Psychiatry Research最新文献

Objective: To evaluate the diagnostic accuracy of the System for the Assessment of Children and Adolescents (SENA) in identifying emotional disorders and suicidal thoughts and behaviors. SENA is a widely used Spanish screening tool for assessing emotional and behavioral symptoms in youth.

Method: 526 primary and secondary pupils aged 8-16 in several Spanish regions (a subset of the EmoChild Project, n=5,652 completed SENA), completed the SENA and underwent with clinical interviews using KSADS-COMP within 3 months. We screened potential participants by identifying possible positive and negative cases based on a T-score equivalent to the 75th percentile and served as a cut-off point for accessing a diagnostic interview.

Results: SENA's Emotional subscale showed a sensitivity (SN) of 78.5% in children and 80.4% in adolescents for detecting any emotional disorder, with specificities (SP) of 65.9% and 66.1%, and Area Under the ROC curve (AUC) of .74 in children and .73 in adolescents. AUCs were adequate for all subscales (0.72-0.93) other than obsessive compulsive disorder (AUC=.67). Specific subscales performed best: Generalized Anxiety Disorder (SN=100%, SP=88.4%) and Social Anxiety Disorder-SAD (SN = 91.4%, SP = 80.3%) in children, and SAD (SN=88.1%, SP=72.5%), Post-Traumatic Stress Disorder (SN=81.2%, SP=68.2%) and suicidal thoughts in adolescents (SN=84.5%, SP=73.8%).

Conclusions: SENA is a valuable screening tool for educational and clinical settings, facilitating early intervention through a standardized and user-friendly assessment. Nevertheless, there is need for refined thresholds to enhance specificity and clinical alignment.

Background: Classic serotonergic psychedelics such as LSD and psilocybin show promising antidepressant effects in controlled trials, but real-world data from routine clinical care remain limited.

Methods: This study retrospectively analysed routine data from adults with treatment-resistant depressive and/or anxiety disorders who received a first standardized Psychedelic-assisted Psychotherapy (PAP) cycle with 100 µg LSD or 25 mg psilocybin at a Swiss university hospital (May 2024-October 2025). Self-reported depression (BDI) and trait anxiety (STAI-T) were assessed at screening, one month before treatment, and 1-3 months post-treatment. In a subset of participants, cognitive emotion regulation (CERQ) was assessed pre- and post-treatment. Subjective drug effects and adverse events were recorded on the treatment day.

Results: The sample consisted of 115 patients (56.5 % female; Mean age = 47.5 years). Depressive and anxiety symptoms significantly decreased over time (BDI: F(2178) = 63.50, p < 0.001, partial η² = 0.42; STAI-T: F(1.74,145.9) = 16.97, p < 0.001, partial η² = 0.17), with no main effect of substance. CERQ analyses indicated reduced self-blame, rumination and catastrophizing, and increased positive refocusing and reappraisal. Perceived intensity followed distinct temporal profiles for LSD and psilocybin, but comparable subjective drug effects and clinical outcomes. Adverse events were mostly mild and transient, with no serious complications or treatment discontinuations.

Conclusions: In this compassionate-use real-world cohort, a first fully-active dose PAP session with LSD or psilocybin was well tolerated and associated with significant improvements in depressive and anxiety symptoms. These findings support the feasibility and effectiveness of PAP in specialised routine care.

Individuals with severe mental illness (SMI) experience markedly reduced life expectancy, yet evidence on the sociodemographic and service-related factors contributing to premature mortality within psychiatric populations remains limited, particularly in Israel. Here we analyzed electronic health records from 4253 patients who underwent a total of 19,902 hospitalizations at Lev Hasharon Mental Health Center in 2020-2024. Among these patients, 346 were confirmed deceased. Sociodemographic and clinical variables were extracted, including sex, marital status, parenthood, immigration characteristics, and hospitalization history. Statistical analyses included descriptive statistics, correlation tests, and inferential statistics. The mean age at death was 59.97 ± 18.29 years, significantly lower than national life expectancy for both men and women (p < 0.001). Male patients died younger than females (58.2 vs 63.1 years), reflecting an average life-expectancy reduction of 22.5 years in men and 21.5 years in women. Earlier mortality was associated with male gender, single marital status, absence of children, and a higher number of hospitalizations (Spearman R = -0.223, p < 0.001). Life expectancy varied significantly by region, with younger deaths observed among patients born in Israel, Ethiopia, and American countries. In conclusion, psychiatric patients in Israel die approximately two decades earlier than the general population. Social and service-related characteristics, particularly male sex, social isolation, and repeated hospitalizations emerge as key predictors of premature death. These findings underscore the need for targeted, socially informed interventions to mitigate excess mortality in severe mental illness.

This critical analysis of the study by Narine et al. (2026) investigates the effectiveness of a non-culturally adapted partial hospital program (PHP) using Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) across ethnoracial groups. The study found that Asian participants reported better relationship functioning post-treatment, although the effect size was small. Black participants showed greater perceived improvements in symptoms, including anxiety and depression, potentially due to the PHP's intensive approach. The study also revealed that Black participants reported the highest levels of respect and dignity in treatment, highlighting the importance of interpersonal dynamics in therapeutic success. The findings underscore the need for further exploration into culturally sensitive approaches to therapy, particularly for marginalized ethnoracial groups who may face unique challenges in mental health treatment. The analysis suggests that culturally adapted CBT and DBT may further enhance outcomes for these groups, ensuring more inclusive and effective care in acute psychiatric settings.

As a central hub of emotional processing, alterations in amygdala functional connectivity (FC) have garnered significant attention in both major depressive disorder (MDD) and bipolar disorder (BD), which holds promise in identifying differential biomarkers and highlighting their similarities. However, current findings are limited by inconsistency. To address this, we conducted a comparative and conjunction analysis using the Seed-based d Mapping (SDM) toolbox to examine amygdala FC alterations in MDD and BD patients. Our results revealed distinct amygdala FC alterations between MDD and BD were primarily identified in the left temporal pole, cingulate cortex, and left supramarginal gyrus, while shared amygdala FC abnormalities were particularly observed in the fronto-limbic regions and occipitotemporal gyrus. These findings highlight both commonalities and differences in amygdala FC alterations across MDD and BD, providing insights into the underlying pathophysiology of mood disorders and offering potential neural biomarkers for differential diagnosis, thereby aiding in the improvement of treatment strategies.

Introduction: The global prevalence of autism spectrum disorder (ASD) is increasing, yet effective strategies for early prediction and prevention are still limited. This umbrella review aims to synthesize available evidence on the association between maternal pregnancy complications and offspring ASD.

Methods: Following PRISMA guidelines, we systematically searched all published literature from PubMed, Embase, Web of Science, and Cochrane Library up to July 16, 2025, for systematic reviews on pregnancy complications and ASD. Only systematic reviews published in English were considered. Observational studies were included, while those on other neurodevelopmental disorders or teratogens were excluded. Study selection, data extraction, and quality assessment (using AMSTAR 2 and ROBIS) were conducted independently by two reviewers. Statistical analyses included random-effects meta-analysis, excess significance bias, Egger's test for publication bias, and sensitivity analysis.

Results: Among 596 identified records, 43 systematic reviews were assessed, with 2 (4.65%) moderate quality, 7 (16.28%) low quality, and 34 (79.07%) critically low quality. Fourteen meta-analyses (10 complication types, 30 studies) were included. Significant associations with increased ASD risk were found for gestational diabetes (OR = 1.29, 95% CI:1.14-1.45), preconception obesity (OR = 1.42, 95%CI:1.22-1.65), excessive gestational weight gain (OR = 1.18, 95%CI:1.08-1.29), polycystic ovary syndrome (OR = 1.64, 95%CI:1.50-1.82), gestational hypertension (OR = 1.37, 95%CI:1.22-1.55), pre-eclampsia (OR = 1.50, 95%CI:1.26-1.78), unclassified pregnancy infections (OR = 1.13, 95%CI:1.03-1.23), maternal autoimmune diseases (OR = 1.30, 95%CI:1.20-1.42), and asthma (OR = 1.36, 95%CI:1.28-1.44). All analyses had a high risk of bias; no convincing evidence was identified.

Conclusions: In conclusion, this umbrella review provides a stratified assessment of evidence linking pregnancy complications to offspring ASD. No associations were supported by convincing evidence; most were based on suggestive or weak evidence, with only a limited number reaching highly suggestive levels. These findings underscore the need for more robust primary studies to clarify these associations and their effect sizes.