Pub Date : 2026-05-01Epub Date: 2026-02-09DOI: 10.1016/j.jpsychores.2026.112565
Jens Gaab , Antje Frey Nascimento , Clara Wehlage , Lee C. Park
Open-label placebos have been studied extensively and with rigor for about 15 years, and clinically meaningful effects have been replicated in experiments and clinical trials since then, across countries, with different populations, with differing methodologies. But are open-label placebos the first to harness placebo effects in an ethically manner? Not quite. About 60 years ago, Lee C. Park and Lino Covi conducted a study using so-called nonblind placebos in psychiatric patients, with striking effect. But how was this study possible as there were hardly any antecedents as much as there were no discernible subsequents for 45 years, i.e. until 2010. When one of the authors (AFN) received a short email in March 2025, it was to our surprise and joy to find it written by no other that Lee C. Park himself, 60 years to the month after the publication of the “Nonblind placebo trial”. Between July and October 2025, a vivid email dialogue emerged on how the idea of using placebos with full disclosure evolved and how it has been received by patients and colleagues at the time, including the discussion of ethical and practical issues. This also included the relationship between psychotherapy and placebos and why the placebo effect also may be better labeled as a brief psychotherapy effect.
开放标签安慰剂已经被广泛而严格地研究了大约15年，从那时起，在不同国家、不同人群、不同方法的实验和临床试验中，已经重复了具有临床意义的效果。但是，开放标签安慰剂是第一个以道德方式利用安慰剂效应的药物吗？不完全是。大约60年前，Lee C. Park和Lino Covi在精神病患者中使用所谓的非盲安慰剂进行了一项研究，取得了惊人的效果。但这项研究是如何可能的，因为几乎没有任何先例，也没有明显的后续45年，即直到2010年。当其中一位作者（AFN）在2025年3月收到一封简短的电子邮件时，让我们又惊又喜的是，这封邮件不是别人写的，而是李·c·帕克本人，在“非盲安慰剂试验”发表60年后的一个月。在2025年7月至10月期间，一封生动的电子邮件对话出现了，内容涉及使用完全披露的安慰剂的想法是如何演变的，以及当时患者和同事如何接受它，包括对伦理和实际问题的讨论。这也包括心理治疗和安慰剂之间的关系，以及为什么安慰剂效应也可以更好地标记为短暂的心理治疗效果。
{"title":"The first on the dark side of the moon: Revisiting the first nonblind placebo trial","authors":"Jens Gaab , Antje Frey Nascimento , Clara Wehlage , Lee C. Park","doi":"10.1016/j.jpsychores.2026.112565","DOIUrl":"10.1016/j.jpsychores.2026.112565","url":null,"abstract":"<div><div>Open-label placebos have been studied extensively and with rigor for about 15 years, and clinically meaningful effects have been replicated in experiments and clinical trials since then, across countries, with different populations, with differing methodologies. But are open-label placebos the first to harness placebo effects in an ethically manner? Not quite. About 60 years ago, Lee C. Park and Lino Covi conducted a study using so-called nonblind placebos in psychiatric patients, with striking effect. But how was this study possible as there were hardly any antecedents as much as there were no discernible subsequents for 45 years, i.e. until 2010. When one of the authors (AFN) received a short email in March 2025, it was to our surprise and joy to find it written by no other that Lee C. Park himself, 60 years to the month after the publication of the “Nonblind placebo trial”. Between July and October 2025, a vivid email dialogue emerged on how the idea of using placebos with full disclosure evolved and how it has been received by patients and colleagues at the time, including the discussion of ethical and practical issues. This also included the relationship between psychotherapy and placebos and why the placebo effect also may be better labeled as <em>a brief psychotherapy effect</em>.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"204 ","pages":"Article 112565"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146154201","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 : 2026-05-01Epub Date: 2026-02-12DOI: 10.1016/j.jpsychores.2026.112583
Chuan-Ya Lee , Shu-Fen Chen , Chien-Ling Su , Tze-Wah Kao , Yun-Yun Chou , Tzu-Tung Kuo , Sam H. Ahmedzai , Li-Sin Hsiao , Ka-Wai Tam
Background
Disease affects physical, psychological, spiritual, and social well-being, underscoring the need for holistic care. This study assesses the severity of holistic needs among hospitalized patients by using the Sheffield Profile for Assessment and Referral for Care–Taiwan version (SPARC-T)—a multidimensional, self-report questionnaire.
Methods
This cross-sectional study was conducted at a medical center in Taiwan, where the SPARC-T has been implemented across various departments between January 2023 and June 2024. The severity of holistic needs among hospitalized patients was assessed across psychological, spiritual, and social domains; referral thresholds for individual domains were established through discussions among the clinical team. Furthermore, sensitivity and specificity of the SPARC-T in psychological screening using were compared with those of the Brief Symptom Rating Scale (BSRS), with psychiatric consultations used as the reference standard.
Results
Over 17 months, 10,948 patients completed the SPARC-T, of whom 6304 valid responses were included in the analysis. These responses enabled the identification of department-specific variations in holistic needs. Notably, after exceeding domain-specific referral thresholds, 118, 207, and 111 patients directly received psychiatric, social work, and discharge planning consultations, respectively. The SPARC-T also demonstrated higher sensitivity (53.85%) than the BSRS (27.27%) and exhibited a specificity of 83.33% in detecting psychological concerns.
Conclusion
Holistic assessment is integral to patient care, as patients' needs vary across departments. The SPARC-T effectively identifies patients requiring support and exhibits excellent sensitivity in detecting holistic needs, it is a valuable tool for hospital-wide holistic screening and can be integrated into comprehensive care settings.
Structured abstract
Addressing inpatients’ physical, psychological, spiritual and social needs is essential for providing holistic care. This study indicated that SPARC-T questionnaire effectively identified department-specific patient needs. Moreover, the SPARC-T questionnaire exhibited greater sensitivity in evaluating psychological needs than did the BSRS-5. This study highlights the department-specific variations in patients’ holistic needs and can help clinicians provide targeted support.
{"title":"Holistic needs assessment for hospitalized patients: A cross-sectional study","authors":"Chuan-Ya Lee , Shu-Fen Chen , Chien-Ling Su , Tze-Wah Kao , Yun-Yun Chou , Tzu-Tung Kuo , Sam H. Ahmedzai , Li-Sin Hsiao , Ka-Wai Tam","doi":"10.1016/j.jpsychores.2026.112583","DOIUrl":"10.1016/j.jpsychores.2026.112583","url":null,"abstract":"<div><h3>Background</h3><div>Disease affects physical, psychological, spiritual, and social well-being, underscoring the need for holistic care. This study assesses the severity of holistic needs among hospitalized patients by using the Sheffield Profile for Assessment and Referral for Care–Taiwan version (SPARC-T)—a multidimensional, self-report questionnaire.</div></div><div><h3>Methods</h3><div>This cross-sectional study was conducted at a medical center in Taiwan, where the SPARC-T has been implemented across various departments between January 2023 and June 2024. The severity of holistic needs among hospitalized patients was assessed across psychological, spiritual, and social domains; referral thresholds for individual domains were established through discussions among the clinical team. Furthermore, sensitivity and specificity of the SPARC-T in psychological screening using were compared with those of the Brief Symptom Rating Scale (BSRS), with psychiatric consultations used as the reference standard.</div></div><div><h3>Results</h3><div>Over 17 months, 10,948 patients completed the SPARC-T, of whom 6304 valid responses were included in the analysis. These responses enabled the identification of department-specific variations in holistic needs. Notably, after exceeding domain-specific referral thresholds, 118, 207, and 111 patients directly received psychiatric, social work, and discharge planning consultations, respectively. The SPARC-T also demonstrated higher sensitivity (53.85%) than the BSRS (27.27%) and exhibited a specificity of 83.33% in detecting psychological concerns.</div></div><div><h3>Conclusion</h3><div>Holistic assessment is integral to patient care, as patients' needs vary across departments. The SPARC-T effectively identifies patients requiring support and exhibits excellent sensitivity in detecting holistic needs, it is a valuable tool for hospital-wide holistic screening and can be integrated into comprehensive care settings.</div></div><div><h3>Structured abstract</h3><div>Addressing inpatients’ physical, psychological, spiritual and social needs is essential for providing holistic care. This study indicated that SPARC-T questionnaire effectively identified department-specific patient needs. Moreover, the SPARC-T questionnaire exhibited greater sensitivity in evaluating psychological needs than did the BSRS-5. This study highlights the department-specific variations in patients’ holistic needs and can help clinicians provide targeted support.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"204 ","pages":"Article 112583"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146192930","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 : 2026-05-01Epub Date: 2026-02-08DOI: 10.1016/j.jpsychores.2026.112582
Kate Perry , Jane Choi , John Weinman , Keith J. Petrie
Background
Self-administered cancer treatments are increasingly common. While these treatments are often perceived as more convenient, intentional nonadherence – when patients deliberately choose not to take medication as prescribed – remains a significant challenge and is influenced by a range of motivational factors.
Objective
To identify key reasons for intentional nonadherence to self-administered cancer medications, to inform the development of personalised interventions.
Methodology
A cross-sectional e-survey of 126 adults with cancer was conducted. Adherence was assessed using the Medication Adherence Report Scale (MARS-5). Reasons for intentional nonadherence were measured with the Intentional Non-Adherence Scale (INAS). Principal component analysis was conducted, specifying a four-factor structure based on recent studies. Independent samples t-tests compared factor scores between adherent and nonadherent participants.
Results
Half the sample (50.0%) had a diagnosis of breast cancer, followed by thyroid cancer (16.7%), blood cancer (7.1%), and male urologic cancer (6.3%). Fifty-six percent of participants were classified as nonadherent. The most frequently endorsed reasons for intentional nonadherence were “Because I don't like the side effects” (32%) and “Because I want to think of myself as a healthy person again” (28%). Four INAS factors – Sensitivity to Medicines, Testing Treatment, Inconvenience, and Resisting Illness and Medication accounted for 79% of the variance and demonstrated high internal consistency (Cronbach's α = 0.90–0.96). Nonadherent participants scored significantly higher on all factors compared to adherent participants (p < 0.001).
Discussion
Intentional nonadherence to self-administered cancer medications is driven by diverse motivational factors, including concerns about side effects and illness identity, highlighting the need for tailored interventions.
{"title":"Intentional nonadherence to self-administered cancer medications: Identifying key factors for tailored interventions","authors":"Kate Perry , Jane Choi , John Weinman , Keith J. Petrie","doi":"10.1016/j.jpsychores.2026.112582","DOIUrl":"10.1016/j.jpsychores.2026.112582","url":null,"abstract":"<div><h3>Background</h3><div>Self-administered cancer treatments are increasingly common. While these treatments are often perceived as more convenient, intentional nonadherence – when patients deliberately choose not to take medication as prescribed – remains a significant challenge and is influenced by a range of motivational factors.</div></div><div><h3>Objective</h3><div>To identify key reasons for intentional nonadherence to self-administered cancer medications, to inform the development of personalised interventions.</div></div><div><h3>Methodology</h3><div>A cross-sectional e-survey of 126 adults with cancer was conducted. Adherence was assessed using the Medication Adherence Report Scale (MARS-5). Reasons for intentional nonadherence were measured with the Intentional Non-Adherence Scale (INAS). Principal component analysis was conducted, specifying a four-factor structure based on recent studies. Independent samples <em>t</em>-tests compared factor scores between adherent and nonadherent participants.</div></div><div><h3>Results</h3><div>Half the sample (50.0%) had a diagnosis of breast cancer, followed by thyroid cancer (16.7%), blood cancer (7.1%), and male urologic cancer (6.3%). Fifty-six percent of participants were classified as nonadherent. The most frequently endorsed reasons for intentional nonadherence were “Because I don't like the side effects” (32%) and “Because I want to think of myself as a healthy person again” (28%). Four INAS factors – Sensitivity to Medicines, Testing Treatment, Inconvenience, and Resisting Illness and Medication accounted for 79% of the variance and demonstrated high internal consistency (Cronbach's α = 0.90–0.96). Nonadherent participants scored significantly higher on all factors compared to adherent participants (<em>p</em> < 0.001).</div></div><div><h3>Discussion</h3><div>Intentional nonadherence to self-administered cancer medications is driven by diverse motivational factors, including concerns about side effects and illness identity, highlighting the need for tailored interventions.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"204 ","pages":"Article 112582"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146193056","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 : 2026-05-01Epub Date: 2026-02-09DOI: 10.1016/j.jpsychores.2026.112581
Rosa Michaelis , Jörg Meibert , Nicole Alimov , Christoph Kleinschnitz , Stoyan Popkirov
Background
Functional neurological disorder (FND) is common and associated with substantial disability, yet evidence-based treatment options remain limited. Because maladaptive attentional processes are central to FND pathophysiology, mindfulness-based interventions may be beneficial. Mindfulness-Based Stress Reduction (MBSR) has strong empirical support across physical and mental health conditions, but evidence in FND is sparse.
Objectives
To assess feasibility, acceptability, and preliminary clinical outcomes of MBSR for patients with FND.
Methods
In this monocentric, single-arm feasibility study, German-speaking adults with confirmed FND were recruited from a specialized outpatient clinic. Participants completed an 8-week standardized MBSR program across three course cycles (two in-person, one online). Primary outcomes included recruitment, retention, attendance, and self-reported home practice; acceptability was assessed via recommendation likelihood. Secondary outcomes included health-related quality of life (WHODAS 2.0), functional impairment (WSAS), depressive (PHQ-9) and anxiety symptoms (GAD-7), and FND symptom burden (FNSQ). Assessments occurred at baseline, post-intervention, and three-month follow-up.
Results
Of 57 eligible patients, 24 enrolled (42%); 22 completed the course (92%). Recommendation likelihood was high. Statistically significant pre–post improvements were observed in WHODAS 2.0 (d = −0.56) and WSAS (d = −0.67), with comparable values at three-month follow-up. Post-intervention PHQ-9 scores improved (d = −0.75), FNSQ symptom count decreased (d = −0.68), whereas GAD-7 changes were nonsignificant. Online delivery demonstrated particularly strong adherence without dropouts.
Conclusions
MBSR for FND is feasible and well-accepted. A randomized controlled trial is warranted to determine efficacy. Future research could serve as a model for transforming patient-centered care in the digital era.
Clinical trial registration number: German Clinical Trials Register (DRKS00034806).
{"title":"Mindfulness-based stress reduction for functional neurological disorder: A feasibility study","authors":"Rosa Michaelis , Jörg Meibert , Nicole Alimov , Christoph Kleinschnitz , Stoyan Popkirov","doi":"10.1016/j.jpsychores.2026.112581","DOIUrl":"10.1016/j.jpsychores.2026.112581","url":null,"abstract":"<div><h3>Background</h3><div>Functional neurological disorder (FND) is common and associated with substantial disability, yet evidence-based treatment options remain limited. Because maladaptive attentional processes are central to FND pathophysiology, mindfulness-based interventions may be beneficial. Mindfulness-Based Stress Reduction (MBSR) has strong empirical support across physical and mental health conditions, but evidence in FND is sparse.</div></div><div><h3>Objectives</h3><div>To assess feasibility, acceptability, and preliminary clinical outcomes of MBSR for patients with FND.</div></div><div><h3>Methods</h3><div>In this monocentric, single-arm feasibility study, German-speaking adults with confirmed FND were recruited from a specialized outpatient clinic. Participants completed an 8-week standardized MBSR program across three course cycles (two in-person, one online). Primary outcomes included recruitment, retention, attendance, and self-reported home practice; acceptability was assessed via recommendation likelihood. Secondary outcomes included health-related quality of life (WHODAS 2.0), functional impairment (WSAS), depressive (PHQ-9) and anxiety symptoms (GAD-7), and FND symptom burden (FNSQ). Assessments occurred at baseline, post-intervention, and three-month follow-up.</div></div><div><h3>Results</h3><div>Of 57 eligible patients, 24 enrolled (42%); 22 completed the course (92%). Recommendation likelihood was high. Statistically significant pre–post improvements were observed in WHODAS 2.0 (d = −0.56) and WSAS (d = −0.67), with comparable values at three-month follow-up. Post-intervention PHQ-9 scores improved (d = −0.75), FNSQ symptom count decreased (d = −0.68), whereas GAD-7 changes were nonsignificant. Online delivery demonstrated particularly strong adherence without dropouts.</div></div><div><h3>Conclusions</h3><div>MBSR for FND is feasible and well-accepted. A randomized controlled trial is warranted to determine efficacy. Future research could serve as a model for transforming patient-centered care in the digital era.</div><div><strong>Clinical trial registration number:</strong> German Clinical Trials Register (DRKS00034806).</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"204 ","pages":"Article 112581"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146193055","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 : 2026-05-01Epub Date: 2026-01-20DOI: 10.1016/j.jpsychores.2026.112545
Oscar Royuela , Francesco Oliva , Joana Bucker , Cristina De Córdoba Gil , Marta Fontana-McNally , Daniela L. Gatto , Daniel Guinart , Hernando Knobel-Freud , Pablo Knobel , Walter Lupo , Cristina Macias , Mila Montero , Ana Moreno-Alcázar , Johannes Wolf , Frank Padberg , Benedikt L. Amann , Alicia Valiente-Gómez , Bridget Hogg
Background
People living with human immunodeficiency virus (HIV; PLWH) can perceive aspects of the disease as traumatic. Objectives: 1) This study examined the trauma profile and sociodemographic and clinical correlates of HIV-related trauma; 2) to compare the impact of a post-traumatic stress disorder (PTSD) on clinical variables and biological markers in PLWH with HIV-related trauma; 3) to investigate the factors associated with PTSD; 4) to examine the relationship between childhood maltreatment, dissociation, and psychopathology.
Methods
93 Hospital del Mar Barcelona outpatient adults living with HIV with HIV-related trauma were included in this cross-sectional study. Participants were assessed with validated scales for PTSD, trauma, psychopathology, quality of life, functionality, and HIV-related stigma. CD4/CD8 ratio was also collected. PLWH with and without PTSD were compared in terms of clinical and sociodemographic factors and a pathway analysis was conducted.
Results
PLWH with PTSD reported significantly more anxious, depressive, and general psychiatric symptoms, poorer health-related quality of life and more stigma related to HIV compared to those with trauma symptoms only (all p < 0.0024). Age (OR = 1.08, p = 0.045) and previous psychiatric disorder (OR = 15.57, p = 0.010) can predict a PTSD diagnosis. PLWH with PTSD showed stronger correlations between childhood maltreatment, dissociation, and psychiatric symptoms than those with trauma symptoms only.
Conclusions
PTSD is associated with more psychiatric symptoms, lower quality of life and increased HIV-related stigma. Dissociation and PTSD were identified as a potential mechanism linking childhood maltreatment and mental health outcomes, suggesting a target for intervention. These findings support the need for PTSD screening and trauma-focused treatments in HIV care settings.
人类免疫缺陷病毒（HIV； PLWH）感染者可以将该疾病的某些方面视为创伤性疾病。目的：1)本研究探讨了hiv相关创伤的创伤概况、社会人口学和临床相关因素；2)比较创伤后应激障碍（PTSD）对hiv相关创伤PLWH患者临床指标和生物学指标的影响；3)探讨PTSD的相关因素；4)研究童年虐待、精神分离和精神病理之间的关系。方法对巴塞罗那德尔玛医院门诊的93例HIV相关创伤患者进行了横断面研究。用PTSD、创伤、精神病理、生活质量、功能和hiv相关污名的有效量表对参与者进行评估。同时采集CD4/CD8比值。比较合并与不合并PTSD的PLWH患者的临床及社会人口学因素，并进行通路分析。结果与仅有创伤症状的患者相比，患有PTSD的splwh患者报告的焦虑、抑郁和一般精神症状明显更多，健康相关生活质量更差，与HIV相关的耻辱感更多（p < 0.0024）。年龄（OR = 1.08, p = 0.045）和既往精神障碍（OR = 15.57, p = 0.010）可以预测PTSD的诊断。与仅有创伤症状的患者相比，患有PTSD的PLWH在儿童期虐待、精神分离和精神症状之间表现出更强的相关性。结论sptsd患者存在较多的精神症状、较低的生活质量和hiv相关的耻辱感。分离和创伤后应激障碍被确定为联系儿童虐待和心理健康结果的潜在机制，提出了干预的目标。这些发现支持在HIV护理环境中进行创伤后应激障碍筛查和以创伤为重点的治疗的必要性。
{"title":"Stressful life events, PTSD symptoms and mental health in people living with HIV","authors":"Oscar Royuela , Francesco Oliva , Joana Bucker , Cristina De Córdoba Gil , Marta Fontana-McNally , Daniela L. Gatto , Daniel Guinart , Hernando Knobel-Freud , Pablo Knobel , Walter Lupo , Cristina Macias , Mila Montero , Ana Moreno-Alcázar , Johannes Wolf , Frank Padberg , Benedikt L. Amann , Alicia Valiente-Gómez , Bridget Hogg","doi":"10.1016/j.jpsychores.2026.112545","DOIUrl":"10.1016/j.jpsychores.2026.112545","url":null,"abstract":"<div><h3>Background</h3><div><strong>People living with human immunodeficiency virus (HIV; PLWH) can perceive aspects of the disease as traumatic. Objectives:</strong> 1) This study examined the trauma profile and sociodemographic and clinical correlates of HIV-related trauma; 2) to compare the impact of a post-traumatic stress disorder (PTSD) on clinical variables and biological markers in PLWH with HIV-related trauma; 3) to investigate the factors associated with PTSD; 4) to examine the relationship between childhood maltreatment, dissociation, and psychopathology.</div></div><div><h3>Methods</h3><div>93 Hospital del Mar Barcelona outpatient adults living with HIV with HIV-related trauma were included in this cross-sectional study. Participants were assessed with validated scales for PTSD, trauma, psychopathology, quality of life, functionality, and HIV-related stigma. CD4/CD8 ratio was also collected. PLWH with and without PTSD were compared in terms of clinical and sociodemographic factors and a pathway analysis was conducted.</div></div><div><h3>Results</h3><div>PLWH with PTSD reported significantly more anxious, depressive, and general psychiatric symptoms, poorer health-related quality of life and more stigma related to HIV compared to those with trauma symptoms only (all <em>p</em> < 0.0024). Age (OR = 1.08, <em>p</em> = 0.045) and previous psychiatric disorder (OR = 15.57, <em>p</em> = 0.010) can predict a PTSD diagnosis. PLWH with PTSD showed stronger correlations between childhood maltreatment, dissociation, and psychiatric symptoms than those with trauma symptoms only.</div></div><div><h3>Conclusions</h3><div>PTSD is associated with more psychiatric symptoms, lower quality of life and increased HIV-related stigma. Dissociation and PTSD were identified as a potential mechanism linking childhood maltreatment and mental health outcomes, suggesting a target for intervention. These findings support the need for PTSD screening and trauma-focused treatments in HIV care settings.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"204 ","pages":"Article 112545"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146193009","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 : 2026-05-01Epub Date: 2026-02-09DOI: 10.1016/j.jpsychores.2026.112579
Caroline Märtens , Britta Stapel , Ivo Heitland , Jan Zeidler , Johann Bauersachs , Jona T. Stahmeyer , Kai G. Kahl
Background
Previous studies have linked depression and depressive symptoms to major adverse cardiovascular events (MACE, i.e. stroke and acute myocardial infarction (AMI)) and mortality. However, data on the association of diagnosed depressive disorders and MACE in large samples are scarce. In the present study, we aim to assess the association of depression diagnoses and depression severity with the risk for MACE and all-cause mortality.
Methods
This retrospective cohort study included health insurance data from 1,314,289 individuals in Germany. Depressive disorders and depression severity were defined by ICD-10 codes. Patients with MACE during a three-year pre-observation period were excluded. Incident MACE and all-cause deaths were recorded over a six-year follow-up. Adjusted hazard ratios (HR) and 95% confidence intervals (95%CI) were computed by cox proportional hazard models with confounders age, sex, cardiometabolic- and substance use disorders.
Results
Depression was significantly associated with increased risk for MACE (HR 1.16, 95%CI 1.14–1.18), reflected by heightened risk for AMI (HR 1.10, 95%CI 1.06–1.13) and stroke (HR 1.20, 95%CI 1.17–1.23). MACE risk increased with greater depression severity (mild: HR 1.09, 95%CI 1.05–1.13; moderate: HR 1.19, 95%CI 1.15–1.23; severe: HR 1.19, 95%CI 1.14–1.24). Similarly, depression was significantly linked to augmented mortality risk (HR 1.20, 95%CI 1.18–1.21), depending on depression severity (mild: HR 1.07, 95%CI 1.05–1.09; moderate: HR 1.21, 95%CI 1.18–1.23; severe: HR 1.29, 95%CI 1.26–1.32).
Conclusion
This study demonstrates a significant association between depression and increased risk for MACE and mortality in a large German health insurance claims sample. Additionally, it highlights that depression severity is linked to both, MACE and mortality risk, underscoring the urgent need for targeted cardiovascular disease prevention strategies in patients with clinical depression.
{"title":"Depression severity and major cardiovascular events: Findings from German insurance claims data","authors":"Caroline Märtens , Britta Stapel , Ivo Heitland , Jan Zeidler , Johann Bauersachs , Jona T. Stahmeyer , Kai G. Kahl","doi":"10.1016/j.jpsychores.2026.112579","DOIUrl":"10.1016/j.jpsychores.2026.112579","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies have linked depression and depressive symptoms to major adverse cardiovascular events (MACE, i.e. stroke and acute myocardial infarction (AMI)) and mortality. However, data on the association of diagnosed depressive disorders and MACE in large samples are scarce. In the present study, we aim to assess the association of depression diagnoses and depression severity with the risk for MACE and all-cause mortality.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included health insurance data from 1,314,289 individuals in Germany. Depressive disorders and depression severity were defined by ICD-10 codes. Patients with MACE during a three-year pre-observation period were excluded. Incident MACE and all-cause deaths were recorded over a six-year follow-up. Adjusted hazard ratios (HR) and 95% confidence intervals (95%CI) were computed by cox proportional hazard models with confounders age, sex, cardiometabolic- and substance use disorders.</div></div><div><h3>Results</h3><div>Depression was significantly associated with increased risk for MACE (HR 1.16, 95%CI 1.14–1.18), reflected by heightened risk for AMI (HR 1.10, 95%CI 1.06–1.13) and stroke (HR 1.20, 95%CI 1.17–1.23). MACE risk increased with greater depression severity (mild: HR 1.09, 95%CI 1.05–1.13; moderate: HR 1.19, 95%CI 1.15–1.23; severe: HR 1.19, 95%CI 1.14–1.24). Similarly, depression was significantly linked to augmented mortality risk (HR 1.20, 95%CI 1.18–1.21), depending on depression severity (mild: HR 1.07, 95%CI 1.05–1.09; moderate: HR 1.21, 95%CI 1.18–1.23; severe: HR 1.29, 95%CI 1.26–1.32).</div></div><div><h3>Conclusion</h3><div>This study demonstrates a significant association between depression and increased risk for MACE and mortality in a large German health insurance claims sample. Additionally, it highlights that depression severity is linked to both, MACE and mortality risk, underscoring the urgent need for targeted cardiovascular disease prevention strategies in patients with clinical depression.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"204 ","pages":"Article 112579"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146193010","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: 2026-01-29DOI: 10.1016/j.jpsychores.2026.112549
Lorenzo Pelizza , Simona Pupo , Camilla Barbi , Marika Alessia Incardona , Giovanni Musetti , Marco Menchetti
Purpose
Mental disorders and chronic pain frequently co-occur. The prevalence of this comorbidity varies widely across investigations and is certainly overestimated using screening self-reports. The main aim of this cross-sectional research was to calculate prevalence rates of mental disorders in a chronic pain population during their first consultation in an Italian specialized pain clinic using the narrow diagnostic criteria of the DSM-5. Additionally, we examined the relationship between this psychiatric comorbidity and a broad range of socio-demographic and clinical parameters related to chronic pain.
Procedures
174 participants were enrolled in the Pain Therapy Service at the Parma University Hospital. They completed the Structured Clinical Interview for DSM-5 mental disorders (SCID-5) and the Brief Pain Inventory (BPI). Associations between psychiatric comorbidity and other parameters were explored using regression analyses.
Main findings
57 (32.7%) subjects with chronic pain had DSM-5 psychiatric comorbidity, particularly major depression and anxiety disorders. This comorbid psychopathology showed significant associations with BPI pain severity and interference scores, as well as with the presence of widespread chronic pain (including fibromyalgia) and the prescription of anti-neuropathic medication at entry. Notably, only a minority (n = 18; 31.6%) of these participants with current comorbid mental disorders were treated in psychiatric services.
Conclusions
A large portion of chronic pain patients with comorbid psychiatric syndromes remain undiagnosed and undertreated. The presence of mental health operators in multidisciplinary chronic pain teams is justified and recommended.
{"title":"Comorbid DSM-5 mental disorders and chronic pain: What kind of relationship? Findings from the P3 cross-sectional study","authors":"Lorenzo Pelizza , Simona Pupo , Camilla Barbi , Marika Alessia Incardona , Giovanni Musetti , Marco Menchetti","doi":"10.1016/j.jpsychores.2026.112549","DOIUrl":"10.1016/j.jpsychores.2026.112549","url":null,"abstract":"<div><h3>Purpose</h3><div>Mental disorders and chronic pain frequently co-occur. The prevalence of this comorbidity varies widely across investigations and is certainly overestimated using screening self-reports. The main aim of this cross-sectional research was to calculate prevalence rates of mental disorders in a chronic pain population during their first consultation in an Italian specialized pain clinic using the narrow diagnostic criteria of the DSM-5. Additionally, we examined the relationship between this psychiatric comorbidity and a broad range of socio-demographic and clinical parameters related to chronic pain.</div></div><div><h3>Procedures</h3><div>174 participants were enrolled in the Pain Therapy Service at the Parma University Hospital. They completed the Structured Clinical Interview for DSM-5 mental disorders (SCID-5) and the Brief Pain Inventory (BPI). Associations between psychiatric comorbidity and other parameters were explored using regression analyses.</div></div><div><h3>Main findings</h3><div>57 (32.7%) subjects with chronic pain had DSM-5 psychiatric comorbidity, particularly major depression and anxiety disorders. This comorbid psychopathology showed significant associations with BPI pain severity and interference scores, as well as with the presence of widespread chronic pain (including fibromyalgia) and the prescription of anti-neuropathic medication at entry. Notably, only a minority (<em>n</em> = 18; 31.6%) of these participants with current comorbid mental disorders were treated in psychiatric services.</div></div><div><h3>Conclusions</h3><div>A large portion of chronic pain patients with comorbid psychiatric syndromes remain undiagnosed and undertreated. The presence of mental health operators in multidisciplinary chronic pain teams is justified and recommended.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"203 ","pages":"Article 112549"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081107","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}
Advances in breast cancer treatment have improved survival, making Quality of Life (QOL) a critical endpoint. This study examines longitudinal QOL in Indian breast cancer survivors using the Functional Assessment of Cancer Therapy for Breast (FACT-B) questionnaire.
Methods
A longitudinal cohort study followed 338 women with curable breast cancer, assessing QOL at baseline (before treatment), 3 months, 6 months, 12 months, and 24 months post-treatment. The FACT-B provided total and subscale scores (Physical, Social, Emotional, Functional, and Breast-specific well-being).
Results
Of 338 patients, 63 (18.64%) completed all assessments up to 24 months, and 68 (20.12%) completed up to 12 months. QOL decreased significantly at 3 months post-treatment (mean 74.98 vs. 85.6 at baseline, p < 0.001), remained below baseline at 6 months (79.34, p < 0.001), returned to baseline by 12 months (87.94, p = 0.147), and improved significantly by 24 months (110.92, p < 0.001). Physical and Functional well-being showed early declines, Social and Emotional well-being remained stable or improved, and Breast-specific well-being remained low, reflecting body image concerns.
Conclusion
The U-shaped QOL trajectory highlights the need for interventions at 3–6 months post-treatment, particularly for body image and physical function. These findings provide a foundation for targeted supportive care in Indian breast cancer survivors.
{"title":"Quality of life trajectory in breast cancer survivors: A longitudinal, two-year post treatment follow-up study","authors":"Aashruti Pathania , SreeRekha KR , K. Ramdas , Ankita Chakrawal , Manoj Pandey","doi":"10.1016/j.jpsychores.2026.112551","DOIUrl":"10.1016/j.jpsychores.2026.112551","url":null,"abstract":"<div><h3>Background</h3><div>Advances in breast cancer treatment have improved survival, making Quality of Life (QOL) a critical endpoint. This study examines longitudinal QOL in Indian breast cancer survivors using the Functional Assessment of Cancer Therapy for Breast (FACT-B) questionnaire.</div></div><div><h3>Methods</h3><div>A longitudinal cohort study followed 338 women with curable breast cancer, assessing QOL at baseline (before treatment), 3 months, 6 months, 12 months, and 24 months post-treatment. The FACT-B provided total and subscale scores (Physical, Social, Emotional, Functional, and Breast-specific well-being).</div></div><div><h3>Results</h3><div>Of 338 patients, 63 (18.64%) completed all assessments up to 24 months, and 68 (20.12%) completed up to 12 months. QOL decreased significantly at 3 months post-treatment (mean 74.98 vs. 85.6 at baseline, <em>p</em> < 0.001), remained below baseline at 6 months (79.34, p < 0.001), returned to baseline by 12 months (87.94, <em>p</em> = 0.147), and improved significantly by 24 months (110.92, p < 0.001). Physical and Functional well-being showed early declines, Social and Emotional well-being remained stable or improved, and Breast-specific well-being remained low, reflecting body image concerns.</div></div><div><h3>Conclusion</h3><div>The U-shaped QOL trajectory highlights the need for interventions at 3–6 months post-treatment, particularly for body image and physical function. These findings provide a foundation for targeted supportive care in Indian breast cancer survivors.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"203 ","pages":"Article 112551"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146068365","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: 2026-01-31DOI: 10.1016/j.jpsychores.2026.112563
Kenzo Ogasawara Donato , Luciano Falcão , André Nishizima , Adriane Santos Oliveira , João Victor Gonzalez , Natália Napoli Ribeiro , Caio Abbud , Gabriel Augustus Braga , Gustavo Garrido , Akio Ogasawara Donato , Alan Eckeli , Miguel Meira e Cruz , Cristina Salles
Purpose
To evaluate the effectiveness of Progressive Muscle Relaxation (PMR) in improving sleep quality and mental health in adults.
Methods
This systematic review and meta-analysis followed PRISMA 2020 guidelines. Randomized controlled trials assessing PMR's effect on sleep quality were included. Databases searched included PubMed, Embase, Cochrane and Web of Science. Outcomes included sleep quality, anxiety, and quality of life. Effect sizes were pooled using Standard Mean Difference (SMD) or Mean Difference (MD), and heterogeneity was assessed with the I2. Subgroup analysis was performed according to the duration of PMR intervention in weeks. Statistical analysis was conducted with Rstudio version 4.4.1.
Results
Thirty-one RCTs involving 2277 patients were included. PMR significantly improved sleep quality compared to the control group, with a SMD of −1.74 (95% CI -2.14 to −1.34; I2 = 92.1%). Pittsburgh Sleep Quality Index (PSQI) showed a mean difference of −3.79 (95% CI -4.78 to −2.79; I2 = 94.2%), also indicating statistical significance. Furthermore, PMR significantly reduced anxiety, with an SMD of −1.11 (95% CI -1.69 to −0.53; I2 = 85%), and improved quality of life, which had an SMD of 1.32 (95% CI 0.53 to 2.12; I2 = 83%). Subgroup analysis by PMR duration showed effectiveness across all intervention periods. Despite the high heterogeneity, sensitivity analyses confirmed consistent beneficial effects across all outcomes.
Conclusion
PMR is a non-pharmacological intervention that improves sleep quality and mental health in adults, with effects that vary across populations and settings.
目的：评价渐进式肌肉放松（PMR）对改善成人睡眠质量和心理健康的效果。方法：本系统综述和荟萃分析遵循PRISMA 2020指南。包括评估PMR对睡眠质量影响的随机对照试验。检索的数据库包括PubMed、Embase、Cochrane和Web of Science。结果包括睡眠质量、焦虑和生活质量。使用标准平均差（SMD）或平均差（MD）汇总效应量，并使用I2评估异质性。根据PMR干预时间（周）进行亚组分析。使用Rstudio 4.4.1版本进行统计分析。结果：纳入31项随机对照试验，共2277例患者。与对照组相比，PMR显著改善了睡眠质量，SMD为-1.74 （95% CI为-2.14至-1.34;I2 = 92.1%）。匹兹堡睡眠质量指数（PSQI）平均差异为-3.79 (95% CI -4.78 ~ -2.79; I2 = 94.2%)，也有统计学意义。此外，PMR显着减少焦虑，其SMD为-1.11 (95% CI -1.69至-0.53;I2 = 85%)，并改善生活质量，其SMD为1.32 （95% CI 0.53至2.12;I2 = 83%）。按PMR持续时间进行的亚组分析显示，在所有干预期均有效。尽管异质性很高，但敏感性分析证实了所有结果中一致的有益效果。结论：PMR是一种改善成人睡眠质量和心理健康的非药物干预，其效果因人群和环境而异。
{"title":"Progressive muscle relaxation technique improves sleep quality and mental health: A systematic review and meta-analysis of randomized controlled trials","authors":"Kenzo Ogasawara Donato , Luciano Falcão , André Nishizima , Adriane Santos Oliveira , João Victor Gonzalez , Natália Napoli Ribeiro , Caio Abbud , Gabriel Augustus Braga , Gustavo Garrido , Akio Ogasawara Donato , Alan Eckeli , Miguel Meira e Cruz , Cristina Salles","doi":"10.1016/j.jpsychores.2026.112563","DOIUrl":"10.1016/j.jpsychores.2026.112563","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the effectiveness of Progressive Muscle Relaxation (PMR) in improving sleep quality and mental health in adults.</div></div><div><h3>Methods</h3><div>This systematic review and meta-analysis followed PRISMA 2020 guidelines. Randomized controlled trials assessing PMR's effect on sleep quality were included. Databases searched included PubMed, Embase, Cochrane and Web of Science. Outcomes included sleep quality, anxiety, and quality of life. Effect sizes were pooled using Standard Mean Difference (SMD) or Mean Difference (MD), and heterogeneity was assessed with the I<sup>2</sup>. Subgroup analysis was performed according to the duration of PMR intervention in weeks. Statistical analysis was conducted with Rstudio version 4.4.1.</div></div><div><h3>Results</h3><div>Thirty-one RCTs involving 2277 patients were included. PMR significantly improved sleep quality compared to the control group, with a SMD of −1.74 (95% CI -2.14 to −1.34; I<sup>2</sup> = 92.1%). Pittsburgh Sleep Quality Index (PSQI) showed a mean difference of −3.79 (95% CI -4.78 to −2.79; I<sup>2</sup> = 94.2%), also indicating statistical significance. Furthermore, PMR significantly reduced anxiety, with an SMD of −1.11 (95% CI -1.69 to −0.53; I<sup>2</sup> = 85%), and improved quality of life, which had an SMD of 1.32 (95% CI 0.53 to 2.12; I<sup>2</sup> = 83%). Subgroup analysis by PMR duration showed effectiveness across all intervention periods. Despite the high heterogeneity, sensitivity analyses confirmed consistent beneficial effects across all outcomes.</div></div><div><h3>Conclusion</h3><div>PMR is a non-pharmacological intervention that improves sleep quality and mental health in adults, with effects that vary across populations and settings.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"203 ","pages":"Article 112563"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114506","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: 2026-01-19DOI: 10.1016/j.jpsychores.2026.112542
Xiaoxi Liu , Luhua Zhao , Wei Wu , Yonggui Yuan , Zhaojun Yan
Background
Depressive disorders and asthma frequently co-occur in adolescence, but global co-patterning and shared population-level risk signals remain unclear.
Methods
Using Global Burden of Disease (GBD) 2021 estimates for ages 10–19 years (1990–2021), we characterized global and China-specific trends and sex disparities in incidence, prevalence, and disability-adjusted life years (DALYs) using joinpoint regression. We constructed a 2021 incidence-quartile co-occurrence typology, estimated typology-stratified coupling (Spearman rank correlation coefficient, ρ) using pooled country–year observations (1990/2000/2011/2021), prioritized shared summary exposure value (SEV) correlates using Shapley additive explanations (SHAP)-informed multiclass random forests and negative binomial models, and evaluated bidirectional genetic directionality using two-sample Mendelian randomization (MR).
Results
The burden of depressive disorders remained broadly stable but started to increase from 2019 onward, with persistent female excess. Asthma DALY rates declined overall, whereas incidence and prevalence were largely stable globally, with modest recent increases in North America. In 2021, typology membership showed marked income gradients and positive within-typology coupling (ρ = 0.408–0.925). Ambient particulate matter ≤2.5 μm (PM2.5) and household air pollution from solid fuels were consistently prioritized as shared ecological correlates and showed marked socioeconomic gradients. Two-sample MR supported a modest depressive disorders-to-asthma signal (inverse-variance weighted (IVW) odds ratio (OR) = 1.18, 95% confidence interval (CI) 1.02–1.36), whereas reverse-direction estimates were weaker and more heterogeneous.
Conclusions
Adolescent depressive disorders and asthma exhibit divergent long-term trajectories but cluster into income-patterned co-occurrence typologies with shared ecological risk signals. These findings reflect population-level correlates and do not directly estimate intervention or policy effects.
{"title":"Spatiotemporal co-occurrence and shared exposure profiles of adolescent depressive disorders and asthma worldwide and in China (GBD 2021, 1990–2021): an ecological study with bidirectional two-sample Mendelian randomization","authors":"Xiaoxi Liu , Luhua Zhao , Wei Wu , Yonggui Yuan , Zhaojun Yan","doi":"10.1016/j.jpsychores.2026.112542","DOIUrl":"10.1016/j.jpsychores.2026.112542","url":null,"abstract":"<div><h3>Background</h3><div>Depressive disorders and asthma frequently co-occur in adolescence, but global co-patterning and shared population-level risk signals remain unclear.</div></div><div><h3>Methods</h3><div>Using Global Burden of Disease (GBD) 2021 estimates for ages 10–19 years (1990–2021), we characterized global and China-specific trends and sex disparities in incidence, prevalence, and disability-adjusted life years (DALYs) using joinpoint regression. We constructed a 2021 incidence-quartile co-occurrence typology, estimated typology-stratified coupling (Spearman rank correlation coefficient, ρ) using pooled country–year observations (1990/2000/2011/2021), prioritized shared summary exposure value (SEV) correlates using Shapley additive explanations (SHAP)-informed multiclass random forests and negative binomial models, and evaluated bidirectional genetic directionality using two-sample Mendelian randomization (MR).</div></div><div><h3>Results</h3><div>The burden of depressive disorders remained broadly stable but started to increase from 2019 onward, with persistent female excess. Asthma DALY rates declined overall, whereas incidence and prevalence were largely stable globally, with modest recent increases in North America. In 2021, typology membership showed marked income gradients and positive within-typology coupling (ρ = 0.408–0.925). Ambient particulate matter ≤2.5 μm (PM2.5) and household air pollution from solid fuels were consistently prioritized as shared ecological correlates and showed marked socioeconomic gradients. Two-sample MR supported a modest depressive disorders-to-asthma signal (inverse-variance weighted (IVW) odds ratio (OR) = 1.18, 95% confidence interval (CI) 1.02–1.36), whereas reverse-direction estimates were weaker and more heterogeneous.</div></div><div><h3>Conclusions</h3><div>Adolescent depressive disorders and asthma exhibit divergent long-term trajectories but cluster into income-patterned co-occurrence typologies with shared ecological risk signals. These findings reflect population-level correlates and do not directly estimate intervention or policy effects.</div></div>","PeriodicalId":50074,"journal":{"name":"Journal of Psychosomatic Research","volume":"203 ","pages":"Article 112542"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127281","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号