Pub Date : 2025-07-08DOI: 10.1016/j.comppsych.2025.152616
Stefania Chiappini , Alessio Mosca , Francesco Semeraro , Andrea Amerio , Isabella Berardelli , Laura Cremaschi , Ilaria Di Bernardo , Mauro Pettorruso , Gianluca Serafini , Bernardo Dell'Osso , Giovanni Martinotti
Introduction
Dealing with Substance use disorders (SUDs) in conjunction with psychopathological conditions such as Major Depressive Disorder (MDD), bipolar disorder (BD), and schizophrenia - often referred to as dual diagnosis or co-occurring disorders - poses significant challenges for both patients and clinicians, requiring integrated treatment approaches that simultaneously tackle both substance use and psychopathology.
Aim and methods
The objective of this systematic review is to analyse and summarize the existing research on the various pharmacological treatments for dual diagnosis, providing a comprehensive understanding of their effectiveness and identifying areas requiring further exploration. The systematic review was structured in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered on the International Prospective Register of Systematic Reviews (PROSPERO) with the id number CRD 42024500114.
Results
The analysis of the available literature identified 66 articles, 29 related to SUDs & schizophrenia, 20 focused on SUDs & MDD, and 17 on SUDs & BD. Overall, most manuscripts recording SUDs concerned the following drugs: alcohol (N = 26), cannabis (N = 19), opioids (N = 10), cocaine (N = 10), and amphetamine (N = 3), while several studies described SUDs in general (N = 12). Findings were presented thematically based on the type of intervention for each of the main conditions recorded. In the case of psychotic symptoms and SUDs, aripiprazole appeared to be the most used medication in the maintenance therapy not only for its effectiveness but also for its safety profile. Alternatively, despite the side effects, clozapine showed a good efficacy in the management of symptoms and in terms of relapse prevention. Moreover, long-acting medications might be an effective option in the control of impulsivity and psychotic symptoms, but also in first-episode psychosis, reducing relapse and rehospitalization. With regard to the treatment of MDD/BD and SUDs, there are mixed findings regarding the best medication for symptom control; notably, different degrees of efficacy were recorded if added to psychological/behavioural interventions, or combined with specific SUD treatments, such as opioid receptor agonist/antagonist therapies or the anti-glutamatergic drugs acamprosate/memantine, etc.
Conclusion
The current body of evidence includes mixed findings in terms of which medication is superior in controlling symptoms, according to the specific psychopathology, the specific SUD involved, the treatment setting, and the primary objective of care. Overall, pharmacological treatments for dual diagnosis are complex and require personalized approaches considering the heterogeneity of the population. Future research shoul
{"title":"Navigating the challenges of substance use and psychopathology in depression, bipolar disorder, and schizophrenia","authors":"Stefania Chiappini , Alessio Mosca , Francesco Semeraro , Andrea Amerio , Isabella Berardelli , Laura Cremaschi , Ilaria Di Bernardo , Mauro Pettorruso , Gianluca Serafini , Bernardo Dell'Osso , Giovanni Martinotti","doi":"10.1016/j.comppsych.2025.152616","DOIUrl":"10.1016/j.comppsych.2025.152616","url":null,"abstract":"<div><h3>Introduction</h3><div>Dealing with Substance use disorders (SUDs) in conjunction with psychopathological conditions such as Major Depressive Disorder (MDD), bipolar disorder (BD), and schizophrenia - often referred to as <em>dual diagnosis</em> or <em>co-occurring disorders</em> - poses significant challenges for both patients and clinicians, requiring integrated treatment approaches that simultaneously tackle both substance use and psychopathology.</div></div><div><h3>Aim and methods</h3><div>The objective of this systematic review is to analyse and summarize the existing research on the various pharmacological treatments for dual diagnosis, providing a comprehensive understanding of their effectiveness and identifying areas requiring further exploration. The systematic review was structured in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered on the International Prospective Register of Systematic Reviews (PROSPERO) with the id number CRD 42024500114.</div></div><div><h3>Results</h3><div>The analysis of the available literature identified 66 articles, 29 related to SUDs & schizophrenia, 20 focused on SUDs & MDD, and 17 on SUDs & BD. Overall, most manuscripts recording SUDs concerned the following drugs: alcohol (<em>N</em> = 26), cannabis (<em>N</em> = 19), opioids (<em>N</em> = 10), cocaine (N = 10), and amphetamine (<em>N</em> = 3), while several studies described SUDs in general (<em>N</em> = 12). Findings were presented thematically based on the type of intervention for each of the main conditions recorded. In the case of psychotic symptoms and SUDs, aripiprazole appeared to be the most used medication in the maintenance therapy not only for its effectiveness but also for its safety profile. Alternatively, despite the side effects, clozapine showed a good efficacy in the management of symptoms and in terms of relapse prevention. Moreover, long-acting medications might be an effective option in the control of impulsivity and psychotic symptoms, but also in first-episode psychosis, reducing relapse and rehospitalization. With regard to the treatment of MDD/BD and SUDs, there are mixed findings regarding the best medication for symptom control; notably, different degrees of efficacy were recorded if added to psychological/behavioural interventions, or combined with specific SUD treatments, such as opioid receptor agonist/antagonist therapies or the anti-glutamatergic drugs acamprosate/memantine, etc.</div></div><div><h3>Conclusion</h3><div>The current body of evidence includes mixed findings in terms of which medication is superior in controlling symptoms, according to the specific psychopathology, the specific SUD involved, the treatment setting, and the primary objective of care. Overall, pharmacological treatments for dual diagnosis are complex and require personalized approaches considering the heterogeneity of the population. Future research shoul","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152616"},"PeriodicalIF":4.3,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144611879","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}
Pub Date : 2025-07-07DOI: 10.1016/j.comppsych.2025.152621
Lara Marie Aschenbrenner , Adriana Frei , Thomas Forkmann , Dajana Schreiber , Heide Glaesmer , Juliane Brüdern , Maria Stein , Marie-Anna Sedlinská , Kristina Adorjan , Sebastian Walther , Anja Gysin-Maillart
Objective
This study examined two Death-Implicit Association Test versions targeting associations between the self-concept (standard identity D-IAT; iD-IAT) and internal versus external control (adapted control D-IAT; cD-IAT) and death among suicide attempters. Additionally, correlations with explicit psychological variables and psychometrics were explored.
Method
116 psychiatric inpatients (58.1 % female; age M = 33.6, SD = 12.4) were classified as single versus multiple and recent versus lifetime suicide attempters. Implicit associations were measured using the iD-IAT and cD-IAT. Self-report measures included constructs relevant to suicidal behaviour.
Results
Recent attempters showed weaker self-life (t(114) = 2.18, p = .016) and internal control-life (t(114) = 2.26, p = .013) associations than lifetime attempters. Multiple attempters exhibited weaker internal control-life associations than single attempters (t(114) = 2.25, p = .007). The iD-IAT correlated with suicidal ideation (rs(114) = 0.20, p = .032), depression (rs(114) = 0.20, p = .033) and external control (rs(114) = 0.21, p = .021), the cD-IAT with suicidal ideation (rs(114) = 0.25, p = .006) and depression (rs(114) = 0.26, p = .006). The cD-IAT predicted multiple attempts (χ2(1116) = 3.88, p = .049), showed higher internal consistency (rsb =. 31, p = .001) and predictive validity in detecting multiple (AUC = 0.64; p = .013) and recent (AUC = 0.62; p = .028) attempters than the iD-IAT.
Conclusions
The cD-IAT shows preliminary potential to differentiate suicidal behaviour based on recency and frequency, offering a tentative step toward understanding cognitive vulnerabilities of at-risk subgroups, warranting further refinement, validation and prospective analyses.
目的探讨两种死亡-内隐联想测验版本在自我概念(标准同一性D-IAT；iD-IAT)和内部与外部对照(适应对照D-IAT；cD-IAT)和自杀未遂者的死亡率。此外，还探讨了显式心理变量和心理测量的相关性。方法116例精神科住院患者(女性58.1%；年龄M = 33.6, SD = 12.4)分为单次与多次、近期与终生自杀企图者。使用iD-IAT和cD-IAT测量内隐关联。自我报告测量包括与自杀行为相关的构念。结果近期尝试者的自我寿命（t(114) = 2.18, p = 0.016）和内部控制寿命（t(114) = 2.26, p = 0.013）的相关性较终身尝试者弱。多重尝试者比单一尝试者表现出较弱的内部控制寿命相关性（t(114) = 2.25, p = .007）。iD-IAT与自杀意念（rs(114) = 0.20, p = 0.032）、抑郁（rs(114) = 0.20, p = 0.033）、外部控制（rs(114) = 0.21, p = 0.021）、cD-IAT与自杀意念（rs(114) = 0.25, p = 0.006）、抑郁（rs(114) = 0.26, p = 0.006）相关。cD-IAT预测多次尝试（χ2(1116) = 3.88, p = 0.049），具有较高的内部一致性(rsb =。31, p = .001)和检测多个的预测效度(AUC = 0.64；p = 0.013)和近期(AUC = 0.62；p = .028)。结论cD-IAT显示了基于近期和频率区分自杀行为的初步潜力，为理解高危亚组的认知脆弱性提供了试试性的一步，需要进一步的改进、验证和前瞻性分析。
{"title":"Exploring suicidal behaviour through implicit identity and control biases: Findings from the Death-Implicit Association Test and its novel control-adaptation","authors":"Lara Marie Aschenbrenner , Adriana Frei , Thomas Forkmann , Dajana Schreiber , Heide Glaesmer , Juliane Brüdern , Maria Stein , Marie-Anna Sedlinská , Kristina Adorjan , Sebastian Walther , Anja Gysin-Maillart","doi":"10.1016/j.comppsych.2025.152621","DOIUrl":"10.1016/j.comppsych.2025.152621","url":null,"abstract":"<div><h3>Objective</h3><div>This study examined two <em>Death-Implicit Association Test</em> versions targeting associations between the self-concept (standard identity D-IAT; iD-IAT) and internal versus external control (adapted control D-IAT; cD-IAT) and death among suicide attempters. Additionally, correlations with explicit psychological variables and psychometrics were explored.</div></div><div><h3>Method</h3><div>116 psychiatric inpatients (58.1 % female; age <em>M</em> = 33.6, <em>SD</em> = 12.4) were classified as single versus multiple and recent versus lifetime suicide attempters. Implicit associations were measured using the iD-IAT and cD-IAT. Self-report measures included constructs relevant to suicidal behaviour.</div></div><div><h3>Results</h3><div>Recent attempters showed weaker self-life (<em>t</em>(114) = 2.18, <em>p</em> = .016) and internal control-life (<em>t</em>(114) = 2.26, <em>p</em> = .013) associations than lifetime attempters. Multiple attempters exhibited weaker internal control-life associations than single attempters (<em>t</em>(114) = 2.25, <em>p</em> = .007). The iD-IAT correlated with suicidal ideation (<em>r</em><sub>s</sub>(114) = 0.20, <em>p</em> = .032), depression (<em>r</em><sub>s</sub>(114) = 0.20, <em>p</em> = .033) and external control (<em>r</em><sub>s</sub>(114) = 0.21, <em>p</em> = .021), the cD-IAT with suicidal ideation (<em>r</em><sub>s</sub>(114) = 0.25, <em>p</em> = .006) and depression (<em>r</em><sub>s</sub>(114) = 0.26, <em>p</em> = .006). The cD-IAT predicted multiple attempts (χ<sup>2</sup>(1116) = 3.88, <em>p</em> = .049), showed higher internal consistency (<em>r</em><sub>sb</sub> =. 31, <em>p</em> = .001) and predictive validity in detecting multiple (AUC = 0.64; <em>p</em> = .013) and recent (AUC = 0.62; <em>p</em> = .028) attempters than the iD-IAT.</div></div><div><h3>Conclusions</h3><div>The cD-IAT shows preliminary potential to differentiate suicidal behaviour based on recency and frequency, offering a tentative step toward understanding cognitive vulnerabilities of at-risk subgroups, warranting further refinement, validation and prospective analyses.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152621"},"PeriodicalIF":4.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144587731","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}
Pub Date : 2025-07-01DOI: 10.1016/j.comppsych.2025.152619
Luca Pellegrini , Naomi A. Fineberg , Sorcha O'Connor , Ana Maria Frota Lisboa Pereira De Souza , Kate Godfrey , Sara Reed , Joseph Peill , Mairead Healy , Cyrus Rohani-Shukla , Hakjun Lee , Robin Carhart-Harris , Trevor W. Robbins , David Nutt , David Erritzoe
Background
Obsessive-compulsive disorder (OCD) is a common and disabling condition. A large proportion of patients fail to respond to first-line treatment with serotonin reuptake inhibitors either selective serotonin reuptake inhibitors (SSRIs) or clomipramine. Preliminary evidence suggests psilocybin, a serotonin receptor agonist, might be efficacious. We conducted a pharmacological challenge study to investigate the efficacy and mechanisms of effect of psilocybin in OCD. This analysis reports the clinical outcomes only.
Methods
Participants with a diagnosis of OCD of at least moderate severity, received two single doses of oral psilocybin, 1 mg followed by 10 mg, administered in fixed order separated by 4 weeks. On the day of dosing, they were treated in a day-care facility in the presence of clinicians experienced in the use of psychedelics for treating mental disorders. Psychological support was provided before, during and after dosing. Participants and raters were blinded to the order of treatment. They were assessed on the day before each dose (baseline 1, 2), on the day of dosing and at intervals over a 4-week period afterward using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) (primary clinical outcome) and secondary clinical outcomes including the Montgomery-Åsberg Depression Rating Scale (MADRS). Adverse effects were also recorded.
Results
Nineteen adult participants (aged 20–60) entered the study and 18 completed all assessments. Clinical outcomes following 1 mg and 10 mg psilocybin were compared using a linear mixed-effects model and ANOVA. A significant between-dosage effect favouring 10 mg psilocybin was found one-week after dosing on the Y-BOCS (Cohen's d = 0.82, p = 0.002). In particular, the effect one-week after dosing was statistically significant on the compulsion subscale of the Y-BOCS (Cohen's d: 0.74, p = 0.003), compared to obsession (Cohen's d: 0.50, p = 0.06). The effect diminished over the subsequent 3 weeks. No effect of psilocybin was detected on the MADRS. Psilocybin was well tolerated, with few adverse events reported at both dosages and no serious adverse events.
Conclusions
In this study, which was limited by a small sample size and the absence of randomisation, a 10 mg dose of oral psilocybin was found to be well-tolerated and potentially efficacious in patients with OCD. Psilocybin produced a rapid-onset, moderate to large effect on compulsive symptoms, which lasted up to one week after dosing. Future randomised placebo-controlled clinical trials investigating a longer course of multiple weekly doses of 10 mg psilocybin are indicated in OCD and in other obsessive-compulsive and related disorders characterised by compulsions.
强迫症（OCD）是一种常见的致残疾病。很大一部分患者对血清素再摄取抑制剂（选择性血清素再摄取抑制剂（SSRIs）或氯丙咪嗪）的一线治疗无效。初步证据表明，裸盖菇素，一种血清素受体激动剂，可能是有效的。为了探讨裸盖菇素治疗强迫症的疗效及作用机制，我们进行了药理学挑战实验。本分析仅报告临床结果。方法诊断为强迫症（OCD）的至少中度严重程度的参与者，接受2次单剂量口服裸盖菇素，1 mg和10 mg，按固定顺序给药，间隔4周。在给药当天，他们在日间护理机构接受治疗，有使用致幻剂治疗精神障碍的临床医生在场。在给药前、给药期间和给药后提供心理支持。参与者和评分者不知道治疗顺序。他们在每次给药前一天（基线1、2）、给药当天和给药后4周的间隔时间内使用耶鲁-布朗强迫症量表（Y-BOCS）（主要临床结果）和次要临床结果包括蒙哥马利-Åsberg抑郁评定量表（MADRS）进行评估。不良反应也有记录。结果19名成年参与者（年龄在20-60岁）进入研究，其中18名完成了所有评估。采用线性混合效应模型和方差分析比较1mg和10mg裸盖菇素的临床结果。在Y-BOCS给药一周后，发现10mg裸盖菇素具有显著的剂量间效应（Cohen’s d = 0.82, p = 0.002）。特别是，在给药一周后，与强迫症（Cohen’s d: 0.50, p = 0.06）相比，强迫症在Y-BOCS强迫分量表上的效果具有统计学意义（Cohen’s d: 0.74, p = 0.003）。在随后的3周内，效果逐渐减弱。未检测到裸盖菇素对MADRS的影响。裸盖菇素耐受性良好，在两种剂量下几乎没有不良事件报告，没有严重的不良事件。结论：本研究受样本量小和缺乏随机化的限制，发现10mg口服裸盖菇素对强迫症患者耐受性良好且可能有效。裸盖菇素对强迫症状有快速起效，中等到较大的效果，在给药后持续长达一周。未来的随机安慰剂对照临床试验将研究更长疗程的每周多次剂量10mg裸盖菇素，用于强迫症和其他强迫症及以强迫症为特征的相关疾病。
{"title":"Single-dose (10 mg) psilocybin reduces symptoms in adults with obsessive-compulsive disorder: A pharmacological challenge study","authors":"Luca Pellegrini , Naomi A. Fineberg , Sorcha O'Connor , Ana Maria Frota Lisboa Pereira De Souza , Kate Godfrey , Sara Reed , Joseph Peill , Mairead Healy , Cyrus Rohani-Shukla , Hakjun Lee , Robin Carhart-Harris , Trevor W. Robbins , David Nutt , David Erritzoe","doi":"10.1016/j.comppsych.2025.152619","DOIUrl":"10.1016/j.comppsych.2025.152619","url":null,"abstract":"<div><h3>Background</h3><div>Obsessive-compulsive disorder (OCD) is a common and disabling condition. A large proportion of patients fail to respond to first-line treatment with serotonin reuptake inhibitors either selective serotonin reuptake inhibitors (SSRIs) or clomipramine. Preliminary evidence suggests psilocybin, a serotonin receptor agonist, might be efficacious. We conducted a pharmacological challenge study to investigate the efficacy and mechanisms of effect of psilocybin in OCD. This analysis reports the clinical outcomes only.</div></div><div><h3>Methods</h3><div>Participants with a diagnosis of OCD of at least moderate severity, received two single doses of oral psilocybin, 1 mg followed by 10 mg, administered in fixed order separated by 4 weeks. On the day of dosing, they were treated in a day-care facility in the presence of clinicians experienced in the use of psychedelics for treating mental disorders. Psychological support was provided before, during and after dosing. Participants and raters were blinded to the order of treatment. They were assessed on the day before each dose (baseline 1, 2), on the day of dosing and at intervals over a 4-week period afterward using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) (primary clinical outcome) and secondary clinical outcomes including the Montgomery-Åsberg Depression Rating Scale (MADRS). Adverse effects were also recorded.</div></div><div><h3>Results</h3><div>Nineteen adult participants (aged 20–60) entered the study and 18 completed all assessments. Clinical outcomes following 1 mg and 10 mg psilocybin were compared using a linear mixed-effects model and ANOVA. A significant between-dosage effect favouring 10 mg psilocybin was found one-week after dosing on the Y-BOCS (Cohen's <em>d</em> = 0.82, <em>p</em> = 0.002). In particular, the effect one-week after dosing was statistically significant on the compulsion subscale of the Y-BOCS (Cohen's d: 0.74, <em>p</em> = 0.003), compared to obsession (Cohen's d: 0.50, <em>p</em> = 0.06). The effect diminished over the subsequent 3 weeks. No effect of psilocybin was detected on the MADRS. Psilocybin was well tolerated, with few adverse events reported at both dosages and no serious adverse events.</div></div><div><h3>Conclusions</h3><div>In this study, which was limited by a small sample size and the absence of randomisation, a 10 mg dose of oral psilocybin was found to be well-tolerated and potentially efficacious in patients with OCD. Psilocybin produced a rapid-onset, moderate to large effect on compulsive symptoms, which lasted up to one week after dosing. Future randomised placebo-controlled clinical trials investigating a longer course of multiple weekly doses of 10 mg psilocybin are indicated in OCD and in other obsessive-compulsive and related disorders characterised by compulsions.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152619"},"PeriodicalIF":4.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562825","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}
Pub Date : 2025-06-23DOI: 10.1016/j.comppsych.2025.152618
Raphaela J. Gaertner , Elea S.C. Klink , Annika B.E. Benz , Bernadette F. Denk , Maria Meier , Stella Wienhold , Nina Volkmer , Katharina E. Kossmann , Jens C. Pruessner
Introduction
Borderline Personality Disorder (BPD) is associated with psychological as well as physiological dysregulation in patients, including reduced parasympathetic activity at baseline and difficulties returning to baseline after a stressor. Whether this impacts the relaxation response independent of a stressor has so far not been investigated.
Methods
In a within-subject design, we compared two relaxation interventions, a virtual reality nature video, and a paced breathing intervention. We assessed a female-only sample, with 20 BPD patients (meanage = 23.75 ± 4.39) during their inpatient treatment and 22 matched healthy controls (HC; meanage = 22.68 ± 2.68). Psychological relaxation was assessed with the Relaxation State Questionnaire (RSQ) and physiological relaxation with vagally mediated heart rate variability (HRV).
Results
We employed multilevel models to test whether BPD significantly influenced the psychophysiological relaxation response. For psychological relaxation, we found an increase in RSQ scores in both groups in response to both interventions. The HC showed overall higher RSQ scores. For physiological relaxation, we found overall higher HRV values in the HC group but no differences in the relaxation response.
Conclusion
BPD patients exhibit lower psychophysiological relaxation levels at baseline and throughout the experiment, while there was no significant difference in response to relaxation interventions when compared to HC. Future studies should focus on interventions targeting baseline psychophysiological relaxation in BPD patients.
{"title":"Patients with borderline personality disorder show initially reduced psychophysiological relaxation levels but intact relaxation response","authors":"Raphaela J. Gaertner , Elea S.C. Klink , Annika B.E. Benz , Bernadette F. Denk , Maria Meier , Stella Wienhold , Nina Volkmer , Katharina E. Kossmann , Jens C. Pruessner","doi":"10.1016/j.comppsych.2025.152618","DOIUrl":"10.1016/j.comppsych.2025.152618","url":null,"abstract":"<div><h3>Introduction</h3><div>Borderline Personality Disorder (BPD) is associated with psychological as well as physiological dysregulation in patients, including reduced parasympathetic activity at baseline and difficulties returning to baseline after a stressor. Whether this impacts the relaxation response independent of a stressor has so far not been investigated.</div></div><div><h3>Methods</h3><div>In a within-subject design, we compared two relaxation interventions, a virtual reality nature video, and a paced breathing intervention. We assessed a female-only sample, with 20 BPD patients (mean<sub>age</sub> = 23.75 ± 4.39) during their inpatient treatment and 22 matched healthy controls (HC; mean<sub>age</sub> = 22.68 ± 2.68). Psychological relaxation was assessed with the Relaxation State Questionnaire (RSQ) and physiological relaxation with vagally mediated heart rate variability (HRV).</div></div><div><h3>Results</h3><div>We employed multilevel models to test whether BPD significantly influenced the psychophysiological relaxation response. For psychological relaxation, we found an increase in RSQ scores in both groups in response to both interventions. The HC showed overall higher RSQ scores. For physiological relaxation, we found overall higher HRV values in the HC group but no differences in the relaxation response.</div></div><div><h3>Conclusion</h3><div>BPD patients exhibit lower psychophysiological relaxation levels at baseline and throughout the experiment, while there was no significant difference in response to relaxation interventions when compared to HC. Future studies should focus on interventions targeting baseline psychophysiological relaxation in BPD patients.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152618"},"PeriodicalIF":4.3,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144492173","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}
Pub Date : 2025-06-23DOI: 10.1016/j.comppsych.2025.152617
Jiajia Jin , Xinyi Zhu , Wen Lian , Lu Fan
Objective
Body language plays a vital role in emotion perception, yet the involuntary neural mechanisms through which individuals with social anxiety process these signals remain unclear. This research investigates these mechanisms by analyzing visual components such as P3a, P1, and N190 within a three-stimulus oddball paradigm.
Method
Participants were classified into high social anxiety (HSA, n = 31) and low social anxiety (LSA, n = 26) groups using the Liebowitz Social Anxiety Scale (LSAS). The paradigm employed custom-designed distractors depicting positive, negative, and neutral body expressions to examine the involuntary processing of these stimuli.
Results
The findings indicate that individuals with high social anxiety (HSA) showed significantly higher P3a amplitudes than those with low social anxiety (LSA), especially for positive body expressions. In contrast, negative expressions elicited the weakest amplitudes. The N190 component responded most strongly to positive expressions and least to negative ones, while the P1 component showed uniform responses across all types.
Conclusions
HSA individuals process body expressions more intensely and are highly sensitive to them, regardless of valence. This insight can inform interventions targeting their cognitive and emotional biases.
肢体语言在情绪感知中起着至关重要的作用，但社交焦虑个体处理这些信号的非自愿神经机制尚不清楚。本研究通过在三刺激古怪范式中分析P3a、P1和N190等视觉成分来探讨这些机制。方法采用Liebowitz社交焦虑量表（LSAS）将被试分为高社交焦虑组（HSA, n = 31）和低社交焦虑组（LSA, n = 26）。该范式采用定制设计的描绘积极、消极和中性身体表情的干扰物来检查这些刺激的非自愿加工。结果高社交焦虑（HSA）个体的P3a波幅显著高于低社交焦虑（LSA）个体，尤其是对积极的身体表达。相反，消极表达引起的振幅最弱。N190组分对积极表达的响应最强烈，对消极表达的响应最小，而P1组分在所有类型中表现出一致的响应。结论shsa个体对身体表达的加工更强烈，且对其高度敏感，无论其价态如何。这种见解可以为针对他们的认知和情感偏见的干预提供信息。
{"title":"Unraveling the neurophysiological underpinnings of social anxiety through body language: An ERP study","authors":"Jiajia Jin , Xinyi Zhu , Wen Lian , Lu Fan","doi":"10.1016/j.comppsych.2025.152617","DOIUrl":"10.1016/j.comppsych.2025.152617","url":null,"abstract":"<div><h3>Objective</h3><div>Body language plays a vital role in emotion perception, yet the involuntary neural mechanisms through which individuals with social anxiety process these signals remain unclear. This research investigates these mechanisms by analyzing visual components such as P3a, P1, and N190 within a three-stimulus oddball paradigm.</div></div><div><h3>Method</h3><div>Participants were classified into high social anxiety (HSA, <em>n</em> = 31) and low social anxiety (LSA, <em>n</em> = 26) groups using the Liebowitz Social Anxiety Scale (LSAS). The paradigm employed custom-designed distractors depicting positive, negative, and neutral body expressions to examine the involuntary processing of these stimuli.</div></div><div><h3>Results</h3><div>The findings indicate that individuals with high social anxiety (HSA) showed significantly higher P3a amplitudes than those with low social anxiety (LSA), especially for positive body expressions. In contrast, negative expressions elicited the weakest amplitudes. The N190 component responded most strongly to positive expressions and least to negative ones, while the P1 component showed uniform responses across all types.</div></div><div><h3>Conclusions</h3><div>HSA individuals process body expressions more intensely and are highly sensitive to them, regardless of valence. This insight can inform interventions targeting their cognitive and emotional biases.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152617"},"PeriodicalIF":4.3,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144492175","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}
Pub Date : 2025-06-15DOI: 10.1016/j.comppsych.2025.152614
Philippa Ditton-Phare , Tina Fox , Kristen Vallender , Jose Cuenca , Sally Fitzpatrick
Introduction
Paramedics experience disproportionately high rates of mental health concerns, often relying on informal support from family and friends. While this support is vital, it can impose significant strain on family and friends, who frequently lack the necessary resources and skills for their role. To address this, a novel online program, Minds Together, was developed specifically for family and friends to enhance their ability to support the mental health of paramedics while prioritizing their own mental health and wellbeing.
Methods
The feasibility and acceptability of the program was evaluated through a pilot study involving 53 participants randomized to either program or waitlist groups. Data collection included pre- and post-intervention surveys, program usage metrics, post-project surveys, and feedback from user testing. The Global Impact Analytics Framework (GIAF) guided analysis of planning, pre-engagement, pre-readiness, usability, dissemination, adoption, and contextual factors.
Results
Participants valued the program for its lived-experience content and self-paced format. Broad dissemination reached over one million individuals, and usability and relevance were rated highly. However, low engagement and completion rates reflected challenges common to online interventions. Barriers included limited access duration, participants' time constraints, and difficulties in reaching the target audience. Suggestions included flexible access, advanced content options, and targeted outreach strategies.
Conclusion
Minds Together shows promise as a scalable intervention for family and friends of paramedics. Future research will address barriers, explore long-term outcomes, and refine the program to better meet family and friends' diverse needs, improving mental health support for paramedics and their support network.
{"title":"Pilot implementation of an online program for family and friends supporting the mental health of paramedics in Australia: Lessons learned.","authors":"Philippa Ditton-Phare , Tina Fox , Kristen Vallender , Jose Cuenca , Sally Fitzpatrick","doi":"10.1016/j.comppsych.2025.152614","DOIUrl":"10.1016/j.comppsych.2025.152614","url":null,"abstract":"<div><h3>Introduction</h3><div>Paramedics experience disproportionately high rates of mental health concerns, often relying on informal support from family and friends. While this support is vital, it can impose significant strain on family and friends, who frequently lack the necessary resources and skills for their role. To address this, a novel online program, <em>Minds Together,</em> was developed specifically for family and friends to enhance their ability to support the mental health of paramedics while prioritizing their own mental health and wellbeing.</div></div><div><h3>Methods</h3><div>The feasibility and acceptability of the program was evaluated through a pilot study involving 53 participants randomized to either program or waitlist groups. Data collection included pre- and post-intervention surveys, program usage metrics, post-project surveys, and feedback from user testing. The Global Impact Analytics Framework (GIAF) guided analysis of planning, pre-engagement, pre-readiness, usability, dissemination, adoption, and contextual factors.</div></div><div><h3>Results</h3><div>Participants valued the program for its lived-experience content and self-paced format. Broad dissemination reached over one million individuals, and usability and relevance were rated highly. However, low engagement and completion rates reflected challenges common to online interventions. Barriers included limited access duration, participants' time constraints, and difficulties in reaching the target audience. Suggestions included flexible access, advanced content options, and targeted outreach strategies.</div></div><div><h3>Conclusion</h3><div><em>Minds Together</em> shows promise as a scalable intervention for family and friends of paramedics. Future research will address barriers, explore long-term outcomes, and refine the program to better meet family and friends' diverse needs, improving mental health support for paramedics and their support network.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152614"},"PeriodicalIF":4.3,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144307302","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}
Pub Date : 2025-06-13DOI: 10.1016/j.comppsych.2025.152615
Jessica L. Campbell , Josh Darby , Paul Oswald , Lisa Mackay , Grant Schofield
Background
Firefighters are regularly exposed to potentially psychologically traumatic events (PPTEs), significantly increasing their risk of mental ill-health. Organizational factors such as leadership, support, and workload also influence these outcomes.
Purpose
This study evaluates the Whanaungatanga Program, a participatory initiative designed to address organizational factors affecting firefighter well-being, focusing on early changes in sentiment.
Methods
We conducted a qualitative analysis of open-text responses from two surveys (embedded within broader mental health questionnaires) with firefighters and commanders, and semi-structured interviews with commanders. Thematic and sentiment analyses explored perceptions of organizational interventions and the emotional tone in responses across two time points.
Main Findings
In the pilot region receiving interventions, organizational sentiment shifted substantially: positive sentiment increased from 13 % to 48 %, negative sentiment decreased over 20 % (from 66 % to 40 %), and themes such as improved leadership visibility emerged, reflecting rapid cultural progress.
Conclusions
The results highlight the effectiveness of targeted, participatory interventions in fostering positive organizational change. Marked improvements in sentiment indicate that even in high-stress environments, well-designed interventions can lead to substantial benefits in employee sentiment and organizational culture.
{"title":"Shifting organizational sentiment: Qualitative insights from a mental ill-health prevention program for New Zealand firefighters","authors":"Jessica L. Campbell , Josh Darby , Paul Oswald , Lisa Mackay , Grant Schofield","doi":"10.1016/j.comppsych.2025.152615","DOIUrl":"10.1016/j.comppsych.2025.152615","url":null,"abstract":"<div><h3>Background</h3><div>Firefighters are regularly exposed to potentially psychologically traumatic events (PPTEs), significantly increasing their risk of mental ill-health. Organizational factors such as leadership, support, and workload also influence these outcomes.</div></div><div><h3>Purpose</h3><div>This study evaluates the Whanaungatanga Program, a participatory initiative designed to address organizational factors affecting firefighter well-being, focusing on early changes in sentiment.</div></div><div><h3>Methods</h3><div>We conducted a qualitative analysis of open-text responses from two surveys (embedded within broader mental health questionnaires) with firefighters and commanders, and semi-structured interviews with commanders. Thematic and sentiment analyses explored perceptions of organizational interventions and the emotional tone in responses across two time points.</div></div><div><h3>Main Findings</h3><div>In the pilot region receiving interventions, organizational sentiment shifted substantially: positive sentiment increased from 13 % to 48 %, negative sentiment decreased over 20 % (from 66 % to 40 %), and themes such as improved leadership visibility emerged, reflecting rapid cultural progress.</div></div><div><h3>Conclusions</h3><div>The results highlight the effectiveness of targeted, participatory interventions in fostering positive organizational change. Marked improvements in sentiment indicate that even in high-stress environments, well-designed interventions can lead to substantial benefits in employee sentiment and organizational culture.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152615"},"PeriodicalIF":4.3,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144298138","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}
Pub Date : 2025-06-13DOI: 10.1016/j.comppsych.2025.152611
Mathew Varidel , Ian B. Hickie , Victor An , Sally Cripps , Roman Marchant , Jo Robinson , Louise La Sala , William Capon , Ashlee Turner , Alexander Tashevski , Elizabeth Scott , Frank Iorfino
Background
Suicidal thoughts and behaviours (STBs) have a profound impact on individuals, communities, and healthcare systems. A wide range of factors have been shown to be associated with STBs. Within prior research it is also common to distinguish between proximal and distal factors, usually by distinction of short compared to long-term prediction.
Objective
We aimed to learn the proximal and distal factors of suicidal ideation for young people engaged in mental health care using the inferred structure of probabilistic graphical models (PGMs).
Methods and materials
We used cross-sectional data from a sample of 1020 help-seeking individuals aged 12–25 years from Australia that while engaged in mental health care, contributed data to a digital platform. The posterior distribution of the dependency structure assuming both undirected PGMs and Bayesian networks (BNs) was inferred. Causal effects were then estimated using a counterfactual query of the Bayesian networks.
Results
Depressed mood, functional impairment, poor social connection, and psychosis-like experiences were proximal factors. Whereas experiencing a traumatic event, anxiety, insomnia, and unrefreshed sleep were distal factors. Proximal factors had the greatest effect on suicidal ideation, while anxiety symptoms and experiencing a traumatic event were the most influential distal factors.
Conclusions
These relative timings of events and their effects on suicidal ideation could be used to understand the future likelihood of suicidal ideation, and aid planning of targeted interventions.
{"title":"Pathways to suicidal ideation for young people engaged in mental health care","authors":"Mathew Varidel , Ian B. Hickie , Victor An , Sally Cripps , Roman Marchant , Jo Robinson , Louise La Sala , William Capon , Ashlee Turner , Alexander Tashevski , Elizabeth Scott , Frank Iorfino","doi":"10.1016/j.comppsych.2025.152611","DOIUrl":"10.1016/j.comppsych.2025.152611","url":null,"abstract":"<div><h3>Background</h3><div>Suicidal thoughts and behaviours (STBs) have a profound impact on individuals, communities, and healthcare systems. A wide range of factors have been shown to be associated with STBs. Within prior research it is also common to distinguish between proximal and distal factors, usually by distinction of short compared to long-term prediction.</div></div><div><h3>Objective</h3><div>We aimed to learn the proximal and distal factors of suicidal ideation for young people engaged in mental health care using the inferred structure of probabilistic graphical models (PGMs).</div></div><div><h3>Methods and materials</h3><div>We used cross-sectional data from a sample of 1020 help-seeking individuals aged 12–25 years from Australia that while engaged in mental health care, contributed data to a digital platform. The posterior distribution of the dependency structure assuming both undirected PGMs and Bayesian networks (BNs) was inferred. Causal effects were then estimated using a counterfactual query of the Bayesian networks.</div></div><div><h3>Results</h3><div>Depressed mood, functional impairment, poor social connection, and psychosis-like experiences were proximal factors. Whereas experiencing a traumatic event, anxiety, insomnia, and unrefreshed sleep were distal factors. Proximal factors had the greatest effect on suicidal ideation, while anxiety symptoms and experiencing a traumatic event were the most influential distal factors.</div></div><div><h3>Conclusions</h3><div>These relative timings of events and their effects on suicidal ideation could be used to understand the future likelihood of suicidal ideation, and aid planning of targeted interventions.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152611"},"PeriodicalIF":4.3,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144492174","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}
Adolescents with attachment anxiety can compensate via gaming for their unmet needs of closeness, reassurance, and emotion regulation. However, individual factors linking attachment anxiety to compensation via gaming are still unclear. In this two-wave longitudinal study (Wave 1, W1 = baseline; Wave 2, W2 = 6 months later), we aimed to determine whether intolerance of uncertainty (IU) mediates the link between attachment anxiety and gaming behaviours (gaming compensation, gaming frequency, and problematic gaming). Online questionnaires were administered to Italian adolescent gamers (N = 570; Mage = 15.60; SDage = 1.56; 68.8 % males). First, via path analyses, we tested whether attachment anxiety towards mother and father (W1) and IU (W1) would predict gaming behaviours (W2). Second, we tested whether IU would mediate the link between attachment anxiety and gaming compensation specifically. Multigroup analysis was used to explore gender differences. We found that attachment anxiety towards the mother and father was positively associated with IU, whereas attachment anxiety towards only the mother predicted gaming compensation at W2 both directly and via IU. Moreover, IU positively predicted gaming compensation and problematic gaming at W2. Multigroup analysis further revealed that for females, attachment anxiety towards the mother positively predicted gaming compensation at W2. Findings revealed small/modest effect sizes. Overall, attachment anxiety and IU may boost individuals to compensate via gaming, increasing the risk of problematic gaming. These results hold implications for future prevention interventions, emphasizing the quality of the parent-child relationship and IU as potential targets to foster adaptive coping strategies in adolescence.
{"title":"The role of attachment anxiety and intolerance of uncertainty in gaming during adolescence: A two-wave longitudinal study","authors":"Camilla Gregorini , Claudia Marino , Alessandro Giardina , Joël Billieux , Gioia Bottesi , Chiara Sacchi , Erika Pivetta , Alessio Vieno , Natale Canale","doi":"10.1016/j.comppsych.2025.152613","DOIUrl":"10.1016/j.comppsych.2025.152613","url":null,"abstract":"<div><div>Adolescents with attachment anxiety can compensate via gaming for their unmet needs of closeness, reassurance, and emotion regulation. However, individual factors linking attachment anxiety to compensation via gaming are still unclear. In this two-wave longitudinal study (Wave 1, W1 = baseline; Wave 2, W2 = 6 months later), we aimed to determine whether intolerance of uncertainty (IU) mediates the link between attachment anxiety and gaming behaviours (gaming compensation, gaming frequency, and problematic gaming). Online questionnaires were administered to Italian adolescent gamers (<em>N</em> = 570; M<sub>age</sub> = 15.60; SD<sub>age</sub> = 1.56; 68.8 % males). First, via path analyses, we tested whether attachment anxiety towards mother and father (W1) and IU (W1) would predict gaming behaviours (W2). Second, we tested whether IU would mediate the link between attachment anxiety and gaming compensation specifically. Multigroup analysis was used to explore gender differences. We found that attachment anxiety towards the mother and father was positively associated with IU, whereas attachment anxiety towards only the mother predicted gaming compensation at W2 both directly and via IU. Moreover, IU positively predicted gaming compensation and problematic gaming at W2. Multigroup analysis further revealed that for females, attachment anxiety towards the mother positively predicted gaming compensation at W2. Findings revealed small/modest effect sizes. Overall, attachment anxiety and IU may boost individuals to compensate via gaming, increasing the risk of problematic gaming. These results hold implications for future prevention interventions, emphasizing the quality of the parent-child relationship and IU as potential targets to foster adaptive coping strategies in adolescence.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152613"},"PeriodicalIF":4.3,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144279344","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}
Pub Date : 2025-06-06DOI: 10.1016/j.comppsych.2025.152612
Alexandra Pham-Scottez , Isabelle Sabbah-Lim , Jean Chambry , Valérie Dao , Raphael Gourevitch , David Barruel Ing , Valérie Dauriac-Le Masson
Although psychiatrists working with adolescents know that sometimes they need to be hospitalised in emergency, few studies have described the hospitalisation of adolescents in adult psychiatric wards. We aimed to estimate the prevalence of adolescents hospitalised in adult psychiatric wards (characteristics, gender comparison, subtypes).
We conducted a monocentric retrospective study in the largest psychiatric hospital in France. All patients aged 15 to <18 years hospitalised in adult psychiatric wards were included, with different variables: socio-demographic and family information, history of inpatient / outpatient treatment, clinical data (like ICD-10 diagnoses, care pathway before / after hospitalisation…).
We included 332 hospitalisations (70 % girls), representing 2.8 % of all psychiatric hospitalisations. For 37 hospitalisations (11.1 %), this was the first psychiatric contact; for 54.2 %, patients had no previous psychiatric hospitalisation, for 87.3 %, patients had previous outpatient treatment. Mood disorders was the diagnosis for 47 % of the admissions, suicide attempts and suicidal ideation accounted for 69 % of the clinical situations leading to hospitalisation. Boys and girls differed significantly on many variables. Cluster analyses revealed two subgroups: cluster 1 patients (62 %) more frequently were girls, had previous hospitalisations in child psychiatry, came from home, had suicide attempts / suicidal ideation, had personality disorders, whereas cluster 2 patients (38 %) more frequently had substance use disorders, psychotic episodes, clastic crisis / hetero-aggression, longer hospital stays. Emergency admission of an adolescent with psychiatric issues to an adult psychiatric ward is not uncommon, especially in the context of a suicidal crisis or psychotic episode. Our results suggest the need for establishing unscheduled hospital beds for such adolescents.
{"title":"Characteristics of adolescents hospitalised in adult psychiatric units. Retrospective study in the largest psychiatric hospital in France","authors":"Alexandra Pham-Scottez , Isabelle Sabbah-Lim , Jean Chambry , Valérie Dao , Raphael Gourevitch , David Barruel Ing , Valérie Dauriac-Le Masson","doi":"10.1016/j.comppsych.2025.152612","DOIUrl":"10.1016/j.comppsych.2025.152612","url":null,"abstract":"<div><div>Although psychiatrists working with adolescents know that sometimes they need to be hospitalised in emergency, few studies have described the hospitalisation of adolescents in adult psychiatric wards. We aimed to estimate the prevalence of adolescents hospitalised in adult psychiatric wards (characteristics, gender comparison, subtypes).</div><div>We conducted a monocentric retrospective study in the largest psychiatric hospital in France. All patients aged 15 to <18 years hospitalised in adult psychiatric wards were included, with different variables: socio-demographic and family information, history of inpatient / outpatient treatment, clinical data (like ICD-10 diagnoses, care pathway before / after hospitalisation…).</div><div>We included 332 hospitalisations (70 % girls), representing 2.8 % of all psychiatric hospitalisations. For 37 hospitalisations (11.1 %), this was the first psychiatric contact; for 54.2 %, patients had no previous psychiatric hospitalisation, for 87.3 %, patients had previous outpatient treatment. Mood disorders was the diagnosis for 47 % of the admissions, suicide attempts and suicidal ideation accounted for 69 % of the clinical situations leading to hospitalisation. Boys and girls differed significantly on many variables. Cluster analyses revealed two subgroups: cluster 1 patients (62 %) more frequently were girls, had previous hospitalisations in child psychiatry, came from home, had suicide attempts / suicidal ideation, had personality disorders, whereas cluster 2 patients (38 %) more frequently had substance use disorders, psychotic episodes, clastic crisis / hetero-aggression, longer hospital stays. Emergency admission of an adolescent with psychiatric issues to an adult psychiatric ward is not uncommon, especially in the context of a suicidal crisis or psychotic episode. Our results suggest the need for establishing unscheduled hospital beds for such adolescents.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152612"},"PeriodicalIF":4.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144298091","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号