European Journal of Psychiatry最新文献

Two exploratory studies to investigate the role of self and emotional dysregulation in borderline personality disorder 两项探讨自我和情绪失调在边缘型人格障碍中的作用的探索性研究

IF 1.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2026-04-01 Epub Date: 2026-02-12 DOI: 10.1016/j.ejpsy.2026.100347

Joaquim Soler , Luis Borao , Carlos Schmidt , David Martinez-Rubio , Ausiàs Cebolla , Jesús Montero-Marin , Javier García-Campayo , Santiago Gascón-Santos , Juan C. Pascual

Background and objectives

Emotion dysregulation is traditionally considered a core characteristic of Borderline Personality Disorder (BPD), while alterations in self-concept are often viewed as secondary to emotional dysregulation. "Delusion of Me" (DoM) is a unidimensional construct comprising three domains: acceptance, decentering, and non-attachment. It could be considered closely related to the concept of “self-as-content” and may potentially serve as a measure of this dimension of identity. Across two exploratory studies, the role of DoM as a measure of self-disturbance applied to BPD was investigated.

Method

Study 1: A descriptive study comparing disturbances in self-concept (measured by DoM index) and emotional dysregulation in 127 individuals with BPD and 283 non-clinical comparison participants. Correlations between DoM scores and other clinical variables in BPD were also analyzed. Study 2: An exploratory intervention study comparing changes in DoM scores after participation in a mindfulness skills training (n = 32) with a control group (n = 31) receiving interpersonal effectiveness training.

Results

Individuals with BPD exhibited significantly lower DoM scores compared to non-clinical controls. DoM index correlated with borderline symptoms and emotional overproduction, independent of emotional dysregulation. Additionally, mindfulness training resulted in a significant increase in DoM scores compared to interpersonal effectiveness intervention. Post-intervention, changes in the DoM index predicted improvements in borderline symptoms, independent of changes in emotion dysregulation.

Conclusion

These findings support DoM as a promising transdiagnostic marker of self-disturbances, related to identification, in BPD and suggesting that mindfulness-based interventions may facilitate therapeutic change in part by transforming this component of the self beyond emotional regulation.

背景和目的情绪失调传统上被认为是边缘型人格障碍（BPD）的核心特征，而自我概念的改变通常被认为是情绪失调的次要因素。“自我错觉”（DoM）是一个单维结构，包括三个领域：接受、去中心化和不依恋。它可以被认为与“自我作为内容”的概念密切相关，并可能作为对这方面的认同的衡量标准。在两项探索性研究中，DoM作为一种自我干扰的测量方法应用于BPD进行了研究。方法研究1：对127名BPD患者和283名非临床对照者的自我概念障碍（DoM指数测量）和情绪失调进行描述性研究。并分析了DoM评分与BPD其他临床变量的相关性。研究2：一项探索性干预研究，比较参加正念技能训练（n = 32）和对照组（n = 31）接受人际效能训练后DoM得分的变化。结果与非临床对照组相比，BPD患者表现出明显较低的DoM得分。DoM指数与边缘性症状和情绪过度产生相关，独立于情绪失调。此外，与人际有效性干预相比，正念训练导致DoM得分显著增加。干预后，DoM指数的变化预示着边缘症状的改善，与情绪失调的变化无关。结论：这些发现支持DoM作为BPD中与识别相关的自我障碍的一种有希望的跨诊断标记物，并表明基于正念的干预可能通过将自我的这一部分转化为情绪调节之外的部分来促进治疗变化。

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引用次数: 0

Sex differences in the efficacy of cognitive behavioral therapy for adults with attention-deficit/hyperactivity disorder 成人注意缺陷/多动障碍认知行为治疗效果的性别差异

IF 1.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2026-04-01 Epub Date: 2026-02-07 DOI: 10.1016/j.ejpsy.2026.100345

Juan Jesús Crespín , Montse Corrales , Vanesa Richarte , Gemma Parramón , Santiago Biel , Ferran Mestres , Carolina Ramos-Sayalero , Pol Ibáñez , Gemma Nieva , Carla Torrent , Derek Clougher , Christian Fadeuilhe , Silvia Amoretti , Josep Antoni Ramos-Quiroga

Background and objectives

Cognitive Behavioral Therapy (CBT) is an effective adjunctive treatment for Attention-Deficit/Hyperactivity Disorder (ADHD). This study examined sex differences in the efficacy of a brief 6-session CBT program versus a traditional 12-session format, combined with stable pharmacotherapy, in adults with ADHD.

Methods

A total of 81 adults (58 % male; 41.27 ± 9.26 years) were randomly assigned to 6- or 12-session CBT. ADHD symptoms, psychopathology, and functioning were assessed at baseline, post-treatment, and 3- and 6-month follow-up. Mixed-effects models analyzed interactions between time, treatment group, and sex.

Results

At baseline, females exhibited greater symptom severity (p = 0.019), higher inattention (p < 0.001), and more pronounced impairments (p = 0.004). CBT led to significant clinical improvements regardless of sex. A significant time-by-sex interaction emerged for inattention (CAARS:O:L, p = 0.043), although it did not remain significant after adjusting for baseline severity. Regarding time × group × sex interactions, females in the 6-session group showed smaller reductions in clinical severity during follow-up (CGI-S, p = 0.047); however, this effect was no longer statistically significant after controlling for baseline ADHD severity. Findings should be interpreted with caution given the limited female sample at follow-up and the significant influence of initial symptom burden on long-term trajectories.

Conclusions

CBT improves ADHD symptoms and related impairments in adults, with comparable overall benefits across sexes. Treatment response follow-up differences were better explained by baseline severity and treatment intensity rather than sex-specific differences.

背景与目的认知行为疗法（CBT）是治疗注意力缺陷/多动障碍（ADHD）的有效辅助疗法。这项研究考察了在成人多动症患者中，简短的6期CBT治疗方案与传统的12期CBT治疗方案（结合稳定的药物治疗）在疗效上的性别差异。方法81例成人（男性58%，41.27±9.26岁）随机分为6期和12期CBT组。在基线、治疗后以及3个月和6个月的随访中评估ADHD症状、精神病理和功能。混合效应模型分析了时间、治疗组和性别之间的相互作用。结果在基线时，女性表现出更严重的症状（p = 0.019）、更严重的注意力不集中（p < 0.001）和更明显的损伤（p = 0.004）。无论性别，CBT都能显著改善临床症状。注意力不集中出现了显著的时间-性别交互作用（CAARS: 0:L, p = 0.043），尽管在调整基线严重程度后它仍然不显著。在时间×组×性别互动方面，6次治疗组的女性在随访期间的临床严重程度降低较小（CGI-S, p = 0.047）；然而，在控制了基线ADHD严重程度后，这种效应不再具有统计学意义。考虑到随访时女性样本有限，以及初始症状负担对长期发展轨迹的显著影响，研究结果应谨慎解释。结论：scbt可改善成人ADHD症状和相关损伤，在两性中具有相当的总体益处。治疗反应的随访差异更好地解释了基线严重程度和治疗强度，而不是性别特异性差异。

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引用次数: 0

Mixed-methods analysis of formulations in functional neurological disorder 功能性神经障碍制剂的混合方法分析

IF 1.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2026-04-01 Epub Date: 2026-02-13 DOI: 10.1016/j.ejpsy.2026.100348

Myles Gutkin , Richard A Kanaan , Richard J Brown

Background and objectives

Functional Neurological Disorder (FND) is a relatively common neuropsychiatric condition characterised by disabling or distressing, but potentially reversible, neurological symptoms. There are no well-validated treatments, despite emerging evidence for several psychotherapies. A formulation is a set of explanatory hypotheses answering the question ‘why does this patient suffer from this problem at this time?’ This study examined the formulations of adults with FND who were treated with Shared Individual Formulation Therapy (SIFT). SIFT uses clinical history-taking and hypothesis-refinement over several sessions to collaboratively formulate how symptoms have emerged in the context of the patient’s life experience, to identify relevant vulnerabilities and coping strategies. A shared individual formulation is co-written and verified with each participant to ensure it represents their experience accurately. Our objective was to explore the patterns and associations in these formulations.

Methods

We extracted the formulations from twenty-four letters generated during a prospective, open-label trial of SIFT for FND. Framework analysis was used to identify the key features (‘exposures’, ‘schemas’, ‘activations’ and ‘mechanisms’) within each formulation. Subgroups identified using hierarchical clustering were compared statistically across characteristics, therapy ratings and outcome scores.

Results

Three clusters were identified. Two were characterised by overvigilance and body focus (n = 10), and one was characterised by dissociation and other directedness (n = 14). There was some indication of possible differences in treatment response, but numbers were too small to draw firm conclusions.

Conclusion

Findings support the psychological heterogeneity of adults with FND. Analysis of formulations can be used to identify clinically distinct subgroups.

背景和目的功能性神经障碍（FND）是一种相对常见的神经精神疾病，其特征是致残或痛苦，但可能可逆的神经症状。尽管出现了几种心理疗法的证据，但目前还没有得到充分验证的治疗方法。公式是一组解释性假设，回答这个问题“为什么这个病人在这个时候会有这个问题？”“这项研究检查了接受共享个体配方疗法（SIFT）治疗的成年FND患者的配方。SIFT使用临床病史和假设的改进，在几次会议上共同制定症状是如何在患者生活经历的背景下出现的，以确定相关的脆弱性和应对策略。一个共享的个人公式是与每个参与者共同编写和验证的，以确保它准确地代表了他们的经验。我们的目标是探索这些配方中的模式和关联。方法：我们从一项前瞻性、开放标签的SIFT治疗FND试验中产生的24个字母中提取配方。框架分析用于确定每个公式中的关键特征（“暴露”、“模式”、“激活”和“机制”）。采用分层聚类确定的亚组在特征、治疗评分和结局评分方面进行统计学比较。结果鉴定出3个聚类。两组以过度警觉和身体集中为特征（n = 10），一组以游离和其他定向为特征（n = 14）。有一些迹象表明，在治疗反应方面可能存在差异，但数量太少，无法得出确切的结论。结论研究结果支持成年FND患者的心理异质性。配方分析可用于识别临床不同的亚群。

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引用次数: 0

Translating human rights into perinatal mental health policy in Spain 将人权转化为西班牙的围产期心理健康政策

IF 1.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2026-01-01 Epub Date: 2026-01-28 DOI: 10.1016/j.ejpsy.2026.100344

Rocío Paricio-del-Castillo

引用次数: 0

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 Epub Date: 2026-01-02 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 Epub Date: 2026-01-02 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 Epub Date: 2026-01-02 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 Epub Date: 2026-01-09 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 Epub Date: 2026-01-02 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

The role of 6-lead mobile ECG devices in monitoring QT interval in routine psychiatry clinics: A clozapine cohort survey 6导联移动心电图设备在常规精神病学诊所监测QT间期中的作用：一项氯氮平队列调查

IF 1.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2026-01-01 Epub Date: 2026-02-05 DOI: 10.1016/j.ejpsy.2026.100346

Leticia-Irene Muñoz-Manchado , Natalia Jagodzinska , Rudolf N. Cardinal , Jose-Ildefonso Perez-Revuelta , Julia B. Deakin , Jose-María Villagrán-Moreno , Emilio Fernández-Egea

Background and objetives

Cardiovascular risk assessment is crucial to reduce excess mortality in schizophrenia. We aimed to evaluate the use of a recently developed portable electrocardiography (ECG) device to measure the corrected QT interval (QTc) in a United Kingdom National Health Service (UK NHS) clinical setting and to explore its relationship with clozapine plasma levels.

Methods

Electronic health records were reviewed over one year of routine clinical practice (Sep 2022–Sep 2023) in a cohort of clozapine-treated patients. Use of the portable ECG device and data from different QTc correction formulae were analysed. Correlations between QTc, clozapine dose, and plasma levels were tested.

Results

A total of 300 consecutive clinical appointments were included, covering 184 patients. QTc was recorded in 75% (N = 138) of patients. The prevalence of prolonged QTc varied by formula, ranging from 3% to 9.3% (N = 9–28 patients depending on the QTc used formula). In 63 patients with plasma clozapine concentrations measured within two months of ECG, no significant correlation was found between clozapine levels and QTc interval (p = 0.1).

Conclusions

Portable ECG devices provide a simple and accessible tool for cardiac monitoring in patients on antipsychotics in routine clinical care. Our findings indicate a non-significant trend towards an association between QTc duration and plasma clozapine levels, highlighting the value of integrated monitoring strategies.

背景和目的心血管风险评估对于降低精神分裂症的超额死亡率至关重要。我们的目的是评估最近开发的便携式心电图（ECG）设备在英国国家卫生服务（UK NHS）临床环境中测量校正QT间期（QTc）的使用情况，并探讨其与氯氮平血浆水平的关系。方法回顾性分析氯氮平治疗患者1年（2022年9月- 2023年9月）的电子健康记录。分析了便携式心电仪的使用情况和不同QTc校正公式的数据。检测QTc、氯氮平剂量和血浆水平之间的相关性。结果共纳入连续临床预约300次，患者184例。75% （N = 138）的患者有QTc记录。延长QTc的患病率因配方而异，从3%到9.3%不等（N = 9-28例患者，取决于所使用的QTc配方）。在63例心电图2个月内测量氯氮平血浆浓度的患者中，氯氮平水平与QTc间期无显著相关性（p = 0.1）。结论便携式心电仪为临床常规治疗抗精神病药物患者提供了一种简便易行的心电监测工具。我们的研究结果表明，QTc持续时间与血浆氯氮平水平之间的关联趋势不显著，突出了综合监测策略的价值。

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引用次数: 0