Pub Date : 2025-12-29DOI: 10.1016/j.ajp.2025.104810
Raja Babu Ramawat , Omar Afroz , Rajesh Sagar
{"title":"From exclusion to inclusion: Why premenstrual dysphoric disorder (PMDD) research must include transgender and gender-diverse (TGD) menstruators","authors":"Raja Babu Ramawat , Omar Afroz , Rajesh Sagar","doi":"10.1016/j.ajp.2025.104810","DOIUrl":"10.1016/j.ajp.2025.104810","url":null,"abstract":"","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"116 ","pages":"Article 104810"},"PeriodicalIF":4.5,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145882293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-29DOI: 10.1016/j.ajp.2025.104823
Arsalan Haider , Farhan Haider, Ana Estéveze, Dong-Mei Wang , Xiang-Yang Zhang
{"title":"Identification of risk features for methamphetamine dependence using a machine learning model and comprehensive multimodal measures","authors":"Arsalan Haider , Farhan Haider, Ana Estéveze, Dong-Mei Wang , Xiang-Yang Zhang","doi":"10.1016/j.ajp.2025.104823","DOIUrl":"10.1016/j.ajp.2025.104823","url":null,"abstract":"","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"116 ","pages":"Article 104823"},"PeriodicalIF":4.5,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-29DOI: 10.1016/j.ajp.2025.104824
Lalasa Mukku, Vikas Burri
{"title":"Unsupervised digital counselling: Addressing the safety gap of large language models as mental health tools","authors":"Lalasa Mukku, Vikas Burri","doi":"10.1016/j.ajp.2025.104824","DOIUrl":"10.1016/j.ajp.2025.104824","url":null,"abstract":"","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"116 ","pages":"Article 104824"},"PeriodicalIF":4.5,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145881738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-29DOI: 10.1016/j.ajp.2025.104821
Mohamad Saripudin, Aip Badrujaman
The consensus article by Quah et al. (2025) offers an important framework for strengthening perinatal mental health across the Asia–Pacific region but does not sufficiently address the role of cultural wisdom and ritualized social support in maternal wellbeing. Evidence from Indonesia suggests that cultural pregnancy rituals and strong family or community support can protect against antenatal anxiety and depression, even though direct empirical studies on ritual-specific outcomes remain limited. In Indonesia, longstanding practices such as mitoni, ba bu, and topung tawar function as informal, community-driven psychosocial interventions that reinforce maternal identity, collective empathy, and emotional safety. Integrating these culturally embedded supports into regional perinatal mental health frameworks could enhance cultural relevance, strengthen community participation, and bridge gaps between formal healthcare and indigenous caregiving systems. A culturally grounded approach, guided by voluntariness and safety considerations, may contribute to more holistic and equitable maternal mental health strategies in the region.
{"title":"Integrating cultural rituals and social support into perinatal mental health frameworks: Lessons from indonesian pregnancy traditions","authors":"Mohamad Saripudin, Aip Badrujaman","doi":"10.1016/j.ajp.2025.104821","DOIUrl":"10.1016/j.ajp.2025.104821","url":null,"abstract":"<div><div>The consensus article by Quah et al. (2025) offers an important framework for strengthening perinatal mental health across the Asia–Pacific region but does not sufficiently address the role of cultural wisdom and ritualized social support in maternal wellbeing. Evidence from Indonesia suggests that cultural pregnancy rituals and strong family or community support can protect against antenatal anxiety and depression, even though direct empirical studies on ritual-specific outcomes remain limited. In Indonesia, longstanding practices such as <em>mitoni, ba bu, and topung tawar</em> function as informal, community-driven psychosocial interventions that reinforce maternal identity, collective empathy, and emotional safety. Integrating these culturally embedded supports into regional perinatal mental health frameworks could enhance cultural relevance, strengthen community participation, and bridge gaps between formal healthcare and indigenous caregiving systems. A culturally grounded approach, guided by voluntariness and safety considerations, may contribute to more holistic and equitable maternal mental health strategies in the region.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"116 ","pages":"Article 104821"},"PeriodicalIF":4.5,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145881741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-29DOI: 10.1016/j.ajp.2025.104816
George V. JOY , Febu Elizabeth JOY, Abdulqadir J. NASHWAN
The rapid integration of artificial intelligence (AI) into mental health practice presents both unprecedented opportunities and substantial challenges for contemporary care systems. This discursive review critically examines how AI-enabled tools intersect with the interpersonal foundations of psychotherapy, with particular attention to empathy, therapeutic alliance, and relational dynamics. Drawing on socio-technical theory, psychotherapeutic research, and emerging literature in affective computing and neurotechnology, the review develops a conceptual framework positioning AI as an augmentative, not substitutive partner in mental health care. While AI demonstrates clear strengths in enhancing accessibility, reducing administrative burden, supporting structured interventions, and improving monitoring through data-driven insights, these advantages are counterbalanced by significant concerns. Limitations in genuine empathic capacity, risks to transference and therapeutic authenticity, potential erosion of clinician skills, and ethical tensions related to privacy, accountability, algorithmic bias, and emotional deception underscore the complexity of integrating AI into relationally grounded practices. Differential impacts across therapeutic modalities and clinical conditions reveal that structured, skills-based treatments such as cognitive-behavioral approaches benefit most from AI augmentation, whereas humanistic and psychodynamic therapies rooted in emotional presence and intersubjective meaning-making remain less amenable to technological simulation. The review further highlights the importance of hybrid care models in which human clinicians guide relational processes while AI supports precision, continuity, and scalability. Ethical implementation requires robust frameworks emphasizing transparency, informed consent, equitable access, data protection, and sustained human oversight. Emerging neurotechnologies introduce additional considerations regarding autonomy, identity, and the need for evolving “neurorights.” Overall, this review argues that the future of mental health care depends on harmonizing technological innovation with human compassion. Effective, ethical, and relationally sensitive integration of AI must preserve the therapeutic alliance at its core, ensuring that technology enhances rather than replaces the deep human processes essential to psychological healing.
{"title":"Between empathy and algorithms: Navigating interpersonal dynamics in AI-augmented mental health care- Discursive review","authors":"George V. JOY , Febu Elizabeth JOY, Abdulqadir J. NASHWAN","doi":"10.1016/j.ajp.2025.104816","DOIUrl":"10.1016/j.ajp.2025.104816","url":null,"abstract":"<div><div>The rapid integration of artificial intelligence (AI) into mental health practice presents both unprecedented opportunities and substantial challenges for contemporary care systems. This discursive review critically examines how AI-enabled tools intersect with the interpersonal foundations of psychotherapy, with particular attention to empathy, therapeutic alliance, and relational dynamics. Drawing on socio-technical theory, psychotherapeutic research, and emerging literature in affective computing and neurotechnology, the review develops a conceptual framework positioning AI as an augmentative, not substitutive partner in mental health care. While AI demonstrates clear strengths in enhancing accessibility, reducing administrative burden, supporting structured interventions, and improving monitoring through data-driven insights, these advantages are counterbalanced by significant concerns. Limitations in genuine empathic capacity, risks to transference and therapeutic authenticity, potential erosion of clinician skills, and ethical tensions related to privacy, accountability, algorithmic bias, and emotional deception underscore the complexity of integrating AI into relationally grounded practices. Differential impacts across therapeutic modalities and clinical conditions reveal that structured, skills-based treatments such as cognitive-behavioral approaches benefit most from AI augmentation, whereas humanistic and psychodynamic therapies rooted in emotional presence and intersubjective meaning-making remain less amenable to technological simulation. The review further highlights the importance of hybrid care models in which human clinicians guide relational processes while AI supports precision, continuity, and scalability. Ethical implementation requires robust frameworks emphasizing transparency, informed consent, equitable access, data protection, and sustained human oversight. Emerging neurotechnologies introduce additional considerations regarding autonomy, identity, and the need for evolving “neurorights.” Overall, this review argues that the future of mental health care depends on harmonizing technological innovation with human compassion. Effective, ethical, and relationally sensitive integration of AI must preserve the therapeutic alliance at its core, ensuring that technology enhances rather than replaces the deep human processes essential to psychological healing.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"116 ","pages":"Article 104816"},"PeriodicalIF":4.5,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-29DOI: 10.1016/j.ajp.2025.104819
Mohsen Khosravi
{"title":"Addressing the paradox of help-seeking reluctance among mental health professionals","authors":"Mohsen Khosravi","doi":"10.1016/j.ajp.2025.104819","DOIUrl":"10.1016/j.ajp.2025.104819","url":null,"abstract":"","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"116 ","pages":"Article 104819"},"PeriodicalIF":4.5,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145881739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-29DOI: 10.1016/j.ajp.2025.104813
Yun-An Liu, Yi-Chyan Chen
{"title":"Hemodialysis dramatically alleviates treatment-refractory psychosis in a subject with schizoaffective disorder","authors":"Yun-An Liu, Yi-Chyan Chen","doi":"10.1016/j.ajp.2025.104813","DOIUrl":"10.1016/j.ajp.2025.104813","url":null,"abstract":"","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"116 ","pages":"Article 104813"},"PeriodicalIF":4.5,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145881740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-29DOI: 10.1016/j.ajp.2025.104818
Qi-Hang Zhang , Tian Han , Xiao-Xiao He , Mathangie Gananathan , Xiao-Lin Yin , Hao-Tian Shen , Fuchun Zhou , Chuan-Yue Wang
Objective
This study aimed to compare the long-term clinical and functional outcomes between psychiatric patients with and without catatonia over a 5-year follow-up and to explore the baseline predictors of poor outcomes.
Methods
The study sample comprised 51 with catatonic and 56 non-catatonic psychiatric patients. Catatonia was assessed using the Bush-Francis Catatonia Rating Scale (BFCRS). We also determined serum high-sensitivity C-reactive protein (hs-CRP) levels at the baseline, recorded clinical outcomes during follow-up, and assessed the Global Assessment of Functioning (GAF) scale at endpoint.
Results
Follow-up data were available for 31 catatonic patients and 34 non-catatonia patients. During follow-up, the catatonic group had a significantly higher percentage of treatment-resistant cases compared to the non-catatonic group (25.8 % vs. 5.9 %). Catatonic patients had significantly more readmissions than non-catatonic patients after excluding patients with poor adherence. At the endpoint, patients in the catatonic group scored significantly lower on the GAF than those in the non-catatonic group. In the catatonic group, patients with high inflammatory levels had a significantly higher number of readmissions than those with low inflammatory levels. In the whole sample, multiple linear regression analyses revealed that baseline BFCRS scores were a significant and independent predictor of poor functional outcome at follow-up (Beta = −0.369, P = 0.002, 95 % CI: −0.008 to −0.002).
Conclusion
Findings suggest that catatonia is linked to poorer clinical outcomes and a lower level of functioning. Specifically, baseline high inflammatory levels seem to contribute to a higher relapse rate in catatonic patients.
{"title":"The long-term clinical and functional outcomes of psychiatric patients with catatonia: A 5-year follow-up","authors":"Qi-Hang Zhang , Tian Han , Xiao-Xiao He , Mathangie Gananathan , Xiao-Lin Yin , Hao-Tian Shen , Fuchun Zhou , Chuan-Yue Wang","doi":"10.1016/j.ajp.2025.104818","DOIUrl":"10.1016/j.ajp.2025.104818","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to compare the long-term clinical and functional outcomes between psychiatric patients with and without catatonia over a 5-year follow-up and to explore the baseline predictors of poor outcomes.</div></div><div><h3>Methods</h3><div>The study sample comprised 51 with catatonic and 56 non-catatonic psychiatric patients. Catatonia was assessed using the Bush-Francis Catatonia Rating Scale (BFCRS). We also determined serum high-sensitivity C-reactive protein (hs-CRP) levels at the baseline, recorded clinical outcomes during follow-up, and assessed the Global Assessment of Functioning (GAF) scale at endpoint.</div></div><div><h3>Results</h3><div>Follow-up data were available for 31 catatonic patients and 34 non-catatonia patients. During follow-up, the catatonic group had a significantly higher percentage of treatment-resistant cases compared to the non-catatonic group (25.8 % vs. 5.9 %). Catatonic patients had significantly more readmissions than non-catatonic patients after excluding patients with poor adherence. At the endpoint, patients in the catatonic group scored significantly lower on the GAF than those in the non-catatonic group. In the catatonic group, patients with high inflammatory levels had a significantly higher number of readmissions than those with low inflammatory levels. In the whole sample, multiple linear regression analyses revealed that baseline BFCRS scores were a significant and independent predictor of poor functional outcome at follow-up (Beta = −0.369, P = 0.002, 95 % CI: −0.008 to −0.002).</div></div><div><h3>Conclusion</h3><div>Findings suggest that catatonia is linked to poorer clinical outcomes and a lower level of functioning. Specifically, baseline high inflammatory levels seem to contribute to a higher relapse rate in catatonic patients.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"116 ","pages":"Article 104818"},"PeriodicalIF":4.5,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145916664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-24DOI: 10.1016/j.ajp.2025.104796
Silvia Annunziata , Gabriele Fassina , Michelle Brivio , Laura Santos , Emilia Ambrosini , Paolo Meriggi , Paola Molina , Alessandra Pedrocchi , Anna Cavallini
Introduction
Autism Spectrum Disorder (ASD) is characterized by deficits in social interaction and communication, including joint attention (JA) impairment. This observational case-control study explores quantitative JA metrics in ASD preschool-aged children and typically-developing (TD) toddlers, interacting with both a human agent and a social robot.
Material and methods
Ten ASD and sixteen Typically Developing (TD) children, matched for developmental age, participated completing two JA tasks of the “Échelle par la Communication Sociale Precoce”(ECSP)-Gaze Following and Object Spectacle-administered by both a human (ECSP-H) and a social robot NAO (ECSP-R). A Kinect Azure Camera was used to track children's gaze and five performance indicators were defined to quantify JA-related behaviors: Number of Responses to JA, Time Latency to response and Fixation Time, both towards robot and human agent.
Results
Significant group differences emerged in responsiveness to social cues, particularly in the Gaze Following task. TD children responded more consistently to human prompts (p = 0.01) and showed greater visual interest in the human agent in both ECSP-H (p < 0.01) and ECSP-R (p = 0.02) conditions. In contrast, percentage of fixations on the robot was comparable across groups.
Discussion
This study introduces unobtrusive, gaze-based quantitative measures to assess joint attention in ASD. Significant differences between ASD and TD groups suggest that children with ASD exhibited greater attentional preference to the robot agent, giving potential for these metrics in distinguishing attentional patterns in these two populations. This feature may nonetheless be clinically relevant, as it may be leveraged to facilitate attention, promote participation, and support robot-assisted therapeutic interventions.
自闭症谱系障碍（Autism Spectrum Disorder， ASD）以社会互动和沟通缺陷为特征，包括共同注意缺陷（joint attention， JA）。这项观察性病例对照研究探讨了ASD学龄前儿童和典型发育（TD）幼儿与人类代理人和社交机器人互动的定量JA指标。材料和方法：10名ASD儿童和16名正常发育儿童（TD），符合发育年龄，参与完成“Échelle par la Communication social Precoce”（ECSP）的两个JA任务-凝视跟随和物体观察-由人类（ECSP- h）和社交机器人NAO （ECSP- r）管理。使用Kinect Azure摄像头跟踪儿童的目光，并定义了五个性能指标来量化与JA相关的行为：对JA的反应次数，反应的时间延迟和注视时间，包括机器人和人类代理。结果：在对社会线索的反应上出现了显著的组间差异，特别是在凝视跟随任务中。TD儿童对人类提示的反应更一致（p = 0.01），并且在ECSP-H中对人类媒介表现出更大的视觉兴趣（p ）。讨论：本研究引入了不引人注目的、基于凝视的定量测量来评估ASD的联合注意力。ASD和TD组之间的显著差异表明，ASD儿童对机器人代理表现出更大的注意力偏好，这为区分这两个人群的注意力模式提供了这些指标的潜力。尽管如此，这一特征可能具有临床相关性，因为它可以用来促进注意力，促进参与，并支持机器人辅助的治疗干预。
{"title":"Are social robots more interesting than humans? Quantitative assessment of Joint Attention in autistic and typically developing children","authors":"Silvia Annunziata , Gabriele Fassina , Michelle Brivio , Laura Santos , Emilia Ambrosini , Paolo Meriggi , Paola Molina , Alessandra Pedrocchi , Anna Cavallini","doi":"10.1016/j.ajp.2025.104796","DOIUrl":"10.1016/j.ajp.2025.104796","url":null,"abstract":"<div><h3>Introduction</h3><div>Autism Spectrum Disorder (ASD) is characterized by deficits in social interaction and communication, including joint attention (JA) impairment. This observational case-control study explores quantitative JA metrics in ASD preschool-aged children and typically-developing (TD) toddlers, interacting with both a human agent and a social robot.</div></div><div><h3>Material and methods</h3><div>Ten ASD and sixteen Typically Developing (TD) children, matched for developmental age, participated completing two JA tasks of the “Échelle par la Communication Sociale Precoce”(ECSP)-Gaze Following and Object Spectacle-administered by both a human (ECSP-H) and a social robot NAO (ECSP-R). A Kinect Azure Camera was used to track children's gaze and five performance indicators were defined to quantify JA-related behaviors: Number of Responses to JA, Time Latency to response and Fixation Time, both towards robot and human agent.</div></div><div><h3>Results</h3><div>Significant group differences emerged in responsiveness to social cues, particularly in the Gaze Following task. TD children responded more consistently to human prompts (p = 0.01) and showed greater visual interest in the human agent in both ECSP-H (p < 0.01) and ECSP-R (p = 0.02) conditions. In contrast, percentage of fixations on the robot was comparable across groups.</div></div><div><h3>Discussion</h3><div>This study introduces unobtrusive, gaze-based quantitative measures to assess joint attention in ASD. Significant differences between ASD and TD groups suggest that children with ASD exhibited greater attentional preference to the robot agent, giving potential for these metrics in distinguishing attentional patterns in these two populations. This feature may nonetheless be clinically relevant, as it may be leveraged to facilitate attention, promote participation, and support robot-assisted therapeutic interventions.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"116 ","pages":"Article 104796"},"PeriodicalIF":4.5,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145916705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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