European Journal of Psychiatry最新文献

Disentangling empathy for psychological and physical pain in borderline personality disorder: the interplay with clinical features and emotional competence 边缘型人格障碍心理和生理疼痛的共情解缠：与临床特征和情绪能力的相互作用

IF 1.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2026-01-01 DOI: 10.1016/j.ejpsy.2025.100339

Margherita Bechi , Martin Brüne , Giulia Agostoni , Roberta Bortolla , Maria Vittoria Bongiorno , Gea Spada , Martina Ceresi , Anna Rosini , Laura Sforzini , Marta Bosia , Roberto Cavallaro , Vera Flasbeck

Background and objectives

: Patients with Borderline Personality Disorder (BPD) often struggle in social interactions, exhibiting altered empathy and biased emotion recognition. Understanding how these aspects intertwine and relate to BPD symptoms remains unclear. This study aims at evaluating the ability to perceive both psychological and physical pain from a third-person and first-person perspective in BPD people and healthy controls, as well as to explore the interplay with childhood traumas, subjective empathy, alexithymia, emotion dysregulation and severity of symptoms.

Methods

: We utilized the 'Social Interaction Empathy Task' on an Italian sample (49 BPD patients, 52 healthy controls) to explore empathy for physical and psychological pain. We also evaluated emotion recognition alongside traits like alexithymia, childhood trauma, parenting style, dissociation, and impulsivity.

Results

: BPD patients perceived psychologically painful and neutral social situations as more distressing than controls, especially in the first-person perspective. A linear regression analysis revealed that 'Difficulty Describing Feelings' (DDF) subscale of the Toronto Alexithymia Scale (TAS-20) predicted ratings for psychologically painful images from a third-person view. Additionally, BPD patients frequently misinterpreted happy and neutral faces. We also observed correlations between emotion recognition and adverse childhood experiences, parenting style, and symptom severity.

Conclusion

: These findings suggest altered empathy for psychological pain in BPD patients, partly influenced by challenges in articulating emotions.

背景和目的：边缘型人格障碍（BPD）患者经常在社会交往中挣扎，表现出改变的同理心和有偏见的情绪识别。目前尚不清楚这些方面是如何相互交织并与BPD症状相关的。本研究旨在评估BPD患者和健康对照者以第三人称和第一人称视角感知心理和身体疼痛的能力，并探讨其与童年创伤、主观共情、述情障碍、情绪失调和症状严重程度的相互作用。方法：采用“社会互动共情任务”对意大利样本（49例BPD患者，52例健康对照）探讨共情对生理和心理疼痛的影响。我们还评估了情感识别以及述情障碍、童年创伤、父母教养方式、分离和冲动等特征。结果：BPD患者认为心理痛苦和中性的社会情境比对照组更令人痛苦，尤其是在第一人称视角下。线性回归分析显示，多伦多述情障碍量表（TAS-20）的“情感描述难度”（DDF）子量表预测了第三人称视角下心理痛苦图像的评分。此外，BPD患者经常误解快乐和中性的面孔。我们还观察到情绪识别与不良童年经历、父母教养方式和症状严重程度之间的相关性。结论：这些发现表明BPD患者对心理疼痛的共情改变，部分受表达情绪困难的影响。

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引用次数: 0

Heterogeneity in the association between CYP2D6 genotype and antipsychotic-induced extrapyramidal symptoms: A systematic review CYP2D6基因型与抗精神病药物诱导的锥体外系症状相关性的异质性：一项系统综述

IF 1.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2026-01-01 DOI: 10.1016/j.ejpsy.2025.100338

Antonina Luca , Maria Luca , Paolo Olgiati , Alessandro Serretti

Introduction

Cytochrome‑P450 2D6 (CYP2D6) activity modulates the biotransformation of many antipsychotics and neuroactive endobiotics. Functional polymorphisms yielding poor (PM), intermediate (IM), normal (NM) or ultrarapid (UM) metabolic phenotypes could therefore influence vulnerability to extrapyramidal symptoms (EPS). Aim of the present review was to critically summarize the evidence linking CYP2D6 genotype with antipsychotic‑induced EPS.

Methods

A systematic search of PubMed, MEDLINE and EBSCO (1 January 1997 – 28 April 2025) identified studies that: (i) examined CYP2D6 genotype or phenotype in relation to antipsychotic exposure, (ii) quantitatively assessed EPS, and (iii) enrolled ≥ 10 participants.

Results

Eighteen studies (7 prospective cohorts, 10 cross‑sectional studies, 1 randomized controlled trial; total n= 2037 participants) met inclusion criteria. Typical antipsychotics—particularly haloperidol and zuclopenthixol—dominated the exposure profile (64 % of participants). Eleven studies reported a genotype‑EPS association, consistently showing greater EPS prevalence or severity in PM and IM carriers. Reported odds ratios for EPS across included studies ranged ∼2–5 for PM/IM vs EM/UM. Risperidone and haloperidol were the antipsychotics most frequently associated with EPS. Null findings were primarily reported by studies devoid of PM genotypes and enrolling adolescent cohorts receiving second‑generation antipsychotics.

Conclusion

Some studies summarized in the present review supported the role of CYP2D6 genotype in the occurrence of EPS in patients treated with antipsychotics, particularly with high-potency D₂ antagonists. Prospective, genotype‑stratified trials that incorporate concomitant inhibitors/inducers, polygenic scores and pharmacodynamic modifiers are still required before cost‑effective implementation algorithms can be finalized.

细胞色素P450 2D6 （CYP2D6）活性调节许多抗精神病药物和神经活性内源性药物的生物转化。因此，产生不良（PM）、中等（IM）、正常（NM）或超快速（UM）代谢表型的功能多态性可能影响对锥体外系症状（EPS）的易感性。本综述的目的是批判性地总结CYP2D6基因型与抗精神病药物诱导的EPS相关的证据。方法对PubMed， MEDLINE和EBSCO（1997年1月1日- 2025年4月28日）进行系统检索，确定了以下研究：(i)检查CYP2D6基因型或表型与抗精神病药物暴露的关系，（ii）定量评估EPS，（iii）招募≥10名参与者。结果18项研究（7项前瞻性研究，10项横断面研究，1项随机对照试验，共n= 2037名受试者）符合纳入标准。典型的抗精神病药物——尤其是氟哌啶醇和zuclopenthol——在暴露情况中占主导地位（64%的参与者）。11项研究报告了基因型与EPS的关联，一致显示PM和IM携带者中EPS的患病率或严重程度更高。在纳入的研究中，PM/IM与EM/UM的EPS优势比为~ 2-5。利培酮和氟哌啶醇是最常与EPS相关的抗精神病药物。无效结果主要由缺乏PM基因型和纳入接受第二代抗精神病药物的青少年队列的研究报道。结论本综述总结的一些研究支持CYP2D6基因型在抗精神病药物，特别是高效d2拮抗剂治疗患者发生EPS中的作用。在最终确定具有成本效益的实施算法之前，仍需要前瞻性的基因型分层试验，包括伴随抑制剂/诱导剂、多基因评分和药效学调节剂。

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引用次数: 0

Cognitive reserve and brain plasticity in cannabis-using psychosis patients: A systematic review of neuroimaging and intervention studies 大麻使用精神病患者的认知储备和大脑可塑性：神经影像学和干预研究的系统综述

IF 1.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2026-01-01 DOI: 10.1016/j.ejpsy.2025.100332

Valerio Ricci , Giovanni Martinotti , Giuseppe Maina

Background

Cognitive reserve—the brain's capacity to maintain function despite neural damage—and brain plasticity—the capacity for neural reorganization—represent critical factors influencing outcomes in psychotic disorders. Their interaction with cannabis use in patients with psychotic disorders remains poorly understood.

Objective

To examine relationships between cognitive reserve, brain plasticity, and cannabis use in patients with psychotic disorders specifically investigating neuroimaging outcomes including brain structure (gray matter volume, white matter integrity) and function (neural network connectivity).

Methods

Following PRISMA guidelines, we searched four databases from 2010–2025. Studies examining patients with psychotic disorders (schizophrenia, schizoaffective disorder, first-episode psychosis) with documented cannabis use were included, encompassing the full spectrum of exposure patterns from occasional to daily use. Participants were predominantly male (69 %) with mean age 28.7 ± 8.4 years. Cognitive reserve was assessed through educational attainment, premorbid intellectual functioning (estimated IQ), or composite measures combining these indicators. Brain plasticity was measured via training-induced neuroimaging changes.

Results

Twenty-seven studies representing 3164 participants met inclusion criteria. In observational studies (n = 20), higher cognitive reserve was consistently associated with preserved gray matter volume and white matter integrity despite cannabis exposure (effect sizes d = 0.41–0.52). Intervention studies (n = 7) demonstrated that cognitive training produced measurable neuroplastic changes (d = 0.38–0.62 for structural; d = 0.45–0.59 for functional improvements). Cognitive reserve maintained network integrity specifically in cannabis-using patients. Females showed greater training-induced changes, while neuroprotection was most evident in daily cannabis users.

Conclusions

Cognitive reserve provides neuroprotection against cannabis-related brain alterations in psychotic disorders, while neuroplasticity interventions induce significant brain changes. Findings support precision medicine approaches targeting cognitive enhancement based on individual characteristics.

认知储备——大脑在神经损伤的情况下维持功能的能力——和大脑可塑性——神经重组的能力——是影响精神疾病结果的关键因素。它们与精神病患者使用大麻的相互作用仍然知之甚少。目的研究精神障碍患者的认知储备、脑可塑性和大麻使用之间的关系，特别是研究神经影像学结果，包括脑结构（灰质体积、白质完整性）和功能（神经网络连通性）。方法按照PRISMA指南，检索2010-2025年的4个数据库。纳入了对有大麻使用记录的精神病患者（精神分裂症、分裂情感性障碍、首发精神病）的研究，涵盖了从偶尔使用到日常使用的全部暴露模式。参与者以男性为主（69%），平均年龄28.7±8.4岁。认知储备通过受教育程度、病前智力功能（估计智商）或结合这些指标的综合测量来评估。通过训练引起的神经影像学变化来测量大脑的可塑性。结果27项研究3164名受试者符合纳入标准。在观察性研究中（n = 20），尽管大麻暴露，较高的认知储备始终与保留的灰质体积和白质完整性相关（效应量d = 0.41-0.52）。干预研究（n = 7）表明，认知训练产生了可测量的神经可塑性变化（结构改善d = 0.38-0.62；功能改善d = 0.45-0.59）。认知储备维持网络完整性，特别是在使用大麻的患者。女性表现出更大的训练引起的变化，而神经保护在日常大麻使用者中最为明显。结论认知储备对大麻相关的精神障碍脑改变具有神经保护作用，而神经可塑性干预可诱导显著的脑改变。研究结果支持基于个体特征的以认知增强为目标的精准医学方法。

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引用次数: 0

Pharmacogenetics in refractory psychiatric disorders: Clinical utility in two consanguineous patients 难治性精神疾病的药物遗传学：两名近亲患者的临床应用

IF 1.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2026-01-01 DOI: 10.1016/j.ejpsy.2025.100335

Mar Panisello-Cardona , Ivan Martin da Silva , Pau Riera , Sara Bernal , David Almenta , María Gámez Lechuga

引用次数: 0

Exploring the nexus of cognition and insight in euthymic bipolar patients 探索常怀双相情感障碍患者认知与洞察力的关系

IF 1.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2026-01-01 DOI: 10.1016/j.ejpsy.2025.100336

Carmen Massons , Jesus Cobo , Guillem Navarra-Ventura , Muriel Vicent-Gil , Maria Serra-Blasco , Abigail Jubert , Mireia Agut , Diego J Palao , Narcís Cardoner

Background and Objectives

Although the relationship between clinical and cognitive insight in individuals with bipolar disorder remains unclear, both concepts are potentially related to cognitive performance, particularly to executive function. We aimed to explore associations among cognitive variables, cognitive insight, and clinical insight.

Methods

We assessed 64 clinically stable bipolar patients with a battery of clinical and cognitive tests, the Insight Scale for Affective Disorders to assess clinical insight, and the Beck Cognitive Insight Scale (BCIS) to assess cognitive insight. We used bivariate linear regression models to explore associations between cognitive insight, clinical insight, cognition, and sociodemographic and clinical variables, followed by stepwise multiple regression analyses to account for potential confounders.

Results

Global (F = 4.149; B = 0.201; p = 0.047; R2=0.071) and self-reflectiveness BCIS subscale (F = 4.690; B = 0.265; p = 0.043; R2=0.153) scores were positively associated with executive functions. Self-reflectiveness was negatively associated with premorbid intelligence quotient (F = 4.156; B=-0.170; p = 0.046; R2=0.071). Clinical insight was associated only with the self-certainty subscale of the BCIS (F = 4.120; B = 0.360; p = 0.047; R2=0.063).

Conclusions

Reduced cognitive insight is associated with cognitive impairment, especially diminished executive functioning. Elevated self-certainty scores are associated with diminished clinical insight.

背景和目的虽然双相情感障碍患者的临床和认知洞察力之间的关系尚不清楚，但这两个概念都可能与认知表现，特别是执行功能有关。我们的目的是探讨认知变量、认知洞察力和临床洞察力之间的关系。方法采用一系列临床和认知测试对64例临床稳定型双相情感障碍患者进行评估，其中情感障碍洞察力量表评估临床洞察力，贝克认知洞察力量表（BCIS）评估认知洞察力。我们使用双变量线性回归模型来探索认知洞察力、临床洞察力、认知、社会人口学和临床变量之间的关系，然后采用逐步多元回归分析来解释潜在的混杂因素。结果整体评分（F = 4.149; B = 0.201; p = 0.047; R2=0.071）和自我反思BCIS子量表评分（F = 4.690; B = 0.265; p = 0.043; R2=0.153）与执行功能呈正相关。自我反思与病前智商呈负相关（F = 4.156； B=-0.170; p = 0.046; R2=0.071）。临床洞察力仅与BCIS的自我确定性分量表相关（F = 4.120; B = 0.360; p = 0.047; R2=0.063）。结论认知洞察力下降与认知功能障碍有关，尤其是执行功能下降。自我肯定得分升高与临床洞察力下降有关。

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引用次数: 0

Factors involved in working memory in patients with schizophrenia and bipolar disorder: The role of peripheral biomarkers 精神分裂症和双相情感障碍患者工作记忆的相关因素：外周生物标志物的作用

IF 1.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2026-01-01 DOI: 10.1016/j.ejpsy.2025.100334

Gonzalo Paniagua , Julia Rodríguez-Revuelta , Leticia González-Blanco , Manuel Couce-Sánchez , Ainoa García-Fernández , Francesco Dal Santo , Pilar A. Sáiz , M.Paz García-Portilla

Background and objectives

Cognitive impairment, especially working memory (WM) dysfunction, is a core feature of schizophrenia (SZ) and bipolar disorder (BD), influenced by various factors including lifestyle, psychopathology, pharmacological factors, inflammation, and metabolic dysfunction. This study aimed to investigate the role of metabolic, inflammatory, and intestinal permeability biomarkers in WM impairments in SZ and BD patients.

Methods

A cross-sectional, observational study included 146 outpatients (SZ=96, BD=50). We assessed sociodemographic, clinical, metabolic, and inflammatory markers. Cognitive performance was evaluated using the Screen for Cognitive Impairment in Psychiatry. Biomarkers included glycohemoglobin, C-reactive protein, and lipopolysaccharide-binding protein/soluble CD14. Multivariate analyses identified factors associated with WM dysfunction and, secondarily, with other cognitive deficits.

Results

WM impairment was present in 56.3 % of SZ and 52 % of BD patients, without inter-group differences. Independent predictors of WM dysfunction were antipsychotic polypharmacy (OR=2.415, p = 0.011), abdominal obesity (OR=2.884, p = 0.016), and elevated glycohemoglobin (OR=1.126, p = 0.020). While inflammatory and intestinal permeability markers correlated with metabolic parameters, they were not independent predictors of WM impairment.

Conclusion

WM deficits in SZ and BD are primarily associated with metabolic and pharmacological factors. Addressing modifiable metabolic factors, optimizing antipsychotic treatment, and exploring interventions such as metformin and lifestyle modifications may improve cognitive outcomes in these populations.

背景与目的认知功能障碍，尤其是工作记忆功能障碍是精神分裂症（SZ）和双相情感障碍（BD）的核心特征，受生活方式、精神病理、药理因素、炎症和代谢功能障碍等多种因素的影响。本研究旨在探讨代谢、炎症和肠通透性生物标志物在SZ和BD患者WM损伤中的作用。方法采用横断面观察性研究，纳入146例门诊患者（SZ=96， BD=50）。我们评估了社会人口学、临床、代谢和炎症指标。使用精神病学认知障碍筛查评估认知表现。生物标志物包括糖蛋白、c反应蛋白和脂多糖结合蛋白/可溶性CD14。多变量分析确定了与WM功能障碍相关的因素，其次是与其他认知缺陷相关的因素。结果56.3%的SZ和52%的BD患者存在swm损伤，组间差异无统计学意义。WM功能障碍的独立预测因子为抗精神病药物多药（OR=2.415, p = 0.011）、腹部肥胖（OR=2.884, p = 0.016）和糖蛋白升高（OR=1.126, p = 0.020）。虽然炎症和肠通透性标志物与代谢参数相关，但它们并不是WM损伤的独立预测因子。结论SZ和BD的wm缺陷主要与代谢和药理因素有关。解决可改变的代谢因素，优化抗精神病药物治疗，探索干预措施，如二甲双胍和生活方式的改变，可能会改善这些人群的认知结果。

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引用次数: 0

Discriminative utility and limitations of the strengths and difficulties questionnaire for ADHD in a referred clinical pediatric sample 小儿ADHD优势与困难问卷的鉴别效用与局限性

IF 1.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2026-01-01 DOI: 10.1016/j.ejpsy.2025.100333

Erica Fongaro , Arnaud Carlier , Alexandra Vauclare , Judith Brisot-Dubois , Damien Huzard , Hervé Caci , Hala Kerbage , Diane Purper-Ouakil

Background and objectives

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder. However, access to diagnosis and treatment remains limited, requiring improved screening strategies. This study evaluates the discriminative utility of the Strengths and Difficulties Questionnaire (SDQ) for ADHD diagnosis in a clinical sample and explores group differences and the contribution of different informants.

Methods

We conducted a retrospective analysis of 496 children aged 6–16 referred to a mental health clinic; 358 (72.2 %) received a clinical ADHD diagnosis. Baseline SDQ-Parent (SDQ-P) and SDQ-Teacher (SDQ-T) ratings were analyzed. Logistic regression and receiver operating characteristic (ROC) curve analyses were used to assess the diagnostic performance of SDQ subscales against clinical ADHD diagnoses.

Results

ADHD diagnoses were more frequent in males (65.6 %) and in younger children (mean age = 9.53 ± 2.59). Hyperactivity/Inattention showed the highest discrimination (AUC = 0.806 for SDQ-P; 0.883 for SDQ-T). Sensitivity was high but specificity low (.21 (95 % CI [.09, .43]) for SDQ-P; .30 (95 % CI [.07, .65]) for SDQ-T), limiting differential diagnosis. Teacher ratings outperformed parent ratings (higher AUC and specificity), underscoring informant complementarity.

Conclusion

The SDQ—especially Hyperactivity/Inattention—offers useful screening discrimination in referred youth, with teacher ratings outperforming parent ratings; however, low specificity limits differential diagnosis, so confirmation requires structured clinical interviews using multiple informants.

Future work should test calibrated subscale thresholds and local norms to boost discrimination and clarify context effects on SDQ ratings.

背景与目的注意缺陷多动障碍（ADHD）是一种常见的神经发育障碍。然而，获得诊断和治疗的机会仍然有限，需要改进筛查策略。本研究在临床样本中评估了优势与困难问卷（SDQ）对ADHD诊断的判别效用，并探讨了群体差异和不同供者的贡献。方法对496例6-16岁儿童进行回顾性分析；358例（72.2%）接受了临床ADHD诊断。基线SDQ-Parent （SDQ-P）和SDQ-Teacher （SDQ-T）评分进行分析。采用Logistic回归和受试者工作特征（ROC）曲线分析来评估SDQ量表对ADHD临床诊断的诊断效果。结果男性（65.6%）和低龄儿童（平均年龄= 9.53±2.59）的adhd诊断率较高。多动/注意力不集中表现出最高的区别（SDQ-P的AUC = 0.806； SDQ-T的AUC = 0.883）。敏感性高，特异度低(95% ci[。09年。[43])为SDQ-P；．30 (95% ci[。07年,。[65])，限制了SDQ-T的鉴别诊断。教师评分优于家长评分（更高的AUC和特异性），强调了信息的互补性。结论sdq，尤其是多动症/注意力不集中，在转介青少年中提供了有用的筛选区别，教师评分优于家长评分；然而，低特异性限制了鉴别诊断，因此确认需要使用多个信息提供者的结构化临床访谈。未来的工作应该测试校准的子量表阈值和当地规范，以增强歧视并澄清环境对SDQ评级的影响。

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引用次数: 0

Subjective and objective assessment of negative symptoms in patients with schizophrenia and their clinical and functional associations 精神分裂症患者阴性症状的主客观评价及其临床和功能关联

IF 1.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2026-01-01 DOI: 10.1016/j.ejpsy.2025.100331

Jozef Dragasek, Matus Hrebenar, Martina Ruzickova

Background and Objectives

Negative symptoms significantly affect psychosocial functioning and prognosis in schizophrenia. While clinician-rated scales are standard practice, the clinical value of patient-reported subjective assessments remains underexplored. This study investigated associations between subjective (Self-evaluation of Negative Symptoms, SNS) and objective clinician-rated (modified Short Assessment of Negative Domain-negative subscale, m-SAND-N) assessments, their predictive relationships, and links with psychosocial functioning (Personal and Social Performance, PSP).

Methods

This cross-sectional analysis included 188 outpatients with schizophrenia from 20 psychiatric clinics in Slovakia. Participants completed the SNS, followed by structured clinical interviews assessing negative symptoms (m-SAND), clinical severity (CGI-S), PSP, insight, and adherence. Correlation analyses and hierarchical multiple regressions examined the relationships among demographic, clinical, subjective/objective negative symptoms, as well as psychosocial functioning.

Results

Clinician-rated negative symptoms (m-SAND-N) showed significant correlations with patient-reported negative symptoms (SNS; r = 0.38, p < 0.001) and with poorer psychosocial functioning (PSP; r = 0.68, p < 0.001). In hierarchical regression, objective negative symptoms were the principal factor associated with higher subjective ratings (β = 0.332, p < 0.001). Conversely, higher SNS scores (β = 0.179, p < 0.001), greater overall illness severity (CGI-S; β = 0.156, p < 0.05) and poorer psychosocial functioning (PSP; β = 0.583, p < 0.001) were jointly related to more severe clinician-rated negative symptoms, together accounting for 50.7 % of their variance. Subjective ratings of affective blunting did not correlate significantly with clinician assessments, highlighting a divergence between patient- and clinician-reported measures.

Conclusions

Integrating subjective patient assessments with objective clinician ratings provides a comprehensive understanding of negative symptoms, facilitating improved treatment approaches and psychosocial outcomes in schizophrenia. Clinicians should consider patient insight when interpreting discrepancies, especially in affective blunting.

背景与目的：阴性症状显著影响精神分裂症患者的心理社会功能和预后。虽然临床评定量表是标准做法，但患者报告的主观评估的临床价值仍未得到充分探讨。本研究调查了主观（消极症状自我评价，SNS）和客观临床评定（修正的消极领域-消极亚量表短评估，m-SAND-N）评估之间的关联，它们的预测关系，以及与社会心理功能（个人和社会表现，PSP）的联系。方法对斯洛伐克20家精神科诊所的188例精神分裂症门诊患者进行横断面分析。参与者完成了SNS，随后进行了结构化的临床访谈，评估阴性症状（m-SAND）、临床严重程度（CGI-S）、PSP、洞察力和依从性。相关分析和分层多元回归检验了人口统计学、临床、主观/客观阴性症状以及社会心理功能之间的关系。结果临床评定的阴性症状（m-SAND-N）与患者报告的阴性症状（SNS; r = 0.38, p < 0.001）和较差的社会心理功能（PSP; r = 0.68, p < 0.001）呈显著相关。在层次回归中，客观阴性症状是与较高主观评分相关的主要因素（β = 0.332, p < 0.001）。相反，较高的社交网络评分（β = 0.179, p < 0.001）、较高的总体疾病严重程度（cpi - s; β = 0.156, p < 0.05）和较差的社会心理功能（PSP; β = 0.583, p < 0.001）与更严重的临床医生评定的阴性症状相关，共占其方差的50.7%。情感钝化的主观评分与临床医生的评估没有显著的相关性，突出了患者和临床医生报告的测量之间的差异。结论将患者的主观评价与客观的临床医生评分相结合，可以全面了解精神分裂症的阴性症状，促进改善治疗方法和心理社会结局。临床医生在解释差异时应考虑患者的见解，特别是在情感钝化方面。

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引用次数: 0

Late-Onset ADHD symptoms in the general population: A scoping review of longitudinal trajectories in population-based cohorts 一般人群中的迟发性ADHD症状：基于人群的队列纵向轨迹的范围审查

IF 1.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2026-01-01 DOI: 10.1016/j.ejpsy.2025.100337

Sophie Bayard , Clarisse Madiouni , François Radiguer , Maëva Roulin , Sébastien Henrard

Background and objectives

The developmental validity of late-onset ADHD remains debated. This scoping review aimed to synthesize evidence from longitudinal trajectory studies in the general population to (1) examine the existence and characteristics of late-onset ADHD symptom trajectories, and (2) identify associated factors.

Methods

Following PRISMA-ScR guidelines, we systematically reviewed longitudinal studies published up to May 2025 that applied person-centered trajectory modeling to ADHD symptoms in population-based cohorts. Twelve eligible studies were included.

Results

Among the twelve studies included in this scoping review, ten identified at least one symptom trajectory consistent with late-onset ADHD, with prevalence estimates ranging from 3 % to 17.5 %, and were analyzed to examine associated factors. These late-onset trajectories were predominantly inattentive and less disruptive than persistent profiles, but consistently observed across cohorts but were reported in the majority of cohorts (10/12), not all. The most robustly supported associated factors included higher childhood cognitive functioning, fewer early externalizing problems, emerging internalizing psychopathology during adolescence, lower family socioeconomic status, female gender, and polygenic liability for ADHD. However, methodological variability, particularly in informant source, symptom measurement and model specification, significantly influenced identification. Notably, no study assessed sleep-wake disturbances, treatment history, contextual supports or neurological antecedents.

Conclusion

Late-onset ADHD trajectories are commonly identified in general population cohorts (10/12 studies). Their interpretation calls for a dimensional, developmentally sensitive framework. Future studies should incorporate overlooked domains such as sleep-wake functioning, treatment exposure, and neurological risk factors to refine clinical characterization and diagnostic criteria.

背景与目的迟发性ADHD的发展有效性仍有争议。本综述旨在综合来自一般人群纵向轨迹研究的证据，以(1)检验迟发性ADHD症状轨迹的存在及其特征，以及(2)确定相关因素。方法：遵循PRISMA-ScR指南，我们系统地回顾了截至2025年5月发表的纵向研究，这些研究将以人为中心的轨迹模型应用于以人群为基础的队列中的ADHD症状。纳入了12项符合条件的研究。结果本综述纳入的12项研究中，有10项研究确定了至少一种与迟发性ADHD一致的症状轨迹，患病率估计在3%至17.5%之间，并对其进行了分析以检查相关因素。这些迟发性轨迹主要是注意力不集中，比持续性特征破坏性更小，但在整个队列中一致观察到，但在大多数队列（10/12）中报告，而不是全部。最有力支持的相关因素包括较高的儿童认知功能、较少的早期外化问题、青春期出现的内化精神病理、较低的家庭社会经济地位、女性性别和ADHD的多基因易感性。然而，方法的可变性，特别是在信息来源、症状测量和模型规范方面，显著影响了识别。值得注意的是，没有研究评估睡眠-觉醒障碍、治疗史、背景支持或神经学前因。结论：迟发性ADHD轨迹在普通人群队列中普遍存在（10/12项研究）。他们的解释需要一个多维的、对发展敏感的框架。未来的研究应纳入被忽视的领域，如睡眠-觉醒功能、治疗暴露和神经危险因素，以完善临床特征和诊断标准。

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引用次数: 0

Trauma and personality disorders in Danish treatment-seeking veterans 丹麦寻求治疗的退伍军人的创伤和人格障碍

IF 1.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2025-10-01 DOI: 10.1016/j.ejpsy.2025.100327

Ask Elklit , Signe Fauerholdt Sørensen

Background & objectives

50.000 Danish soldiers have been deployed abroad during the last three decades. A recent study reported that 24 % were registered with either a psychiatric diagnosis or receiving psychotropic medication. We want 1) to explore the relationship between ICD-11 PTSD and complex PTSD (CPTSD), and severe personality pathology as well as clinical syndromes, and 2) to assess the mediating impact of social support, secondary trauma symptoms, and aggression for the two trauma diagnoses.

Method

142 male war veterans were assessed at intake to the outpatient services of a specialized trauma treatment facility. The participants completed an assessment battery. In addition to descriptive statistics, two multiple regression analyses were performed: one for PTSD and one for CPTSD.

Results

While less than half of the personality disorders and the clinical syndromes were associated with PTSD, almost all personality disorders and all the clinical syndromes were associated with CPTSD and to a much higher degree. 52 % of the variation of PTSD could be explained in the regression analysis with three significant factors in the final model: Anxiety, schizotypal personality disorder, and dissociation. In the similar analysis for CPTSD, 61 % of the variation was explained in the final model with Avoidant personality disorder and Negative Affectivity as significant factors. Social support and aggression were not significant predictors in either analysis.

Conclusion

The study supports the more severe sequelae associated with CPTSD compared to PTSD. The relationships between trauma disorders and personality pathology deserve more attention to inform the treatment of veterans.

背景和目标在过去的三十年中，有50,000名丹麦士兵被部署在国外。最近的一项研究报告称，24%的人被登记为精神病诊断或接受精神药物治疗。我们希望1)探讨ICD-11 PTSD与复杂创伤后应激障碍（CPTSD）、严重人格病理和临床综合征之间的关系；2)评估社会支持、继发创伤症状和攻击对两种创伤诊断的中介作用。方法对142名男性退伍军人在入院时进行评估。参与者完成了一系列评估。除描述性统计外，还对PTSD和CPTSD进行了两次多元回归分析。结果人格障碍和临床症状与PTSD相关的比例不到一半，而人格障碍和临床症状与CPTSD相关的比例几乎都很高。52%的PTSD变异可以在回归分析中解释，最终模型中有三个显著因素：焦虑、分裂型人格障碍和分离。在CPTSD的类似分析中，61%的变异在最终模型中得到解释，其中逃避型人格障碍和消极情感是显著因素。社会支持和攻击性在两种分析中都不是显著的预测因子。结论与PTSD相比，CPTSD的后遗症更为严重。创伤障碍与人格病理之间的关系值得关注，为退伍军人的治疗提供参考。

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