Pub Date : 2026-04-01Epub Date: 2026-01-30DOI: 10.1016/j.psychres.2026.116989
Lisha Zhang , Kun Qin , Nanfang Pan , Haoran Xu , Qiyong Gong
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.
{"title":"Common and distinct patterns of aberrant amygdala functional connectivity in major depressive disorder and bipolar disorder: A voxel-wise comparative meta-analysis","authors":"Lisha Zhang , Kun Qin , Nanfang Pan , Haoran Xu , Qiyong Gong","doi":"10.1016/j.psychres.2026.116989","DOIUrl":"10.1016/j.psychres.2026.116989","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"358 ","pages":"Article 116989"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119979","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}
Pub Date : 2026-04-01Epub Date: 2026-02-04DOI: 10.1016/j.psychres.2026.116996
Waseem Abu-Ashour , Rick Audas , John-Michael Gamble , John Hawboldt , Joanna E.M. Sale
Background
Major depressive disorder (MDD) is a chronic condition with high relapse rates affecting patients and health systems. Cognitive behavioral therapy (CBT) and mindfulness-based cognitive therapy (MBCT) are strategies for relapse prevention, but their comparative long-term cost-effectiveness remains unclear.
Methods
We developed a cohort-based Markov model with three health states, depressive episode, remission, and death, to compare MBCT and CBT in adults with MDD. The model used a lifetime horizon, six-month cycles, with healthcare payer and societal perspectives. Costs included direct medical and productivity losses discounted at 1.5%. Health-state utilities were drawn from published sources. Incremental cost-effectiveness ratios (ICERs) and net monetary benefit (NMB) were estimated at willingness-to-pay (WTP) thresholds of $50,000 and $100,000 per quality-adjusted life-year (QALY). Deterministic and probabilistic sensitivity analyses, plus scenario analyses with alternative horizons and discount rates, assessed uncertainty.
Results
In the base case, MBCT was associated with 14.71 QALYs at a cost of $543,861, while CBT yielded 15.07 QALYs at $549,487. CBT provided an incremental 0.37 QALYs at $5625 higher cost, producing an ICER of $15,266 per QALY gained, well below both thresholds. NMB favored CBT ($204,242 vs. $191,443 at $50,000; $957,971 vs. $926,746 at $100,000). Sensitivity analyses highlighted remission- and depression-related costs as main drivers. Probabilistic analyses showed CBT optimal in 56% of simulations at $50,000 and 61% at $100,000, with MBCT preferred at lower thresholds.
Conclusion
CBT may be more cost-effective relative to MBCT for relapse prevention in MDD, though differences are modest. MBCT remains a competitive alternative where CBT access is limited.
{"title":"A cost–utility analysis of mindfulness-based cognitive therapy versus cognitive behavioral therapy for major depressive disorder relapse prevention in primary care","authors":"Waseem Abu-Ashour , Rick Audas , John-Michael Gamble , John Hawboldt , Joanna E.M. Sale","doi":"10.1016/j.psychres.2026.116996","DOIUrl":"10.1016/j.psychres.2026.116996","url":null,"abstract":"<div><h3>Background</h3><div>Major depressive disorder (MDD) is a chronic condition with high relapse rates affecting patients and health systems. Cognitive behavioral therapy (CBT) and mindfulness-based cognitive therapy (MBCT) are strategies for relapse prevention, but their comparative long-term cost-effectiveness remains unclear.</div></div><div><h3>Methods</h3><div>We developed a cohort-based Markov model with three health states, depressive episode, remission, and death, to compare MBCT and CBT in adults with MDD. The model used a lifetime horizon, six-month cycles, with healthcare payer and societal perspectives. Costs included direct medical and productivity losses discounted at 1.5%. Health-state utilities were drawn from published sources. Incremental cost-effectiveness ratios (ICERs) and net monetary benefit (NMB) were estimated at willingness-to-pay (WTP) thresholds of $50,000 and $100,000 per quality-adjusted life-year (QALY). Deterministic and probabilistic sensitivity analyses, plus scenario analyses with alternative horizons and discount rates, assessed uncertainty.</div></div><div><h3>Results</h3><div>In the base case, MBCT was associated with 14.71 QALYs at a cost of $543,861, while CBT yielded 15.07 QALYs at $549,487. CBT provided an incremental 0.37 QALYs at $5625 higher cost, producing an ICER of $15,266 per QALY gained, well below both thresholds. NMB favored CBT ($204,242 vs. $191,443 at $50,000; $957,971 vs. $926,746 at $100,000). Sensitivity analyses highlighted remission- and depression-related costs as main drivers. Probabilistic analyses showed CBT optimal in 56% of simulations at $50,000 and 61% at $100,000, with MBCT preferred at lower thresholds.</div></div><div><h3>Conclusion</h3><div>CBT may be more cost-effective relative to MBCT for relapse prevention in MDD, though differences are modest. MBCT remains a competitive alternative where CBT access is limited.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"358 ","pages":"Article 116996"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146166370","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}
Impaired clinical insight is common in schizophrenia spectrum disorders (SSDs) and predicts poor treatment adherence and outcomes. It is linked to disorganised, positive, negative, and hostility symptoms. However, few studies repeatedly assess insight after antipsychotic initiation while comparing pharmacologically distinct agents. This study examined how symptom levels and changes predict the development and endpoint of clinical insight over 6 weeks, contrasting the partial dopamine agonist aripiprazole (PDA) with two dopamine antagonists (DAs).
Methods
Data from 144 SSD patients in the Bergen-Stavanger-Innsbruck-Trondheim (BeSt InTro) trial, a pragmatic, semi-randomised study of amisulpride, aripiprazole, and olanzapine, were analysed using latent growth curve models. Insight was measured by PANSS Item G12; symptom factors (positive, negative, hostility, cognitive/disorganised) were derived from PANSS.
Results
Lower baseline symptoms and greater improvement between weeks 3 and 6 predicted better insight at 6 weeks across all factors. For positive symptoms, improvement between weeks 1 and 3 (b = 0.57, p = 0.009) also predicted better insight. Patients on aripiprazole showed less improvement in insight, though some findings lost significance after correction.
Conclusion
Symptom reduction is associated with improved insight, with early changes in positive symptoms exerting the fastest effect. Despite symptom improvement, aripiprazole PDA treatment was linked to less insight gain than DA treatment. These preliminary findings warrant further study.
背景：临床洞察力受损在精神分裂症谱系障碍（SSDs）中很常见，并预示着治疗依从性和预后较差。它与混乱、阳性、阴性和敌意症状有关。然而，很少有研究反复评估抗精神病药物开始后的洞察力，同时比较药理学上不同的药物。本研究通过对比部分多巴胺激动剂阿立哌唑（PDA）和两种多巴胺拮抗剂（DAs），研究了症状水平和变化如何预测6周内临床洞察力的发展和终点。方法：采用潜在生长曲线模型分析Bergen-Stavanger-Innsbruck-Trondheim （BeSt InTro）试验中144例SSD患者的数据，该试验是一项实用的、半随机的研究，涉及阿米硫pride、阿立哌唑和奥氮平。洞察力由PANSS项目G12测量；症状因子（阳性、阴性、敌意、认知/紊乱）来源于PANSS。结果：较低的基线症状和在第3周至第6周之间更大的改善预示着6周时所有因素的更好的洞察力。对于阳性症状，第1周至第3周的改善（b = 0.57, p = 0.009）也预示着更好的洞察力。服用阿立哌唑的患者在洞察力方面的改善较少，尽管一些结果在纠正后失去了意义。结论：症状的减轻与洞察力的提高有关，阳性症状的早期改变发挥最快的作用。尽管症状有所改善，但阿立哌唑PDA治疗与DA治疗相比，获得的洞察力较少。这些初步发现值得进一步研究。
{"title":"Levels of and changes in psychosis symptoms and clinical insight: Exploring the impact of differential antipsychotic mechanisms","authors":"Lena Antonsen Stabell , Erik Johnsen , Rune Kroken , Else-Marie Løberg , Eirik Kjelby , Inge Joa , Solveig Klæbo Reitan , Maria Rettenbacher , Kenneth Hugdahl , Rolf Gjestad","doi":"10.1016/j.psychres.2026.116948","DOIUrl":"10.1016/j.psychres.2026.116948","url":null,"abstract":"<div><h3>Background</h3><div>Impaired clinical insight is common in schizophrenia spectrum disorders (SSDs) and predicts poor treatment adherence and outcomes. It is linked to disorganised, positive, negative, and hostility symptoms. However, few studies repeatedly assess insight after antipsychotic initiation while comparing pharmacologically distinct agents. This study examined how symptom levels and changes predict the development and endpoint of clinical insight over 6 weeks, contrasting the partial dopamine agonist aripiprazole (PDA) with two dopamine antagonists (DAs).</div></div><div><h3>Methods</h3><div>Data from 144 SSD patients in the Bergen-Stavanger-Innsbruck-Trondheim (BeSt InTro) trial, a pragmatic, semi-randomised study of amisulpride, aripiprazole, and olanzapine, were analysed using latent growth curve models. Insight was measured by PANSS Item G12; symptom factors (positive, negative, hostility, cognitive/disorganised) were derived from PANSS.</div></div><div><h3>Results</h3><div>Lower baseline symptoms and greater improvement between weeks 3 and 6 predicted better insight at 6 weeks across all factors. For positive symptoms, improvement between weeks 1 and 3 (<em>b</em> = 0.57, <em>p</em> = 0.009) also predicted better insight. Patients on aripiprazole showed less improvement in insight, though some findings lost significance after correction.</div></div><div><h3>Conclusion</h3><div>Symptom reduction is associated with improved insight, with early changes in positive symptoms exerting the fastest effect. Despite symptom improvement, aripiprazole PDA treatment was linked to less insight gain than DA treatment. These preliminary findings warrant further study.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"358 ","pages":"Article 116948"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046959","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}
Pub Date : 2026-04-01Epub Date: 2025-11-17DOI: 10.1016/j.psychres.2025.116845
Jing Min , Tong Zhu , Mengqi Liu , Jingbo Zhang , Taocui Yan , Shuo Zhu , Yuhang Yang , Xumeng Zhu , Renqiang Yu , Yang Huang , Xue Mo , Kewei He , Xinke Li , Fajin Lv , Chao Li , Robert K. McNamara , Xiangqian He , Du Lei
Background
Although electroconvulsive therapy (ECT) is an effective intervention for adolescents with major depressive disorder (MDD), the underlying neuroanatomical mechanisms remain poorly understood. This structural magnetic resonance imaging (sMRI) study investigated cortical and subcortical morphology in adolescents with MDD and suicidal ideation before and after ECT.
Methods
The study included 27 adolescent MDD patients with suicidal ideation and 31 demographically similar healthy controls (HC). Cortical thickness, surface area, and subcortical volumes were quantified from MRI scans using the FreeSurfer. General linear models and linear mixed models were employed to evaluate morphological differences between patients and HCs at baseline, as well as longitudinal changes in patients following ECT. Partial correlation and multiple regression analyses further explored associations between structural alterations and symptom improvement.
Results
At baseline, MDD patients showed widespread morphological deficits within the cingulate-insula-dorsolateral prefrontal cortical circuit and subcortical regions including the hippocampus and thalamus. Following ECT, significant structural increases were observed in the hippocampus, amygdala, insula, and dorsolateral prefrontal cortex. Subcortical volumetric changes were not linearly associated with symptom improvement, while dorsolateral prefrontal alterations were negatively correlated with changes in suicidal ideation.
Conclusion
ECT partially reversed baseline cortical-subcortical structural deficits in patients, particularly in the insula, dorsolateral prefrontal cortex (DLPFC), and hippocampus. Structural alterations in the DLPFC may be associated with the alleviation of suicidal ideation, whereas no significant linear relationships were observed between subcortical volumetric changes and symptom improvement.
{"title":"Electroconvulsive therapy induces cortical and subcortical structural changes in adolescents with major depressive disorder","authors":"Jing Min , Tong Zhu , Mengqi Liu , Jingbo Zhang , Taocui Yan , Shuo Zhu , Yuhang Yang , Xumeng Zhu , Renqiang Yu , Yang Huang , Xue Mo , Kewei He , Xinke Li , Fajin Lv , Chao Li , Robert K. McNamara , Xiangqian He , Du Lei","doi":"10.1016/j.psychres.2025.116845","DOIUrl":"10.1016/j.psychres.2025.116845","url":null,"abstract":"<div><h3>Background</h3><div>Although electroconvulsive therapy (ECT) is an effective intervention for adolescents with major depressive disorder (MDD), the underlying neuroanatomical mechanisms remain poorly understood. This structural magnetic resonance imaging (sMRI) study investigated cortical and subcortical morphology in adolescents with MDD and suicidal ideation before and after ECT.</div></div><div><h3>Methods</h3><div>The study included 27 adolescent MDD patients with suicidal ideation and 31 demographically similar healthy controls (HC). Cortical thickness, surface area, and subcortical volumes were quantified from MRI scans using the FreeSurfer. General linear models and linear mixed models were employed to evaluate morphological differences between patients and HCs at baseline, as well as longitudinal changes in patients following ECT. Partial correlation and multiple regression analyses further explored associations between structural alterations and symptom improvement.</div></div><div><h3>Results</h3><div>At baseline, MDD patients showed widespread morphological deficits within the cingulate-insula-dorsolateral prefrontal cortical circuit and subcortical regions including the hippocampus and thalamus. Following ECT, significant structural increases were observed in the hippocampus, amygdala, insula, and dorsolateral prefrontal cortex. Subcortical volumetric changes were not linearly associated with symptom improvement, while dorsolateral prefrontal alterations were negatively correlated with changes in suicidal ideation.</div></div><div><h3>Conclusion</h3><div>ECT partially reversed baseline cortical-subcortical structural deficits in patients, particularly in the insula, dorsolateral prefrontal cortex (DLPFC), and hippocampus. Structural alterations in the DLPFC may be associated with the alleviation of suicidal ideation, whereas no significant linear relationships were observed between subcortical volumetric changes and symptom improvement.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"358 ","pages":"Article 116845"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080188","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}
Pub Date : 2026-04-01Epub Date: 2026-01-22DOI: 10.1016/j.psychres.2026.116952
Ke Wan , Yueling Liu , Ke Chen , Mengyao He , Woxin Pan , Yian Xiao , Wanying Zhang , Xuemeng Chen , Fengqiong Yu , Kai Wang , Chunyan Zhu
Introduction
The objectives of this study are to describe the disease-specific characteristics of EEG microstates in obsessive–compulsive disorder (OCD) and to evaluate the effects of 1-Hz repetitive transcranial magnetic stimulation (rTMS) on both OCD symptoms and microstate characteristics by a randomized controlled trial (RCT).
Methods
Thirty-nine patients with OCD and 34 healthy controls (HCs) were included in the first study phase examining disease-specific differences in EEG microstate characteristics. Subsequently, all patients were included in a double-blind, randomized, and sham-controlled trial comparing microstate changes in response to active 1-Hz rTMS (n = 20) or sham rTMS N(n = 19) over the right pre-supplementary motor area (pre-SMA) for 15 consecutive days.
Results
Microstate C (MS C) was stronger in the beta band at baseline among OCD patients compared to HCs, but these differences did not remain significant after correction for multiple comparisons. In the RCT, linear mixed-effects model revealed a significant group × time interaction for Y-BOCS scores, with greater symptom reduction following active rTMS compared to sham rTMS (P = 0.003). A significant group × time interaction was also found for beta-band microstate D (MS D). Post hoc tests showed that the active group exhibited significant post-treatment increase in MS D duration (P = 0.020) and coverage (P = 0.033) relative to the sham group. Additionally, within the sham group, changes in beta-band microstate dynamics were significantly associated with changes in Y-BOCS scores, suggesting a potential link between spontaneous brain activity and symptom improvement in the absence of active stimulation.
Conclusion
Patients with OCD exhibit a trend toward aberrant EEG microstates in the beta band. Administration of 1-Hz rTMS targeting the right pre-SMA can alleviate OCD symptoms and modulate beta-band microstate properties. Nonetheless, beta-band microstate dynamics may serve as state-sensitive neural markers of OCD, reflecting disease progression or spontaneous symptom fluctuations. Their clinical relevance in informing individualized or stratified neuromodulation strategies warrants further investigation.
{"title":"EEG microstate beta-band abnormalities in obsessive–compulsive disorder: Associations with disease symptoms and sensitivity to repetitive transcranial magnetic stimulation","authors":"Ke Wan , Yueling Liu , Ke Chen , Mengyao He , Woxin Pan , Yian Xiao , Wanying Zhang , Xuemeng Chen , Fengqiong Yu , Kai Wang , Chunyan Zhu","doi":"10.1016/j.psychres.2026.116952","DOIUrl":"10.1016/j.psychres.2026.116952","url":null,"abstract":"<div><h3>Introduction</h3><div>The objectives of this study are to describe the disease-specific characteristics of EEG microstates in obsessive–compulsive disorder (OCD) and to evaluate the effects of 1-Hz repetitive transcranial magnetic stimulation (rTMS) on both OCD symptoms and microstate characteristics by a randomized controlled trial (RCT).</div></div><div><h3>Methods</h3><div>Thirty-nine patients with OCD and 34 healthy controls (HCs) were included in the first study phase examining disease-specific differences in EEG microstate characteristics. Subsequently, all patients were included in a double-blind, randomized, and sham-controlled trial comparing microstate changes in response to active 1-Hz rTMS (<em>n</em> = 20) or sham rTMS N(<em>n</em> = 19) over the right pre-supplementary motor area (pre-SMA) for 15 consecutive days.</div></div><div><h3>Results</h3><div>Microstate C (MS C) was stronger in the beta band at baseline among OCD patients compared to HCs, but these differences did not remain significant after correction for multiple comparisons. In the RCT, linear mixed-effects model revealed a significant group × time interaction for Y-BOCS scores, with greater symptom reduction following active rTMS compared to sham rTMS (<em>P</em> = 0.003). A significant group × time interaction was also found for beta-band microstate D (MS D). Post hoc tests showed that the active group exhibited significant post-treatment increase in MS D duration (<em>P</em> = 0.020) and coverage (<em>P</em> = 0.033) relative to the sham group. Additionally, within the sham group, changes in beta-band microstate dynamics were significantly associated with changes in Y-BOCS scores, suggesting a potential link between spontaneous brain activity and symptom improvement in the absence of active stimulation.</div></div><div><h3>Conclusion</h3><div>Patients with OCD exhibit a trend toward aberrant EEG microstates in the beta band. Administration of 1-Hz rTMS targeting the right pre-SMA can alleviate OCD symptoms and modulate beta-band microstate properties. Nonetheless, beta-band microstate dynamics may serve as state-sensitive neural markers of OCD, reflecting disease progression or spontaneous symptom fluctuations. Their clinical relevance in informing individualized or stratified neuromodulation strategies warrants further investigation.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"358 ","pages":"Article 116952"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080189","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}
Pub Date : 2026-04-01Epub Date: 2026-01-23DOI: 10.1016/j.psychres.2026.116975
Liliane Smaniotto, Arthur Tolentino, Felipe M.R. Barros, Eduardo Barreto, Barbara Colnaghi, Lais Ker, Eloisa Helena Rubello Valler Celeri, Osmar Della-Torre, Renata C.S. Azevedo
Background
Non-suicidal self-injury (NSSI) is a significant mental health concern that often co-occurs with attention-deficit/hyperactivity disorder (ADHD). Although growing evidence suggests a link between ADHD and NSSI, the prevalence and moderating factors of this association remain unclear.
Methods
We conducted a systematic review and meta-analysis to quantify the prevalence of NSSI in individuals with ADHD and to examine age- and sex-stratified differences across studies conducted in clinical, community, convenience, and population-based samples. A comprehensive search was performed across MEDLINE, EMBASE, and PsycINFO. Fourteen studies met inclusion criteria. Pooled prevalence estimates and odds ratios (ORs) were calculated using random-effects models. Subgroup analyses were performed by age group (adolescents vs. adults) and sex.
Results
The overall pooled prevalence of NSSI among individuals with ADHD was 27% (95% CI: 19%–37%), with similar rates among adolescents (28%) and adults (25%). Compared to individuals without ADHD, those with ADHD had twice the odds of engaging in NSSI (OR = 2.26, 95% CI: 1.69–3.00). Sex-stratified analysis, based on three eligible studies, suggested a higher risk in females with ADHD compared to males with ADHD (OR = 4.07, 95% CI: 3.09–5.36). High heterogeneity was observed across studies, potentially attributable to differences in diagnostic criteria, assessment tools, sample characteristics, and sociocultural contexts.
Conclusions
Individuals with ADHD show elevated rates of NSSI across developmental stages, with preliminary evidence indicating a potentially greater risk among females. However, these sex-specific findings should be interpreted cautiously due to the limited number of studies. Future research should investigate underlying mechanisms and longitudinal trajectories to better inform targeted interventions and prevention strategies. PROSPERO: CRD420251017948.
{"title":"Non-suicidal self-injury in individuals with attention-deficit/hyperactivity disorder: A systematic review and Meta-analysis with Age- and Sex-stratified findings","authors":"Liliane Smaniotto, Arthur Tolentino, Felipe M.R. Barros, Eduardo Barreto, Barbara Colnaghi, Lais Ker, Eloisa Helena Rubello Valler Celeri, Osmar Della-Torre, Renata C.S. Azevedo","doi":"10.1016/j.psychres.2026.116975","DOIUrl":"10.1016/j.psychres.2026.116975","url":null,"abstract":"<div><h3>Background</h3><div>Non-suicidal self-injury (NSSI) is a significant mental health concern that often co-occurs with attention-deficit/hyperactivity disorder (ADHD). Although growing evidence suggests a link between ADHD and NSSI, the prevalence and moderating factors of this association remain unclear.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and meta-analysis to quantify the prevalence of NSSI in individuals with ADHD and to examine age- and sex-stratified differences across studies conducted in clinical, community, convenience, and population-based samples. A comprehensive search was performed across MEDLINE, EMBASE, and PsycINFO. Fourteen studies met inclusion criteria. Pooled prevalence estimates and odds ratios (ORs) were calculated using random-effects models. Subgroup analyses were performed by age group (adolescents vs. adults) and sex.</div></div><div><h3>Results</h3><div>The overall pooled prevalence of NSSI among individuals with ADHD was 27% (95% CI: 19%–37%), with similar rates among adolescents (28%) and adults (25%). Compared to individuals without ADHD, those with ADHD had twice the odds of engaging in NSSI (OR = 2.26, 95% CI: 1.69–3.00). Sex-stratified analysis, based on three eligible studies, suggested a higher risk in females with ADHD compared to males with ADHD (OR = 4.07, 95% CI: 3.09–5.36). High heterogeneity was observed across studies, potentially attributable to differences in diagnostic criteria, assessment tools, sample characteristics, and sociocultural contexts.</div></div><div><h3>Conclusions</h3><div>Individuals with ADHD show elevated rates of NSSI across developmental stages, with preliminary evidence indicating a potentially greater risk among females. However, these sex-specific findings should be interpreted cautiously due to the limited number of studies. Future research should investigate underlying mechanisms and longitudinal trajectories to better inform targeted interventions and prevention strategies. PROSPERO: CRD420251017948.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"358 ","pages":"Article 116975"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114173","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}
Pub Date : 2026-04-01Epub Date: 2026-01-27DOI: 10.1016/j.psychres.2026.116981
Taeyoung Lee , Bum-Sung Choi , Ji-Hoon Kim
Adolescent-onset schizophrenia is rare but clinically severe. While neurodevelopmental disorders (NDDs) are recognized antecedents, the absolute risk of transition to psychosis in pediatric NDD clinic populations has not been clearly quantified relative to other psychiatric conditions. We conducted a retrospective cohort study using electronic medical records from Pusan National University Children’s Hospital (2008–2023). We compared the cumulative incidence of schizophrenia-spectrum disorders between a cohort of youth diagnosed with NDDs (N = 558) and an internal clinical control group of youth treated for non-neurodevelopmental psychiatric disorders (N = 824) during the same period. The 10-year cumulative incidence of schizophrenia-spectrum disorders was significantly higher in the NDD group (2.3 %, 13/558) compared to the internal clinical control group (0.1 %, 1/824) (Log-rank test, p < 0.01). Sensitivity analysis in the ADHD subgroup found no association between stimulant medication use and psychosis onset. Youth with NDDs in a tertiary care setting face a distinct and significantly higher risk of developing schizophrenia-spectrum disorders compared to psychiatric controls. These findings underscore the importance of routine monitoring for emerging psychotic symptoms in this high-risk population.
{"title":"Cumulative incidence of schizophrenia-spectrum disorders in children and adolescents with neurodevelopmental disorders: A retrospective cohort study","authors":"Taeyoung Lee , Bum-Sung Choi , Ji-Hoon Kim","doi":"10.1016/j.psychres.2026.116981","DOIUrl":"10.1016/j.psychres.2026.116981","url":null,"abstract":"<div><div>Adolescent-onset schizophrenia is rare but clinically severe. While neurodevelopmental disorders (NDDs) are recognized antecedents, the absolute risk of transition to psychosis in pediatric NDD clinic populations has not been clearly quantified relative to other psychiatric conditions. We conducted a retrospective cohort study using electronic medical records from Pusan National University Children’s Hospital (2008–2023). We compared the cumulative incidence of schizophrenia-spectrum disorders between a cohort of youth diagnosed with NDDs (<em>N</em> = 558) and an internal clinical control group of youth treated for non-neurodevelopmental psychiatric disorders (<em>N</em> = 824) during the same period. The 10-year cumulative incidence of schizophrenia-spectrum disorders was significantly higher in the NDD group (2.3 %, 13/558) compared to the internal clinical control group (0.1 %, 1/824) (Log-rank test, <em>p</em> < 0.01). Sensitivity analysis in the ADHD subgroup found no association between stimulant medication use and psychosis onset. Youth with NDDs in a tertiary care setting face a distinct and significantly higher risk of developing schizophrenia-spectrum disorders compared to psychiatric controls. These findings underscore the importance of routine monitoring for emerging psychotic symptoms in this high-risk population.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"358 ","pages":"Article 116981"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133029","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}
Pub Date : 2026-04-01Epub Date: 2026-01-18DOI: 10.1016/j.psychres.2026.116961
Katherine A. Billetdeaux , Musa Yilanli , Eric E. Nelson , Kendra Heck , Jaclyn Tissue , Donna Ruch , Jeffrey Bridge
{"title":"Corrigendum to Patterns of suicidal thoughts and behaviors in depressed adolescents with and without psychotic features","authors":"Katherine A. Billetdeaux , Musa Yilanli , Eric E. Nelson , Kendra Heck , Jaclyn Tissue , Donna Ruch , Jeffrey Bridge","doi":"10.1016/j.psychres.2026.116961","DOIUrl":"10.1016/j.psychres.2026.116961","url":null,"abstract":"","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"358 ","pages":"Article 116961"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080190","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}
Pub Date : 2026-04-01Epub Date: 2026-01-18DOI: 10.1016/j.psychres.2026.116956
Claudia Asenjo-Lobos , Marcelo Arancibia , Marcela Cortés-Jofré , Tianming Huang , Ting Li , Eva Madrid , Stefan Leucht
Schizophrenia is a chronic mental illness characterized by disruptions in thought processes and emotional responsiveness. Clozapine is often more effective for treatment-resistant cases but carries risks like agranulocytosis, while olanzapine has fewer severe side effects but may offer reduced efficacy. This review compares the efficacy and safety of these antipsychotics in the treatment of schizophrenia. We conducted a systematic review that included ten double-blind, randomized clinical trials involving 761 participants. The findings show no significant differences in global clinical outcomes between the two drugs. However, a small difference favouring olanzapine was observed on the PANSS negative subscore. Regarding adverse effects, clozapine is associated with distinct metabolic side effects, particularly a notable increase in triglyceride levels, raising concerns about its overall metabolic impact. Also, clozapine showed a higher risk of adverse effects leading to higher dropout rates for this reason.
The study emphasizes the need for personalized treatment plans that consider the comprehensive side effect profiles and metabolic implications of these antipsychotics. Future research should continue to refine the long-term management strategies for schizophrenia, focusing on optimizing patient outcomes and addressing the metabolic challenges associated with these treatments.
{"title":"Comparative efficacy and safety of clozapine and olanzapine in schizophrenia and related disorders: An updated systematic review","authors":"Claudia Asenjo-Lobos , Marcelo Arancibia , Marcela Cortés-Jofré , Tianming Huang , Ting Li , Eva Madrid , Stefan Leucht","doi":"10.1016/j.psychres.2026.116956","DOIUrl":"10.1016/j.psychres.2026.116956","url":null,"abstract":"<div><div>Schizophrenia is a chronic mental illness characterized by disruptions in thought processes and emotional responsiveness. Clozapine is often more effective for treatment-resistant cases but carries risks like agranulocytosis, while olanzapine has fewer severe side effects but may offer reduced efficacy. This review compares the efficacy and safety of these antipsychotics in the treatment of schizophrenia. We conducted a systematic review that included ten double-blind, randomized clinical trials involving 761 participants. The findings show no significant differences in global clinical outcomes between the two drugs. However, a small difference favouring olanzapine was observed on the PANSS negative subscore. Regarding adverse effects, clozapine is associated with distinct metabolic side effects, particularly a notable increase in triglyceride levels, raising concerns about its overall metabolic impact. Also, clozapine showed a higher risk of adverse effects leading to higher dropout rates for this reason.</div><div>The study emphasizes the need for personalized treatment plans that consider the comprehensive side effect profiles and metabolic implications of these antipsychotics. Future research should continue to refine the long-term management strategies for schizophrenia, focusing on optimizing patient outcomes and addressing the metabolic challenges associated with these treatments.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"358 ","pages":"Article 116956"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146026240","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}
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