Pub Date : 2025-07-20DOI: 10.1016/j.comppsych.2025.152625
Faccini Julie , Joshi Vrutti , Del-Monte Jonathan
Background
Diurnal and nocturnal symptoms of insomnia are strongly associated with anxiety and depression. Interoception provides a new reading window for understanding the development and maintenance of psychopathology and sleep disorders. While previous studies have provided preliminary insights into the relationships between depression, anxiety, insomnia, and interoceptive sensibility, to our knowledge, no study has comprehensively examined these relationships.
Methods
We used mediation and network analyses to investigate the associations between interoceptive sensibility, diurnal and nocturnal symptoms of insomnia, anxiety, and depression in a sample of 542 individuals from the general population. The Multidimensional Assessment of Interoceptive Awareness, the Sleep Condition Indicator, and the Hospital Anxiety and Depression Scale were used for the assessment.
Results
The results showed that the dimensions “trust” and “attention regulation” of interoceptive sensibility are central nodes in the interrelationship network. The “trust” dimension is strongly and negatively related to depression and anxiety. Nocturnal symptoms are more strongly related to anxiety, and diurnal symptoms are more strongly related to depression. Mediation analyses highlight the predominant mediating role of the “trust” dimension in the relationships between insomnia symptoms and clinical variables.
Conclusions
These findings suggest that interoceptive sensibility plays a critical role in bridging the relationship between both nocturnal and diurnal insomnia symptoms and anxiety-depressive symptomatology.
{"title":"Interoceptive sensibility: links with insomnia symptoms, anxiety, and depression in the general population","authors":"Faccini Julie , Joshi Vrutti , Del-Monte Jonathan","doi":"10.1016/j.comppsych.2025.152625","DOIUrl":"10.1016/j.comppsych.2025.152625","url":null,"abstract":"<div><h3>Background</h3><div>Diurnal and nocturnal symptoms of insomnia are strongly associated with anxiety and depression. Interoception provides a new reading window for understanding the development and maintenance of psychopathology and sleep disorders. While previous studies have provided preliminary insights into the relationships between depression, anxiety, insomnia, and interoceptive sensibility, to our knowledge, no study has comprehensively examined these relationships.</div></div><div><h3>Methods</h3><div>We used mediation and network analyses to investigate the associations between interoceptive sensibility, diurnal and nocturnal symptoms of insomnia, anxiety, and depression in a sample of 542 individuals from the general population. The Multidimensional Assessment of Interoceptive Awareness, the Sleep Condition Indicator, and the Hospital Anxiety and Depression Scale were used for the assessment.</div></div><div><h3>Results</h3><div>The results showed that the dimensions “trust” and “attention regulation” of interoceptive sensibility are central nodes in the interrelationship network. The “trust” dimension is strongly and negatively related to depression and anxiety. Nocturnal symptoms are more strongly related to anxiety, and diurnal symptoms are more strongly related to depression. Mediation analyses highlight the predominant mediating role of the “trust” dimension in the relationships between insomnia symptoms and clinical variables.</div></div><div><h3>Conclusions</h3><div>These findings suggest that interoceptive sensibility plays a critical role in bridging the relationship between both nocturnal and diurnal insomnia symptoms and anxiety-depressive symptomatology.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152625"},"PeriodicalIF":4.3,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144680722","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 : 2025-07-17DOI: 10.1016/j.comppsych.2025.152626
Yuna Jang , EKyong Yoon , Arum Hong , Hye Youn Park
Objectives
Somatic symptom disorder (SSD) is characterized by persistent physical symptoms and excessive emotional responses, but the influence of emotional factors such as anger and alexithymia on symptom severity and course remains unclear. This study examined whether baseline levels and six-month changes in emotional factors are associated with somatic symptom severity and course in SSD, considering sex.
Methods
Eighty-three SSD patients and 80 age- and sex-matched healthy controls completed self-report measures of emotional and somatic symptoms at baseline and six-month follow-up. Changes in symptom levels were compared between patients and controls. Emotional factors associated with symptom severity and change were also examined. Linear mixed models, multiple regression, and Bayesian mediation analyses were employed.
Results
Compared to controls, the SSD group showed significant improvement in somatic symptoms over six months. Trait anger was significantly associated with somatic symptom severity in females, and an interaction between anxiety and trait anger predicted symptom severity. Within the SSD group, reductions in anxiety and alexithymia were significantly associated with symptom improvement. Mediation analyses supported indirect pathways between affective change and symptom reduction.
Conclusions
This prospective study highlights the contribution of emotional dysregulation to both the severity and course of somatic symptoms in SSD. The findings emphasize the relevance of sex differences and emotion-focused mechanisms in symptom maintenance and improvement, supporting the need for tailored interventions in SSD treatment.
{"title":"Affective dysregulation and sex differences in somatic symptom disorder: A 6-month longitudinal and mediation analysis","authors":"Yuna Jang , EKyong Yoon , Arum Hong , Hye Youn Park","doi":"10.1016/j.comppsych.2025.152626","DOIUrl":"10.1016/j.comppsych.2025.152626","url":null,"abstract":"<div><h3>Objectives</h3><div>Somatic symptom disorder (SSD) is characterized by persistent physical symptoms and excessive emotional responses, but the influence of emotional factors such as anger and alexithymia on symptom severity and course remains unclear. This study examined whether baseline levels and six-month changes in emotional factors are associated with somatic symptom severity and course in SSD, considering sex.</div></div><div><h3>Methods</h3><div>Eighty-three SSD patients and 80 age- and sex-matched healthy controls completed self-report measures of emotional and somatic symptoms at baseline and six-month follow-up. Changes in symptom levels were compared between patients and controls. Emotional factors associated with symptom severity and change were also examined. Linear mixed models, multiple regression, and Bayesian mediation analyses were employed.</div></div><div><h3>Results</h3><div>Compared to controls, the SSD group showed significant improvement in somatic symptoms over six months. Trait anger was significantly associated with somatic symptom severity in females, and an interaction between anxiety and trait anger predicted symptom severity. Within the SSD group, reductions in anxiety and alexithymia were significantly associated with symptom improvement. Mediation analyses supported indirect pathways between affective change and symptom reduction.</div></div><div><h3>Conclusions</h3><div>This prospective study highlights the contribution of emotional dysregulation to both the severity and course of somatic symptoms in SSD. The findings emphasize the relevance of sex differences and emotion-focused mechanisms in symptom maintenance and improvement, supporting the need for tailored interventions in SSD treatment.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152626"},"PeriodicalIF":4.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672565","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 : 2025-07-12DOI: 10.1016/j.comppsych.2025.152624
Lara R. Piccoli , Lucy Albertella , Alexandra Ghiţă , Chao Suo , Shuo Chen , José Gutiérrez-Maldonado , Karyn Richardson , Murat Yücel , Rico Sze Chun Lee
Objective
Stress is well-known to increase alcohol craving and alcohol cue-induced anxiety in individuals with alcohol use disorder (AUD). While previous research suggests that individuals who drink for relief experience strong alcohol cravings and associated anxiety, the interaction between stress and relief-seeking motives in predicting craving and anxiety responses to alcohol cues is not well understood. Using a virtual reality cue exposure paradigm, this study investigated the moderating role of stress on the relationship between relief-seeking motives and cue-induced alcohol craving and anxiety. We hypothesised that individuals with AUD who report high relief-seeking motives would show greater cue-induced craving and anxiety when exposed to a psychosocial stressor, compared to those not exposed to the stressor.
Method
Forty-nine participants were randomised into stress (n = 24) or no-stress (n = 25) exposure groups. Participants completed the Habit, Reward, and Fear Scale to measure drinking motives and visual analogue scales to measure cue-induced alcohol craving and anxiety. Heart rate and subjective stress were measured throughout the session.
Results
Stress moderated the relationship between relief-seeking motives and cue-induced alcohol craving (β = 1.90, p = .015); those with high relief-seeking motives exhibited greater cue-induced alcohol craving when stressed (β = 1.65, p = .011). Stress did not moderate the relationship between relief-seeking motives and cue-induced anxiety (β = 1.55, p = .148).
Conclusion
Individuals with high relief-seeking motives exhibit greater cue-induced alcohol craving when stressed, highlighting their increased vulnerability to harmful drinking and relapse, particularly during stressful situations. Further research is required to elucidate the cognitive-affective mechanisms of relief-driven drinking to inform more targeted interventions for these at-risk individuals.
目的：众所周知，压力会增加酒精使用障碍（AUD）患者的酒精渴望和酒精线索诱发的焦虑。虽然之前的研究表明，为了缓解压力而喝酒的人会有强烈的酒精渴望和相关的焦虑，但压力和寻求缓解动机之间的相互作用，在预测酒精线索的渴望和焦虑反应方面，还没有得到很好的理解。本研究采用虚拟现实线索暴露范式，探讨了压力在寻求缓解动机与线索诱导的酒精渴望和焦虑之间的调节作用。我们假设，与未暴露于压力源的个体相比，报告高寻求缓解动机的AUD患者在暴露于社会心理压力源时表现出更大的线索诱导的渴望和焦虑。方法49例受试者随机分为应激组（n = 24）和无应激组（n = 25）。参与者完成了习惯、奖励和恐惧量表来衡量饮酒动机，以及视觉模拟量表来衡量线索引起的酒精渴望和焦虑。在整个过程中测量心率和主观压力。结果应激可调节缓解寻求动机与提示性酒精渴望的关系（β = 1.90, p = 0.015）；那些有高度寻求缓解动机的人在压力下表现出更大的线索诱导的酒精渴望（β = 1.65, p = 0.011）。压力没有调节寻求救济动机和线索诱发焦虑之间的关系（β = 1.55, p = .148）。结论：具有高度寻求缓解动机的个体在压力下表现出更大的线索诱导的酒精渴望，突出了他们更容易有害饮酒和复发，特别是在压力情况下。需要进一步的研究来阐明缓解型饮酒的认知-情感机制，从而为这些高危人群提供更有针对性的干预措施。
{"title":"Effect of stress on the relationship between relief-seeking and cue-induced alcohol craving and anxiety: A virtual reality cue exposure study","authors":"Lara R. Piccoli , Lucy Albertella , Alexandra Ghiţă , Chao Suo , Shuo Chen , José Gutiérrez-Maldonado , Karyn Richardson , Murat Yücel , Rico Sze Chun Lee","doi":"10.1016/j.comppsych.2025.152624","DOIUrl":"10.1016/j.comppsych.2025.152624","url":null,"abstract":"<div><h3>Objective</h3><div>Stress is well-known to increase alcohol craving and alcohol cue-induced anxiety in individuals with alcohol use disorder (AUD). While previous research suggests that individuals who drink for relief experience strong alcohol cravings and associated anxiety, the interaction between stress and relief-seeking motives in predicting craving and anxiety responses to alcohol cues is not well understood. Using a virtual reality cue exposure paradigm, this study investigated the moderating role of stress on the relationship between relief-seeking motives and cue-induced alcohol craving and anxiety. We hypothesised that individuals with AUD who report high relief-seeking motives would show greater cue-induced craving and anxiety when exposed to a psychosocial stressor, compared to those not exposed to the stressor.</div></div><div><h3>Method</h3><div>Forty-nine participants were randomised into stress (<em>n</em> = 24) or no-stress (<em>n</em> = 25) exposure groups. Participants completed the Habit, Reward, and Fear Scale to measure drinking motives and visual analogue scales to measure cue-induced alcohol craving and anxiety. Heart rate and subjective stress were measured throughout the session.</div></div><div><h3>Results</h3><div>Stress moderated the relationship between relief-seeking motives and cue-induced alcohol craving (β = 1.90, <em>p</em> = .015); those with high relief-seeking motives exhibited greater cue-induced alcohol craving when stressed (β = 1.65, <em>p</em> = .011). Stress did not moderate the relationship between relief-seeking motives and cue-induced anxiety (β = 1.55, <em>p</em> = .148).</div></div><div><h3>Conclusion</h3><div>Individuals with high relief-seeking motives exhibit greater cue-induced alcohol craving when stressed, highlighting their increased vulnerability to harmful drinking and relapse, particularly during stressful situations. Further research is required to elucidate the cognitive-affective mechanisms of relief-driven drinking to inform more targeted interventions for these at-risk individuals.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152624"},"PeriodicalIF":4.3,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144655923","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 : 2025-07-12DOI: 10.1016/j.comppsych.2025.152623
Harshdeep S. Mangat , Róbert Urbán , Patrik Koncz , Zsolt Demetrovics , Andrea Czakó , Mark D. Griffiths , Orsolya Király
Background and aims
Esports playing (i.e., competitive videogaming) is an ever-growing activity but has a variety of risks or harms associated with problematic consumption. The aim of the present study was to investigate the extent to which esports is associated with different indicators of problematic consumption and how motivations for playing videogames reflect differences between esports players, recreational players, and highly engaged gamers.
Methods
Self-report data were collected regarding personality, psychopathological symptoms, and gaming behavior among 14,727 gamers (mean age = 24.1 years [SD = 7.0]; 89.3 % male) comprising 557 esports players (mean age = 21.5 years [SD = 6.5]; 95.9 % male), 5101 recreational players (mean age = 26.1 years [SD = 7.5]; 87.8 % male), and 9069 highly engaged gamers (mean age = 23.2 years [SD = 6.4]; 89.7 % male).
Results
Comparing all three groups, esports players were more likely to be male, younger in age, and were more likely to have a competitive personality. When compared to highly engaged gamers with regard to gaming motivation, esports players showed lower mastery, stimulation, and escapism motives. Highly engaged gamers displayed higher sensation seeking, higher negative affectivity, and lower sociability compared to the other two groups.
Conclusion
Esports players tend to have a balanced psychological profile, which indicates that esports themselves are not necessarily associated with problematic use characteristics. Highly engaged gamers showed potentially harmful characteristics in terms of higher perceived stress and depression, and motivations to play (escapism). Interventions are encouraged to protect and support this group of gamers.
{"title":"Personality, motivations, and gaming disorder symptoms: A large-scale comparative study of esports players, highly engaged gamers, and recreational players.","authors":"Harshdeep S. Mangat , Róbert Urbán , Patrik Koncz , Zsolt Demetrovics , Andrea Czakó , Mark D. Griffiths , Orsolya Király","doi":"10.1016/j.comppsych.2025.152623","DOIUrl":"10.1016/j.comppsych.2025.152623","url":null,"abstract":"<div><h3>Background and aims</h3><div>Esports playing (i.e., competitive videogaming) is an ever-growing activity but has a variety of risks or harms associated with problematic consumption. The aim of the present study was to investigate the extent to which esports is associated with different indicators of problematic consumption and how motivations for playing videogames reflect differences between esports players, recreational players, and highly engaged gamers.</div></div><div><h3>Methods</h3><div>Self-report data were collected regarding personality, psychopathological symptoms, and gaming behavior among 14,727 gamers (mean age = 24.1 years [SD = 7.0]; 89.3 % male) comprising 557 esports players (mean age = 21.5 years [SD = 6.5]; 95.9 % male), 5101 recreational players (mean age = 26.1 years [SD = 7.5]; 87.8 % male), and 9069 highly engaged gamers (mean age = 23.2 years [SD = 6.4]; 89.7 % male).</div></div><div><h3>Results</h3><div>Comparing all three groups, esports players were more likely to be male, younger in age, and were more likely to have a competitive personality. When compared to highly engaged gamers with regard to gaming motivation, esports players showed lower mastery, stimulation, and escapism motives. Highly engaged gamers displayed higher sensation seeking, higher negative affectivity, and lower sociability compared to the other two groups.</div></div><div><h3>Conclusion</h3><div>Esports players tend to have a balanced psychological profile, which indicates that esports themselves are not necessarily associated with problematic use characteristics. Highly engaged gamers showed potentially harmful characteristics in terms of higher perceived stress and depression, and motivations to play (escapism). Interventions are encouraged to protect and support this group of gamers.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152623"},"PeriodicalIF":4.3,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665776","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}
We examined the association between metacognitive performance, functioning, and quality of life (QoL) in schizophrenia using structural equation model analyses.
Study design
A sample of 249 participants was assessed for symptoms, functioning, QoL, and both objective and subjective cognitive performance. Metacognitive performance was defined as the adequation between objective and subjective measures of cognitive performance.
Study results
Our model showed an excellent fit (CFI = 0.981; RMSEA = 0.014–0.081) and explained 53.3 % of the variance in functioning and 50.3 % in QoL. Metacognitive performance was not significantly associated with functioning but showed a negative association with QoL (β = −0.383, p < 0.001). Thus, a greater underestimation of one's cognitive abilities was linked with lower QoL, potentially reflecting heightened awareness of deficits that affect well-being. Depression, also negatively associated with QoL (β = −0.359, p < 0.001), was linked to the underestimation of cognitive abilities, whereas symptom severity was associated with their overestimation (β = −0.296, p < 0.001). Complementary analyses suggest that the subjective cognition model closely mirrors that of metacognitive performance, questioning the distinctiveness of metacognition as an explanatory factor in schizophrenia outcomes.
Conclusion
Our findings imply that interventions that boost confidence in cognitive abilities, such as cognitive remediation, may improve QoL. Future research should investigate the causal pathways between these factors and explore the role of social cognition, often impaired in schizophrenia, as another mediator. Comprehensive treatment that addresses clinical symptoms, depression, and subjective cognition challenges appear essential to improve outcomes in schizophrenia.
背景与假设我们使用结构方程模型分析精神分裂症患者的元认知表现、功能和生活质量之间的关系。研究设计对249名参与者的症状、功能、生活质量以及客观和主观认知表现进行了评估。元认知表现被定义为认知表现的客观和主观测量之间的适当性。研究结果模型拟合良好(CFI = 0.981；RMSEA = 0.014-0.081)，解释了53.3%的功能差异和50.3%的生活质量差异。元认知表现与功能无显著相关，但与生活质量呈负相关(β = - 0.383, p <；0.001)。因此，对一个人的认知能力的严重低估与较低的生活质量有关，这可能反映了对影响幸福感的缺陷的高度认识。抑郁与生活质量也呈负相关(β = - 0.359, p <；0.001)，与认知能力的低估有关，而症状严重程度与认知能力的高估有关(β = - 0.296, p <；0.001)。补充分析表明，主观认知模型密切反映了元认知表现，质疑元认知作为精神分裂症结局解释因素的独特性。结论增强认知能力自信的干预措施，如认知修复，可以改善患者的生活质量。未来的研究应该调查这些因素之间的因果关系，并探索社会认知的作用，通常在精神分裂症中受损，作为另一个中介。针对临床症状、抑郁和主观认知挑战的综合治疗似乎对改善精神分裂症的预后至关重要。
{"title":"Flowers for Algernon: How metacognition affects quality of life in schizophrenia. Structural equation modeling with the FACE-SZ cohort","authors":"Solène Frileux , Nathan Faivre , Mathieu Urbach , Nathan Vidal , Hugo Bottemanne , Fabrice Berna , Cristobal Belmonte , Laurent Boyer , Delphine Capdevielle , Julie Clauss , Isabelle Chéreau , Thierry D'Amato , Caroline Dubertret , Julien Dubreucq , Guillaume Fond , Sylvain Leigner , Pierre-Michel Llorca , Jasmina Mallet , David Misdrahi , Baptiste Pignon , Paul Roux","doi":"10.1016/j.comppsych.2025.152622","DOIUrl":"10.1016/j.comppsych.2025.152622","url":null,"abstract":"<div><h3>Background and hypothesis</h3><div>We examined the association between metacognitive performance, functioning, and quality of life (QoL) in schizophrenia using structural equation model analyses.</div></div><div><h3>Study design</h3><div>A sample of 249 participants was assessed for symptoms, functioning, QoL, and both objective and subjective cognitive performance. Metacognitive performance was defined as the adequation between objective and subjective measures of cognitive performance.</div></div><div><h3>Study results</h3><div>Our model showed an excellent fit (CFI = 0.981; RMSEA = 0.014–0.081) and explained 53.3 % of the variance in functioning and 50.3 % in QoL. Metacognitive performance was not significantly associated with functioning but showed a negative association with QoL (<em>β</em> = −0.383, <em>p</em> < 0.001). Thus, a greater underestimation of one's cognitive abilities was linked with lower QoL, potentially reflecting heightened awareness of deficits that affect well-being. Depression, also negatively associated with QoL (<em>β</em> = −0.359, <em>p</em> < 0.001), was linked to the underestimation of cognitive abilities, whereas symptom severity was associated with their overestimation (β = −0.296, p < 0.001). Complementary analyses suggest that the subjective cognition model closely mirrors that of metacognitive performance, questioning the distinctiveness of metacognition as an explanatory factor in schizophrenia outcomes.</div></div><div><h3>Conclusion</h3><div>Our findings imply that interventions that boost confidence in cognitive abilities, such as cognitive remediation, may improve QoL. Future research should investigate the causal pathways between these factors and explore the role of social cognition, often impaired in schizophrenia, as another mediator. Comprehensive treatment that addresses clinical symptoms, depression, and subjective cognition challenges appear essential to improve outcomes in schizophrenia.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152622"},"PeriodicalIF":4.3,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672566","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}
Cannabis use disorder (CUD) is highly prevalent with ∼44 million cases worldwide. CUD has been associated with compulsive use despite experiencing adverse psychosocial outcomes. Such adverse outcomes of CUD have been attributed to altered cognition - a set of mental processes that support the organisation and implementation of goal-directed behaviour. However, the evidence is mixed and limited by methodological issues including inconsistent assessment of CUD and metrics of cannabis use.
Objective/Methods
This study examined distinct domains of cognition (i.e., executive function, working memory, episodic memory, verbal reasoning, attention, IQ) in 115 participants aged 18.5 to 32.5 years. We compared performance between 83 participants who endorsed a CUD and 32 controls. We also explored whether the level of problematic cannabis use, and cannabis grams/past month was associated with cognition in CUD. All analyses accounted for alcohol/nicotine use and trait anxiety.
Results
CUD compared to control participants showed significantly lower IQ, with a strong effect size (p < .001, d = 0.862), which was driven by lower verbal IQ, and survived adjusting for education years. There were no other significant effects of group or associations between cognition, level of problematic cannabis use, or dosage.
Conclusions
Altered cognition in young adults who endorse a CUD may be specific to verbal IQ. Future work is required to confirm whether these findings generalise to CUD samples across the lifespan, including the most vulnerable individuals with a CUD who are seeking or receiving treatment and that endorse comorbid psychopathologies.
理性大麻使用障碍（CUD）非常普遍，全世界约有4400万例。尽管经历了不良的社会心理后果，但CUD与强迫性使用有关。CUD的这些不良后果被归因于认知的改变——一套支持目标导向行为的组织和实施的心理过程。然而，证据是混杂的，并受到方法学问题的限制，包括对CUD和大麻使用指标的评估不一致。目的/方法本研究考察了115名年龄在18.5岁至32.5岁之间的参与者的不同认知领域（即执行功能、工作记忆、情景记忆、言语推理、注意力、智商）。我们比较了83名接受CUD治疗的参与者和32名对照组的表现。我们还探讨了有问题的大麻使用水平和大麻克数/过去一个月是否与CUD的认知有关。所有的分析都说明了酒精/尼古丁的使用和特质焦虑。结果与对照组相比，cud组受试者的智商显著降低，且存在较强的效应量(p <；.001, d = 0.862)，由较低的语言智商驱动，并在调整教育年限后存活。认知、问题大麻使用水平或剂量之间没有其他显著的群体影响或关联。结论年轻成人的认知障碍可能与语言智商有关。未来的工作需要证实这些发现是否适用于整个生命周期的CUD样本，包括那些正在寻求或接受治疗的最脆弱的CUD个体，以及那些认可共病精神病理的个体。
{"title":"Cognitive performance in young adults who endorse a cannabis use disorder","authors":"Gabrielle Abbott , Lisa Greenwood , Jessica G. Bartschi , Suraya Dunsford , Isabella Goodwin , Anastasia Paloubis , Marianna Quinones Valera , Eugene McTavish , Antonio Verdejo-Garcia , Janna Cousijn , Gary C.K. Chan , Nadia Solowij , Valentina Lorenzetti","doi":"10.1016/j.comppsych.2025.152620","DOIUrl":"10.1016/j.comppsych.2025.152620","url":null,"abstract":"<div><h3>Rationale</h3><div>Cannabis use disorder (CUD) is highly prevalent with ∼44 million cases worldwide. CUD has been associated with compulsive use despite experiencing adverse psychosocial outcomes. Such adverse outcomes of CUD have been attributed to altered cognition - a set of mental processes that support the organisation and implementation of goal-directed behaviour. However, the evidence is mixed and limited by methodological issues including inconsistent assessment of CUD and metrics of cannabis use.</div></div><div><h3>Objective/Methods</h3><div>This study examined distinct domains of cognition (i.e., executive function, working memory, episodic memory, verbal reasoning, attention, IQ) in 115 participants aged 18.5 to 32.5 years. We compared performance between 83 participants who endorsed a CUD and 32 controls. We also explored whether the level of problematic cannabis use, and cannabis grams/past month was associated with cognition in CUD. All analyses accounted for alcohol/nicotine use and trait anxiety.</div></div><div><h3>Results</h3><div>CUD compared to control participants showed significantly lower IQ, with a strong effect size (<em>p</em> < .001, <em>d</em> = 0.862), which was driven by lower verbal IQ, and survived adjusting for education years. There were no other significant effects of group or associations between cognition, level of problematic cannabis use, or dosage.</div></div><div><h3>Conclusions</h3><div>Altered cognition in young adults who endorse a CUD may be specific to verbal IQ. Future work is required to confirm whether these findings generalise to CUD samples across the lifespan, including the most vulnerable individuals with a CUD who are seeking or receiving treatment and that endorse comorbid psychopathologies.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152620"},"PeriodicalIF":4.3,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665771","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 : 2025-07-08DOI: 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}
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