Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by difficulties in social interaction, restricted interests, and repetitive behaviors. Evaluating short-term treatment progress and outcomes in children with ASD is important for determining subsequent treatment goals. Aim: This study aimed to evaluate the outcomes during the first 3 months of applied behavior analysis (ABA)-based intervention using changes in Autism Treatment Evaluation Checklist (ATEC) scores. Materials and Methods: A prospective observational study was conducted among 21 children with ASD. Caregivers completed the 77-item ATEC before initiation of treatment and again after 3 months. Scores were calculated for four ATEC domains: Speech/Language/Communication, Sociability, Sensory/Cognitive Awareness, and Health/Physical/Behavior. Result: The mean age of participants was 5.51±1.45 years, and 16 children (76.19%) were male. Mean baseline Clinical Global Impressions–Severity (CGI-S) score was 4.71±0.72, and participants received a mean of 10.00±1.38 hours of ABA-based intervention per week. Mean total ATEC score decreased from 72.71±7.60 at baseline to 67.14±7.81 after 3 months, corresponding to a mean change of -5.57±2.18 points (-7.66%; t=11.706, p<0.001, d=2.55). Speech/Language/ Communication decreased by 7.05%, Sociability by 6.96%, and Sensory/Cognitive Awareness by 6.56%. The largest relative change was observed in the Health/Physical/Behavior domain (-1.90±1.14; -9.80%; p<0.001). Wilcoxon signed-rank tests were significant across all ATEC domains (p<0.001). Sixteen children (76.19%) met the study-defined criterion of more than a 5-point reduction. Baseline CGI-S was correlated with pre-post ATEC change using Pearson correlation (r=0.466, p=0.033), whereas the corresponding Spearman analysis was not statistically significant (ρ=0.349, p=0.121); therefore, this association could not be considered a robust predictor. Weekly ABA treatment hours were not significantly associated with ATEC change (r=-0.183, p=0.427), and age was also not associated with change (r=-0.043, p=0.855). Conclusion Changes across all ATEC domains were observed during the period in which children received ABA-based intervention, suggesting that some treatment-related changes may be detectable over a relatively short period in everyday settings. However, because only two assessment points were available, the rate and sequence of change could not be determined. Future studies should include larger samples, a comparison group, repeated assessments over 6–12 months, and independent developmental and clinical outcome measures.

Background: In Mongolia, identifying the factors and circumstances associated with children and adolescents’ involvement in crime may provide an important evidence base for the early identification of risk factors and the development of effective preventive interventions. In 2021, juveniles accounted for 20.7% (n=218) of the 1,053 civil and criminal forensic psychiatric evaluations conducted at the National Center for Mental Health (NCMH) in Mongolia. However, empirical data regarding the context and risk factors associated with juvenile involvement in the justice system are limited, necessitating this investigation. Aim: To investigate some factors associated with criminal involvement and victimization among children and adolescents. Materials and Methods: A retrospective study was conducted using the records of 725 forensic psychiatric evaluation records of children and adolescents assessed at the NCMH between 2020 and 2022. Data were collected using a researcherdeveloped structured data collection form consisting of six domains and 84 variables. Statistical analysis was performed using STATA, with statistical significance established at p < 0.05. Result: Among the 725 cases included in the study, 197 (27.1%) involved children and adolescents who had committed criminal offenses, while 528 (72.9%) involved child victims of sexual violence. The reason for forensic psychiatric evaluation differed significantly by sex: girls were more frequently evaluated as victims of sexual violence, whereas boys were more frequently evaluated in connection with having committed a criminal offense (p<0.001). The mean age of children who had committed criminal offenses was 16.4±1.6 years, compared with 12.6±3.6 years among victims of crime. Significant differences were observed between these groups with regard to sex (p=0.001) and age (p=0.001). Conclusion 1. Of the 725 participants, 197 children and adolescents (27.1%) were subjected to forensic psychiatric assessment to evaluate their psychological state at the time of committing a crime, while 528 (72.9%) were assessed to determine their capacity to provide true and accurate testimony as victims. 2. Among the 197 crime cases committed, 45.7% involved sexual violence, 27.4% were drug-related offenses, and 13.2% were crimes against the health of others. Males accounted for 94.4% of all crime-committed cases.

Background: Peacekeeping operations (PKOs) demand not only high professional expertise but also immense physical and psychosocial endurance from military personnel. Comprehensively identifying the psychological health challenges and specific risk factors influencing combat stress is of paramount practical significance for maintaining unit combat readiness. Aim: This study aims to evaluate the changes in psychosocial health, personality traits, and underlying risk factors for combat stress among personnel during pre-deployment and active deployment phases. Materials and Methods: A prospective, two-phase longitudinal study was conducted during the pre-deployment training and the subsequent 6-month deployment in UNMISS, South Sudan. Data from 283 personnel who fully completed both phases were analyzed using SPSS via McNemar, Chi-square, Pearson correlation, and multivariable logistic regression. Result: Participants were predominantly male (92.9%) with a mean age of 28.9±5.8 years. During deployment, neurotic symptoms (33.9%), cognitive decline (15.9%), and sleep disturbances (15.2%) were highly prevalent. Female personnel demonstrated statistically significantly higher rates of neurosis, sleep disorders, and anxiety (p<0.05). Multivariable logistic regression analysis revealed that the presence of Post-Traumatic Stress Disorder (PTSD) symptoms significantly increased the risk of developing combat stress by 4.22 times (aOR=4.22, 95% CI: 1.36-13.16, p=0.013). Furthermore, a prior history of exposure to severe life stressors increased the odds of combat stress by 2.68 times (aOR=2.68, 95% CI: 1.01-7.11, p=0.048). Conclusion 1. During peacekeeping operations, service members most frequently encounter environmental and domestic challenges related to health, animals, and insects (44.2–44.5%). Furthermore, high rates of anxiety symptoms (>72.0%) and neurotic symptoms (33.9%, significantly higher in women, p<0.05) were reported. Consequently, personnel highly prioritize psychological resilience (59.0%) and teamwork skills (57.6%) in real-world deployment settings. 2. Logistic regression analysis demonstrated that the primary independent predictors increasing service members’ risk of exposure to combat stress are a personal history of severe life stressors (aOR = 2.68, p=0.048) and the presence of post-traumatic stress disorder (PTSD) symptoms (aOR = 4.22, p=0.013).

Background: In the context of Mongolia, identifying and establishing the causes and underlying factors associated with juvenile and adolescent involvement in crime carries substantial practical significance for the early detection of risk factors and the implementation of targeted preventive measures. In 2021, minors accounted for 20.7% of the total 1,053 cases subjected to forensic psychiatric evaluation at the National Center for Mental Health (NCMH). Subsequently, minors constituted 20.4% (n=251) of cases in 2022, 19.6% (n=203) in 2023, 19.4% (n=225) in 2024, and 23.6% (n=318) in 2025. Notably, the proportion observed in 2025 represents a 4.2 percentage point increase compared to the preceding year. Nevertheless, comprehensive empirical data regarding the underlying causes, surrounding conditions, and specific offense types associated with juvenile criminal involvement remain insufficient, thereby establishing the primary rationale for conducting this study. Aim: To investigate the underlying causes, contributing risk factors, and mental health status of juvenile offenders involved in criminal activities. Materials and Methods: A cross-sectional study design was utilized, enrolling a total sample of 105 male adolescents aged 15–18 years. This sample comprised 35 residents from a Specialized Training and Educational Institution (juvenile correctional facility) and 70 control students from general secondary schools. Primary data collection was conducted using the Child PTSD Symptom Scale for DSM-5 Self-Report (CPSS-5-SR), the Parental Bonding Instrument (PBI), the Kidcope / Family Life Scale (KFLS), and a specially designed structured questionnaire. Result: The overall mean age of participants was 16.69±0.87 years. Among the institutionalized juvenile offenders, 45.7% had a history of prior criminal involvement; specifically, 45.7% had committed rape and 17.1% had committed theft. Regarding substance use behaviors, 82.9% of the juvenile offenders reported smoking tobacco, 71.4% consumed alcohol, and 20.0% had experimented with other illicit or controlled substances, all of which were markedly higher than the rates observed among general secondary school students. Multivariate regression analysis demonstrated that adolescent tobacco use, alcohol consumption, paternal alcoholism, and domestic family conflict exerted statistically significant effects on criminal involvement. Furthermore, screen-positive cases for probable Post-Traumatic Stress Disorder (PTSD) were identified in 40.0% of the institutionalized juvenile offenders, compared to 27.5% among the general secondary school students. Conclusion The prevalence of tobacco, alcohol, and other substance use, alongside adverse family environment influences, is significantly higher among residents of the Specialized Training and Educational Institution compared to general secondary school students. Because juvenile criminal involvement is directly associated with the development of Post-Traumatic Stress Disorder, there is an urgent imperative to integrate targeted mental health care services into rehabilitation and protection efforts.

Background: Depression, anxiety, and stress related to diabetes create psychosocial distress. In Mongolia, although the prevalence of diabetes has been rapidly increasing in recent years, studies on psychosocial and mental health–related clinical factors among people with diabetes are limited. To study some psychosocial and mental health–related changes occurring in people with diabetes in relation to disease complications and control indicators. Materials and Methods: The study was conducted using an analytical cross-sectional design, including 172 adults with diabetes. Standard assessment tools such as the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Diabetes Distress Scale questionnaires were used to collect data. Cases that tested positive on two or more instruments were defined as having “composite psychosocial distress.” Univariate and multivariate logistic regression analyses were performed to identify factors associated with composite psychosocial distress, and additional statistical models were developed for each outcome. Result: The mean age of participants was 58.3±10.4 years, and 57.6% were female. The mean HbA1c value was 9.0% (IQR 7.5–11.0), and the average duration of diabetes was 10 years (IQR 6–16). Among all participants, 16.9% had composite psychosocial distress. One chronic complication related to diabetes was observed in 47.7% of participants, while 17.0% had two or more complications. Scores of depression, anxiety, and diabetes-related distress were positively correlated (all p<0.001). In univariate analysis, with each additional chronic complication, composite psychosocial distress increased (OR=1.93, 95% CI 1.31–2.87; p=0.001). In univariate regression analysis, higher HbA1c significantly increased the risk of composite psychosocial distress (for each 1% increase, OR=1.14, 95% CI 1.01–1.28; p=0.040). In multivariate analysis including number of chronic complications and HbA1c, the number of chronic complications remained an independent factor increasing risk (adjusted OR=1.92, 95% CI 1.21–3.05; p=0.005), while HbA1c was not statistically significant. The prevalence of composite psychosocial distress tended to increase depending on complications. Among participants without chronic complications, it was 8.9%; among those with one complication, 19.2%; and among those with two or more complications, 37.9%. The prevalence of moderate to severe depression, anxiety, and high levels of diabetes-related distress also increased similarly with the number of chronic complications. Conclusion Composite psychosocial distress is present in 1 out of every 6 adults with diabetes. The presence of chronic complications increases the risk of composite psychosocial distress by 3.5 times.

Background: Cancer is not only a physiological disease but also a complex condition that profoundly affects an individual’s psychological well-being and social relationships. Misconceptions about cancer within the public, including its association with death and the tendency to attribute blame to patients as being “personally responsible,” contribute to the development of social stigma among cancer survivors. This stigma negatively impacts patients’ engagement in treatment and their quality of life, highlighting the need to assess societal attitudes based on survivors’ lived experiences. Aim: To examine the everyday lived experiences of cancer survivors, measure perceived social stigma, and identify psychological challenges as well as sources of support. Materials and Methods: A mixed-methods design was employed. In the quantitative component, the Cancer Stigma Scale (CASS) and the Attitudes Toward Cancer Questionnaire (ATCQ) were translated and their content validity was evaluated by an expert panel using the Content Validity Index (CVI), followed by pilot testing to confirm feasibility (FVI). In the qualitative component, focus group discussions were conducted with cancer survivors, and coping ability was assessed using psychological assessment tools. Result: A total of 207 participants (68% female; mean age 33.82±13.7 years) were included in the quantitative study. Participants experienced a moderate level of cancer-related stigma, with negative attitudes most strongly associated with perceptions of disease severity and individual responsibility. Qualitative findings revealed that physician communication and family support played a decisive role in psychological responses at the time of diagnosis disclosure. Excessive sympathy or social distancing increased psychological distress, whereas normal interpersonal interaction and realistic encouragement were identified as the most effective forms of support. Conclusion To improve psychosocial support for cancer survivors, it is essential to enhance healthcare professionals’ communication skills, promote accurate public understanding of cancer, and strengthen the sustainability of survivor support group activities.

Background: Substance use remains a critical public health and social concern, closely linked to increased sexual risk behaviors and a heightened vulnerability to sexually transmitted infections (STIs), particularly HIV and syphilis. International and national evidence suggests that individuals who use drugs often experience impaired judgment during intoxication, leading to unprotected intercourse, casual sexual encounters, and multiple sexual partners. In Mongolia, empirical data regarding sexual risk behaviors within this population remain scarce. Therefore, there is a pressing need to determine the prevalence of sexual risk behaviors and identify the specific factors influencing these patterns among drug users. Materials and Methods: This study employed a cross-sectional analytical design involving 181 participants who use drugs. Data were collected via structured questionnaires. Sexual risk behavior was evaluated using two approaches: as a dichotomous categorical variable and as a cumulative sexual risk score. Statistical analysis was performed using frequency distributions, percentages, means, and standard deviations. The associations between variables were tested using the (chi square test, Pearson correlation analysis, and multiple linear regression models. Results: The findings revealed that 12.2% of participants exhibited high-level sexual risk behaviors, with a mean cumulative risk score of 8.13 ±4.40. Engaging in sexual intercourse while under the influence of alcohol, the frequency of intoxicated sex (reported as "often" or "always"), and a history of casual sexual encounters were significantly associated with sexual risk behaviors. Furthermore, gender, cohabitation status, condom use during the first sexual experience, and the frequency of alcohol-involved sexual encounters were statistically significant predictors of the cumulative risk score. A weak positive correlation was observed between the number of sexual partners in the past year and the cumulative sexual risk score, which remained a significant positive predictor in the linear regression model. Conclusion Sexual risk behavior among people who use drugs is more closely associated with behavioral factors—such as alcohol-influenced sexual activity, casual encounters, lack of condom use during sexual debut, and multiple partnership—than with basic socio-demographic characteristics. Consequently, risk reduction interventions should move beyond general awareness. Efforts must prioritize reducing substance- and alcohol-related sexual risks, promoting consistent condom use, and enhancing the accessibility of STI screening and counseling services tailored to this high-risk group.

Background: Drug use is closely associated with sexually transmitted infections, especially syphilis and HIV, through unsafe sexual practices, multiple partners, and high-risk patterns of substance use. Prisoners with a history of drug use represent a particularly vulnerable subgroup. Aim: This study aimed to determine the prevalence of rapid syphilis test positivity and selected associated factors among incarcerated people who use drugs. Materials and Methods: A cross-sectional analytic study was conducted among 105 prisoners. Data were collected using a structured questionnaire and a finger-prick rapid dual test. Descriptive statistics, chi-square tests, and Fisher exact tests were used, with p<0.05 considered statistically significant. Results: The mean age of participants was 29.1±8.4 years; 78.1% were male. A history of STI was reported by 16.2%, STI-related symptoms during the last 12 months by 19.0%, STI testing during the last 12 months by 39.0%, and STI testing while incarcerated by 45.7%. However, 79.0% had received STI-related education or information. Among 81 participants with valid rapid syphilis test results, 27 were positive, giving a prevalence of 33.3%. Syphilis positivity was significantly higher among those using more than one route of drug administration (41.4% vs 13.0%, p=0.018) and among those with a prior STI history (70.0% vs 26.6%, p=0.011). No significant associations were found with sex, age, education, marital status, cohabitation, income, syringe use, recent STI symptoms, casual sex before arrest, or overall sexual risk behavior. Conclusion These findings suggest that targeted syphilis screening, counseling, and linkage to confirmatory testing and treatment should be strengthened among incarcerated people who use drugs, particularly those with multi-route drug use and a previous STI history.

Background: Sexual risk behavior is an important issue that requires early identification and assessment because it is associated with sexually transmitted infections, particularly HIV and syphilis, unintended pregnancy, and adverse reproductive, psychosocial, and mental health outcomes. Clients with sexual risk behaviors may also experience fear, anxiety, depression, shame, and stigma. Therefore, psychiatrists have an important role in identifying these risks, providing counseling, and referring clients for further care when needed. However, in routine clinical practice, obtaining a full sexual health history and identifying sexual risk behavior through interview may be limited. Aim: This study aimed to assess psychiatrists’ current practice in asking about sexual risk behavior, their basic knowledge of HIV/STIs, attitudes toward clients with sexual risk behavior, and training needs. Materials and Methods: A descriptive cross-sectional questionnaire survey was conducted between July and October 2025. The study included 158 psychiatrists working at the National Center for Mental Health, district and local health centers, and private clinics providing mental health services. Data were collected using a questionnaire developed by the research team. The survey included socio-demographic and professional characteristics, practice related to asking about sexual risk behavior, knowledge of HIV/STIs, attitudes toward clients with sexual risk behavior, and institutional training needs. Data were analyzed using Microsoft Excel and SPSS version 23. Descriptive statistics, chi-square tests, non-parametric tests, Spearman correlation, and linear regression models were applied. Results: Of the participants, 78.5% were female, and the mean age was 36.8±10.2 years. Psychiatrists asked a mean of 6.2±5.7 out of 22 questions required to identify sexual risk behavior, indicating that only a limited number of relevant questions were routinely covered in clinical practice. General questions such as marital status, age at first sexual intercourse, sexual health-related complaints, and history of sexually transmitted infections were asked more frequently, whereas questions on sex with commercial sex workers, casual and multiple sexual partners in the last 3 months, and sexual orientation were asked less often. Male psychiatrists (p=0.036) and psychiatrists working in private practice (p=0.034) asked significantly more questions. Among the 131 participants eligible for HIV/STI knowledge assessment, 29.8% had adequate knowledge and 70.2% had inadequate knowledge. Misconceptions about mosquito transmission of HIV remained common. The mean attitude score among 131 psychiatrists was 14.3±1.7. Significant differences were observed across age groups (p=0.004), and psychiatrists with 0–10 years of experience had higher attitude scores than those with more than 10 years of experience (p=0.026). A weak but statistically significant negative correlation was found between years of work as a psychiatrist and attitude score toward clients with sexual risk behavior (Spearman r=-0.304, p<0.001; n=131). In addition, 69.0% of participants had previously worked with clients with sexual risk behavior, and 48.1% had provided care to such clients in the last 12 months. Conclusion The practice of asking about sexual risk behavior among psychiatrists remains limited and non-standardized. Differences were observed according to physician sex and type of institution. Continuous workplace-based training and practical guidelines are needed to strengthen psychiatrists’ capacity to identify sexual risk behavior and provide appropriate care.

Background: According to WHO research, there are approximately 24 million people living with schizophrenia worldwide and schizophrenia is characterized by a combination of psychotic and non-psychotic symptoms. Since the cause of the disease is not fully understood, antipsychotic medications are used as symptomatic treatment. According to the 2022 statistics of the NCMH, 718 people with schizophrenia are being treated under active surveillance in Mongolia. The reason for conducting this study is that the manifestation of drug side effects resulting movement disorders in patients with schizophrenia, which has not been studied in Mongolia. Aim: To investigate the relationship between adherence of medication regimen and abnormal involuntary movements in patients with schizophrenia. Materials and Method: The study was conducted using a descriptive method, cross-sectional design, purposive sampling with the questionnaire and standardized tests. Ethical approval for this study was approved by the NCMH (№3/77 30th of January, 2023) and Research Ethics Review Committee of MNUMS (№2023/3-02). Each participant was asked to complete 5 groups of 36 questionnaires, and standard tests were used to assess patients’ adherence to medication regimens (Morisky scale) and abnormal involuntary movement scale (AIMS). The study was conducted between March and August 2023, and the results were summarized and analyzed using STATA 14 software. Results: The study included 209 patients with schizophrenia, aged 18-79 years, of whom 47.4% (n=99) were male and 52.6% (n=110) were female (p=0.21). Of the participants, 28.2% (n=59) had less than secondary education, 76.5% (n=160) were unmarried, and 85.2% (n=178) had a disability due to mental health. 32.5% (n=68) of the patients with schizophrenia in the study used a combination of typical and atypical medications, and the most commonly used antipsychotic drugs were haloperidol (30.6%), chlorpromazine (26.8%), levomepromazine (25.8%), risperidone (24.4%), and quetiapine (21.1%). 1.4% (n=3) of the patients had good, 52.6% (n=110) had moderate, and 45.9% (n=96) had poor adherence to the medication regimen (Cronbach’s α=0.781). However, according to the results of the test for assessing abnormal involuntary that are performed without self-control, 49.76% (n=104) responded that they felt more sensitive to facial and oral movements, and 44.5% (n=93) to limb movements. The patients’ adherence to the medication regimen was statistically significant with facial and oral movements (n=104; p=0.036) and general body movement disorders (n=94; p=0.05). Conclusion 32.5% of patients with schizophrenia were taking typical and atypical antipsychotics, and 45.9% had poor adherence to medication regimens and were more likely to exhibit clinical forms of abnormal involuntary movements, including facial (p=0.036) and general movement disorders (p=0.05).