Journal of psychiatric research最新文献

{"title":"A systematic review and meta-analysis of anxiety and depression in children and adolescents with inflammatory bowel disease: Prevalence and association","authors":"Tingting Xu ,&nbsp;Yanhong Chen ,&nbsp;Qiqi Shen ,&nbsp;Sichao Dai ,&nbsp;Haohao Yan ,&nbsp;Jianjuan Ren","doi":"10.1016/j.jpsychires.2026.02.008","DOIUrl":"10.1016/j.jpsychires.2026.02.008","url":null,"abstract":"<div><h3>Background</h3><div>Anxiety and depression are prevalent comorbidities in patients with inflammatory bowel disease (IBD). However, their prevalence and impact in children and adolescents with IBD remain poorly defined. This meta-analysis aimed (i) to estimate the prevalence of anxiety and depression in this population and (ii) to explore the association between these psychological issues and IBD.</div></div><div><h3>Methods</h3><div>A thorough search of Embase, Web of Science, and PubMed from inception through February 1, 2025, was conducted. Two authors independently extracted data and assessed study quality. Pooled prevalence estimates, odds ratios (ORs), and hazard ratios (HRs) were calculated using a random-effects model. Subgroup and sensitivity analyses were performed to examine sources of heterogeneity and assess result robustness.</div></div><div><h3>Results</h3><div>The meta-analysis included 48 studies with 189,032 children and adolescents with IBD. Pooled prevalence estimates were as follows: anxiety symptoms (12%; 95% confidence interval [CI]: 7%–17%; k [number of studies] = 14; n [number of subjects] = 1574); anxiety disorders (9%; 95% CI: 5%–14%; k = 6; n = 168,378); depressive symptoms (15%; 95% CI: 11%–19%; k = 35; n = 4426); and depressive disorder (8%; 95% CI: 5%–11%; k = 7; n = 168,475). Pooled HRs indicated a significantly higher risk of developing anxiety and depressive disorders in this population, with HRs of 1.95 and 1.65, respectively.</div></div><div><h3>Conclusions</h3><div>Children and adolescents with IBD face a substantial burden of anxiety and depression. Routine mental health screening is essential for early intervention and comprehensive management of these comorbidities.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"196 ","pages":"Pages 78-89"},"PeriodicalIF":3.2,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146172344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of common antipsychotic medications with weight gain in youth and adults: a target trial emulation study","authors":"Joshua Petimar ,&nbsp;Sheryl L. Rifas-Shiman ,&nbsp;Jessica G. Young ,&nbsp;Han Yu ,&nbsp;Matthew F. Daley ,&nbsp;William J. Heerman ,&nbsp;David M. Janicke ,&nbsp;W. Schuyler Jones ,&nbsp;Kristina H. Lewis ,&nbsp;Pi-I.D. Lin ,&nbsp;Doug Lunsford ,&nbsp;L. Charles Bailey ,&nbsp;Sengwee Toh ,&nbsp;Jason P. Block","doi":"10.1016/j.jpsychires.2026.02.007","DOIUrl":"10.1016/j.jpsychires.2026.02.007","url":null,"abstract":"<div><h3>Background</h3><div>Few real-world studies have estimated differences in weight gain between antipsychotic medications. This study estimated effects of initiating 4 first-line antipsychotic medications on weight change in adults and children/adolescents.</div></div><div><h3>Methods</h3><div>Electronic health record data were collected from 31,270 adults (≥20 years) and 29,496 children/adolescents (&lt;20 years) newly prescribed 1 of 4 antipsychotics (aripiprazole, olanzapine, quetiapine, risperidone) from 2010 to 2019 across 15 U.S. health systems. Target trial emulation estimated the effect of initiating each medication on weight change in adults and body mass index z-score (BMIz) in children/adolescents at 6 (primary) and 12 months (secondary) versus aripiprazole (reference). Inverse probability weighted estimation of repeated outcome marginal structural models adjusted for baseline confounding and informative outcome measurement.</div></div><div><h3>Results</h3><div>In adults, initiation of aripiprazole was associated with greater 6-month weight change than initiation of olanzapine (difference = −0.60 kg [95% CI: −0.97, −0.25]), quetiapine (difference = −1.17 kg [-1.43, −0.91]), and risperidone (difference = −0.35 kg [-0.73, 0.03]); 12-month weight gain was similar between aripiprazole and olanzapine (difference = −0.11 [-0.61, 0.38]). In children/adolescents, olanzapine was associated with greater 6-month BMIz change than aripiprazole (difference = 0.15 [0.10, 0.20]); quetiapine and risperidone were associated with slightly smaller BMIz increases than aripiprazole. Six-month adherence was lower for olanzapine (5-7%) than other medications (15-21%) in adults and children/adolescents.</div></div><div><h3>Conclusions</h3><div>Among 4 first-line antipsychotic medications, aripiprazole was associated with the greatest 6-month weight gain in adults and olanzapine was associated with the greatest 6-month BMIz increase in children/adolescents, though adherence was lower for olanzapine than other medications. Clinicians should consider these differences in weight gain when initiating antipsychotic medications.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"196 ","pages":"Pages 90-96"},"PeriodicalIF":3.2,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146172345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to \"Letter to the Editor: Temporal patterns of suicide following psychiatric discharge\".","authors":"Kristoffer Bele Ødegård, Martin Øverlien Myhre, Ole Klungsøyr, Lars Mehlum, Anita Johanna Tørmoen, Fredrik A Walby","doi":"10.1016/j.jpsychires.2026.02.002","DOIUrl":"https://doi.org/10.1016/j.jpsychires.2026.02.002","url":null,"abstract":"","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating levels of glial cell line-derived neurotrophic factor in bipolar disorder: A meta-analysis of case-control studies and efficacy of therapeutic interventions","authors":"Omran Davarinejad ,&nbsp;Saeid Komasi ,&nbsp;Mohammad-Taher Moradi ,&nbsp;Fatemeh Kazemisafa","doi":"10.1016/j.jpsychires.2026.02.005","DOIUrl":"10.1016/j.jpsychires.2026.02.005","url":null,"abstract":"<div><h3>Background</h3><div>Bipolar disorder (BD) is a chronic and debilitating mental illness characterized by alternating episodes of mania and depression, affecting approximately 5-6% of the global population. Despite extensive research, the underlying pathophysiology of BD remains poorly understood, necessitating further exploration of potential biomarkers. This meta-analysis investigates peripheral levels of glial cell line-derived neurotrophic factor (GDNF) to evaluate its utility as a biomarker in individuals with BD.</div></div><div><h3>Methods</h3><div>We systematically searched four international databases, identifying 13 case-control studies (825 patients with BD vs. 885 healthy controls) and 4 clinical trials encompassing 153 patients with BD. The study adhered to PRISMA guidelines and employed rigorous quality assessment tools, including the Newcastle-Ottawa Scale for observational studies and the Cochrane Risk of Bias tool for clinical trials.</div></div><div><h3>Results</h3><div>The analysis revealed a pooled standardized mean difference of d = −0.81 [CI: 1.41 to −0.22], p = 0.007. However, extreme heterogeneity (I² &gt; 96%) and publication bias preclude reliable interpretation of this estimate. Furthermore, the meta-regression analyses were significant for illness duration, YMRS score, and year of study. Subgroup analysis showed significant estimates for blood sample, mania episode, and Asian region. Although treatment interventions increased GDNF levels, these changes were not statistically significant (<em>d</em> = 0.12, [95% CI: 0.20 to 0.44], <em>p</em> = 0.463). High heterogeneity was observed across studies, indicating substantial variability in study designs and participant characteristics.</div></div><div><h3>Conclusion</h3><div>The literature provides preliminary, highly heterogeneous evidence suggestive of altered GDNF levels in BD, primarily within serum during mania. The plasma-serum discrepancy highlights a major methodological confounder (platelet GDNF release), and the significant heterogeneity and publication bias preclude a reliable estimate of the true effect size. GDNF cannot be considered a disorder-specific biomarker for BD, as similar alterations are reported in major depression and schizophrenia. Future research must prioritize plasma measurements, standardized protocols, and longitudinal designs in medication-naïve cohorts to clarify whether GDNF acts as a state-dependent marker of acute mood episodes within a transdiagnostic framework.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"196 ","pages":"Pages 30-39"},"PeriodicalIF":3.2,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Planning and problem solving across multiple psychiatric disorders in young adults","authors":"Raj A. Shetty ,&nbsp;Jon E. Grant","doi":"10.1016/j.jpsychires.2026.01.059","DOIUrl":"10.1016/j.jpsychires.2026.01.059","url":null,"abstract":"<div><h3>Introduction</h3><div>Planning and problem solving, subdomains of executive functioning, are important for daily functioning and clinical outcomes. Although executive functioning encompasses several domains, whether planning-specific deficits are a transdiagnostic feature across psychiatric disorders remains unclear.</div></div><div><h3>Methods</h3><div>Planning and problem solving in 658 young adults aged 18-29 was assessed in a cross-sectional study using the One Touch Stocking of Cambridge (OTS) task, with the number of problems solved correctly on first choice and mean latency to correct response as outcomes. Participants had a diverse range of psychiatric diagnoses, which were determined by structured clinical interviews. Planning and problem solving performance was compared between psychiatric groups and healthy controls using standardized z-scores and Cohen's d effect sizes.</div></div><div><h3>Results</h3><div>Participants with psychiatric diagnoses generally demonstrated impaired planning and problem solving compared to controls. Large effect deficits in problem-solving accuracy were found in obsessive-compulsive disorder (z = −1.32) and trichotillomania (z = −0.87). Moderate effect deficits were observed in agoraphobia, gambling disorder, panic disorder, antisocial personality disorder, compulsive buying disorder, substance abuse, and borderline personality disorder. Trichotillomania also showed the highest planning latency (z = 0.59). Results for diagnostic groups with small sample sizes should be interpreted with caution.</div></div><div><h3>Conclusion</h3><div>These data indicate that planning and problem solving may be impaired in several psychiatric disorders. Future work may wish to examine the contribution of comorbidities and psychoactive substances to the profiles identified.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"196 ","pages":"Pages 1-7"},"PeriodicalIF":3.2,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146116403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time-limited model of an evidence-based telemental health intervention in a graduate student mental health program","authors":"Suza C. Scalora ,&nbsp;Stephanie Lechich ,&nbsp;Alyssa DePasquale ,&nbsp;Helene Geramian ,&nbsp;Katharine Blodget ,&nbsp;Irena Ilieva ,&nbsp;Andrea Temkin-Yu ,&nbsp;Patricia Marino","doi":"10.1016/j.jpsychires.2026.01.062","DOIUrl":"10.1016/j.jpsychires.2026.01.062","url":null,"abstract":"<div><div>This study evaluated the feasibility, acceptability, and preliminary clinical outcomes of a time-limited, evidence-based telemental health (TMH) intervention delivered within a Graduate Student Mental Health program at a northeastern U.S. university between August 2022 and January 2023. Standard measures of depression and anxiety were collected at pre- and post-treatment and supplemented with electronic health record data for 28 participants who initiated and completed treatment.</div><div>The program consisted of 12 weekly, 45-minute individual psychotherapy sessions delivered via a HIPAA-compliant virtual platform. Feasibility was assessed using enrollment and retention, and acceptability was assessed using engagement indicators, including attendance rates. Thirty-eight students initiated treatment, and 28 completed the program (73.6% retention), with an average attendance of 9.79 of 12 sessions (SD = 2.91). Significant pre-to post-treatment reductions were observed in depression scores, (M = 9.61, SD = 5.24) to M = 5.46, SD = 3.78); t (27) = 5.50, p = &lt; .001), d = 1.04 and anxiety scores (M = 9.93, SD = 4.83) to M = 5.54, SD = 3.81); t (27) = 5.41, p = &lt; .001), d = 1.02.</div><div>These findings provide preliminary evidence that a time-limited TMH model may be a feasible and acceptable intervention for graduate students experiencing psychological distress; however, the small, self-selected, non-randomized sample and the absence of a control group limit conclusions about effectiveness and generalizability. In the context of substantial mental health needs and barriers to care in university settings, the results highlight the potential value of scalable TMH programs for expanding access to treatment among graduate students.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"196 ","pages":"Pages 24-29"},"PeriodicalIF":3.2,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Auricular acupressure with five-element music therapy reduces labor pain and short-term postpartum depression: A randomized controlled trial","authors":"Wenjie Sun ,&nbsp;Jie Gong ,&nbsp;Xiuhong Wang,&nbsp;Xianwen Wan,&nbsp;Wei Zheng","doi":"10.1016/j.jpsychires.2026.02.004","DOIUrl":"10.1016/j.jpsychires.2026.02.004","url":null,"abstract":"<div><h3>Background</h3><div>Labor pain and postpartum depression (PPD) are prevalent peripartum complications affecting mothers globally. Conventional interventions for pain management are often limited by contraindications or side effects.</div></div><div><h3>Purpose</h3><div>This study aims to investigate the effects of auricular acupressure combined with five-element music therapy (FEMT) in alleviating labor pain and reducing PPD incidence.</div></div><div><h3>Methods</h3><div>This randomized controlled trial enrolled 146 parturients with singleton cephalic pregnancy preparing for vaginal delivery. Participants were randomly assigned to either the treatment group (auricular acupressure at five points: Internal Genitals, Shenmen, Endocrine, Sympathetic and Subcortex, combined with FEMT) or the control group (routine care). Auricular acupressure was administered during labor until 2 h postpartum, while FEMT involved listening to five-element music. Pain level was evaluated using the Numerical Rating Scale (NRS), and PPD incidence was assessed via Edinburgh Postnatal Depression Scale (EPDS) scores at 1 and 6 weeks postpartum.</div></div><div><h3>Results</h3><div>The treatment group exhibited significantly lower median NRS scores at 6 cm cervical dilation (6 vs. 8, <em>P</em> &lt; 0.001) and 10 cm dilation (7 vs. 9, <em>P</em> &lt; 0.001). At 1 week postpartum, the treatment group had lower EPDS scores (8 vs. 9, <em>P</em> = 0.036), with reduced PPD incidence (15.1% vs. 32.9%, <em>P</em> = 0.012) and major PPD incidence (6.8% vs. 19.2%, <em>P</em> = 0.027). No significant differences in PPD rates were observed at 6 weeks postpartum. Neonatal outcomes and intrapartum cesarean rates were comparable between groups.</div></div><div><h3>Conclusions</h3><div>The combination of auricular acupressure and FEMT effectively alleviated labor pain and reduced short-term PPD incidence.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"196 ","pages":"Pages 71-77"},"PeriodicalIF":3.2,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146172343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicidality calls to a national helpline: One year post the October 7 terror attack and amidst a prolonged war","authors":"Shiri Daniels ,&nbsp;Gil Zalsman ,&nbsp;Liat Itzhaky ,&nbsp;Ohad Szepsenwol ,&nbsp;Ella Sarel Mahlev ,&nbsp;Joy Benatov","doi":"10.1016/j.jpsychires.2026.02.003","DOIUrl":"10.1016/j.jpsychires.2026.02.003","url":null,"abstract":"<div><div>This study provides insights into the impact of prolonged war on suicidality, focusing specifically on suicide-related calls to Israel's national mental health helpline during the year following the October 7, 2023, Hamas terror attack and ongoing war.</div><div>Utilizing data from 615,046 helpline calls between October 7, 2022, and November 2, 2024, the findings showed an immediate, significant increase in overall distress calls after the attack. Conversely, there was a notable and persistent decrease in both the proportion and total number of suicide-related calls throughout the year-long period of war. These findings align with previous research suggesting that heightened war-related distress does not necessarily lead to increased suicide risk, possibly due to factors such as increased social cohesion. Building upon our previous research, the current study contributes to the limited body of knowledge regarding suicidality patterns during prolonged wars. The study underscores the complexity of suicidality patterns during a prolonged war and emphasizes the need for ongoing monitoring and targeted mental health interventions during sustained national crises.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"196 ","pages":"Pages 18-23"},"PeriodicalIF":3.2,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Escitalopram treatment for patients with major depressive disorder: decision trees for treatment algorithm","authors":"Xuequan Zhu ,&nbsp;Rou Zhong ,&nbsp;Xu Chen ,&nbsp;Lei Feng ,&nbsp;Yuan Feng ,&nbsp;Ling Zhang ,&nbsp;Gang Wang","doi":"10.1016/j.jpsychires.2026.02.001","DOIUrl":"10.1016/j.jpsychires.2026.02.001","url":null,"abstract":"<div><h3>Background</h3><div>Current treatment algorithms for major depressive disorder (MDD) lack dynamic prediction capabilities, leading to delayed therapeutic adjustments. This study sought to develop escitalopram-specific decision tree models to identify critical treatment adjustment time points and optimize personalized treatment strategies for MDD.</div></div><div><h3>Methods</h3><div>Using longitudinal data from two multicenter studies in China (2015–2020), we analyzed 800 patients with MDD receiving escitalopram monotherapy. Decision tree models incorporated baseline characteristics (age, BMI, disease duration, depressive symptoms) and dynamic treatment parameters (dose, 2-/4-week improvement) to predict full response (&gt;50% symptom reduction) or non-full response (≤50% reduction) at weeks 2 and 4, and remission status (QIDS-SR16≤5 vs. &gt;5) at week 8. Model performance was assessed by accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC).</div></div><div><h3>Results</h3><div>The week 2 model (n = 800) identified BMI, age, disease duration, course and baseline symptom severity as primary predictors (accuracy = 61.88%, NPV = 84.04%). By week 4 (n = 650), early response status (week 2) merged as a key predictor (accuracy = 69.23%, NPV = 71.62%). The week 8 model (n = 456) demonstrated enhanced predictive power, driven by life quality score, week 2/4 response status, and week 4 dosage (accuracy = 78.02%, PPV = 81.48%, NPV = 72.97%). Logistic regression confirmed week 4 response status as a significant predictor of week 8 outcome (p &lt; 0.005).</div></div><div><h3>Conclusions</h3><div>Week 4 emerges as a key decision point for escitalopram-treated MDD patients, where integration of baseline profiles, early response patterns, and dose parameters allows timely intervention. Our decision tree framework offers a methodological approach for dynamic decision points that warrant prospective validation and extension to other antidepressants.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"195 ","pages":"Pages 284-290"},"PeriodicalIF":3.2,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicide-related metacognitions in psychiatric inpatients admitted after suicide attempt or an acute suicidal crisis: a longitudinal mediation analysis","authors":"Thomas Forkmann ,&nbsp;Tobias Teismann ,&nbsp;Jana Serebriakova ,&nbsp;Jannik Eimen ,&nbsp;Cora Spahn ,&nbsp;Sonja Omlor ,&nbsp;Peer Abilgaard ,&nbsp;Markus Frings ,&nbsp;Ralf Kudling ,&nbsp;Jens Kuhn ,&nbsp;Martin Schaefer ,&nbsp;Norbert Scherbaum ,&nbsp;Heide Glaesmer ,&nbsp;Lena Spangenberg","doi":"10.1016/j.jpsychires.2026.01.061","DOIUrl":"10.1016/j.jpsychires.2026.01.061","url":null,"abstract":"<div><h3>Background</h3><div>The metacognitive model of suicidality suggests that suicide-related metacognitions activate a Cognitive Attentional Syndrome (CAS)—including suicide-specific rumination, attentional fixation, and thought suppression—which may intensify and prolong suicidal ideation. While initial support has emerged from general population samples, longitudinal evidence in high-risk clinical populations remains lacking.</div></div><div><h3>Methods</h3><div>In a multicenter, prospective study, we examined model assumptions in a sample of 184 psychiatric inpatients (M = 37.5 years, 50% male), all admitted following a suicide attempt or severe suicidal crisis. Participants completed baseline assessments prior to discharge and engaged in a 3-week ecological momentary assessment (EMA) protocol measuring suicide-specific rumination, thought suppression, and suicidal intent up to four times daily. Past suicidal ideation and suicide-related metacognitions (positive and negative) were assessed using validated scales.</div></div><div><h3>Results</h3><div>Past suicidal ideation significantly predicted both positive and negative suicide-related metacognitions. These, in turn, prospectively predicted suicide-specific rumination but not thought suppression. Mediation analyses indicated that positive metacognitions mediated the relationship between past suicidal ideation and future suicide-specific rumination. Additionally, suicide-specific rumination—rather than thought suppression—mediated the relationship between suicide-related metacognitions and both intensity and frequency of suicidal intent during the EMA period.</div></div><div><h3>Limitations</h3><div>Attentional fixation was not assessed. EMA compliance averaged 48.3%, and some measures were adapted from preliminary versions.</div></div><div><h3>Conclusions</h3><div>Findings provide the first longitudinal support for the metacognitive model of suicidality in a clinical sample. Suicide-specific rumination and positive metacognitions may be important drivers of intensification and prolongation of suicidal ideation and suicidal intent formation in the high-risk post-discharge period.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"196 ","pages":"Pages 44-52"},"PeriodicalIF":3.2,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}