Journal of psychiatric research最新文献

This study examines the asymmetric effects of economic hardship on depressive symptoms among Korean women. It focuses on whether transitions into and out of hardship have differing impacts on depressive symptoms and how these effects vary by socioeconomic status. This study used data from the Korean Longitudinal Survey of Women & Families (2007-2022). An asymmetric fixed effects model was employed to separately estimate the effects of transitioning into and out of perceived economic hardship on depressive symptoms. We also included interaction terms for housing tenure and years of education in separate models. Transitioning into economic hardship significantly increases depressive symptoms, with a stronger effect than transitioning out. Individuals with homeownership and higher education experience a smaller increase in depressive symptoms when transitioning into hardship compared to others. However, housing tenure and educational attainment do not moderate the effects of transitioning out of hardship on depressive symptoms. These findings highlight the need for targeted interventions to improve the psychological health of women experiencing economic hardship.

Wide number of basic, preclinical and clinical research have led to increase our knowledge on understanding the potential roles of neuroinflammation in neurodegenerative diseases such as Alzheimer's disease (AD). In fact, neuroinflammation is considered as one of the key pathological factors of neuronal dysfunction leading to dementia in AD and other forms of dementias or related dementias (RD). Central nervous system (CNS) network communicates and control the immune system signaling pathways within the brain as well as peripheral part of the body. Hence, disturbance in the physiological immune system regulation is susceptible to the etiology or pathogenesis of the diseases. Microglia, astrocytes, oligodendrocytes, B-/T-cells and neutrophils are potential regulatory cells in keeping our immune system in balance. The imbalance in the regulatory function of these cells results to inflammatory consequences and has direct or indirect influence in the AD trajectory. In the brain, neuroinflammation is strongly linked to the accumulation of Aβ plaques and tau tangles which lead to pathogenesis underlying dementia of AD. Currently, neuroinflammation is considered as one of the pathological hallmarks of AD, alongside Aβ plaques and tau tangles. Various research and review articles have described the dysregulation of immune system cells leading to neuroinflammation in AD and RD pathogenesis. However, how these immune cells become coordinately imbalanced in the disease pathogenesis has been rarely reported, which is necessary for deeper understanding of the disease pathology and therapeutic development. In this review, we intend to highlight and discuss the neuroinflammatory pathways mediated via dysregulation of microglia, astrocyte, oligodendrocyte, neutrophil, B-cell and T-cell functions, which leads to neuronal dysfunction, dementia or cognitive decline in AD and RD. We believe that the narrative in this review will be helpful in the future basic/clinical research and therapeutic development for AD and RD.

Background: Individuals with autism spectrum disorder (ASD) and their caregivers often face challenges such as emotional distress and stress management, which severely impact their quality of life. Mindfulness-Based Stress Reduction (MBSR) holds potential value in emotional regulation; however, there is a lack of systematic evaluation targeting the ASD population, particularly caregivers. This systematic review aims to clarify the clinical effects of MBSR interventions on individuals with ASD and their caregivers, providing a reference for the clinical implementation of targeted interventions.

Method: We systematically searched PubMed, the Cochrane Library, Web of Science, Embase, Ovid, and CINAHL databases using predefined search terms and combinations, with supplementary handsearching for relevant literature. The search timeframe covered the period from the establishment of each database to October 1, 2025. This systematic review protocol has been prospectively registered in PROSPERO with the registration number CRD420251159313.

Results: A total of 13 clinical studies were included. The results indicate that MBSR demonstrates certain intervention potential for adults with ASD and their caregivers. Specifically, among adults with ASD (N = 8), MBSR may help improve emotional symptoms such as anxiety and depression. For ASD caregivers (N = 4), MBSR has shown preliminary effects in relieving psychological stress and improving emotional states, suggesting that it may provide potential psychological support for this population. It should be noted that only one study in the current evidence focuses on children with ASD, and the adolescent population remains uncovered.

Conclusion: Preliminary research suggests that MBSR may hold potential value in improving anxiety and depression symptoms among adults with ASD, as well as alleviating caregiving stress and emotional distress among ASD caregivers. However, due to limitations such as the small number of included studies, limited sample sizes, and high heterogeneity, the current evidence remains insufficient in strength, and conclusions should be interpreted with caution. Future research should focus on conducting larger-scale, high-quality studies to enhance the reliability of findings.

Background: Obsessive-compulsive disorder (OCD) is a chronic psychiatric condition in which delays to appropriate treatment-known as duration of untreated illness (DUI)-are common and clinically consequential. Although prolonged DUI has been associated with poor response, the specific time point beyond which treatment resistance becomes likely remains unclear.

Methods: We analysed 220 adults with DSM-5 OCD consecutively recruited at the University of Turin OCD clinic (2015-2023). DUI was defined as the interval between onset of clinically significant symptoms and the initiation of an adequate selective serotonin reuptake inhibitor (SSRI) trial (moderate-to-high dose for ≥12 weeks). Response was defined as a ≥35 % reduction in Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score and a Clinical Global Impression-Improvement (CGI-I) rating ≤2. Receiver-operating-characteristic (ROC) analysis identified the DUI cut-off predicting SSRI non-response.

Results: Mean age was equal to 34.5 ± 12.4 years; mean DUI was 107.2 ± 116.7 months. Half of the sample (50.4 %) responded to first-line SSRIs. ROC analysis yielded area under the curve = 0.634 (p < 0.001). The optimal cut-off was 42 months, corresponding to a sensitivity of 70.1 % and a specificity of 53.9 %.

Conclusions: A DUI exceeding about 3.5 years is associated with a substantially lower probability of SSRI response. These data suggest that a duration of untreated illness beyond forty-two months may predict reduced responsiveness to first-line SSRI therapy in OCD, though replication in larger, multicentric samples is warranted.

Hoarding disorder has been found to co-occur with eating disorders. However, no prior systematic reviews or meta-analyses have examined the pooled lifetime prevalence of hoarding disorder symptoms in adults with an eating disorder. Based on PRISMA guidelines, 4 electronic databases (MEDLINE, PubMed, PsycINFO, and Cochrane) were searched on September 17, 2025. A total of 539 articles were identified for screening using a combination of search terms. The effect size is the pooled lifetime prevalence of hoarding disorder symptoms among adults with an eating disorder. A total of 5 studies were included in the overall meta-analysis for hoarding disorder symptom prevalence. The results revealed that the pooled lifetime prevalence of hoarding disorder symptoms in adults with an eating disorder was 24 % (95 % CI: 0.23-0.25) with low heterogeneity between studies (I² = 12.0 %). Results suggest that hoarding disorder symptoms co-occur often with eating disorders. Based on these findings, clinicians should consider screening for comorbid hoarding disorder when assessing for eating disorders.

Mental and neurodevelopmental disorders are heterogeneous, complex, and overlapping entities. Despite progress, their neurobiological underpinnings are not well understood, and current treatments have limited efficacy. However, a growing number of studies have shown impaired brain and systemic energy metabolism evidenced by low-grade inflammation, metabolic syndrome, mitochondrial dysfunction, and abnormal glucose utilization, although their underlying mechanisms remain poorly understood. This paper reviews metabolic shifts in mental disorders, examines the underlying mechanisms driving these metabolic abnormalities in patient subgroups, and explores targeted therapeutic strategies. We argue here that this inflammation results in hyperosmolarity because of increased protein concentration in the extracellular fluid, resulting from vascular leakages. Hyperosmolarity exerts pressure on the capillaries resulting in altered blood flow (hypoperfusion and/or hyper perfusion). Another consequence of hyperosmolarity is metabolic shifts such as aerobic glycolysis. Hyperosmolarity is also responsible for releasing neurotransmitters such as serotonin, dopamine, glutamate, or gamma-aminobutyric acid (GABA). Drugs known to interfere with metabolism such as methylene blue and lipoic acid have been found to have antidepressant, anxiolytic, and neuroprotective effects (both in animals and in humans) in a large array of mental disorders. We suggest that metabolic shifts are a hallmark of mental disorders and that treatments aiming to alleviate these metabolic shifts may improve patients' prognoses. Mechanisms-based treatments should be tested in future clinical trials, where subgroups of patients characterized as having the most profoundly impaired metabolism should be included, following the rules of precision psychiatry.

Suicidality (suicidal ideation and -plans (SI) and deliberate self-harm (DSH)), has been extensively studied in different patient populations. Fewer studies have examined predictors of suicide within an extensive longitudinal frame, which is problematic since findings from studies including participants with non-lethal suicidal behavior are not easily generalizable to patients that complete suicide. We aimed to address this gap by examining demographic and clinical factors as predictors of suicide in a longitudinal prospective cohort study of 7,000 consecutively admitted patients. Mean observation time was 4.1 years. Male gender, more frequent admissions during the follow-up period, and having SI, DSH and substance-induced psychosis at the final admission before suicide, directly predicted shorter time to suicide. Shorter time to suicide was indirectly predicted by borderline personality disorder (BPD) via DSH and by psychotic depression and neurotic disorders via SI. In contrast, longer time to suicide was indirectly predicted by substance-induced psychosis and psychotic disorders via reduced probability of SI and DSH at the final admission. Patients diagnosed with BPD had more frequent admissions and higher levels of SI and DSH across admissions, which predicted shorter time to suicide via increased risk of DSH at the final admission. Similarly, patients diagnosed with neurotic disorders had a higher level of SI and DSH across admissions, with shorter time to suicide via SI and DSH at the final admission. Findings suggest different pathways to suicide for different clinical subgroups, and this is discussed in relation to current theoretical models that emphasize suicide as a transdiagnostic phenomenon.

Obsessive-compulsive disorder (OCD) is a heterogeneous condition often characterized in relation to major symptom dimensions, including contamination, symmetry/exactness, religious, aggressive, sexual, hoarding/saving, somatic, and miscellaneous. Aggressive obsessions, defined as intrusive thoughts of (unintentionally or intentionally) harming oneself or others, are experienced as distressing, commonly misdiagnosed by healthcare providers, and highly stigmatized. The aims of the current study were to: (a) provide an aggregate estimate of the worldwide prevalence of aggressive obsessions among adults (18+ years) with clinician-diagnosed OCD; and (b) quantify sources of heterogeneity amongst prevalence estimates using moderator analyses. A systematic review was conducted using PubMed, PsycINFO, and CINAHL databases. Of the 7794 studies screened, 110 were coded for analysis. Lifetime and current (e.g., past-week) prevalence rates were estimated to be 70.3 %, CI_95 % [61.6, 77.7], and 52.6 %, CI_95 % [46.3, 59.0], respectively, and reflected substantial heterogeneity. For 28.0 % of individuals, aggressive obsessions were categorized as their primary and most distressing symptom. Moderator analyses revealed higher current prevalence of aggressive obsessions across samples with a greater mean age, longer mean illness duration, lower mean age of OCD onset, and greater comorbid social anxiety disorder prevalence, while significantly fewer aggressive obsessions were reported in samples from the Asia Pacific region, and with higher percentages of married individuals. Finally, risk ratio analyses revealed that individuals with: a) early vs. late OCD onset; and b) suicidal ideation vs. not, were 1.17 times, CI_95 % [1.07, 1.27], and 1.98 times, CI_95 %[1.47, 2.66], more likely to report aggressive obsessions, respectively. Results support the need for early identification and increased monitoring among individuals experiencing aggressive obsessions.

Objective: To develop a concise version of the Psychological Strain Scale (PSS-40) by integrating Classical Test Theory (CTT) and Item Response Theory (IRT).

Methods: PSS-40 was applied to measure the psychological strain in a total of 10478 college students. The demographic information was collected by a self-designed questionnaire. The analysis of PSS-40 items was conducted using classical measurements including variability, correlation coefficient, factor analysis, Cronbach coefficient, as well as the Samejima graded response model from IRT. IRT parameters include discrimination, difficulty, average information volume, etc. RESULTS: 20 items with the highest comprehensive evaluation of PSS-40 were selected based on methods combined CTT and IRT. Exploratory factor analysis revealed that each item in PSS-20 had a standardized factor loading greater than 0.6, and the cumulative variance explained exceeded 66 %. Additionally, confirmatory factor analysis showed good fit of the model (RMESA = 0.057, RMR = 0.028). PSS-20 exhibited excellent reliability with a Cronbach's alpha coefficient of 0.939 and criterion validity of 0.558.

Conclusions: The PSS-20 scale has been validated to have good reliability and validity, and can be used as a tool to evaluate psychological strain.