Psychiatry Research最新文献_第4页

Optimizing antipsychotic dosing for relapse prevention in cannabis-induced psychosis: A nationwide cohort study 优化抗精神病药物剂量预防大麻诱导的精神病复发：一项全国性队列研究

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2026-01-22 DOI: 10.1016/j.psychres.2026.116966

Antti Mustonen , Solja Niemelä , Alexander Denissoff , Marta Di Forti , Antti Tanskanen , Ellenor Mittendorfer-Rutz , Jari Tiihonen , Heidi Taipale

Background

Cannabis-induced psychosis (CIP) carries a high risk of relapse. Research has shown that antipsychotic medications are effective in relapse prevention after first diagnosed CIP. Given that antipsychotics carry the potential for dose-related adverse effects, understanding the optimal dose is critical. Therefore, we conducted a dose–response analysis to evaluate the real-world effectiveness of oral antipsychotics in preventing relapse after CIP.

Methods

We used data from linkage of administrative and health care registers from Sweden to identify all individuals with first diagnosis of CIP (ICD-10 F12.5). We modelled oral antipsychotic exposure (aripiprazole, clozapine, risperidone, olanzapine, quetiapine, antipsychotic polytherapy, other oral antipsychotics) as time-dependent using validated PRE2DUP-method. Dose–response association of antipsychotic exposure and outcome were examined across three predefined daily dose (DDD) categories (<0.6, 0.6–<1.4, ≥1.4) using within-individual models in a stratified Cox-regression analysis. The primary outcome was hospitalization for any psychotic episode, defined as schizophrenia-spectrum disorder (F20–F29) or substance-induced psychosis (F1x.5) as the main diagnosis.

Results

We identified 1,772 individuals aged 16-64 years with first-time CIP between 2006 and 2021. Antipsychotic polytherapy was associated with reduced risk of psychosis hospitalization across all dose ranges (HRs=0.54–0.65). Clozapine (0.6–<1.4 DDDs/day), olanzapine (≥0.6 DDDs/day), aripiprazole (0.6–<1.4 DDDs/day), risperidone (<0.6 DDDs/day), and other oral antipsychotics (0.6–<1.4 DDDs/day) were effective, while quetiapine showed no significant benefit.

Conclusions

Findings indicate dose-dependent real-world effectiveness of antipsychotics in CIP, with most agents performing best at 0.6–<1.4 DDDs/day. These results support optimizing dosing of oral antipsychotic medications for relapse prevention after CIP to balance efficacy and adverse effects.

大麻诱导的精神病（CIP）有很高的复发风险。研究表明，抗精神病药物对首次诊断为CIP后的复发预防有效。鉴于抗精神病药物具有剂量相关的潜在副作用，了解最佳剂量是至关重要的。因此，我们进行了一项剂量反应分析，以评估口服抗精神病药物在预防CIP后复发的实际有效性。方法：我们使用来自瑞典的行政和卫生保健登记链接的数据来识别所有首次诊断为CIP的个体（icd - 10f12.5）。我们使用经过验证的pre2dup方法模拟口服抗精神病药物（阿立哌唑、氯氮平、利培酮、奥氮平、喹硫平、抗精神病综合治疗、其他口服抗精神病药物）暴露的时间依赖性。在分层cox -回归分析中，使用个体内模型检查了三种预定义日剂量（DDD）类别（<0.6, 0.6 -<1.4,≥1.4）中抗精神病药物暴露与结果的剂量-反应相关性。主要结局是任何精神病发作的住院治疗，定义为精神分裂症谱系障碍（F20-F29）或物质诱导精神病（F1x.5）作为主要诊断。结果在2006年至2021年间，我们确定了1772名16-64岁的首次CIP患者。在所有剂量范围内，抗精神病综合治疗与精神病住院风险降低相关（hr = 0.54-0.65）。氯氮平（0.6 - 1.4 DDDs/天）、奥氮平（≥0.6 DDDs/天）、阿立哌唑（0.6 - 1.4 DDDs/天）、利培酮（0.6 - 1.4 DDDs/天）及其他口服抗精神病药物（0.6 - 1.4 DDDs/天）均有效，喹硫平无显著获益。结论：研究结果表明抗精神病药物在CIP中的实际疗效与剂量有关，大多数药物在0.6 - 1.4 DDDs/d时表现最佳。这些结果支持优化口服抗精神病药物的剂量来预防CIP后复发，以平衡疗效和不良反应。

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引用次数: 0

Transdiagnostic investigation of white matter integrity and cortical thickness in cognitive subgroups within the schizophrenia-bipolar spectrum 精神分裂症-双相谱系认知亚群白质完整性和皮质厚度的跨诊断研究

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2026-01-20 DOI: 10.1016/j.psychres.2026.116964

Burcu Verim , Cemal Demirlek , Nabi Zorlu , Burak Erdeniz , Ozge Akgul , Deniz Ceylan , Koksal Alptekin , Aysegul Ozerdem , Berna Binnur Akdede , Emre Bora

Background

Cognitive deficits are cardinal features of schizophrenia-spectrum disorders (SSD) and bipolar disorder (BD). However, their heterogeneous and overlapping characteristics require a dimensional approach to better understand the neurobiological basis of cognition in the psychosis spectrum. To date, only a few studies have examined the neuroanatomical features of cognitive subgroups in transdiagnostic samples, and white matter microstructural characteristics of these subgroups have not been elucidated. This study aimed to investigate white matter and cortical thickness alterations in cognitive subgroups in the schizophrenia-bipolar spectrum.

Methods

Globally Impaired (n = 31) and Near-Normal (n = 28) cognitive subgroups, comprising individuals diagnosed with schizophrenia (SZ), schizoaffective disorder (SAD) or BD, and healthy controls (HCs, n = 29), underwent 3T T1-weighted structural magnetic resonance imaging and diffusion tensor imaging scanning. Fractional anisotropy and cortical thickness measures were compared between the cognitive subgroups and healthy controls.

Results

Abnormalities in white matter microstructure were only observed in patients with global cognitive impairment compared to HCs. The Near-Normal subgroup did not differ from HCs in white matter integrity. A bilateral reduction in cortical thickness was observed in both the Globally Impaired and Near-Normal subgroups when compared to HCs. Cortical thickness measures did not differentiate between the cognitive subgroups.

Conclusions

While reductions in cortical thickness in frontal and temporal regions appear to be a common feature of SZ and BD, abnormalities in white matter microstructure are associated with global cognitive impairment in the schizophrenia-bipolar spectrum. These original findings may be important in identifying more biologically valid clinical syndromes within the schizophrenia-bipolar spectrum.

认知缺陷是精神分裂症谱系障碍（SSD）和双相情感障碍（BD）的主要特征。然而，它们的异质性和重叠特征需要一个维度的方法来更好地理解精神病谱系中认知的神经生物学基础。迄今为止，只有少数研究检查了跨诊断样本中认知亚群的神经解剖学特征，并且这些亚群的白质微观结构特征尚未阐明。本研究旨在研究精神分裂症-双相情感障碍认知亚组中白质和皮质厚度的变化。方法认知功能全面受损（n = 31）和接近正常（n = 28）亚组，包括被诊断为精神分裂症（SZ）、分裂情感障碍（SAD）或BD的个体，以及健康对照（hc, n = 29），接受3tt1加权结构磁共振成像和弥散张量成像扫描。在认知亚组和健康对照组之间比较分数各向异性和皮质厚度测量。结果与hc相比，白质微结构异常仅在整体认知障碍患者中观察到。近正常亚组与hc在白质完整性方面没有差异。与hcc相比，在整体受损和接近正常亚组中均观察到双侧皮质厚度减少。皮质厚度测量不能区分认知亚组。结论：额叶和颞叶皮质厚度的减少似乎是SZ和BD的共同特征，而白质微观结构的异常与精神分裂症-双相障碍患者的整体认知障碍有关。这些最初的发现可能对识别精神分裂症-双相谱系中更多生物学上有效的临床综合征很重要。

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引用次数: 0

Genetic and environmental factors in pain symptoms and self-harm, and their association. A twin study 疼痛症状和自残的遗传和环境因素及其相关性一项双胞胎研究。

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2026-01-19 DOI: 10.1016/j.psychres.2026.116962

Jenny Rickardsson , Mark J. Taylor , Paul Lichtenstein , Henrik Larsson , Sebastian Lundström , Karin Jensen , Maria Lalouni

Individuals who self-harm are often insensitive to pain, and consequently pain sensitivity has been proposed as a barrier for self-harm. It is unclear how pain and self-harm interplay in real life settings, and to what extent genetics and environmental factors contribute to the etiology of both.

This study was registry based using classical twin design. A cohort of 16 948 Swedish twin pairs born between 1992 and 2010, was prospectively assessed for pain symptoms at ages 9 and 18, and followed up for later self-harm until 2016 and a maximum age of 24.

The relative contributions of genetic and environmental factors to each phenotype were estimated using univariate twin models. Logistic regression models assessed their association, and conditional models adjusted for familial confounding.

Genetics and non-shared environment contributed to pain and self-harm to a moderate degree at both age 9 and age 18, while the contribution of shared environment was small for both pain and self-harm at both ages. At age 18 the pain symptoms group had higher odds for later self-harm (odds ratio 1.59, 95% CI 1.06–2.41, p = .003), and pain seemed to be partially in the causal pathway as it was not explained by familial confounding. This study adds to the evidence of pain symptoms as a predictor for self-harm.

自我伤害的个体通常对疼痛不敏感，因此疼痛敏感性被认为是自我伤害的障碍。目前还不清楚疼痛和自我伤害在现实生活中是如何相互作用的，也不清楚遗传和环境因素在多大程度上影响了两者的病因。本研究采用经典双胞胎设计。对1992年至2010年间出生的16948对瑞典双胞胎进行了前瞻性评估，评估了他们在9岁和18岁时的疼痛症状，并对后来的自我伤害进行了随访，直到2016年，最大年龄为24岁。使用单变量双胞胎模型估计遗传和环境因素对每种表型的相对贡献。逻辑回归模型评估了它们之间的关联，条件模型对家族混淆进行了调整。在9岁和18岁时，遗传和非共享环境对疼痛和自残都有中等程度的影响，而共享环境对疼痛和自残的影响都很小。在18岁时，疼痛症状组后来自残的几率更高（优势比1.59,95% CI 1.06-2.41, p = 0.003），疼痛似乎是部分因果途径，因为它不能用家族混淆来解释。这项研究进一步证明，疼痛症状是自我伤害的前兆。

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引用次数: 0

Clinician awareness and systemic barriers of diagnostic overshadowing in emergency psychiatry: A latent class analysis 急诊精神病学诊断阴影的临床医生意识和系统障碍：一个潜在类别分析

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2026-01-19 DOI: 10.1016/j.psychres.2026.116958

Omer Faruk Karakoyun , Yalcin Golcuk , Fulden Cantas Turkis , Meltem Derya Sahın , Halil Emre Koyuncuoglu , Omer Harun Sagnic

Objective

Diagnostic overshadowing (DO)—the misattribution of new physical symptoms to a pre-existing psychiatric diagnosis—can delay recognition of medical illness and worsen outcomes in emergency care. This study examined clinicians’ awareness of DO, the provider- and system-level factors perceived as driving it, and whether distinct awareness/attribution profiles can be identified among emergency physicians and psychiatrists in Türkiye.

Methods

We conducted a nationwide cross-sectional online survey of emergency department–facing emergency physicians and psychiatrists between 15 March and 1 May 2025. A 51-item questionnaire on DO-related determinants was developed and psychometrically refined, yielding a concise nine-item indicator set. Latent class analysis of responses to these indicators was used to identify subgroups of clinicians with similar patterns of DO-related awareness and attribution.

Results

Of 215 invitees, 120 completed the survey (56 % response; median age 33 years; 46.7 % female). Participants: 65% emergency medicine, 35% psychiatry. A three-class solution best fit the data (AIC=2620.17; BIC=2926.80; SS-BIC=2579.03; entropy=0.949; LMR-LRT/BLRT p < 0.001), with the smallest class ≥25%. LCA defined: Low Recognition; System-Tilted Awareness; Multidimensional High Awareness. Age and years in practice differed modestly across classes (p < 0.05), whereas gender, institution, academic title, and DO familiarity did not (p > 0.05).

Conclusions

These findings show that DO awareness is heterogeneous and not confined to a single specialty. A brief indicator set and profile-based framework may support tailored education and service redesign to reduce diagnostic overshadowing and improve safety and equity in emergency care.

诊断阴影（DO）——将新的身体症状错误地归因于先前的精神诊断——可以延迟对医学疾病的认识，并恶化急诊护理的结果。本研究调查了临床医生对DO的认识，被认为是驱动DO的提供者和系统级因素，以及是否可以在 rkiye的急诊医生和精神科医生中确定不同的认识/归因概况。方法：我们在2025年3月15日至5月1日期间对急诊科急诊医师和精神科医生进行了全国性的横断面在线调查。开发了一份51项关于do相关决定因素的问卷，并从心理测量学上进行了改进，得出了一个简明的9项指标集。对这些指标的反应进行潜在分类分析，以确定具有类似do相关意识和归因模式的临床医生亚组。结果在215名被邀请者中，120人完成了调查（56%的回复率，中位年龄33岁，46.7%为女性）。参与者：65%急诊医学，35%精神病学。三类解最适合数据（AIC=2620.17； BIC=2926.80; SS-BIC=2579.03；熵=0.949;LMR-LRT/BLRT p < 0.001），最小类≥25%。LCA定义：低识别度；System-Tilted意识;多维的高意识。不同班级的年龄和实习年限差异不大（p < 0.05），而性别、机构、学术头衔和DO熟悉程度没有差异（p < 0.05）。结论：这些发现表明，DO意识是异质性的，并不局限于单一的专业。一个简短的指标集和基于概况的框架可支持量身定制的教育和服务重新设计，以减少诊断的阴影，并改善急诊护理的安全性和公平性。

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引用次数: 0

Social networks and symptomatology in recently hospitalized individuals with schizophrenia-spectrum disorders: A six-month longitudinal study 最近住院的精神分裂症谱系障碍患者的社会网络和症状学：一项为期六个月的纵向研究

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2026-01-19 DOI: 10.1016/j.psychres.2026.116960

Gabriella V. Schock , Andrew R. Kittleson , Annalise S. Halverson , Jinyuan Liu , Julia M. Sheffield

Individuals with psychosis have reduced social networks; however, little is known about whether social networks change over time, particularly after an acute episode requiring hospitalization. Furthermore, longitudinal associations between social network engagement, symptom severity, and the impact of illness duration remains unclear. Using linear mixed models controlling for age and sex, we analyzed self-reported social network engagement, positive and negative symptom severity, and self-reported paranoia in individuals with a schizophrenia-spectrum disorder (SSD; N = 68) during six months following psychiatric hospitalization and compared them with non-clinical participants (NC; N = 70). SSD participants reported significantly lower social network scores than NC participants at every time point (b = –5.77), and significantly greater disruption in friendship than family ties (b = – 2.00). Social networks remained stable over time in both groups (b = –0.01), regardless of illness stage in the SSD group (b = 8.08). Notably, lower social engagement with family at baseline predicted greater increases in paranoia over time (b = –1.01). Conversely, more severe paranoia at baseline predicted greater reductions in friend networks over time (b = –0.03). Finally, social network related to negative symptom severity at baseline (b = –0.42) and longitudinally (b = –0.18). These findings suggest that clinical severity may influence the social network disruptions commonly found in psychotic disorders, especially during vulnerable periods of recovery following a psychotic exacerbation. Ultimately, this highlights the need for tailored post-discharge interventions that address social network deficits, particularly within families and in the context of severe paranoia.

精神病患者的社交网络较少；然而，人们对社交网络是否会随着时间的推移而改变知之甚少，尤其是在需要住院治疗的急性发作之后。此外，社会网络参与、症状严重程度和疾病持续时间的影响之间的纵向关联尚不清楚。使用控制年龄和性别的线性混合模型，我们分析了精神分裂症谱系障碍患者（SSD; N = 68）在精神病住院后6个月内自我报告的社交网络参与、阳性和阴性症状严重程度以及自我报告的偏执，并将其与非临床参与者（NC; N = 70）进行了比较。SSD参与者在每个时间点的社交网络得分都明显低于NC参与者（b = - 5.77），友谊的破坏程度明显高于家庭关系（b = - 2.00）。两组的社交网络随着时间的推移保持稳定（b = -0.01），与SSD组的疾病阶段无关（b = 8.08）。值得注意的是，基线时较低的家庭社交参与度预示着随着时间的推移偏执狂会增加（b = -1.01）。相反，在基线时，更严重的偏执预示着随着时间的推移，朋友网络的减少幅度更大（b = -0.03）。最后，社交网络在基线（b = -0.42）和纵向（b = -0.18）上与负性症状严重程度相关。这些发现表明，临床严重程度可能会影响精神疾病中常见的社会网络中断，特别是在精神病加重后的脆弱恢复期。最终，这突出了需要量身定制的出院后干预措施，以解决社会网络缺陷，特别是在家庭内部和严重偏执的情况下。

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引用次数: 0

A year into the war: Longitudinal effects of trauma, displacement, and income loss on mental health in conflict zones 战争一年：冲突地区创伤、流离失所和收入损失对心理健康的纵向影响

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2026-01-18 DOI: 10.1016/j.psychres.2026.116953

Doron Amsalem , Chana T. Fisch , John C. Markowitz , Amit Lazarov , Yossi Levi-Belz , Ido Lurie , Milton L. Wainberg , Shlomo Mendlovic , Yuval Neria , Shilat Haim-Nachum

Background

Research has linked war-related stressors like traumatic loss, forced displacement, and income disruption to acute mental health symptoms. Little is known about how symptoms evolve longitudinally during prolonged conflict. Extending our 90-day studies, we tracked clinical symptoms and betrayal-based moral injury over one full year following the October 7, 2023, attack and ensuing war in Israel. We hypothesized stressor-exposed individuals would report persistent psychological distress and heightened betrayal perceptions one year later.

Methods

A four-wave longitudinal study followed 1,052 individuals aged 18–40 living in northern and southern Israel, areas heavily affected by October 7 and the ongoing war. Assessments occurred in February, March, and May 2024 and March 2025. Anxiety, depression, and Post-Traumatic Stress Disorder (PTSD) symptoms The Generalized Anxiety Disorder 7-item scale (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Primary Care PTSD (PC-PTSD) measured. The Moral Injury Events betrayal subscale assessed betrayal-based moral injury. Linear Mixed Models examined symptom trajectories and associations with baseline war-related traumatic loss, forced displacement, and income loss.

Results

At baseline, 75 % of participants reported ≥1 probable clinical condition. Symptoms remained high after 12 months (66 %). Baseline exposure to traumatic loss, displacement, or income loss correlated with significantly higher anxiety, depression, PTSD, and betrayal scores across timepoints (F values 14.4-243.9, p<.001). Depression symptoms remained steady over time, whereas betrayal scores significantly increased.

Conclusions

This one-year longitudinal study found initial traumatic stressors predicted persistently elevated anxiety, depression, PTSD, and betrayal-based moral injury. Findings highlight the lasting psychological impact of cumulative war-related adversity and call for innovative, sustained treatment strategies that address both acute and evolving effects of prolonged conflict.

研究已经将战争相关的压力因素，如创伤性损失、被迫流离失所和收入中断，与急性精神健康症状联系起来。在长期冲突中，症状是如何纵向演变的，我们所知甚少。我们延长了为期90天的研究，在2023年10月7日以色列袭击和随后的战争之后的一整年里，我们追踪了临床症状和基于背叛的道德伤害。我们假设压力暴露的个体会在一年后报告持续的心理困扰和更高的背叛感。方法一项四波纵向研究追踪了1052名18-40岁的人，他们生活在以色列北部和南部，受10月7日和正在进行的战争严重影响的地区。评估发生在2024年2月、3月和5月以及2025年3月。焦虑、抑郁和创伤后应激障碍（PTSD）症状采用广泛性焦虑障碍7项量表（GAD-7）、患者健康问卷-9 （PHQ-9）和初级保健PTSD （PC-PTSD）进行测量。道德伤害事件背叛分量表评估基于背叛的道德伤害。线性混合模型检验了症状轨迹及其与基线战争相关的创伤损失、被迫流离失所和收入损失的关联。结果在基线时，75%的参与者报告了≥1种可能的临床状况。12个月后症状仍然严重（66%）。创伤性损失、流离失所或收入损失的基线暴露与跨时间点的焦虑、抑郁、PTSD和背叛得分显著升高相关（F值14.4-243.9,p<.001）。随着时间的推移，抑郁症状保持稳定，而背叛得分显著增加。这项为期一年的纵向研究发现，最初的创伤性压力源预示着持续升高的焦虑、抑郁、创伤后应激障碍和基于背叛的道德伤害。研究结果强调了与战争有关的逆境累积造成的持久心理影响，并呼吁制定创新、持续的治疗战略，以解决长期冲突的急性和演变影响。

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引用次数: 0

Fractured trust amidst war: The role of institutional betrayal and childhood maltreatment in shattered world assumptions and multilevel distress 战争中破碎的信任：制度背叛和儿童虐待在破碎的世界假设和多层次痛苦中的作用

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2026-01-18 DOI: 10.1016/j.psychres.2026.116959

Ada Talmon , Rachel Hasson , Yael Hollander , Noga Tsur

Background

The October 7th, 2023, terrorist attacks and subsequent war in Israel constituted an unprecedented assault on the civilian population, resulting in widespread trauma, a collapse of physical and psychological safety, and civilians' perceptions that the government's actions did not prioritize their safety and interests. This study investigates how the disruption of world assumptions, experiences of institutional betrayal, and childhood maltreatment (CM) contributed to multilevel stress outcomes, affecting Israeli civilians' perceptions of their mind, body, and relationships.

Methods

A community sample of 690 Israeli adults completed questionnaires assessing war exposure, CM, institutional betrayal, world assumptions, acute stress disorder (ASD), disturbances in self-organization (DSO), and somatization. A moderated mediation model was tested to examine whether CM and institutional betrayal moderated the relationship between war exposure and the distress outcomes, via world assumptions.

Results

War exposure was indirectly associated with ASD, DSO, and somatization through shattered world assumptions. This relationship was significantly moderated by institutional betrayal (B = −.075, p = .002); higher levels of institutional betrayal amplified the impact of war exposure on world assumptions. The indirect effects of war exposure on ASD, DSO, and somatization via world assumptions were moderated by institutional betrayal (ps < 0.05), but not CM (ps > 0.05).

Conclusion

Institutional betrayal plays a significant role in shaping trauma responses to war exposure and societal crises by eroding trust and contributing to multidimensional distress. Interventions should address institutional betrayal to promote healing and restore societal trust.

2023年10月7日，以色列的恐怖袭击和随后的战争构成了对平民人口的前所未有的攻击，造成了广泛的创伤，身心安全的崩溃，平民认为政府的行动没有优先考虑他们的安全和利益。本研究调查了世界假设的破坏、制度背叛的经历和童年虐待（CM）如何导致多层次的压力结果，影响以色列平民对他们的思想、身体和关系的看法。方法对690名以色列成年人进行社区问卷调查，评估战争暴露、CM、制度背叛、世界假设、急性应激障碍（ASD）、自我组织障碍（DSO）和躯体化。通过世界假设，检验了一个有调节的中介模型，以检验CM和制度背叛是否调节了战争暴露与痛苦结果之间的关系。结果战争暴露与ASD、DSO和破碎世界假设的躯体化间接相关。制度背叛显著调节了这一关系（B =−）。075, p = .002)；更高水平的制度背叛放大了战争曝光对世界假设的影响。战争暴露对ASD、DSO和通过世界假设的躯体化的间接影响被制度背叛调节（ps < 0.05），但不被CM调节（ps < 0.05）。结论制度背叛通过侵蚀信任和造成多维痛苦，在战争暴露和社会危机的创伤反应中起着重要作用。干预措施应解决体制背叛问题，以促进康复和恢复社会信任。

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引用次数: 0

Corrigendum to Patterns of suicidal thoughts and behaviors in depressed adolescents with and without psychotic features 有或无精神病性特征的抑郁青少年的自杀想法和行为模式的勘误表

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2026-01-18 DOI: 10.1016/j.psychres.2026.116961

Katherine A. Billetdeaux , Musa Yilanli , Eric E. Nelson , Kendra Heck , Jaclyn Tissue , Donna Ruch , Jeffrey Bridge

引用次数: 0

Mental health of adolescents during times of war 战争时期青少年的心理健康

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2026-01-18 DOI: 10.1016/j.psychres.2026.116957

Lena Lipskaya-Velikovsky, Reut Komemi, Yafit Gilboa, Mor Nahum

Objective

War-related prolonged stress is associated with poorer adolescent mental health. This cross-sectional study aimed to characterize the mental health of adolescents in Israel during an ongoing war situation and to examine how emotional, cognitive, and occupational factors were associated with their mental health during this period.

Methods

Data from 973 Israeli adolescents (ages 13–18, 65.8% female) were collected remotely eight months after the October 7th, 2023, attack and the subsequent war. Participants completed validated self-report questionnaires assessing their mental health, dispositional resilience, subjective executive functions (EFs), sense of coherence, and war-related changes in their daily-life participation.

Results

Overall, 40.2% of adolescents scored within the abnormal range for mental health symptoms, exceeding the expected normative 10%. Female and older participants reported worse emotional status. Adolescents reported reduced participation across all occupational domains, with notable individual variability. A regression model explained over 50% of the variance in mental health scores, with greater executive dysfunction and lower resilience showing the strongest associations with poorer mental health. Decision tree analysis indicated that adolescents with better inhibitory control and more stable participation were more likely to report better mental health. Among adolescents with EF difficulties, lower arousal symptoms were associated with better mental health.

Conclusions

These findings indicate a substantial and concerning mental health burden among adolescents living under prolonged war-related stress and highlight individual differences linked to internal resources and participation. EFs, patterns of daily-life participation, and arousal symptoms were associated with adolescents’ capacity to cope with war-related stress. Addressing them as potential intervention targets may help mitigate the long-term negative consequences of prolonged conflict-related stress.

目的：与战争相关的长期压力与青少年较差的心理健康有关。本横断面研究旨在描述以色列青少年在持续战争期间的心理健康状况，并研究在此期间情绪、认知和职业因素如何与他们的心理健康相关。方法在2023年10月7日袭击及随后的战争发生8个月后，远程收集973名以色列青少年（13-18岁，女性65.8%）的数据。参与者完成了有效的自我报告问卷，评估他们的心理健康、性格弹性、主观执行功能（EFs）、一致性感和他们日常生活参与中的战争相关变化。结果总体而言，40.2%的青少年心理健康症状得分在异常范围内，超过了预期的10%的标准。女性和年长的参与者报告了更糟糕的情绪状态。据报告，青少年在所有职业领域的参与度都有所下降，且存在显著的个体差异。一个回归模型解释了超过50%的心理健康得分差异，更大的执行功能障碍和更低的恢复力显示了与更差的心理健康的最强关联。决策树分析表明，抑制控制较好、参与稳定的青少年更有可能报告较好的心理健康状况。在有EF困难的青少年中，较低的觉醒症状与较好的心理健康有关。结论：这些研究结果表明，长期生活在战争相关压力下的青少年存在严重的、令人担忧的心理健康负担，并突出了与内部资源和参与有关的个体差异。EFs、日常生活参与模式和觉醒症状与青少年应对战争相关压力的能力有关。将其作为潜在的干预目标，可能有助于减轻长期冲突相关压力的长期负面后果。

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引用次数: 0

Comparative efficacy and safety of clozapine and olanzapine in schizophrenia and related disorders: An updated systematic review 氯氮平和奥氮平治疗精神分裂症及相关疾病的比较疗效和安全性：一项最新的系统综述

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2026-01-18 DOI: 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.

精神分裂症是一种以思维过程和情绪反应中断为特征的慢性精神疾病。氯氮平通常对治疗难治性病例更有效，但有粒细胞缺乏症等风险，而奥氮平的严重副作用较少，但疗效可能会降低。这篇综述比较了这些抗精神病药物治疗精神分裂症的有效性和安全性。我们进行了一项系统综述，包括10项双盲、随机临床试验，涉及761名参与者。研究结果显示，两种药物的总体临床结果没有显著差异。然而，在PANSS阴性评分上观察到有利于奥氮平的小差异。关于副作用，氯氮平与明显的代谢副作用相关，特别是甘油三酯水平显著升高，引起对其整体代谢影响的担忧。此外，氯氮平显示出更高的不良反应风险，导致更高的辍学率。该研究强调需要个性化的治疗计划，考虑到这些抗精神病药物的综合副作用和代谢影响。未来的研究应继续完善精神分裂症的长期管理策略，重点是优化患者的预后，并解决与这些治疗相关的代谢挑战。

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