International Journal of Social Psychiatry最新文献

Background: Potential clinical applications for emerging large-language models (LLMs; e.g. ChatGPT) are well-documented, and newer systems (e.g. DeepSeek) have attracted increasing attention. Yet, important questions endure about their reliability and cultural responsiveness in psychiatric settings.

Methods: This study explored the diagnostic accuracy, therapeutic appropriateness and cultural sensitivity of ChatGPT-4o, ChatGPT-4.5, and DeepSeek-R1 (all March 2025 versions). DeepSeek-R1 was evaluated for one of the first times in this context, and this also marks one of the first longitudinal inquiries into LLMs in psychiatry. Three psychiatric cases from earlier literature about sleep-related problems and cooccurring issues were utilised, allowing for cross-comparisons with a 2023 ChatGPT version, alongside culturally-specific vignette adaptations. Thus, overall, outputs for six scenarios were derived and were subsequently qualitatively reviewed by four psychiatrists for their strengths and limitations.

Results: ChatGPT-4o, ChatGPT-4.5, and DeepSeek-R1 showed modest improvements from the 2023 ChatGPT model but still exhibited significant limitations. Communication was empathetic and non-pharmacological advice typically adhered to evidence-based practices. Primary diagnoses were broadly accurate but often omitted somatic factors and comorbidities. Nevertheless, consistent with past findings, clinical reasoning worsened as case complexity increased; this was especially apparent for suicidality safeguards and risk stratification. Pharmacological recommendations frequently diverged from established guidelines, whilst cultural adaptations remained largely superficial. Finally, output variance was noted in several cases, and the LLMs occasionally failed to clarify their inability to prescribe medication.

Conclusion: Despite incremental advancements, ChatGPT-4o, ChatGPT-4.5 and DeepSeek-R1 were affected by major shortcomings, particularly in risk evaluation, evidence-based practice adherence, and cultural awareness. Presently, we conclude that these tools cannot substitute mental health professionals but may confer adjunctive benefits. Notably, DeepSeek-R1 did not fall behind its counterparts, warranting further inquiries in jurisdictions permitting its use. Equally, greater emphasis on transparency and prompt engineering would also be necessary for safe and equitable LLM deployment in psychiatry.

Background: Homeless Individuals with Intellectual Developmental Disabilities (IDDs) are living in institutional settings. Understanding the prevalence of physical and mental health conditions and daily life abilities is essential for developing informed service strategies.

Aims: The study aims to examine the prevalence and pattern of neuropsychiatric comorbidities and their association with the severity of IDD.

Methods: This observational study is based on a retrospective chart review of 93 female homeless individuals with IDD residing in a shelter home for women. Descriptive statistics were used to analyse sociodemographic and clinical characteristics and other psychosocial factors.

Results: The mean age of the sample was 39.9 ± 9.9 years, with an average stay in the shelter home is 12.6 years. Most (93.5%) were unmarried or had no information about their family of origin. 86.0% had moderate to profound IDDs, and almost half (43.0%) also had comorbid psychiatric disorders. Furthermore, 20.4% had a seizure disorder, 21.5% had expressive speech and 17.2% had hearing disorders. Nearly half (49.5%) required help in activities of daily living.

Conclusion: The study highlights the neuropsychiatric multimorbidity common in individuals with IDD residing in long-term institutional settings. Hence, it is essential to support these individuals with informed medical and psychosocial services, alongside shelter provision.

Background: Although the health effects of trauma have been increasingly recognized, much less is known about the intergenerational effects of trauma and its outcomes.

Aims: This study examined trauma and trauma-related mental health problems among socio-economically disadvantaged parents.

Methods: We recruited parents in disadvantaged housing and living conditions from a community development center in Hong Kong (response rate = 74.09%). Participants completed standardized self-report measures.

Results: In this sample of 203 parents, 40.39% and 43.84%, respectively, reported at least one childhood and adulthood traumatic event; 6.90% suffered from probable ICD-11 PTSD/Complex PTSD and/or somatoform dissociation. Parents' disturbances in self-organization (DSO) symptoms were associated with problematic parenting styles. Parents' childhood trauma and DSO symptoms were also associated with children's behavioral problems.

Conclusions: Although trauma is not particularly prevalent in this sample, trauma and trauma-related symptoms are strongly linked to problematic parenting styles (such as over-reacting) and children's behavioral issues. More attention to the intergenerational effects of trauma is necessary from a public mental health perspective.

Background: Schizophrenia is a mental illness that can affect an individual's social functioning in various ways.

Aims: This study aimed to determine the self-management and subjective recovery levels of individuals with schizophrenia and to examine the effects of these variables on their level of social functioning.

Methods: The study was conducted on individuals with schizophrenia who were followed up at a community mental health centre. Data were collected using the 'Chronic Illness Self-Management Scale', 'Social Functionality Assessment Scale' and 'Subjective Recovery Assessment Scale'. Descriptive statistics, Pearson's correlation analysis, and a stepwise multiple regression model were used.

Results: The subjective recovery of the participants was 52.56 (SD 19.95), social functioning 39.18 (SD 7.76), self-stigmatisation 2.49 (SD 0.93), coping with stigmatisation 2.95 (SD 0.70), health care effectiveness 3.22 (SD 0.93), and adherence to treatment 3.90 (SD 0.93). According to the Pearson correlation test, a statistically significant moderate positive correlation was found between self-management, subjective recovery and social functioning (r = .595 and .525, p ⩽ .001). Subjective recovery, self-stigmatisation, and healthcare effectiveness levels explained 44.7% of the total variance in social functioning.

Conclusion: In this study, the most important predictors of social functioning were subjective recovery, self-stigmatisation, and health care effectiveness self-management. To improve social functioning in schizophrenia, the development of self-management strategies that increase subjective recovery and promote social integration is recommended.

Background: Stigma towards mental illness is a problem faced by health science professionals, acting as a barrier to providing care and seeking help.

Aims: The aim of this study was to evaluate and compare social stigma among Medical, Pharmacy and Veterinary students from the same university campus and assess the impact of their respective curricula on stigma levels.

Method: We performed an observational cross-sectional study, involving first and final-year students of the Integrated Master's in Medicine, Veterinary Medicine and Pharmaceutical Sciences, from two Institutions of the University of Porto, Portugal. An online self-report questionnaire, using the preliminary Portuguese version of the Attribution Questionnaire AQ-27, was employed. Additionally, a brief sociodemographic questionnaire was administered, also inquiring about close contact with mental illness.

Results: A total of 182 students were considered for analysis. In terms of comparative analysis, first-year pharmacy students exhibited a higher score in the Segregation dimension compared to first-year veterinary medicine and final-year medicine students (p < .001). Younger age and a lower level of education corresponded to higher mean scores in the dimensions of Avoidance (p = .006 and .008) and Segregation (p < .001 for both). However, older students exhibited a lower mean score in the Pity dimension (p = .009). Students who did not report any close relationship with mental health problems demonstrate a higher mean score in the Avoidance dimension (p = .041), whereas those who cohabited with individuals with mental health problems demonstrated a lower mean score in the Segregation dimension (p = .014).

Conclusion: This study emphasises the importance of critically design health sciences curricula to address mental health stigma, suggesting that structured evidence-based anti-stigma interventions, particularly those fostering empathy, may be essential to improve students' attitudes and promote more compassionate future healthcare practice.

Background: Parenting styles (PSs) are significant risk factors for major depressive disorder (MDD) in young adults. Understanding the common features of these parenting styles and their specific effects on depression is crucial for effective intervention.

Aims: To assess the profiles of paternal and maternal parenting styles and their impact on depression-related symptoms in young Chinese adults with MDD.

Method: This study involved 717 young adult outpatients (24.20 ± 3.84 years) with MDD, diagnosed at Renmin Hospital of Wuhan University between April and December 2019. Participants completed the Egna Minnen av Barndoms Uppfostran (EMBU) questionnaire and scales measuring depression (PHQ-9), anxiety (GAD-7), anhedonia (SHAPS), and physical symptoms (PHQ-15). Latent profile analysis (LPA) was used to identify PS profiles. The effects of different parenting style profiles on depression, anxiety, and anhedonia were assessed using stepwise linear regression.

Results: LPA identified three profiles for both paternal and maternal PSs. For fathers: 'Warm-Preference PS' (27.2%), 'moderate PS' (65.3%), and 'Harsh-Controlling PS' (7.53%). For mothers: 'Warm-Preference PS' (34.7%), 'moderate PS' (12%), and 'Harsh-Controlling PS' (53.3%). Regression analyses revealed that punitive and overprotective parenting significantly affected depression and anxiety, while emotionally warm parenting correlated with better mental health.

Conclusions: This study applied LPA to classify PS in MDD patients and revealing maternal-specific effects, addressing gaps in prior research. It underscores three distinguished PSs and the significant correlations between PSs and the severity of depression, anxiety, and somatic symptoms in young adults with MDD. Specific patterns of parenting influence mental health outcomes, highlighting the importance of early intervention.

Aims: When the etiology of major depression is examined, the existence of psychosocial factors is undeniably important. Inadequate social support and use of dysfunctional coping strategies are psychosocial factors that play a role in the etiology of depression. This study investigated the perceived social support and coping strategies in patients with depression and whether they change with remission.

Design: Both cross-sectional and longitudinal surveys were conducted.

Methods: This study included 50 patients in the active phase of a major depressive disorder, 30 patients in the remission of depression, and 50 healthy controls. The Hamilton Depression Rating Scale (HAM-D), Multidimensional Scale of Perceived Social Support (MSPSS), and Assessment Scale for Coping Attitudes (COPE) were applied to all subjects. The same scales were repeated in 20 patients, who were in the active phase of depression at the beginning of the study and were in remission after approximately 3 years of follow-up. Psychometric test scores of three groups were compared with one-way ANOVA test, Kruskal-Wallis test, and post hoc tests. In the longitudinal analysis, the paired t-test and Wilcoxon tests were used.

Results: The patients' perceived social support scores were lower than the remission and control groups (p < .001). The total scores of non-functional coping attitudes of both the patient and remission groups were higher than those of the control group (p < .001 and <.001). The problem-focused coping and emotion-focused coping total subscale scores of the patient group were found to be lower than both the remission group (p < .001 and <.001) and the control group (p = .001 and .001). When the follow-up patients were evaluated while in remission, perceived social support scores increased compared to those in the active phase (p = .008 for total social support score). Non-functional coping scores decreased (p = .023). Perceived social support level associated with problem-focused and emotion-focused coping attitudes.

Conclusion: The prognosis of depression might be affected by the perception of social support and coping attitudes.

Background: Earthquakes can result in mental health issues for both earthquake survivors and rescue workers.

Aims: To compare the prevalence and severity of PTSD, suicide risk, depression and anxiety between adults with primary earthquake trauma and rescue-aid personnel with secondary trauma exposure.

Methods: In this analytic cross-sectional study, 133 survivors - hospitalised for crush injuries or residing in Nurdağı temporary shelters - and 127 rescue-aid personnel completed a sociodemographic form and three validated measures: the Clinician-Administered PTSD Scale-5 (CAPS-5) for PTSD diagnosis and severity, the Depression Anxiety Stress Scale-21 (DASS-21) for depression, anxiety and stress symptoms and the Suicide Probability Scale (SPS) for suicide risk.

Results: The sample comprised 260 adults (39.6% male; 60.4% female), classified as primary-trauma (N: 133) or secondary-trauma (N: 127). PTSD prevalence was significantly higher in the primary group (N: 98, 73.7%) than in the secondary group (N: 75, 59.1%; p: .012). PTSD rates were also higher in women (N: 117, 74.5%) and in participants with low monthly income (N: 55, 91.7%; p: .001). The primary group showed greater anxiety (6.95) and depression (9.58) scores and higher PTSD severity (p < .05). The secondary group scored higher on the SPS 'negative self' subscale (p: .001). Suicidal ideation was identified in 18.1% of all participants; younger age and being single/living alone were linked to higher suicide risk (p < .05).

Conclusions: The findings of this study demonstrate that both primary and secondary trauma are significant issues that should be addressed with equal seriousness. Providing necessary psychosocial support to both earthquake survivors and responders after traumatic events like earthquakes is crucial.