Psychiatry Res [JOURNAL]
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200 papers
Prevalence and mental health correlates of non-suicidal self-injury in elementary school children.
Hadj-Youssef S, Civita A, Chartrand E … +10 more , Malboeuf-Hurtubise C, Fuoco J, Loose T, Ouellet-Morin I, Heath N, Maltais N, Baetens I, Spodenkiewicz M, Côté S, Geoffroy MC
Psychiatry Res · 2026 Jun · PMID 41865642 · Publisher ↗
BACKGROUND: Non-suicidal self-injury (NSSI) is relatively common in adolescence and associated with mental health symptoms, yet the prevalence of NSSI and mental health correlates in childhood remain poorly understood. O...
BACKGROUND: Non-suicidal self-injury (NSSI) is relatively common in adolescence and associated with mental health symptoms, yet the prevalence of NSSI and mental health correlates in childhood remain poorly understood. OBJECTIVE: Document the lifetime prevalence of NSSI in elementary-school children and concurrent associations with self- and teacher-reported mental health symptoms and peer problems. METHODS: Cross sectional analysis of 859 children (mean age=10.9 years; n = 419 males) from 33 elementary schools in Quebec, Canada who completed a self-report measure of NSSI (5-item Self-Mutilation subscale; Self Harm Inventory) and self- and teacher-report measures of concurrent mental health, including depressive symptoms (Children's Depression Inventory-Short-Form; self-reported only), emotional distress, withdrawal, impulsive/hyperactive/inattentive behaviors, disruptive behaviors, prosocial behaviors, and peer relationship difficulties (victimization) (Social Behavior Questionnaire). Mental health symptoms were transformed into z-scores. RESULTS: Lifetime prevalence of NSSI (any method, at least once) was 28.2 %, with no sex differences between males (26.7 %) and females (29.4 %) (p=.403), with scratching being the most frequently reported method (17.2 %). Children reporting NSSI had significantly poorer mental health across indicators examined in both self- and teacher reports, although associations were generally smaller for teacher-reported symptoms. To illustrate, for 1 standard deviation increase in self-reported symptom scores, odds of NSSI were 2.31 times higher for depressive symptoms (95 % CI 1.82-2.92), and 1.70 times higher for peer victimization (95 % CI 1.46-1.99). Associations were stronger among children endorsing multiple NSSI methods compared to those reporting only one. CONCLUSION: NSSI (especially scratching) is present in late childhood and associated with worse mental health symptoms and peer problems.
Letter to editor on "Integrating expert knowledge into large language models improves performance for psychiatric reasoning and diagnosis".
Hadianfard H, Moshfeghinia R
Psychiatry Res · 2026 Jun · PMID 41863903 · Publisher ↗
Abstract loading — click title to view on PubMed.
The longitudinal mechanism of alexithymia and social cognition influencing depression: Based on cross-lagged panel network analysis and structural equation model.
Lu Y, Cao L, Yang H … +4 more , Tang M, Cao X, Jiao G, Yi J
Psychiatry Res · 2026 Jun · PMID 41863902 · Publisher ↗
BACKGROUND: Alexithymia and social cognitive deficits may be the risk factors of depression. Guided by the cognitive-development theory of emotional awareness, this study aims to construct an integrated framework to eluc...
BACKGROUND: Alexithymia and social cognitive deficits may be the risk factors of depression. Guided by the cognitive-development theory of emotional awareness, this study aims to construct an integrated framework to elucidate the dynamic relationships among alexithymia, social cognition and depression at the dimensional level. METHODS: A two-wave follow-up survey was conducted among 1651 college students. Participants completed measures assessing depression (CES-D), alexithymia (TAS-20), mentalization (MentS), and empathy (IRI-C). Data were analyzed using a combination of cross-sectional network analysis, cross-lagged panel network (CLPN) analysis, and structural equation modeling (SEM). RESULTS: (1) Both contemporaneous networks showed that depressed affect, difficulty identifying feelings (DIF) and motivation to mentalize had the highest strength centrality. (2) CLPN analysis showed that DIF at baseline predicted increases in difficulty describing feelings (DDF) and depressed affect, decreases in self-oriented mentalization over time. DIF had the highest out-Expected Influence (out-EI = 1.284); DDF had the highest in-Expected Influence (in-EI = 1.224); personal distress exhibited the highest Bridge Expected Influence (BEI = 0.150). (3) SEM revealed that DIF not only directly affected depression (β = 0.559, p < 0.001), but also through three indirect pathways: through self-oriented mentalization and personal distress (β = 0.128, p < 0.001), through DDF and motivation to mentalize (β = 0.159, p< 0.001), and through single motivation to mentalize (β = -0.125, p < 0.001). CONCLUSIONS: Difficulty identifying feelings is the core driver in the alexithymia-social cognition-depression network. The primary psychological mechanism involves difficulty identifying feelings eroding the capacity for self-oriented mentalization, which in turn fosters empathic personal distress, ultimately leading to depression.
Breaking the spline: Why distributed lag non-linear models miss thresholds in environmental psychiatry.
Oka S, Yamazaki T, Takefuji Y
Psychiatry Res · 2026 Jun · PMID 41861506 · Publisher ↗
This critique evaluates Monti et al.'s investigation into associations between air pollution, apparent temperature, and schizophrenia severity. While their findings indicate significant short‑ and medium‑term effects of...
This critique evaluates Monti et al.'s investigation into associations between air pollution, apparent temperature, and schizophrenia severity. While their findings indicate significant short‑ and medium‑term effects of PM and thermal stress on PANSS scores, several methodological limitations warrant caution. Their study relies on residential exposure assignments, which may not capture individual mobility or indoor environments, potentially introducing substantial exposure misclassification. Despite appropriately modeling delayed and non-linear effects, the DLNM's reliance on predefined spline structures may oversimplify the complex, synergistic interactions among atmospheric variables. Seasonal discrepancies-such as the absence of PM effects in autumn-winter-may reflect unmodeled dependencies or limited pollutant data, particularly for PM and black carbon. To address these constraints, future research should incorporate flexible, data‑driven approaches, particularly those capable of uncovering latent structures within environmental mixtures. Unsupervised feature‑clustering methods can identify correlated pollutant groupings and reduce dimensional noise, while rank‑based correlation metrics provide robust assessment of non‑linear dependencies that are often obscured by parametric spline specifications. These non‑parametric techniques can complement DLNM by capturing multivariate synergies and interaction patterns that rigid basis structures may overlook. Overall, integrating such approaches is essential for advancing analytical capacity and improving risk assessment for vulnerable psychiatric populations.
Telomere length in bipolar disorder: An updated meta-analysis of observational studies.
Hung TH, Chen IL, Huang YC … +1 more , Lin PY
Psychiatry Res · 2026 Jun · PMID 41861505 · Publisher ↗
BACKGROUND: Telomere length, a biological marker related to cellular aging, has been associated with several psychiatric conditions, including bipolar disorder (BD). However, previous meta-analyses were limited by small...
BACKGROUND: Telomere length, a biological marker related to cellular aging, has been associated with several psychiatric conditions, including bipolar disorder (BD). However, previous meta-analyses were limited by small sample sizes and substantial heterogeneity in measurement methods, sampling sources, and clinical characteristics. METHODS: We systematically searched Embase, MEDLINE, Cochrane CENTRAL, CINAHL, and Scopus for observational studies comparing telomere length between patients with BD and healthy controls. Random-effects models were used to estimate pooled effect sizes. Subgroup analyses were conducted according to sampling source, mood status, and measurement method. Meta-regression was performed to explore potential clinical moderators. The certainty of evidence was assessed using the GRADE approach. RESULTS: Thirty studies were included, comprising 5639 patients with BD and 226,358 healthy controls. Overall, BD was associated with shorter telomere length compared with controls (Hedges' g = -0.309, 95% CI -0.437 to -0.181). This association was observed in studies using peripheral blood leukocytes and lymphoblastoid cell lines, but not in studies using post-mortem brain tissue. Shorter telomere length was observed across studies sampling different mood states at the group level and in studies using qPCR or Southern blot methods, but not Q-FISH. Meta-regression revealed that the sex distribution difference between patients and control significantly moderated the magnitude of telomere length differences. CONCLUSION: This updated meta-analysis suggests an association between bipolar disorder and shorter telomere length at the group level. However, substantial heterogeneity and the observational nature of the included studies resulted in a very low certainty of evidence, warranting cautious interpretation.
Zonulin as an endophenotype for schizophrenia: A study in patients and unaffected siblings.
Sedef MM, Oruc EB, Bulut SD … +2 more , Hatil SI, Karadağ H
Psychiatry Res · 2026 Jun · PMID 41861504 · Publisher ↗
BACKGROUND: Zonulin, a key regulator of epithelial tight junctions, is implicated in intestinal and blood-brain barrier permeability and neuroinflammation. Although elevated zonulin is reported in schizophrenia, its expr...
BACKGROUND: Zonulin, a key regulator of epithelial tight junctions, is implicated in intestinal and blood-brain barrier permeability and neuroinflammation. Although elevated zonulin is reported in schizophrenia, its expression in unaffected siblings and status as an endophenotype remain unclear. We compared serum zonulin levels among patients with schizophrenia, unaffected siblings and healthy controls, investigating association with symptom severity and cognitive function. METHODS: This cross-sectional study included 43 patients with schizophrenia (SZ), 43 unaffected siblings (UAS), and 43 healthy controls (HC). Serum zonulin was measured via sandwich enzyme-linked immunosorbent assay (ELISA). Clinical symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS) and cognition with the Cognitive Assessment Interview-Turkish Version (CAI-TR). Group differences were examined using ANOVA/ANCOVA (adjusting for age, sex, BMI and smoking), and associations via Spearman correlations. RESULTS: Unadjusted serum zonulin levels (ng/mL) were higher in SZ (146.8 ± 11.5) and UAS (145.6 ± 9.7) compared with HC (140.1 ± 6.4). After adjustment for confounders, the SZ-HC difference remained significant, while the UAS-HC difference was no longer statistically significant. Correlations between zonulin and PANSS domains were null after FDR correction. Zonulin was not significantly associated with CAI-TR domains or total scores in patients or siblings (all p > 0.05). CONCLUSIONS: Elevated zonulin in schizophrenia, together with its unadjusted elevation in unaffected siblings and lack of robust association with symptom severity or cognition, suggests that zonulin may represent a candidate trait-related marker of gut-brain barrier dysfunction within an endophenotypic framework. However, the sibling finding was attenuated after adjustment for confounders and should be interpreted cautiously.
Comment on "Facial expression recognition in older adults with depression: A meta-analytic review".
Li Q, Lu X
Psychiatry Res · 2026 Jun · PMID 41855642 · Publisher ↗
We comment on the recent meta-analysis examining facial expression recognition (FER) in older adults with major depressive disorder (MDD). While the study provides an important quantitative synthesis at the intersection...
We comment on the recent meta-analysis examining facial expression recognition (FER) in older adults with major depressive disorder (MDD). While the study provides an important quantitative synthesis at the intersection of socioemotional aging and depression, several interpretative and methodological issues merit clarification. First, negative standardized mean differences were interpreted in parts of the discussion as reflecting heightened sensitivity to negative emotions, although reduced accuracy in forced-choice paradigms more directly indicates impaired decoding rather than hypersensitivity. Second, substantial heterogeneity was markedly reduced only after exclusion of influential studies, raising concerns that pooled effects may be contingent on study selection and potentially reflect methodological compression. Third, meta-regression findings suggest that sample size and stimulus modality meaningfully influence effect estimates, underscoring design-related variability. Finally, cognitive status was not formally modeled as a moderator, despite its potential relevance to emotion recognition performance in late-life depression. We suggest that clearer differentiation between perceptual deficit and interpretative bias, alongside greater attention to methodological and cognitive moderators, would strengthen theoretical inference and future meta-analytic work in this domain.
Longitudinal associations among childhood trauma, oxytocin, and metabolic risk in schizophrenia.
Goh KK, Chen PY, Chang HM … +5 more , Kanahara N, Chen C, Cheng MH, Yang CT, Lu ML
Psychiatry Res · 2026 Jun · PMID 41855641 · Publisher ↗
Childhood trauma has been consistently associated with adverse physical and metabolic outcomes in schizophrenia, yet the neurobiological mechanisms translating early-life adversity into long-term metabolic risk remain un...
Childhood trauma has been consistently associated with adverse physical and metabolic outcomes in schizophrenia, yet the neurobiological mechanisms translating early-life adversity into long-term metabolic risk remain unclear. Oxytocin, a stress-sensitive neuropeptide involved in metabolic regulation, may modulate stress-related metabolic vulnerability. In this 24-month prospective cohort study, 90 individuals with schizophrenia receiving stable antipsychotic monotherapy and 60 age- and sex-matched healthy controls underwent assessments of anthropometric measures, metabolic parameters, and plasma oxytocin levels at baseline and follow-up. Metabolic outcomes included Continuous Metabolic Syndrome Severity Scores (cMetS-S) and metabolic syndrome (MetS) incidence, while childhood trauma was assessed using the Childhood Trauma Questionnaire-Short Form with cross-validation interviews. Generalized estimating equations were applied to evaluate longitudinal associations, and moderation analyses tested oxytocin × childhood trauma interactions. Greater childhood trauma exposure was associated with lower plasma oxytocin levels (p = .001), higher body mass index (p < .001), and greater metabolic burden over time (p = .009). At 24-month follow-up, individuals with schizophrenia exhibited higher MetS incidence (p = .043) and higher cMetS-S (p = .006) compared with healthy controls.Lower oxytocin levels predicted increased MetS risk (OR = 0.27, p = .009). Importantly, a significant childhood trauma × oxytocin interaction (OR = 0.95, p = .018) indicated that higher oxytocin levels attenuated trauma-related metabolic deterioration. These findings suggest that oxytocinergic dysregulation may be involved in the association between early-life trauma and metabolic risk in schizophrenia and support oxytocin as a candidate biomarker associated with trauma-related metabolic vulnerability.
Role of depression and anxiety in the treatment modalities and age-stratified dementia risk in patients with schizophrenia, a real-world nationwide cohort study.
Li YW, Yeh TC, Chien WC … +3 more , Chung CH, Yang CC, Tzeng NS
Psychiatry Res · 2026 Jun · PMID 41849924 · Publisher ↗
BACKGROUND: Schizophrenia is associated with elevated dementia risk, yet large-scale epidemiological evidence from Asian populations remains scarce. This study aimed to quantify dementia incidence and identify its key pr...
BACKGROUND: Schizophrenia is associated with elevated dementia risk, yet large-scale epidemiological evidence from Asian populations remains scarce. This study aimed to quantify dementia incidence and identify its key predictors, with particular attention to psychiatric comorbidities and antipsychotic treatment modalities, in a nationwide cohort of patients with schizophrenia in Taiwan. METHODS: Using Taiwan's National Health Insurance Research Database (NHIRD), we conducted a nationwide retrospective cohort study encompassing 8480 patients with schizophrenia followed from 2000 to 2015 (mean follow-up: 9.5 years). Dementia incidence was compared between patients receiving long-acting injectable (LAI) and oral antipsychotics using Fine and Gray competing risk analysis. A 5-year washout period was incorporated to mitigate potential reverse causality bias. RESULTS: The cumulative dementia prevalence was 12.98% over the study period. Advanced age emerged as the primary risk factor. Comorbid anxiety (adjusted hazard ratio [aHR] = 2.77) and depression (aHR = 2.42) were independently associated with significantly elevated dementia risk, findings that remained robust after accounting for potential prodromal confounding. No statistically significant difference in dementia incidence was observed between the LAI and oral antipsychotic groups. CONCLUSIONS: Dementia risk among older patients with schizophrenia is substantially amplified in the presence of psychiatric comorbidities. The comparable cognitive trajectories observed across antipsychotic treatment modalities suggest that the underlying neuroprogressive pathology of schizophrenia may attenuate the anticipated adherence-related benefits of LAIs. These findings underscore the clinical imperative for heightened vigilance and support the integration of structured dementia screening into routine care for this vulnerable population.
Virtual reality-based Avatar Therapy for treatment-resistant major depressive disorder: A pilot study.
Giguère S, Potvin S, Fortier A … +5 more , Phraxayavong K, Lespérance F, Do A, Bahremand A, Dumais A
Psychiatry Res · 2026 Jun · PMID 41849923 · Publisher ↗
BACKGROUND: Major depressive disorder (MDD) is a common and disabling mental health condition, with a substantial proportion of patients failing to achieve symptom relief through standard pharmacological or psychotherape...
BACKGROUND: Major depressive disorder (MDD) is a common and disabling mental health condition, with a substantial proportion of patients failing to achieve symptom relief through standard pharmacological or psychotherapeutic treatments. Treatment-resistant depression (TRD), therefore, remains a significant clinical and public health challenge. To address this, our team developed Avatar Therapy, a virtual reality-based intervention with strong experiential and relational components. This pilot clinical trial aimed to evaluate the short-term efficacy of Avatar Therapy for TRD on 12 participants. METHODS: During therapy sessions, participants engaged in dialogue in virtual reality with an avatar representing a person who played a significant role in their depressive symptoms. The avatar was animated in real-time by the therapist. The primary outcomes were the rates of response and remission, along with depressive symptom severity. Secondary outcomes were severity of anxiety symptoms, self-esteem, quality of life, and functioning. Changes in these outcomes between the pre- and post-therapy assessment periods were analyzed using linear mixed-effects models. RESULTS: Among completers, the response rate was 80%, and the remission rate was 20%. At post-therapy, results showed a significant large reduction in depressive symptoms as measured both by self-report (d=1.48, p<0.001) and clinician-rated assessments (d=1.36, p<0.001). Moreover, large significant improvements were observed in the severity of anxiety (d=1.27, p<0.001), self-esteem (d=1.11, p=0.003), quality of life (d=1.42, p<0.001), and functioning (d=1.21, p=0.003). CONCLUSION: This unique psychotherapy shows promising preliminary results for treating individuals with TRD. Future trials should assess efficacity in larger controlled samples and its long-term out.
Prevalence and moderators of personality disorders in adults with ADHD: A meta-analysis.
Adamis D, Zhang T, Gavin B … +1 more , McNicholas F
Psychiatry Res · 2026 Jun · PMID 41849922 · Publisher ↗
This meta-analysis investigated the prevalence and moderators of personality disorders (PDs) in adults with Attention-Deficit/Hyperactivity Disorder (ADHD), synthesizing data from 11 studies encompassing 2120 participant...
This meta-analysis investigated the prevalence and moderators of personality disorders (PDs) in adults with Attention-Deficit/Hyperactivity Disorder (ADHD), synthesizing data from 11 studies encompassing 2120 participants across clinical and nonclinical settings. The results indicate a substantial but highly variable burden of personality pathology, with a pooled prevalence for the presence of at least one comorbid PD estimated at 57 % (95 % CI [42-71]). However, this figure was largely driven by specialized outpatient populations, and statistical heterogeneity was exceptionally high (I² > 90 %), suggesting that prevalence is deeply context-dependent. Among specific diagnoses, the highest co-occurrence rates were observed for Passive-Aggressive (25.3 %), Avoidant (23.1 %), and Borderline (21.9 %) personality disorders. Moderator analyses revealed that these estimates were significantly influenced by diagnostic methodology; structured clinical interviews (such as the SCID-II) and self-report inventories (like the MCMI) consistently yielded higher rates than standard clinical assessments. Furthermore, setting played a critical role, with ADHD-specific clinics showing significantly higher coexistence than prison or student samples. While tests for publication bias were non-significant, they were limited by low statistical power. Ultimately, these findings underscore the high frequency of personality-related impairment in adult ADHD while highlighting the challenges of "diagnostic noise" and phenotypic overlap. The extreme fluctuations in reported rates suggest that clinicians must look beyond categorical labels, acknowledging that the identified prevalence is often a byproduct of the specific instruments and clinical frameworks employed.
The longitudinal and reversible causal link between depressive symptoms and cardiovascular disease among middle-aged and older adults: findings from three national cohorts.
Tang X, Shen D, Li S … +6 more , Ge Y, Liu H, Sun T, Zhang C, Zhang H, Feng S
Psychiatry Res · 2026 Jun · PMID 41849921 · Publisher ↗
BACKGROUND: Although the association between depressive symptoms and cardiovascular disease (CVD) has been extensively studied, evidence for a long-term causal relationship remains sparse. This research employed advanced...
BACKGROUND: Although the association between depressive symptoms and cardiovascular disease (CVD) has been extensively studied, evidence for a long-term causal relationship remains sparse. This research employed advanced causal inference techniques to evaluate this longitudinal effect and its potential reversibility. METHOD: We analyzed data from 37,668 participants across three prospective cohorts: CHARLS (China), HRS (USA), and KLoSA (South Korea). Applying the Longitudinal Targeted Maximum Likelihood Estimation (LTMLE) method across five time points, we assessed the causal effect of depression (defined by CES-D scale cutoffs) on self-reported physician-diagnosed CVD. Subgroup analyses were conducted by gender and age. Multiple sensitivity analyses were conducted to validate the robustness of the findings. RESULTS: Across all cohorts, the risk of CVD significantly increased with longer follow-up durations under persistent depressive symptoms. For example, in CHARLS, the adjusted odds ratio (OR) increased from 1.570 (95% CI: 1.398-1.798) at Year 2 to 2.097 (95% CI: 1.659-2.651) by Year 9. Further analysis of different exposure sequences of depressive symptoms revealed that the risk of CVD increased gradually with a greater cumulative number of waves with depressive symptoms, whereas it decreased correspondingly with more waves without depressive symptoms, demonstrating a pattern consistent with reversible association. CONCLUSIONS: This multi-cohort study provides evidence for a longitudinal causal relationship between depressive symptoms and CVD, showing temporal cumulative effect and a risk pattern consistent with reversible association. These results highlight the need to integrate mental health care into CVD prevention.
Efficacy and safety of brexpiprazole in early-episode schizophrenia: post hoc analysis of Phase 3 clinical trials in adults and adolescents.
Correll CU, Yildirim M, Zhang Z … +3 more , Palma AM, Pham T, Pflug B
Psychiatry Res · 2026 Jun · PMID 41849920 · Publisher ↗
OBJECTIVE: To evaluate the efficacy and safety of brexpiprazole in patients with early-episode schizophrenia. METHODS: Data were pooled from four 6-week, randomized, double-blind, placebo-controlled trials in schizophren...
OBJECTIVE: To evaluate the efficacy and safety of brexpiprazole in patients with early-episode schizophrenia. METHODS: Data were pooled from four 6-week, randomized, double-blind, placebo-controlled trials in schizophrenia. Three trials (ClinicalTrials.gov identifiers: NCT01396421, NCT01393613, NCT01810380) enrolled adults aged 18-65 years; one trial (NCT03198078) enrolled adolescents aged 13-17 years. Data from participants meeting early-episode criteria (age 13-35 years, ≤5 years illness duration) were pooled for participants randomized to brexpiprazole 2-4 mg or placebo. Efficacy on schizophrenia symptoms was primarily evaluated using the Positive and Negative Syndrome Scale (PANSS; primary endpoint in all trials). Change in functioning was measured using the Personal and Social Performance (PSP) scale in adults and Children's Global Assessment Scale (CGAS) in adolescents. Safety was also assessed. RESULTS: Across 476 participants (brexpiprazole 2-4 mg/day, n = 289; placebo, n = 187), change from baseline to Week 6 was greater with brexpiprazole versus placebo on PANSS total score (least squares [LS] mean difference -3.6; 95% confidence interval [CI] -7.0, -0.1; p = 0.04; Cohen's d 0.19), and a combined PSP/CGAS functioning score (LS mean difference 2.3; 95% CI: 0.1, 4.5; p = 0.04; Cohen's d 0.19). The incidence of treatment-emergent adverse events (TEAEs) was 50.7% with brexpiprazole and 46.3% with placebo. The most common TEAEs with brexpiprazole were insomnia (brexpiprazole, 9.2%; placebo, 9.5%) and akathisia (brexpiprazole, 6.5%; placebo, 2.1%). CONCLUSION: This analysis expands the evidence base for brexpiprazole in schizophrenia by demonstrating efficacy in patients who are early in their disease course. The safety profile of brexpiprazole was consistent with previous clinical trials.
Belief in a just world and prolonged grief disorder among individuals bereaved by 9/11.
Fisher JE, Andersen CC, Zhou J … +4 more , Rice AJ, Ogle CM, Sumberg LL, Cozza SJ
Psychiatry Res · 2026 Jun · PMID 41844455 · Publisher ↗
BACKGROUND: Belief in a just world is the conviction that the world is fundamentally fair and that people deserve to be rewarded for admirable actions and punished for unjust actions. However, these beliefs can be challe...
BACKGROUND: Belief in a just world is the conviction that the world is fundamentally fair and that people deserve to be rewarded for admirable actions and punished for unjust actions. However, these beliefs can be challenged by a traumatic event, especially bereavement by a sudden and violent death, increasing the risk for Prolonged Grief Disorder (PGD). This study examined the association between belief in a just world and PGD among family members bereaved by the September 11, 2001 terrorist attacks. METHODS: 380 bereaved family members provided responses on a cross-sectional survey that included the Inventory of Complicated Grief (ICG) and the Global Belief in a Just World (BJW). Multivariable logistic regressions were used to examine associations between endorsed BJW items and meeting threshold for PGD. An interaction between BJW and relationship type to the deceased was also evaluated. RESULTS: A weaker belief in a just world (as indicated by higher scores) was associated with an increased risk of meeting the threshold for PGD among bereaved parents, but not among other relationships to the deceased. CONCLUSIONS: The death of a family member due to sudden and violent causes, especially when the decedent is a child, increases the risk for PGD. However, a stronger belief in a just world can potentially buffer against PGD. These findings highlight the need to incorporate perceptions of justice within the world as a potential therapeutic target for grief support.
Adverse childhood experiences and biological rhythms can predict the coexisting symptoms of depression and anxiety in adolescents.
Cui Y, Wu W, Liu Z … +8 more , Shen JJ, Ban X, Li R, Hu J, Zhou F, Zhang J, Lou X, Wang X
Psychiatry Res · 2026 Jun · PMID 41844454 · Publisher ↗
OBJECTIVE: Mental health in adolescents has been a growing problem in recent decades. However, comprehensive discussion of the research on the distal and proximal factors related to adolescent mental health were limited...
OBJECTIVE: Mental health in adolescents has been a growing problem in recent decades. However, comprehensive discussion of the research on the distal and proximal factors related to adolescent mental health were limited and the evidence was lacking. This study aimed to explore the result of adverse childhood experiences and biological rhythms for depressive and anxiety symptoms in adolescents. METHODS: The data used in this study were obtained from China in 2021 (as baseline) and 2023 (as follow-up). Participants provided self-reported information through an anonymous questionnaire. Logistic regression, cluster analysis, restriction cubic spline plots and receiver operating characteristic curves were used for statistical analysis. RESULTS: The study involved 2103 teenagers (mean age 15 years old), consisting of 1089 females and 1014 males. Multiple logistic regression results based on this subgroup showed that higher scores on either ACEs or biorhythms were associated with a greater risk of concurrent depressive-anxiety symptoms at baseline and follow-up, the adjusted ORs (95% CI) were 14.46 (7.14-29.26), 12.09 (5.83-22.08), respectively. The area under the receiver operating characteristic curve of the joint predictive effect of the ACEs and biorhythms were 0.664 for depressive symptoms, 0.656 for anxiety symptoms, and 0.667 for co-morbidity. CONCLUSION: These findings emphasize the necessity of balancing past risk factors with emerging risk factors (biorhythms) in the precaution and management of adolescent depression and anxiety symptoms problems.
Costs and cost-effectiveness of stepped, evidence-based and integrated care for common and persistent severe mental illness: Results of the RECOVER trial.
Zimmermann A, Kreis L, Janßen C … +14 more , Karow A, Schindler A, König H, Konnopka A, Brettschneider C, Peth J, Schulz H, Pepic A, Ozga AK, Zapf A, Gallinat J, König HH, Lambert M, Lüdecke D
Psychiatry Res · 2026 Jun · PMID 41833147 · Publisher ↗
RECOVER is a severity-stratified, evidence-based care model integrating multiple levels of mental illness. This analysis focuses on individuals with severe and persistent mental illness (SMI/SPMI) and complex care needs,...
RECOVER is a severity-stratified, evidence-based care model integrating multiple levels of mental illness. This analysis focuses on individuals with severe and persistent mental illness (SMI/SPMI) and complex care needs, who received outreach-based services through Assertive Community Treatment (ACT) and Crisis Resolution Teams (CRT) as core components of the RECOVER intervention. This study assesses cost-effectiveness from a societal perspective, informed by clinical outcomes. Three domains were analyzed: (1) societal costs over a 12-month follow-up were compared between RECOVER and treatment as usual (TAU) using adjusted generalized linear models; (2) cost-effectiveness was assessed by estimating the incremental cost-effectiveness ratio (ICER) and cost-effectiveness probabilities via net monetary benefit regressions; and (3) psychosocial functioning was assessed via linear mixed model for repeated measures. Among 891 randomized trial participants, 506 (56.8 %) met criteria for SMI/SPMI (RECOVER n = 252, TAU n = 254). RECOVER was associated with lower societal costs (-€6681; p < 0.01). Although outpatient costs increased (+€1593; p < 0.001), these were more than offset by inpatient cost savings (-€6382; p < 0.001), resulting in a substantial net cost reduction. The ICER revealed dominance of RECOVER compared to TAU; cost-effectiveness probabilities exceeded 99 % across varying willingness-to-pay thresholds. Effectiveness analyses showed improved psychosocial functioning in the RECOVER group relative to TAU. The RECOVER model, characterized by outreach-based care (ACT/CRT), demonstrated cost-effectiveness and reductions in inpatient service use. Results highlight the economic and structural benefits of shifting from inpatient to community-focused care for individuals with SMI/SPMI. RECOVER offers a scalable framework for sustainable mental health service reform and should inform future standard care models.
Letter to the Editor: Comment on "Workplace racial discrimination as a major public health threat: Association with depression, anxiety, stress and PTSD symptoms among racialized and Indigenous peoples in Canada".
Putra BJ
Psychiatry Res · 2026 Jun · PMID 41833146 · Publisher ↗
Abstract loading — click title to view on PubMed.
Classification of functional near-infrared spectroscopy (fNIRS) signals in schizophrenia and bipolar disorder using deep learning methods.
Mou L, Gong B, Tan Q … +5 more , Wang H, Zhang X, Cui R, Wang Z, Shen Z
Psychiatry Res · 2026 Jun · PMID 41831295 · Publisher ↗
BACKGROUND: Schizophrenia (SCZ) and Bipolar Disorder (BD) are prevalent mental disorders. This study uses functional near-infrared spectroscopy (fNIRS) combined with a verbal fluency task (VFT) to examine prefrontal func...
BACKGROUND: Schizophrenia (SCZ) and Bipolar Disorder (BD) are prevalent mental disorders. This study uses functional near-infrared spectroscopy (fNIRS) combined with a verbal fluency task (VFT) to examine prefrontal function in SCZ and BD patients, differentiating them via hemodynamic change analysis. It also applies deep learning and interpretability methods to assess fNIRS' reliability as a clinical diagnostic tool and potential for differential diagnosis during cognitive tasks. METHODS: A total of 50 SCZ, 67 BD patients and 52 healthy controls (HC) were enrolled. All underwent fNIRS to monitor prefrontal oxyhemoglobin (Oxy-Hb) concentration changes during VFT. Kruskal-Wallis test was used to compare Oxy-Hb changes across groups, with post-hoc attribution analysis to identify key fNIRS channels for classification. RESULTS: Relative to HC, SCZ and BD patients exhibited markedly reduced prefrontal cortex activity during VFT. SCZ patients had lower activation levels than BD patients in the rFPC, lFPC, lDLPFC and lOFC (all P < 0.05). The three-category classification accuracy for the whole brain was 0.933 ± 0.044, with a mean AUC of 0.988 ± 0.017. Attribution analysis identified channel 17 as the top contributor to SCZ-BD differentiation. CONCLUSION: The lOFC is expected to be the most critical neuroimaging biomarker for differentiating these two diseases. fNIRS has application value as an auxiliary diagnostic tool for mental diseases in clinical practice, and its diagnostic efficacy and clinical transformation potential are expected to be further enhanced when combined with deep learning technology.
Identification of a critical medication trajectory for depression risk in hypertension: A nationwide dual-cohort longitudinal study in china.
Zeng C, Jie B, Zhang J … +4 more , Tao L, Wang Y, Mei Z, Han L
Psychiatry Res · 2026 Jun · PMID 41831294 · Publisher ↗
The longitudinal relationship between antihypertensive medication patterns and depression risk remains controversial. This study aimed to identify distinct long-term medication trajectories among Chinese middle-aged and...
The longitudinal relationship between antihypertensive medication patterns and depression risk remains controversial. This study aimed to identify distinct long-term medication trajectories among Chinese middle-aged and older adults with hypertension and prospectively examine their association with incident depression. Using data from the China Health and Retirement Longitudinal Study (CHARLS), we constructed two independent cohorts. A primary analysis cohort included 4304 participants aged ≥45 years without baseline depression. Latent Class Growth Modeling was applied to individuals with baseline hypertension (n = 2477) to identify medication use trajectories across three survey waves (2011-2015). An independent validation cohort comprised individuals with new-onset hypertension and a persistently normotensive control group (total n = 1625). Incident depression was assessed using the CESD-10 scale. Associations were examined using Kaplan-Meier analysis and multivariable Cox proportional hazards models, with robustness assessed through multiple sensitivity analyses. In the primary analysis cohort, four medication trajectories were identified. The transition from non-use to use had the highest cumulative incidence of depression (39.3%) and was the only trajectory significantly associated with increased depression risk after full adjustment (Hazard Ratio [HR]=1.389, 95% Confidence Interval [CI]: 1.180-1.635). This association was confirmed in the validation cohort (HR=1.761, 95% CI: 1.159-2.676) and remained consistent across all sensitivity analyses. These findings indicate that the transition from medication non-use to use represents a significant risk factor for incident depression, identifying a critical behavioral window for targeted monitoring and integrated mental health intervention in hypertension management.
The role of serum BDNF levels in cognitive dysfunction among psychiatric disorders.
Xiao D, Zhu C
Psychiatry Res · 2026 Jun · PMID 41825398 · Publisher ↗
Brain-derived neurotrophic factor (BDNF) is a key regulator of neuroplasticity, synaptic integrity and cognitive function and its dysregulation has been implicated across major psychiatric disorders. However, its transdi...
Brain-derived neurotrophic factor (BDNF) is a key regulator of neuroplasticity, synaptic integrity and cognitive function and its dysregulation has been implicated across major psychiatric disorders. However, its transdiagnostic association with cognitive performance remains incompletely understood. In this cross-sectional study, 160 participants were examined, including individuals with schizophrenia (SCZ), bipolar disorder (BD), major depressive disorder (MDD) and healthy controls (HC) (n = 40 per group). Serum BDNF concentrations were measured using enzyme-linked immunosorbent assay (ELISA). Cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA), Trail Making Tests (TMT-A/B) and Digit Span (Forward/Backward). Significant group differences were observed for both serum BDNF levels and cognitive performance. Serum BDNF concentrations were lowest in SCZ (18.2 ± 4.6 ng/mL) and MDD (19.5 ± 5.1 ng/mL), intermediate in BD (23.7 ± 5.9 ng/mL) and highest in HC (26.3 ± 6.2 ng/mL) (F(3156) = 15.47, p < 0.001). Cognitive impairment followed a parallel gradient, with SCZ exhibiting the most severe deficits (p < 0.001). Across the full cohort, serum BDNF showed moderate positive associations with global cognition (MoCA: r = 0.42, p < 0.001) and working memory (Digit Span Backward: r = 0.38, p < 0.001) and a negative association with executive dysfunction as indexed by TMT-B completion time (r = -0.46, p < 0.001). These findings indicate that serum BDNF is modestly but consistently associated with cognitive performance across major psychiatric disorders, supporting its role as a transdiagnostic neurobiological correlate of impaired neuroplasticity rather than a disorder-specific or deterministic biomarker.
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