J Psychiatr Res [JOURNAL]
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200 papers
Examining multilevel resilience as a moderator of associations between gendered racial microaggressions and postpartum mental health and functioning.
Howell FM, Boychuk N, Collins L … +5 more , Dupont-Reyes MJ, Nowlin S, Levine L, Howell EA, Janevic T
J Psychiatr Res · 2026 Apr · PMID 42191454 · Full text
The United States is currently facing a maternal health crisis, and mental health issues are a leading preventable cause of maternal mortality. We assessed the influence of resilience on the relationship between gendered...
The United States is currently facing a maternal health crisis, and mental health issues are a leading preventable cause of maternal mortality. We assessed the influence of resilience on the relationship between gendered racial microaggressions (GRM) and postpartum depressive symptoms and functioning. We analyzed data among 265 postpartum Global Majority participants across four Philadelphia and New York hospitals. We administered the adapted Gendered Racial Microaggressions Scale (α = 0.97) to participants before discharge. Postpartum depressive symptoms, postpartum functioning, and resilience were assessed at 3 months postpartum using the Edinburgh Postnatal Depression Scale, the Patient-Reported Outcomes Measurement Information System Global Short Form, the Collective Efficacy Scale, and the Connor-Davidson Resilience Scale, respectively. Multilinear regressions tested the associations between GRM and postpartum depressive symptoms and functioning. Moderation analysis examined how community and personal resilience changed the relationship between GRM and postpartum depressive symptoms and functioning. Experiencing GRM during obstetric care was associated with postpartum depressive symptoms and lower postpartum functioning symptoms. Personal resilience moderated the association between GRM and postpartum functioning; this moderation was not observed for postpartum depressive symptoms. Community resilience did not moderate the association between GRM or postpartum depression and functioning symptoms. Gendered racial microaggressions, in obstetric contexts, harm postpartum mental and physical health. However, personal resilience may mitigate the impact of racism in obstetric care on postpartum health.
Abnormal directed functional connectivity in emotional cognitive control in patients with major depressive disorder.
He S, Wan L, Chen Y … +4 more , Zhang Q, Yang T, Xie W, Wang X
J Psychiatr Res · 2026 Sep · PMID 42190598 · Publisher ↗
OBJECT: This study combined emotional pictures with a cognitive control task paradigm (attention network test, ANT) to investigate abnormal directed functional connectivity (FC) during emotional cognitive control process...
OBJECT: This study combined emotional pictures with a cognitive control task paradigm (attention network test, ANT) to investigate abnormal directed functional connectivity (FC) during emotional cognitive control process in major depressive disorder (MDD) patients and reveal the abnormal hub brain regions. METHODS: This study included 38 MDD patients and 26 healthy controls (HC). Electroencephalography (EEG) data were collected while each participant performed the emotional ANT paradigm. Directed FC in the beta frequency band (13-30 Hz) was calculated based on the Phase Slope Index (PSI). Network-Based Statistics (NBS) were used to test for group differences. Additionally, brain network analysis and correlation analysis were used to examine abnormal manifestations in brain regions of MDD patients. RESULTS: Key neural findings revealed that under the negative congruent (-in-) condition, MDD patients exhibited abnormally increased directed FC from Mid-Fronto-Central (MFC) to Left-Temporo-Parietal (LTP) and from Right-Fronto-Central (RFC) to LTP. LTP was the brain region receiving the largest inflow of information. Under the incongruent (+in-) condition, the scope of regions exerting excessive regulation over LTP in MDD patients expanded further, including frontal, temporal, parietal and occipital lobes. Network analysis further revealed that the nodal efficiency of the LTP region in MDD patients was significantly reduced. CONCLUSION: This study reveals an abnormal pattern in MDD patients during emotional cognitive control, where the LTP acts as a core hub region characterized by excessive information input but reduced integration efficiency. These abnormal connectivity patterns reflect the pathological mechanisms of MDD and provide a basis for developing targeted interventions.
Comparative diagnostic accuracy of panic provocation tests: A meta-analysis.
Tural U, Shannon SR, Iosifescu DV
J Psychiatr Res · 2026 Sep · PMID 42190597 · Publisher ↗
Panic provocation tests have been widely used to investigate the biological underpinnings of panic disorder (PD). However, their diagnostic specificity remains uncertain, as several agents can also induce panic-like reac...
Panic provocation tests have been widely used to investigate the biological underpinnings of panic disorder (PD). However, their diagnostic specificity remains uncertain, as several agents can also induce panic-like reactions in healthy individuals. This meta-analysis estimated and compared diagnostic odds ratios (DORs) across different provocation methods. Random-effects meta-analyses were conducted using the Hartung-Knapp adjustment. Based on 123 studies including 5693 participants, sodium lactate infusion showed the highest pooled DOR (24.77, 95% CI 19.03-32.25, GRADE certainty = High), followed by isoproterenol (18.85, 95% CI 12.39-28.66, GRADE certainty = Moderate), cholecystokinin tetrapeptide (CCK-4; 15.03, 95% CI 7.83-28.84, GRADE certainty = Moderate), meta-chlorophenyl piperazine (m-CPP; 14.51, 95% CI 4.67-45.07, GRADE certainty = Low), caffeine (14.11, 95% CI 4.79-41.54, GRADE certainty = Moderate), hyperventilation (11.89, 95% CI 6.51-21.73, GRADE certainty = High), carbon dioxide inhalation (CO; 11.12, 95% CI 8.63-14.32, GRADE certainty = High), and yohimbine (7.87, 95% CI 1.12-55.13, GRADE certainty = Very low). Breath holding, fenfluramine and flumazenil did not demonstrate statistically significant discriminative ability. Meta-regression analysis confirmed that sodium lactate yielded significantly higher DORs than m-CPP, hyperventilation, CO, fenfluramine, flumazenil, and yohimbine. No substantial between-study heterogeneity or publication bias was identified across the pooled analyses. These findings suggest that provocation methods targeting acid-base balance, especially sodium lactate infusion, are associated with superior diagnostic discrimination between individuals with PD and healthy controls.
Neural, neurotransmitter, and molecular signatures of gray matter volume alterations in digital addiction.
Hu Y, Wu X, Gao F … +2 more , Gao L, Yang H
J Psychiatr Res · 2026 Sep · PMID 42190596 · Publisher ↗
BACKGROUND AND AIMS: Digital addiction (DA), involving compulsive use of social media, gaming, and smartphones, is increasingly viewed as a behavioral addiction with neurobiological underpinnings. However, neuroimaging f...
BACKGROUND AND AIMS: Digital addiction (DA), involving compulsive use of social media, gaming, and smartphones, is increasingly viewed as a behavioral addiction with neurobiological underpinnings. However, neuroimaging findings remain heterogeneous, and underlying neurotransmitter and molecular mechanisms are unclear. This study aimed to identify consistent gray matter volume (GMV) alterations in DA and explore their neurotransmitter and transcriptomic correlates. METHODS: A voxel-based morphometry (VBM) meta-analysis using seed-based d mapping (SDM) was performed to determine GMV alterations in DA compared to controls. Spatial correlations between GMV changes and normative neurotransmitter maps were assessed using Juspace. Transcriptomic decoding was conducted via partial least squares regression (PLSR) using the Allen Human Brain Atlas, followed by gene enrichment and cell-type analyses. RESULTS: The meta-analysis revealed GMV reductions in the bilateral anterior cingulate cortex (ACC), left middle frontal gyrus (MFG), and left medial orbitofrontal cortex (mOFC). These regions corresponded spatially with serotonergic and GABAergic systems. Transcriptomic analysis identified 534 genes associated with GMV changes, enriched for synaptic function and ion channel activity, primarily expressed in excitatory and inhibitory neurons. CONCLUSIONS: This multiscale integrative analysis links DA-related GMV alterations to specific neurotransmitter systems and gene expression profiles. The findings provide convergent evidence for the involvement of serotonergic, inhibitory, and reward-related neurobiological systems, and may contribute to a more comprehensive neurobiological understanding of DA within the I-PACE framework.
Perspective taking processes across anorexia nervosa subtypes: considering egocentric and altercentric bias.
Auger E, Bigot A, Bukowski H … +3 more , Doba K, Constant E, Nandrino JL
J Psychiatr Res · 2026 Sep · PMID 42190595 · Publisher ↗
While research has identified difficulties in perspective taking (PT) among patients with anorexia nervosa, it is unclear how these difficulties may vary across anorexia subtypes. This study assessed PT in individuals wi...
While research has identified difficulties in perspective taking (PT) among patients with anorexia nervosa, it is unclear how these difficulties may vary across anorexia subtypes. This study assessed PT in individuals with restrictive (AN-R) and binge/purge (AN-B/P) subtypes of anorexia nervosa using the Level-2 Visual Perspective-Taking task, which isolates the PT processes of self-other distinction, self-other priority, altercentric bias, and egocentric bias. A sample of 172 women (88 healthy controls, 56 AN-R, 28 AN-B/P) completed this task, revealing subtype-specific PT biases. Patients with AN-R exhibited a stronger altercentric bias, as reflected in longer response times, suggesting that their own perspective may be involuntarily influenced by the perspectives of others, even when those perspectives are irrelevant. This effect on response time rather than accuracy may indicates that participants actively perceive perspective conflicts and expend additional cognitive effort to process them. In contrast, patients with AN-B/P displayed a greater egocentric bias, as evidenced by their accuracy rates. This suggests a more dominant self-perspective and reduced processing of others' viewpoints, suggesting that perspective conflict is overlooked rather than explicitly processed. These preliminary findings highlight subtype-specific PT biases in patients with AN during visual PT and advocate for further replication.
Jumping-to-conclusions bias, cognitive function, and intolerance of uncertainty in adolescents with major depressive disorder.
Geng F, Guo R, Shao Y
J Psychiatr Res · 2026 Sep · PMID 42184716 · Publisher ↗
BACKGROUND: The jumping-to-conclusions (JTC) bias, which involves making hasty decisions based on limited evidence, has been extensively studied in schizophrenia spectrum disorders but remains under-explored in affective...
BACKGROUND: The jumping-to-conclusions (JTC) bias, which involves making hasty decisions based on limited evidence, has been extensively studied in schizophrenia spectrum disorders but remains under-explored in affective disorders, particularly among adolescents. This study aimed to: (1) assess JTC bias in adolescents with major depressive disorder (MDD), (2) examine its relationships with clinical symptoms, cognitive functions, and intolerance of uncertainty (IU), and (3) evaluate the potential impact of comorbid conditions. METHODS: Forty-three adolescents with MDD (mean age = 14.70 ± 1.32 years; 26 female) and 33 age-matched healthy controls (mean age = 14.97 ± 1.47 years; 15 female) completed two computerized JTC tasks (beads task and words task) with varying difficulty levels. Measures included draws to decision (DTD), decision threshold (DT), and the reaction time of the final decision (final reaction time, FRT). Participants also completed the Stroop Test, Letter-Number Span Test, and the Intolerance of Uncertainty Scale. RESULTS: Generalized estimating equations revealed no significant group differences in DTD, DT, or FRT. A significant group-by-difficulty interaction was found for DT: the MDD group showed significantly lower DT than controls under easy conditions. Correlational analyses indicated that working memory was associated with more DTD, while higher depression and anxiety severity and poorer executive function were linked to longer FRT. Comorbidity did not affect task performance. Results were consistent across both JTC paradigms. CONCLUSIONS: Adolescents with depression demonstrated reduced decision thresholds but not a typical JTC bias. Future studies should consider the role of working memory in clinical populations.
Rest-activity rhythm across the clinical spectrum of depression among adolescents.
Cho TSM, So SH, Wu DCH … +11 more , Chau SWH, Chan SSM, Mo FYM, Ching EWK, Wong OWH, Lai KYC, Ma SL, Tsoi KKF, Kwok NT, Hung SF, Leung PWL
J Psychiatr Res · 2026 Sep · PMID 42177868 · Publisher ↗
BACKGROUND: Rest-activity rhythm (RAR) disruptions are implicated in adults with major depressive disorder (MDD), but their roles in adolescent MDD and subclinical depressive presentations remain unclear. This study exam...
BACKGROUND: Rest-activity rhythm (RAR) disruptions are implicated in adults with major depressive disorder (MDD), but their roles in adolescent MDD and subclinical depressive presentations remain unclear. This study examined RAR parameters in adolescents varying in depression burden. METHODS: 148 Chinese adolescents aged 12-18 were classified into three groups based on structured diagnostic interview: MDD (n = 59), subthreshold depression (n = 30), and healthy controls (n = 59). Adolescents completed a 14-day actigraphy assessment of physical activity, sleep, circadian amplitude and regularity, alongside depressive symptom ratings. RAR parameters were examined across groups and in relation to depressive symptoms. RESULTS: Adolescents with MDD showed significantly later sleep onset (p = .020) and a lower sleep regularity index (p < .001) than controls. The subthreshold depression group demonstrated significantly later sleep onset than controls (p = .034), but had sleep regularity comparable to controls and significantly higher than the MDD group (p = .029). Lower sleep regularity was significantly associated with greater depressive symptom severity (p < .001). Findings for gross motor activity and minutes spent on moderate-to-vigorous physical activity varied by day type and by whether depression was examined using group-based or dimensional approaches. CONCLUSIONS: Adolescent depression was associated with disrupted RAR. Later sleep onset was evident in clinical and subclinical depression, whereas sleep irregularity was most pronounced in clinical depression. These findings support the potential utility of targeting sleep-related disruptions in adolescent depression prevention and management. Findings of physical activity suggest that activity interventions may benefit from considering weekday-weekend variation.
Does negative affective forecasting increase the risk of suicidal ideation?
Rizeq J, Etherson ME, O'Connor RC
J Psychiatr Res · 2026 Sep · PMID 42173044 · Publisher ↗
Suicidal ideation is a key precursor to suicidal behaviour. It is therefore important that we identify factors that predict suicidal ideation. Affective Forecasting, estimations of future emotional reactions, is an impor...
Suicidal ideation is a key precursor to suicidal behaviour. It is therefore important that we identify factors that predict suicidal ideation. Affective Forecasting, estimations of future emotional reactions, is an important future-oriented process that underlies daily decision making and has potential to be implicated in the emergence of suicidal ideation. In this study, we aimed to test cross-sectional and longitudinal associations between negative affective forecasting towards various hypothetical future life events and test the moderating effect of negative affective forecasting on the association between depression, entrapment, and defeat and suicidal ideation. We used a short-term longitudinal design with data across two timepoints from a total of 262 participants aged between 18 and 81 (72.52% identified as females). Participants completed questionnaires online assessing depressive symptoms, defeat, entrapment, and suicidal ideation and indicated their negative affective predictions towards three hypothetical scenarios of future life events. Higher negativity in affective forecasting was cross-sectionally and longitudinally associated with higher levels of suicidal ideation at Time 1 and 2. Negative affective forecasting did not have significant main effects on suicidal ideation above and beyond known risk factors (i.e., depressive symptoms, defeat, and entrapment). However, negative affective forecasting moderated the effect of these risk factors on suicidal ideation, exacerbating the effect of these factors at higher levels of negative affective forecasting. In conclusion, we show that affective forecasting is an important factor that should be studied further in relation to suicide risk and considered in clinical interventions.
Elevated serotonin 1A receptor binding in borderline personality disorder co-morbid with major depressive episodes appears attributable to major depression alone.
Elizabeth Sublette M, Byrnes A, Todd Ogden R … +6 more , Zanderigo F, Burke A, Oquendo MA, Stanley B, John Mann J, Miller JM
J Psychiatr Res · 2026 Sep · PMID 42173043 · Publisher ↗
Borderline personality disorder (BPD) is characterized by interpersonal dysfunction, emotional lability, impulsivity, and risk of self-injurious behaviors, and is frequently comorbid with mood disorders. Several BPD symp...
Borderline personality disorder (BPD) is characterized by interpersonal dysfunction, emotional lability, impulsivity, and risk of self-injurious behaviors, and is frequently comorbid with mood disorders. Several BPD symptoms have been associated with altered serotonin (5-HT) system function. We sought to determine whether 5-HT 1A (5-HT) receptor binding measured with [C]WAY-100635 positron emission tomography (PET) differed in individuals with mood disorders (Major Depressive Disorder or Bipolar Disorder I or II) and comorbid BPD (n = 21), compared to those with mood disorders without comorbid BPD (n = 63) and healthy volunteers (HV; n = 27). In thirteen a priori determined brain regions, the groups differed significantly in binding potential (BP), with higher relative BP in the mood disorders group compared to HV (F = 3.64; p = 0.03). Planned post-hoc analyses found that these differences in binding compared to HV were driven by higher binding associated with mood disorder, and not with BPD. There were no effects of impulsivity, aggression, depression severity or suicidal ideation on 5-HT receptor binding. The finding that higher 5-HT binding appears to be related primarily to the presence of a comorbid mood disorder may explain why treatments that target the 5-HT autoreceptor, like selective serotonin uptake inhibitors (SSRIs), are effective for mood disorders but have limited efficacy for BPD.
Real-world patient characteristics, treatment patterns, and healthcare resource utilization and costs of tardive dyskinesia in Germany.
Correll CU, Haas JS, Chaijale N … +4 more , Duma K, Hipp J, Zhang D, Driessen MT
J Psychiatr Res · 2026 Sep · PMID 42167038 · Publisher ↗
Tardive dyskinesia (TD) may increase healthcare burden for patients with underlying psychiatric disorders. To examine treatment patterns, healthcare resource utilization, and costs for patients with TD in Germany, a retr...
Tardive dyskinesia (TD) may increase healthcare burden for patients with underlying psychiatric disorders. To examine treatment patterns, healthcare resource utilization, and costs for patients with TD in Germany, a retrospective claims analysis using the Institute for Applied Health Research Berlin (InGef) database was conducted for the study period 2016-2022. Adults with International Classification of Diseases, 10th Revision, German Modification code G24.0 (drug-induced dystonia, including TD) recorded ≥2 times in 2 different quarters within 1 year during the enrollment period (2017-2021) were included in the overall TD population. The first observable code G24.0 marked the TD index date. Patients without any code G24.0 in the 4 quarters prior to index quarter were included in the incident TD population. Patients with incident TD were matched (1:3) to non-TD controls using propensity score matching analysis. Among 3,236,637 patients in the InGef research database, 389 adults with TD were identified (mean [SD] age 67.2 [16.0] years, 64.0% female, 21.1% with claims for authorized treatments for TD [tetrabenazine or tiapride]). In the matched incident TD cohort (n = 145), proportions of patients with all-cause hospitalizations (62.1% vs 48.7%), emergency department visits (35.9% vs 25.1%) and neurologist outpatient visits (69.7% vs 40.5%) were significantly greater (p ≤ 0.01) than in non-TD controls (n = 435). Annual post-index mean all-cause total healthcare costs were significantly higher for the incident TD cohort compared with non-TD controls (€13,176 vs €7288; p < 0.001). Higher healthcare costs in the incident TD population were driven by increased inpatient encounters.
Automatic measurement of social gaze during naturalistic conversations in autism.
Yankowitz LD, Pargi MK, DeJardin E … +15 more , Zampella CJ, Guthrie W, Pandey J, Keith Bartley G, Chen D, McDonald DQ, Manakiwala A, Khanna M, Keen K, Buboltz G, Yang A, Herrington JD, Sariyanidi E, Schultz RT, Tunç B
J Psychiatr Res · 2026 Sep · PMID 42161147 · Full text
Standardized, granular measurement of social communication behaviors, such as social gaze during natural interactions, is needed for a range of psychiatric applications including diagnosis and detecting clinical change i...
Standardized, granular measurement of social communication behaviors, such as social gaze during natural interactions, is needed for a range of psychiatric applications including diagnosis and detecting clinical change in conditions such as autism. Computational approaches show promise in automatically measuring social behaviors within natural settings. This study aims to automatically measure social gaze features from videos of dyadic conversations, characterize autism-related differences, and capture individual-level differences. 46 autistic Participants and 36 neurotypical Participants, aged 8-29 years, engaged in a brief video-recorded conversation with a research staff member (Partner). An automated social gaze detector was trained to detect whether each partner was looking at the other and achieved 89% cross-validated accuracy with human annotations. Comparing detailed automatic gaze measurements, autistic Participants spent less time looking at Partners and engaging in mutual gaze than neurotypical Participants did. They also initiated mutual gaze less frequently and had shorter mutual gaze episodes, but did not differ in mutual gaze counts. A social gaze summary score fusing individual variables correlated specifically with ADOS-2 Social Affect scores and not Restricted and Repetitive Behavior scores. A cross-validated multivariate classification model using gaze features was able to make individual-level diagnostic prediction (autism versus neurotypical) with 73% accuracy. This study provides a framework for automatically quantifying social gaze behaviors with high granularity and demonstrates its use in psychiatric research. This framework has a potential for enhancing measurement of social skills and tracking therapeutic progress in autism and other psychiatric conditions.
Core symptoms and directional pathways of problematic smartphone use in high-risk adolescents: A large-scale gender-specific network analysis.
Jiang J, Su Z, Chen Z … +1 more , Fang Y
J Psychiatr Res · 2026 Sep · PMID 42161146 · Publisher ↗
Problematic smartphone use (PSU) has emerged as a pressing public health issue among adolescents, particularly those at high risk of it. While most studies focused on prevalence, risk factors, and outcomes, little is kno...
Problematic smartphone use (PSU) has emerged as a pressing public health issue among adolescents, particularly those at high risk of it. While most studies focused on prevalence, risk factors, and outcomes, little is known about how symptoms interact in high-risk adolescents or how these processes differ by gender. A large sample of 9030 high-risk adolescents (M = 12.96, SD = 1.51; 55.94% boys), identified via the Smartphone Addiction Scale-Short Version (SAS-SV). Gaussian Graphical Models (GGMs) were used to examine symptom interconnections, and Directed Acyclic Graphs (DAGs) were applied to explore potential pathways. The GGM revealed that Plan Disruption, Distraction, and Physical Pain clustered into one community. Core symptoms differed by gender: Anxiety and Compulsion for boys, Loss of Control and Mental Preoccupation for girls. DAG analyses revealed gender-specific progression patterns. In boys, Anxiety quickly led to Dependency, whereas Distraction rarely developed into terminal symptoms. In girls, both Distraction and Mental Preoccupation acted as triggers, rapidly leading to Physical Pain, Overuse, or Dependency through three short paths. By focusing on high-risk adolescents, this study highlights gender-specific core, trigger symptoms, and short directional paths of problematic smartphone use. The findings point to tailored intervention targets-such as anxiety regulation for boys and management of distraction and preoccupation for girls-to inform more effective, gender-sensitive prevention and treatment strategies.
A retrospective comparative analysis of the clinical response to clozapine between patients with early and late treatment-resistant schizophrenia.
Okada K, Kanahara N, Otsuka Y … +15 more , Kobayashi R, Yamanaka H, Takaoki Y, Ito F, Komatsu H, Yoshida T, Kikuchi Y, Kimura H, Oiwa T, Ono T, Saiga T, Noda S, Oda Y, Niitsu T, Iyo M
J Psychiatr Res · 2026 Sep · PMID 42155318 · Publisher ↗
BACKGROUND: Individuals with treatment-resistant schizophrenia (TRS) exhibit varying responses to clozapine (CLZ). We hypothesized that a subclassification of TRS into early and late subtypes and by dopamine supersensiti...
BACKGROUND: Individuals with treatment-resistant schizophrenia (TRS) exhibit varying responses to clozapine (CLZ). We hypothesized that a subclassification of TRS into early and late subtypes and by dopamine supersensitivity psychosis (DSP) status may provide clinically relevant predictors of CLZ response. METHODS: We retrospectively analyzed the cases of 150 patients with TRS treated with CLZ. We classified them into Early and Late TRS groups based on their medical records and further stratified them by DSP status. Clinical/demographic variables including the delay between TRS designation and CLZ initiation were analyzed. CLZ treatment outcomes at 1 year were evaluated using the GAF, SOFAS, and CGI scales. RESULTS: The Late TRS group demonstrated significantly greater GAF improvement with CLZ treatment versus the Early group. DSP was significantly more prevalent in the Late TRS group and was associated with greater functional improvement. A multivariate regression analysis identified the baseline GAF score, age at TRS designation, and delay between TRS designation and CLZ initiation as significant treatment-response predictors. We observed a significant negative correlation between the length of this delay and GAF improvement only in the DSP subgroup. CONCLUSIONS: The CLZ response among patients with TRS may be influenced by TRS subtypes and DSP status. DSP, observed more often in the late-TRS patients, might be related to the better response to CLZ in this subtype. Timely CLZ initiation is particularly important to optimize outcomes and prevent functional decline in patients with TRS. Subtyping TRS and identifying DSP may support more personalized treatment strategies.
Corrigendum to "The effect of bilateral high-definition γ-tACS on negative symptoms and mismatch negativity in schizophrenia" [188 (2025) 43-51].
Liu W, Wan L, Chen Y … +2 more , Fei L, Liu H
J Psychiatr Res · 2026 Sep · PMID 42155317 · Publisher ↗
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The use of virtual environments to prevent or treat behavioral addictions: A systematic review.
de Almeida Cunha NB, Peixoto M, Dores AR
J Psychiatr Res · 2026 Sep · PMID 42155316 · Publisher ↗
BACKGROUND: Gambling Disorder (GbD) and Gaming Disorder (GmD) are associated with negative consequences that affect personal, social, and professional/academic domains. Although various efforts have been made to prevent...
BACKGROUND: Gambling Disorder (GbD) and Gaming Disorder (GmD) are associated with negative consequences that affect personal, social, and professional/academic domains. Although various efforts have been made to prevent and treat both conditions, traditional approaches have limitations, particularly given the technological nature of the environments in which these disorders develop. The aim of this review is to examine the characteristics of Virtual Reality (VR) and Augmented Reality (AR) based interventions for primary and secondary prevention of GbD and GmD. METHODS: The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA). A search was conducted across PubMed, Web of Science, Scopus, and EBSCO. Study quality was assessed using the Appraisal Tool for Cross-Sectional Studies (AXIS). RESULTS: Twelve studies (n = 498; 32.1% female) examined VR and AR interventions for GbD and GmD. Multiple VR therapy sessions significantly reduced craving and anxiety in GbD, while educational and self-regulation approaches promoted responsible gambling. In GmD, VR/AR-based interventions reduced symptom severity, gaming time, and negative emotions, improving physical activity and coping skills. Overall, immersive technologies showed consistent therapeutic and preventive benefits across both disorders, enhancing self-regulation and reducing addictive behaviors. CONCLUSIONS: The findings support the feasibility, safety, and therapeutic potential of immersive technologies in managing GbD and GmD, although evidence remains insufficient to determine optimal dosage. Future research should focus on long-term interventions with larger and more diverse samples to ensure generalizable results. Studies should also assess the cost-effectiveness of VR and AR as scalable prevention tools for both disorders.
Is problematic sexuality a marker for the onset of mental disorders? A cross-sectional study on psychotic-like experiences and sexual behaviour in a non-clinical sample.
Doroldi D, Origlia G, Giannini T … +8 more , Jannini TB, Boldrini T, Del Casale A, Lo Buglio G, Spitoni G, Limoncin E, Pelizza L, Ciocca G
J Psychiatr Res · 2026 Sep · PMID 42150511 · Publisher ↗
Impairments in sexual functioning or behaviour may increase the risk of developing mental disorders, including in young people with early psychosis. The aim of this cross-sectional study was to examine the relationship b...
Impairments in sexual functioning or behaviour may increase the risk of developing mental disorders, including in young people with early psychosis. The aim of this cross-sectional study was to examine the relationship between psychotic-like experiences (PLEs) and sexual functioning and dysfunctional sexual behaviour. We collected a convenience sample of 582 subjects. Of them, 197 experienced clinically relevant PLEs (having a cut-off score of ≥6 in the Prodromal Questionnaire 16-item). In addition, they completed a specific self-reported psychometric protocol assessing sexual function, hypersexual behaviour, problematic pornography use, depression and PLEs. The PQ-16 Absence/Presence score correlated significantly with hypersexuality, problematic pornography use, and difficulties in reaching orgasm. The PQ-16 Intensity score correlated significantly with hypersexuality, problematic pornography use, difficulties in reaching orgasm, orgasm dissatisfaction, and achieving and/or maintaining an erection or lubrication. When comparing subjects experiencing significant PLEs with control subjects while covarying age and depression, the former exhibited more hypersexuality and problematic pornography use, and poorer sexual function related to difficulties in orgasm attainment. The difference in hypersexuality was maintained when the analysis was limited to the female subgroups or the male subgroups, while the difference in problematic pornography use was confirmed only in the female subgroups. Both dysfunctional sexual behaviour and sexual dysfunction are associated with the severity of PLEs. Sexological aspects related to behaviour differentiate more individuals with relevant PLEs from the control group, compared to functional aspects. Screening for sexual health problems could be valuable among individuals with PLEs.
Neuroendocrine and neuroinflammatory mechanisms in postpartum depression: From hormonal withdrawal to central immune dysregulation and emerging therapeutic targets.
Chamanara S, Irandoost E, Dahmardeh N … +1 more , Aghaamoo S
J Psychiatr Res · 2026 Sep · PMID 42143824 · Publisher ↗
Postpartum depression (PPD) affects approximately 10-15% of new mothers worldwide with profound consequences extending to offspring and partners. While the classical "hormonal withdrawal hypothesis" has long emphasized t...
Postpartum depression (PPD) affects approximately 10-15% of new mothers worldwide with profound consequences extending to offspring and partners. While the classical "hormonal withdrawal hypothesis" has long emphasized the abrupt decline in estradiol, progesterone, and cortisol following childbirth, emerging evidence demonstrates that these endocrine perturbations converge with dysregulated neuroimmune pathways as central drivers of PPD pathophysiology. This narrative review integrates mechanistic evidence linking reproductive hormone withdrawal, HPA axis dysregulation, neurotransmitter imbalances, and peripheral immune activation to central neuroinflammatory pathways in PPD, with the goal of providing a unified framework for understanding pathophysiology and identifying translational therapeutic opportunities. We synthesize evidence on increased inflammatory cytokines, including IL-6, TNF-α, and IL-1β, blood-brain barrier disruption, microglial activation, and neuroinflammatory signaling pathways. Additionally, we examine structural and functional neuroimaging abnormalities in limbic-prefrontal circuits and metabolic disturbances in monoaminergic, glutamatergic, and GABAergic systems. We evaluate established and emerging therapeutic strategies, including conventional antidepressants, FDA-approved neuroactive steroids (brexanolone, zuranolone), and novel immune-targeted interventions (NLRP3 inhibitors, cytokine antagonists). By integrating biological, genetic, and psychosocial risk factors, this review provides a precision-medicine framework for targeting neuroinflammatory pathways, particularly TLR-mediated immune activation, alongside conventional treatments, while identifying NLRP3 inflammasome signaling as a promising but clinically unvalidated therapeutic target warranting direct investigation in postpartum populations.
Examining the independent effects of motivational factors and withdrawal mechanisms on functional impairment.
Gallagher MR, Fournier JC
J Psychiatr Res · 2026 Sep · PMID 42143823 · Full text
Motivational factors representing approach and avoidance mechanisms (i.e., behavioral inhibition system, behavioral activation system) have been implicated with depression and anxiety, and have a negative impact on funct...
Motivational factors representing approach and avoidance mechanisms (i.e., behavioral inhibition system, behavioral activation system) have been implicated with depression and anxiety, and have a negative impact on functional outcomes. The independent effects of withdrawal mechanisms, anhedonia and social anxiety, have been established, but are often examined in isolation of one another. The potential modulating or additive relationship between these motivational factors and withdrawal mechanisms remains unclear. Thus, the current study examined the additive and interactive effects of trait level motivational factors and withdrawal mechanisms on impairment in key domains of life. Participants (N = 110) with depression and anxiety symptoms ranging from none to severe completed measures of behavioral inhibition (BIS) and behavioral activation (BAS), anhedonia, social anxiety, and functional outcomes. Linear regressions were conducted to assess the interactive and main effects of these factors on life functioning. While no significant interactions emerged, the main effects of anhedonia and social anxiety were stable predictors of life impairment. Additionally, while behavioral inhibition initially exhibited a significant main effect on life impairment in some of the models, this effect appeared to be accounted for by social anxiety; suggesting they measure components of the same underlying construct. These findings suggest that anhedonia and social anxiety are more stable predictors of proximal functional impairment, as we observed no evidence that the interactive relationship between motivational and withdrawal mechanisms resulted in worse functioning.
Ratio of rates of suicide attempts to suicides in the general population and in mood disorder patients.
Miola A, Tondo L, Baldessarini RJ
J Psychiatr Res · 2026 Aug · PMID 42142958 · Publisher ↗
INTRODUCTION: Attempt/suicide rate-ratios indicate lethality in clinical samples, but comparisons with nonclinical populations require better information on attempt-rates. METHODS: We conducted a protocol-based, systemat...
INTRODUCTION: Attempt/suicide rate-ratios indicate lethality in clinical samples, but comparisons with nonclinical populations require better information on attempt-rates. METHODS: We conducted a protocol-based, systematic review to identify reports of attempt (A) and suicide (S) rates per 100,000 person-exposure years (100k PEY) in general-population samples, compared with corresponding standardized rates from large clinical samples of men and women diagnosed with DSM-5-TR bipolar disorder (BD) or major depressive disorder (MDD). RESULTS: In 50 international reports (81M nonclinical subjects), A averaged 178/100k PEY [CI: 123-234] (men), 270 [188-353] (women); S averaged 17.4 [15.3-19.5] (men), 6.50 [5.42-7.58] (women); A/S averaged 9.56 [6.97-12.2] (men), 45.1 [34.2-56.0] (women), 27.4 [20.6-34.2] overall. Among 4388 mood-disorder patients (62.7% women, 33.3% BD), rates averaged: BD-men: A 908, S 165, A/S 5.49; MDD men: A 451, S 52.0, A/S 8.67; BD-women: A 1210, S 46.1, A/S 26.2; MDD-women: A 513, S 24.9, A/S 20.6. Rate-ratios for mood-disorder vs. general-population samples were: men: A 3.76, S 6.32, A/S 1/1.57; women: A 2.84, S 4.66, A/S 1/1.78. Regional and temporal variability in reported suicide attempt rates and variance in ascertainment methods probably contribute to difficulties in identifying suicide attempts accurately worldwide. CONCLUSION: A averaged 224, S 12.0, and A/S 27.4/100k PEY in general-population samples. Standardized rates of A and S were higher and A/S lower with mood-disorders vs. nonclinical samples, with consistently greater suicidal lethality (4.15-fold lower A/S: 6.09 vs. 25.3) in men vs. women.
Effects of a novel individualized digital cognitive training on ADHD characteristics, quality of life, and cognitive functioning in adults with ADHD: A randomized controlled trial.
Bergmann M, Schröfel J, Zimmermann L … +6 more , Fastenau A, Pafel S, Sauermann P, Fecht J, Philipsen A, Lux S
J Psychiatr Res · 2026 Sep · PMID 42142506 · Publisher ↗
BACKGROUND: ADHD is characterized by inattention, hyperactivity, and impulsivity, often linked to cognitive impairment. Digital cognitive training has emerged as a potential non-pharmacological treatment, but evidence in...
BACKGROUND: ADHD is characterized by inattention, hyperactivity, and impulsivity, often linked to cognitive impairment. Digital cognitive training has emerged as a potential non-pharmacological treatment, but evidence in adults remains limited. This study evaluated the effectiveness of a novel digital cognitive training application "NeuroNation MED" in improving executive functions, ADHD characteristics, psychological quality of life, and everyday functioning in adults with ADHD. METHOD: A single-blind randomized controlled trial with cross-over design included 77 adults with ADHD (German Clinical Trial Register: DRKS00030767). Participants were randomized to a 12-week training program or to a control group receiving treatment as usual before crossing over. RESULTS: Training produced a significant interaction effect on psychological quality of life, with participants in the training group showing improvements not observed in controls. Additionally, subjective ratings indicated greater perceived gains in attention, memory, language, and executive functions (d = 0.47 - 0.94). Exploratory analyses indicated associations between baseline performance and change scores; however, these findings were not specific to the training condition and should be interpreted with caution. These subjective benefits were not paralleled by significant changes in objective neuropsychological test performance or ADHD characteristics. CONCLUSION: Cognitive Training demonstrated promising effects on perceived cognition and psychological well-being, though objective cognitive improvements were not observed. The discrepancy highlights the importance of considering both subjective and objective outcomes in ADHD interventions. Digital cognitive training may serve as an adjunct therapy for adults with ADHD, particularly in enhancing perceived functioning and quality of life. Larger, long-term studies with ecologically valid measures are needed to establish efficacy and generalizability.
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