Duration of Untreated Illness (DUI) has emerged as a crucial prognostic factor in Bipolar Disorder (BD), with growing evidence linking longer DUI to worse clinical, functional, and cognitive outcomes. Despite increased recognition of BD's early onset, significant delays persist between symptom emergence and initiation of appropriate treatment, often exceeding several years. This delay is particularly critical given the neuroprogressive nature of BD and the importance of early intervention that may modify the illness course.
Methods
This narrative review synthesizes findings from major epidemiological studies and review articles to analyze the implications of DUI in BD. We examined studies reporting on mean DUI duration, geographical and demographic variability, and DUI-related outcomes. Additionally, we discussed early identification strategies, the clinical utility of the staging model, and ongoing efforts to develop diagnostic biomarkers to facilitate earlier intervention.
Results
The mean DUI in BD varies across studies, with an average of 9 years, and longer duration associated with depressive onset, BD-II subtype, younger age at onset, and comorbidities. Longer DUI correlates with increased episode recurrence, poorer treatment response, reduced cognitive function, and structural brain changes consistent with neuroprogression. Emerging evidence supports the staging model as a framework for guiding diagnosis in early illness phases.
Conclusions
DUI represents a modifiable factor with profound impact on the course of BD. Reducing diagnostic latency through earlier recognition, staging-based care, and targeted early interventions is essential. Implementing these strategies in routine practice could significantly improve long-term outcomes and quality of life for individuals with BD.
{"title":"Duration of untreated illness in bipolar disorder","authors":"Monica Macellaro , Chiara Bucca , Iden Balla , Cesare Galimberti , Bernardo Dell’Osso","doi":"10.1016/j.psycom.2025.100223","DOIUrl":"10.1016/j.psycom.2025.100223","url":null,"abstract":"<div><h3>Introduction</h3><div>Duration of Untreated Illness (DUI) has emerged as a crucial prognostic factor in Bipolar Disorder (BD), with growing evidence linking longer DUI to worse clinical, functional, and cognitive outcomes. Despite increased recognition of BD's early onset, significant delays persist between symptom emergence and initiation of appropriate treatment, often exceeding several years. This delay is particularly critical given the neuroprogressive nature of BD and the importance of early intervention that may modify the illness course.</div></div><div><h3>Methods</h3><div>This narrative review synthesizes findings from major epidemiological studies and review articles to analyze the implications of DUI in BD. We examined studies reporting on mean DUI duration, geographical and demographic variability, and DUI-related outcomes. Additionally, we discussed early identification strategies, the clinical utility of the staging model, and ongoing efforts to develop diagnostic biomarkers to facilitate earlier intervention.</div></div><div><h3>Results</h3><div>The mean DUI in BD varies across studies, with an average of 9 years, and longer duration associated with depressive onset, BD-II subtype, younger age at onset, and comorbidities. Longer DUI correlates with increased episode recurrence, poorer treatment response, reduced cognitive function, and structural brain changes consistent with neuroprogression. Emerging evidence supports the staging model as a framework for guiding diagnosis in early illness phases.</div></div><div><h3>Conclusions</h3><div>DUI represents a modifiable factor with profound impact on the course of BD. Reducing diagnostic latency through earlier recognition, staging-based care, and targeted early interventions is essential. Implementing these strategies in routine practice could significantly improve long-term outcomes and quality of life for individuals with BD.</div></div>","PeriodicalId":74595,"journal":{"name":"Psychiatry research communications","volume":"5 3","pages":"Article 100223"},"PeriodicalIF":0.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144749905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-22DOI: 10.1016/j.psycom.2025.100222
Hallie Rodney , Shira B. Taylor , Ari Zaretsky , Raquel Ocvirk , Romy Shenderey
Background
University students continue to suffer from mental illness at staggering rates. Currently, arts-based approaches have been found to increase mental health literacy in educational settings, such as universities. Specifically, digital storytelling interventions have shown promise in addressing mental health awareness and stigma related to mental illness.
Methods
This study involves McMaster University students viewing a set of narrative films from the Out of Darkness project, followed by a semi-structured focus group discussion to determine what elements of the short films made them impactful. Thematic analysis was used to extract these themes.
Results
The university students participating in this study identified the following three aspects that made the films impactful: connection to the films, the humanization of illness and the emotionality and vulnerability of the individuals depicted in the films.
Conclusion
The results of this qualitative study suggest that digital storytelling interventions can be effective in addressing stigma surrounding mental health disorders and certain elements of narrative films allow for attitude change within the viewers.
{"title":"The Out of Darkness project - What makes an impactful digital storytelling tool?","authors":"Hallie Rodney , Shira B. Taylor , Ari Zaretsky , Raquel Ocvirk , Romy Shenderey","doi":"10.1016/j.psycom.2025.100222","DOIUrl":"10.1016/j.psycom.2025.100222","url":null,"abstract":"<div><h3>Background</h3><div>University students continue to suffer from mental illness at staggering rates. Currently, arts-based approaches have been found to increase mental health literacy in educational settings, such as universities. Specifically, digital storytelling interventions have shown promise in addressing mental health awareness and stigma related to mental illness.</div></div><div><h3>Methods</h3><div>This study involves McMaster University students viewing a set of narrative films from the <em>Out of Darkness</em> project, followed by a semi-structured focus group discussion to determine what elements of the short films made them impactful. Thematic analysis was used to extract these themes.</div></div><div><h3>Results</h3><div>The university students participating in this study identified the following three aspects that made the films impactful: connection to the films, the humanization of illness and the emotionality and vulnerability of the individuals depicted in the films.</div></div><div><h3>Conclusion</h3><div>The results of this qualitative study suggest that digital storytelling interventions can be effective in addressing stigma surrounding mental health disorders and certain elements of narrative films allow for attitude change within the viewers.</div></div>","PeriodicalId":74595,"journal":{"name":"Psychiatry research communications","volume":"5 3","pages":"Article 100222"},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144749906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-12DOI: 10.1016/j.psycom.2025.100221
Stefan Tschoeke , Lukas Stürner , Erich Flammer , Leonhard Kratzer , Benjamin Grieb , Susanne Jaeger
Purpose
Considering the clinical relevance of the association between dissociation and psychotic symptoms for the differential diagnosis of psychotic symptoms, we investigated the distribution and type of dissociative and psychotic symptoms in inpatients with non-psychotic disorders.
Basic procedures
We used routine data from 1020 patients to conduct latent profile analyses using the German version of the Dissociative Experiences Scale and items from the Symptom Checklist-90-Revised, which captures psychotic symptoms.
Main findings
Exploratory factor analysis revealed two qualitatively distinct factors of psychotic symptoms, one comprising paranoid ideation and the other perceptual and self-disturbances. Subsequent latent profile analysis revealed a three profile solution of dissociative and psychotic symptoms. One profile was characterized by almost no paranoid ideation and no perceptual and self-disturbances, one profile was characterized by almost exclusively paranoid ideation and the last profile was characterized by up to the most severe perceptual and self-disturbances combined with paranoid ideation. The first profile showed no pathological dissociation, in the second profile mainly absorption and derealization/depersonalization in particular were elevated, while the last profile was associated with severe dissociation on all subscales.
Principal conclusions
The results indicate a close relationship between dissociation and psychotic symptoms in non-psychotic disorders. While paranoid ideation appears to be associated with moderate dissociation, perceptual and self-disturbances are almost exclusively present in the profile with the strongest dissociation. Therefore, dissociation should be considered in the differential diagnosis of psychotic symptoms, and psychotic symptoms in non-psychotic disorders may benefit from approaches that address dissociation.
{"title":"Dissociation and psychotic symptoms in a non-psychotic inpatient sample, a latent profile analysis","authors":"Stefan Tschoeke , Lukas Stürner , Erich Flammer , Leonhard Kratzer , Benjamin Grieb , Susanne Jaeger","doi":"10.1016/j.psycom.2025.100221","DOIUrl":"10.1016/j.psycom.2025.100221","url":null,"abstract":"<div><h3>Purpose</h3><div>Considering the clinical relevance of the association between dissociation and psychotic symptoms for the differential diagnosis of psychotic symptoms, we investigated the distribution and type of dissociative and psychotic symptoms in inpatients with non-psychotic disorders.</div></div><div><h3>Basic procedures</h3><div>We used routine data from 1020 patients to conduct latent profile analyses using the German version of the Dissociative Experiences Scale and items from the Symptom Checklist-90-Revised, which captures psychotic symptoms.</div></div><div><h3>Main findings</h3><div>Exploratory factor analysis revealed two qualitatively distinct factors of psychotic symptoms, one comprising paranoid ideation and the other perceptual and self-disturbances. Subsequent latent profile analysis revealed a three profile solution of dissociative and psychotic symptoms. One profile was characterized by almost no paranoid ideation and no perceptual and self-disturbances, one profile was characterized by almost exclusively paranoid ideation and the last profile was characterized by up to the most severe perceptual and self-disturbances combined with paranoid ideation. The first profile showed no pathological dissociation, in the second profile mainly absorption and derealization/depersonalization in particular were elevated, while the last profile was associated with severe dissociation on all subscales.</div></div><div><h3>Principal conclusions</h3><div>The results indicate a close relationship between dissociation and psychotic symptoms in non-psychotic disorders. While paranoid ideation appears to be associated with moderate dissociation, perceptual and self-disturbances are almost exclusively present in the profile with the strongest dissociation. Therefore, dissociation should be considered in the differential diagnosis of psychotic symptoms, and psychotic symptoms in non-psychotic disorders may benefit from approaches that address dissociation.</div></div>","PeriodicalId":74595,"journal":{"name":"Psychiatry research communications","volume":"5 3","pages":"Article 100221"},"PeriodicalIF":0.0,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144662588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-09DOI: 10.1016/j.psycom.2025.100220
Beverlin Rosario-Williams , Jorge Valderrama , Evan Gilmer , Florissell Rosales , Regina Miranda
Background
Understanding cognitive responses to stress among individuals at risk for suicide attempts may help identify intervention targets to decrease the risk of future attempts. We examined differences between individuals with and without a suicide attempt history in physiological and cognitive responses to social exclusion.
Methods
Emerging adults with (n = 37) and without (n = 39) a suicide attempt history were assigned to a social exclusion or control (inclusion) condition. Saliva samples were taken before and after the stressor to measure salivary cortisol. Participants then completed behavioral measures of impulsivity, problem solving, and semantic interference from suicide-related words.
Results
There were no differences in cortisol reactivity trajectories by suicide attempt history, irrespective of stress condition. There was a trend for individuals with a suicide attempt history to show less semantic interference from suicide-related stimuli, compared to those without a suicide attempt history, regardless of stress condition. Furthermore, there was a trend for individuals who experienced social exclusion to perform better on the Tower of London test (a measure of problem solving) if they had a suicide attempt history than if they had no prior suicide attempt history. There were no other group differences on cognitive measures.
Conclusions
Emerging adults with a suicide attempt history who are not in an acutely suicidal state appear to demonstrate similar physiological and cognitive responses to social exclusion as do emerging adults without a suicide attempt history, and in some cases, may show improved problem solving. Findings are contextualized within the broader literature.
{"title":"Physiological and cognitive reactivity to social exclusion among emerging adults with versus without a suicide attempt history","authors":"Beverlin Rosario-Williams , Jorge Valderrama , Evan Gilmer , Florissell Rosales , Regina Miranda","doi":"10.1016/j.psycom.2025.100220","DOIUrl":"10.1016/j.psycom.2025.100220","url":null,"abstract":"<div><h3>Background</h3><div>Understanding cognitive responses to stress among individuals at risk for suicide attempts may help identify intervention targets to decrease the risk of future attempts. We examined differences between individuals with and without a suicide attempt history in physiological and cognitive responses to social exclusion.</div></div><div><h3>Methods</h3><div>Emerging adults with (<em>n</em> = 37) and without (<em>n</em> = 39) a suicide attempt history were assigned to a social exclusion or control (inclusion) condition. Saliva samples were taken before and after the stressor to measure salivary cortisol. Participants then completed behavioral measures of impulsivity, problem solving, and semantic interference from suicide-related words.</div></div><div><h3>Results</h3><div>There were no differences in cortisol reactivity trajectories by suicide attempt history, irrespective of stress condition. There was a trend for individuals with a suicide attempt history to show less semantic interference from suicide-related stimuli, compared to those without a suicide attempt history, regardless of stress condition. Furthermore, there was a trend for individuals who experienced social exclusion to perform better on the Tower of London test (a measure of problem solving) if they had a suicide attempt history than if they had no prior suicide attempt history. There were no other group differences on cognitive measures.</div></div><div><h3>Conclusions</h3><div>Emerging adults with a suicide attempt history who are not in an acutely suicidal state appear to demonstrate similar physiological and cognitive responses to social exclusion as do emerging adults without a suicide attempt history, and in some cases, may show improved problem solving. Findings are contextualized within the broader literature.</div></div>","PeriodicalId":74595,"journal":{"name":"Psychiatry research communications","volume":"5 3","pages":"Article 100220"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144611585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-17DOI: 10.1016/j.psycom.2025.100218
Jennifer Swainson , Claudio N. Soares , Roger S. McIntyre , Gilmar Gutierrez , Atul Khullar , Jay Wang , Ron Shore
As psychedelic research moves forward, trial design could benefit from assessments of potential risks of treatment. One such risk is future abuse or misuse of the drug or other drugs of abuse. Like the ketamine literature, psychedelic studies to date have not included measures designed to thoroughly address this risk. With aims to fill this gap, we previously developed a ketamine/esketamine drug liking and craving questionnaire (DLCQ), which primarily considered level of drug liking as a risk factor for potential future misuse or abuse. In adapting this for use with psychedelics, several considerations arose, including the likelihood that the psychedelic experience may be more universally pleasurable, and that desire to use psychedelics again may carry several underlying reasons. Here, we describe the Liability for Abuse of Psychedelics Questionnaire (LAPQ), which provides a framework incorporating 3 domains; substance use history, liking and craving for the drug in question, and subsequent changes in substance use patterns after exposure to the drug. While not a validated instrument, we propose this framework may be used in conjunction with other side effect tracking tools to more comprehensively address risks in psychedelic studies.
{"title":"A framework to assess risks for non-medical use of psychedelics: The liability for abuse of psychedelics questionnaire (LAPQ)","authors":"Jennifer Swainson , Claudio N. Soares , Roger S. McIntyre , Gilmar Gutierrez , Atul Khullar , Jay Wang , Ron Shore","doi":"10.1016/j.psycom.2025.100218","DOIUrl":"10.1016/j.psycom.2025.100218","url":null,"abstract":"<div><div>As psychedelic research moves forward, trial design could benefit from assessments of potential risks of treatment. One such risk is future abuse or misuse of the drug or other drugs of abuse. Like the ketamine literature, psychedelic studies to date have not included measures designed to thoroughly address this risk. With aims to fill this gap, we previously developed a ketamine/esketamine drug liking and craving questionnaire (DLCQ), which primarily considered level of drug liking as a risk factor for potential future misuse or abuse. In adapting this for use with psychedelics, several considerations arose, including the likelihood that the psychedelic experience may be more universally pleasurable, and that desire to use psychedelics again may carry several underlying reasons. Here, we describe the Liability for Abuse of Psychedelics Questionnaire (LAPQ), which provides a framework incorporating 3 domains; substance use history, liking and craving for the drug in question, and subsequent changes in substance use patterns after exposure to the drug. While not a validated instrument, we propose this framework may be used in conjunction with other side effect tracking tools to more comprehensively address risks in psychedelic studies.</div></div>","PeriodicalId":74595,"journal":{"name":"Psychiatry research communications","volume":"5 3","pages":"Article 100218"},"PeriodicalIF":0.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-16DOI: 10.1016/j.psycom.2025.100219
Patrick Raynal
Schizotypy, encompassing cognitive-perceptual, interpersonal, and disorganized dimensions, is a significant risk factor for psychosis and associated functional impairments. Internalized stigma, involving the internalization of negative societal stereotypes about mental illness, contributes to psychological distress and hinders recovery. Despite the significant impact of internalized stigma on mental health, the relationship between schizotypy and internalized stigma remains unexplored. In this study, 502 university students completed assessments including the Schizotypal Personality Questionnaire-Brief and the Internalized Stigma of Mental Illness scale, alongside measures of repetitive negative thinking (RNT), social phobia, anxiety, and depression. Findings indicate that the higher levels of schizotypy are strongly associated with increased internalized stigma, with RNT and depression symptoms acting as significant mediators. Hierarchical regression analyses identified schizotypy as the strongest predictor of internalized stigma, surpassing social phobia and anxiety. These findings highlight the importance of addressing schizotypy and cognitive patterns like RNT in interventions aimed at reducing internalized stigma in individuals with high levels of schizotypy.
{"title":"A strong association of schizotypy with internalized stigma: the role of cognitive and emotional mediators","authors":"Patrick Raynal","doi":"10.1016/j.psycom.2025.100219","DOIUrl":"10.1016/j.psycom.2025.100219","url":null,"abstract":"<div><div>Schizotypy, encompassing cognitive-perceptual, interpersonal, and disorganized dimensions, is a significant risk factor for psychosis and associated functional impairments. Internalized stigma, involving the internalization of negative societal stereotypes about mental illness, contributes to psychological distress and hinders recovery. Despite the significant impact of internalized stigma on mental health, the relationship between schizotypy and internalized stigma remains unexplored. In this study, 502 university students completed assessments including the Schizotypal Personality Questionnaire-Brief and the Internalized Stigma of Mental Illness scale, alongside measures of repetitive negative thinking (RNT), social phobia, anxiety, and depression. Findings indicate that the higher levels of schizotypy are strongly associated with increased internalized stigma, with RNT and depression symptoms acting as significant mediators. Hierarchical regression analyses identified schizotypy as the strongest predictor of internalized stigma, surpassing social phobia and anxiety. These findings highlight the importance of addressing schizotypy and cognitive patterns like RNT in interventions aimed at reducing internalized stigma in individuals with high levels of schizotypy.</div></div>","PeriodicalId":74595,"journal":{"name":"Psychiatry research communications","volume":"5 3","pages":"Article 100219"},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144491385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.psycom.2025.100214
Robert C. McMahon, Lindsay Merenda, Madelon Belle Wood
<div><h3>Background and aims</h3><div>A significant amount of literature documents the importance of potentially modifiable risk factors, including inadequate physical activity and excessive sedentary behaviors, as contributors to adolescent mental health problems. This study examined associations between variations in vigorous physical activity, weight training/muscle toning, sports team involvement, and sedentary behavior (screen time) in cluster subgroups of high school-age young men and young women that were defined based on the presence or absence of depressed mood, suicide contemplation, and suicide attempts during 2021, a period of COVID-19 restriction.</div></div><div><h3>Method</h3><div>Data from the 2021 US Centers for Disease Control Youth Risk Behavior Survey (YRBS) was used to form mental health status subgroups and to evaluate physical activity and sedentary behavior. Two-Step Cluster Analysis (SPSS) of YRBS items involving depressive episodes, suicide contemplation, and suicide attempts was used to define mental health subgroups. Multinomial regression evaluated differences among subgroups in physical activity, sports team involvement, and sedentary behavior (screen time).</div></div><div><h3>Results</h3><div>The proportions of females identified in symptomatic subgroups (61 %) defined by the presence of depression episodes or depression and suicidal behavior differed substantially from those in similarly defined symptomatic male subgroups (35 %). Among female students, those in the asymptomatic versus depression episode and depression with suicide risk subgroups showed a significantly higher likelihood of daily aerobic exercise (44 % vs. 27 % and 28 %) and sports team involvement (52 % vs 43 % and 43 %), and a lower likelihood of 3+ hours of daily screen time (74 % vs 83 % and 84 %). Among male students, those in the asymptomatic versus depression episode and depression with suicide risk subgroups showed a significantly higher likelihood of daily aerobic exercise (58 % vs 49 % and 48 %) and sports team involvement (54 % vs 48 % and 46 %), and a lower likelihood of 3+ hours of daily screen time (73 % vs 78 % and 79 %).</div></div><div><h3>Conclusions</h3><div>Findings are consistent with previous research linking depressive symptoms and suicidal behavior with limited aerobic exercise, sports team involvement, and excessive screen time. Few differences in exercise or screen time were found in comparisons between depression episode and depression and suicidal behavior subgroups in comparisons involving young women or young men. Low proportions reporting daily aerobic exercise, particularly among young women, and high proportions reporting elevated screen time, were identified across symptomatic and asymptomatic subgroups. Interventions designed to increase physical activity and reduce excessive screen time are recommended for high school students, particularly those experiencing depressive symptoms and suicidal risk behaviors.</div><
{"title":"Physical activity, sedentary behavior, and psychological symptoms among US high school students during COVID-19","authors":"Robert C. McMahon, Lindsay Merenda, Madelon Belle Wood","doi":"10.1016/j.psycom.2025.100214","DOIUrl":"10.1016/j.psycom.2025.100214","url":null,"abstract":"<div><h3>Background and aims</h3><div>A significant amount of literature documents the importance of potentially modifiable risk factors, including inadequate physical activity and excessive sedentary behaviors, as contributors to adolescent mental health problems. This study examined associations between variations in vigorous physical activity, weight training/muscle toning, sports team involvement, and sedentary behavior (screen time) in cluster subgroups of high school-age young men and young women that were defined based on the presence or absence of depressed mood, suicide contemplation, and suicide attempts during 2021, a period of COVID-19 restriction.</div></div><div><h3>Method</h3><div>Data from the 2021 US Centers for Disease Control Youth Risk Behavior Survey (YRBS) was used to form mental health status subgroups and to evaluate physical activity and sedentary behavior. Two-Step Cluster Analysis (SPSS) of YRBS items involving depressive episodes, suicide contemplation, and suicide attempts was used to define mental health subgroups. Multinomial regression evaluated differences among subgroups in physical activity, sports team involvement, and sedentary behavior (screen time).</div></div><div><h3>Results</h3><div>The proportions of females identified in symptomatic subgroups (61 %) defined by the presence of depression episodes or depression and suicidal behavior differed substantially from those in similarly defined symptomatic male subgroups (35 %). Among female students, those in the asymptomatic versus depression episode and depression with suicide risk subgroups showed a significantly higher likelihood of daily aerobic exercise (44 % vs. 27 % and 28 %) and sports team involvement (52 % vs 43 % and 43 %), and a lower likelihood of 3+ hours of daily screen time (74 % vs 83 % and 84 %). Among male students, those in the asymptomatic versus depression episode and depression with suicide risk subgroups showed a significantly higher likelihood of daily aerobic exercise (58 % vs 49 % and 48 %) and sports team involvement (54 % vs 48 % and 46 %), and a lower likelihood of 3+ hours of daily screen time (73 % vs 78 % and 79 %).</div></div><div><h3>Conclusions</h3><div>Findings are consistent with previous research linking depressive symptoms and suicidal behavior with limited aerobic exercise, sports team involvement, and excessive screen time. Few differences in exercise or screen time were found in comparisons between depression episode and depression and suicidal behavior subgroups in comparisons involving young women or young men. Low proportions reporting daily aerobic exercise, particularly among young women, and high proportions reporting elevated screen time, were identified across symptomatic and asymptomatic subgroups. Interventions designed to increase physical activity and reduce excessive screen time are recommended for high school students, particularly those experiencing depressive symptoms and suicidal risk behaviors.</div><","PeriodicalId":74595,"journal":{"name":"Psychiatry research communications","volume":"5 2","pages":"Article 100214"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.psycom.2025.100217
Amelia Austin , Michaela Flynn , Katie Richards , Karina Allen , Victoria A. Mountford , Danielle Glennon , Amy Brown , Nina Grant , Mary Franklin-Smith , Monique Schelhase , William Rhys Jones , Gabrielle Brady , Lucy Serpell , Ulrike Schmidt
The relationship between duration of untreated symptoms and clinical outcomes in eating disorders (EDs) is not fully understood. We explored whether the duration of prodrome (DOP) or duration of untreated eating disorder (DUED) impacts clinical outcomes. Emerging adults (N = 236) aged 16–25 years, with an early-stage ED were recruited at the outset of treatment, completing a semi-structured interview to establish DOP and DUED. Clinical outcomes were measured at baseline and 12-months. DUED was positively correlated with binge eating (rs = .236, p < .001) and vomiting (rs = .131, p = .047) at baseline, and negatively correlated with BMI for anorexia nervosa at follow-up (rs [58] = -.26, p = .038). After subsequent regression analysis, the only significant finding was DUED as a predictor of the presence of binge eating at baseline. Future studies should examine symptom duration in more diverse samples.
进食障碍（EDs）症状未治疗的持续时间与临床结果之间的关系尚不完全清楚。我们探讨了前驱期（DOP）或未治疗进食障碍（DUED）的持续时间是否会影响临床结果。在治疗开始时招募年龄16-25岁、早期ED的新生成人（N = 236），完成半结构化访谈以确定DOP和DUED。在基线和12个月时测量临床结果。DUED与暴食呈正相关(rs = 0.236, p <；.001)和呕吐（rs = 0.131, p = 0.047），随访时神经性厌食症与BMI呈负相关（rs[58] = -）。26, p = .038)。在随后的回归分析后，唯一有意义的发现是DUED作为基线暴食存在的预测因子。未来的研究应该在更多不同的样本中检查症状持续时间。
{"title":"The relationship between duration of untreated symptoms and clinical outcomes in first episode eating disorders","authors":"Amelia Austin , Michaela Flynn , Katie Richards , Karina Allen , Victoria A. Mountford , Danielle Glennon , Amy Brown , Nina Grant , Mary Franklin-Smith , Monique Schelhase , William Rhys Jones , Gabrielle Brady , Lucy Serpell , Ulrike Schmidt","doi":"10.1016/j.psycom.2025.100217","DOIUrl":"10.1016/j.psycom.2025.100217","url":null,"abstract":"<div><div>The relationship between duration of untreated symptoms and clinical outcomes in eating disorders (EDs) is not fully understood. We explored whether the duration of prodrome (DOP) or duration of untreated eating disorder (DUED) impacts clinical outcomes. Emerging adults (<em>N</em> = 236) aged 16–25 years, with an early-stage ED were recruited at the outset of treatment, completing a semi-structured interview to establish DOP and DUED. Clinical outcomes were measured at baseline and 12-months. DUED was positively correlated with binge eating (<em>r</em><sub><em>s</em></sub> = .236, <em>p</em> < .001) and vomiting (<em>r</em><sub><em>s</em></sub> = .131, <em>p</em> = .047) at baseline, and negatively correlated with BMI for anorexia nervosa at follow-up (<em>r</em><sub>s</sub> [58] = -.26, <em>p</em> = .038). After subsequent regression analysis, the only significant finding was DUED as a predictor of the presence of binge eating at baseline. Future studies should examine symptom duration in more diverse samples.</div></div>","PeriodicalId":74595,"journal":{"name":"Psychiatry research communications","volume":"5 2","pages":"Article 100217"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144241041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-21DOI: 10.1016/j.psycom.2025.100216
Rose Kong Liu , Jessica Green , Richard Newton
Introduction
Factitious disorder imposed on self (FDIS) has a deleterious impact on sufferers through the sequalae of induced illness as well as the consequences of unnecessary investigations and treatments.
Objective
This scoping review aimed to map the existing literature regarding the types of data, data quality, treatment options and outcomes, and changes in treatment approaches over time.
Method
A search was performed using Ovid Medline, Ovid Embase, Ovid PsycINFO, Cumulated Index in Nursing and Allied Health Literature (CINAHL), Central Register of Controlled Trials, Scopus, and Google Scholar.
Results
Seventy-two studies were included (71 case reports and one case series) relating to the management of 107 participants. The quality of reporting was limited for 61 % of studies. The most common factitious illnesses were dermatological manipulation creating a skin lesion, anaemia, and bleeding. The most common treatments were supportive psychotherapy, psychiatric hospitalization, and antidepressants. Mapping publications across time revealed that 50 % of all data were published after 2011, and medication treatments became more common over time. Confrontation was reported in 40 % of participants.
Conclusions
Evidence has expanded slightly in the past 17 years and this data remains exclusively at the case study level. Data relating to management were of poor quality and incompletely reported. The high frequency of confrontation and positive outcomes reported is suggestive of selection and publication bias.
{"title":"A scoping review of treatment for factitious disorder (imposed on self)","authors":"Rose Kong Liu , Jessica Green , Richard Newton","doi":"10.1016/j.psycom.2025.100216","DOIUrl":"10.1016/j.psycom.2025.100216","url":null,"abstract":"<div><h3>Introduction</h3><div>Factitious disorder imposed on self (FDIS) has a deleterious impact on sufferers through the sequalae of induced illness as well as the consequences of unnecessary investigations and treatments.</div></div><div><h3>Objective</h3><div>This scoping review aimed to map the existing literature regarding the types of data, data quality, treatment options and outcomes, and changes in treatment approaches over time.</div></div><div><h3>Method</h3><div>A search was performed using Ovid Medline, Ovid Embase, Ovid PsycINFO, Cumulated Index in Nursing and Allied Health Literature (CINAHL), Central Register of Controlled Trials, Scopus, and Google Scholar.</div></div><div><h3>Results</h3><div>Seventy-two studies were included (71 case reports and one case series) relating to the management of 107 participants. The quality of reporting was limited for 61 % of studies. The most common factitious illnesses were dermatological manipulation creating a skin lesion, anaemia, and bleeding. The most common treatments were supportive psychotherapy, psychiatric hospitalization, and antidepressants. Mapping publications across time revealed that 50 % of all data were published after 2011, and medication treatments became more common over time. Confrontation was reported in 40 % of participants.</div></div><div><h3>Conclusions</h3><div>Evidence has expanded slightly in the past 17 years and this data remains exclusively at the case study level. Data relating to management were of poor quality and incompletely reported. The high frequency of confrontation and positive outcomes reported is suggestive of selection and publication bias.</div></div>","PeriodicalId":74595,"journal":{"name":"Psychiatry research communications","volume":"5 2","pages":"Article 100216"},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-21DOI: 10.1016/j.psycom.2025.100215
Sara K. Nutley , Catherine W. Striley , Linda B. Cottler , Joseph Eichenbaum , Rachel L. Nosheny , R. Scott Mackin , Carol A. Mathews
Background
Psychiatric comorbidity and self-reported cognitive dysfunction are common among individuals with hoarding disorder (HD). However, common patterns of co-occurring neuropsychiatric symptoms, and their potential impact on the clinical manifestation of hoarding, including functional impairment, are not well-established.
Methods
Latent class analysis (LCA) was used to identify and characterize distinct neuropsychiatric symptom subgroups among 7606 adult internet-based research participants who reported experiencing social impairment due to household clutter. An additional 1129 participants who screened negative but had evidence of hoarding on additional assessment (“false negative”) were identified and compared to the LCA-identified classes. Demographic and clinical characteristics associated with class membership were assessed.
Results
The best fitting model yielded five subgroups, including three subgroups characterizing individuals with hoarding symptoms: “hoarding only” (12.1 %), hoarding with depressive symptoms (“depressed + hoarding”; 11.8 %), and hoarding with depressive symptoms, inattention, and subjective memory decline (“multisymptomatic”; 14.6 %). These subgroups fell along a continuum of increasing neuropsychiatric burden, with individuals in the “multisymptomatic” class experiencing the greatest deficits to general functional ability and cognitive functioning, as well as elevated rates of comorbid neuropsychiatric diagnoses. The “false negative” group was similar to the “hoarding only” class, although comprised of a significantly higher proportion of male participants and married individuals.
Conclusions
Neuropsychiatric symptom patterns among individuals with hoarding are heterogenous in nature and uniquely associated with clinical features and functional outcomes. These findings may inform the development of targeted interventions for HD that include assessment and management of depressive symptoms, inattention, and memory.
{"title":"Classification of hoarding and comorbid neuropsychiatric symptoms","authors":"Sara K. Nutley , Catherine W. Striley , Linda B. Cottler , Joseph Eichenbaum , Rachel L. Nosheny , R. Scott Mackin , Carol A. Mathews","doi":"10.1016/j.psycom.2025.100215","DOIUrl":"10.1016/j.psycom.2025.100215","url":null,"abstract":"<div><h3>Background</h3><div>Psychiatric comorbidity and self-reported cognitive dysfunction are common among individuals with hoarding disorder (HD). However, common patterns of co-occurring neuropsychiatric symptoms, and their potential impact on the clinical manifestation of hoarding, including functional impairment, are not well-established.</div></div><div><h3>Methods</h3><div>Latent class analysis (LCA) was used to identify and characterize distinct neuropsychiatric symptom subgroups among 7606 adult internet-based research participants who reported experiencing social impairment due to household clutter. An additional 1129 participants who screened negative but had evidence of hoarding on additional assessment (“false negative”) were identified and compared to the LCA-identified classes. Demographic and clinical characteristics associated with class membership were assessed.</div></div><div><h3>Results</h3><div>The best fitting model yielded five subgroups, including three subgroups characterizing individuals with hoarding symptoms: “hoarding only” (12.1 %), hoarding with depressive symptoms (“depressed + hoarding”; 11.8 %), and hoarding with depressive symptoms, inattention, and subjective memory decline (“multisymptomatic”; 14.6 %). These subgroups fell along a continuum of increasing neuropsychiatric burden, with individuals in the “multisymptomatic” class experiencing the greatest deficits to general functional ability and cognitive functioning, as well as elevated rates of comorbid neuropsychiatric diagnoses. The “false negative” group was similar to the “hoarding only” class, although comprised of a significantly higher proportion of male participants and married individuals.</div></div><div><h3>Conclusions</h3><div>Neuropsychiatric symptom patterns among individuals with hoarding are heterogenous in nature and uniquely associated with clinical features and functional outcomes. These findings may inform the development of targeted interventions for HD that include assessment and management of depressive symptoms, inattention, and memory.</div></div>","PeriodicalId":74595,"journal":{"name":"Psychiatry research communications","volume":"5 2","pages":"Article 100215"},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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