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Parental bonding and eating disorder core beliefs in a non-clinical sample 父母关系和饮食失调在非临床样本中的核心信念。
IF 3.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2026-01-20 DOI: 10.1016/j.jpsychires.2026.01.027
Myra J. Cooper , Esben Strodl
This study investigated the relationship between early childhood experiences and eating disorder related core beliefs in the context of cognitive behavioural models of eating disorders highlighting the role of core beliefs or schema. A non-clinical sample of 736 participants (87 % female) was recruited and completed online self report questionnaires. Given the complexity of the relationship between the independent (parental bonding) and dependent (eating disorder related core belief) variables canonical correlation analysis was used to analyse the relationship between the two variable sets. Five functions explained 27.4 % of the variance shared between the two variable sets, and indicated one significant canonical function. Mother and father levels of care and overprotection were the strongest predictors of participant self ratings of the core beliefs self-loathing and abandonment. The results support an association between adverse childhood experiences and negative core beliefs in those with anorexia nervosa and bulimia nervosa, a key link in cognitive behavioural models of eating disorders. It will, of course, be important to seek to replicate this work in a clinical eating disorder sample.
本研究在饮食失调认知行为模型的背景下探讨了儿童早期经历与饮食失调相关核心信念的关系,强调了核心信念或图式的作用。招募了736名非临床参与者(87%为女性),并完成了在线自我报告问卷。考虑到独立变量(父母关系)和依赖变量(饮食失调相关核心信念)之间关系的复杂性,我们采用典型相关分析来分析两个变量集之间的关系。五个函数解释了两个变量集之间共享方差的27.4%,并表明一个显著的规范函数。母亲和父亲的关心和过度保护水平是参与者对核心信念自我评价的最强预测因子,自我厌恶和遗弃。研究结果支持了神经性厌食症和神经性贪食症患者不良童年经历与消极核心信念之间的联系,这是饮食失调认知行为模型的关键环节。当然,寻求在临床饮食失调样本中复制这项工作是很重要的。
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引用次数: 0
Reality monitoring across disorders of reality: Systematic and narrative reviews of dissociation and psychosis 跨越现实障碍的现实监测:对分离和精神病的系统和叙述性回顾。
IF 3.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2026-01-19 DOI: 10.1016/j.jpsychires.2026.01.021
Gwynnevere Suter , Ian Apperly , Lei Zhang , Emma Černis
Reality monitoring is the ability to remember whether information was internally- or externally-generated and is often impaired in clinical populations. Though an altered sense of reality characterizes both dissociation and psychosis, no review has compared reality monitoring between them. This paper compares these fields to inform the relation between dissociation and psychosis and the role of reality monitoring in mental health.
First, a systematic review identified four eligible high-quality papers (according to Kmet and Lee's Quantitative Checklist; n = 482) which measured dissociation directly and tested reality monitoring experimentally. Meta-analysis indicated a small significant negative association between reality monitoring and dissociation (Correlation = −0.013, [-0.22, −0.04]), implying reality monitoring impairment in dissociation. Papers were identified from inception to May 15, 2025 through searching Web of Science, Scopus, PsycINFO, PsycARTICLES, EMBASE, and MEDLINE.
Next, a narrative review of psychosis and reality monitoring, covering pre-existing systematic reviews and original articles, indicated variation across the clinical spectrum. While clinical psychosis was robustly associated with impaired reality monitoring ability and externalising bias, results at non-clinical and sub-clinical levels were mixed.
Finally, the reviews were compared to understand how reality monitoring and research practices vary across dissociation and psychosis. This indicated that both dissociation and psychosis are associated with impaired reality monitoring. Though this suggests a shared cognitive basis, no papers on dissociation included clinical presentations or bias towards internalising/externalising the item's source, meaning any comparison is incomplete. Future research should consider clinical dissociation, reality monitoring bias in dissociation, and compare dissociation and psychosis directly.
现实监测是记住信息是内部产生还是外部产生的能力,在临床人群中经常受损。虽然现实感的改变都是精神分裂和精神病的特征,但没有评论比较过它们之间的现实监测。本文将这些领域进行比较,以了解分离与精神病之间的关系以及现实监测在心理健康中的作用。首先,系统回顾确定了四篇合格的高质量论文(根据Kmet和Lee的定量清单;n = 482),这些论文直接测量了解离,并通过实验测试了现实监测。meta分析显示,现实监测与解离之间存在显著负相关(相关系数= -0.013,[-0.22,-0.04]),表明现实监测存在解离障碍。通过检索Web of Science、Scopus、PsycINFO、PsycARTICLES、EMBASE和MEDLINE,确定论文从成立到2025年5月15日。接下来,一篇关于精神病和现实监测的叙述性综述,涵盖了已有的系统综述和原始文章,指出了临床谱上的差异。虽然临床精神病与现实监测能力受损和外化偏见密切相关,但非临床和亚临床水平的结果却参差不齐。最后,对这些综述进行比较,以了解现实监测和研究实践在分离和精神病之间的差异。这表明分离和精神病都与现实监测受损有关。虽然这表明有共同的认知基础,但没有关于分离的论文包括临床表现或对内化/外化项目来源的偏见,这意味着任何比较都是不完整的。未来的研究应考虑临床解离、解离中的现实监测偏差,并将解离与精神病进行直接比较。
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引用次数: 0
Insular cortex-lateral habenula circuit mediates chronic itch-associated affective comorbidities 岛叶皮层-外侧缰环介导慢性瘙痒相关的情感性合并症
IF 3.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2026-01-17 DOI: 10.1016/j.jpsychires.2026.01.026
Zhiqiang Chen , Shuaibo Wang , Yifei Wang
Pruritus triggers scratching-induced skin damage and anxiety/depression, forming a vicious cycle that exacerbates inflammatory skin diseases. The insular cortex (IC) integrates itch and emotional processing, while the lateral habenula (LHb) regulates depression.Using acute (3-day) and chronic (14-day) histamine-induced murine itch models combined with chemogenetic manipulation, we demonstrate that the insular cortex (IC) bidirectionally regulates acute itch and anxiety-like behaviors, whereas chronic itch engages the IC-lateral habenula (LHb) circuit to drive comorbid depression. These results establish the IC–LHb circuit as a critical mechanistic driver of chronic itch–associated affective comorbidities. They further highlight serotonergic modulation of this pathway as a promising therapeutic strategy for neuroinflammatory itch.
瘙痒会引发抓挠引起的皮肤损伤和焦虑/抑郁,形成恶性循环,加剧炎症性皮肤病。岛叶皮质(IC)整合瘙痒和情绪处理,而外侧缰(LHb)调节抑郁。利用急性(3天)和慢性(14天)组胺诱导的小鼠瘙痒模型,结合化学发生操作,我们证明岛叶皮质(IC)双向调节急性瘙痒和焦虑样行为,而慢性瘙痒参与IC-外侧链(LHb)回路驱动共病抑郁。这些结果确立了IC-LHb回路是慢性瘙痒相关情感合并症的关键机制驱动因素。他们进一步强调了该途径的血清素能调节作为神经炎性瘙痒的有希望的治疗策略。
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引用次数: 0
Lithium treatment and risk of neurocognitive disorders in older patients with bipolar disorder: A systematic review 老年双相情感障碍患者的锂治疗和神经认知障碍风险:一项系统综述。
IF 3.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2026-01-16 DOI: 10.1016/j.jpsychires.2026.01.022
Eleni Parlapani , Anna Kirka , Vasiliki Holeva , Stergios Kaprinis

Objective

Bipolar disorder is a chronic mental illness that requires long-term treatment. Reports from patients of cognitive dulling have prompted research into the impact of long-term Lithium treatment on cognition. The present systematic review aimed to investigate the effects of Lithium on neurocognitive disorder outcomes in older patients with bipolar disorder.

Method

A systematic literature search was conducted in four databases: PubMed, Scopus, ScienceDirect and EBSCO. Study inclusion was based on concrete inclusion/exclusion criteria. The literature search and the final study selection were conducted in four stages. Included studies were assessed for quality using the Newcastle-Ottawa Quality Assessment Scale for cohort studies, and the Modifications to the Newcastle-Ottawa Scale for cross-sectional studies.

Results

The original search yielded a total of 8285 records. Among these, nine studies were included in the systematic review. Eight out of nine studies did not support an association between Lithium treatment and increased risk of neurocognitive disorders. One study found that the association between bipolar disorder and neurocognitive disorder may be mediated by Lithium treatment.

Conclusion

There is no conclusive evidence that long-term Lithium treatment is harmful with respect to neurocognitive outcomes in older patients with bipolar disorder. Beyond its efficacy as a mood-stabilizer, accumulating evidence supports Lithium's neurotrophic effects. To date, there is enough evidence to support Lithium maintenance as a first-line treatment for older patients with bipolar disorder.
目的:双相情感障碍是一种需要长期治疗的慢性精神疾病。来自认知迟钝患者的报告促使人们研究长期锂离子治疗对认知的影响。本系统综述旨在探讨锂对老年双相情感障碍患者神经认知障碍结局的影响。方法:系统检索PubMed、Scopus、ScienceDirect和EBSCO 4个数据库的文献。研究纳入基于具体的纳入/排除标准。文献检索和最后的研究选择分四个阶段进行。纳入的研究采用纽卡斯尔-渥太华质量评估量表对队列研究进行质量评估,对纽卡斯尔-渥太华量表的修改对横断面研究进行质量评估。结果:最初的搜索总共产生了8285条记录。其中9项研究纳入系统评价。九项研究中有八项不支持锂治疗与神经认知障碍风险增加之间的联系。一项研究发现,双相情感障碍和神经认知障碍之间的关联可能是由锂治疗介导的。结论:没有确凿的证据表明长期锂治疗对老年双相情感障碍患者的神经认知结果有害。除了作为情绪稳定剂的功效,越来越多的证据支持锂的神经营养作用。迄今为止,有足够的证据支持锂维持作为老年双相情感障碍患者的一线治疗。
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引用次数: 0
The association between self-concept, self-concept clarity, and self-injurious thoughts and behaviors (SI, SA, and NSSI): A three-level meta-analysis 自我概念、自我概念清晰与自伤思想和行为(自伤、自伤和自伤)的关系:一个三层次元分析
IF 3.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2026-01-16 DOI: 10.1016/j.jpsychires.2026.01.024
CongYuan Liao , Yi Hou , DongKui Li , Dong Yang , Ying Li

Background

Self-injurious thoughts and behaviors (SITBs), including suicidal ideation (SI), suicide attempts (SA), and non-suicidal self-injury (NSSI), pose a significant global public health challenge. This meta-analysis examines the relationship between self-concept, self-concept clarity, and SITBs. Although prior research suggests associations between self-concept, self-concept clarity, and SITBs, the strength and direction of these relationships remain inconsistent.

Methods

This meta-analysis synthesized effect sizes from studies in PubMed, PsycInfo, and Web of Science, using a three-level meta-analytic model to examine associations between self-concept, self-concept clarity, and SITBs.

Results

A total of 33 studies with 113 effect sizes (N = 23,772) were analyzed. Significant negative correlations were found between self-concept and suicidal ideation (r = −0.234), and suicide attempts (r = −0.194). The correlation with NSSI (r = −0.258) was not stable. Significant heterogeneity was present, but no significant moderators were found. No publication bias was identified. Self-concept clarity was negatively associated with suicidal ideation (r = −0.295) and NSSI (r = −0.257). The association with suicide attempts (r = −0.244) was inconclusive. The results for self-concept clarity should be considered exploratory, and no publication bias, sensitivity, or moderator tests were conducted due to the limited number of effect sizes.

Conclusion

This meta-analysis highlights some significant, albeit small, negative associations between self-concept, self-concept clarity, and SITBs. However, due to the limited number of studies and effect sizes, some results should be considered exploratory. Future research should explore potential mediating and moderating factors and examine longitudinal relationships to better understand the causal pathways.
自伤思想和行为(SITBs),包括自杀意念(SI)、自杀企图(SA)和非自杀性自伤(NSSI),构成了一个重大的全球公共卫生挑战。本荟萃分析考察了自我概念、自我概念清晰度和sitb之间的关系。尽管先前的研究表明自我概念、自我概念清晰度和sitb之间存在关联,但这些关系的强度和方向仍然不一致。方法本荟萃分析综合了PubMed、PsycInfo和Web of Science研究的效应量,使用三级荟萃分析模型来检验自我概念、自我概念清晰度和sitb之间的关系。结果共分析33项研究,113个效应量(N = 23,772)。自我概念与自杀意念(r = - 0.234)、自杀企图(r = - 0.194)呈显著负相关。与自伤的相关性(r = - 0.258)不稳定。存在显著异质性,但未发现显著调节因子。未发现发表偏倚。自我概念清晰度与自杀意念(r = - 0.295)和自伤(r = - 0.257)呈负相关。与自杀企图的关系(r = - 0.244)尚无定论。自我概念清晰度的结果应该被认为是探索性的,由于效应量的数量有限,没有进行发表偏倚、敏感性或调节试验。结论:本荟萃分析强调了自我概念、自我概念清晰度和sitb之间的一些显著的负相关关系。然而,由于研究数量和效应量有限,一些结果应该被认为是探索性的。未来的研究应探索潜在的中介和调节因素,并检查纵向关系,以更好地了解因果途径。
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引用次数: 0
Alterations in white matter integrity and asymmetry in children with autism spectrum disorder: an automated fiber quantification tractography study 自闭症谱系障碍儿童白质完整性和不对称性的改变:一项自动纤维定量束束造影研究
IF 3.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2026-01-13 DOI: 10.1016/j.jpsychires.2026.01.018
Dan Luo , Chunfeng Zhao , Lisha Nie , Yu Yin , Xiaoqing Liu , Haoyue Yu , Fuqin Wang , Heng Chen , Heng Liu

Objective

To investigate microstructural and lateralization abnormalities of white matter (WM) in children with autism spectrum disorder (ASD) using automated fiber quantification tractography, assess their relationship with behavioral symptoms, and analyze developmental trajectories of WM tracts with age.

Materials and methods

This study analyzed diffusion tensor imaging data of 36 children with ASD (mean age, 5.44 ± 0.95 years; male:female, 28:8) and 27 healthy controls (mean age, 5.06 ± 1.83 years; male:female, 17:10) using automated fiber quantification. A support vector machine (SVM) classifier was applied to distinguish ASD from healthy controls (HC) based on WM metrics.

Results

ASD children exhibited local WM abnormalities, atypical lateralization, and impaired age-related development of WM. The callosum forceps major (CF_major) and left inferior longitudinal fasciculus impairments correlated with social impairments, while CF_major and right thalamic radiation impairments correlated with repetitive behaviors. The cingulum cingulate was atypically lateralized and negatively correlated with the Childhood Autism Rating Scale. SVM classification based on WM metrics achieved 75 % accuracy (AUC = 0.81) in distinguishing ASD from HC.

Conclusions

Children with ASD show subtle microstructural abnormalities, atypical lateralization patterns, and delayed development of WM tracts, correlated with behavioral symptoms. SVM classification supports the discriminative utility of WM metrics as potential ASD biomarkers.
目的应用自动纤维量化神经束造影研究自闭症谱系障碍(ASD)儿童白质(WM)的显微结构和侧化异常,评估其与行为症状的关系,并分析WM束随年龄的发展轨迹。材料与方法采用自动纤维定量分析36例ASD患儿(平均年龄5.44±0.95岁,男:女,28:8)和27例健康对照(平均年龄5.06±1.83岁,男:女,17:10)的弥散张量成像资料。基于WM指标,应用支持向量机(SVM)分类器对ASD与健康对照(HC)进行区分。结果asd患儿表现为局部WM异常、非典型侧化、WM年龄相关发育受损。胼胝体大尺蠖(CF_major)和左下丘脑纵束损伤与社交障碍相关,而胼胝体大尺蠖(CF_major)和右丘脑辐射损伤与重复性行为相关。扣带呈非典型偏侧化,与儿童自闭症评定量表呈负相关。基于WM指标的SVM分类在区分ASD和HC方面准确率达到75% (AUC = 0.81)。结论ASD患儿表现出细微的显微结构异常,不典型的侧化模式,WM束发育迟缓,与行为症状相关。支持向量机分类支持WM指标作为潜在ASD生物标志物的判别效用。
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引用次数: 0
Neurocognitive correlates of Food and Alcohol Disturbances: An integrated neuropsychological investigation 食物和酒精障碍的神经认知相关性:一项综合神经心理学研究
IF 3.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2026-01-13 DOI: 10.1016/j.jpsychires.2026.01.020
Ludivine Ritz , Nicolas Mauny , Charlotte Montcharmont , Hélène Beaunieux , Pierre Maurage
Food and Alcohol Disturbance (FAD) represents a functional relationship between alcohol use and eating behaviors, in which individuals engage in disordered eating to enhance alcohol intoxication and/or compensate for alcohol-related caloric intake. FAD is highly prevalent among young adults, particularly University students. While the biopsychosocial correlates of FAD are documented, its specific neurocognitive correlates remain unexplored, despite extensive literature describing the distinct neurocognitive correlates of alcohol consumption and eating disorders. We therefore investigated whether FAD is associated with neurocognitive correlates in university students and examined whether different FAD sub-dimensions relate to distinct cognitive profiles. We assessed FAD in 130 French university students using the CEBRACS scale and administered an extensive neuropsychological battery measuring visuospatial abilities, episodic memory, and executive functions. We compared cognitive performance between individuals who do and do not engage in FAD and then conducted exploratory multivariate regression analyses to identify variations in cognitive profiles across the CEBRACS subscales. The general comparison between individuals who do and do not engage in FAD did not reveal significant differences. Conversely, analyses of the CEBRACS subscales identified specific patterns: (1) dietary restraint was associated with poorer visuospatial abilities and verbal episodic memory; (2) purging behaviors were associated with lower executive functioning but improved visual episodic memory; (3) extreme fasting and self-induced vomiting were associated with poorer visual episodic memory performance but higher executive functioning. These findings suggest that FAD is an umbrella term encompassing various cognitive profiles according to the distinct eating behaviors involved and highlight the importance of considering the subcomponents of FAD when exploring its neurocognitive correlates.
食物和酒精障碍(FAD)代表了酒精使用与饮食行为之间的功能关系,其中个体参与饮食失调以增强酒精中毒和/或补偿与酒精相关的热量摄入。FAD在年轻人中非常普遍,尤其是大学生。虽然FAD的生物心理社会相关性已被记录,但其特定的神经认知相关性仍未被探索,尽管大量文献描述了饮酒和饮食失调之间独特的神经认知相关性。因此,我们研究了FAD是否与大学生的神经认知相关,并检查了不同的FAD子维度是否与不同的认知特征相关。我们使用CEBRACS量表评估了130名法国大学生的FAD,并进行了广泛的神经心理学测试,测量视觉空间能力、情景记忆和执行功能。我们比较了参与FAD和不参与FAD的个体之间的认知表现,然后进行了探索性的多变量回归分析,以确定认知概况在CEBRACS子量表中的变化。在进行FAD和不进行FAD的个体之间的一般比较没有显示显着差异。相反,对CEBRACS亚量表的分析发现了特定的模式:(1)饮食限制与较差的视觉空间能力和言语情景记忆有关;(2)净化行为与执行功能降低有关,但与视觉情景记忆改善有关;(3)极度禁食和自我诱导呕吐与视觉情景记忆表现较差有关,但与执行功能较高有关。这些发现表明,FAD是一个总称,根据所涉及的不同饮食行为,涵盖了各种认知概况,并强调了在探索其神经认知相关性时考虑FAD的子成分的重要性。
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引用次数: 0
The placebo effect on depressive symptoms and brain age in patients with depression: a reanalysis study of a randomized controlled clinical trial on the antidepressive effect of bright light therapy 安慰剂对抑郁症患者抑郁症状和脑年龄的影响:一项关于强光治疗抗抑郁效果的随机对照临床试验的再分析研究
IF 3.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2026-01-13 DOI: 10.1016/j.jpsychires.2026.01.019
Chun-Chao Huang , Hui-Chun Huang , Huei-Yu Tsai , Hsin-Fan Chiang , Cheng-Chih Hsieh , Shih-Yang Wei , Chen-Yuan Kuo , Shen-Ing Liu , Ching-Po Lin

Background

Depression is associated with accelerated brain aging. Bright light therapy (BLT) shows promise in treating depression and alleviating cognitive deficits, but it remains unclear if BLT can improve brain age and if clinical benefits are related to changes in brain age. This study evaluates the impact of BLT on brain age in depression and explores the relationship between symptomatic improvement and changes in brain age.

Methods

This study reanalyzed data from a double-blind, randomized controlled trial comparing BLT to dim red light (dRL) therapy. Scores from the Hamilton Depression Rating Scale-24 (HAMD-24) and the nine-item Patient Health Questionnaire (PHQ-9) were recorded at baseline and 4 weeks after therapy. Brain MRI scans estimated individual brain age gap (BAG), which was the difference between predicted brain age and chronological age. BAGs were calculated for global and cognition-specific domains (executive function, memory, language, and vision). Changes in clinical scores and BAG were assessed within and between groups, including analyses based on symptom improvement.

Results

The study included 21 participants in the BLT group and 18 in the dRL group. Both groups showed improvements in clinical scores without significant between-group differences. Although there were no group differences in BAG, the combined group had a significantly younger BAG in global, vision, and language domains after intervention. Additionally, patients with improvement in PHQ-9 scores showed reduced BAG in global brain and executive function domains and greater improvement in PHQ-9 was correlated with a younger executive function brain age.

Conclusion

No specific effect of BLT on brain age was observed compared with the control group. However, reductions in global and executive function brain age were associated with subjective symptom improvement, suggesting a potential role of placebo effects or neuroplasticity. These findings highlight the importance of considering subjective measures and brain aging biomarkers in evaluating antidepressant interventions.
抑郁症与大脑加速老化有关。光明疗法(BLT)在治疗抑郁症和减轻认知缺陷方面显示出希望,但目前尚不清楚BLT是否能改善脑老化,以及临床益处是否与脑老化的改变有关。本研究评估BLT对抑郁症患者脑年龄的影响,探讨症状改善与脑年龄变化之间的关系。方法本研究重新分析了一项双盲、随机对照试验的数据,比较了BLT和暗红光(dRL)治疗。在基线和治疗后4周记录汉密尔顿抑郁评定量表-24 (HAMD-24)和9项患者健康问卷(PHQ-9)的得分。脑核磁共振扫描估计个体脑年龄差距(BAG),即预测的脑年龄与实际年龄之间的差异。对全局和认知特定域(执行功能、记忆、语言和视觉)计算bag。评估组内和组间临床评分和BAG的变化,包括基于症状改善的分析。结果本研究包括21名BLT组和18名dRL组。两组临床评分均有改善,组间无显著差异。虽然在BAG方面没有组间差异,但在干预后,联合组在全球、视觉和语言领域的BAG明显更年轻。此外,PHQ-9评分改善的患者表现出全球大脑和执行功能域的BAG减少,PHQ-9的更大改善与更年轻的执行功能脑年龄相关。结论与对照组相比,BLT对脑龄无特异性影响。然而,全球和执行功能脑年龄的减少与主观症状的改善有关,这表明安慰剂效应或神经可塑性的潜在作用。这些发现强调了在评估抗抑郁药物干预措施时考虑主观测量和脑老化生物标志物的重要性。
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引用次数: 0
Stimulant and non-stimulant ADHD medication prescriptions for homeless veteran service users with mental illness 为患有精神疾病的无家可归的退伍军人提供兴奋剂和非兴奋剂的ADHD药物处方
IF 3.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2026-01-09 DOI: 10.1016/j.jpsychires.2026.01.017
Katherine A. Koh , Dorota Szymkowiak , Jack Tsai

Objective

Prescribing of ADHD medications has not been examined in the US homeless population. This study examined frequency of prescriptions for stimulant and non-stimulant ADHD medications, as well as risky and potentially inappropriate prescribing (RPIP) of stimulants, in three groups of veterans with mental illness.

Methods

Using 2021–2022 national VA administrative data, we compared frequency of stimulant and non-stimulant ADHD medication prescriptions using logistic regression between homeless veterans (n = 105,062), veterans in the Department of Housing and Urban Development-VA Supportive Housing (HUD-VASH; n = 33,884), and independently housed (IH) veterans (n = 1,875,083). We also compared indicators of RPIP of stimulants using chi-square tests between the three groups.

Results

Adjusted for sociodemographic, clinical, and health care utilization characteristics, homeless veterans were less likely to be prescribed stimulants (adjusted odds ratio (aOR) = 0.80, 99 % CI = 0.76–0.85) relative to IH veterans and more likely to be prescribed non-stimulants (aOR = 1.12, CI = 1.06–1.18). However, among veterans prescribed stimulants, homeless veterans had more indicators of RPIP, including being prescribed stimulants in the presence of a psychotic disorder (7.9 % vs. 6.4 % for HUD-VASH vs. 2.2 % for IH, p < .001).

Conclusion

Homeless veterans with mental illness were less likely to be prescribed stimulants and more likely to be prescribed non-stimulant ADHD medications relative to IH veterans with mental illness. However, RPIP of stimulant prescriptions was more common for homeless and HUD-VASH veterans relative to IH veterans.
目的:在美国无家可归的人群中,尚未对ADHD药物的处方进行研究。这项研究调查了三组患有精神疾病的退伍军人中兴奋剂和非兴奋剂药物的处方频率,以及有风险和潜在不适当的兴奋剂处方(RPIP)。方法使用2021-2022年国家退伍军人管理局的数据,我们使用logistic回归比较了无家可归的退伍军人(n = 105,062)、住房和城市发展部-退伍军人保障性住房(HUD-VASH; n = 33,884)和独立居住(IH)退伍军人(n = 1,875,083)之间兴奋剂和非兴奋剂ADHD药物处方的频率。我们还使用卡方检验比较了三组之间兴奋剂的RPIP指标。结果:经社会人口学、临床和卫生保健利用特征调整后,无家可归退伍军人相对于IH退伍军人更不可能开兴奋剂处方(调整优势比(aOR) = 0.80, 99% CI = 0.76-0.85),而更可能开非兴奋剂处方(aOR = 1.12, CI = 1.06-1.18)。然而,在服用兴奋剂的退伍军人中,无家可归的退伍军人有更多的RPIP指标,包括在存在精神障碍的情况下服用兴奋剂(HUD-VASH为7.9%,IH为6.4%,IH为2.2%,p < 0.001)。结论与患有精神疾病的无家可归退伍军人相比,患有精神疾病的无家可归退伍军人服用兴奋剂的可能性更小,而服用非兴奋剂类药物的可能性更大。然而,相对于IH退伍军人,兴奋剂处方的RPIP在无家可归者和HUD-VASH退伍军人中更为常见。
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引用次数: 0
Pre-deployment prediction of partial and full PTSD in a French military cohort 法国军队队列中部分和完全PTSD的部署前预测。
IF 3.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2026-01-08 DOI: 10.1016/j.jpsychires.2026.01.013
Héloïse Lauga-Cami , Dominique Fromage , Christel Becker , Jean-Guillaume Houël , Jean-Jacques Benoliel , Frédéric Canini , Marion Trousselard , Damien Claverie

Background

Post-traumatic stress disorder (PTSD), in its partial or full forms, is frequently observed in military populations. It is therefore important to predict the risk of PTSD prior to deployment. Objective. Since elevated allostatic load markers have been described in PTSD, we investigated whether these alterations pre-exist before PTSD onset. Our objective was to explore the ability of four allostatic load markers (urinary and blood cortisol, BDNF and 8-iso-PGF2α) to predict partial/full PTSD onset after a 6-month deployment. Methods. We conducted a prospective study in a French military cohort deployed to Afghanistan. PTSD was assessed before (M0) and after (M6) deployment using PTSD Checklist Scale (PCLS). At M0, only subjects who were medically fit and who scored healthy at PCLS were considered. We evaluated whether biological markers of allostatic load at M0 would predict partial/full PTSD at M6. Psychological correlates were assessed, including anxious-depressive symptoms (HAD; Hospital Anxiety and Depression), burnout (BMS; Burnout Measure-Short version), anxiety (STAI; Spielberger State-Trait Anxiety Inventory), general mood (POMS; Profile of Mood State), perceived stress (PSS; Perceived Stress Scale), alexithymia (TAS; Toronto Alexithymia scale) and mental health–related scores (GHQ-28; General Health Questionnaire-28 items). Results. After controlling for age, pre-deployment PCLS scores, and the number of missions, we found that elevated M0 nocturnal urinary cortisol excretion predicted M6 partial/full PTSD. Conclusions. Asymptomatic subjects at risk of partial/full PTSD exhibit a common pattern of hypothalamic-pituitary axis dysregulation, similar to that observed in established PTSD.
背景:部分或全部形式的创伤后应激障碍(PTSD)在军人群体中经常观察到。因此,在部署前预测PTSD的风险是很重要的。目的:由于在PTSD中已经描述了适应负荷标志物的升高,我们研究了这些改变是否在PTSD发病前就存在。我们的目的是探讨四种适应负荷标志物(尿和血皮质醇、BDNF和8-iso-PGF2α)在6个月部署后预测部分/完全PTSD发作的能力。方法:我们在部署到阿富汗的法国军队队列中进行了一项前瞻性研究。采用PTSD检查量表(PCLS)对部署前(M0)和部署后(M6)的PTSD进行评估。在M0时,只考虑医学上健康且PCLS评分健康的受试者。我们评估了M0时适应负荷的生物学标记是否能预测M6时的部分/完全PTSD。评估心理相关因素,包括焦虑抑郁症状(HAD;医院焦虑和抑郁)、倦怠(BMS;倦怠量表-短版)、焦虑(STAI; Spielberger状态-特质焦虑量表)、一般情绪(POMS;情绪状态概况)、感知压力(PSS;感知压力量表)、述情障碍(TAS;多伦多述情障碍量表)和心理健康相关评分(GHQ-28;一般健康问卷-28项)。结果:在控制了年龄、部署前PCLS评分和任务数量后,我们发现夜间尿皮质醇水平升高可预测M6部分/完全PTSD。结论:有部分/完全PTSD风险的无症状受试者表现出一种共同的下丘脑-垂体轴失调模式,类似于在已建立的PTSD中观察到的。
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Journal of psychiatric research
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