Psychiatry Res [JOURNAL]
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200 papers
Post-traumatic stress in Israeli civilians following the October 7th attack: The roles of personality and resilience.
Zvi L, Bitton MS
Psychiatry Res · 2026 Jul · PMID 41955840 · Publisher ↗
AIMS: Following the unprecedented trauma and grief of the October 7 attacks and ensuing political violence, the Israeli population continues to experience significant psychological distress, the full scope of which is st...
AIMS: Following the unprecedented trauma and grief of the October 7 attacks and ensuing political violence, the Israeli population continues to experience significant psychological distress, the full scope of which is still being defined. Against this backdrop, the present study examined how personality traits and personal resilience contribute to post-traumatic stress (PTS) symptoms among Israeli civilians. METHODS: A total of 636 Israeli adults completed self-report measures assessing trauma exposure, personality traits, personal resilience, and post-traumatic stress symptoms. RESULTS: Findings revealed high rates of probable PTSD, with 38.7% of participants falling within the clinical range. Greater trauma exposure was associated with more severe symptoms. Higher levels of neuroticism and lower personal resilience emerged as significant risk factors. CONCLUSIONS: The findings highlight the substantial mental health impact of the October 7 attacks and ensuing political violence, as well as the importance of accounting for individual differences when developing targeted interventions to support psychological recovery following collective trauma.
GLP-1 receptor agonists, psychiatric training, and metabo-psychiatric practice.
Gorman BL, Lemus Silva EG, Nickel GC … +1 more , Bojdani E
Psychiatry Res · 2026 Jul · PMID 41950541 · Publisher ↗
Abstract loading — click title to view on PubMed.
Using natural language processing to assess MDD psychotherapy patterns among Veterans Affairs patients with suicide risk.
Levis M, Dimambro M, Levy J … +3 more , Nerish M, Riblet N, Shiner B
Psychiatry Res · 2026 Jul · PMID 41946193 · Publisher ↗
Major depressive disorder (MDD) is a leading risk factor for suicide. Within the US Department of Veterans Affairs (VA), psychotherapy is widely used to treat MDD and prevent suicide. Little is known about how classified...
Major depressive disorder (MDD) is a leading risk factor for suicide. Within the US Department of Veterans Affairs (VA), psychotherapy is widely used to treat MDD and prevent suicide. Little is known about how classified suicide risk impacts this treatment. Addressing this gap, this study assesses patterns in MDD-diagnosed VA patients' unstructured electronic health record (EHR) notes using Latent Dirichlet Allocation, a methodology that evaluates textual patterns. We developed a suicide-risk-stratified sample (high-, moderate-, and low-) of MDD-diagnosed VA patients who died by suicide in 2017-2018 (cases) and risk-matched patients with similar demographics, diagnoses, and care who did not die by suicide (controls). After collecting all psychotherapy EHR notes within 1-year of case death, we derived topics, monitored topic differences across patient groups, and evaluated clinical relevance. We identified five topics: Disclosure, Suicide Risk, Treatment Goals, Symptoms, and Medication. Risk-matched cases and controls' topic patterns were consistently significantly different except for the Disclosure and Medication topics for high-risk patients and the Suicide Risk and Symptoms topics for low-risk patients. Our analyses highlighted how classified suicide risk-tier may impact psychotherapy delivery and utilization for suicide-risk-matched cases and controls. Most topics displayed decreased prominence for higher-risk versus lower-risk patients, with cases tending to receive more illness-focused care and controls tending to receive more supportive care. Identified differences offer to enhance risk modeling and improve suicide prevention psychotherapy.
Care trajectories of Quebec patients with substance-related disorders within five years before death.
Fleury MJ, Cao Z, Grenier G
Psychiatry Res · 2026 Jul · PMID 41936158 · Publisher ↗
AIMS: This study identifies care trajectories five years before death of 1468 patients with substance-related disorders (SRDs), associated with the patients' social and clinical characteristics, quality of care received,...
AIMS: This study identifies care trajectories five years before death of 1468 patients with substance-related disorders (SRDs), associated with the patients' social and clinical characteristics, quality of care received, and causes of death. METHODS: Care trajectories integrated outpatient SRD, mental health (MH) and physical health care, and acute care. Group-based multi-trajectory modeling identified service use patterns in three-month intervals across the five years preceding death. Multinomial logistic regression assessed associations between trajectory membership, patient characteristics, quality of care received, and causes of death. RESULTS: Four distinct trajectories emerged: "Low service users" (Profile 1, 34 % of sample, the reference group), "High physical health service users" (Profile 2, 30 %), "High but decreasing SRD service users" (Profile 3, 15 %), and "High but decreasing mental disorder (MD) service users, high users of other services" (Profile 4, 21 %). Profile 1 comprised mostly younger men with better health but poor continuity and regularity of care. Profile 3 patients had the most severe conditions, received the most intensive care, but had more accidental/intentional deaths than Profile 1. Profile 2 included older patients with severe chronic physical illnesses, injection drug use, and more emergency department users than Profile 1. Profile 4 had older patients reporting more MDs, suicidal behaviors, lower functioning, and greater use of specialized MH care. CONCLUSION: Service use was low overall and remained low even near death. Physical health care was the most used, followed by acute care. SRD and MH care declined before death across all profiles. Tailored interventions for each profile are suggested.
Qualitative analysis of long-term clozapine adherence in schizophrenia: An exploratory study.
Daniel DTG, Choi JJ, Aluri J … +4 more , McCaulley C, Brandt AS, Nucifora FC, Margolis RL
Psychiatry Res · 2026 Jul · PMID 41936157 · Publisher ↗
Clozapine is the most effective antipsychotic for treatment-resistant schizophrenia, yet patients face substantial challenges in maintaining long-term adherence. In this investigation, we used a qualitative approach to u...
Clozapine is the most effective antipsychotic for treatment-resistant schizophrenia, yet patients face substantial challenges in maintaining long-term adherence. In this investigation, we used a qualitative approach to understand how patients overcome obstacles to clozapine use. We conducted semi-structured interviews with 14 patients at the Johns Hopkins Bayview Clozapine Clinic who had been receiving clozapine for at least one year (mean = 5.7 years). Participants reflected a diverse sample across gender (five women and nine men), self-identified race (White = 8, Black = 3, biracial = 3), and age (range 24-68 years, mean = 35.5 years). Thematic analysis identified three key themes: barriers to adherence, facilitators of adherence, and rationale for adherence. Most participants reported difficulty managing side effects of clozapine, while routine blood monitoring was generally not perceived as a significant barrier. When discussing facilitators, many participants emphasized the importance of collaborative dose titration to balance side effects and symptom control. Nearly all participants described family members as providing substantial support through medication management, transportation, and encouragement. In a novel finding, avoidance of withdrawal-like symptoms following missed doses of clozapine was a major motivator for adherence. These findings highlight the importance of individualized care plans, proactive management of side effects, and family engagement. To our knowledge, this is the first qualitative study of factors affecting long-term clozapine use. Our findings may facilitate clinician conversations with patients uncertain about clozapine initiation or continuation.
Sertraline blood concentrations and clinical efficacy in depression: a retrospective, exploratory determination of optimal therapeutic range.
Tapia-Alzuguren B, Canga-Espina C, Molero P … +1 more , Aldaz A
Psychiatry Res · 2026 Jul · PMID 41936156 · Publisher ↗
PURPOSE: To establish, in patients with depression, the baseline sertraline concentration range associated with optimal antidepressant response in clinical practice and compare it with previously proposed therapeutic ran...
PURPOSE: To establish, in patients with depression, the baseline sertraline concentration range associated with optimal antidepressant response in clinical practice and compare it with previously proposed therapeutic ranges to improve interpretation of pharmacokinetic monitoring. METHODS: This retrospective naturalistic study analyzed inpatient serum sertraline concentrations paired with Hamilton Depression Rating Scale (HAMD) scores collected at admission and discharge. Concentration was the primary unit of analysis due to marked intra- and inter-individual variability. RESULTS: A total of 115 sertraline concentrations from 62 patients were obtained, each measured at any point during hospitalization and paired with HAMD scores at admission and discharge. Non-responders (< 50% HAMD improvement; n = 22) showed concentrations < 25 ng/mL, longer admissions, higher doses, and more adverse effects. Responders (≥ 50% HAMD improvement; n = 93) had a median of 39 ng/mL (IQR: 25-62). A subgroup with discharge-day measurements (n = 47) exhibited a median of 48 ng/mL (IQR: 35-65). Patients with psychotic depression (n = 19) had higher concentrations (median 67 ng/mL, IQR: 44-95) and greater clinical improvement. Responder concentrations aligned with literature HAMD and Brief Psychiatric Rating Scale (BPRS)-based studies. While the 10-150 ng/mL range proposed by guidelines encompasses most real-world values, concentrations < 25 ng/mL were associated with non-response. CONCLUSIONS: Therapeutic response to sertraline was achieved with concentrations > 25 ng/mL. Optimal response was associated with 35-65 ng/mL in the overall sample, and 45-95 ng/mL in patients with depressive and psychotic symptoms.
Early life adversity, inhibitory control, and behavioral dysregulation among individuals with OCD.
Fedorenko EJ, Sherman AL, Nestadt G … +6 more , Grados M, Samuels J, McCracken JT, Chang S, Greenberg BD, McLaughlin NCR
Psychiatry Res · 2026 Jul · PMID 41936155 · Publisher ↗
INTRODUCTION: Individuals with OCD exhibit poorer inhibitory control on behavioral tasks, such as the stop signal task. Early life adversity (ELA; e.g., childhood abuse, parental divorce) might further diminish inhibitor...
INTRODUCTION: Individuals with OCD exhibit poorer inhibitory control on behavioral tasks, such as the stop signal task. Early life adversity (ELA; e.g., childhood abuse, parental divorce) might further diminish inhibitory control, however, the relationship between ELA and inhibitory control has not yet been examined in individuals with OCD. We hypothesized that greater ELA would predict poorer inhibitory control and poorer self-reported behavioral regulation ability among individuals with OCD. METHODS: Participants were 78 adults with OCD. The total number of adverse experiences reported by participants on a dichotomous scale indexed ELA. Inhibitory control was indexed by reaction time on the stop signal task (SSRT), wherein greater SSRTs indicated poorer inhibitory control. Behavioral dysregulations were self-reported on the Behavioral Regulation Index (BRI) of the Behavior Rating Inventory of Executive Function and peak lifetime OCD severity was clinician-assessed. RESULTS: ELA was associated with SSRT in a univariable model (b = 0.287, p = 0.028), but not in a multivariable model with age and OCD severity. Additionally, ELA was associated with the BRI (b = 0.365, p = 0.018), and in subscale analyses, ELA related to inhibition (b = 0.327, p = 0.023) and self-monitoring (b = 0.375, p = 0.008) subscales. CONCLUSION: These results suggest that, among individuals with OCD, greater ELA is associated with poorer inhibitory control, but not when controlling for age, and that greater ELA is associated with poorer behavioral regulation ability, particularly in inhibition and self-monitoring. Limitations of this study include the use of a noncomprehensive ELA measure. Future studies should clarify the mechanisms by which ELA can degrade inhibitory control among people with OCD.
Reconsidering resilience in war contexts: Integrating conflict resolution counselling into socioecological mental health frameworks.
Purwoko B, Sujarwanto, Sa'idah I … +1 more , Ghozali MA
Psychiatry Res · 2026 Jul · PMID 41935508 · Publisher ↗
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Association between rheumatoid arthritis and depressive symptoms: A population-based analysis from the Paracelsus 10,000 study.
Ausserwinkler M, Hueber AJ, Gensluckner S … +7 more , Paulweber B, Trinka E, Langthaler P, Iglseder B, Flamm M, Aigner E, Wernly B
Psychiatry Res · 2026 Jul · PMID 41935507 · Publisher ↗
BACKGROUND: Depression is common in the general population and may occur more frequently in individuals with rheumatoid arthritis (RA). This study examined the association between RA and depressive symptoms in a populati...
BACKGROUND: Depression is common in the general population and may occur more frequently in individuals with rheumatoid arthritis (RA). This study examined the association between RA and depressive symptoms in a population-based cohort from Salzburg, Austria. METHODS: Data were obtained from the Paracelsus 10,000 cohort, comprising 9401 participants. RA was determined according to the EULAR/ACR classification criteria and verified through structured baseline interviews and medical documentation. Depressive symptoms were assessed using the Beck Depression Inventory-II (BDI-II). Depression was defined as a BDI-II score >13, according to national guidelines. Logistic regression analyses were used to estimate the association between RA and depression, and linear regression analyses assessed differences in continuous BDI-II scores. Models were adjusted sequentially for demographics, socioeconomic, and clinical covariates. RESULTS: Among 293 participants with RA and 9108 without RA, elevated depressive symptoms were present in 20% and 9%, respectively. RA was associated with higher odds of elevated depressive symptoms in unadjusted analyses (OR 2.48, 95% CI 1.84-3.35; p < 0.001), after adjustment for age and sex (OR 2.39, 95% CI 1.76-3.23; p < 0.001), and in fully adjusted models (OR 2.10, 95% CI 1.52-2.89; p < 0.001). Median BDI-II scores were higher in participants with RA compared to those without RA (6 [IQR 2-11] vs. 3 [IQR 0-7]; p < 0.001). In linear regression analyses, RA was associated with a mean increase of 3.40 BDI-II points (95% CI 2.65-4.14; p < 0.001), exceeding the minimal clinically important difference. CONCLUSION: In this population-based cohort, RA was statistically associated with higher depressive symptoms after adjustment for demographic, socioeconomic and clinical covariates. Given the cross-sectional design, causal inferences cannot be drawn. These findings support routine depression screening and integrated care for patients with RA. Moreover, the bidirectional link between rheumatic and psychiatric conditions highlights that psychiatrists should consider underlying rheumatic disease in patients presenting with depression, fatigue or unexplained pain.
Physical activity domains and suicidal ideation: Findings from a nationally representative Korean survey.
Noh J, Kim L, Hwang C … +3 more , Park EJ, Yang JS, Jung SJ
Psychiatry Res · 2026 Jul · PMID 41935506 · Publisher ↗
BACKGROUND: Suicide is a major public health issue, and Korea has the highest suicide rate among OECD countries. Suicidal ideation is a precursor to suicide. Although physical activity benefits mental health, evidence fo...
BACKGROUND: Suicide is a major public health issue, and Korea has the highest suicide rate among OECD countries. Suicidal ideation is a precursor to suicide. Although physical activity benefits mental health, evidence for its link with suicidality is inconsistent, particularly regarding domain-specific effects. We examined domain-specific physical activity in relation to suicidal ideation in a nationally representative sample of Korean adults. METHODS: We analyzed data from 31,723 adults aged ≥19 years in the Korea National Health and Nutrition Examination Survey (2015-2023). Suicidal ideation was self-reported, and physical activity was measured with the WHO Global Physical Activity Questionnaire. The Metabolic equivalent (MET)-minutes/week for work, leisure, and transportation time were calculated separately. Multiple logistic regression with survey weights was used, with subgroup analyses by sex, age, and occupation. Exploratory mediation analysis was conducted to examine depression as a mediator in association between domain-specific physical activity and suicidal ideation. RESULTS: 4.8% of participants reported suicidal ideation. In men, high work activity remained significantly increased odds for suicide ideation, particularly among those aged 19-39 years (OR=2.21, 95% CI: 1.17-4.15) and in pink-collar workers (service and sales workers) (OR=3.36, 95% CI: 1.45-9.09), while high leisure activity was protective in those ≥60 years (OR=0.18, 95% CI: 0.07-0.48). No significant associations between physical activity and suicidal ideation were observed in women. CONCLUSIONS: Domain-specific physical activity was differentially associated with suicidal ideation. Work-related activity increased risk in certain male subgroups, whereas leisure-time activity was protective in older men, underscoring the need to consider activity context in suicide prevention.
Changes in insular subregion functional connectivity and its correlation with cognitive flexibility in patients with first-episode and treatment-naïve obsessive-compulsive disorder.
Tian L, Zhang D, Hu X … +6 more , Wang X, Teng C, Lu H, Xu Y, Li Z, Guan C
Psychiatry Res · 2026 Jul · PMID 41935505 · Publisher ↗
OBJECTIVES: The purpose of this study was to investigate the changes of functional connectivity (FC) and its relationship with cognitive flexibility in patients with first-episode, treatment-naïve obsessive-compulsive di...
OBJECTIVES: The purpose of this study was to investigate the changes of functional connectivity (FC) and its relationship with cognitive flexibility in patients with first-episode, treatment-naïve obsessive-compulsive disorder (OCD), using bilateral insula as seed regions. METHODS: 45 OCD patients and 40 healthy controls (HC) were recruited to undergo a clinical symptom assessment, the Wisconsin Card Sorting Test (WCST), and rs-fMRI scans. Six seed regions in the bilateral insula were selected for whole-brain FC analyses. A two-sample t-test was utilized to compare the differences in FC between two groups. SPSS software was used to analyze the relationship between the strength of FC in different brain regions and cognitive flexibility in the OCD group using Pearson correlation. RESULTS: Compared with the HC, FC between the left ventral anterior insula and left ventrolateral nucleus of thalamus was reduced in the OCD(p < 0.001), FC between the left dorsal anterior insula and right posterior central gyrus was increased (p < 0.001), and FC between the right dorsal anterior insula and right posterior central/middle temporal gyrus was increased (p < 0.001). FC between right dorsal anterior insula and right posterior central gyrus was significantly negatively correlated with cognitive flexibility(uncorrected p < 0.05). FC between left ventral anterior insula and left ventrolateral thalamus was positively correlated with cognitive flexibility(uncorrected p < 0.05). Finally, the FC between right dorsal anterior insula and right middle temporal gyrus was negatively correlated with cognitive flexibility (uncorrected p < 0.05). CONCLUSION: Patients with OCD exhibit abnormal FC network involving insula, which are associated with cognitive flexibility, supporting a functional mechanism of cognitive inflexibility in OCD.
Sex-specific brain morphometric associations with psychopathology severity in obsessive-compulsive disorder.
Yi X, Zhang C, Han H … +6 more , Zhang Z, Chen Y, Gao R, Cao X, Zhang X, Fan Q
Psychiatry Res · 2026 Jul · PMID 41933540 · Publisher ↗
OBJECTIVE: Female patients with obsessive-compulsive disorder (OCD) exhibit more severe psychopathological symptoms, yet their underlying neural correlates remain unclear. This study aimed to determine OCD-specific sex d...
OBJECTIVE: Female patients with obsessive-compulsive disorder (OCD) exhibit more severe psychopathological symptoms, yet their underlying neural correlates remain unclear. This study aimed to determine OCD-specific sex differences in brain structure and examine whether these differences are associated with the greater psychopathological burden observed in female patients. METHODS: Structural MRI data and symptom severity assessments were obtained from 147 unmedicated OCD patients (69 females) and 98 demographically matched healthy controls (HC; 46 females). RESULTS: Female patients with OCD showed significantly higher levels of OCD symptom severity, depression and anxiety symptoms than male patients. A significant interaction effect between group and sex on cortical complexity in the right paracentral lobule was identified, indicating that sex differences in this brain region differed significantly between OCD and HC groups. More specifically, female patients with OCD showed lower cortical complexity in the right paracentral lobule than male patients, whereas in the HC group, females exhibited higher cortical complexity than males. In the OCD group, lower cortical complexity was related to greater depression and anxiety symptoms and showed an indirect serial association with OCD symptom severity via anxiety. CONCLUSIONS: This study identified an OCD-specific brain morphometric basis of sex differences and suggested a potential pathway through which morphometric features in this region may be associated with greater OCD symptom severity in females via anxiety.
Underdiagnosis of PTSD in eating disorders?
Brewerton TD
Psychiatry Res · 2026 Jul · PMID 41933539 · Publisher ↗
In the recently published paper by Hubel and colleagues entitled, "Comorbid Posttraumatic Stress Disorder Complicates Eating Disorder Treatment: A Nationwide Study," the authors reported that among a large sample of 8906...
In the recently published paper by Hubel and colleagues entitled, "Comorbid Posttraumatic Stress Disorder Complicates Eating Disorder Treatment: A Nationwide Study," the authors reported that among a large sample of 8906 adult inpatients and outpatients (96% female) with eating disorders (EDs), the current rates of traumatic experiences and current PTSD were only 16% and 4%, respectively. However, these are unusually low numbers when compared to other existing data in nationally representative samples and in clinical samples of eating disorder patients. In this commentary several possible explanations that may explain these lower-than-expected results are reviewed, particularly in reference to use of the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) in acutely ill eating disorder patients. Sociocultural factors and clinical features of traumatized ED patients are also considered as possible factors in explaining these differences.
Metabolomics revealed novel associations between multiple ambient air pollutants exposure and substance use disorders: Evidence from a prospective cohort study.
Jia XY, Wang JY, Liu C … +2 more , Jia CX, Liu BP
Psychiatry Res · 2026 Jul · PMID 41933538 · Publisher ↗
BACKGROUND: Substance use disorders (SUDs) constitute a significant global public health challenge. Although air pollution is a recognized risk factor for various mental and behavioral disorders, its prospective relation...
BACKGROUND: Substance use disorders (SUDs) constitute a significant global public health challenge. Although air pollution is a recognized risk factor for various mental and behavioral disorders, its prospective relationship with SUDs and the underlying mechanisms involved remain inadequately elucidated. METHODS: This prospective cohort study included 216,737 participants from the UK Biobank. An air pollution score (APS) was constructed based on NO, NO, PM, PM and PM concentrations. An APS-related metabolic signature was derived using elastic net regression from 168 plasma metabolites. Cox proportional hazards models evaluated associations between air pollution, the metabolic signature, and the incidence of SUDs, including alcohol use disorders (AUDs) and tobacco use disorders (TUDs). Mediation analysis quantified the mediation proportion of metabolites and the metabolic signature. RESULTS: Long-term exposure to air pollution was significantly associated with increased risk of SUDs, AUDs, and TUDs. The APS-related metabolic signature comprising 151 metabolites was significantly associated with an increased risk of SUDs (HR = 1.127, 95% CI: 1.106-1.148) and TUDs (HR = 1.159, 95% CI: 1.135-1.183). Further analysis revealed that citrate was the primary mediator linking APS to SUDs and TUDs, whereas cholesterol and cholesteryl esters in medium very low-density lipoprotein (VLDL) constituted the principal mediators for AUDs. The overall metabolic signature mediated 5.4% and 6.8% of the relationship between APS and SUDs and TUDs, respectively. CONCLUSION: Long-term ambient air pollution is associated with higher SUD risk, partially mediated by metabolomic changes.
Critical appraisal of digital phenotyping approaches in predicting treatment response in depression.
Tahir HN, Sadia Z, Tariq U … +1 more , Mustafa FG
Psychiatry Res · 2026 Jul · PMID 41933537 · Publisher ↗
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Mental health stigma in Latin American youth with obsessive-compulsive disorder.
McCarty RJ, Jensen M, Cruz EPJS … +18 more , Sagarnaga MN, Quiroz PC, Miño T, Giusti-Rodriguez P, Mallen MCM, Moyano MB, Berrones D, Anderberg JL, Frederick RM, Moore HC, Muñoz JS, Cruz VZ, Latin American Trans-ancestry INitiative for OCD genomics (LATINO), Brazilian Obsessive-Compulsive Spectrum Working Group (GTTOC), Onyeka OC, Wiese AD, Crowley JJ, Storch EA
Psychiatry Res · 2026 Jul · PMID 41933536 · Full text
Obsessive-compulsive disorder (OCD) is an impairing mental health condition that affects individuals across the lifespan. Some literature has evaluated mental health stigma in adults with OCD but limited attention has be...
Obsessive-compulsive disorder (OCD) is an impairing mental health condition that affects individuals across the lifespan. Some literature has evaluated mental health stigma in adults with OCD but limited attention has been given to youth, as well as those of Latino ancestry. The present study reported the extent of stigma experiences among Latin American youth with OCD, as well as examined sociodemographic, clinical and psychological correlates. 235 youth with clinician confirmed diagnoses of OCD from 10 North and South American countries completed questionnaires assessing stigma experiences, symptomatology, and functioning. Sociodemographic and clinical variables were also collected. The average OCD stigma response corresponded to a frequency rating of "rarely" (M=16.4 on an 8 to 40 possible range), though 42.1% of the sample endorsed experiencing at least one stigma-related item "often" or greater. Multivariate regression analyses indicated that depressive symptomatology was the strongest predictor of stigma, with no sociodemographic or clinical variables independently associated with stigma. Additional regression analyses revealed that stigma was uniquely associated with higher clinician-rated OCD symptom severity and higher parent-rated impact of OCD, but stigma did not independently associate with youth-rated quality of life. Findings highlight that stigma related concerns affect many Latin American youth with OCD, with links to worse psychological health.
Does hearing voices make you nervous? An ecological momentary assessment investigation of momentary emotional responses to the occurrence of psychotic symptoms.
Hubbard LA, Zhang JN, Moore RC … +4 more , Depp CA, Ackerman RA, Pinkham AE, Harvey PD
Psychiatry Res · 2026 Jul · PMID 41931857 · Full text
BACKGROUND: Auditory hallucinations and delusions occur across neuropsychiatric conditions. As psychosis in bipolar disorder (BD) is often mood congruent, spikes in sad moods could precede occurrences of psychosis. The t...
BACKGROUND: Auditory hallucinations and delusions occur across neuropsychiatric conditions. As psychosis in bipolar disorder (BD) is often mood congruent, spikes in sad moods could precede occurrences of psychosis. The temporal association of episodic psychosis and negative affect (NA) is not understood in schizophrenia (SZ). We identified occurrences of episodic psychosis and temporally related them to NA with ecological momentary assessment (EMA). METHODS: Participants with SZ (N = 126) or BD (N = 114) were surveyed 3 times per day, 7 days a week, for 30 days. Surveys assessed location, social context, activities, mood states, and psychotic symptoms. Psychosis was queried on a present/absent basis and included auditory hallucinations, paranoia, and three other delusions. We examined the intensity (on a 1-7 scale) of NA (average of Sadness and Anxiety) concurrently, prior to, and after momentary psychosis. HLM was used to examine temporal convergence. RESULTS: SZ reported paranoia on 52% of surveys and voices on 42%, while participants with BD reported paranoia on 18% of surveys and no other symptoms on 10% or more. NA ratings were correlated with all 5 psychotic experiences in participants with SZ (all p < .009) and with paranoia in BD (p < .001). Concurrent NA was more strongly associated with symptoms in both groups compared to prior or later intensity. Anxiety was significantly more strongly correlated than sadness with psychosis in both groups. IMPLICATIONS: Anxiety was associated with concurrent psychotic symptoms in BD and SZ. There were no differential antecedent or consequent associations, and momentary sadness was less strongly associated with episodic psychosis than anxiety.
Association of reproductive lifespan with depression in postmenopausal women from NHANES (2005-2018): A cross-sectional study.
Li C, Lin Q, Wan C … +1 more , Li L
Psychiatry Res · 2026 Jul · PMID 41931856 · Publisher ↗
BACKGROUND: Depression, a common mental health disorder, exerts substantial adverse effects on physical health and longevity. While reproductive factors have been established as determinants of depression in women, and t...
BACKGROUND: Depression, a common mental health disorder, exerts substantial adverse effects on physical health and longevity. While reproductive factors have been established as determinants of depression in women, and the association between reproductive lifespan (RLS) -a critical indicator of reproductive health- and depression remains insufficiently elucidated. METHODS: This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) 2005-2018. Multiple imputation was used to handle missing covariate data. Multivariable logistic regression with five sequential adjustment models was used to estimate the association between RLS with depression. Restricted cubic spline (RCS) analysis was conducted to explore a potential nonlinear relationship between them. Sensitivity analyses were performed to assess the robustness of the findings. RESULTS: The study included 7218 postmenopausal women, which, after weighting, represent a population of approximately 42,437,141 in the United States, with a depression prevalence of 10.07 %. The risk of depression decreased by 4 % for each additional year of RLS without covariate adjustment [odds ratio (OR) = 0.96, 95 % Confidence interval (CI): 0.95-0.97, P < 0.001]. However, in contrast to previous findings, no significant association was observed between RLS and depression risk after adjusted for demographics, lifestyle factors, comorbidities, reproductive variables, and female hormone use (OR=0.99, 95 % CI: 0.97-1.00, P = 0.122). These findings remained robust across sensitivity analysis. CONCLUSIONS: RLS was not found to be associated with depression in postmenopausal women in the United States. After adjustment for covariates, the initially observed inverse association was no longer significant. Further cohort studies are needed to explore the association between RLS and depression and its underlying mechanisms.
Key factors associated with social anxiety symptoms among Chinese adolescents: An exploration via machine learning models.
Feng L, Huang Z, Tang X … +1 more , Guo J
Psychiatry Res · 2026 Jul · PMID 41924768 · Publisher ↗
BACKGROUND: Numerous factors from the family environment, school contexts, and individual characteristics have been shown to be associated with adolescent social anxiety, but the relative importance of these factors is r...
BACKGROUND: Numerous factors from the family environment, school contexts, and individual characteristics have been shown to be associated with adolescent social anxiety, but the relative importance of these factors is rather unclear. This study aimed to quantify the importance of these factors using machine learning techniques and identify key predictors. METHODS: Participants were 27,373 adolescents aged 10-18 years from a county in northern China. A total of 24 candidate variables were selected into three machine learning models (Random Forest [RF], Extreme Gradient Boosting [XGBoost], and Light Gradient Boosting Machine [LightGBM]). SHapley Additive exPlanations values were used to evaluate the relative importance of each predictor and to identify key features. Subgroup analyses were performed for gender, residence, number of siblings, and family economic status. RESULTS: The RF, XGBoost and LightGBM models identified 12, 13, and 12 key features, respectively. Eleven key features were selected from an integrative perspective, and nine were retained after considering subgroup analyses. These included verbal bullying victimization, self-esteem, school support, anxious attachment, avoidant attachment, social bullying victimization, age, sleep duration and resilience. CONCLUSION: Social anxiety symptoms among adolescents are associated with a range of factors across family, school, and individual domains. School contexts and individual characteristics show relatively higher importance for adolescent social anxiety, whereas family-related factors contribute less to it.
Neurotransmitter dysregulation in depression, anxiety, and suicidality: From synaptic dysfunction to cellular pathogenesis.
K S V ABG, Verma AK, A SS … +3 more , Sinha SS, Boyina R, Kosanam S
Psychiatry Res · 2026 Jul · PMID 41924767 · Publisher ↗
Affective disorders such as depression, anxiety disorders and suicidality are major contributors to global psychiatry. The "chemical imbalance" theory has been traditionally used; however recent research suggests that ne...
Affective disorders such as depression, anxiety disorders and suicidality are major contributors to global psychiatry. The "chemical imbalance" theory has been traditionally used; however recent research suggests that neurotransmitter dysfunction may represent an important early contributor within a broader, bidirectional cascade of cellular changes. Stress responses and neural circuits are disrupted by dysregulation of the serotonergic, noradrenergic, dopaminergic, GABAergic, and glutamatergic systems, which leads to oxidative stress, excitotoxicity, neuroinflammation, and decreased trophic support. Reduced brain-derived neurotrophic factor (BDNF) signaling, dendritic retraction, synapse loss, and apoptotic susceptibility are the common pathways that result in both amygdala hyperactivity and structural atrophy in the hippocampus and prefrontal cortex. Rumination, fear, anhedonia, cognitive impairment, and suicidal ideation are clinical manifestations of the ensuing circuit failure. This study proposes a unified model of pathogenesis in which increasing cellular damage is driven by neurotransmitter dysregulation, integrating evidence from both the neurochemical and cellular domains. Reassessing the delayed but plasticity-enhancing benefits of SSRIs and SNRIs, the quick synaptic repair brought about by NMDA antagonists like ketamine, and the potential of new drugs that target oxidative stress, inflammation, and glutamate receptor subtypes are some of the therapeutic implications. Lastly, it is highlighted that developing biomarkers for oxidative damage and neuroinflammation is an essential next step in the development of precision psychiatry. This paradigm aims to shift the emphasis from regulating neurotransmitters to promoting cellular resilience and rebuilding brain circuits in order to reimagine the future of treatment for depression, anxiety, and suicidality.
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