by patients was discovered to be of consequence. Literature review emphasizes the benefits of psychological support and empathetic attitude of medical practitioners. Conclusions: Multidisciplinary team is essential in order to provide intervention strategies leading to greater therapeutic outcomes in endometriosis treatment. Endometriosis and mental disorders are inextricably connected. More research is needed to accent the importance of mental health in the treatment of physical conditions.

Introduction and purpose: The topic of apple cider vinegar supplementation and insulin resistance is becoming increasingly widespread, especially on the internet, which carries many potential risks. There is a need to understand both how apple cider vinegar reduces insulin resistance and improves metabolic parameters, as well as the potential risks of its use. Material and methods: Medical databases like PubMed, Google Scholar, and Embase were searched for scientific papers on the safety, benefits, mechanisms, and risks of apple cider vinegar in insulin resistance and related conditions. These were analyzed and summarized in a single review. State of knowledge: Apple cider vinegar supplementation contributes to a reduction in insulin resistance, which is reflected in parameters such as decreased postprandial insulin secretion, lower levels of triglycerides (TG) and total cholesterol (TC), reduced fasting glucose, lower HbA1c levels, and supports weight loss, potentially improving insulin sensitivity. In most cases, no adverse effects or serious side effects were observed with doses of 15-30 ml per day. However, potential risks include delayed gastric emptying, exacerbation of gastroesophageal reflux disease (GERD), gastrointestinal disturbances, tooth erosion, although one study suggests that such supplementation may be associated with acute pancreatitis. Conclusions: More research is needed on supplementation, particularly regarding its duration. Another risk is the search for health information online without critically evaluating the content. Weight loss through a proper diet and exercise appears to be key for improving insulin sensitivity, but supplementation may help achieve results in certain patient groups.

Summary: Background: The burden of psychiatric symptoms in Parkinson's disease includes depression, anxiety, apathy, psychosis, and impulse control disorders. However, the relationship between psychiatric comorbidities and subsequent prognosis and neurological outcomes is not yet well understood. In this systematic review and meta-analysis, in individuals with Parkinson's disease, we aimed to characterise the association between specific psychiatric comorbidities and subsequent prognosis and neurological outcomes: cognitive impairment, death, disability, disease progression, falls or fractures and care home admission. Methods: We searched MEDLINE, Embase, PsycINFO and AMED up to 13th November 2023 for longitudinal observational studies which measured disease outcomes in people with Parkinson's disease, with and without specific psychiatric comorbidities, and a minimum of two authors extracted summary data. Studies of individuals with other parkinsonian conditions and those with outcome measures that had high overlap with psychiatric symptoms were excluded to ensure face validity. For each exposure-outcome pair, a random-effects meta-analysis was conducted based on standardised mean difference, using adjusted effect sizes–where available–in preference to unadjusted effect sizes. Study quality was assessed using the Newcastle–Ottawa Scale. Between-study heterogeneity was assessed using the I2 statistic and publication bias was assessed using funnel plots. PROSPERO Study registration number: CRD42022373072. Findings: There were 55 eligible studies for inclusion in meta-analysis (n = 165,828). Data on participants’ sex was available for 164,514, of whom 99,182 (60.3%) were male and 65,460 (39.7%) female. Study quality was mostly high (84%). Significant positive associations were found between psychosis and cognitive impairment (standardised mean difference [SMD] 0.44, [95% confidence interval [CI] 0.23–0.66], I2 30.9), psychosis and disease progression (SMD 0.46, [95% CI 0.12–0.80], I2 70.3%), depression and cognitive impairment (SMD 0.37 [95% CI 0.10–0.65], I2 27.1%), depression and disease progression (SMD 0.46 [95% CI 0.18–0.74], I2 52.2), depression and disability (SMD 0.42 [95% CI 0.25–0.60], I2 7.9%), and apathy and cognitive impairment (SMD 0.60 [95% CI 0.02–1.19], I2 27.9%). Between-study heterogeneity was moderately high. Interpretation: Psychosis, depression, and apathy in Parkinson's disease are all associated with at least one adverse outcome, including cognitive impairment, disease progression and disability. Whether this relationship is causal is not clear, but the mechanisms underlying these associations require exploration. Clinicians should consider these psychiatric comorbidities to be markers of a poorer prognosis in people with Parkinson's disease. Future studies should investigate the underlying mechanisms and which treatments for these comorbidities may affect Parkinson's disease outcomes. Funding: Wellcome Trust, UK National Institute for Health Research (NIHR), National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation Trust and King's College London, National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at University College London Hospitals NHS Foundation Trust, National Brain Appeal.