Frontiers in Psychiatry最新文献

Introduction: Mental health in Lebanon has been profoundly affected by recent crises, altering the patterns of substance use and psychiatric presentations. In this context, the link between psychopathy and substance use is relevant, but is underexplored in Arab cultural settings. This study aimed to assess the relationship between psychopathy and substance use in the Arab world, focusing on whether individuals in a Lebanese non-institutionalized population who use substances have higher psychopathy traits than those who do not.

Methods: This is a cross-sectional study conducted among 534 non-institutionalized Lebanese adults between May and June 2021. Participants completed a self-administered questionnaire including the validated Levenson Self-Report Psychopathy (LSRP) scale, TAPS (the Tobacco, Alcohol, Prescription medication, and Other substance use screener), the short version of the Urgency, Premeditation (lack of), Perseverance (lack of), Sensation Seeking, Positive Urgency, Impulsive Behavior scale (S-UPPS-P), and the Adverse Childhood Experiences (ACE) questionnaire. Bivariate analysis and multivariable regression were used to assess the association between psychopathy traits and substance use, adjusting for relevant factors.

Results: The mean age of the participants was 36.58 ± 11.94 years, and approximately 80% were women. Callousness was linked with tobacco, alcohol, and illicit drug use, while antisocial traits were associated with tobacco and prescription drug misuse. The regression analyses revealed that the antisocial factor was robustly associated with overall substance use (OR = 1.07, 95% CI = 1.01-1.14, p = 0.02), including tobacco use (OR = 1.13, 95% CI = 1.05-1.21, p = 0.001) and prescription drug misuse (OR = 1.28, 95% CI = 1.14-1.43, p < 0.001). Moreover, it showed that callousness significantly increased the odds of alcohol (OR = 1.15, 95% CI = 1.05-1.26, p = 0.003) and illicit drug use (OR = 1.13, 95% CI = 1.03-1.24, p = 0.01).

Discussion: This is the first study that examined the relationship between substance use and psychopathy traits in a Lebanese population. These results argue for trait-specific interventions to improve the efficacy and cost-effectiveness of substance use prevention and rehabilitation programs.

Introduction: Mental health difficulties are a common complication affecting 1 in 5 women during the perinatal period (from conception up to two years after childbirth). As well as affecting the wellbeing of the mother, perinatal mental health difficulties can contribute to adverse long-term outcomes for the infant by disrupting the mother-infant relationship. Effective interventions are needed to enhance maternal and infant wellbeing during the perinatal period. Perinatal compassion focused therapy (P-CFT) is a promising intervention that has been adapted for perinatal mental health difficulties, and which may also help enhance the mother-infant relationship through its focus on generating compassionate and empathic cognitions of self and others. While CFT is in use in perinatal clinical settings, few studies exist that explore its potential benefits. The aims of this study were to explore the feasibility of recruitment, to determine the suitability of the outcome measures, to assess the acceptability of P-CFT through qualitative evaluation, and to explore the effects of P-CFT on compassion-based outcomes, wellbeing, and parent-infant interactions.

Methods: The multisite feasibility and acceptability study will adopt a single pre-post, quasi-experimental study design comprising three components using a sample of service users attending P-CFT groups. Component 1 is a feasibility study measuring maternal self-report questionnaire outcomes (e.g., self-compassion, postpartum bonding) at baseline, post-intervention and six-month follow-up, and recruitment and retention rates. Component 2 will evaluate mother-infant interactions through the coding of video observations from baseline to post-intervention. Component 3 will entail qualitative semi-structured interviews to explore the acceptability of the intervention. Data will be analysed using statistical methods of analysis for quantitative data (Component 1 and Component 2) and reflexive thematic analysis for qualitative data (Component 3).

Discussion: To the authors' knowledge, this study will be the first multisite feasibility and acceptability study of perinatal compassion focused therapy offered to mothers and birthing parents in specialist perinatal mental health services in England's National Health Service (NHS). This study will identify any necessary refinements for future studies and considerations for good practice in this specific population and clinical setting, as well as the intervention itself.

Introduction: Adolescent anxiety is rising globally, yet access to engaging mental health support remains limited, especially outside clinical care. Virtual reality (VR) offers a promising platform for delivering immersive mindfulness experiences. This study evaluated SpiritVR Journey, a six-session VR mindfulness programme designed for young people, delivered in real-world school and community environments.

Methods: Using an exploratory pre-post mixed-methods design, data were collected from 53 participants across schools, community organisations, and youth mental health services. Recruitment was facilitator-led and internal to each site. Quantitative data were gathered before and after each session using an adapted Generalised Anxiety Disorder scale (GAD-7), while qualitative reflections were obtained from participant diary entries. Sessions were delivered approximately once per week, depending on site scheduling.

Results: Participants showed a significant reduction in self-reported anxiety symptoms across sessions (mean GAD-7 change = 4.88; Cohen's d = 2.06). Qualitative themes highlighted relaxation, emotional relief, and improved self-regulation. The immersive format appeared particularly engaging for individuals who had found traditional mindfulness approaches challenging.

Discussion: Findings provide preliminary evidence of impact and acceptability of immersive VR mindfulness in youth and community contexts. While results suggest promise for future scalable applications, broader feasibility depends on access to VR hardware, training of facilitators, and setting-specific implementation support.

Oxytocin (OT) neurotransmission has emerged as a promising target for alleviating psychiatric symptoms associated with depression, stress, and fear. This mini-review focuses on the therapeutic alliance, highlighting five core components: (1) attachment, (2) empathy, (3) social synchrony, (4) trust and cooperation, and (5) social support. We explore how these factors both influence and are modulated by the oxytocinergic system. Based on current empirical evidence, we propose a conceptual framework in which OT-mediated mechanisms dynamically and reciprocally strengthen the therapeutic alliance. We postulate that activation of the OT system by one or more of these components may synergistically enhance all alliance factors, creating a self-reinforcing cycle with potential therapeutic benefits. Finally, we discuss the clinical implications of this model and identify key avenues for future research.

Introduction: Physiological signals offer a significant advantage in the field of emotion recognition due to their objective nature, as they are less susceptible to volitional control and thus provide a more veridical reflection of an individual's true affective state. The use of multimodal physiological signals enables a more holistic characterization of emotions, establishing multimodal emotion recognition as a critical area of research. However, existing multimodal fusion methods often fail to capture the complex, dynamic interactions and correlations between different modalities. Consequently, they exhibit limitations in fully leveraging complementary information from other physiological signals during the feature learning process.

Methods: To address these shortcomings, we propose a novel framework for multimodal physiological emotion recognition. This framework is designed to comprehensively learn and extract features from multiple modalities simultaneously, effectively simulating the integrative process of human emotion perception. It utilizes a dual-branch representation learning architecture to process electroencephalography (EEG) and peripheral signals separately, providing high-quality inputs for subsequent feature fusion. Furthermore, we employ a cross attention mechanism tailored for multimodal signals to fully exploit the richness and complementarity of the information. This approach not only improves the accuracy of emotion recognition but also enhances robustness against issues such as missing modalities and noise, thereby achieving precise classification of emotions from multimodal signals.

Results: Experimental results on the public DEAP and SEED-IV multimodal physiological signal datasets confirm that our proposed model demonstrates superior performance in the emotion classification task compared to other state-of-the-art models. Our findings prove that the proposed model can effectively extract and fuse features from multimodal physiological signals.

Discussion: These results underscore the potential of our model in the domain of affective computing and hold significant implications for research in healthcare and human-computer interaction.

Background: Claudin-5 is an important cell adhesion molecule of tight junctions in brain endothelial cells and plays an important role in the permeability of the blood-brain barrier (BBB). Panic disorder (PD) is a disorder characterized by increased neuroinflammatory processes that may result in increased BBB permeability. This study aimed to examine claudin-5 levels in PD at baseline and after a 6-week follow-up and to compare them with those of the healthy control (HC) group.

Methods: Twenty-seven PD subjects (17 women and 10 men) and 25 HC subjects (15 women and 10 men) were included in this prospective cohort study.

Results: Pre-treatment claudin-5 (p = 0.021), C-reactive protein (CRP) (p < 0.001), CRP/albumin ratio (p < 0.001), and neutrophil count (p < 0.001) were higher in the PD group than in the HC group. Claudin-5 levels (p = 0.001) and Panic Disorder Scale (PDS) scores (p < 0.001) of the PD group decreased significantly after 6 weeks of follow-up compared to those at baseline. Post-treatment claudin-5 levels of the PD group were similar to those of the HC group (p = 0.230). In the PD group, partial correlation analysis was performed by controlling for the effects of age, gender, body mass index (BMI), smoking status, antidepressant and benzodiazepine status, and a significant relationship was found between the pre-treatment PDS score and pre-treatment claudin-5 level (r = 0.474, p = 0.030). After various modeling attempts, a hierarchical model (controlling for age, gender, and BMI) was created using pre-treatment claudin-5 level and the aggregate index of systemic inflammation (sensitivity = 70.4%, specificity = 76.0%; Nagelkerke R² = 0.468). The area under the receiver operating characteristic (ROC) curve of pre-treatment claudin-5 level for PD was 0.687 (p = 0.021).

Conclusion: In subjects presenting with PD symptoms, increased parameters that may be associated with increased inflammation (such as CRP, CRP/albumin ratio, and neutrophil count), along with claudin-5 levels and the association between them, and the decrease in claudin-5 levels after a 6-week follow-up following a decrease in PD symptom severity, suggest that alterations in claudin-5 level in PD may be related to PD symptomatology. The high level of claudin-5 at the initial clinical presentation may be explained as a direct consequence of neuroinflammation in PD and/or as a compensatory change that occurs secondary to the neuroinflammation in PD. It can be assumed that as PD symptom severity decreases, neuroinflammation decreases, and claudin-5 production slows down.

Background: Forensic mental health care has evolved from mixed-sex provision to specialised sex-specific services. It is important to understand how the characteristics of women admitted to medium secure care have changed over time and how this may impact on their outcomes after discharge.

Objective: The study aims to describe and compare admission and discharge characteristics of two consecutive cohorts; women admitted between 1983 and 2001 to a mixed-sex medium secure care ('Mixed' cohort) and women admitted between 2005 and 2013 to single-sex medium secure care ('Specialised' cohort).

Methods: Data came from a 30-year study of outcomes for first admissions to an NHS medium secure hospital (the ALACRITy study). Follow-up data were available up to a census date of June 30^th 2013.

Results: 93 women comprised the Mixed cohort (mean age 29.3 years; 81% White ethnicity; 49% personality disorder diagnosis) and 45 women comprised the Specialised cohort (mean age 32.4 years; 76% White ethnicity; 49% personality disorder diagnosis). The Specialised cohort were more likely than the Mixed cohort to be admitted from high security, or under a forensic section of the Mental Health Act. The Specialised cohort were more likely than the Mixed cohort to have previous convictions, or to have committed a 'grave' index offence warranting a life sentence. Over 95% of all women had received previous inpatient psychiatric care. The Specialised cohort had greater prevalence of alcohol use, self-harm and childhood adversity than the Mixed cohort. At the census, 99% of the Mixed cohort and 42% of the Specialised cohort had been discharged. Women in the Specialised cohort had a longer median length of stay than the Mixed cohort; 859 days and 229 days respectively. Over 80% of patients in the Mixed cohort were readmitted during the follow-up period.

Conclusion: The study provides empirical data for two consecutive cohorts of women admitted to one medium secure hospital over the course of thirty years. Women admitted to single-sex services had more criminological and adverse trauma histories than women admitted to the earlier mixed-sex service. Further research is required to establish the long-term outcomes of women admitted to specialised single-sex medium secure care.

Objective: This study investigated the effects of an adapted physical activity (APA) program, based on the ICF-CY framework, on physical activity and social adaptive behaviors in children with autism spectrum disorder (ASD).

Methods: 41 children with ASD (aged 6~12) were ultimately included and divided into an experimental group (EG) and a control group (CG). The EG received the APA intervention, while the CG participated in routine extracurricular physical activity sessions. Both groups received 24-week interventions, with 3 sessions per week, each lasting 80 minutes. Assessments were conducted before and after the intervention using the ActiGraph wGT3X-BT triaxial accelerometer and the Child Adaptive Behavior Rating Scale (CABRS).

Results: After 24 weeks, the EG showed significant improvements in adaptive behaviors (independent, cognitive, social/self-control, and total scores), reduced sedentary time, and increased light and moderate-to-vigorous physical activity compared to the CG.

Conclusions: The ICF-CY-based APA program effectively enhanced physical activity levels and social adaptive behaviors in children with ASD.

Background: Approximately 25% of people with trichotillomania recover without receiving formal treatment. Rates of natural recovery in skin picking disorder are unknown. More importantly, variables that predict natural recovery in trichotillomania and skin picking disorder have been understudied. This study aims to examine these variables in a sample of individuals with trichotillomania and/or skin picking disorder.

Methods: 21 adults (76.2% trichotillomania only, 14.3% skin picking disorder only, 9.5% both; 85.7% female; mean age=32.19, SD = 10.21) who reported naturally recovering (i.e., not meeting full DSM-5 diagnostic criteria in the previous 12 months) from trichotillomania or skin picking disorder completed a virtual interview and self-report forms. The mean number of years since criteria was unmet was 5.95 (SD = 6.27). 41 participants with current trichotillomania or skin picking disorder were matched to naturally recovered participants on sex, diagnosis, and age (mean age=31.02, SD = 7.95; 2 matches for each participant except for one participant who has 1 match). They were compared on demographics, clinical characteristics, and treatment history.

Results: When asked about their pulling or picking at its worst, there were no significant differences in self-reported days per week or time per day spent pulling or picking, or functional interference from pulling or picking. Participants with current trichotillomania or skin picking disorder reported greater distress from their pulling or picking, but this did not remain significant after controlling for current comorbidities. Naturally recovered participants were significantly less likely to have a current comorbid psychiatric disorder, specifically depression and ADHD. However, they were significantly more likely to have a lifetime substance use disorder and current alcohol use disorder. In total, 77.8% of participants either still pulled or picked occasionally and/or replaced it with another behavior.

Conclusion: Although it may seem intuitive that those who naturally recover can do so because their disorder is less severe, these results indicate that severity was not associated with natural recovery. Given the persistence of subclinical symptoms after natural recovery, the effectiveness of natural recovery over recovery via treatment is questionable. A major limitation of this study is its small sample size and limited power. Future research should use larger sample sizes and further explore potential differences in comorbidities.

Background: Arts therapy has gained increasing popularity for alleviating post-traumatic stress disorder (PTSD) in adolescents and children due to its non-intrusive nature and ease of interaction with participants. In this pre-registered systematic review (PROSPERO: 420251060744), we synthesized existing literature on arts therapies as interventions for managing PTSD symptoms in adolescents and children.

Methods: We conducted systematic searches of APA PsycNET, PubMed, EMBASE, Cochrane Library, and Web of Science up to June 15^th 2025.

Results: 1,273 articles were identified through systematic searches, with 10 articles meeting our inclusion criteria. These studies reported some positive outcomes from visual art therapy, music therapy, dance therapy, drama therapy, and poetry therapy; however, the effectiveness of individual arts therapies in improving PTSD symptoms was inconclusive.

Conclusion: Arts therapies demonstrate significant effects on certain symptoms of children and adolescents with PTSD. However, more rigorous studies are warranted to substantiate the efficacy and generalizability of arts therapies.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD420251060744.