Comprehensive psychiatry最新文献

{"title":"Blowing Minds: A cross-cultural, longitudinal investigation to unravel the highs and lows of recreational and medicinal cannabis users","authors":"Nora de Bode,&nbsp;Emese Kroon,&nbsp;Jia Hua Hsieh,&nbsp;Janna Cousijn","doi":"10.1016/j.comppsych.2025.152659","DOIUrl":"10.1016/j.comppsych.2025.152659","url":null,"abstract":"<div><div>Cannabis use is widely on the rise for recreational and medicinal purposes, with the latter often aimed at improving mental health and cognition. Simultaneously, the prevalence of cannabis-related health harms, such as cannabis use disorder (CUD), is increasing.</div><div>Product potency, route of administration, and preexisting mental health symptoms play a role in the effects of cannabis; however, there is limited research on how broader factors, such as local cannabis legislation and perceptions of use, may influence these outcomes. Moreover, knowledge remains sparse regarding the growing population of medicinal users, predominantly using without medical supervision. Altogether, this illustrates the need for ecologically valid ways to investigate individuals and their cannabis usage within real-world settings.</div><div>Therefore, this longitudinal, cross-cultural online study examines an international sample of regular recreational and medicinal users (aged 18–65) from different cannabis jurisdictions (e.g., the Netherlands, the United States, Brazil, Canada, and regions in Asia and Africa) in their natural environment via their mobile phone. By using the Experience Sampling Method (ESM), alongside a comprehensive battery of cognition and mental health related assessments over a 2-year period, we aim to gain insight into the short- and long-term mental health and cognitive determinants and consequences of cannabis use, and how these interact with broader, contextual factors, such as legislation. This is one of the first cross-cultural studies assessing both positive and negative effects of cannabis longitudinally, examining the full range of effects that cannabis may have on the individual.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"145 ","pages":"Article 152659"},"PeriodicalIF":4.2,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attentional bias in people with moderate-to-severe cannabis use disorder","authors":"Marianna Quinones-Valera ,&nbsp;Gary Chan ,&nbsp;Madeleine I. Fraser ,&nbsp;Andrew Jones ,&nbsp;Tom P. Freeman ,&nbsp;Chandni Hindocha ,&nbsp;Hannah Thomson ,&nbsp;Eugene McTavish ,&nbsp;Hannah Sehl ,&nbsp;Adam Clemente ,&nbsp;Janna Cousijn ,&nbsp;Izelle Labuschagne ,&nbsp;Peter Rendell ,&nbsp;Gill Terrett ,&nbsp;Lisa-Marie Greenwood ,&nbsp;Govinda Poudel ,&nbsp;Chao Suo ,&nbsp;Victoria Manning ,&nbsp;Valentina Lorenzetti","doi":"10.1016/j.comppsych.2025.152658","DOIUrl":"10.1016/j.comppsych.2025.152658","url":null,"abstract":"<div><h3>Background</h3><div>Attentional bias to cannabis images is posited to drive loss of control over cannabis use and relapse in cannabis use disorder (CUD), but the literature is mixed and limited by inconsistent measurement of CUD and of confounders, including alcohol and nicotine use. This study examined attentional bias in moderate-to-severe CUD (<em>n</em> = 66) compared to controls (<em>n</em> = 42), and its relationship with cannabis/nicotine use, accounting for alcohol use.</div></div><div><h3>Methods</h3><div>We measured attentional bias using the visual probe task, as the difference in reaction times (RTs) for cannabis versus neutral images, in order to account for individual variability. Linear mixed effect models examined how RTs were affected by (i) group (CUD, control), image type (cannabis, neutral), group-by-image type, and group-by-image type-by-Stimulus Onset Asynchrony (SOA, 200/500 milliseconds) in the whole sample; and (ii) by image type, SOA, and moderators in the CUD group only (i.e., Cannabis Use Disorder Identification Test-Revised [CUDIT-R], subjective craving, arousal/valence ratings of the task’s cannabis/neutral images, and nicotine). All models were adjusted for alcohol use.</div></div><div><h3>Results</h3><div>There were no significant group differences in attentional bias. In the CUD group, image type-by-CUDIT-R subgroups differed on RTs (β = −0.748, <em>p</em> = .014), whereby the high-CUDIT-R versus lower CUDIT-R subgroups had significantly faster RTs to cannabis versus neutral images (<em>p</em> = .034, <em>d</em> = −0.10), but this effect did not survive Bonferroni correction for multiple comparisons. No other results were significant.</div></div><div><h3>Conclusion</h3><div>Attentional bias might not be a robust feature of CUD, though this notion requires validation in a larger sample using more direct measures of attentional bias.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"146 ","pages":"Article 152658"},"PeriodicalIF":4.2,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency medical personnel perspectives on value and use of tailored discussion forum for mental health support. A qualitative longitudinal study","authors":"Milica Petrovic ,&nbsp;Anne Blume ,&nbsp;Mikołaj Zarzycki ,&nbsp;Nico Niedermeier ,&nbsp;Hanna Reich","doi":"10.1016/j.comppsych.2025.152655","DOIUrl":"10.1016/j.comppsych.2025.152655","url":null,"abstract":"<div><h3>Background</h3><div>Emergency medical personnel experience high job-related strain elevating their risk for mental ill-health and depressive symptoms. This study explored emergency medical personnel user-perspectives in terms of added value of the anonymous online discussion forum RUPERT dedicated to rescue and emergency workers mental health support.</div></div><div><h3>Methods</h3><div>Using a survey as a qualitative longitudinal tool, we explored emergency medical personnel perceptions, experiences, and expectations in terms of support needs, information and knowledge sought, perceived benefits of RUPERT, interests expressed, as well as perceived value and advantages of RUPERT.</div></div><div><h3>Results</h3><div>A total of 37 participants joined the qualitative survey in time-point 1 (T1), 17 in time-point 2 (T2), and four in time-point 3 (T3). The thematic analysis generated 34 dominant subthemes within seven a priori domains and six overarching themes across domains. The overarching themes showed present concepts in the context of the discussion forum and emergency medical personnel, including <em>Shared experiences and mutual understanding</em>, <em>Support networks and Social connection</em>, <em>Access to Information and Practical tools</em>, <em>Barriers to Participation and Usability</em>, <em>Mental health and Work-related challenges</em>, and <em>Curiosity and Passive participation</em>.</div></div><div><h3>Conclusion</h3><div>The current findings have an important role for enhancing forums as an online tool for supporting rescue workers and emergency medical personnel. The overarching themes can support the future user-centered design principles in terms of functionality, usability, accessibility and more importantly serve as a guideline for practitioners who work on the content development via online tools for this population.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"145 ","pages":"Article 152655"},"PeriodicalIF":4.2,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic networks of prolonged grief symptoms in daily life","authors":"Justina Pociūnaitė-Ott ,&nbsp;Jorge Piano Simões ,&nbsp;Talya Greene ,&nbsp;Minita Franzen ,&nbsp;Lonneke I.M. Lenferink","doi":"10.1016/j.comppsych.2025.152660","DOIUrl":"10.1016/j.comppsych.2025.152660","url":null,"abstract":"<div><h3>Background</h3><div>According to network theories, mental disorders, including prolonged grief disorder (PGD), comprise networks of dynamically connected symptoms. Examining how prolonged grief symptoms are connected over time could reveal the patterns driving their persistence. This study provides the first empirical investigation of prolonged grief symptom networks using self-reported data on prolonged grief assessed multiple times daily.</div></div><div><h3>Methods</h3><div>Adults whose partner, family member, or friend died on average 30 months ago (<em>N</em> = 229, 80 % women, <em>M</em>_<em>age</em> = 51) rated prolonged grief symptom intensity using 11 items (e.g., “In the past three hours, I found myself yearning for him/her”) five times per day for two weeks. We used a two-step multilevel vector autoregressive model to produce between-person, contemporaneous, and temporal networks.</div></div><div><h3>Results</h3><div>In the between-person network, yearning and sadness were the most strongly and positively connected symptoms. In the contemporaneous network, yearning, preoccupation, and sadness formed a cluster of positively connected symptoms. Simultaneously, difficulty reintegrating after the loss, emotional numbness, meaninglessness, and loneliness due to the loss formed another positively connected symptom cluster. In the temporal network, emotional numbness had the greatest positive influence on other prolonged grief symptoms at the subsequent timepoint.</div></div><div><h3>Conclusion</h3><div>We propose that targeting emotional suppression, promoting flexible emotion regulation, and supporting integrated continuing bonds (approach-behaviors) and targeting avoidance of the reality of the loss (avoidance-behaviors) may help people to adapt to loss.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"145 ","pages":"Article 152660"},"PeriodicalIF":4.2,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficient screening and outcome assessment for borderline personality disorder: A psychometric evaluation of the uBPDc","authors":"Carlijn J.M. Wibbelink ,&nbsp;Jan H. Kamphuis ,&nbsp;Marieke Effting ,&nbsp;Roland Sinnaeve ,&nbsp;Michiel Boog ,&nbsp;Eliane C.P. Dek ,&nbsp;Arnoud Arntz","doi":"10.1016/j.comppsych.2025.152656","DOIUrl":"10.1016/j.comppsych.2025.152656","url":null,"abstract":"<div><div>There is a need for a brief and psychometrically sound questionnaire to assess borderline personality disorder (BPD) symptomatology that can serve both as a screening tool and outcome measure. We conducted a comprehensive psychometric evaluation of a shortened version of the validated BPD Checklist, the Ultrashort BPD Checklist (uBPDc). Data from 204 individuals diagnosed with BPD, 57 individuals diagnosed with Cluster-C personality disorder, and 103 non-clinical controls were analysed. As an initial step, we determined the final item composition, with separate items to index the presence or absence of intense anger or difficulty controlling anger (DSM-5 BPD criterion 8), and of paranoid ideation or dissociation (DSM-5 BPD criterion 9). The final 11-item version demonstrated strong internal consistency, and our findings provide consistent support for its concurrent and known-group validity. The uBPDc also showed satisfactory diagnostic accuracy and sensitivity to change. The one-factor structure of the uBPDc was confirmed by factor analysis. Measurement invariance was subsequently assessed across individuals with BPD and non-clinical controls, revealing support for partial measurement invariance. To conclude, the uBPDc demonstrated strong psychometric properties and thus makes for an efficient tool for screening and outcome assessment in BPD.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"145 ","pages":"Article 152656"},"PeriodicalIF":4.2,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research protocol for BootStRaP assessment phase: A nine-nation study on boosting societal adaptation and mental health in a rapidly digitalising, post-pandemic Europe","authors":"Naomi A. Fineberg ,&nbsp;Annika Brandtner ,&nbsp;Nana Löchner ,&nbsp;Christopher Kannen ,&nbsp;Megan Smith ,&nbsp;Simon Foster ,&nbsp;Anita Meinke ,&nbsp;Kristin Mosler ,&nbsp;Shai Fine ,&nbsp;Lior Carmi ,&nbsp;Talia Friedman ,&nbsp;Zsolt Demetrovics ,&nbsp;Célia Sales ,&nbsp;Julia Jones ,&nbsp;Hernâni Oliveira ,&nbsp;Samuel R. Chamberlain ,&nbsp;Konstantinos Ioannidis ,&nbsp;Katalin Felvinczi ,&nbsp;Joseph Zohar ,&nbsp;Andres Roman-Urrestarazu ,&nbsp;Matthias Brand","doi":"10.1016/j.comppsych.2025.152653","DOIUrl":"10.1016/j.comppsych.2025.152653","url":null,"abstract":"<div><h3>Background</h3><div>There is increasing global concern about the harms associated with problematic usage of the internet (PUI) affecting young people. Various risk factors have been proposed, but there is a scarcity of reliable evidence on the extent of the problem, who is most at risk of developing PUI and why, and how best to tackle it.</div></div><div><h3>Objectives</h3><div>BootStRaP (ISRCTN59576080) is a five-year multinational research programme designed to boost young people's health and resilience by determining, through prospective longitudinal assessment, the risk factors associated with PUI and its health economic impact and designing and testing preventative self-management interventions tailored to individual risk factors.</div></div><div><h3>Methods</h3><div>This paper describes the first phase of the project (i.e., Cohort 1). A sample of over 2500 schoolchildren aged 12–16 years was recruited across nine European countries. They were prospectively monitored over a 6-month period using a dedicated smartphone application (<em>BootstrApp</em>), through which their internet use habits, health and wellbeing were measured. Young people were involved in the co-design of aspects of the protocol including the recruitment plan and elements of the app design. The components of the assessment battery were chosen to investigate specific individual, clinical, cognitive and environmental risk determinants as defined a priori in an evidence-based logic-model. Participants were assessed using a combination of standardised demographic and clinical questionnaires, ambulatory assessment techniques, cognitive testing and passive digital monitoring. Multimodal data is analysed according to machine learning and structured equation modelling.</div></div><div><h3>Expected outcomes</h3><div>Our findings will contribute toward A) developing algorithms for predicting individuals at risk for PUI, B) identifying actionable variables for application to subjects as interventions for testing in the second phase of the project, C) validating risk hypotheses stated in the logic model of PUI including the interplay between predisposing risk factors (e.g., impulsivity, compulsivity), affective and cognitive processes (e.g., reward-related attentional biases), and executive functions (e.g., inhibitory control), D) calculating the health economic cost and impact of PUI in young people across Europe.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"145 ","pages":"Article 152653"},"PeriodicalIF":4.2,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning analysis of clinical, psychological and sociodemographic factors predicting mental well-being in patients with severe mental illness: Insights from the French REHABase cohort","authors":"Quentin Adrian ,&nbsp;Renaud F. Cohen ,&nbsp;Julien Plasse ,&nbsp;Isabelle Chéreau-Boudet ,&nbsp;Benjamin Gouache ,&nbsp;Emilie Legros-Lafarge ,&nbsp;Catherine Massoubre ,&nbsp;Nathalie Guillard-Bouhet ,&nbsp;Léon Temblay ,&nbsp;Nicolas Franck ,&nbsp;Guillaume Barbalat","doi":"10.1016/j.comppsych.2025.152651","DOIUrl":"10.1016/j.comppsych.2025.152651","url":null,"abstract":"<div><h3>Purpose</h3><div>Mental well-being is a cornerstone of recovery for people with mental disorders. Unfortunately, despite many studies on the topic, the literature still lacks results from large samples processed using advanced models capable of taking numerous variables into account. This study aims to leverage robust machine learning techniques on data from the REHABase cohort to identify key predictors of mental well-being in patients with severe mental disorders, with a particular focus on schizophrenia.</div></div><div><h3>Methods</h3><div>In all, 47 clinical, psychological, and sociodemographic variables were selected. Three distinct samples were analyzed: all patients (<em>n</em> = 2206), schizophrenia patients (<em>n</em> = 1136) and non-schizophrenia patients (<em>n</em> = 1070). The performances of 3 machine learning algorithms were compared: regularized linear regression, random forest, and gradient boosting with tenfold cross-validation.</div></div><div><h3>Results</h3><div>The regularized linear regression model was found to be the best performing in terms of generalizability. Results highlighted the influence of the internalized stigmatization subscales of resistance, resilience, and alienation alongside the resilience dimension of quality of life in predicting mental well-being across all of the disorders. For schizophrenia patients, mental well-being was primarily predicted by social withdrawal.</div></div><div><h3>Conclusion</h3><div>Using advanced machine learning methodology on a large sample of patients with transdiagnostic exploration, our results showed both the crucial role of resilience and resistance to stigma in overall mental well-being and the critical importance of social contact in schizophrenia. These insights should help improve care trajectories for individuals with severe psychopathologies, particularly by promoting social cognitive remediation in schizophrenia.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"145 ","pages":"Article 152651"},"PeriodicalIF":4.2,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosing and treating catatonia in low- and middle-income countries – a scoping review","authors":"Franz Belz ,&nbsp;Sarah Alnaher ,&nbsp;Madeleine Coffey ,&nbsp;Jessica Guo ,&nbsp;Angela Liu ,&nbsp;Ye Kyung Song ,&nbsp;Lucy Zheng ,&nbsp;Sophie Fourniquet ,&nbsp;Sarah Atieno Ouma ,&nbsp;Rick Peter Fritz Wolthusen","doi":"10.1016/j.comppsych.2025.152652","DOIUrl":"10.1016/j.comppsych.2025.152652","url":null,"abstract":"<div><div>Catatonia is a common neuropsychiatric condition in in- and outpatient settings that can be life-threatening if not diagnosed and treated promptly. Over the last few decades, our understanding of catatonia has significantly evolved. Where, how, and in which patient populations catatonia gets diagnosed and treated in low- and middle-income countries is unclear. We conducted a scoping review to answer this question. In total, we extracted data from 249 papers published between 2013 and 2022. Seventy seven percent of extracted papers came from five countries. Patients were typically seen in diverse care settings with diagnostic workups and therapeutic interventions approximating the 2023 guidelines for managing catatonia published by the British Association of Psychopharmacology. However, rigorous reports of the criteria for diagnosing catatonia, the underlying cause, and the specifics of treatment are missing. This scoping review may orient researchers to address gaps in the current body of knowledge.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"145 ","pages":"Article 152652"},"PeriodicalIF":4.2,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a residential group therapy program for Canadian first responders","authors":"Duncan M Shields ,&nbsp;Jan Klimas ,&nbsp;Theo Niyonsenga ,&nbsp;Kevin Lutz ,&nbsp;Aynsley J. Wong ,&nbsp;David Kuhl","doi":"10.1016/j.comppsych.2025.152650","DOIUrl":"10.1016/j.comppsych.2025.152650","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the effects of a four-day, group-based residential treatment program focused on enhancing psychological health and social functioning of firefighter and police first responders in British Columbia, Canada.</div></div><div><h3>Methods</h3><div>Using a repeated-measures design, participants completed seven validated self-report questionnaires at baseline (pre-test T0), two weeks after the session (post-test T1), and six months follow-up (T2). A multilevel approach to the analysis of repeated measures examined the effects of the program on several indicators. These included symptoms of major depressive disorder, symptoms of generalized anxiety, symptoms of post-traumatic stress disorder, social role functioning, social support (giving and receiving), quality of life, and health related impairments.</div></div><div><h3>Results</h3><div>A total of 106 police and 114 firefighters undertook the program. The baseline measures were completed by 207 (94 %) participants and 175 (80 %) completed at least one questionnaire at the longest follow-up. All outcomes measured improved from baseline to two-weeks post intervention (T0 to T1, <em>p</em> &lt; 0.001), and sustained reductions at six months follow-up (T0 to T2, <em>p</em> &lt; 0.001), except for giving social support. The highest standardized effect size (Cohen's <em>d</em>) observed at six months (T2) was for symptoms of major depressive disorder (<em>d</em> = −0.90), followed by symptoms of generalized anxiety disorder (<em>d</em> = −0.75), symptoms of post-traumatic stress disorder (<em>d</em> = −0.69), symptom distress (<em>d</em> = −0.62), social role challenges (<em>d</em> = −0.58), quality of life (<em>d</em> = 0.44), interpersonal relations (<em>d</em> = −0.40), and receiving emotional support (<em>d</em> = 0.23).</div></div><div><h3>Conclusion</h3><div>Participation in this program appeared to improve subjective ratings of Canadian firefighter and police psychological health and social functioning. The results are promising and require further exploration with a randomized trial and longer-term follow-up.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"145 ","pages":"Article 152650"},"PeriodicalIF":4.2,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145718809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term risk of psychiatric disorders in women with endometriosis: A retrospective cohort study","authors":"Yu-Hsiang Shih ,&nbsp;Shao-Jing Wang ,&nbsp;Chun-Ting Fan ,&nbsp;Ting-Fang Lu ,&nbsp;Yen-Fu Chen ,&nbsp;Lou Sun ,&nbsp;Shih-Tien Hsu ,&nbsp;Jenn-Jhy Tseng ,&nbsp;Chien-Hsing Lu","doi":"10.1016/j.comppsych.2025.152649","DOIUrl":"10.1016/j.comppsych.2025.152649","url":null,"abstract":"<div><h3>Background</h3><div>Endometriosis is a chronic, estrogen-dependent condition associated with substantial physical and psychological burden. Although psychiatric comorbidities are frequently reported, large-scale real-world data remain limited.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using the TriNetX U.S. Collaborative Network, including women aged 21–60 diagnosed with endometriosis between 2001 and 2020. Patients were matched 1:1 with controls without endometriosis using propensity score matching (PSM) based on age, race, nicotine dependence, alcohol abuse, obesity, infertility, delivery history, insomnia, and menopause. Psychiatric outcomes included depressive episodes, recurrent major depressive disorder, anxiety disorders, and substance use disorders. Subgroup analyses assessed differences by race, age, and postoperative hormonal therapy use.</div></div><div><h3>Results</h3><div>After PSM, each group included 7563 patients. Endometriosis was significantly associated with increased risks of several psychiatric disorders, including depressive episodes (HR = 1.35, 95 % CI: 1.24–1.47), recurrent major depressive disorder (HR = 1.30, 95 % CI: 1.10–1.53), anxiety disorders (HR = 1.39, 95 % CI: 1.29–1.49), phobic anxiety disorder (HR = 1.47, 95 % CI: 1.01–2.13), and substance use disorders (HR = 1.43, 95 % CI: 1.30–1.56). The composite outcome of all assessed psychiatric disorders—including depressive episodes, recurrent major depressive disorder, anxiety disorders, phobic anxiety disorder, mental and behavioral disorders due to psychoactive substance use, and suicidal ideation—was also significantly elevated in the endometriosis group (HR = 1.38, 95 % CI: 1.30–1.46). These associations were most pronounced among White patients, while Black patients showed elevated risks for recurrent depression and anxiety disorders only. No significant associations were observed among Asian patients. Additionally, postoperative hormonal therapy did not significantly reduce the risk of psychiatric disorders compared to surgery alone.</div></div><div><h3>Conclusions</h3><div>Women with endometriosis face elevated risks of psychiatric disorders, with notable racial disparities. Hormonal therapy may not mitigate these mental health risks. Our findings underscore the importance of integrated gynecologic and psychological care in the management of endometriosis.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"144 ","pages":"Article 152649"},"PeriodicalIF":4.2,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145621028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}