Comprehensive psychiatry最新文献

{"title":"Schizophrenia genetic risk and labour market outcomes in the Finnish general population: Are schizophrenia-related traits penalised or rewarded?","authors":"Aaro Hazak ,&nbsp;Johanna Liuhanen ,&nbsp;Katri Kantojärvi ,&nbsp;Sonja Sulkava ,&nbsp;Tuija Jääskeläinen ,&nbsp;Veikko Salomaa ,&nbsp;Seppo Koskinen ,&nbsp;Markus Perola ,&nbsp;Tiina Paunio","doi":"10.1016/j.comppsych.2025.152600","DOIUrl":"10.1016/j.comppsych.2025.152600","url":null,"abstract":"<div><h3>Background</h3><div>Schizophrenia polygenic risk scores (SCZ_PRS) have been linked to cognitive functioning, creativity, behavioural traits, and psychiatric conditions beyond schizophrenia. This study examines how labour market segments reward or penalise traits associated with SCZ_PRS in the general population.</div></div><div><h3>Methods</h3><div>We merged genetic, socio-economic and health registry data with repeated cross-sectional survey data from six Finnish cohorts (1992 to 2017), representing individuals aged 25–64 across Finnish regions (<em>N</em> = 20,121). Various regression models were employed to study labour market outcomes.</div></div><div><h3>Results</h3><div>Individuals in the highest SCZ_PRS quintile were 6.4 percentage points less likely to be employed than those in the lowest quintile (<em>P</em> &lt; 0.001; 99.5 % CI: 3.9–9.0 pp). Among employed individuals in knowledge-based occupations, an inverse U-shaped relationship between SCZ_PRS and income emerged after 2000. Knowledge workers in both the lowest (<em>P</em> = 0.004) and highest (<em>P</em> = 0.03) SCZ_PRS quintiles were 4–5 percentage points less likely to be in the highest income tertile than those in the middle quintile. No significant association was found between SCZ_PRS and income in physical labour.</div></div><div><h3>Conclusions</h3><div>Beyond its overall negative association with employment, SCZ_PRS exhibits a non-linear relationship with income in cognitive-intensive occupations, where both low and high SCZ_PRS appear to be penalised. This pattern became more pronounced post-2000, coinciding with rising income inequality and technological advancements, likely reshaping labour market demands. While effect sizes are substantial, compensatory factors may mitigate these outcomes. Greater awareness of these associations and individual differences in labour market experiences could contribute to a more inclusive society.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"140 ","pages":"Article 152600"},"PeriodicalIF":4.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing prolonged grief symptoms using experience sampling methodology: The development of the prolonged grief symptoms - short ecological assessment (PGS-SEA) scale","authors":"Turan Deniz Ergun ,&nbsp;Peter M. ten Klooster ,&nbsp;Ernst T. Bohlmeijer ,&nbsp;Gerben J. Westerhof ,&nbsp;Minita Franzen ,&nbsp;Lonneke I.M. Lenferink","doi":"10.1016/j.comppsych.2025.152597","DOIUrl":"10.1016/j.comppsych.2025.152597","url":null,"abstract":"<div><div>Early grief reactions have been hypothesized to fluctuate within persons and to be one of the strongest predictors of Prolonged Grief Disorder (PGD). Experience Sampling Methodology (ESM) offers an opportunity to examine (early) PGD dynamics in daily contexts. For this, however, a brief and valid ESM scale is needed to accurately assess PGD symptoms in everyday life. We investigated the psychometric properties of ESM items developed to assess momentary prolonged grief symptoms in daily life (ESM-PGD). Additionally, we aimed to create a valid brief scale for future ESM studies. Bereaved adults (<em>N</em> = 169) whose loved ones died 3–6 months earlier completed 11 ESM-PGD items based on 10 PGD symptoms, as defined in DSM-5-TR, five times a day for 14 consecutive days at semi-random intervals. We performed multilevel confirmatory factor analysis (MCFA), calculated root-mean-square of successive differences (RMSSD) and intraclass correlations (ICC), and conducted correlational analyses of ESM-PGD items with related mental health symptoms (e.g., depression) to identify the best-performing items. MCFA confirmed that the hypothesized one-factor model fits the data well with good composite reliability at the between- and within-person levels. All ESM-PGD items were able to distinguish between people with and without early PGD. Examination of within-person level factor loadings, ICCs and RMSSDs revealed that not all ESM-PGD items were able to capture fluctuations of momentary PGD symptoms. The best-performing items were selected, resulting in a valid 2-item Prolonged Grief Symptoms – Short Ecological Assessment (PGS-SEA) scale for assessing PGD in daily life to facilitate ESM-research on PGD.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"140 ","pages":"Article 152597"},"PeriodicalIF":4.3,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143855892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in recreational drug use, reasons for those changes and their consequence during and after the COVID-19 pandemic in the UK","authors":"Maria Bălăeţ ,&nbsp;Ana Zadel ,&nbsp;Anne Lingford-Hughes ,&nbsp;Louise M. Paterson ,&nbsp;Samuel R. Chamberlain ,&nbsp;William Trender ,&nbsp;Peter J. Hellyer ,&nbsp;Adam Hampshire","doi":"10.1016/j.comppsych.2025.152598","DOIUrl":"10.1016/j.comppsych.2025.152598","url":null,"abstract":"<div><div>Changes in drug use in the general population during the COVID-19 pandemic and their long-term consequences are not well understood. We employed natural language processing and machine learning to analyse a large dataset of self-reported rates of and reasons for drug use during the pandemic, along with their associations with anxiety, depression and substance use problems post-pandemic. Our findings revealed a transient decrease in drug use at the pandemic's peak, primarily attributed to reduced social opportunities. Conversely, some participants reported increased drug use for self-medication, boredom, and lifestyle disruptions. While users of psychedelics and MDMA had anxiety and depression rates similar to non-users, users of opioid agonists and depressants—representing one in ten active drug users—reported greater mental health challenges post-pandemic. These results suggest that a subset of active drug users with distinct profiles faces elevated risks, particularly for anxiety and depression, and may benefit from targeted support.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"140 ","pages":"Article 152598"},"PeriodicalIF":4.3,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143842978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adapting the group traumatic episode protocol approach as a paraprofessional-led early intervention for law enforcement personnel","authors":"Monika Ozga ,&nbsp;Maryjo Hart ,&nbsp;Theo Niyonsenga ,&nbsp;Larissa Coulter","doi":"10.1016/j.comppsych.2025.152596","DOIUrl":"10.1016/j.comppsych.2025.152596","url":null,"abstract":"<div><h3>Background</h3><div>Law enforcement personnel experience high levels of occupational stress and frequent exposure to potentially traumatic events, requiring effective early interventions. The Modified Group Traumatic Episode Protocol (mGTEP) is an adaptation of Eye Movement Desensitization and Reprocessing (EMDR) designed to help individuals process traumatic experiences in a group setting. This study evaluated the feasibility and effectiveness of a paraprofessional-led mGTEP within the law enforcement population.</div></div><div><h3>Methods</h3><div>Police officers and staff, with peer support background, were trained as paraprofessionals to facilitate mGTEP as early mental health support for their colleagues. Their role bridges the gap between informal peer support and professional mental health services. Psychological distress (single-item scale), depression (PHQ-9), anxiety (GAD-7), and trauma-related stress (PCL-5) were assessed at baseline (T1), post-intervention (T2), and follow-up (T3). Multilevel statistical analyses were conducted to evaluate changes over time. A sample of 40 law enforcement personnel participated in online mGTEP sessions. The sample consisted of mostly males (54 %), ranging from age 28 to 53 with an average of 14 years working in the police. Multilevel modelling was applied to the repeated measures design to analyse changes across three time points, combining both random (e.g., participant) and fixed (e.g., time) effects.</div></div><div><h3>Results</h3><div>Significant reductions were observed from T1 to T2 in distress (d = 0.69, large), anxiety (d = 0.65, large), and trauma-related stress (d = 0.48, medium), with sustained improvements in depression (d = 0.26, small) and trauma-related stress (d = 0.48, medium) at follow-up. Anxiety scores slightly increased between T2 and T3 (d = 0.36, small). Similarly, distress scores did not continue to decline beyond T2. These results potentially reflect the ongoing demands of policing and continued exposure to trauma.</div></div><div><h3>Conclusion</h3><div>This study highlights the feasibility of mGTEP as a paraprofessional-led early intervention for law enforcement personnel, demonstrating significant symptom reductions. While improvements in depression and trauma-related stress persisted, fluctuations in anxiety and distress levels suggest the need for continued support post-intervention. Given the cumulative nature of occupational stress in policing, regular implementation may be necessary to sustain benefits. Integrating mGTEP into existing mental health programs could enhance accessibility, allowing it to complement other psychological support initiatives.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"140 ","pages":"Article 152596"},"PeriodicalIF":4.3,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143842979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between exposure to potentially psychologically traumatic events and mental ill health among New Zealand firefighters: A cross-sectional study","authors":"Lisa Mackay ,&nbsp;Jessica L. Campbell ,&nbsp;Josh Darby ,&nbsp;Kate Pendergast ,&nbsp;Grant Schofield","doi":"10.1016/j.comppsych.2025.152595","DOIUrl":"10.1016/j.comppsych.2025.152595","url":null,"abstract":"<div><h3>Background</h3><div>Fire and emergency services personnel face unique occupational hazards, including repeated exposure to potentially psychologically traumatic events (PPTEs), which can impact their mental health. Despite growing awareness, comprehensive data on the mental health of fire and emergency services personnel in New Zealand remains sparse.</div></div><div><h3>Purpose</h3><div>This study examined the prevalence of symptoms of mental health disorders, including PTSD, Major Depressive Disorder, and Generalized Anxiety Disorder, and assessed the association between PPTE exposure, coping mechanisms, and mental ill health among New Zealand firefighters and commanders.</div></div><div><h3>Methods</h3><div>A comprehensive online survey using the Qualtrics platform was administered to fire and emergency personnel, assessing exposure to PPTEs and various mental health parameters. The survey utilized standard assessment tools including the PHQ-9, GAD-7, SPRINT, and AUDIT-C alongside measures of life satisfaction, emotional numbing and demographic questions.</div></div><div><h3>Main findings</h3><div>The prevalence of symptoms of Major Depressive Disorder (24 %), Generalized Anxiety Disorder (13 %), and probable PTSD (13 %) among 1264 fire and emergency personnel are higher than those observed in the general population. High exposure to PPTEs was associated with higher odds of reporting moderate-to-severe symptoms of Major Depressive Disorder, Generalized Anxiety Disorder, and probable PTSD. Also of note were findings revealing a high prevalence of potentially hazardous drinking patterns (68 %).</div></div><div><h3>Conclusions</h3><div>Highlights a critical need for effective mental ill health prevention and support programs tailored to fire and emergency personnel, considering their high exposure to PPTEs and elevated risk of experiencing symptoms of Major Depressive Disorder, Generalized Anxiety Disorder, and PTSD</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"139 ","pages":"Article 152595"},"PeriodicalIF":4.3,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of events scale-revised (IES-R): Validation of the Ukrainian version","authors":"Liudmyla Krupelnytska ,&nbsp;Nazar Yatsenko ,&nbsp;Vladyslava Keller ,&nbsp;Olha Morozova-Larina","doi":"10.1016/j.comppsych.2025.152593","DOIUrl":"10.1016/j.comppsych.2025.152593","url":null,"abstract":"<div><h3>Background</h3><div>The aftermath of warfare in Ukraine has witnessed traumatic experiences emerge as a significant concern. This highlights the need for strengthened secondary prevention strategies targeting trauma and stress-related disorders. Providing mental health professionals with tools to support refugees is crucial. The Impact of Events Scale – Revised (IES-R) stands out as the prevalent early diagnostic and clinical assessment tool for measuring the traumatic stress symptoms. However, this questionnaire has yet to be psychometrically adapted to the Ukrainian linguistic and cultural context.</div></div><div><h3>Objective</h3><div>This study sought to verify the reliability and validity of the Ukrainian version of the Impact of Events Scale – Revised for adult Ukrainian refugees.</div></div><div><h3>Method</h3><div>A psychometric evaluation was conducted within broader longitudinal research on refugee mental health. The study incorporated a convenience sample of 584 Ukrainian refugees located in Germany. The Ukrainian IES-R's factorial structure underwent validation using CFA with the DWLS estimator. Internal consistency was ascertained using both Cronbach's α and MacDonald's ω. The convergent and divergent validity of the questionnaire were established through Pearson's correlation coefficient. The DIF analysis evaluated diagnostic disparities between groups of respondents identifying as women and men. The ICC, derived from a two-way mixed ANOVA model, and Pearson's correlation coefficients were employed to gauge the test-retest reliability of the IES-R over an 8-month interval between the two data collection waves.</div></div><div><h3>Results</h3><div>The Ukrainian version of the IES-R retains a three-factor, classification-free structure, with a modification of item No. 12 being shifted to the Hyperarousal subscale. Confirmatory metrics (CMIN/DF = 2.874, RMSEA = 0.049, SRMR = 0.065, CFI = 0.977, TLI = 0.974) bolster the model's fit. Consistency coefficients (α, ω) for each subscale ranged from 0.75 to 0.84, with the IES-R's overall values being ω = 0.92 and α = 0.91. The IES-R total score and individual factor values displayed significant (moderate to high) correlations with PSS-10 and either weak or inverse correlations with SWLS, TIPI, and ZTPI-S, aligning with expectations. The test-retest measures showed low temporal stability with an ICC of 0.206 for the total score and a moderate correlation (<em>r</em> = 0.412, <em>p</em> &lt; 0.01), indicating the questionnaire assesses trauma and stressor-related symptoms rather than underlying traits.</div></div><div><h3>Conclusion</h3><div>The data reveal the IES-R as an efficacious diagnostic tool to discern trauma-induced distress in adult Ukrainian refugees. Given its robust psychometric properties, the IES-R is relevant for screening wartime impact.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"139 ","pages":"Article 152593"},"PeriodicalIF":4.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unravelling early transdiagnostic dynamics of psychotic-like experiences in young adults: Results from a cross-lagged panel network analysis","authors":"Błażej Misiak ,&nbsp;Michał Wroński ,&nbsp;Jerzy Samochowiec","doi":"10.1016/j.comppsych.2025.152594","DOIUrl":"10.1016/j.comppsych.2025.152594","url":null,"abstract":"<div><h3>Background</h3><div>Psychotic-like experiences (PLEs) are potential transdiagnostic markers of psychopathology. However, temporal patterns of associations between PLEs and other symptoms remain unclear. Moreover, it needs to be clarified as to whether PLEs might be primary targets for interventions. This study aimed to investigate longitudinal associations of PLEs with other psychopathological symptoms.</div></div><div><h3>Methods</h3><div>A total of 1314 young adults (aged 29.3 ± 5.7, 49.2 % women) without a lifetime history of psychiatric treatment completed online assessments, measuring psychopathological symptoms, at baseline and after 6 months. A cross-lagged panel network was analyzed. Output (the sum of edge weights from a specific node to all other nodes) and input (the sum of edge weights to a specific node from all other nodes) centralities were estimated. Age, gender, education, employment, and place of residence were the covariates.</div></div><div><h3>Results</h3><div>The highest output centrality was found for PLEs while the highest input centrality was observed for obsessive-compulsive symptoms. Centrality metrics of these symptom domains were significantly higher compared to centrality metrics of other psychopathological domains. PLEs showed cross-lagged associations with all other symptom domains. The strongest cross-lagged edge in the network led from PLEs to obsessive-compulsive symptoms (weight = 0.611). It was significantly stronger compared to all other cross-lagged edges in the network. The results were partially replicated in the network of specific symptoms.</div></div><div><h3>Conclusions</h3><div>The findings indicate that PLEs might precede the emergence of other domains of psychopathology. The highest output centrality of PLEs suggests their potential utility as primary targets for early interventions.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"139 ","pages":"Article 152594"},"PeriodicalIF":4.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resilient coping during the Russian-Ukrainian war: Does it buffer the effects of cumulative trauma on ICD-11 posttraumatic stress disorder symptoms?","authors":"Annett Lotzin ,&nbsp;Olha Morozova-Larina ,&nbsp;Antje Paetow ,&nbsp;Lisa Schratz ,&nbsp;Vladyslava Keller ,&nbsp;Illia Zarubin ,&nbsp;Liudmyla Krupelnytska","doi":"10.1016/j.comppsych.2025.152592","DOIUrl":"10.1016/j.comppsych.2025.152592","url":null,"abstract":"<div><h3>Background</h3><div>Individuals with higher resilient coping may manage war-related trauma better than individuals with lower resilient coping. If so, resilient coping may weaken the relationship between war trauma and posttraumatic stress disorders.</div></div><div><h3>Objective</h3><div>This study aimed to investigate the role of resilient coping in moderating the associations between cumulative war trauma exposure and ICD-11 posttraumatic stress disorders during war.</div></div><div><h3>Methods</h3><div>This cross-sectional study included <em>N</em> = 851 Ukrainian students living in the Ukraine between December 2022 and January 2023 during the Russian-Ukrainian war. We tested a model in which resilient coping was specified as a moderator of the effect of war-related cumulative trauma exposure (Harvard Trauma Questionnaire-R) on ICD-11 posttraumatic stress disorder (PTSD), and disturbances in self-organization (DSO) symptom levels (International Trauma Questionnaire-R), respectively. We used Structural Equation Modeling and controlled our analysis for previous trauma exposure, gender, years of study, and level of income.</div></div><div><h3>Results</h3><div>In contrast to our hypothesis, the level of resilient coping did not moderate the effect of cumulative war trauma exposure on PTSD and DSO symptom levels. Instead, we found a strong direct effect of the level of resilient coping on PTSD and DSO symptom levels.</div></div><div><h3>Conclusions</h3><div>Resilient coping may directly affect the level of PTSD and DSO symptoms but may not weaken the association between trauma exposure and posttraumatic stress disorders during war.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"140 ","pages":"Article 152592"},"PeriodicalIF":4.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143815603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of physical activity and sleep with mental health during and post-COVID-19 pandemic in chinese college students: a longitudinal cohort study","authors":"Haonan Wang ,&nbsp;Yixiao Ding ,&nbsp;Yinghong Dai ,&nbsp;Zilin Fan ,&nbsp;Shubo Wen ,&nbsp;Xinying Wang ,&nbsp;Jie Yuan ,&nbsp;Yibo Wu ,&nbsp;Liang Yu","doi":"10.1016/j.comppsych.2025.152591","DOIUrl":"10.1016/j.comppsych.2025.152591","url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 pandemic seriously impacted people's lifestyles, leading to changes in physical activity, sleep and mental health. This study aimed to assess the recovery of these indicators in Chinese university students post-COVID-19 pandemic, and explore the association between lifestyle changes and psychological problems.</div></div><div><h3>Methods</h3><div>A two-wave longitudinal study was conducted with 2,748 college students in Hebei, China. Self-report questionnaires measured physical activity, sleep and psychological variables (depression symptoms, anxiety symptoms, and perceived stress) in 2022 and 2024. McNemar chi-square test compared differences between the two waves. Additionally, univariate and multivariate logistic regression analyses were performed to examine the independent and joint associations between changes in lifestyle behaviors and psychological problems across this period.</div></div><div><h3>Results</h3><div>Proportion of physical inactivity decreased from 22.5% to 16.2%, and poor sleep quality reduced from 18.3% to 16.2% after the pandemic (P &lt; 0.05). Depression symptoms and anxiety symptoms also improved (P &lt; 0.05), while perceived stress remained high (64.5%). Compared to consistently inactive students, those becoming physically active (depression OR = 0.40, anxiety OR = 0.34, stress 0.56) and those persistently active (depression OR = 0.43, anxiety OR = 0.38, stress 0.47) had reduced psychological symptoms. However, after adjusting for confounders, the association between improved physical activity and mental health problems was insignificant (P &gt; 0.05). Improved sleep (depression OR = 0.42, anxiety OR = 0.24, stress 0.42) and consistently good sleep (depression OR = 0.20, anxiety OR = 0.20, stress 0.37) also demonstrated a protective effect after fully adjusting for demographics and socioeconomic status.</div></div><div><h3>Conclusions</h3><div>This study found that high perceived stress persisted. Although physical activity improved across this period, its change was not significantly associated with mental health after adjustments. However, improved sleep quality was significantly associated with reductions in depression levels, anxiety levels, and perceived stress. These findings highlight the importance of sleep and physical activity in mental health recovery post-pandemic and the need for targeted interventions.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"139 ","pages":"Article 152591"},"PeriodicalIF":4.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contingency-based flexibility mechanisms through a reinforcement learning model in adults with attention-deficit/hyperactivity disorder and obsessive-compulsive disorder","authors":"Rocío Rodríguez-Herrera ,&nbsp;José Juan León ,&nbsp;Pilar Fernández-Martín ,&nbsp;Ana Sánchez-Kuhn ,&nbsp;Miguel Soto-Ontoso ,&nbsp;Laura Amaya-Pascasio ,&nbsp;Patricia Martínez-Sánchez ,&nbsp;Pilar Flores","doi":"10.1016/j.comppsych.2025.152589","DOIUrl":"10.1016/j.comppsych.2025.152589","url":null,"abstract":"<div><h3>Background and aims</h3><div>Impaired cognitive flexibility is associated with the characteristic symptomatology of ADHD and OCD. However, the mechanisms underlying learning and flexibility under uncertainty in adults with OCD or ADHD remain unclear. This study aimed to identify the mechanisms underlying contingency-based flexibility in a sample of adults with ADHD or OCD, using probabilistic learning reversal task, functional near-infrared spectroscopy, and computational modelling.</div></div><div><h3>Methods</h3><div>148 Spanish-speaking adults (43 OCD, 53 ADHD and 52 healthy controls) completed a probabilistic learning reversal task. Previously, we obtained a resting-state functional connectivity (rsFC) record between several frontoparietal network regions using functional near-infrared spectroscopy. Contingency-based flexibility was explored by reinforcement learning model in combination with a Bayesian Generalized Logistic Model (GLM). The reinforcement learning parameters included reward and punishment learning rates (feedback sensitivity), and inverse temperature (decision consistency). Bayesian GLM parameters were defined to measure final accuracy, learning and speed of learning.</div></div><div><h3>Results</h3><div>We found that the groups showed optimal performance in the discrimination block and a higher performance of healthy controls compared to patients in the reversal block. Model parameters predicted task performance differently by phase and group. In the discrimination block, while the performance of healthy controls was predicted by a combination of parameters such as high inverse temperature and punishment learning rate together with low values of reward learning rate, in the case of the clinical groups it was only by high inverse temperature. In the reversal block, the performance of OCD was predicted by high punishment learning rate and that of ADHD by low reward learning rate; in contrast, the performance of healthy controls was also predicted by a combination of parameters with high punishment learning rate and inverse temperature as predictors. We found the rsFC between the left and right posterior parietal cortex appears to credibly predict performance in the discrimination block in healthy controls.</div></div><div><h3>Conclusions</h3><div>These results suggest that OCD and ADHD in adults could be associated with poor behavioral adaptation when reinforcement-punishment contingencies changed. The difficulties observed in ADHD and OCD likely stem from different underlying mechanisms that affect both learning and switching processes. Findings highlighted how OCD appears to show greater sensitivity to punishment when there is uncertainty about the behavior-outcome association. Instead, the ADHD group can be guided by sensitivity to reinforcement. Interhemispheric rsFC posterior parietal cortex could be important for optimal learning of the task.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"139 ","pages":"Article 152589"},"PeriodicalIF":4.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}