Psychiatry Research最新文献

英文中文

Personal recovery and future self-continuity in individuals with schizophrenia

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-04-21 DOI: 10.1016/j.psychres.2025.116510

Ecem Demirli , Anthony O. Ahmed , Mark Serper

Introduction

Personal (or self-rated) recovery in schizophrenia represents an adaptive process of constructing meaning in life, finding hope, and establishing a positive identity. In this sense, recovery is linked to and dependent upon one’s sense of future self. Although self-rated recovery has been explored in relation to various affective, social, and psychological factors, the relationship between personal recovery and future-self continuity has not been examined. Future self-continuity (or continuous identity) refers to the sense of connection between one’s present and future self, as the same person now as in the future. Individuals, who cannot connect their present selves to future selves view their future self as a stranger and have a decreased sense of self-empowerment and feel less motivated to work towards future-oriented and personally meaningful treatment goals. We postulate that having good future self-continuity may be a prerequisite to success in recovery-oriented treatment programs. The current study explored the relationship between self-rated recovery and future self-continuity in individuals with schizophrenia.

Method

Forty participants with schizophrenia were recruited from two inpatient units and completed a battery of assessments including cognitive functioning, symptom severity, level of functioning as well as an assessment of personal recovery.

Results

The results indicated that higher future self-continuity predicted better personal recovery in individuals with schizophrenia after controlling for key demographic variables, symptom severity, psychosocial and cognitive functioning ability.

Conclusion

Future self-continuity was the only significant psychological variable that predicted personal recovery in individuals with schizophrenia. Clinical implications and future directions are discussed.

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引用次数: 0

Mental disorders in people with undiagnosed diseases presenting to German centres for rare diseases – prevalence, type and relevance

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-04-19 DOI: 10.1016/j.psychres.2025.116509

Jan Dieris-Hirche , Stephan Herpertz , Helge Hebestreit , Lavinia Bârlescu , Alexandra Berger , Lilly Brandstetter , Jürgen Deckert , Moritz de Greck , Harald Gündel , Kirsten Haas , Isabel Heinrich , Anne Herrmann-Werner , Julian Hett , Gereon Heuft , Kevin Koschitzki , Christian Krauth , Thomas Lücke , Tim Maisch , Christine Mundlos , Mariel Nöhre , Martina de Zwaan

People presenting to centres for rare diseases (CRD) for diagnostic work-up often suffer from mental disorders. The prevalence and distribution of these mental disorders and their relevance for care remain largely unclear and well-controlled multicentre studies are missing. The ZSE-DUO study was a multicentre, prospective, controlled cohort study involving 11 German CRD. In total, 662 adult patients with an unclear diagnosis were evaluated by an additional mental health specialist along with their usual CRD care. Mental disorders were assessed through a standardized clinical examination, including the Mini-DIPS interview. Prevalence of diagnosed mental disorders (ICD-10 coding) was assessed and compared to population prevalence. A total of 54.5 % (361 patients) of adults with unexplained symptoms presenting to a CRD had current mental disorders. Mental disorders were deemed the sole explanation for the entire symptomatology in 53.5 % of cases. In 36.2 % of cases, a combination of a mental disorder with a somatic disease was considered to explain the unexplained symptoms. In 8.3 % of cases, it was assessed that the mental disorder was not involved in explaining the unexplained symptoms. Assessing whether a mental disorder contributes to the patient's symptom complex is crucial for determining suitable treatment strategies in terms of a bio-psycho-social approach.

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引用次数: 0

A novel artificial intelligence-based methodology to predict non-specific response to treatment

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-04-19 DOI: 10.1016/j.psychres.2025.116506

Clotilde Guidetti , Maurizio Fava , Paolo L. Manfredi , Marco Pappagallo , Roberto Gomeni

Non-specific response to treatment (NSRT) is the primary contributor to the failure of randomized clinical trials in major depressive disorder (MDD). The objective of this study is to develop artificial neural network (ANN) models to predict the individual probability for NSRT. Pre-randomization data from a failed antidepressant trial were considered as potential predictors of the NSRT probability (prob-NSRT) using the response endpoint in subjects randomized to placebo. The inverse of the individual prob-NSRT (NSRT propensity score) was used as a weight in the mixed-effects model applied to assess treatment effect (TE). The comparison of the results obtained with and without the NSRT propensity score indicated that the weighted analyses provided an estimate of TE significantly larger than the conventional analyses. The propensity score weighted (PSW) analysis, adjusting for inter-individual variability in prob-NSRT, enhanced signal detection of TE. These findings support the potential role of PSW methodology for analyzing RCTs and determining TE. However, external validation of these ANN models in at least one independent trial is needed before advocating regulatory or broader clinical use.

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引用次数: 0

Global evidence on screen time and suicidal behavior: Implications for policy and practice

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-04-19 DOI: 10.1016/j.psychres.2025.116508

Riza Amalia , Aji Prasetya Wibawa , Arbin Janu Setiyowati , Ronal Surya Aditya , Rudi Haryadi , Lutfiatus Zuhroh , Eva Meizara Puspita Dewi , Ajeng Ayu Widiastuti , Surahman Surahman

引用次数: 0

Calling for PAT clinical trials catering to racially minoritized populations: A letter to the editor regarding Haft et al., (2025)

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-04-18 DOI: 10.1016/j.psychres.2025.116499

Naomi Faber, Olga Chernoloz

引用次数: 0

Compulsory admission as access to early intervention service for patients with first episode psychosis: What relevance for clinical outcomes? Further findings from the Pr-EP program

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-04-17 DOI: 10.1016/j.psychres.2025.116507

Lorenzo Pelizza , Emanuela Leuci , Emanuela Quattrone , Derna Palmisano , Giuseppina Paulillo , Clara Pellegrini , Simona Pupo , Pietro Pellegrini , Marco Menchetti

Purpose

Patients with psychosis have a higher risk of compulsory admission. However, knowledge about its prognostic relevance in First Episode Psychosis (FEP) is poor. The aims of this study were to calculate its baseline prevalence rate in FEP individuals treated within an “Early Intervention” (EI) service, and to longitudinally compare clinical outcomes between FEP patients with and without baseline compulsory admission across 2 years of follow-up.

Methods

500 FEP youths completed the PANSS and the GAF. Chi-squared/Mann-Whitney tests, mixed-design ANOVA, logistic regression, and Kaplan-Meier survival analysis were used for inter-group comparisons.

Results

53 (10.6 %) FEP participants were compulsory admitted at entry. They were likely to be unemployed and to have lower baseline GAF score and more severe positive symptoms. They showed significant “time x group” effects for improvements in GAF and PANSS uncooperativeness scores. No inter-group difference in terms of service disengagement and new compulsory admission was found.

Conclusion

A non-negligible portion (1/10) of FEP participants entered the EI program through compulsory admission. However, this did not negatively impact on longitudinal outcomes, suggesting the beneficial effect of EI intervention in longitudinally promoting functional recovery and treatment adherence also in FEP recruited though compulsory admission.

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引用次数: 0

Longitudinal analysis of post-COVID-19 surge in hospital admissions for suicide attempts: A five-year study of pandemic and post-pandemic trends 对 19COVID 后因自杀未遂入院人数激增的纵向分析：对大流行和大流行后趋势的五年研究

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-04-15 DOI: 10.1016/j.psychres.2025.116500

Roberto Rodriguez-Jimenez , Lorena García-Fernández , Beatriz Baón-Pérez , Juan Carlos Ansede-Cascudo , Cristina Martín-Arriscado Arroba , Juan Manuel Sendra-Gutierrez , Verónica Romero-Ferreiro , Miguel A. Alvarez-Mon , Rolf Wynn , Diego Palao , Mercedes Navío-Acosta

This study investigates trends in psychiatric hospital admissions due to severe suicide attempts, defined as those requiring hospitalization for at least 24 h, in the Madrid region, Spain, over a five-year period (2019–2023), encompassing pre-pandemic, pandemic, and post-pandemic contexts. Using the Minimum Basic Data Set (MBDS) from 34 public hospitals, we analyzed data for individuals requiring hospital admission due to suicidal ideation or attempts. A total of 7681 patients, primarily female (65 %), were included, and analyses were stratified by age and gender. The findings indicate a significant increase in hospitalizations for suicidal behaviors among adolescent females, beginning in late 2020, with this trend persisting through 2023. No substantial changes were observed in other age groups. Despite increases in suicide attempts, overall suicide rates remained stable, possibly reflecting improved intervention efforts. These results underscore the pressing need for targeted prevention strategies, particularly for adolescent girls, who exhibited heightened vulnerability to post-pandemic mental health challenges. This study highlights the critical role of continuous monitoring and intervention in reducing suicidal behaviors in at-risk populations.

本研究调查了西班牙马德里地区五年内（2019-2023 年）因严重自杀未遂（定义为需要住院至少 24 小时的自杀未遂）而入院的精神病患者的趋势，其中包括大流行前、大流行中和大流行后的情况。我们利用 34 家公立医院的最低基本数据集 (MBDS)，分析了因有自杀倾向或企图自杀而需要入院治疗的患者数据。共纳入了 7681 名患者，主要为女性（65%），并按年龄和性别进行了分层分析。研究结果表明，从 2020 年末开始，青少年女性中因自杀行为住院的人数大幅增加，这一趋势一直持续到 2023 年。其他年龄组没有观察到实质性变化。尽管自杀未遂率有所上升，但总体自杀率保持稳定，这可能反映出干预工作有所改善。这些结果凸显了制定有针对性的预防策略的迫切需要，尤其是针对青春期少女，因为她们更容易受到大流行后心理健康挑战的影响。这项研究强调了持续监测和干预对于减少高危人群自杀行为的关键作用。

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引用次数: 0

Cannabis use and psychotic-like experiences: A systematic review of biological vulnerability, potency effects, and clinical trajectories

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-04-15 DOI: 10.1016/j.psychres.2025.116496

Valerio Ricci , Stefania Chiappini , Giovanni Martinotti , Giuseppe Maina

Epidemiological data have provided evidence that psychotic-like experiences (PLEs) occur in the general population without clinical impairment. According to the psychosis continuum hypothesis, PLEs are subject to multiple risk factors. This review synthesizes current research on biological, substance use-related, and environmental risk factors for PLEs in non-clinical populations. PubMed/Medline and Scopus databases were searched for peer-reviewed studies published until January 2024 investigating risk factors for PLEs in non-clinical samples. Following PRISMA guidelines, 38 full-text articles were analyzed after title/abstract and full-text screening (PROSPERO registration ID: N 1001,807). Four main risk factor categories emerged. Biological vulnerabilities included specific metabolic profiles, genetic predisposition, and neurobiological alterations. Substance use patterns, particularly high-potency cannabis, showed significant associations with PLEs, with evidence for bidirectional relationships. Socio-demographic factors revealed influences of digital media use, ethnic density, and gender differences. Outcome studies demonstrated associations between PLEs and consequences including suicidal behavior and cognitive impairments. Findings suggest a complex interplay between multiple risk factors in PLE development. More attention should be paid to the interaction between biological vulnerabilities and environmental factors, as these experiences may represent important markers for mental health outcomes. A comprehensive assessment approach and proactive early intervention strategies are essential for the timely identification and management of at-risk individuals. Our findings support a multifactorial model where genetic vulnerabilities, cannabis use patterns, and socio-environmental factors influence PLE trajectories. The bidirectional cannabis-PLE relationship suggests self-regulatory mechanisms that could inform preventive interventions. Early identification of PLEs in young cannabis users represents a crucial opportunity for targeted clinical interventions.

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引用次数: 0

Assessing bias in AI-driven psychiatric recommendations: A comparative cross-sectional study of chatbot-classified and CANMAT 2023 guideline for adjunctive therapy in difficult-to-treat depression

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-04-15 DOI: 10.1016/j.psychres.2025.116501

Yu Chang , Yi-Chun Liu , Si-Sheng Huang , Wen-Yu Hsu

The integration of chatbots into psychiatry introduces a novel approach to support clinical decision-making, but biases in their recommendations pose significant concerns. This study investigates potential biases in chatbot-generated recommendations for adjunctive therapy in difficult-to-treat depression, comparing these outputs with the Canadian Network for Mood and Anxiety Treatments (CANMAT) 2023 guidelines. The analysis involved calculating Cohen’s kappa coefficients to measure the overall level of agreement between chatbot-generated classifications and CANMAT guidelines. Differences between chatbot-generated and CANMAT classifications for each medication were assessed using the Wilcoxon signed-rank test. Results reveal substantial agreement for high-performing models, such as Google AI's Gemini 2.0 Flash, which achieved the highest Cohen’s kappa value of 0.82 (SE = 0.052). In contrast, OpenAI’s o1 model showed a lower agreement of 0.746 (SE = 0.057). Notable discrepancies were observed in the overestimation of medications such as quetiapine and lithium and the underestimation of modafinil and ketamine. Additionally, a distinct bias pattern was observed in OpenAI’s chatbots, which demonstrated a tendency to over-recommend lithium and bupropion. Our study highlights both the promise and the challenges of employing AI tools in psychiatric practice, and advocates for multi-model approaches to mitigate bias and improve clinical reliability.

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引用次数: 0

The effectiveness of combining interactive media based cognitive behaviour therapy with art and music therapies for ameliorating the generalised anxiety disorder of children exposed to abduction

IF 4.2 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2025-04-14 DOI: 10.1016/j.psychres.2025.116498

Jiaqi Xu , Shamim Akhter , Oberiri Destiny Apuke

The researchers examined the efficacy of integrating interactive media-based cognitive behaviour in conjunction with art and music therapy for treating generalised anxiety disorder (GAD) in children abducted in Nigeria. A randomised control trial was carried out using three randomly selected secondary schools in Northern part of Nigeria. The study sample comprised 450 students randomly divided into a control group of (n = 225) and an experimental group of (n = 225). The treatment group was randomly selected into (n = 56) each for cognitive behaviour, art, and music therapy. While CBT + art and music had (n = 57) participants. This study's finding shows that cognitive behaviour therapy combined with art and music delivered through interactive media may be superior for treating paediatric GAD, than using only either CBT, art or music therapy. Participants who were assigned to a combined therapy that involved integrating CBT, music and art therapies reported a lower level of GAD, compared to those who were assigned to either CBT, art, or music alone. However, a cost benefit analysis points to the adopting of CBT in treating the GAD of children kidnapped. This study concluded with some implication for theory and health promotion.

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