Frontiers in Psychiatry最新文献

This article presents a novel methodology for detecting multiple biomarkers in high-dimensional mediation models by utilizing a modified Least Absolute Shrinkage and Selection Operator (LASSO) alongside Pathway LASSO. This approach effectively addresses the problem of overestimating direct effects, which can result in the inaccurate identification of mediators with nonzero indirect effects. To mitigate this overestimation and improve the true positive rate for detecting mediators, two constraints on the L ₁-norm penalty are introduced. The effectiveness of the proposed methodology is demonstrated via extensive simulations across various scenarios and compared against other popular mediation methods, highlighting its robustness and reliability under different conditions. Furthermore, a procedure for selecting an optimal threshold for dimension reduction using sure independence screening is introduced, enhancing the accuracy of true biomarker detection and yielding a final model that is both robust and well-suited for real-world applications. To illustrate the practical utility of this methodology, the results are applied to a study dataset involving patients with internalizing psychopathology and another dataset involving patients with late-life depression, showcasing its applicability in clinical settings. Overall, this methodology signifies a substantial advancement in biomarker detection within high-dimensional mediation models, offering promising implications for both research and clinical practices.

Background: The purpose of this study is to use a variety of machine learning (ML) algorithms to build a risk prediction model for nursing students' social anxiety, select the optimal model, and identify risk factors.

Methods: The cross-sectional survey was conducted among nursing students at 10 universities from September to December 2024. A total of 2024 nursing students were included in this study. Nine acceptable features were selected through Logistic analysis. We developed and evaluated seven ML models: Logistic regression (LR), Elastic net (EN), k-nearest neighbors (KNN), Decision tree (DT), Extreme gradient boosting (XGBoost), Support vector machine (SVM), Random forest (RF).

Results: The area under the Area Under Curve (AUC: 0.71) of the random forest model was the highest among the 7 models that predicted nursing students' social anxiety. The most important characteristics that predicted social anxiety in nursing students included Sleep condition, alexithymia, depression, education level, and religious belief.

Conclusion: Our findings suggest that ML models, specifically random forests, can best predict the risk of social anxiety among nursing students.

Background: Somatic symptom and related disorders (SSRDs) are prevalent worldwide, but their expression, help-seeking patterns, and management are strongly shaped by cultural context. In the Arab world, where mental health stigma and distinct explanatory models are common, SSRDs remain under-studied despite their clinical and public health significance.

Methods: We conducted a narrative review of 35 studies published through June 2025 on SSRDs in Arab populations. Searches of PubMed, Scopus, and Google Scholar identified observational studies, case reports, and cross-sectional surveys addressing Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) SSRD categories.

Results: Somatic symptoms disorder (SSD) was the most frequently investigated disorder, with prevalence ranging from 12% to 46%. Across studies, female gender, low educational attainment, chronic medical comorbidity, and trauma history were consistent risk factors. Common symptoms included muscle, back, and abdominal pain, often accompanied by depression and anxiety. Illness anxiety disorder, functional neurological symptom disorder, and factitious disorders were less studied but carried important diagnostic, cultural, and service delivery challenges.

Conclusion: SSRDs are common but under-recognized in Arab contexts. Effective management requires early detection in primary care, culturally sensitive communication, and disorder-specific interventions. Future research should broaden the scope beyond SSD, examine longitudinal and trauma-related pathways, and evaluate culturally adapted models of care.

Background: Self perception includes both self-esteem and self-schema and is an important factor in determining an individual's mental health. This is particularly true in contexts that have been affected by war or conflict, such as post-conflict Mosul, Iraq. The city of Mosul has experienced long term exposure to trauma, displacement and social economic hardship; these experiences will likely cause disruption to the personal and community identities of residents. Therefore, it is necessary to understand how self-perception relates to mental health in order to develop effective interventions.

Aim: This research aims to investigate the relationship between self-perception (self-esteem and self-schema) and mental health in adults living in Mosul. Additionally, we aim to identify cultural and context factors which may influence the relationship between self-perception and mental health.

Methods: Using a cross-sectional mixed-methods design, 232 adults who live in Mosul participated in our research. We used three quantitative instruments: the Rosenberg Self Esteem Scale, the Self Schema Questionnaire, and the General Health Questionnaire-28 to collect quantitative data. The qualitative data were collected via 20 semi-structured interviews with participants who were purposefully selected from our sample of 232. Descriptive statistics, Pearson correlation and multiple linear regression were used to analyze quantitative data. Thematic analysis was used to analyze qualitative data.

Results: Low self-esteem was reported by 41.4% of participants, and over half (52.6%) showed signs of possible psychological distress. Self-esteem (r = 0.52, p < 0.001) and positive self-schemas (r = 0.48, p < 0.001) were positively correlated with mental health, while negative self-schemas were negatively correlated (r = -0.55, p < 0.001). Multiple regression identified self-esteem (β = 0.37, p < 0.001), negative self-schemas (β = -0.34, p < 0.001), and employment status (β = 0.19, p = 0.014) as significant predictors of mental health, explaining 46.2% of the variance. Qualitative findings revealed three themes: identity reconstruction after conflict, cultural pressures on self-perception, and resilience through community support.

Conclusion: Perceptions of oneself are an important predictor of mental health in adults living in Mosul, Iraq. Enhancing positive self-esteem and reducing maladaptive self schemas may increase psychological resilience in post-conflict settings. Culturally sensitive interventions that incorporate community and family support systems are recommended.

Background: Although global evidence demonstrates a clear mental health impact of COVID-19 on healthcare workers, data from Latin American settings, particularly during the first pandemic wave and within social security hospital systems, remain limited and heterogeneous. The objective was to determine the prevalence and factors associated with depression and anxiety in health human resources of three hospitals of the Social Security of Piura and Lambayeque, during the first pandemic wave of COVID-19.

Methods: Cross-sectional analytical study in which anxiety and depression, and their association with resilience, insomnia, physical activity, eating disorder, tobacco and alcohol consumption, Burnout Syndrome and physical, psychosocial, occupational and personal health variables were evaluated. Multivariate analyses were used to estimate prevalence ratios (PR) and generalized linear models (GLM) to identify association between variables.

Results: Of 182 health care workers, the prevalence of depression and anxiety was 42.9% and 50.6%, respectively. The factors associated with depression were being diabetic (PR: 1.41), mistreatment (PR: 1.35), moderate concern about working in a COVID environment (PR: 1.23), much/extreme concern about working in a COVID environment (PR: 1.23), much/extreme concern about being marginalized by the surrounding environment (PR: 2.00), insomnia (PR: 1.62) and burnout syndrome (PR: 1.42). The factors associated with anxiety were moderate (PR: 1.92) and very/extreme worry (PR: 2.25) about working in a COVID-19 environment, moderate (PR: 1.26) and very/extreme (PR: 1.85) and worry about being marginalized by the neighborhood environment.

Conclusions: There is an urgent need for action to address the mental health of these professionals, who have played a critical role in pandemic response and care.

Background: Chronic excessive alcohol consumption is associated with cognitive deficits. Patients with cognitive impairment, particularly memory deficits, may have difficulties in acquiring new semantic and procedural information which could affect the effectiveness of clinical treatments. Memory training (MT) as an adjunct to evidence-based treatments is a promising approach to improve memory, cognitive functions, and abstinence rates. The objective of the study was to determine whether MT could positively influence memory function and long-term abstinence in individuals with alcohol use disorder (AUD) undergoing detoxification.

Methods: Patients with AUD were recruited in a two-stage process from a clinic for medical rehabilitation of alcohol dependence in Lübeck, Germany (N = 210) and assigned to the control arm (treatment-as-usual only; no-MT) or the experimental arm (treatment-as-usual with MT). At weeks 2, 6, and 10, cognitive function was examined using a comprehensive battery of neuropsychological tests. The abstinence rate was assessed at months 3 and 6 after discharge.

Results: Memory performance significantly improved over the course of treatment, among both groups. However, patients who had received MT showed significantly greater improvement and a significantly higher abstinence rate six months after discharge (53%), compared to the no-MT group (36%).

Conclusions: Memory training appears to be a promising supplementary therapy for withdrawal treatment of patients with AUD, resulting in improved memory and long-term abstinence. Future research into the effectiveness of cognitive training should be conducted in other treatment settings and for other substance use disorders.

Objective: To examine the association between 24-hour movement behaviors and depressive symptoms in older adults using compositional data analysis, and to investigate the dose-response characteristics of time reallocations between movement behaviors in relation to depressive symptoms.

Methods: A cross-sectional study was conducted among 1093 urban-dwelling older adults aged 60 years and above in selected communities of Jinan City, Shandong Province, China, between April 2024 and September 2024. The Chinese version of the International Physical Activity Questionnaire-Long Form (IPAQ-LF) was used to estimate time spent in moderate to vigorous-intensity physical activity (MVPA), light-intensity physical activity (LPA), sedentary behavior (SB), and sleep (SLP) across a typical 24-hour day. The Chinese version of the Patient Health Questionnaire Depression Scale-9 item (PHQ-9) was applied to assess depressive symptoms. Compositional isotemporal substitution models were employed to explore the associations between time reallocations among 24-hour movement behaviors and depressive symptoms, accounting for the co-dependent nature of time-use data.

Results: (1) The geometric means of time spent in MVPA, LPA, SB, and SLP were 25.33 minutes, 141.26 minutes, 738.10 minutes, and 455.15 minutes, respectively. Variation matrix analysis revealed the highest log-ratio variance between MVPA and SB (0.168), and the lowest between SLP and SB (0.031). (2) The prevalence of screening-positive depressive symptoms was 16.29% among Chinese urban older adults. (3) Results from compositional linear regression models showed that time allocated to MVPA, LPA, and SLP (relative to the remaining movement behaviors) was negatively associated with depressive symptoms, while time spent in SB was positively associated. (4) Dose-response analysis further indicated that: (a) MVPA substitutions with other movement behaviors exhibited nonlinear and markedly asymmetric effects on depressive symptoms; (b) replacing MVPA with LPA, SB, or SLP resulted in increasingly larger changes in predicted scores as substitution duration increased, whereas the reverse substitution (MVPA for other movement behaviors) produced progressively smaller changes; and (c) substitutions between SB and LPA displayed linear and symmetrical effects.

Conclusions: The findings provide evidence of an association between 24-hour movement behaviors and depressive symptoms in Chinese urban-dwelling older adults and reinforce the importance of achieving a balance between different types of movement behaviors over a 24-hour period for mental health.

Objective: This review systematically examines the current research on bibliotherapy for adolescent depressive disorders, emphasizing its efficacy and potential as a non-pharmacological intervention, while also considering the variations across different types of bibliotherapy and inherent limitations of the intervention itself.

Methods: A narrative review of the literature was conducted to explore the therapeutic mechanisms of bibliotherapy-including emotional resonance, cognitive restructuring, and social support-and to analyze various application models, such as guided versus unguided formats, creative versus self-help bibliotherapy, group reading, individualized interventions, and emerging digital approaches.

Results: Evidence indicates that bibliotherapy can effectively reduce depressive symptoms in adolescents across diverse intervention strategies. Both creative and self-help bibliotherapy, as well as group-based and individualized formats, have shown promising outcomes, particularly when integrated with structured discussion or other therapeutic approaches like CBT and mindfulness. However, the intervention's effectiveness can be moderated by factors such as text selection, reader characteristics, and cultural context. Potential limitations include emotional triggering from certain narratives, variability in individual engagement, and inconsistent long-term efficacy, especially among adolescents. Existing studies are further constrained by small sample sizes, brief intervention periods, and a lack of standardized material selection criteria.

Conclusion: Bibliotherapy represents a valuable, accessible intervention for adolescent depression, yet its application requires careful implementation to mitigate potential drawbacks. Future research should focus on large-scale, multicenter trials, further investigation of neuroscientific mechanisms, development of personalized reading programs, establishment of practitioner training systems, and cross-cultural adaptation. Efforts should also address ethical and privacy concerns, particularly within digital platforms, and explore creative integration with complementary therapeutic methods to enhance overall efficacy and safety.

Introduction: Intermittent Explosive Disorder (IED) is characterized by recurrent impulsive aggression and has been linked to impairments in physical and psychological functioning. However, population-based evidence examining health-related correlates of IED remains limited. This study evaluated whether individuals with IED differ from matched controls in tobacco use and pain, two clinically relevant health domains.

Methods: Data were drawn from the All of Us Research Program. Individuals with IED were matched 10:1 to participants without IED based on age, sex, race/ethnicity, and income. Group differences in tobacco use and pain were examined using chi-square analyses and logistic regression. Models estimated odds ratios (ORs) with 95% confidence intervals (CIs), with multivariable models additionally adjusting for major depressive disorder (MDD) and generalized anxiety disorder (GAD).

Results: Relative to matched controls, individuals with IED showed significantly higher odds of lifetime cigarette smoking, and this association remained robust after adjusting for MDD and GAD. Participants with IED also demonstrated significantly greater odds of reporting moderate to severe pain during the past seven days.

Discussion: Findings suggest that IED is associated with elevated vulnerability to both smoking and pain, independent of co-occurring depressive and anxiety disorders. These results highlight the importance of integrating tobacco cessation and pain management strategies into clinical care for individuals with IED and underscore the value of large-scale biobank data in clarifying health risks associated with psychiatric disorders.

Introduction: Children with autism spectrum disorder (ASD) often experience reduced quality of life due to core autistic traits, such as restricted and repetitive behaviors (RRBs), yet no pharmacological treatments have been established to date. Oxidative stress, a potential contributor to ASD pathology, may reduce taurine and glutathione (GSH) levels. Although animal studies have reported altered antioxidant levels, studies investigating the brain antioxidant levels in individuals with ASD remain limited. This study investigated whether reduced antioxidant levels in the anterior cingulate cortex (ACC), a region consistently characterized by functional and metabolic abnormalities in individuals with ASD, and closely associated with RRBs.

Methods: A total of 44 children with ASD and 40 typically developing controls were enrolled in this study. Diagnoses were confirmed using the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2). Magnetic resonance spectroscopy was used to quantify taurine and GSH levels in the ACC. Statistical analyses were conducted to compare metabolite levels between the groups and assess associations with ADOS-2 subscale scores.

Results: The ASD group exhibited significantly lower taurine levels, whereas GSH levels remained unchanged. Taurine levels were negatively correlated with RRBs but not with social affect.

Discussion: These findings suggest that reduced taurine levels in the ACC of children with ASD, alongside unchanged GSH levels, may indicate distinct biosynthetic pathways and functional roles of these metabolites in oxidative stress defense mechanisms associated with ASD pathology. Taurine depletion may disrupt physiological processes associated with RRBs and could serve as a potential therapeutic target for symptom management.