Psychiatry Res [JOURNAL]
Sun
200 papers
The efficacy of virtual reality interventions for depressive disorder due to another medical condition: A three-level meta-analysis.
He X, Wang Z, Yang X … +2 more , Zhou Y, Yang J
Psychiatry Res · 2026 Jul · PMID 42000599 · Publisher ↗
BACKGROUND: Depressive Disorder Due to Another Medical Condition significantly impairs treatment adherence and quality of life. While established treatments face limitations like adverse drug reactions and poor adherence...
BACKGROUND: Depressive Disorder Due to Another Medical Condition significantly impairs treatment adherence and quality of life. While established treatments face limitations like adverse drug reactions and poor adherence, Virtual Reality (VR) has emerged as a promising tool due to its immersive and controllable nature. However, systematic evidence on its efficacy and optimal parameters is insufficient. METHODS: A systematic search was conducted across multiple databases from inception to July 31, 2025. Following PRISMA guidelines, 21 randomized controlled trials (27 effect sizes) were included. A three-level meta-analysis using Hedges' g was performed in R, employing a random-effects model to pool effect sizes, followed by heterogeneity, publication bias, and moderator analyses. RESULTS: VR intervention demonstrated a moderate and significant therapeutic effect (g = -0. 446, 95% CI [-0. 727, -0. 166], p = 0. 0036). Moderator analyses showed significantly greater effects for patients under 60 years (g = -0. 595) than for older patients (g = -0. 295). High-frequency intervention (≥5 sessions/week, g = -0. 743) was superior to low-frequency (<5 sessions/week, g = -0. 207). Short-duration sessions (≤20 min, g = -0. 529) outperformed longer sessions (>20 min, g = -0. 344). Gamified design (g = -0. 688) yielded larger effects than virtual scene construction (g = -0. 242). All between-group differences were significant (p < 0. 05). CONCLUSIONS: VR effectively alleviates this depressive disorder. Optimal outcomes are achieved with high-frequency, short-duration, game-based protocols, particularly for younger patients (<60 years), supporting personalized VR strategies in clinical practice.
Domain-specific hopelessness and near-term suicide risk: Evidence from ecological momentary assessment in a high-risk clinical sample.
Zank A, Knetter J, Rogers ML … +3 more , Sharma P, Peck R, Muehlenkamp JJ
Psychiatry Res · 2026 Jul · PMID 42000598 · Publisher ↗
INTRODUCTION: Hopelessness is a well-established correlate of suicidal thoughts and behaviors, yet most research conceptualizes it as a global construct. Less is known about how hopelessness within specific life domains...
INTRODUCTION: Hopelessness is a well-established correlate of suicidal thoughts and behaviors, yet most research conceptualizes it as a global construct. Less is known about how hopelessness within specific life domains relates to near-term suicide risk and whether general hopelessness accounts for these associations. This study examined these relationships using ecological momentary assessment (EMA). METHODS: Twenty-six adults (M age = 35.6, SD = 14.36) receiving outpatient therapy who reported suicidal ideation in the past two weeks completed EMA prompts three times daily for 21 days, yielding 1309 observations. At each prompt, participants rated hopelessness across six domains (work, partner, social/friends, home/family, finances, health), general hopelessness, and suicidal urge intensity. Within-person multi-level indirect effect models tested whether general hopelessness accounted for associations between domain-specific hopelessness and concurrent suicidal urges. RESULTS: Hopelessness specific to work, partner, social/friends, home/family, and health were positively concurrently associated with both general hopelessness and suicidal urges. General hopelessness also predicted suicidal urges. After adjusting for general hopelessness, direct effects persisted for social/friends and home/family, whereas effects for work, health, and partner became nonsignificant. Financial hopelessness was not significantly related to concurrent suicidal urges. CONCLUSION: Findings suggest that domain-specific hopelessness fluctuates proximally with suicidal urges and contributes to general hopelessness in shaping suicide risk. Assessing both general and domain-specific hopelessness may improve short-term risk evaluation and inform targeted interventions for high-risk clinical populations.
Digital self-harm among adolescents in China: Latent profiles, correlates, and its relationship with suicidal behaviors.
Sun M, Wu C, Xu B … +1 more , Wang D
Psychiatry Res · 2026 Jul · PMID 42000597 · Publisher ↗
BACKGROUND: To explore the latent profiles of digital self-harm among Chinese adolescents and to examine between-profile differences in sample characteristics and psychological variables, as well as their associations wi...
BACKGROUND: To explore the latent profiles of digital self-harm among Chinese adolescents and to examine between-profile differences in sample characteristics and psychological variables, as well as their associations with suicidal behaviors. METHODS: A total of 5655 adolescents (mean age = 16.26 ± 0.82 years; 53.2% male) were recruited from 27 April to 19 May 2025. All participants completed self-report web-based questionnaires covering demographic characteristics, lifestyle variables, depressive symptoms, cyber-victimization, digital self-harm, physical self-harm, and suicidal behaviors. Latent profile analysis and logistic regression analysis were used to analyze the data. RESULTS: Three latent profiles of digital self-harm in adolescents were identified: high digital self-harm (7.0%), inner self-emotion harm (11.2%), and low digital self-harm (81.8%). Multivariate logistic regression indicated that sex, grade, parental marital status, history of mental disorders, and smoking status distinguished the digital self-harm subtypes. Short sleep duration, depressive symptoms, and cyber-victimization were risk factors for digital self-harm (p < 0.05). After controlling for covariates, both high digital self-harm and inner self-emotional harm were associated with physical self-harm and suicidal behaviors. Notably, inner self-emotional harm demonstrated a unique association with suicidal ideation (OR = 2.00, 95% CI = 1.60-2.51) and suicide attempts (OR = 1.70, 95% CI = 1.10-2.61) even after additionally controlling for physical self-harm. CONCLUSIONS: Healthcare and educational professionals should prioritize early screening for digital self-harm, promptly identify high-risk groups, and provide targeted psychological counselling and support to safeguard adolescent mental health and prevent suicide.
Characterization of medical and recreational cannabis use among U.S. adults: Results from a nationally representative sample.
Secades-Villa R, González-Roz A, Belisario KL … +2 more , Martins SS, MacKillop J
Psychiatry Res · 2026 Jul · PMID 42000596 · Publisher ↗
This study estimates the prevalence and correlates of medical cannabis use (MCU), recreational cannabis use (RCU) and combined medical + recreational cannabis use (MRCU) among U.S. adults. We analyzed data from the sub-s...
This study estimates the prevalence and correlates of medical cannabis use (MCU), recreational cannabis use (RCU) and combined medical + recreational cannabis use (MRCU) among U.S. adults. We analyzed data from the sub-sample of adults aged 18 or older who had used cannabis in the past year (N = 12,706), drawn from the 2022 National Survey on Drug Use and Health (NSDUH). Descriptive and bivariate analyses were conducted to identify the correlates of MCU, RCU and MRCU. A total of 11.14% reported MCU, 83.02% RCU, and 5.83% MRCU. Past-year cannabis use disorder (CUD) prevalence was higher for MRCU (43.61%) compared to MCU (34.43%) and RCU (28.85%), and for MCU compared to RCU (ps<0.001). Individuals reporting MRCU were more likely to report past year serious psychological distress and any past year illegal drug use in comparison to those reporting strictly recreational or medical use (ps<0.05), and were also more likely to report past year major depressive episode (p<.05), receiving treatment for mental health in the past year (p<.05), and more days of cannabis use in the past month than people who only used cannabis recreationally (p<.001). In summary, adults who reported MRCU have a higher prevalence of CUD and endorsed worse mental health relative to people reported RCU and MCU, especially in comparison with RCU. This underscores the importance of physicians accurately selecting patients who will be good candidates for medical cannabis, regularly conducting assessments for CUD and other mental disorders, and, when necessary, referring patients to appropriate services.
Speech-in-noise perception and spectro-temporal resolution in obsessive-compulsive disorder.
Çağal Karabulut E, Çetin Kara H, Yaman AY … +2 more , Kılıç A, Özcebe E
Psychiatry Res · 2026 Jul · PMID 41997035 · Publisher ↗
AIM: This study aimed to evaluate speech-in-noise perception and spectro-temporal resolution skills in individuals with obsessive-compulsive disorder (OCD). METHOD: A total of 84 adults participated: 42 individuals with...
AIM: This study aimed to evaluate speech-in-noise perception and spectro-temporal resolution skills in individuals with obsessive-compulsive disorder (OCD). METHOD: A total of 84 adults participated: 42 individuals with OCD and 42 healthy controls. Participants had an OCD diagnosis for at least six months and no additional neurological, psychiatric, or organic conditions. All had normal hearing. Speech-in-noise perception was assessed with the Turkish Matrix Test (TURMatrix), spectral resolution with the Spectral-Temporally Modulated Ripple Test (SMRT), and temporal resolution with the Gap-In-Noise Test (GIN). OCD severity was measured using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), while depression and anxiety levels were evaluated with the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). Independent t-tests were used for between-group comparisons, multiple linear regression examined predictors of auditory performance, and ANCOVA assessed the effects of group and auditory factors on TURMatrix outcomes. RESULTS: Significant differences were observed between groups in TURMatrix adaptive SNR scores and in both GIN threshold and GIN performance (p < 0.05), while SMRT scores did not differ between groups. Within the OCD group, OCD duration significantly predicted GIN thresholds, whereas Y-BOCS, BDI, and BAI scores showed no significant influence. ANCOVA indicated that both group and SMRT scores significantly predicted TURMatrix critical SNR values, explaining 26% of the variance. CONCLUSION: This study demonstrates that individuals with OCD exhibit deficits in speech perception in noise alongside a selective weakness in temporal resolution; however, spectral resolution appears to remain intact. This selectivity offers a compelling explanation for why speech perception in noise is particularly challenging in OCD and suggests that the commonly reported sensitivity to background noise may stem, at least in part, from an objective timing-related processing deficit. These findings delineate potential targets for auditory-cognitive rehabilitation and highlighting the need for further large-scale studies.
Autistic children and their parents during war - A mixed-methods study.
Aviran SG, Nitzan T, Rozenblat S … +6 more , Graucher T, Ophir S, Vaisman TM, Lifshits TM, Rum Y, Koller J
Psychiatry Res · 2026 Jul · PMID 41997034 · Publisher ↗
This mixed-methods study examined the psychological effects of war exposure on autistic and non-autistic children and their parents following the October 7th, 2023, terrorist attack and the ensuing Israel-Hamas War. Prio...
This mixed-methods study examined the psychological effects of war exposure on autistic and non-autistic children and their parents following the October 7th, 2023, terrorist attack and the ensuing Israel-Hamas War. Prior research shows that children exposed to war have elevated risk for post-traumatic stress symptoms (PTSS), with autistic children being particularly vulnerable. In this study, 72 parents of children aged 3-17 (38 of autistic children, 34 of non-autistic children) completed standardized measures assessing child PTSS, parental PTSS, depression, anxiety, stress, and resilience. A subsample of 22 parents (12 of autistic children) also answered open-ended questions, which were analyzed qualitatively. Quantitative findings indicated that parents of autistic children reported significantly higher levels of depression, anxiety, and PTSS than parents of non-autistic children. Similarly, autistic children showed higher PTSS than non-autistic children. In the full sample, parental PTSS and anxiety significantly predicted child PTSS. When analyzed separately, parental PTSS was the strongest predictor among families of autistic children, while parental stress predicted child PTSS in families of non-autistic children. Qualitative analysis identified four themes in parents' and their children's experiences: Difficulties, Coping Resources, Routine, and Functioning. Parents of autistic children emphasized their children's behavioral regression, emotional distress, and reliance on routine and specialized support, while parents of non-autistic children described their own psychological challenges. These findings emphasize the unique vulnerabilities faced by autistic children and their parents in times of war and highlight the need for tailored mental health and community-based support that address the specific needs of those families.
Social disconnection and health among refugees in a low-resource setting: A longitudinal study.
Kurt G, Specker P, Liddell B … +6 more , Keegan D, Nandyatama R, Yuanita A, Rachmah RA, Hoffman J, Nickerson A
Psychiatry Res · 2026 Jul · PMID 41997033 · Publisher ↗
BACKGROUND: Social disconnection- social isolation and loneliness- is global public health concern, adversely impacting mental and physical health. There is an urgent need to expand the evidence base with studies focused...
BACKGROUND: Social disconnection- social isolation and loneliness- is global public health concern, adversely impacting mental and physical health. There is an urgent need to expand the evidence base with studies focused on at-risk populations in low-resource contexts. This study aimed to examine the longitudinal association of social disconnection and health outcomes (probable depression and post-traumatic stress disorder (PTSD), and general health), and to identify its individual and social determinants among refugees in a low-resource context. METHOD: A longitudinal study involving 1235 culturally and linguistically diverse refugees was conducted over a 2-year period across four time points. Social disconnection, probable depression and PTSD, and general health were measured using self-report instruments across four time points over two years (six-month intervals). Generalised Linear Mixed Models were used to examine whether social disconnection at the previous time point predicts health outcomes at the subsequent time point over a 2-year period. Linear regression was used to identify individual, social, and contextual factors associated with experiencing greater social disconnection. RESULTS: Social disconnection at the previous time-point was associated with increased odds of probable depression (OR = 1.41, 95% CI 1.32, 1.51), PTSD (OR = 1.29, 95% CI 1.20, 1.39), and poor health (OR = 0.86, 95% CI 0.81, 0.92) at the subsequent time point, after adjusting for the prior levels of these outcomes. Younger age (β = - 0.01, p = 0.031), higher education (β = - 0.23, p = 0.026), family separation (β = 0.29, p < 0.001), traumatic experiences (β = 0.03, p = 0.003), longer time in the protracted displacement settings (β = 0.05, p = 0.030), and post-displacement stressors (β = 0.99, p < 0.001) significantly predicted higher social disconnection at baseline. CONCLUSION: This study highlights the significant health risk associated with social disconnection among refugees in a low-resource setting. Multilevel interventions addressing individual, social, and contextual factors are needed to tackle social disconnection and improve health among refugees.
What would feeling better mean to you? Understanding patient language used for PTSD treatment improvement.
Grubbs KM, Matteo RA, Ranney RM … +2 more , Hamblen JL, Larsen SE
Psychiatry Res · 2026 Jul · PMID 41997032 · Publisher ↗
Patients undergoing shared decision-making (SDM) for posttraumatic stress disorder (PTSD) treatment rank treatment effectiveness as a top consideration, yet little is known about how clinicians can best convey this infor...
Patients undergoing shared decision-making (SDM) for posttraumatic stress disorder (PTSD) treatment rank treatment effectiveness as a top consideration, yet little is known about how clinicians can best convey this information. The goal of this study is to explore preferences for language around "getting better" from PTSD. Survey participants who screened positive for PTSD (n = 887) completed open- and closed-ended questions about ways of describing PTSD recovery. Half of the sample rated terminology like "no longer meets criteria for PTSD" or "PTSD remission" based on how well the language captured their general views of recovery and then rated how these terms would apply to their own experiences. The other half of the sample rated specific indicators of recovery (e.g., no longer have a PTSD diagnosis) and completed an open-ended question asking them to describe what recovery would look like. Participants rated the terms "no longer have PTSD" and "cured" as showing the most recovery and endorsed "PTSD recovery" and "symptom reduction" as terms they would more often use to describe their own recovery. When asked about which recovery terms would help them to choose a treatment, participants rated most examples very positively; however, fewer than half endorsed "no longer have a PTSD diagnosis." Open-ended responses focused on symptom reduction, quality of life, and functioning, with a small subset noting uncertainty about their potential to "get better." The majority of respondents focused on dimensional rather than categorical descriptions of improvement, valuing symptom reductions, better quality of life, and improved functioning.
A diffusion MRI-derived perivascular metric related to glymphatic-associated processes in bipolar disorder vulnerability: Multimodal correlates across emotion dysregulation patients and offspring.
Pascucci A, Delavari F, Ville DV … +3 more , Eliez S, Piguet C, Saccaro LF
Psychiatry Res · 2026 Jul · PMID 41990523 · Publisher ↗
Bipolar disorder (BD) is characterized by marked emotion dysregulation and high familial risk. Identifying early biological markers of vulnerability in BD, including unaffected offspring, is critical to improve risk stra...
Bipolar disorder (BD) is characterized by marked emotion dysregulation and high familial risk. Identifying early biological markers of vulnerability in BD, including unaffected offspring, is critical to improve risk stratification and intervention, and glymphatic-associated processes may contribute to this vulnerability. We examined 237 participants, including 97 patients with emotion dysregulation disorders (EDD; 34 BD, 33 borderline personality disorder [BPD], 30 attention-deficit/hyperactivity disorder [ADHD]), 67 offspring of EDD patients (EDDoff; including 23 BD offspring [BDoff]), and 73 healthy controls (CTRL). All participants underwent clinical assessments, diffusion and resting-state functional MRI, and serum immune and neurotrophic biomarker sampling. Perivascular diffusion was estimated using diffusion tensor imaging analysis along the perivascular space (DTI-ALPS), a diffusion-derived perivascular metric proposed to relate to glymphatic-associated processes, and compared across groups. To explore multimodal correlates of DTI-ALPS, principal component analyses (PCA) were conducted across clinical, biological, and neuroimaging domains. BD patients and BDoff showed significantly reduced DTI-ALPS compared with CTRL, ADHD, and BPD, supporting its potential role as a vulnerability-related imaging feature for BD. By contrast, ADHD and BPD showed comparable or higher DTI-ALPS relative to controls. Across participants, DTI-ALPS was associated with components reflecting white matter integrity and serum immune and neurotrophic markers. Within BD, lower DTI-ALPS correlated with more manic episodes and poorer working memory. Reduced DTI-ALPS may represent a BD-specific vulnerability-related feature, observable in both patients and at-risk offspring, and not shared by other emotion dysregulation disorders. Multimodal associations with white matter, inflammation, and symptoms underscore its relevance for risk stratification in high-risk populations.
Alcohol use disorder and emotional processing patterns: Insights from a systematic review.
Camacho-Ruiz JA, Galvez-Sánchez CM, Martins AT … +2 more , Ros A, Limiñana-Gras RM
Psychiatry Res · 2026 Jul · PMID 41990522 · Publisher ↗
BACKGROUND: Alcohol use and misuse represent a significant public health issue associated with physical, psychological, emotional, and neurological risks. This systematic review aims to explore emotional processing in in...
BACKGROUND: Alcohol use and misuse represent a significant public health issue associated with physical, psychological, emotional, and neurological risks. This systematic review aims to explore emotional processing in individuals with alcohol use disorder (AUD) through both a gender-informed perspective and an intersectional approach, to identify potential targets for intervention. METHODS: This systematic review was conducted following the Cochrane Collaboration guidelines and reported based on the PRISMA guidelines. The review protocol was previously registered in PROSPERO. The literature search was carried out across the PubMed, Scopus, and Web of Science databases, resulting in the inclusion of 11 studies after the screening process. RESULTS: Individuals with AUD consistently exhibit impairments in social and emotional cognition, particularly in tasks involving emotional facial recognition. These deficits extend to broader neuropsychological domains, such as working memory and spatial frequency processing. They demonstrate attentional biases, including difficulties disengaging from alcohol-related cues and reduced accuracy in interpreting emotional facial expressions. Theory of Mind (ToM) -especially its affective components- and empathy are significantly impaired in individuals with AUD, with the duration of problematic alcohol use being the strongest predictor of impaired ToM reasoning. Neuroimaging studies corroborate these findings, revealing decreased fusiform gyrus activity in response to emotional faces, increased pallidum activation to alcohol-related cues, reduced hippocampal network efficiency, lower occipito-temporal sensitivity to emotional stimuli, heightened striatal reactivity to alcohol cues, and diminished activation in the inferior frontal gyrus. Although gender-specific neural differences in the processing of emotional facial expressions in individuals with AUD have been reported, there is a lack of studies in this field, and social and cultural variable are often overlooked in the analysis. CONCLUSIONS: Deficits in social and emotional processing among individuals with AUD may present significant barriers to achieving and maintaining abstinence, ultimately diminishing the effectiveness of therapeutic interventions. These findings underscore the need for comprehensive treatment approaches that address social and emotional cognitive impairments as integral components of recovery, incorporating both a gender perspective and an intersectional framework.
Multivariate machine learning regression approaches to predict adolescent suicide risk.
Liu Y, Pan Y, Wang F … +3 more , Li W, Gao L, Zhao G
Psychiatry Res · 2026 Jul · PMID 41990521 · Publisher ↗
BACKGROUND: Suicide is a leading cause of death among adolescents, yet most prediction models rely on binary classification and limited predictors, failing to capture the complexity of suicide risk. This study aimed to d...
BACKGROUND: Suicide is a leading cause of death among adolescents, yet most prediction models rely on binary classification and limited predictors, failing to capture the complexity of suicide risk. This study aimed to develop a more accurate and comprehensive prediction model using machine learning regression with a broad set of psychological and behavioral variables. METHOD: A total of 2241 adolescents were recruited from school settings and completed self-report questionnaires assessing 31 variables. Three machine learning regression algorithms: Lasso regression, support vector regression, and random forest regression were applied. Model performance was evaluated using the coefficient of determination (R²). To obtain robust estimates of predictive performance, all three models were evaluated using a 10-fold cross-validation procedure. RESULTS: (1) 13 features were selected by the Lasso regression from the original set of 31 suicide risk-related variables; (2) Among the three models tested, the random forest regression model demonstrated the best predictive performance, with an R² of 0.61 [95 % CI: 0.60, 0.62]; (3) Further analysis revealed that the five most important predictors of suicide risk were depression, emotion regulation, perceived burdensomeness, non-suicidal self-injury, and family function. CONCLUSION: A multivariate, integrative approach significantly improves the accuracy and precision of suicide risk prediction among school-based community sample. Beyond depression and emotion-related factors, perceived burdensomeness, non-suicidal self-injury, and family function also played important roles in predicting suicide risk, suggesting that these variables should be considered in future screening frameworks to improve early detection and targeted intervention.
Glymphatic Dysfunction in bipolar disorder: A scoping review and integrative pathophysiological framework.
Shan Z, Zhu Q, Wang S … +3 more , Xia Y, Yang Y, Tian L
Psychiatry Res · 2026 Jul · PMID 41985281 · Publisher ↗
The glymphatic system is a brain-wide perivascular clearance pathway increasingly implicated in neurodegenerative and neuropsychiatric disorders. This scoping review examines its potential role in bipolar disorder (BD),...
The glymphatic system is a brain-wide perivascular clearance pathway increasingly implicated in neurodegenerative and neuropsychiatric disorders. This scoping review examines its potential role in bipolar disorder (BD), synthesizes evidence linking glymphatic function to BD, and outlines a testable integrative framework connecting glymphatic disruption with key clinical and biological features of the disorder. Preliminary neuroimaging work indicates that individuals with BD show alterations in glymphatic-related indices, including diffusion-based and volumetric measures, some of which correlate with illness duration and regional gray matter volumes. Complementary molecular and cellular findings suggest that activation of the hypothalamic-pituitary-adrenal (HPA) axis, neuroimmune signaling, and neuroinflammatory activity may perturb astrocytic aquaporin-4 (AQP4) and related markers in cerebrospinal fluid (CSF) and choroid plexus (CP), providing a mechanistically plausible link between chronic stress biology and impaired brain waste clearance. AQP4-bearing extracellular vesicles in CSF have emerged as a putative indicator of astrocyte stress in BD. Preclinical work further indicates that lithium can modulate circadian properties of the CP clock, blood-brain barrier (BBB) integrity, and AQP4-related indices, raising the possibility that aspects of its therapeutic profile are mediated through effects on glymphatic pathways. Although indirect and methodologically heterogeneous, current evidence supports glymphatic dysfunction as a candidate mechanism integrating sleep-wake cycle, stress-related and immune processes, astrocytic pathology, and progressive structural and cognitive changes in BD. The framework proposed here is intended to guide hypothesis generation and future longitudinal, multimodal, and mechanistic studies aimed at developing glymphatic-informed biomarkers and intervention targets.
A real-world pharmacovigilance study of Xanomeline-Trospium events in the FDA adverse event reporting system (FAERS).
Song X, Feng T, Lin H … +2 more , Qian H, Ji J
Psychiatry Res · 2026 Jul · PMID 41985280 · Publisher ↗
BACKGROUND: Xanomeline-Trospium (Cobenfy®) improves cognitive function in schizophrenia, yet its post-marketing reporting patterns remain incompletely characterized. This hypothesis-generating pharmacovigilance study exp...
BACKGROUND: Xanomeline-Trospium (Cobenfy®) improves cognitive function in schizophrenia, yet its post-marketing reporting patterns remain incompletely characterized. This hypothesis-generating pharmacovigilance study explores adverse event associations during its first year on market. OBJECTIVE: To characterize disproportionate reporting patterns and generate hypotheses for clinical monitoring strategies, acknowledging the inherent limitations of spontaneous reporting data. METHODS: Adverse event reports from Q4 2024-Q3 2025 were analyzed using disproportionality methods (ROR, PRR, BCPNN) and temporal distribution analysis. A dual-track approach incorporated both statistical signal detection (n ≥ 3) and descriptive surveillance of rare serious events (n < 3). RESULTS: Of 1142 reports, urinary and neurological events exhibited the strongest statistical disproportionality: urinary retention (ROR=45.63, 95% CI: 35.97-57.87) and hypersalivation (ROR=64.39, 95% CI: 43.25-95.85). Psychiatric events were frequently reported but showed weaker specificity, likely reflecting disease confounding rather than drug-induced effects. Treatment non-adherence showed elevated reporting (ROR=7.58), potentially associated with psychiatric symptomatology. Time-to-onset analysis suggested acute-phase reporting concentration (median 2 days; 45.4% of non-day-0 events occurring within days 1-7). CONCLUSION: These findings suggest disproportionate reporting patterns for urinary, neurological, and psychiatric events associated with Xanomeline-Trospium. While these signals warrant further validation through prospective cohort studies, they offer complementary real-world context for clinical decision-making. Active monitoring during initial treatment weeks may be prudent, particularly among patients with renal impairment or concomitant anticholinergic use.
Cross-national comparison of depression and risk of diabetes in South Korea and the US: a nationwide representative comparative study.
Joo H, Choi T, Park S … +6 more , Oh J, Park J, Son Y, Fond G, Boyer L, Yon DK
Psychiatry Res · 2026 Jul · PMID 41967196 · Publisher ↗
BACKGROUND: Although a bidirectional relationship between depression and diabetes has been suggested, evidence remains limited across cultural contexts. This study compared the association between depression and diabetes...
BACKGROUND: Although a bidirectional relationship between depression and diabetes has been suggested, evidence remains limited across cultural contexts. This study compared the association between depression and diabetes in South Korea and the US. METHODS: We used data from the Korea National Health and Nutrition Examination Survey (KNHANES; 2014, 2016, 2018, and 2020) and the US National Health and Nutrition Examination Survey (NHANES; 2013-2020). Adults aged ≥20 years were included from KNHANES and NHANES. Depression was defined as a PHQ-9 score ≥10, and diabetes as fasting glucose ≥126 mg/dL, HbA1c ≥6.5%, or a physician diagnosis. Each dataset was analyzed independently using weighted quantile sum (WQS) regression and multivariable logistic regression to estimate weighted odds ratios (wORs) and 95% confidence intervals (CIs), incorporating subgroup interactions and restricted cubic spline analyses. RESULTS: This analysis included 16,964 adults from KNHANES (69.30% female) and 10,073 adults from NHANES (52.13%). Depression was associated with higher odds of diabetes in South Korea (wOR 1.46, [95% CI 1.19-1.80]) but not in the US (1.26, [0.96-1.64]). Across both cohorts, significant positive associations between depression and diabetes were consistently observed among females, adults aged 45-64 years, frequent alcohol consumers, never-smokers, individuals without CVD, and those with obesity. WQS regression revealed that sleep-related symptoms carried the greatest weight in both South Korea (weight=0.18) the US (weight=0.15). CONCLUSIONS: Depression is independently associated with higher odds of diabetes in South Korea, but not the US. In both countries, sleep problems showed the highest relative contribution among depressive symptoms, suggesting a potential target for future intervention research.
Changes in serum Nogo-A and BDNF levels following treatment in drug-naive first-episode schizophrenia: A naturalistic prospective study.
Dudaklı BB, Uzel HK, Ocak MS … +3 more , Esen Öksüzoğlu M, Levent Çıraklı Z, Karamustafalıoğlu N
Psychiatry Res · 2026 Jul · PMID 41962339 · Publisher ↗
BACKGROUND: Neuroplasticity dysregulation is implicated in the early pathophysiology of schizophrenia. Nogo-A, a myelin- and neuron-associated inhibitor of structural plasticity, has been less studied in first-episode sc...
BACKGROUND: Neuroplasticity dysregulation is implicated in the early pathophysiology of schizophrenia. Nogo-A, a myelin- and neuron-associated inhibitor of structural plasticity, has been less studied in first-episode schizophrenia (FES) than brain-derived neurotrophic factor (BDNF). This study examined short-term changes in serum Nogo-A and BDNF in drug-naïve patients with FES. METHODS: Thirty-nine drug-naïve FES patients and 43 healthy controls (HC) were assessed. Serum Nogo-A and BDNF were measured at baseline in both groups and re-measured in FES after achieving ≥20 % reduction in Positive and Negative Syndrome Scale total score (PANSS). RESULTS: Baseline Nogo-A levels were higher in FES than HC (p = .022) and increased further after treatment (p < .001). Baseline BDNF did not differ between groups (p = .069) and showed no significant change after treatment (p = .094). PANSS total and subscale scores decreased significantly after treatment (all p < .001). Baseline Nogo-A modestly discriminated FES from HC (AUC = 0.648, 95 % CI = 0.53-0.77, sensitivity 66.7 %, specificity 60.5 %). In multivariable analysis, only smoking independently predicted FES (OR = 3.69, 95 % CI = 1.48-9.23, p = .005), whereas Nogo-A was not retained. CONCLUSIONS: Serum Nogo-A is elevated at illness onset in FES and increases during early treatment, suggesting that peripheral Nogo-A may be associated with early illness-related and/or treatment-related biological changes. Although Nogo-A does not show sufficient performance as a stand-alone diagnostic biomarker, these findings should be interpreted cautiously given the relatively small sample size and naturalistic treatment design. Nogo-A may warrant further investigation as part of broader multi-marker approaches in early schizophrenia.
Alcohol abuse by mood disorder patients.
Tondo L, Miola A, Baldessarini RJ
Psychiatry Res · 2026 Jul · PMID 41962338 · Publisher ↗
BACKGROUND: Abuse of alcohol is associated with psychiatric disorders but requires updating of risks, outcomes, and associated factors, particularly for patients with co-occurring major mood disorders. METHODS: A total o...
BACKGROUND: Abuse of alcohol is associated with psychiatric disorders but requires updating of risks, outcomes, and associated factors, particularly for patients with co-occurring major mood disorders. METHODS: A total of 1768 consecutive, consenting adult patients (1070 women, 698 men, aged 47.0 [CI: 46.4-47.5] years) with information about alcohol abuse and with a DSM-5-TR mood disorder (897 bipolar disorder [BD: 466 BD1, 431 BD2], 871 major depressive disorder [MDD]), ill for a total of 19.2 [18.5-19.9] years, were evaluated extensively and followed prospectively for 4.61 [4.25-5.00] years. RESULTS: Alcohol abuse was identified in 228/1768 subjects (12.9 % [11.4-14.5]); prevalence was greater with BD (18.8 % [16.3-21.6]) than MDD (6.77 % [5.20-8.65]), similar with BD1 (20.7 % [17.1-24.7]) and BD2 (17.0 % [13.5-20.9]), and 2.52-times greater among men (20.3 % [17.4-23.5]) than women (8.04 % [6.48-9.83]). Factors associated notably with alcohol abuse included: early sexual > physical abuse, earlier illness-onset, higher cyclothymic and irritable temperament ratings, unemployment, suicide attempt, separation or divorce and less marriage, fewer children, more smoking, less general medical morbidity, but not greater psychiatric morbidity (as depressive or [hypo]manic episodes/year, %-time-ill, -depressed, or-[hypo]manic, or hospitalizations/year). Multivariable logistic modeling found six factors to be significantly and independently associated with alcohol abuse, ranking: men > women, BD > MDD, suicide attempt, fewer children, early sexual abuse, and lack of somatic comorbidity. CONCLUSIONS: Alcohol abuse, as expected, was associated with more adverse social measures and outcomes but surprisingly, not greater psychiatric, and even less general medical morbidity.
The transdiagnostic role of emotional dysregulation and temperament in non suicidal self-injury: Cross sectional study among adolescents receiving intensive psychiatric care.
Maglio G, Pontillo M, Apicella M … +8 more , Minutolo A, Serra G, D'Amario G, Della Santa G, Andracchio E, Labonia M, Averna R, Vicari S
Psychiatry Res · 2026 Jul · PMID 41962337 · Publisher ↗
This study investigated dimensions of emotional dysregulation (ED) and cyclothymic temperamental traits in adolescents, focusing on their association with non-suicidal self-injury (NSSI) from a transdiagnostic perspectiv...
This study investigated dimensions of emotional dysregulation (ED) and cyclothymic temperamental traits in adolescents, focusing on their association with non-suicidal self-injury (NSSI) from a transdiagnostic perspective. A total of 208 adolescents undergoing treatment for acute psychiatric condition (aged 12-18) completed comprehensive diagnostic assessment and were divided into two groups: those meeting Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revised (DSM-5-TR) criteria for NSSI-D (NSSI group) and psychiatric controls (PC group). To assess ED and temperament participants completed the RIPoST-Y scale and the Cyclothymic Hypersensitive Temperament (CHT) questionnaire; depressive symptoms have been assessed by using the Children's Depression Inventory-2 (CDI-2). The NSSI group exhibited significantly higher levels of both ED and CHT compared to controls. Logistic regression analysis identified the interpersonal sensitivity domain of ED and depressive symptoms, as independent predictors of NSSI, regardless of DSM-5 diagnostic categories. These findings underscore the strong association between emotional dysregulation, temperamental affective instability and self-harm behaviors, highlighting these dimensions as potentially important clinical targets in prevention and treatment for adolescents with NSSI.
Psychedelics as a potential treatment for borderline personality disorder: A narrative review.
Artna E, Sandhu G, Chisamore N … +5 more , Lipsitz O, Kaczmarek ES, Johnson DE, Rosenblat JD, Sediqzadah S
Psychiatry Res · 2026 Jul · PMID 41955843 · Publisher ↗
Borderline personality disorder (BPD) is a serious mental illness with high rates of morbidity and stigma; however, successful remission is frequently limited by a paucity of accessible treatment options. In an era of gr...
Borderline personality disorder (BPD) is a serious mental illness with high rates of morbidity and stigma; however, successful remission is frequently limited by a paucity of accessible treatment options. In an era of growing interest in psychedelics as novel psychiatric treatment modalities, patients with BPD are often excluded from research due to perceived safety risks, particularly pertaining to suicide and substance misuse. However, there is evolving evidence that psychedelic treatment may effectively target core BPD symptoms, in addition to those of the mood and anxiety disorders frequently comorbid with BPD. As such, characterizing the therapeutic potential of psychedelics in BPD represents an important opportunity to enhance patient outcomes. This narrative review aims to broadly analyze the existing literature on experiences with psychedelics in this population. Data were coalesced from multiple electronic databases (Ovid MEDLINE, PsychInfo, and Embase) to characterize the current evidence for psychedelic safety and effectiveness in individuals with BPD. The 22 studies included in this review encompass a broad range of study designs and outcomes involving ketamine, esketamine, and psilocybin. There is some preliminary evidence that these psychedelics may be implemented as safe and effective treatments to improve core BPD symptoms and socio-occupational functioning. However, further high-quality evidence focusing on BPD-specific outcomes is needed to better elucidate their potential role as a treatment modality.
Development of a risk prediction model for relapse in patients with schizophrenia based on a systematic review and meta-analysis.
Tang W, Guan C, Ling Z … +2 more , Zhang X, Cui H
Psychiatry Res · 2026 Jul · PMID 41955842 · Publisher ↗
BACKGROUND: The high relapse rate in patients with schizophrenia imposes a significant burden on both families and society, hindering patients' recovery. Predictive modeling of relapse risk factors aids in early identifi...
BACKGROUND: The high relapse rate in patients with schizophrenia imposes a significant burden on both families and society, hindering patients' recovery. Predictive modeling of relapse risk factors aids in early identification of high-risk patients for timely intervention. METHODS: A comprehensive search of multiple databases was conducted to collect both domestic and international publications on factors influencing relapse in patients with schizophrenia, up to July 1, 2024. After literature screening, data extraction, and quality assessment by two researchers, meta-analysis was performed using RevMan 5.4 software to calculate combined odds ratios (OR) and 95% confidence intervals (CIs). A risk prediction model was constructed based on the natural logarithmic transformation of the composite hazard values. Inpatient medical records of patients with schizophrenia from Wuhu Fourth People's Hospital, collected between January 2022 and July 2024, were screened for analysis. The model's effectiveness in predicting relapse risk was validated through multiple curves and decision analysis. RESULTS: A total of 35 papers (27 cohort studies and 8 case-control studies), involving 159,973 participants and 5924 relapses, were included in the analysis. The meta-analysis identified 11 relapse risk factors. The corresponding logistic regression risk prediction model is: Logit(P) = α + 1.477X + 1.495X + 0.604X + 0.668X + 1.637X + 1.351X + 1.141X + 1.413X + 0.888X + 0.582X + 1.281X. The model was validated using an external dataset of 452 medical records, demonstrating good diagnostic performance. The Hosmer-Lemeshow test, calibration curves, and decision analysis further confirmed the model's accuracy and high clinical applicability. CONCLUSION: An evidence-based predictive model for relapse risk in patients with schizophrenia was developed, demonstrating moderate predictive ability. This model allows for early identification of high-risk patients and facilitates targeted interventions to improve outcomes.
Comparison of demographic and clinical features in adolescent-onset vs. adult-onset bipolar disorder an analysis of BIPAS Phase II data.
Zhao G, Wang Z, Zhu Y … +20 more , Wang X, Xu G, Pan M, Chen Z, Li W, Li M, Zhang Y, Chen J, Chen X, Li N, Sun J, Zhang J, Hu S, Gan Z, Qin Y, Wang Y, Ma Y, Li X, Jiao Z, Fang Y
Psychiatry Res · 2026 Jul · PMID 41955841 · Publisher ↗
OBJECTIVE: The literature on large-scale studies of Chinese patients with adolescent-onset bipolar disorder (adolescent-onset BD) was limited. Based on the analysis of the National Bipolar Mania Pathway Survey (BIPAS) Ph...
OBJECTIVE: The literature on large-scale studies of Chinese patients with adolescent-onset bipolar disorder (adolescent-onset BD) was limited. Based on the analysis of the National Bipolar Mania Pathway Survey (BIPAS) Phase II data, we examined the demographic and clinical characteristics of adults with adolescent-onset BD. METHODS: Among 899 participants diagnosed with BD from 20 mental health services, demographics and clinical data were collected at screening. Comparisons were made using chi-square (or Fisher's exact) tests and ANOVA. Multivariate logistic regression identified independent factors for adolescent-onset BD, and a CHAID decision tree analysis (SPSS) was constructed to detect risk factors. RESULTS: In the sample, 360 (40 %) had adolescent-onset BD and 539 (60 %) adult-onset BD. Significant differences between the two groups were observed in current age, number of episodes, years of education, gender, age of onset, education level, marital status, occupation, comorbid chronic physical illness, and first episode type. Stratified analysis also revealed significant differences between adolescent-onset BD I and BD II. Multivariate logistic regression identified younger onset age, more frequent episodes, lower education level, marital status, occupation, first episode type, and prior hospitalization as independent factors for adolescent-onset BD. The decision tree model selected current age as the first splitting variable, followed by occupation and marital status as the second, and years of education and prior hospitalization as the third. CONCLUSIONS: Adolescent-onset BD exhibits distinct demographic and clinical features compared to adult-onset BD. Early recognition and tailored treatment strategies may improve prognosis and outcomes in this population.
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