Psychiatry Research最新文献_第5页

Clinical remission, functional recovery, and employment in early-phase schizophrenia treated with paliperidone palmitate: An 18-month longitudinal Asia-Pacific study 帕利哌酮棕榈酸酯治疗早期精神分裂症的临床缓解、功能恢复和就业：一项为期18个月的亚太纵向研究

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2026-01-18 DOI: 10.1016/j.psychres.2026.116955

Chien-Heng Lin , Chih-Lin Chiang , Dae Young Yu , Hiroshi Horio , Natsuko Tokushige , David Bin-Chia Wu

Objective

The study aimed to evaluate the impact of monthly paliperidone palmitate (PP1M) on competitive employment and clinical/function remission in patients with early-phase schizophrenia during an 18-month observational period of a multicenter, open-label, single-arm clinical trial.

Methods

Patients with schizophrenia diagnosed within 5 years were enrolled across the Asia-Pacific region and received PP1M treatment. Employment status (full-time or part-time), symptom severity, and psychosocial functioning were assessed using standardized instruments. Predictors of employment improvement were identified through logistic regressions.

Results

A total of 474 patients were enrolled, with competitive employment rates rising from 28.1 % at baseline to 45.4 % at month 18. For patients unemployed at baseline, the employment rate improved to 33.8 % at month 18. Significant remission improvements were observed in PANSS (40.0 % to 80.4 %), CGI-SCH (55.6 % to 89.3 %), and PSP (25.2 % to 65.4 %) over the same period. Employment and remissions followed distinct improvement trajectories. Baseline employment status (adjusted OR 5.544, 95 % CI: 2.902-10.592) and male sex (adjusted OR 1.927, 95 % CI 1.066–3.483) were significantly associated with employment improvement in multivariate analyses.

Conclusion

PP1M treatment resulted in significant improvements in clinical symptoms, functional recovery, and competitive employment over 18 months. The findings emphasize the need to address systemic barriers to employment while supporting sustained clinical and functional recovery to facilitate workforce reintegration for schizophrenia patients.

目的：在一项为期18个月的多中心、开放标签、单臂临床试验中，研究旨在评估每月服用帕利哌酮棕榈酸酯（PP1M）对早期精神分裂症患者竞争性就业和临床/功能缓解的影响。方法入选亚太地区5年内诊断为精神分裂症的患者，并接受PP1M治疗。使用标准化工具评估就业状况（全职或兼职）、症状严重程度和社会心理功能。通过逻辑回归确定就业改善的预测因子。结果共纳入474例患者，竞争就业率从基线时的28.1%上升到18个月时的45.4%。对于基线失业的患者，就业率在第18个月提高到33.8%。在同一时期，PANSS（40.0%至80.4%）、CGI-SCH（55.6%至89.3%）和PSP（25.2%至65.4%）的缓解改善显著。就业和减排遵循明显的改善轨迹。在多变量分析中，基线就业状况（调整后的OR为5.544,95% CI: 2.902-10.592）和男性性别（调整后的OR为1.927,95% CI为1.066-3.483）与就业改善显著相关。结论pp1m治疗18个月后，患者的临床症状、功能恢复和竞争性就业均有显著改善。研究结果强调需要解决系统性就业障碍，同时支持持续的临床和功能恢复，以促进精神分裂症患者重返劳动力市场。

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引用次数: 0

Genetic studies of psychosocial disability establish correlations and causal relationships with neuropsychiatric disorders. 社会心理残疾的遗传研究与神经精神疾病建立了相关性和因果关系。

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2026-01-18 DOI: 10.1016/j.psychres.2026.116963

Evie Doherty, Aodán Laighneach, Mia Casburn, Fergus Quilligan, Gary Donohoe, Dara M Cannon, Derek W Morris

Psychosis is a clinically heterogenous disorder associated with significant difficulties with social and occupational function (psychosocial disability; PD). While environmental and cognitive factors are identified predictors of PD, the genetic contribution remains unclear. Here, we investigated the hypothesis that objective social participation (SP) and occupational engagement are genetically influenced. We performed mixed-linear-model genome-wide association studies of these phenotypes in the UK Biobank (N∼404,500) and a series of post-hoc analyses including Mendelian randomization (MR) to interpret findings. SP was defined as the frequency of social visits and leisure activities based on response to questionnaires. Occupational engagement was represented by two variables: occupational function (OF) and the established Not in Education, Employment, and Training (NEET) measure, both derived from employment status responses. We identified 17 independent loci for SP, with a SNP-based heritability of 4.1%. A list of contributory genes included TNRC6B, STAU1, CDH7, GBE1, DDX27, and several known schizophrenia risk genes including CSE1L, ZNF536 and TCF4. The regulation of synaptic signalling was implicated in the biology of SP by gene-set analysis. SNP-based heritabilities for OF and NEET were 1.8% and 1.3% respectively and DRD2 was associated with both phenotypes by gene-based analysis. Reduced SP and occupational engagement demonstrated genetic correlations with an increased risk for neuropsychiatric disorders, socioeconomic deprivation, lower cognitive ability, loneliness, neuroticism and chronic pain. MR indicated that attention-deficit hyperactivity disorder and schizophrenia were likely causal for reduced occupational engagement. PD has a genetic component with shared genetic links and relationships with neuropsychiatric disorders and related traits.

精神病是一种临床异质性疾病，与社会和职业功能方面的重大困难相关（心理社会障碍；PD）。虽然环境和认知因素已被确定为帕金森病的预测因素，但遗传因素仍不清楚。在此，我们研究了客观社会参与（SP）和职业投入受遗传影响的假设。我们在UK Biobank （N ~ 404,500）中对这些表型进行了混合线性模型全基因组关联研究，并进行了一系列事后分析，包括孟德尔随机化（MR）来解释研究结果。SP定义为社会访问和休闲活动的频率，基于对问卷的回答。职业投入由两个变量表示：职业功能（OF）和既定的不参与教育、就业和培训（NEET）测量，两者都来自就业状况回应。我们发现了17个独立的SP位点，基于snp的遗传率为4.1%。致病基因包括TNRC6B、STAU1、CDH7、GBE1、DDX27，以及一些已知的精神分裂症风险基因包括CSE1L、ZNF536和TCF4。通过基因集分析，发现突触信号的调控与SP的生物学有关。基于snp的OF和NEET遗传率分别为1.8%和1.3%，通过基因分析，DRD2与两种表型相关。降低SP和职业投入与神经精神疾病、社会经济剥夺、认知能力低下、孤独、神经质和慢性疼痛的风险增加具有遗传相关性。MR显示注意缺陷多动障碍和精神分裂症可能是职业投入减少的原因。PD具有遗传成分，与神经精神疾病和相关特征具有共同的遗传联系和关系。

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引用次数: 0

Metabolic brain connectivity analysis of a depressive-like phenotype in rats: a graph theory PET study 大鼠抑郁样表型的代谢脑连通性分析：图论PET研究

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2026-01-17 DOI: 10.1016/j.psychres.2026.116951

Daniel A. Vazquez-Matias, Erik F.J. de Vries, Cyprien G.J. Guerrin, Kavya Prasad, Janine Doorduin

This study aimed to investigate whether there are metabolic connectivity alterations in the brain of rats with a depressive-like phenotype, using positron emission tomography (PET) and graph theory methods. Male Wistar rats were exposed to 5 days of repeated social defeat (RSD) to induce a depressive-like phenotype, and brain connectivity was assessed with [¹⁸F]FDG-PET. Sucrose preference tests were conducted to assess anhedonia-like behaviour, a symptom of depression. The results showed that anhedonia-like behaviour was present one day after RSD and recovered after seven days. The analysis of large-scale brain networks revealed a reduction in connectivity in the default mode network of RSD-exposed animals one day after RSD, suggesting a link between reduced connectivity and the presence of anhedonia-like behaviour. Seven days after RSD, an increase in connectivity was observed in the salience network, which coincided with the recovery of sucrose preference. Modular analysis revealed different configurations of brain regions at one and seven days after RSD, with asymmetrical segregation of left and right hemisphere structures. These findings suggest that changes in brain connectivity may play a role in the development and recovery of anhedonia-like behaviour in rats exposed to RSD and may have implications for understanding depressive phenotypes.

本研究旨在利用正电子发射断层扫描（PET）和图论方法探讨抑郁样表型大鼠大脑中是否存在代谢连通性改变。雄性Wistar大鼠暴露于5天的重复社会失败（RSD）中以诱导抑郁样表型，并用[18F]FDG-PET评估脑连通性。蔗糖偏好测试被用来评估类似快感缺乏的行为，这是抑郁症的一种症状。结果显示，RSD后1天出现快感缺乏样行为，7天后恢复。对大规模大脑网络的分析显示，RSD暴露的动物在RSD后一天默认模式网络的连通性减少，这表明连通性减少与快感缺乏样行为的存在之间存在联系。RSD后7天，显著性网络的连通性增加，这与蔗糖偏好的恢复相一致。模块化分析显示，在RSD后1天和7天，大脑区域的结构不同，左右半球结构不对称分离。这些发现表明，大脑连通性的变化可能在RSD暴露大鼠的快感缺乏样行为的发展和恢复中发挥作用，并可能对理解抑郁表型具有启示意义。

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引用次数: 0

Cutoff scores and predictive validity of the Acute Suicidal Affective Disturbance Inventory (ASADI) for future suicide attempts and suicidal ideation with intent 急性自杀情感障碍量表（ASADI）对未来自杀企图和有意图自杀意念的截止分数和预测效度

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2026-01-15 DOI: 10.1016/j.psychres.2026.116950

Jimin Lee, Yuna Oh, Sungeun You

Background

Identification of individuals at elevated risk for suicidal behavior is an important component of suicide prevention efforts. This study aimed to examine the predictive validity of the Acute Suicidal Affective Disturbance Inventory (ASADI) and to explore potential cutoff scores in relation to subsequent suicidal outcomes

Methods

We analyzed data from a community-based sample of 682 Korean adults who have experienced drastic increase in suicide intent, of whom 373 completed a one-year follow-up assessment. Using a one-year longitudinal data, receiver operating characteristics (ROC) analyses were conducted to examine cutoff scores in predicting future suicide attempts and suicidal ideation with intent. Potential cutoff scores were further evaluated by assessing their predictive performance after controlling for demographic and clinical covariates through multivariate logistic regression.

Results

Higher ASADI scores were prospectively associated with suicide attempts and suicidal ideation with intent during the follow-up period. A cutoff score of 248 demonstrated the strongest discriminative performance for suicide attempts, with individuals scoring above this threshold showing an increased likelihood of attempting suicide over one year after adjusting for covariates. Additional cutoffs of 192 and 206 were associated with suicidal ideation with intent.

Conclusion

These findings provide preliminary, empirically derived cutoff scores for the ASADI and support its prospective relevance as a measure of identifying at-risk individuals who warrant closer monitoring.

背景自杀行为高危个体的识别是自杀预防工作的重要组成部分。本研究旨在检验急性自杀情感障碍量表（ASADI）的预测有效性，并探讨与随后自杀结果相关的潜在临界值。方法：我们分析了682名自杀意图急剧增加的韩国成年人的社区样本数据，其中373人完成了为期一年的随访评估。使用为期一年的纵向数据，进行受试者工作特征（ROC）分析，以检验预测未来自杀企图和有意图自杀意念的截止分数。在通过多变量逻辑回归控制人口统计学和临床协变量后，通过评估其预测性能进一步评估潜在临界值。结果在随访期间，较高的ASADI评分与自杀企图和有意图的自杀意念有潜在的相关性。临界值为248分显示出对自杀企图的最强烈的区别性表现，在调整协变量后，得分高于这个阈值的个体在一年内尝试自杀的可能性增加。另有192和206的临界值与有意图的自杀意念有关。结论：这些发现为ASADI提供了初步的、经验推导的临界值，并支持其作为识别需要密切监测的高危个体的前瞻性相关性。

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引用次数: 0

A bibliometric analysis of inhalant misuse among street-involved children: Trends, patterns, and research gaps 街头儿童吸入剂滥用的文献计量学分析：趋势、模式和研究差距。

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2026-01-10 DOI: 10.1016/j.psychres.2026.116949

Faisal Adi Irawan , Christina Yeni Kustanti , Koko Srimulyo , Rifky Octavia Pradipta , Nuzul Qur’aniati , Rika Sarfika , Lisa McKenna , Ferry Efendi

Introduction

Inhalant misuse, particularly glue sniffing, is one of the most harmful yet least studied forms of substance abuse among street-involved children. Despite high prevalence in some low- and middle-income countries (LMICs), research is limited, fragmented, and often embedded within broader substance use studies. This study aimed to map global research trends, identify thematic patterns, and highlight gaps in the literature on inhalant misuse among this population.

Methods

A bibliometric analysis was conducted using Scopus and Web of Science databases, searched on June 12, 2025 without date restrictions, guided by a Population–Concept–Context framework. Screening and data cleaning were performed by two reviewers. Eligible records were analyzed using Bibliometrix (Biblioshiny) to examine publication trends, authorship, journal sources, keyword co-occurrence, and thematic patterns.

Results

From 343 records, 161 articles (1989–2025) were included. Publications spanned 94 sources and 532 authors, with 5.55% annual growth and a mean 26.23 citations per document. International co-authorship was 11.8%. The United States contributed most, followed by Canada and Australia. The Journal of Adolescent Health was the top source; Substance Use & Misuse and Children and Youth Services Review also ranked highly. Eight keyword clusters were identified, led by terms including “homelessness adolescents,” “street children,” “HIV,” “substance abuse,” “alcohol,” “substance use,” “homelessness,” and “adolescents.”. Themes centered on abuse, risky behaviors, drug use, depression, and support, while socio-cultural and educational impacts in LMICs were notably sparse.

Conclusion

Inhalant misuse among street-involved children is an under-recognized global health and social issue. Strengthening interdisciplinary and geographically inclusive research can guide targeted interventions and policies aligned with Sustainable Development Goal (SDG) 3.5 on substance abuse prevention and treatment.

简介：滥用吸入剂，特别是吸胶，是街头儿童中最有害但研究最少的药物滥用形式之一。尽管在一些低收入和中等收入国家（LMICs）中发病率很高，但研究是有限的、零散的，而且往往被纳入更广泛的药物使用研究。本研究旨在绘制全球研究趋势，确定专题模式，并突出这一人群中吸入剂滥用的文献差距。方法：使用Scopus和Web of Science数据库进行文献计量学分析，检索日期为2025年6月12日，无日期限制，采用Population-Concept-Context框架。筛选和数据清理由两名审查员进行。使用Bibliometrix （Biblioshiny）分析符合条件的记录，以检查出版趋势、作者身份、期刊来源、关键词共现和主题模式。结果：共纳入343篇文献161篇（1989-2025）。出版物跨越94个来源和532位作者，年增长率为5.55%，平均每篇论文被引用26.23次。国际合作作者占11.8%。美国贡献最多，其次是加拿大和澳大利亚。《青少年健康杂志》是最主要的来源；《物质使用与滥用》和《儿童与青少年服务评论》的排名也很高。确定了八个关键字集群，其中包括“无家可归的青少年”、“街头儿童”、“艾滋病毒”、“药物滥用”、“酒精”、“药物使用”、“无家可归”和“青少年”。主题集中于虐待、危险行为、药物使用、抑郁和支持，而对中低收入国家的社会文化和教育影响明显较少。结论：街头儿童滥用吸入剂是一个未得到充分认识的全球健康和社会问题。加强跨学科和地域包容性研究可以指导有针对性的干预措施和政策，这些措施和政策符合关于预防和治疗药物滥用的可持续发展目标3.5。

{"title":"A bibliometric analysis of inhalant misuse among street-involved children: Trends, patterns, and research gaps","authors":"Faisal Adi Irawan , Christina Yeni Kustanti , Koko Srimulyo , Rifky Octavia Pradipta , Nuzul Qur’aniati , Rika Sarfika , Lisa McKenna , Ferry Efendi","doi":"10.1016/j.psychres.2026.116949","DOIUrl":"10.1016/j.psychres.2026.116949","url":null,"abstract":"<div><h3>Introduction</h3><div>Inhalant misuse, particularly glue sniffing, is one of the most harmful yet least studied forms of substance abuse among street-involved children. Despite high prevalence in some low- and middle-income countries (LMICs), research is limited, fragmented, and often embedded within broader substance use studies. This study aimed to map global research trends, identify thematic patterns, and highlight gaps in the literature on inhalant misuse among this population.</div></div><div><h3>Methods</h3><div>A bibliometric analysis was conducted using Scopus and Web of Science databases, searched on June 12, 2025 without date restrictions, guided by a Population–Concept–Context framework. Screening and data cleaning were performed by two reviewers. Eligible records were analyzed using Bibliometrix (Biblioshiny) to examine publication trends, authorship, journal sources, keyword co-occurrence, and thematic patterns.</div></div><div><h3>Results</h3><div>From 343 records, 161 articles (1989–2025) were included. Publications spanned 94 sources and 532 authors, with 5.55% annual growth and a mean 26.23 citations per document. International co-authorship was 11.8%. The United States contributed most, followed by Canada and Australia. The <em>Journal of Adolescent Health</em> was the top source; <em>Substance Use & Misuse</em> and <em>Children and Youth Services Review</em> also ranked highly. Eight keyword clusters were identified, led by terms including <em>“homelessness adolescents,” “street children,” “HIV,” “substance abuse,” “alcohol,” “substance use,” “homelessness,”</em> and <em>“adolescents.”</em>. Themes centered on abuse, risky behaviors, drug use, depression, and support, while socio-cultural and educational impacts in LMICs were notably sparse.</div></div><div><h3>Conclusion</h3><div>Inhalant misuse among street-involved children is an under-recognized global health and social issue. Strengthening interdisciplinary and geographically inclusive research can guide targeted interventions and policies aligned with Sustainable Development Goal (SDG) 3.5 on substance abuse prevention and treatment.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"357 ","pages":"Article 116949"},"PeriodicalIF":3.9,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146011669","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}

引用次数: 0

Associations over time between wartime deployment, parental burnout and child adjustment 随着时间的推移，战时部署，父母倦怠和儿童适应之间的联系

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2026-01-09 DOI: 10.1016/j.psychres.2026.116943

Mor Keleynikov , Dana Lassri , Joy Benatov , Noga Cohen , Reuma Gadassi-Polack

Military deployment places significant stress on families, yet little is known about its effects in contexts where both deployed and non-deployed family members face ongoing threat. This longitudinal study, conducted during the first seven months of the Israel–Hamas War, investigated how spousal deployment interacts with parental burnout and child emotional and behavioral problems, and whether parental burnout moderates this relationship. The study included 123 Israeli mothers (Mean age = 39.11, SD = 6.10) of children aged 5–18 years (Mean age = 8.47, SD = 3.32), 35 of whom had partners deployed to reserve duty during the war (28%). Participants completed measures of parental burnout and child adjustment at two time points: one month and seven months after the outbreak of the war. Results indicated that at baseline, mothers whose partners were deployed reported significantly higher levels of parental burnout and child's behavioral and emotional difficulties. Over time, parental burnout remained stable in the deployed group but increased among mothers with non-deployed partners. Importantly, parental burnout moderated the association between deployment status and child adjustment, such that deployment was significantly associated with child difficulties only when parental burnout was high. These findings underscore the critical role of parental emotional well-being in shaping child outcomes during armed conflict. Parental burnout emerges as a key factor that can moderate the link between deployment and children’s mental health and should be a central target in family-based support strategies during times of war.

军事部署给家庭带来了巨大的压力，但在部署和非部署的家庭成员都面临持续威胁的情况下，对其影响知之甚少。这项纵向研究在以色列-哈马斯战争的前七个月进行，调查配偶部署如何与父母倦怠和孩子的情绪和行为问题相互作用，以及父母倦怠是否调节这种关系。该研究包括123名5-18岁儿童（平均年龄= 8.47,SD = 3.32）的以色列母亲（平均年龄= 39.11,SD = 6.10），其中35名母亲的伴侣在战争期间被部署为预备役（28%）。参与者在两个时间点完成了父母倦怠和儿童适应的测量：战争爆发后一个月和七个月。结果表明，在基线时，伴侣被派遣的母亲报告的父母倦怠程度和孩子的行为和情感困难程度明显更高。随着时间的推移，父母的倦怠在部署组保持稳定，但在没有部署伴侣的母亲中有所增加。重要的是，父母倦怠调节了部署状态和儿童适应之间的关系，只有当父母倦怠高时，部署才与儿童困难显著相关。这些发现强调了在武装冲突期间，父母的情感健康在塑造儿童发展方面的关键作用。父母倦怠是一个关键因素，可以缓和部署与儿童心理健康之间的联系，应成为战争期间基于家庭的支持战略的中心目标。

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引用次数: 0

Levels of and changes in psychosis symptoms and clinical insight: Exploring the impact of differential antipsychotic mechanisms 精神病症状的水平和变化与临床洞察：探索不同抗精神病药物机制的影响。

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2026-01-09 DOI: 10.1016/j.psychres.2026.116948

Lena Antonsen Stabell , Erik Johnsen , Rune Kroken , Else-Marie Løberg , Eirik Kjelby , Inge Joa , Solveig Klæbo Reitan , Maria Rettenbacher , Kenneth Hugdahl , Rolf Gjestad

Background

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。

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引用次数: 0

Burnout as an occupational phenomenon: Navigating the Twilight Zone 职业倦怠作为一种现象：在模糊地带中穿行

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2026-01-08 DOI: 10.1016/j.psychres.2026.116947

Leon T. De Beer

This commentary on Parker and Russo’s (2025) review engages with ongoing debates about the conceptual and diagnostic status of burnout, focusing specifically on the implications of its ICD-11 classification as an occupational phenomenon. While the review insightfully distinguishes between “burning out” and “burnt out,” it pays less attention to how this classification shapes practical assessment and management in workplace contexts. This commentary argues that organizational and clinical approaches to burnout should be understood as complementary rather than competing. Organizational screening plays a preventive role by identifying employees at risk and highlighting modifiable job demands and resources, whereas clinical diagnosis, when appropriate referrals are made, remains the domain of qualified health professionals. By maintaining these dual approaches, organizations can act on burnout as currently classified, avoiding the methodological impasse created by applying clinical expectations to occupational assessment. This pragmatic stance enables effective prevention and referral while accommodating ongoing conceptual debates.

这篇对Parker和Russo（2025）的评论涉及到关于职业倦怠的概念和诊断地位的持续争论，特别关注其作为一种职业现象的ICD-11分类的含义。虽然这篇综述深刻地区分了“燃尽”和“燃尽”，但它对这种分类如何在工作场所环境中形成实际评估和管理的关注较少。这篇评论认为，组织和临床倦怠的方法应该被理解为互补而不是竞争。组织筛查通过确定有风险的员工并突出可改变的工作需求和资源发挥预防作用，而临床诊断，在适当转诊时，仍然是合格的卫生专业人员的领域。通过保持这些双重方法，组织可以按照目前的分类对职业倦怠采取行动，避免将临床期望应用于职业评估所造成的方法僵局。这种务实的立场使有效的预防和转诊成为可能，同时适应正在进行的概念辩论。

引用次数: 0

The impact of combat intensity and deployment stressors on veteran post-traumatic stress 战斗强度和部署应激源对退伍军人创伤后应激的影响

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2026-01-08 DOI: 10.1016/j.psychres.2026.116944

Nimrod Hertz-Palmor , Naama de la Fontaine , Eden Maharat , Yael Carmel , Or Atar , Nevo Perez , Anna Bevan , Tim Dalgleish , Amit Lazarov , Roi Sar-El

Background

Veteran trauma is central to trauma research. Combat exposure, perceived threat, and concerns about disruptions to life and family are key predictors of posttraumatic stress symptoms (PTSS) in veterans. This study examines how various deployment stressors relate to PTSS and other psychological outcomes.

Methods

Eighty-six Israeli combat veterans (active duty=60; reserve duty=26) with intense combat exposure reported their combat experiences and deployment-related concerns and completed mental health measures. A cluster analysis identified clusters of co-occurring deployment stressors. Bayesian Graphical Gaussian Models (BGGM) mapped the interrelationships between combat stressors, PTSS, and other psychological outcomes. A subsample of 66 completed a two-month follow-up, enabling analysis of symptom change trajectories.

Results

Active-duty soldiers reported more combat exposures, whereas reservists expressed greater concerns about disruptions to life and family. The strongest correlate of PTSS and anxiety was concern over a partner during deployment. Urban operations were also linked to PTSS and specific symptom clusters and vivid trauma memory. Sustaining an injury was associated with more vivid traumatic memories. Longitudinal analyses revealed three symptom trajectories: stable, improvement, and exacerbation, but these were unrelated to sociodemographic factors and unaffected by post-deployment support, unit cohesion, or family functioning.

Conclusions

Deployment-related stressors differentially affect veteran mental health. Chronic concerns over partner and family, as well as stressors and exposures involving uncertainty and threat, warrant special attention in clinical and research settings.

退伍军人创伤是创伤研究的核心。战斗暴露、感知威胁和对生活和家庭中断的担忧是退伍军人创伤后应激症状（PTSS）的关键预测因素。本研究探讨了各种部署压力源与创伤后应激障碍和其他心理结果的关系。方法86名激烈战斗暴露的以色列退伍军人（现役60人，预备役26人）报告了他们的战斗经历和部署相关问题，并完成了心理健康测量。聚类分析确定了共同发生的部署压力源的聚类。贝叶斯图形高斯模型（BGGM）绘制了战斗压力源、创伤后应激障碍和其他心理结果之间的相互关系。66个子样本完成了两个月的随访，能够分析症状变化轨迹。结果现役士兵报告了更多的战斗经历，而预备役人员则表达了对生活和家庭中断的更多担忧。创伤后应激障碍与焦虑的最强相关性是在部署期间对伴侣的关注。城市手术也与创伤后应激障碍、特定症状群和生动的创伤记忆有关。持续的伤害与更生动的创伤记忆有关。纵向分析揭示了三种症状轨迹：稳定、改善和恶化，但这些与社会人口因素无关，也不受部署后支持、单位凝聚力或家庭功能的影响。结论部署相关应激源对退伍军人心理健康的影响存在差异。对伴侣和家庭的长期担忧，以及涉及不确定性和威胁的压力源和暴露，需要在临床和研究环境中得到特别关注。

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引用次数: 0

Chronotype and depression: A global systematic review and meta-analysis 睡眠类型与抑郁症：一项全球系统综述和荟萃分析

IF 3.9 2区医学 Q1 PSYCHIATRY

Psychiatry Research

Pub Date : 2026-01-07 DOI: 10.1016/j.psychres.2026.116945

Xianjian Dong , Jieyu Liu , Xinxin Wang , Ze Liang

Background

Depression persists as a substantial contributor to global disability burdens. Emerging evidence implicates circadian rhythm variations in mental health outcomes, with evening chronotypes potentially exacerbating depression risk through multifactorial pathways, including circadian misalignment, increased social isolation, and dysregulated stress responses.

Methods

We conducted a systematic meta-analysis of observational studies (cross-sectional/cohort designs) from PubMed//Cochrane/Web of Science through September 5, 2025. Eligible studies assessed depression outcomes by chronotype. Pooled risk ratios (RRs, 95% CIs) were derived using random-effects models. Heterogeneity was evaluated via Q-statistics and I², with stratification by study design/assessment tools. Publication bias was assessed using funnel plots (Begg’s and Egger’s tests), and result stability was verified via sensitivity analyses with iterative imputation.

Results

Our analysis synthesized data from 22 rigorously selected studies (20 cross-sectional, 2 cohort). Evening chronotype demonstrated a significant association with elevated depression risk across study designs: cross-sectional RR=1.83 (1.40∼2.38); cohort RR=1.79 (0.59∼5.46). Morning preference exhibited protective effects, particularly in longitudinal analyses: cohort RR=0.88 (0.81∼0.96) versus cross-sectional RR=0.80 (0.59∼1.09). High heterogeneity was observed (I²=91.1∼97.3%), resolved through stratification by study design and assessment tools. Sensitivity analyses confirmed result stability, with no evidence of publication bias.

Conclusion

This meta-analysis substantiates the chronotype-depression relationship through robust epidemiological evidence. Evening-type individuals face substantially heightened depression risk (83% increase in cross-sectional data), while morning orientation demonstrates consistent protective associations, particularly in longitudinal studies. These findings emphasize chronotype assessment as a potential biomarker for depression risk stratification. Mechanistic investigations into circadian disruption pathways and targeted chronotherapeutic interventions are urgently warranted.

抑郁症一直是造成全球残疾负担的一个重要因素。新出现的证据表明，昼夜节律变化与心理健康结果有关，夜间睡眠类型可能通过多因素途径加剧抑郁风险，包括昼夜节律失调、社会隔离加剧和应激反应失调。方法：我们对PubMed/ Cochrane/Web of Science截至2025年9月5日的观察性研究（横断面/队列设计）进行了系统的荟萃分析。符合条件的研究按时间类型评估抑郁症的结果。综合风险比（rr, 95% ci）采用随机效应模型推导。异质性通过q统计和I²进行评估，并通过研究设计/评估工具进行分层。采用漏斗图（Begg’s和Egger’s检验）评估发表偏倚，并通过迭代归算的敏感性分析验证结果的稳定性。结果我们的分析综合了22项严格选择的研究数据（20项横断面研究，2项队列研究）。在所有研究设计中，夜间睡眠类型与抑郁风险升高有显著关联：横截面RR=1.83 (1.40 ~ 2.38)；队列RR=1.79（0.59 ~ 5.46）。早晨偏好表现出保护作用，特别是在纵向分析中：队列RR=0.88(0.81 ~ 0.96)，而横断面RR=0.80（0.59 ~ 1.09）。观察到高异质性（I²=91.1 ~ 97.3%），通过研究设计和评估工具分层解决。敏感性分析证实了结果的稳定性，没有发表偏倚的证据。结论本荟萃分析通过强有力的流行病学证据证实了时间型与抑郁之间的关系。夜猫子的抑郁风险显著增加（横断面数据增加83%），而早起的人表现出一致的保护关联，尤其是在纵向研究中。这些发现强调了时间型评估作为抑郁症风险分层的潜在生物标志物。迫切需要对昼夜节律中断途径和有针对性的时间治疗干预进行机制研究。

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