Pub Date : 2026-01-01DOI: 10.1016/j.ejpsy.2026.100343
Mathilde Souchon , Raffaella Calati , Lissa Garcia Segui , Madison Roopchand , Adriana Foster , Marta Maisto , Daniele Romano , Giuseppe Delvecchio , Paolo Brambilla , Fabio Madeddu , Jorge Lopez-Castroman
Empathy for pain (EfP) refers to the capacity to experience and understand others’ pain and represents a fundamental process for psychosocial functioning. Psychiatric literature on EfP remains at times paradoxical, reflecting both intra- and interindividual variability. Notably, EfP appears either diminished or heightened across various psychiatric conditions. This scoping review aims to synthesize current findings to identify unifying patterns, focusing specifically on the influence of early life adversity (ELA), adulthood stressors, and personality traits on EfP processes. The literature was reviewed across two core domains: the neurobiological mechanisms underlying EfP and psychiatric diagnoses characterized by empathic dysfunction. Therapeutic implications are also discussed.
EfP consistently recruits the anterior insula and anterior cingulate cortex. Exposure to stressors results in differential patterns of activation in this core network, depending on the nature and severity of the experienced stress. Severe ELA heightens sensitivity to negative emotional cues and disrupts the balance between emotional and cognitive components of empathy, while moderate ELA induces a global decrease in both. Stressors encountered in adulthood tend to blunt empathic responses overall. Personality traits and disorders show specific EfP patterns: individuals with borderline personality disorder tend to display heightened emotional responses to others’ pain, while those with psychopathic traits exhibit reduced emotional signal processing. Mentalization-based treatment has shown promising results in improving empathy deficits in personality disorders. Other approaches, such as mindfulness-based interventions and behavioral empathy training, may also support empathic functioning but remain under-investigated.
{"title":"The paradox of empathy for pain: Personality, adversity, and affective resonance in psychiatry","authors":"Mathilde Souchon , Raffaella Calati , Lissa Garcia Segui , Madison Roopchand , Adriana Foster , Marta Maisto , Daniele Romano , Giuseppe Delvecchio , Paolo Brambilla , Fabio Madeddu , Jorge Lopez-Castroman","doi":"10.1016/j.ejpsy.2026.100343","DOIUrl":"10.1016/j.ejpsy.2026.100343","url":null,"abstract":"<div><div>Empathy for pain (EfP) refers to the capacity to experience and understand others’ pain and represents a fundamental process for psychosocial functioning. Psychiatric literature on EfP remains at times paradoxical, reflecting both intra- and interindividual variability. Notably, EfP appears either diminished or heightened across various psychiatric conditions. This scoping review aims to synthesize current findings to identify unifying patterns, focusing specifically on the influence of early life adversity (ELA), adulthood stressors, and personality traits on EfP processes. The literature was reviewed across two core domains: the neurobiological mechanisms underlying EfP and psychiatric diagnoses characterized by empathic dysfunction. Therapeutic implications are also discussed.</div><div>EfP consistently recruits the anterior insula and anterior cingulate cortex. Exposure to stressors results in differential patterns of activation in this core network, depending on the nature and severity of the experienced stress. Severe ELA heightens sensitivity to negative emotional cues and disrupts the balance between emotional and cognitive components of empathy, while moderate ELA induces a global decrease in both. Stressors encountered in adulthood tend to blunt empathic responses overall. Personality traits and disorders show specific EfP patterns: individuals with borderline personality disorder tend to display heightened emotional responses to others’ pain, while those with psychopathic traits exhibit reduced emotional signal processing. Mentalization-based treatment has shown promising results in improving empathy deficits in personality disorders. Other approaches, such as mindfulness-based interventions and behavioral empathy training, may also support empathic functioning but remain under-investigated.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"40 1","pages":"Article 100343"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 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。
{"title":"Subjective and objective assessment of negative symptoms in patients with schizophrenia and their clinical and functional associations","authors":"Jozef Dragasek, Matus Hrebenar, Martina Ruzickova","doi":"10.1016/j.ejpsy.2025.100331","DOIUrl":"10.1016/j.ejpsy.2025.100331","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>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).</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>Clinician-rated negative symptoms (m-SAND-N) showed significant correlations with patient-reported negative symptoms (SNS; <em>r</em> = 0.38, <em>p</em> < 0.001) and with poorer psychosocial functioning (PSP; <em>r</em> = 0.68, <em>p</em> < 0.001). In hierarchical regression, objective negative symptoms were the principal factor associated with higher subjective ratings (β = 0.332, <em>p</em> < 0.001). Conversely, higher SNS scores (β = 0.179, <em>p</em> < 0.001), greater overall illness severity (CGI-S; β = 0.156, <em>p</em> < 0.05) and poorer psychosocial functioning (PSP; β = 0.583, <em>p</em> < 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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"40 1","pages":"Article 100331"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145974146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Discriminative utility and limitations of the strengths and difficulties questionnaire for ADHD in a referred clinical pediatric sample","authors":"Erica Fongaro , Arnaud Carlier , Alexandra Vauclare , Judith Brisot-Dubois , Damien Huzard , Hervé Caci , Hala Kerbage , Diane Purper-Ouakil","doi":"10.1016/j.ejpsy.2025.100333","DOIUrl":"10.1016/j.ejpsy.2025.100333","url":null,"abstract":"<div><h3>Background and objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div><div>Future work should test calibrated subscale thresholds and local norms to boost discrimination and clarify context effects on SDQ ratings.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"40 1","pages":"Article 100333"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145876950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 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.
{"title":"Late-Onset ADHD symptoms in the general population: A scoping review of longitudinal trajectories in population-based cohorts","authors":"Sophie Bayard , Clarisse Madiouni , François Radiguer , Maëva Roulin , Sébastien Henrard","doi":"10.1016/j.ejpsy.2025.100337","DOIUrl":"10.1016/j.ejpsy.2025.100337","url":null,"abstract":"<div><h3>Background and objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"40 1","pages":"Article 100337"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145940124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.ejpsy.2026.100341
Maria Antonieta Also Fontanet , Sandra Murgui , Elisenda Sant , Mireia Sans-Corrales , Antoni Sisó-Almirall , Ariadna Mas , Clàudia Valenzuela-Pascual , Gerard Anmella , Jordi Blanch , Myriam Cavero , Eduard Vieta , Diego Hidalgo-Mazzei
Background and objectives
Benzodiazepine (BZD) consumption has increased globally, with Spain among the highest-use countries. This study examines factors associated with intensive BZD in Catalonia’s primary care (PC) from 2010–2019.
Methods
Analyzed data from 713,196 adults attending PC without mental health service contact, excluding children, adolescents, and individuals with alcohol use disorders. Intensive BZD use was defined as >56 Defined Daily Doses within an 8-week period. A hurdle model with a negative binomial distribution assessed factors influencing initiation and duration of intensive prescriptions. Multiple imputation addressed missing covariates.
Results
Of the study population, 67,184 adults (9.4%) received intensive BZD prescriptions in at least one year. Persistent users—those with prescriptions in all 10 follow-up years—numbered 6,767 and were predominantly female (81.6%) and Spanish nationals (99.2%). After adjustment, 54 of 92 associations (58.7%) remained significant. The strongest for sex, hypertension, and nationality:Females showed a 39% increase in the odds of heavy BZD use, while non-Spanish nationality was associated with a 45% reduction. Hypertension increased the odds by 57%, constituting comorbidity with the greatest impact on heavy use.Among persistent users, the most frequent diagnoses were anxiety (15.1%), insomnia (13.3%), and depression (8.5%).
Conclusions
Findings show initiation and persistence of intensive BZD use are influenced by different factors: initiation relates to sociodemographic characteristics, while persistence is driven by medical complexity. Women, Spanish nationals, and patients with hypertension are at highest risk of long-term use, underscoring the need for targeted interventions and deprescribing strategies.
{"title":"Use of benzodiazepines in primary care: prescriptions from 2010 to 2019 in Catalonia","authors":"Maria Antonieta Also Fontanet , Sandra Murgui , Elisenda Sant , Mireia Sans-Corrales , Antoni Sisó-Almirall , Ariadna Mas , Clàudia Valenzuela-Pascual , Gerard Anmella , Jordi Blanch , Myriam Cavero , Eduard Vieta , Diego Hidalgo-Mazzei","doi":"10.1016/j.ejpsy.2026.100341","DOIUrl":"10.1016/j.ejpsy.2026.100341","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Benzodiazepine (BZD) consumption has increased globally, with Spain among the highest-use countries. This study examines factors associated with intensive BZD in Catalonia’s primary care (PC) from 2010–2019.</div></div><div><h3>Methods</h3><div>Analyzed data from 713,196 adults attending PC without mental health service contact, excluding children, adolescents, and individuals with alcohol use disorders. Intensive BZD use was defined as >56 Defined Daily Doses within an 8-week period. A hurdle model with a negative binomial distribution assessed factors influencing initiation and duration of intensive prescriptions. Multiple imputation addressed missing covariates.</div></div><div><h3>Results</h3><div>Of the study population, 67,184 adults (9.4%) received intensive BZD prescriptions in at least one year. Persistent users—those with prescriptions in all 10 follow-up years—numbered 6,767 and were predominantly female (81.6%) and Spanish nationals (99.2%). After adjustment, 54 of 92 associations (58.7%) remained significant. The strongest for sex, hypertension, and nationality:Females showed a 39% increase in the odds of heavy BZD use, while non-Spanish nationality was associated with a 45% reduction. Hypertension increased the odds by 57%, constituting comorbidity with the greatest impact on heavy use.Among persistent users, the most frequent diagnoses were anxiety (15.1%), insomnia (13.3%), and depression (8.5%).</div></div><div><h3>Conclusions</h3><div>Findings show initiation and persistence of intensive BZD use are influenced by different factors: initiation relates to sociodemographic characteristics, while persistence is driven by medical complexity. Women, Spanish nationals, and patients with hypertension are at highest risk of long-term use, underscoring the need for targeted interventions and deprescribing strategies.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"40 1","pages":"Article 100341"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146034315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 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.
{"title":"Trauma and personality disorders in Danish treatment-seeking veterans","authors":"Ask Elklit , Signe Fauerholdt Sørensen","doi":"10.1016/j.ejpsy.2025.100327","DOIUrl":"10.1016/j.ejpsy.2025.100327","url":null,"abstract":"<div><h3>Background & objectives</h3><div>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.</div></div><div><h3>Method</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 4","pages":"Article 100327"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.ejpsy.2025.100326
João Cortes Cardoso , Cíntia Águas Pereira , Silvana Galderisi , Mariana Pinto da Costa , Meryam Schouler-Ocak , Thomas Pollmächer , Luís Madeira
Background and Objectives
In recent years, tensions have risen between the legislative context of Mental Health Laws (MHL) across Europe and the provisions set forth by the UN Convention on the Rights of Persons with Disabilities, pointing to ongoing discussions about autonomy and the conditions under which involuntary measures may occur.
Methods
A comparative analysis of national Mental Health Laws (MHL) across 44 European countries was conducted, focusing on legal frameworks for involuntary psychiatric care. It identifies 38 countries with MHL, excluding six without national legislation or where mental health is governed by regional frameworks. Data were collected from official sources and verified through the WHO Mental Health Atlas 2020. A total of 38 MHLs were analysed across four key domains: general definitions, formal procedures for involuntary admission, emergency procedures, and best practices in involuntary care.
Results
All MHLs require the presence of a mental disorder for involuntary admission, with 92 % also citing dangerousness. However, only 45 % provide a legal definition of mental disorder, and 29 % reference international diagnostic criteria (e.g., ICD, DSM). Procedures for involuntary admission are typically initiated by healthcare professionals (66 %), with courts serving as the primary deciding authority in 76 % of cases. Emergency detention durations vary, with many countries lacking clear limits. Best practices—such as distinguishing admission from treatment, allowing outpatient commitment, and requiring periodic legal review—are applied inconsistently. Only 14 countries explicitly prohibit controversial practices like psychosurgery or non-consensual ECT. While most laws emphasize protection of rights, the study highlights ethical tensions with the UN Convention on the Rights of Persons with Disabilities (CRPD), particularly around involuntary measures. Limitations include reliance on translated texts, the omission of subnational laws, and the lack of enforcement analysis.
Conclusions
These findings highlight the need for harmonized legal standards, enhanced procedural safeguards, and stronger rights-based frameworks in mental health legislation across Europe. Reforms should aim for standardized legal definitions, clearer procedures, and alignment with international norms, while remaining sensitive to clinical and cultural contexts.
近年来,欧洲各地的精神卫生法(MHL)的立法背景与联合国残疾人权利公约(Convention on Persons of Disabilities)的规定之间的紧张关系日益加剧,关于自主性和可能发生非自愿措施的条件的讨论正在进行中。方法对44个欧洲国家的国家精神卫生法(MHL)进行比较分析,重点是非自愿精神科护理的法律框架。报告确定了38个存在精神卫生问题的国家,但不包括6个没有国家立法或精神卫生由区域框架管理的国家。数据从官方来源收集,并通过世卫组织《2020年精神卫生地图集》进行核实。总共分析了四个关键领域的38个mhl:一般定义、非自愿入院的正式程序、紧急程序和非自愿护理的最佳做法。结果:所有mhl患者在非自愿入院时都需要有精神障碍,其中92%的患者还提到了危险。然而,只有45%提供了精神障碍的法律定义,29%参考了国际诊断标准(例如,ICD, DSM)。非自愿入院的程序通常由保健专业人员发起(66%),在76%的案件中,法院作为主要裁决机构。紧急拘留期限各不相同,许多国家缺乏明确的限制。最佳实践——例如区分入院和治疗,允许门诊承诺,以及要求定期法律审查——的应用并不一致。只有14个国家明确禁止有争议的做法,如精神外科手术或未经同意的ECT。虽然大多数法律都强调对权利的保护,但该研究强调了与《联合国残疾人权利公约》(CRPD)在道德上的紧张关系,特别是在非自愿措施方面。限制包括依赖翻译文本、遗漏地方法律以及缺乏执行分析。结论:这些发现突出表明,需要在整个欧洲的精神卫生立法中统一法律标准、加强程序保障和更强有力的基于权利的框架。改革的目标应是标准化的法律定义、更明确的程序以及与国际规范保持一致,同时对临床和文化背景保持敏感。
{"title":"Mental health law in Europe: Structures, standards, and ethical dilemmas a comparative analysis of 38 national frameworks in light of international guidelines, regarding involuntary measures in mental healthcare services","authors":"João Cortes Cardoso , Cíntia Águas Pereira , Silvana Galderisi , Mariana Pinto da Costa , Meryam Schouler-Ocak , Thomas Pollmächer , Luís Madeira","doi":"10.1016/j.ejpsy.2025.100326","DOIUrl":"10.1016/j.ejpsy.2025.100326","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>In recent years, tensions have risen between the legislative context of Mental Health Laws (MHL) across Europe and the provisions set forth by the UN Convention on the Rights of Persons with Disabilities, pointing to ongoing discussions about autonomy and the conditions under which involuntary measures may occur.</div></div><div><h3>Methods</h3><div>A comparative analysis of national Mental Health Laws (MHL) across 44 European countries was conducted, focusing on legal frameworks for involuntary psychiatric care. It identifies 38 countries with MHL, excluding six without national legislation or where mental health is governed by regional frameworks. Data were collected from official sources and verified through the WHO Mental Health Atlas 2020. A total of 38 MHLs were analysed across four key domains: general definitions, formal procedures for involuntary admission, emergency procedures, and best practices in involuntary care.</div></div><div><h3>Results</h3><div>All MHLs require the presence of a mental disorder for involuntary admission, with 92 % also citing dangerousness. However, only 45 % provide a legal definition of mental disorder, and 29 % reference international diagnostic criteria (e.g., ICD, DSM). Procedures for involuntary admission are typically initiated by healthcare professionals (66 %), with courts serving as the primary deciding authority in 76 % of cases. Emergency detention durations vary, with many countries lacking clear limits. Best practices—such as distinguishing admission from treatment, allowing outpatient commitment, and requiring periodic legal review—are applied inconsistently. Only 14 countries explicitly prohibit controversial practices like psychosurgery or non-consensual ECT. While most laws emphasize protection of rights, the study highlights ethical tensions with the UN Convention on the Rights of Persons with Disabilities (CRPD), particularly around involuntary measures. Limitations include reliance on translated texts, the omission of subnational laws, and the lack of enforcement analysis.</div></div><div><h3>Conclusions</h3><div>These findings highlight the need for harmonized legal standards, enhanced procedural safeguards, and stronger rights-based frameworks in mental health legislation across Europe. Reforms should aim for standardized legal definitions, clearer procedures, and alignment with international norms, while remaining sensitive to clinical and cultural contexts.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 4","pages":"Article 100326"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145324556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.ejpsy.2025.100323
L.I. Muñoz-Manchado , M. Bernardo , J.M. Villagrán-Moreno , E. Fernández-Egea
Background and objectives
Schizophrenia is a psychiatric disorder with a global crude prevalence of approximately 23.6 million individuals and ranks among the top ten leading causes of disability worldwide. Antipsychotic medications, including olanzapine (Zyprexa), represent the most effective treatment option for these patients. This study aimed to assess the current prescribing patterns of olanzapine (Zyprexa).
Methods
To explore real-world prescribing patterns of olanzapine (Zyprexa), patient adherence, and the perceived incidence of adverse effects—especially metabolic syndrome—a structured, purpose-designed survey was distributed to psychiatrists across Spain.
Results
A total of 197 Consultant psychiatrists practising in Spain responded to a survey on olanzapine (Zyprexa) use patterns. olanzapine (Zyprexa) was noted for its high efficacy, rapid onset of action, and tolerability. The majority of psychiatrists (77.8 %) reported prescribing olanzapine (Zyprexa) primarily to patients aged 31–50 years. Regarding metabolic syndrome, out of 111 responses, 60.4 % (66 psychiatrists) considered olanzapine (Zyprexa) to be associated with a higher incidence of metabolic syndrome, which was reported to occur predominantly at an early stage (61.3 %).
Conclusions
Treatment adherence to olanzapine (Zyprexa) may be negatively affected by adverse events such as weight gain and the development of metabolic syndrome, which could serve as causal factors for treatment discontinuation. The implementation of both pharmacological and non-pharmacological strategies aimed at metabolic control may play a key role in optimizing the therapeutic management of schizophrenia.
{"title":"Clinical practice and metabolic consequences of olanzapine use in schizophrenia: results from a national survey in Spain","authors":"L.I. Muñoz-Manchado , M. Bernardo , J.M. Villagrán-Moreno , E. Fernández-Egea","doi":"10.1016/j.ejpsy.2025.100323","DOIUrl":"10.1016/j.ejpsy.2025.100323","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Schizophrenia is a psychiatric disorder with a global crude prevalence of approximately 23.6 million individuals and ranks among the top ten leading causes of disability worldwide. Antipsychotic medications, including olanzapine (Zyprexa), represent the most effective treatment option for these patients. This study aimed to assess the current prescribing patterns of olanzapine (Zyprexa).</div></div><div><h3>Methods</h3><div>To explore real-world prescribing patterns of olanzapine (Zyprexa), patient adherence, and the perceived incidence of adverse effects—especially metabolic syndrome—a structured, purpose-designed survey was distributed to psychiatrists across Spain.</div></div><div><h3>Results</h3><div>A total of 197 Consultant psychiatrists practising in Spain responded to a survey on olanzapine (Zyprexa) use patterns. olanzapine (Zyprexa) was noted for its high efficacy, rapid onset of action, and tolerability. The majority of psychiatrists (77.8 %) reported prescribing olanzapine (Zyprexa) primarily to patients aged 31–50 years. Regarding metabolic syndrome, out of 111 responses, 60.4 % (66 psychiatrists) considered olanzapine (Zyprexa) to be associated with a higher incidence of metabolic syndrome, which was reported to occur predominantly at an early stage (61.3 %).</div></div><div><h3>Conclusions</h3><div>Treatment adherence to olanzapine (Zyprexa) may be negatively affected by adverse events such as weight gain and the development of metabolic syndrome, which could serve as causal factors for treatment discontinuation. The implementation of both pharmacological and non-pharmacological strategies aimed at metabolic control may play a key role in optimizing the therapeutic management of schizophrenia.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 4","pages":"Article 100323"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145358594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.ejpsy.2025.100328
Esther Rosado , Amalia Zarzuela , Gustavo J. Gil-Berrozpe , Xabier Ansorena , Julen Chato , Victor Peralta , Manuel J. Cuesta , Ana M. Sánchez-Torres
Background and objectives
Individuals with psychotic disorders may display over the illness course a wide range of core deficits in clinical and cognitive domains, including social cognition (SC). One of the main domains of SC is emotional processing, a key component of emotional intelligence (EI). However, the extent to which EI, as self-perceived or performance-based, is related to psychopathological domains has been scarcely studied. This study aimed to examine the relationships between self-reported EI and performance-based EI with psychopathological and insight dimensions as well as to explore the correspondence between both types of EI assessments.
Methods
Seventy patients with psychotic disorders who were consecutively admitted to a psychiatric hospitalization unit were included. Psychotic, affective, and insight dimensions, as well as EI, were evaluated once psychopathological stability had been achieved.
Results
Manic symptoms were associated with greater emotional clarity (r = 0.25, p < 0.05) and regulation (r = 0.30, p < 0.05), whereas depressive symptoms were associated with lower emotional regulation (r=-0.25, p < 0.05). No significant relationships were found between the EI measures and psychotic dimensions. Lack of feeling sick and lack of insight were related to worse performance-based EI (emotional management, r=-0.29 and r=-0.25, p < 0.05) and self-reported EI (emotional attention, r=-0.24, p < 0.05 and r=-0.31, p < 0.01), and the former was also related to better emotional regulation (r = 0.26, p < 0.05).
Conclusion
The discrepancy between self-reported and performance-based EI regarding their associations with psychopathological domains might be due to the different sources of assessment but may also add evidence to the need to integrate patient-reported outcome measures in the assessment of social cognition.
背景和目的精神病患者在病程中可能表现出临床和认知领域的广泛核心缺陷,包括社会认知(SC)。情感处理是情感智力(EI)的一个重要组成部分。然而,在多大程度上,EI,作为自我感知或绩效为基础,是与精神病理领域的研究很少。本研究旨在探讨自我报告型情商和绩效型情商在精神病理和洞察力维度上的关系,并探讨两种情商评估之间的对应关系。方法选取连续入住精神科的70例精神障碍患者。一旦达到精神病理稳定,就对精神病、情感和洞察力维度以及EI进行评估。结果躁狂症状与情绪清晰度(r= 0.25, p < 0.05)和情绪调节能力(r= 0.30, p < 0.05)相关,抑郁症状与情绪调节能力较低相关(r=-0.25, p < 0.05)。在EI测量和精神病维度之间没有发现显著的关系。缺乏感觉不适和缺乏洞察力与较差的绩效EI(情绪管理,r=-0.29和r=-0.25, p < 0.05)和自我报告的EI(情绪注意,r=-0.24, p <; 0.05和r=-0.31, p < 0.01)有关,而缺乏洞察力和较好的情绪调节也与较好的情绪调节有关(r = 0.26, p < 0.05)。结论自我报告和基于绩效的EI与精神病理领域的关联存在差异,这可能是由于评估来源不同,但也可能表明需要将患者报告的结果测量纳入社会认知评估中。
{"title":"Self-reported and performance-based emotional intelligence and its associations with psychopathological dimensions and insight dimensions in psychosis","authors":"Esther Rosado , Amalia Zarzuela , Gustavo J. Gil-Berrozpe , Xabier Ansorena , Julen Chato , Victor Peralta , Manuel J. Cuesta , Ana M. Sánchez-Torres","doi":"10.1016/j.ejpsy.2025.100328","DOIUrl":"10.1016/j.ejpsy.2025.100328","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Individuals with psychotic disorders may display over the illness course a wide range of core deficits in clinical and cognitive domains, including social cognition (SC). One of the main domains of SC is emotional processing, a key component of emotional intelligence (EI). However, the extent to which EI, as self-perceived or performance-based, is related to psychopathological domains has been scarcely studied. This study aimed to examine the relationships between self-reported EI and performance-based EI with psychopathological and insight dimensions as well as to explore the correspondence between both types of EI assessments.</div></div><div><h3>Methods</h3><div>Seventy patients with psychotic disorders who were consecutively admitted to a psychiatric hospitalization unit were included. Psychotic, affective, and insight dimensions, as well as EI, were evaluated once psychopathological stability had been achieved.</div></div><div><h3>Results</h3><div>Manic symptoms were associated with greater emotional clarity (<em>r</em> = 0.25, <em>p</em> < 0.05) and regulation (<em>r</em> = 0.30, <em>p</em> < 0.05), whereas depressive symptoms were associated with lower emotional regulation (<em>r</em>=-0.25, <em>p</em> < 0.05). No significant relationships were found between the EI measures and psychotic dimensions. Lack of feeling sick and lack of insight were related to worse performance-based EI (emotional management, <em>r</em>=-0.29 and <em>r</em>=-0.25, <em>p</em> < 0.05) and self-reported EI (emotional attention, <em>r</em>=-0.24, <em>p</em> < 0.05 and <em>r</em>=-0.31, <em>p</em> < 0.01), and the former was also related to better emotional regulation (<em>r</em> = 0.26, <em>p</em> < 0.05).</div></div><div><h3>Conclusion</h3><div>The discrepancy between self-reported and performance-based EI regarding their associations with psychopathological domains might be due to the different sources of assessment but may also add evidence to the need to integrate patient-reported outcome measures in the assessment of social cognition.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 4","pages":"Article 100328"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.ejpsy.2025.100329
Isabel Argila-Plaza , Ana Aquino-Servín , María Ángeles García-León , Paola Fuentes-Claramonte , Núria Ramiro , Pilar Salgado-Pineda , Joan Soler-Vidal , María Llanos Torres , Amalia Guerrero-Pedraza , Manel Sánchez , Salvador Sarró , Raymond Salvador , Peter J McKenna , Ana Barajas , Edith Pomarol-Clotet
Background and objectives
Referentiality is a common symptom in psychotic and also some non-psychotic disorders, but there are few existing measures for assessing it. A recently developed detailed measure for this purpose is the Ideas of Reference Interview Scale (IRIS), which however has only been validated in a Chinese population of first episode psychosis patients.
Methods
We examined the reliability and validity of a Spanish version of the IRIS (IRIS-S) in 185 patients aged between 18 and 65 with schizophrenia or schizoaffective disorder.
Results
The IRIS-S showed internal consistency, with this being good or acceptable for the presence scale and its three subsidiary measures. Inter-rater reliability was good and test-retest reliability was also good, except for one subsidiary measure. Convergent reliability was demonstrated but was lower than expected.
Conclusion
The IRIS-S has acceptable psychometric properties when employed in patients with schizophrenia/schizoaffective disorder. Caution is necessary for its use outside psychotic disorders as it has not been examined in such populations.
背景与目的参考性是精神障碍和一些非精神障碍的常见症状,但现有的评估方法很少。参考访谈量表(Ideas of Reference Interview Scale, IRIS)是最近开发的一种详细的测量方法,但它只在中国首发精神病患者中得到验证。方法我们对185例年龄在18 - 65岁的精神分裂症或分裂情感性障碍患者进行了西班牙语版IRIS (IRIS- s)的信度和效度检验。结果IRIS-S量表具有内部一致性,存在度量表及其三个辅助指标的一致性良好或可接受。量表间信度较好,重测信度也较好。证明了收敛可靠性,但低于预期。结论IRIS-S在精神分裂症/分裂情感性障碍患者中具有良好的心理测量特性。在精神疾病之外使用它是必要的,因为它还没有在这类人群中被检验过。
{"title":"Measuring referentiality in psychiatric disorders: Psychometric properties of the Spanish version of the Ideas of Reference and Interview Scale (IRIS-S)","authors":"Isabel Argila-Plaza , Ana Aquino-Servín , María Ángeles García-León , Paola Fuentes-Claramonte , Núria Ramiro , Pilar Salgado-Pineda , Joan Soler-Vidal , María Llanos Torres , Amalia Guerrero-Pedraza , Manel Sánchez , Salvador Sarró , Raymond Salvador , Peter J McKenna , Ana Barajas , Edith Pomarol-Clotet","doi":"10.1016/j.ejpsy.2025.100329","DOIUrl":"10.1016/j.ejpsy.2025.100329","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Referentiality is a common symptom in psychotic and also some non-psychotic disorders, but there are few existing measures for assessing it. A recently developed detailed measure for this purpose is the Ideas of Reference Interview Scale (IRIS), which however has only been validated in a Chinese population of first episode psychosis patients.</div></div><div><h3>Methods</h3><div>We examined the reliability and validity of a Spanish version of the IRIS (IRIS-S) in 185 patients aged between 18 and 65 with schizophrenia or schizoaffective disorder.</div></div><div><h3>Results</h3><div>The IRIS-S showed internal consistency, with this being good or acceptable for the presence scale and its three subsidiary measures. Inter-rater reliability was good and test-retest reliability was also good, except for one subsidiary measure. Convergent reliability was demonstrated but was lower than expected.</div></div><div><h3>Conclusion</h3><div>The IRIS-S has acceptable psychometric properties when employed in patients with schizophrenia/schizoaffective disorder. Caution is necessary for its use outside psychotic disorders as it has not been examined in such populations.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 4","pages":"Article 100329"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145358593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}