Frontiers in Psychiatry最新文献

Introduction: Eating disorders (EDs), particularly Anorexia Nervosa (AN), remain one of the most severe and treatment-resistant eating disorders, with high relapse rates and limited pharmacological options. While second-generation antipsychotics and antidepressants are commonly prescribed as adjuncts to nutritional rehabilitation, their real-world impact on weight restoration and psychopathological symptom severity remains unclear.

Methods: We conducted a prospective, naturalistic observational study of 127 inpatients diagnosed with restrictive anorexia nervosa (AN-r), binge-purge anorexia nervosa (AN-bp), or bulimia nervosa (BN). BMI and weekly psychopathological symptom burden were systematically monitored throughout a ten-week inpatient treatment program. Psychopharmacological treatments were recorded in real time, and the Average Morbidity Index (AMI), adapted from the Life Chart Methodology, was computed weekly as a prospective measure of clinical severity. Generalized Linear Models assessed the associations between specific drug classes and changes in BMI and AMI.

Results: Patients treated with mood stabilizers (e.g., Carbamazepine, Lithium) showed a smaller BMI increase compared to other groups (Coef. = -0.96 to -1.70; p< 0.05), suggesting a potential weight-stabilizing effect. Diazepam use was associated with greater weight gain (Coef. = +2.06; p = 0.02) but no clear benefit on AMI. Several antidepressants (e.g., Sertraline, Escitalopram) correlated with higher AMI scores, indicating less improvement in psychopathological symptom burden. Atypical antipsychotics (e.g., Olanzapine, Aripiprazole) were linked to greater reductions in AMI.

Conclusions: Prospective monitoring of BMI and AMI revealed differential associations between psychopharmacological agents and both nutritional and symptomatic trajectories in an inpatient ED cohort predominantly composed of patients with AN. Mood stabilizers were associated with smaller BMI increases, while several antidepressants corresponded to less improvement in psychopathological symptom burden. Atypical antipsychotics showed the strongest prospective reductions in AMI. These findings highlight the value of prospective, real-world monitoring to inform pharmacological strategies in treatment-resistant eating disorders.

Introduction: This study examines Facebook-based ADHD support groups for adults, addressing a gap in the understanding of how participation in ADHD-specific online communities contributes to informational, emotional, and social support, and how these processes relate to mental well-being.

Methods: An inductive qualitative design was employed, based on semi-structured interviews with twenty adults (nine men and eleven women) diagnosed with ADHD who actively participate in large Facebook support groups comprising tens of thousands of members. The interviews were analyzed inductively to identify recurring themes related to engagement and support within these online communities.

Results: The analysis revealed that Facebook-based ADHD groups function as supportive networks that provide informational, emotional, and social support. Participants described these groups as safe spaces for sharing experiences and advice, fostering a sense of belonging, reducing feelings of isolation, and enhancing engagement within the community.

Discussion: The findings underscore the potential of online peer support as a complementary resource for improving coping, adjustment, and mental well-being among adults with ADHD. These results suggest practical implications for psychoeducation and clinical interventions that incorporate digital social support environments.

Aim: Attention-Deficit-Hyperactivity-Disorder (ADHD) is a neurodevelopmental-condition characterized by two symptom-domains, inattention and hyperactivity/impulsivity, as per DSM-5. Prior research, indicates conceptual-overlap among symptoms within each domain, potentially compromising the diagnostic utility of symptom structure itself. This structural redundancy has direct implications for evaluation of ADHD-screening-tools, which already show substantial heterogeneity in item-content and focus. While full psychometric-validation is resource-intensive, assessing tool alignment with DSM-5 offers a more practical and clinically relevant alternative.

Method: Considering these challenges, this study first employed a three-layer-similarity-framework with entropy-based-weighted-combined-score, to investigate intra-domain symptom redundancy. Subsequently, a multi-stage-classification-pipeline, comprising a filtering-layer and machine-learning-classifiers (Random-Forest, Support-Vector-Machine and Logistic-Regression), was trained on DSM-5 ADHD and Non-ADHD (Conduct-Disorder, Major-Depressive-Disorder, Oppositional-Defiant-Disorder) statements, tested on Vanderbilt-preschool-assessment-questionnaire and validated on ADHD-Rating-Scale, Swanson-Nolan-and-Pelham-Rating-Scale (SNAP-IV) and Modified-Checklist-for-Autism-in-Toddlers (M-CHAT), to assess screening-tool's alignment with DSM-5.

Results: The results revealed moderate-overlap between symptom-pairs (2 and 5) and (5 and 7) within the inattention-domain, with similarity-scores of 0.62 and 0.58 respectively. The filtering-layer demonstrated high accuracy of 97%, perfect precision and specificity in isolating ADHD symptoms. Among classifiers, Random-Forest achieved the best performance with 92% accuracy, 83% precision, 100% recall and 91% F1-score. Validation with ADHD-Rating-Scale ensured near-perfect classification due to its focused symptom set, while SNAP-IV's inclusion of non-ADHD-items slightly reduced subtype specificity. M-CHAT validation further confirmed the designed pipeline's ability to exclude non-ADHD symptoms, supporting its classification precision.

Conclusion: The proposed pipeline can be adopted for analyzing strength and limitations of screening-tools, which serve as a catalyst for refinements, ensuring reliability and effectiveness in practical applications.

Background: Limited attention to middle-aged and younger populations has obscured important age-related differences in fear-avoidance mechanisms. Moreover, most existing research on kinesiophobia focuses narrowly on single disease groups and lacks a systematic examination of the multi-dimensional "pain cognition-fear emotion-avoidance behavior" framework. These gaps have led to uniform interventions that overlook diverse fear triggers, hindering precision case and wasting medical resources.

Objective: To identify latent subtypes of kinesiophobia in patients with hip fractures, examine their clinical characteristics, and explore associated factors and intergroup differences, with the aim of informing more targeted intervention strategies.

Methods: This cross-sectional study was conducted between November 2024 and June 2025. Patients with clinically diagnosed hip fractures were recruited through convenience sampling from the orthopedic wards of two tertiary hospitals and two community healthcare centers in Lishui City. Data were collected using the General Information Questionnaire, Tampa Scale for Kinesiophobia (TSK), Self-Rating Scale of Sleep (SRSS), Tilburg Frailty Indicator (TFI), and Visual Analogue Scale (VAS), and subsequently analyzed with SPSS version 27.0. Univariate and multivariate logistic regression analyses were conducted to identify significant predictors of subgroup membership, with the low avoidance type as the reference. Latent profile analysis was conducted using Mplus version 8.3. Among the tested models, the three-class solution (Model 3; AIC = 12738.385, BIC = 13006.411, aBIC = 12784.358, entropy = 0.963) demonstrated the best fit and was selected as the optimal model.

Results: A total of 340 patients with hip fractures were included, with a mean TSK score of 46.68 ± 12.33. Latent profile analysis revealed three distinct kinesiophobia subtypes: low avoidance type, 29.7%, cautious avoidance type, 17.6%, and prominent avoidance type, 52.6%. Logistic regression analysis indicated that academic level, comorbid painful conditions, pain intensity (5.59 ± 3.16), frailty (8.91 ± 4.81), and sleep disturbances (30.99 ± 11.47) were independent predictors of subgroup membership (P < 0.05).

Conclusion: This study identified three kinesiophobia subtypes among patients with hip fractures, supporting the relevance of the fear-avoidance model in trauma rehabilitation and providing a basis for tailored intervention strategies (e.g., multimodal therapies for the subtype of significant avoidance kinesiophobia) to optimize rehabilitation outcomes. Future research should investigate the longitudinal trajectory of these subtypes, evaluate the sustained effects of targeted interventions, and examine the generalizability of the model to guide precision rehabilitation care.

The consequences of violence differ depending on gender. This study explores the associations between exposure to violence and mental health outcomes in Ecuador, a country with high levels of violence yet limited research on its psychological effects. Using a nationally representative dataset and Propensity Score Matching (PSM) to reduce confounding bias, we examine gender-specific patterns of psychological outcomes. The analysis reveals that men exposed to violence are significantly more likely to display externalizing behaviors, including a near doubling of alcohol use (+93.6%) and heightened impulsivity, supporting theories of substance-based coping and behavioral dysregulation. In contrast, women exposed to violence show marked increases in internalizing symptoms, including depressive affect (+35.7%), perceived stress, and loneliness, reflecting emotion-focused coping strategies and affective vulnerability. While these findings support established gendered theories of violence, such as the self-medication hypothesis and emotion-focused coping, they must be interpreted with caution. The associations observed reflect robust statistical links rather than definitive causal pathways. It remains possible that pre-existing psychological vulnerabilities or unmeasured third variables contribute to both the likelihood of experiencing violence and subsequent mental health outcomes. The results underscore the importance of gender-sensitive mental health interventions: substance use and impulsivity should be targeted among men, while women's care must be integrated with social and economic support systems. By focusing on a Latin American context, this study adds to global knowledge on the gendered psychological consequences of violence and highlights the need for longitudinal and interdisciplinary approaches.

Introduction: Benefit finding (BF) refers to the phenomenon of identifying positive changes from challenging circumstances. This review aimed to comprehensively assess the BF prevalence in persons with somatic non-communicable chronic diseases (pSNCDs).

Materials and methods: Electronic databases were systematically searched using the concept "benefit finding". Eligible studies (adult persons with SNCDs, BF measured by the Benefit Finding Scale, written in English, observational in design, and published until June 30, 2023) were reviewed and underwent quality and publication bias assessments; prevalence and mean were extracted and synthesized.

Results: Of the 55 included articles, 35 were rated "weak", 18 "moderate", and 2 "strong" in quality. BF mean was 3.25 (25,972 observations), BF prevalence was 97.5% (10,720 observations), and moderate-to-high BF prevalence was 74.1% (12,363 observations). Subgroup analysis indicated higher moderate-to-high BF in cancer survivors (highest: 89% in breast cancer) than non-cancer survivors (highest: 72.4% in HIV). The lowest BF and moderate-to-high BF prevalence occurred in cancer survivors aged 60 +. Meta-regression suggested that study design and quality, time since diagnosis, gender, and mean age may explain heterogeneity in BF means. Subgroup analyses showed the lowest BF mean in pSNCDs aged 70+ years.

Discussion: Persons with SNCDs generally reported a moderate BF mean. Age is an important factor associated with BF. Future studies are needed to better understand how pSNCDs find/perceive benefits, especially for older adults aged 60+ years.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42022308513, identifier CRD42022308513.

Introduction: This global systematic review evaluated the psychometric properties, namely the reliability and validity, of all WHODAS 2.0 versions and forms, including WHODAS-Child, which has been used in specific populations since 2010, in assessing alignment with the WHO manual.

Materials and methods: Following PRISMA-COSMIN guideline, electronic databases and a curated personal library were searched up to April 30, 2025. Included were 143 empirical studies on WHODAS 2.0 and WHODAS-Child in samples with specific populations, spanning 43 countries.

Results: Across five data extraction forms, the mean and median values of the aggregated data regarding the measurement characteristics of WHODAS 2.0 and WHODAS-Child are reported. The 36-item version demonstrated excellent internal consistency (mean α = 0.92), while the 12-item one showed good reliability (mean α = 0.88), and the test-retest reliability was strong for both (ICC = 0.89-0.91). Factor analyses supported the six-domain structure for the 36-item version and WHODAS-Child, though more variability was noted for the 12-item version. Cultural and age-related challenges emerged, indicating the need for contextual adaptations.

Discussion and conclusions: The results showed good behavior of WHODAS 2.0, albeit slightly lower than the psychometric profiles described in the Manual. WHODAS-Child, though promising, requires further validation and refinement, particularly for cross-cultural applications.

Objective: This study aimed to explore the hematology-derived relationship between the blood-based indices associated with sarcopenia including the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and serum AST/ALT ratio, and the risk of pneumonia and delirium among hospitalized patients experiencing acute withdrawal from excessive alcohol consumption.

Study design: For this retrospective study, patients experiencing acute withdrawal from excessive alcohol consumption who underwent inpatient treatment at a psychiatric teaching hospital in western China between January 1, 2014 and December 31, 2023 were analyzed. Patient-related data were accessed through an electronic medical record database, and logistic regression analyses were used to explore the relationship between the blood-based indices associated with sarcopenia and the risk of developing pneumonia and delirium in this population.

Result: This study enrolled 553 patients. The incidence of pneumonia and delirium in this group of patients was 13.74%. AST/ALT ratios were significantly higher in patients with pneumonia relative to non-pneumonia patients (P<0.001) and in those with delirium versus those with no delirium (P<0.01); compared with the low AST/ALT group, the high AST/ALT group had a higher prevalence of pneumonia (21.90% vs. 11.06%, P<0.01) and delirium (20.44% vs. 11.54%, P<0.05). When the AST/ALT was used as a categorical variable, after adjustment for confounding factors, logistic regression showed that the high AST/ALT group had a higher risk of pneumonia (OR = 1.91, 95%CI: 1.09-3.34) and delirium (OR = 1.92, 95%CI: 1.03-3.58) than the low-AST/ALT group. When the AST/ALT were used as continuous variables, after adjustment for potential risk factors, logistic regression showed that higher AST/ALT was associated with a greater risk of both pneumonia and delirium (pneumonia, OR = 1.48, 95%CI: 1.10-2.00; delirium, OR = 1.58, 95%CI: 1.14-2.19). However, NLR and PLR were not associated with a risk of pneumonia and delirium.

Conclusion: These results suggest that in patients with a history of excessive alcohol consumption and hospitalization for acute alcohol withdrawal, the AST/ALT ratio is associated with increased risk of both pneumonia and delirium, while NLR and PLR are not.

Background: Excessive screen time among college students is increasingly prevalent and may impair executive functions, particularly working memory (WM). However, the behavioral and neural mechanisms remain unclear.

Methods: A total of 42 college students participated in the experiment and were assigned to either a high screen time group (HSTG) or a low screen time group (LSTG). Brain activity was measured with functional near-infrared spectroscopy (fNIRS) covering the frontal, temporal, and parietal regions during the 2-back working memory task. Group differences in behavioral performance (accuracy, reaction time, false alarms), task-related activation, functional connectivity, and graph-theoretical network were analyzed.

Results: LSTG participants demonstrated significantly higher accuracy and hit rates than those in HSTG, while no group differences were observed in reaction time or false alarm rate. Neuroimaging analyses revealed greater activation in bilateral dorsolateral prefrontal cortex (DLPFC-R: p< 0.001, DLPFC-L: p = 0.007) as well as premotor and supplementary motor cortex (PreM & SMC-R, p = 0.007) in LSTG. Functional connectivity was higher in LSTG at whole-brain (p = 0.047), intra-hemispheric (right: p = 0.022, left: p = 0.049), and inter-hemispheric levels (p = 0.033). Graph-theoretical results further indicated lower clustering coefficient (p = 0.040) and network density (p = 0.035) in HSTG, although global and local efficiency did not differ between groups.

Conclusion: High screen exposure is linked to reduced working memory accuracy, weaker prefrontal engagement, and disrupted network organization, which suggests reliance on less efficient neural strategies. Screen use may thus represent a modifiable factor affecting cognition and brain networks.

[This corrects the article DOI: 10.3389/fpsyt.2025.1595131.].