Frontiers in Psychiatry最新文献

Objective: Parental knowledge and attitudes are key determinants of inclusive education and children's social participation, yet little is known about how parents conceptualize different types of disabilities. This study explored patterns of perceived knowledge, ability to help, and attitudes toward structural and relational inclusion across multiple disability categories within a network-analytic framework.

Method: A cross-sectional online survey was completed by 347 Hungarian parents. Respondents rated five domains (knowledge, perceived impact, ability to help, class inclusion, and friendship inclusion) and reported prior experiences for nine disability types (autism spectrum disorder, attention-deficit/hyperactivity disorder, anxiety disorders, intellectual disability, orthopedic impairment, visual impairment, hearing impairment, speech impairment, and Down syndrome). Network analyses (EBICglasso) were performed for six sufficiently represented conditions.

Results: Overall, parents expressed favorable attitudes toward inclusion but reported limited self-efficacy in helping children with disabilities. Across networks, friendship and class inclusion formed a robust positive cluster, and perceived knowledge was positively linked to helping capability, although the strength of this connection varied across conditions. In contrast, perceived impact displayed negative edges with helping and inclusion willingness, particularly for ADHD, intellectual disability, and speech impairment.

Conclusion: The findings highlight a consistent triadic structure connecting knowledge, ability to help, and inclusion willingness, with contact and perceived impact shaping their balance differently by disability type. Interventions promoting guided contact and targeted knowledge-building may enhance both perceived competence and inclusive attitudes. Future studies should adopt longitudinal or experimental designs, employ multi-item measures, and test causal pathways linking parental experience, knowledge, and inclusion behavior.

Background: Comorbidity of bipolar disorder and aspects of neurodevelopmental disorders present unique challenges and opportunities in understanding the formation and maintenance of selfhood and worldview in psychopathology. Traditional cognitive models often overlook the narrative and phenomenological dimensions of patient experience, particularly how autobiographical narration and emotionally charged worldviews mediate lived experience.

Objectives: This study aims to explore (i) how worldviews are shaped by emotion and memory in psychiatric illness, and (ii) how narrative forms provide existential coherence in psychopathology. The research adopts a multidisciplinary approach integrating psychiatric, phenomenological, linguistic, narratological, and hermeneutic perspectives, through an in-depth case study.

Methods: A single-case study design was employed, focusing on "Benjamin," a 60-year-old male with a lifelong history of bipolar disorder type I and suspected Asperger's syndrome. Data sources included clinical interviews, autobiographical writings (five book-length texts), and clinical observation. Analyses were conducted using phenomenological, narratological, and linguistic frameworks to trace the evolution from self-narration to worldview construction.

Results: Benjamin's case illustrates a transition from immediate self-description to the development of a coherent, philosophy-like worldview. His autobiographical narratives reveal the interplay between minimal and narrative self, with mood episodes influencing both self-experience and identity coherence. Emotional memories-regardless of factual accuracy-serve as organizing phenomena, providing existential structure and meaning. The study highlights the limitations of cognitive schema theory and underscores the importance of narrative scaffolding and affect-logic in shaping worldviews.

Conclusions: The study demonstrates how a multidisciplinary analysis of autobiographical narration can be useful for characterizing emotionally charged worldviews when working with individuals with complex, comorbid and chronic psychiatric disorders. Integrating phenomenological and narratological approaches yields a deeper understanding of selfhood and meaning-making in psychopathology, with implications for clinical assessment and intervention.

Introduction: Recent studies using Automated Fiber Quantification (AFQ) have revealed localized white matter connectivity alterations in individuals with autism spectrum disorder (ASD), offering insights beyond traditional tract-wise Diffusion Tensor Imaging (DTI) analyses. However, the relationship between these alterations and language variability in preschool-aged children with ASD remains poorly understood.

Methods: This study included 28 children with ASD and 22 typically developing (TD) peers aged 1.5-6.07 years. Using AFQ, we examined eight language-related tracts-bilateral arcuate fasciculus, inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, and superior longitudinal fasciculus-at both tract-wise and point-wise levels. We analyzed the white matter alterations in metrics including fractional anisotropy, mean diffusivity, radial diffusivity, and axial diffusivity, and correlated these metrics with language abilities and ASD symptom severity.

Results: Both groups exhibited significant lateralization patterns, though no between-group differences in lateralization were found. However, ASD and TD groups showed distinct associations between white matter lateralization and language abilities. Tract-wise comparisons revealed no significant group differences, but point-wise analyses identified localized alterations in DTI metrics within the ASD group. While these alterations showed different patterns of association with language abilities in the ASD and TD groups, the between-group comparison of these association patterns did not reach statistical significance. Additionally, DTI metrics correlated significantly with ASD symptom severity.

Discussion: Our findings underscore the importance of white matter lateralization and microstructural integrity in supporting language abilities in young children with ASD. The study provides novel insights into the neuroanatomical foundations of language deficits and their association with symptom severity, highlighting the value of point-wise analyses in understanding ASD-related connectivity alterations.

Introduction: Methamphetamine use is increasing and is associated with substantial health, social and economic harms. Despite these harms, many individuals delay or avoid treatment due to personal and systemic barriers. Digital health interventions (DHIs) are a promising avenue for expanding treatment access, however their application for methamphetamine use remains relatively underexplored. This scoping review aimed to identify and synthesise existing evidence on the feasibility, acceptability, and potential clinical impact of DHIs for people who use methamphetamine.

Methods: Four databases (Embase, PubMed, PsychINFO, and Scopus) were searched up to December 18, 2024. Eligible peer-reviewed studies examined DHIs aimed at reducing methamphetamine use and reported outcomes related to feasibility, acceptability, engagement, or clinical outcomes. Data were extracted and synthesised descriptively.

Results: Seventeen records (from 15 studies) reporting on 1269 participants (aged ≥18) across six counties were included. Women were underrepresented (180/1,217; 14.8%) in studies reporting gender. Most participants (772/1269, 60.8%) met study inclusion criteria for methamphetamine use; the remainder (497/1269, 39.2%) met diagnostic criteria for methamphetamine use disorder. Thirteen unique DHIs were identified including web-based programs (n=2), text messaging (n=2), smartphone apps (n=6), chatbots or virtual agents (n=2), and virtual reality (n=1). Cognitive behavioural therapy approaches underpinned 8 of 13 (61.5%) interventions, and 8 of 15 studies (53.3%) used randomised controlled trial designs. Most DHIs were feasible and acceptable, with high satisfaction reported. Initial engagement was generally strong but declined over time; dropout rates ranged from 7.3% to 67.7%. Clinical impact was mixed. Some DHIs demonstrated reductions in methamphetamine use, craving or improvements in cognitive functioning and help-seeking, with some sub-groups appearing to benefit more than others.

Discussion: DHIs show promise for people who use methamphetamine. While current evidence supports feasibility and acceptability, clinical outcomes are variable. High attrition and engagement challenges persist. Heterogeneity in study designs, measures, and reporting limits comparability. Future research should explore long-term outcomes, hybrid models, and co-designed approaches with a focus on gender and equity. With further development, DHIs may play a valuable role in the broader intervention landscape.

Objective: Postpartum depression is a frequent complication after childbirth, affecting maternal health, infant development, and family well-being. This study evaluated the role of artificial intelligence (AI) in preventing and detecting postpartum depression early.

Methods: A systematic search was conducted in Scopus, PubMed, Web of Science, and CINAHL for studies (2020-2025) applying AI to identify postpartum depression. PRISMA guidelines guided selection and appraisal. Two random-effects meta-analyses estimated pooled sensitivity and accuracy based on total sample size and reported metrics.

Results: Of 1,857 records, 16 studies met inclusion criteria. Machine learning models (Random Forest, XGBoost, neural networks) showed greater accuracy than traditional methods. Integration of AI with medical records and social media data enabled earlier, personalized detection. Reported challenges included algorithmic bias, data privacy, and implementation barriers. Pooled sensitivity was 69% (95% CI: 55-81%; n=277,496) and accuracy 79% (95% CI: 73-85%; n=306,156).

Conclusions: AI shows promise for enhancing postpartum depression detection and prevention but requires addressing ethical, technical, and educational challenges to achieve equitable clinical integration.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251004175, identifier CRD420251004175.

Background: Major depressive disorder (MDD) affects one in five individuals, often recurs, and up to 50% of cases are deemed treatment resistant. Aberrant brain connectivity is associated with both depression symptoms and a thought pattern characteristic of depression, repetitive negative thought (RNT). Transcranial focused ultrasound (tFUS) is a novel neuromodulation technique that can directly target a hypothesized neural mechanism in depression, default mode network (DMN) hyperconnectivity. The present study assessed whether tFUS decreases DMN connectivity in individuals with MDD. Exploratory analyses assessed whether changes in DMN connectivity tracked changes in depressive symptoms and RNT.

Methods: Twenty participants with MDD completed up to 11 sessions of tFUS treatment targeting the left anterior medial prefrontal cortex, a major hub of the DMN. Before commencing and after completing treatment, participants completed resting state functional magnetic resonance imaging, self -report assessments, and clinical interviews. Participants also completed daily self-report and adverse event assessments.

Results: We previously reported a significant decrease in depression symptoms and RNT after tFUS treatment. Here we report that DMN connectivity between the left medial prefrontal cortex and left posterior cingulate cortex, major hubs of the DMN, significantly decreased after treatment. Exploratory analysis revealed no significant relationship between change in DMN connectivity and change in depressive symptoms or RNT.

Conclusions: tFUS shows promise in the treatment for MDD, as hyperconnectivity within the DMN decreased, alongside decreases in depression symptoms and RNT. These findings provide evidence supporting future clinical trials.

Clinical trial registration: https://clinicaltrials.gov/study/NCT06320028, identifier NCT06320028.

Background: Addressing women's sexuality during the perinatal period receives little attention in research, and few studies are available. Furthermore, there is no consensus on the factors that influence the development of sexual dysfunction in the late postpartum period.

Objective: Determine the prevalence of sexual dysfunction in women during the late postpartum period and the factors associated with it.

Method: A observational study was conducted with women who had given birth in Spain in 2024. Information was collected on sociodemographic variables, personal history, and sexual function. Mean differences (MD), adjusted mean differences (aMD), odds ratios (OR), and adjusted odds ratios (aOR) with their respective 95% confidence intervals (CI) were calculated, as appropriate. All analyses were performed using the statistical program SPSS 29.0.

Results: A total of 341 women participated. The prevalence of sexual dysfunction (FSFI scores <26.5) was 64.5%. The woman's age (aOR: 1.10; 95%CI: 1.03-1.18), breastfeeding between 3 and 6 months postpartum (aOR: 3.34; 95%CI: 1.72-6.50), quality of life (SF-12) (aOR: 0.97; 95%CI: 0.95-0.99), and the WAST (aOR: 1.48; 95%CI: -1.13-1.93) are factors that influence the development of sexual dysfunction in the late postpartum period.

Conclusion: The prevalence of sexual dysfunction in the medium term after childbirth is high. Younger age, non-breastfeeding status, good quality of life, and intimate partner relationships without violence are less likely to develop sexual dysfunction and have better sexual function.

The World Psychiatric Association condemns the sentencing to death and execution of individuals with mental illness or intellectual and developmental disabilities. However, in Japan, death sentences have been confirmed in individuals diagnosed with delusional disorders and autism spectrum disorder (ASD). We report two Japanese court cases in which medical professionals with ASD or autistic traits committed multiple homicides. Although ASD characteristics were acknowledged, one defendant received the death penalty while the other was sentenced to indefinite imprisonment. This case note aims to analyze how psychiatric evaluations and judicial reasoning distinguished between these two outcomes. We highlight the reliance on subjective assessments of remorse and the limited standardization in evaluating rehabilitation potential when distinguishing between the death penalty and indefinite imprisonment in defendants with ASD traits. Psychiatric expertise should contribute to fairer and more evidence-based sentencing.

Background: The Kurdistan region experienced a series of devastating events, such as the 1988 chemical attacks and the 2014 Yazidi genocide, which have had substantial impacts on the psychological and physical health of survivors.

Objectives: This study evaluates the long-term mental health of individuals who were exposed to chemical gas, with a focus on the prevalence and severity of psychological symptoms and their associations with sociodemographic, clinical, and trauma-related factors.

Methods: A total of 534 participants were recruited (300 women and 234 men). Data collection was completed in 7 months, from March to September 2023. All participants completed validated psychological assessments, including the PTSD Checklist for DSM-5 (PCL-5), Patient Health Questionnaire-15 (PHQ-15), and Hopkins Symptom Checklist-25 (HSCL-25). Multivariate General Linear Modeling (GLM) was performed, adjusting for trauma exposure to simultaneously assess the effects of demographic and clinical variables on multiple symptom domains.

Results: Most of the participants exhibited clinically significant symptoms, with 78.8% meeting the post-traumatic stress disorder (PTSD) threshold and 46.3% exhibiting comorbid symptoms across multiple domains. The GLM demonstrated that gender, trauma exposure, education level, and clinical factors were significantly associated with symptom severity across PTSD, somatic, and anxiety/depression symptoms (p < 0.001). The model explained up to 47% of variance in symptom outcomes. After adjusting for covariates, women showed higher symptom severity than men. Greater trauma exposure and lower education independently predicted increased symptoms.

Conclusion: These findings highlight serious psychological and somatic effects among survivors and underscore the urgent need for targeted mental health interventions for those affected by chemical attacks, with particular attention to individuals with lower levels of education and socioeconomic status, while incorporating gender-sensitive approaches to address differential vulnerabilities.