J Psychiatr Res [JOURNAL]
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200 papers
Blunted neural response to positive facial feedback and suicidal risk in patients with major depressive disorder.
Zhang Q, Bao C, Chen W … +5 more , Hua L, Yan R, Zou H, Yao Z, Lu Q
J Psychiatr Res · 2026 Aug · PMID 42090980 · Publisher ↗
BACKGROUND: Individuals with major depressive disorder (MDD) exhibit a blunted neural response to happy (relative to neutral) facial feedback, indicated by attenuated feedback-related negativity (FRN). However, the relat...
BACKGROUND: Individuals with major depressive disorder (MDD) exhibit a blunted neural response to happy (relative to neutral) facial feedback, indicated by attenuated feedback-related negativity (FRN). However, the relationship between FRN and suicide risk remains unclear. METHODS: The study included 110 MDD patients and 70 healthy controls (HCs) who completed an electroencephalogram social incentive delay task. According to the suicide risk module of the Mini International Neuropsychiatric Interview (MINI), patients were divided into low-suicide-risk (LSR, n = 34), moderate-suicide-risk (MSR, n = 36), and high-suicide-risk (HSR, n = 40) groups. FRN data were analyzed with repeated-measures analysis of variance across the groups. FRN source localization was conducted with standardized low-resolution brain electromagnetic tomography (sLORETA). RESULTS: A significant group × condition interaction was found (F = 3.138, p = 0.028, η = 0.070). HCs showed significant mean amplitude differences between gain and neutral feedback (p = 0.028), but MDD groups did not (all ps > 0.05). Post-hoc analyses showed the HSR group had the lowest FRN amplitudes. Furthermore, FRN under the gain condition (FRN-gain) was correlated with clinical variables, including consummatory anhedonia and suicide risk (all ps < 0.05). FRN-gain source localization showed reduced orbitofrontal cortex, right fusiform gyrus, and insula activation, but increased left superior temporal gyrus activation in the HSR group. CONCLUSIONS: The findings indicate the possibility of blunted neurophysiological responses to happy (vs. neutral) facial feedback and abnormal brain activation in high-suicide-risk MDD patients, which may be associated with increased suicide risk. Nevertheless, because the task lacked loss and non-social control conditions, the specificity of these findings to reward or social processing remains to be determined.
Corrigendum to "ECT augmentation of clozapine for clozapine-resistant schizophrenia: A meta-analysis of randomized controlled trials" [J. Psychiatr. Res. (2018) 105 23-32].
Wang G, Zheng W, Li XB … +6 more , Wang SB, Cai DB, Yang XH, Ungvari GS, Xiang YT, Correll CU
J Psychiatr Res · 2026 Aug · PMID 42085823 · Publisher ↗
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Neuroimaging insights into Borderline Personality Disorder patients with and without suicide attempts: A multi-modal structural MRI study.
Boccali A, Crema C, De Francesco S … +17 more , Pedrini L, Lanfredi M, Meloni S, Quattrini G, Pievani M, Gasparotti R, Corbo D, Carcione A, Semerari A, Nicolò G, Riccardi I, Demaria C, Baronio CM, Archetti D, Rossi R, Redolfi A, CLIMAMITHE study group
J Psychiatr Res · 2026 Aug · PMID 42070367 · Publisher ↗
BACKGROUND: Borderline Personality Disorder (BPD) is characterized by emotional dysregulation and high-risk behaviors, including self-harm and suicide attempts. Despite the high prevalence of suicidal behavior in BPD, th...
BACKGROUND: Borderline Personality Disorder (BPD) is characterized by emotional dysregulation and high-risk behaviors, including self-harm and suicide attempts. Despite the high prevalence of suicidal behavior in BPD, the neurobiological substrates underlying suicide vulnerability remain poorly understood. This study aimed to investigate differences in BPD and a history of suicide attempt (BPD-SA) with those without such a history (BPD-NA) using multimodal magnetic resonance imaging (MRI). METHODS: Neuroimaging data from 60 individuals with BPD were analyzed. Acquisitions included high-resolution T1-weighted, Fluid-Attenuated Inversion Recovery sequences, and Diffusion Weighted Imaging. Imaging features were compared between BPD-SA (n = 30) and BPD-NA (n = 30) subgroups, adjusting for alcohol and substance abuse. Pearson's correlation was used to examine associations between imaging features and clinical questionnaires, including childhood trauma and symptom severity. RESULTS: Significant differences (p < 0.05) were found between BPD-SA and BPD-NA in brain volume, cortical thickness, and Fractional Anisotropy. The most pronounced changes were localized to limbic structures (hippocampus and fornix), the frontal cortex, corpus callosum, and cortico-thalamic pathways, with BPD-SA showing more severe white matter alterations. Correlation analyses revealed that imaging abnormalities in BPD-SA were negatively correlated with the Childhood Trauma Questionnaire (CTQ). In contrast, Zanarini Rating Scale (ZAN-BPD) scores were negatively correlated with MRI-assessed neurobiological alterations only in the BPD-NA subgroup. CONCLUSION: This study provides preliminary evidence that BPD-SA may exhibit distinct patterns of structural and white matter alterations compared to BPD-NA. Such neuroimaging differences may reflect underlying neurobiological dimensions related to vulnerability, illness severity, and developmental risk exposure.
Links between parental internalizing disorder severity and default mode network connectivity in adolescent offspring.
Tan SL, Pawlak M, Bray S … +1 more , Kopala-Sibley DC
J Psychiatr Res · 2026 Aug · PMID 42068654 · Publisher ↗
BACKGROUND: Internalizing disorders have been linked to alterations in default mode network (DMN) resting-state functional connectivity (RSFC). Given the increased risk of internalizing disorders in offspring of parents...
BACKGROUND: Internalizing disorders have been linked to alterations in default mode network (DMN) resting-state functional connectivity (RSFC). Given the increased risk of internalizing disorders in offspring of parents with a history of internalizing disorders, this study examined associations between parental depression and anxiety severity and adolescent DMN RSFC. METHODS: Participants were 116 parent-adolescent dyads with youth between ages of 11-17 years. Structured diagnostic interviews and self-report questionnaires were completed by parents and adolescents to assess history and severity of internalizing disorders. Adolescents completed resting-state functional magnetic resonance imaging to determine the RSFC between regions of the DMN including the medial prefrontal cortex (mPFC), posterior cingulate cortex (PCC), and bilateral lateral parietal cortices (LPC). Analyses examined region-of-interest (ROI) to ROI RSFC, with bivariate correlations and linear regressions used to assess whether child age, sex, child internalizing symptoms, and parental internalizing symptoms were associated with child RSFC alterations. RESULTS: After controlling for child age, sex, internalizing symptoms, and in-scanner motion, increased parental depressive severity was associated with increased child RSFC between the PCC and right LPC. Child internalizing symptoms were also linked to decreased RSFC between the right LPC and the mPFC. LIMITATIONS: This study is limited by its modest sample size relative to effect sizes for functional connectivity-phenotype associations, cross-sectional design, and a relatively homogeneous sample in terms of ethnicity, socioeconomic status, and parental sex. CONCLUSIONS: Results suggest that, among youth with a parental history of depression or anxiety, increased severity of parental depression is associated with altered offspring DMN RSFC.
The impact of Open Dialogue on health care costs: A nationwide register-based cohort study among young Danes in acute psychiatric crises.
Sopina L, Erlangsen A, Buus N … +2 more , Bikic A, Hastrup LH
J Psychiatr Res · 2026 Aug · PMID 42068653 · Publisher ↗
BACKGROUND: Open Dialogue has been linked to better outcomes and reduced hospital admissions amongst patients with mental health problems. Yet, information on associated health care costs is scarce. OBJECTIVE: To conduct...
BACKGROUND: Open Dialogue has been linked to better outcomes and reduced hospital admissions amongst patients with mental health problems. Yet, information on associated health care costs is scarce. OBJECTIVE: To conduct an evaluation of downstream health care costs of Open Dialogue provided to young patients in acute psychiatric crises and compared with treatment as usual. DESIGN: Matched case-cohort study based on clinical and register data. SETTING: Open Dialogue was offered between 2000 and 2019 as standard care to adolescents in acute psychiatric crisis in four municipalities in Region Southern Denmark. PARTICIPANTS: 355 individuals between 14 and 19 years received treatment with Open Dialogue and were compared to 979 peers who had received standard acute psychiatric treatment in two other Danish Regions (Central Denmark Region and North Denmark Region) where Open Dialogue was not implemented. METHODS: Health care cost data (including primary care, psychiatric and somatic care) was available during 2005-2018. We matched controls to the cases based on a X-factor propensity score and a 3:1 ratio. The statistical analysis took a double-robust approach combining matching with Difference-in-Difference analysis over 12-year follow-up. Graphical inspection and placebo tests were used to test parallel trends assumption, and generalized estimation equations were applied as a robustness check to validate the results. RESULTS: In the intervention group, the unadjusted yearly mean health care costs were €299 the year before receiving Open Dialogue. In the subsequent year, it was €1523, equivalent of a €1224 increase. In corresponding years, the respective health care costs were €208 and €1813 for members of the control group, implying an increase of €1605. The increase in health care costs was driven by psychiatric costs in both groups. Follow-up up to 12 years showed a decrease in total health care costs to €457 in the Open Dialogue group and €938 in the control group. The difference between the groups was not statistically significant. CONCLUSIONS: This evaluation did not find statistically significant differences in total health care costs between patients receiving Open Dialogue and controls over 12-year follow-up. SOCIAL MEDIA ABSTRACT: Young patients in treatment with Open Dialogue during acute psychiatric crisis did not have higher total health care costs up to 12-year follow-up compared to controls.
Urinary pesticide biomarker associations with depression and anxiety scores from adolescence into young adulthood in the ESPINA cohort.
Chronister BNC, Hussari MN, Lopez-Paredes D … +8 more , Checkoway H, Suarez-Torres J, Gahagan S, Bradman A, Martinez D, Hong S, Moore RC, Suarez-Lopez JR
J Psychiatr Res · 2026 Aug · PMID 42068652 · Full text
INTRODUCTION: Growing evidence suggests pesticide exposure can affect emotional well-being; limited research exists across adolescence and young adulthood. We examined cross-sectional and longitudinal associations of pes...
INTRODUCTION: Growing evidence suggests pesticide exposure can affect emotional well-being; limited research exists across adolescence and young adulthood. We examined cross-sectional and longitudinal associations of pesticide biomarkers with anxiety and depression scores. METHODS: We analyzed 646 participants from Ecuadorian agricultural communities: 510 in 2016 (ages 11-17y) and 485 in 2022 (17-24y). Twelve urinary insecticide metabolites were measured. Validated questionnaires assessed depression and anxiety. Generalized estimating equations (GEE) estimated associations for continuous scores and logit GEE calculated odds ratios (OR) of elevated symptoms, adjusting for demographic and anthropometric variables. RESULTS: In 2016, an interquartile range higher overall pesticides summed (β = 1.01 95%CI:[0.48, 1.53]), organophosphates summed (β = 0.99 [0.47, 1.51]), 3,5,6-trichloro-2-pyridinol (TCPy; β = 0.97 [0.49, 1.45]), pyrethroids summed (β = 0.69 [0.11, 1.27]) and 3-phenoxybenzoic acid (β = 0.31 [0.01, 0.61]) were positively associated with depression. Detectable 5-hydroxy imidacloprid (OHIM) doubled elevated depression odds. In 2022, higher sulfoxaflor isomers were protective, but higher clothianidin increased elevated depression odds. Longitudinally, depression was positively associated with overall pesticides summed (β = 0.06 [0.02, 0.11]), organophosphates summed (β = 0.05 [0.001, 0.10]), TCPy (β = 0.06 [0.02, 0.10]), pyrethroids summed and trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane carboxylic acid (trans-DCCA; β = 0.01 [0.003, 0.02]). For anxiety, in 2016 detectable trans-DCCA (OR = 2.52 [1.52, 4.16]) was associated with elevated symptoms. In 2022, higher clothianidin increased elevated anxiety odds (OR = 1.44 [1.07, 1.93]). Longitudinally, trans-DCCA (OR = 1.39 [1.03, 1.87]) and OHIM (OR = 1.44 [1.02, 2.04]) increased elevated anxiety odds. CONCLUSIONS: Organophosphates, pyrethroids, and neonicotinoids were generally linked to higher depression and anxiety, while sulfoximines and one organophosphate appeared protective. OHIM and trans-DCCA showed consistent adverse associations across years.
Beyond medication choice: Predictors of psychiatric readmission after inpatient initiation of long-acting injectable antipsychotics.
Lynch ST, Chaia AI, Renard KB … +2 more , Cohen LJ, Kymissis CM
J Psychiatr Res · 2026 Aug · PMID 42061210 · Full text
BACKGROUND: Long-acting injectable (LAI) antipsychotics are frequently initiated during psychiatric hospitalization to improve adherence and reduce relapse risk. However, real-world data comparing outcomes across LAI for...
BACKGROUND: Long-acting injectable (LAI) antipsychotics are frequently initiated during psychiatric hospitalization to improve adherence and reduce relapse risk. However, real-world data comparing outcomes across LAI formulations remain limited, particularly after accounting for illness severity and discharge complexity. METHODS: This retrospective cohort study included adult psychiatric in patients who received an LAI antipsychotic prior to discharge from an urban academic hospital between January 2020 and October 2022. LAI exposure was categorized as first-generation antipsychotic (FGA) LAIs (haloperidol or fluphenazine decanoate) or second-generation LAIs (aripiprazole lauroxil or paliperidone palmitate). Outcomes included psychiatric readmission within one year of discharge and time to readmission. Time-to-event analyses (Kaplan-Meier and Cox proportional hazards models) were conducted using readmissions captured within the health system, with logistic regression used as a complementary analysis of 1-year readmission risk. RESULTS: The cohort included 264 patients with schizophrenia spectrum disorders. Receipt of an FGA LAI was associated with increased odds of readmission and a shorter observed time to readmission within the health system compared with second-generation agents, particularly paliperidone palmitate. Multiple markers of illness severity and care complexity, including prior psychiatric hospitalizations, discharge on dual antipsychotics, and referral to high-level outpatient services, were also independently associated with readmission. Cannabis or synthetic cannabinoid use was associated with lower readmission risk. CONCLUSIONS: Psychiatric readmission following inpatient LAI initiation was independently associated with both LAI formulation and markers of illness severity and discharge complexity. Associations with FGA LAIs may reflect confounding by indication. These findings highlight the importance of comprehensive discharge planning and individualized risk stratification alongside LAI initiation.
Cerebral metabolism as an isolated predictor of 50% symptomatic improvement over 12 weeks of acute psychotic episode treatment in schizophrenia.
Donicz P, Krzyściak W, Szwajca M … +7 more , Śmierciak N, Bryll A, Karcz P, Rozynek M, Popiela T, Silverstein SM, Pilecki M
J Psychiatr Res · 2026 Aug · PMID 42061209 · Publisher ↗
BACKGROUND: Schizophrenia outcomes remain suboptimal due to relapses, treatment resistance and limited measurement tools for assessing treatment goals and effectiveness. This study identified predictors of symptomatic im...
BACKGROUND: Schizophrenia outcomes remain suboptimal due to relapses, treatment resistance and limited measurement tools for assessing treatment goals and effectiveness. This study identified predictors of symptomatic improvement (≥50% Positive and Negative Syndrome Scale (PANSS) reduction) during 12-week treatment of acute episodes using a multi-dimensional approach encompassing psychopathological, psychological, and biological factors. METHODS: Forty patients (22.68 ± 7.39 years) were assessed during psychotic decompensation. Blood markers (biochemical, metabolic, inflammatory), demographic and clinical data (e.g. PANSS, Beck Depression Inventory (BDI-II)) were analyzed at 1st and 12th week of the hospitalization. Central neurochemical profiles and white matter integrity were measured at baseline using 1.5 T Magnetic Resonance Spectroscopy (MRS) and Diffusion Tensor Imaging (DTI). RESULTS: Greater clinical improvement was significantly correlated with lower childhood trauma, fewer prior episodes, lower baseline depression, and lower inflammatory marker levels. Multinomial logistic regression identified scale-specific predictors: higher baseline PCr + Cr in the left frontal lobe (FL) for the Positive scale (OR = 3.96), higher glucose (OR = 4.90) and lower NAA/Cr (OR = 0.07) in the left FL for the Negative scale and higher fractional anisotropy (FA) in the left anterior cingulate cortex (ACC), alongside higher glucose and NAA in the left FL for the Total scale. No variables met inclusion criteria for the General subscale. CONCLUSIONS: Baseline neurochemical and structural parameters in the left hemisphere serve as isolated predictors of robust symptomatic improvement. These findings support the utility of multi - modal biomarkers integrating neurochemistry and structural integrity for clinical prognosis in acute schizophrenia.
Vitamin D mitigates post-stroke depression by rescuing IL-6-mediated BDNF reduction.
Huang G, Chen J, Long J … +4 more , Zhang H, Han L, Shu Y, Wu Y
J Psychiatr Res · 2026 Aug · PMID 42061208 · Publisher ↗
BACKGROUND: Post-stroke depression (PSD) is a common complication after stroke, while Vitamin D (VD) deficiency is common in stroke patients. This study aims to investigate the relationship between VD and PSD, as well as...
BACKGROUND: Post-stroke depression (PSD) is a common complication after stroke, while Vitamin D (VD) deficiency is common in stroke patients. This study aims to investigate the relationship between VD and PSD, as well as the underlying mechanisms. METHODS: 390 patients with acute ischemic stroke (AIS) were assessed for PSD using Hamilton Depression Rating Scale at 1 month after stroke. PSD model rats were developed by middle cerebral artery occlusion with chronic unpredictable mild stress, and further classified into VD Normal (VDN), VD Deficiency (VDD), and VD-deficient rats receiving VD supplementation (VDS) groups. Depression-like behaviors were evaluated using sucrose preference test (SPT) and forced swim test (FST). RESULTS: PSD patients had significantly lower VD levels compared with patients without depression. The effect of VD deficiency on PSD was mediated by IL-6 and BDNF (chain mediated effect = 0.004, 95%CI = 0.001 - 0.011, P = 0.032). VDD rats showed lower sucrose preference and higher immobility time compared with rats in VDN and VDS groups (P < 0.05). Consistently, increased IL-6 and decreased BDNF was detected in the hippocampus of VDD rats, while VDS mitigated PSD phenotype, as well as reducing IL-6 levels and increasing BDNF levels. CONCLUSION: VD deficiency increases the risk of PSD, which is significantly associated with the upregulation of IL-6 and the subsequent downregulation of BDNF in both AIS patients and PSD model rats. Early VD supplementation mitigates PSD symptoms in rats, as well as suppressing IL-6 and enhancing BDNF. Our study demonstrated that VD supplementation is a potential effective approach for PSD intervention.
The structural core of dual diagnosis: Personality structure profiles in substance use disorders with and without Comorbid personality pathology.
Fanti E, Felici C, Di Pierro R … +3 more , Di Sarno M, Madeddu F, Preti E
J Psychiatr Res · 2026 Aug · PMID 42061207 · Publisher ↗
The coexistence of substance use disorders (SUDs) and personality disorders (PDs) is a complex and frequent phenomenon that presents significant clinical challenges. This study adopted Kernberg's Object Relations Theory...
The coexistence of substance use disorders (SUDs) and personality disorders (PDs) is a complex and frequent phenomenon that presents significant clinical challenges. This study adopted Kernberg's Object Relations Theory (ORT) to explore differences in profiles of personality structure among SUD patients with and without comorbid PD. A total of 60 nonclinical participants, 45 outpatients with SUDs, and 42 inpatients with both SUD and PD (dual diagnosis, DD) were assessed using the STIPO-R, a semi-structured interview grounded in ORT. Group differences were analyzed across all domains and subdomains of the interview. The STIPO-R effectively distinguished both DD and SUD patients from nonclinical participants across all domains and subdomains of personality functioning. However, after adjusting for age and gender, no significant differences emerged between DD and SUD groups. Both clinical groups showed comparable levels of impairment across identity, object relations, defenses, aggression, moral functioning, and narcissism. Our findings support the utility of the STIPO-R and highlight the relevance of dimensional models in capturing personality dysfunction in SUD populations, even in the absence of comorbid PD.
Comprehensive integrative analysis of Exosome-associated genes in major depressive disorder: Diagnostic biomarker discovery, immune modulation, and therapeutic implications.
Li Y, Huang J, Miao P … +3 more , Li F, Fan L, Zhang Y
J Psychiatr Res · 2026 Aug · PMID 42061206 · Publisher ↗
OBJECTIVE: This study systematically analyzed the expression profiles of exosome-associated genes in Major Depressive Disorder (MDD), constructed diagnostic models, and explored their association with immune regulation,...
OBJECTIVE: This study systematically analyzed the expression profiles of exosome-associated genes in Major Depressive Disorder (MDD), constructed diagnostic models, and explored their association with immune regulation, pharmacological targeting, and molecular regulatory networks. METHODS: Three MDD-related datasets (GSE39653, GSE52790, and GSE98793) were retrieved from the Gene Expression Omnibus database, merged, and subjected to differential expression analysis to identify the MDD-associated genes. Exosome-associated genes were identified by intersecting differentially expressed genes (DEGs) with exosome-associated gene sets from GeneCards. Machine learning algorithms were employed to construct diagnostic models, and model performance was evaluated using calibration curves, decision curve analysis, and Receiver Operating Characteristic curves. Immune cell infiltration was assessed using single-sample gene set enrichment analysis, while drug-gene interactions, RNA-binding protein networks, and transcription factor regulatory networks were constructed using the DSigDB, ENCORI, and TRRUST databases, respectively. RESULTS: Twenty-one exosome-associated DEGs were identified, which were enriched in pathways, including ribosome biogenesis, complement cascade, and serotonergic synapses. The machine learning algorithms prioritized seven hub genes (HP, RPS9, TNF, FAM3B, CRYZ, NIP7, and YBX1). The calibration curves demonstrated a high concordance between the model predictions and actual observations. Immune infiltration analysis revealed elevated macrophage and natural killer cell levels in patients with MDD, with significant correlations between hub genes and immune cells. A drug-gene network predicted 654 potential therapeutics, and the molecular docking of lorazepam with HP and TNF suggested anti-inflammatory mechanisms. YBX1 has been identified as a regulatory hub with dual transcription factor functionality. CONCLUSION: This bioinformatic study elucidated the critical role of exosome-associated genes in MDD, established a clinically applicable diagnostic model, and delineated their interplay with immune dysregulation, pharmacological targets, and post-transcriptional networks. These findings deepen the understanding of the pathophysiological mechanisms of MDD and provide a foundation for novel biomarkers and therapeutic development.
Glutamatergic neurotransmission in violence and psychosis: an LTP-like cortical plasticity study.
Bang N, Berg Nesset M, Rasmussen K … +9 more , Dahl H, Bell C, Fischer-Vieler T, Friestad C, Andreassen OA, Moberget T, Jönsson EG, Haukvik UK, Elvsåshagen T
J Psychiatr Res · 2026 Aug · PMID 42056809 · Publisher ↗
BACKGROUND: Among the various mechanisms implicated in abnormal aggression and violent behavior, impaired glutamatergic neurotransmission may represent one contributing factor. However, this hypothesis has been insuffici...
BACKGROUND: Among the various mechanisms implicated in abnormal aggression and violent behavior, impaired glutamatergic neurotransmission may represent one contributing factor. However, this hypothesis has been insufficiently explored in human studies. METHODS: The purpose of the present study was to investigate associations between violent behavior in individuals with and without psychosis and electroencephalography (EEG)-based measures of long-term potentiation (LTP)-like plasticity of the visually evoked potential (VEP), which was previously linked to glutamatergic neurotransmission. Here, healthy controls (HC, n = 180), individuals with psychosis and history of aggression and violent behavior (violent-PSY, n = 16), individuals with psychosis without a history of violence (nonviolent-PSY, n = 25), and individuals with a history of violence without psychosis (violent non-PSY, n = 23) underwent EEG and clinical assessments. RESULTS: Plasticity of VEP component P2 was significantly reduced in violent-PSY compared to nonviolent-PSY (P = .004). Plasticity of P1 component was reduced in violent non-PSY compared to HCs (P = .031). There was no significant association between VEP plasticity and clinical measures of psychotic symptoms, global functioning, and psychopathic traits. CONCLUSIONS: Our findings suggest that synaptic plasticity-the adaptive strengthening or weakening of synaptic connections-may be reduced in patients with psychosis and in individuals with a history of violence. Further research is needed to clarify whether plasticity of the P2 component may serve as a marker of violent behavior in psychosis.
Systematic review of machine learning and deep learning models for EEG-based detection of depression.
Luna-Guevara GR, Vargas-Huicochea I, Rodríguez-Machain AC
J Psychiatr Res · 2026 Aug · PMID 42056808 · Publisher ↗
OBJECTIVE: Depression is a leading cause of global disability, motivating the development of objective and scalable diagnostic approaches. Quantitative electroencephalography (QEEG) combined with machine learning (ML) an...
OBJECTIVE: Depression is a leading cause of global disability, motivating the development of objective and scalable diagnostic approaches. Quantitative electroencephalography (QEEG) combined with machine learning (ML) and deep learning (DL) techniques has gained increasing attention for depression detection. This systematic review aimed to critically examine and descriptively compare the methodologies, performance metrics, and limitations of ML- and DL-based models applied to EEG data for depression detection. METHODS: A systematic review was conducted in accordance with PRISMA 2020 guidelines. Seven electronic databases (PubMed, Scopus, IEEE Xplore, ScienceDirect, Web of Science, SAGE Journals, and MDPI) were searched for peer-reviewed studies published between 2020 and 2024. Eligible studies included human participants, used EEG signals for depression detection, and applied ML or DL algorithms. Extracted information comprised algorithm type, sample size, EEG acquisition parameters, validation strategies, and reported performance metrics, which were synthesized descriptively across studies. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. RESULTS: A total of 42 studies met the inclusion criteria, including 23 ML-based and 19 DL-based investigations. Reported classification accuracy ranged from approximately 76% to 100%. DL studies showed a higher mean reported accuracy than ML studies (93.92% vs. 90.78%); however, this difference was not statistically significant in the exploratory non-parametric comparison. Near-perfect performance values were frequently observed in studies with small sample sizes and subject-dependent or exclusively internal validation strategies, raising concerns regarding overfitting and limited generalizability. Studies relying on publicly available datasets tended to report more stable performance. QUADAS-2 assessment revealed recurrent risk-of-bias concerns, particularly in the domains of patient selection and index test conduct. CONCLUSIONS: Both ML and DL approaches demonstrate potential for EEG-based depression detection, but reported performance differences between them should be interpreted cautiously. Although DL studies tended to report higher accuracy values, this pattern was not statistically significant in exploratory analyses and was strongly influenced by sample size, validation strategy, and methodological design. Future research should prioritize larger and more diverse samples, subject-independent or external validation strategies, and standardized reporting frameworks to enhance methodological rigor and clinical applicability.
Sleep disturbances as a short-term within-person risk-factor for suicidal ideation: A systematic review and meta-analysis.
Bourke M, Sippel F, Fortnum K
J Psychiatr Res · 2026 Aug · PMID 42056807 · Publisher ↗
BACKGROUND: Suicidal ideation is a strong predictor of suicide attempts making it a major public health concern. While long-term risk factors have been well-established, understanding short-term fluctuations in suicidal...
BACKGROUND: Suicidal ideation is a strong predictor of suicide attempts making it a major public health concern. While long-term risk factors have been well-established, understanding short-term fluctuations in suicidal ideation is crucial for developing timely interventions. This meta-analysis examined whether sleep disturbances represent a within-person risk factor for next-day suicidal ideation among at-risk populations. METHODS: Five databases (MEDLINE, PsycINFO, CINAHL, Embase, and Web of Science) were searched from inception to November 2025 for studies using intensive longitudinal designs to assess within-person associations between sleep and suicidal ideation in at-risk populations. A correlated and hierarchical random effects meta-analysis was used to synthesize results, while cluster wild bootstrapping examined subgroup differences. RESULTS: Fifteen reports representing 12 unique studies (67 effect sizes, 959 participants) were included. A significant positive within-person association emerged between sleep disturbances and next-day suicidal ideation (r = .128, 95% CI = .075-.191, p < .001). Results were robust to publication bias. Subgroup analyses revealed no significant differences between sleep dimensions, assessment methods (self-report vs. device-based), or participant age groups (adolescents vs. adults). CONCLUSION: Sleep disturbances constitute a modest but significant short-term risk factor for suicidal ideation in at-risk populations. Though individual night-to-night effects are small, cumulative impacts over time may meaningfully contribute to suicide risk. These findings support integrating sleep monitoring into digital suicide prevention interventions and highlight the need for research examining specific within-person patterns of sleep disturbances and underlying mechanisms.
Supply, demand, and adequacy of the adult psychiatry workforce in the United States: Projecting a shortage to 2038.
Silvestre J, Seeger S, Reitman CA … +1 more , Dubé B
J Psychiatr Res · 2026 Aug · PMID 42048910 · Publisher ↗
BACKGROUND: The adequacy of the psychiatric workforce in the United States remains uncertain due to the increasing mental health demands and projected physician retirement. This study aimed to assess the national and reg...
BACKGROUND: The adequacy of the psychiatric workforce in the United States remains uncertain due to the increasing mental health demands and projected physician retirement. This study aimed to assess the national and regional trends in the adult psychiatric workforce. METHODS: A cross-sectional analysis of the full-time equivalent (FTE) supply and demand projections of adult psychiatrists from 2026 to 2038 was conducted utilizing the Health Workforce Simulation Model (HWSM). Workforce adequacy was defined as the ratio of FTE supply to demand, and trends were analyzed on national, regional and state levels. Linear regression and chi-squared tests were employed to evaluate temporal and geographic trends. The significance threshold was set at 0.05. RESULTS: From 2026 to 2038, the national supply of psychiatrists was projected to decrease from 37,470 to 36,550 (2.5% decrease, P < 0.001) while demand was projected to increase from 52,100 to 73,330 (40.7% increase, P < 0.001). As a result, psychiatry workforce adequacy was projected to decrease (71.9% to 49.8%, P < 0.001). In 2026, psychiatry workforce adequacy was lowest in non-metropolitan areas (34.8% vs 75.9%, P < 0.001). By 2038, the states with the lowest psychiatry workforce adequacy were Kentucky (25.2%), Indiana (26.8%), and Mississippi (28.3%). Psychiatry workforce adequacy ranked in last place among twenty additional specialties in 2026 and 2038. CONCLUSION: Projections indicate a significant gap between supply and demand for adult psychiatrists in the US. These findings highlight the need for ongoing monitoring and strategic interventions in workforce planning, including expansion of training programs, redistribution of providers, and integration of team-based care models.
A clinical perspective of Gambling Dual Disorder: an italian cross-sectional multicenter study.
Girone N, Leuzzi R, Ciliberti C … +15 more , Liguori SN, Delli Zotti GB, Rabà T, Colletti MA, Cocchi M, Ferrero F, Leonardi M, Turco M, Longo L, Zita G, Fiocchi MI, Benatti B, Limosani I, Percudani M, Dell'Osso B
J Psychiatr Res · 2026 Aug · PMID 42044564 · Publisher ↗
INTRODUCTION: Gambling Dual Disorder (GDD) is a proposed clinical construct describing the co-occurrence of Gambling Disorder (GD) with other psychiatric conditions. Although preliminary evidence supports this model, cli...
INTRODUCTION: Gambling Dual Disorder (GDD) is a proposed clinical construct describing the co-occurrence of Gambling Disorder (GD) with other psychiatric conditions. Although preliminary evidence supports this model, clinical data remain limited. This multicenter, cross-sectional Italian study aimed to further characterize GDD by comparing patients with GD only and those with co-occurring psychiatric disorders. METHODS: A total of 227 outpatients diagnosed with GD were consecutively recruited from two specialized psychiatric clinics in Milan. Patients were stratified into two subgroups: GD-only and GDD (i.e., GD plus ≥1 additional DSM-5 psychiatric disorder). Sociodemographic and clinical variables were collected, including the distribution of lifetime comorbidities. Psychometric questionnaires were used to assess gambling severity and key psychopathological dimensions. RESULTS: Among the total sample, 137 patients (60.4%) met criteria for GDD. Compared to the GD-only group, GDD patients were significantly older (44.35 ± 14.85 vs. 36.76 ± 15.03 years; p < .05) and reported a later onset of gambling behavior (33.16 ± 13.13 vs. 26.03 ± 11.58 years; p < .005). The GDD group showed higher rates of lifetime suicidal ideation and suicide attempts, along with significantly greater emotional dysregulation. Personality disorders and mood disorders emerged as the most frequent psychiatric comorbidities. CONCLUSION: This study confirms that psychiatric comorbidities are highly prevalent among patients with GD and are associated with distinct sociodemographic and clinical features. These findings support the clinical relevance of the GDD model and underscore the importance of recognizing and integrating this model into clinical practice to enhance diagnostic accuracy, improve therapeutic strategies, and guide future investigations in refining the management of gambling-related disorders.
Neighborhood disadvantage and accelerated epigenetic aging in the early aftermath of trauma: The moderating role of individual psychological resources.
Webb EK, Zannas AS, Linnstaedt SD … +32 more , House SL, Beaudoin FL, An X, Stevens JS, Neylan TC, Clifford GD, Jovanovic T, Rauch SL, Haran JP, Storrow AB, Lewandowski C, Musey PI, Hendry PL, Sheikh S, Jones CW, Pascual JL, Seamon MJ, Harris E, Pearson C, Peak DA, Merchant RC, Domeier RM, Rathlev NK, O'Neil BJ, Sergot P, Sanchez LD, Bruce SE, Harte SE, Koenen KC, Ressler KJ, McLean SA, Harnett NG
J Psychiatr Res · 2026 Aug · PMID 42033878 · Publisher ↗
Socioenvironmental factors may be associated with patterns of biological age and modify individual vulnerability to trauma- and stress-related psychiatric conditions. We examined whether neighborhood socioeconomic disadv...
Socioenvironmental factors may be associated with patterns of biological age and modify individual vulnerability to trauma- and stress-related psychiatric conditions. We examined whether neighborhood socioeconomic disadvantage is associated with accelerated epigenetic aging in the early aftermath of trauma. Next, we tested whether individual psychological resources, previously shown to attenuate stress-related accelerated aging, moderated the association between neighborhood disadvantage and epigenetic aging. Participants provided blood samples approximately 2 weeks post-trauma (N = 203; 64% female) and completed sociodemographic and psychometric assessments, including a measure of individual psychological resources (Connor-Davidson Resilience Scale [CD-RISC]). Epigenetic aging was assessed using the Horvath, Hannum, GrimAge, PhenoAge, and DunedinPACE clocks. Neighborhood disadvantage (national area deprivation index [ADI]) was derived from participants' home addresses. Linear models evaluated the relationship between ADI and epigenetic aging as well as a subsequent CD-RISC x ADI interaction after covarying for chronological age, income, sex, lifetime trauma, lifetime tobacco and alcohol use, PTSD symptoms, and five estimated cell-type proportions. Higher ADI was associated with accelerated aging in GrimAge, PhenoAge, and DunedinPACE models (ps <0.05) after adjusting for covariates. There was an ADI x CD-RISC interaction on GrimAge, such that the effect of neighborhood disadvantage was not significant among individuals with higher levels of individual psychological resources. Findings underscore a link between neighborhood disadvantage and accelerated biological aging and highlight several modifiable factors at both the neighborhood and individual levels associated with epigenetic age.
The association between mental health disorders and allergic reactions: a multicenter retrospective analysis.
Chen K, Maroney M, Liu MT … +4 more , Greer D, Chou I, Golbin S, McCarthy C
J Psychiatr Res · 2026 Aug · PMID 42033877 · Publisher ↗
BACKGROUND: Psychiatric disorders and allergies are highly prevalent and are increasingly recognized as interconnected. This study aimed to characterize the association between psychiatric diagnosis and allergies by inve...
BACKGROUND: Psychiatric disorders and allergies are highly prevalent and are increasingly recognized as interconnected. This study aimed to characterize the association between psychiatric diagnosis and allergies by investigating correlations between a wide range of psychiatric diagnostic categories and the documentation of allergies to different types of allergens. METHODS: This was an IRB-approved, multi-center, retrospective analysis of patients aged 18-90 years old admitted to seven hospital sites across a large health system between October 1st, 2023, and September 30th, 2024. The primary analysis investigated the correlation between the presence of a psychiatric diagnosis and the number of documented allergies utilizing a linear regression model adjusted for potential confounders of age, sex, and body mass index, and the associations between specific psychiatric diagnosis categories and the number of allergies to non-psychiatric drugs, psychotropic drugs, and non-drug substances. RESULTS: 71,725 patients were included in the final analysis. A statistically significant positive correlation between the presence of any psychiatric diagnosis and the number of allergies was found: F (4, 71723) = 2722.091, B = 0.74, R = 0.132, p < 0.001. The strongest associations were observed in somatic symptom and related disorders (B = 0.846, p < 0.001), trauma-and stressor-related disorders (B = 0.832, p < 0.001), and obsessive-compulsive and related disorders (B = 0.798, p < 0.001). CONCLUSIONS: This study found that patients with psychiatric diagnoses had more documented allergies than those without psychiatric diagnoses. Psychiatric diagnoses associated with increased somatization reported more than other diagnoses, highlighting the importance of allergy verification in those with underlying psychiatric conditions.
Comparing ADHD symptom network structure in Chinese youth with ADHD: ADHD alone vs. ADHD with comorbidities.
Luo J, Shao W, Wu Y … +6 more , Huang H, Xu G, Qi Y, Overton P, Zheng Y, He F
J Psychiatr Res · 2026 Aug · PMID 42025101 · Publisher ↗
BACKGROUND: ADHD is often comorbid with other psychiatric conditions, but it remains unclear whether comorbidities influence the structure of ADHD symptoms. This study examines ADHD symptom profiles in individuals with A...
BACKGROUND: ADHD is often comorbid with other psychiatric conditions, but it remains unclear whether comorbidities influence the structure of ADHD symptoms. This study examines ADHD symptom profiles in individuals with ADHD and comorbidities (AC) and individuals with ADHD only (AP). METHODS: The study used a secondary dataset obtained from a mental health survey of 1906 Chinese youth with ADHD, comprising AP (n = 897) and AC (n = 1009). Symptoms were assessed using the caregiver-rated CBCL DSM-oriented ADHD scale (CBCL-ADH). Partial correlation networks were estimated using the EBICglasso algorithm. Network Comparison Tests (NCTs) were conducted to compare the structure of CBCL-ADH items between the AP and AC groups, as well as across subgroups (e.g., gender and age groups). RESULTS: The network of CBCL-ADH items remained largely invariant across groups, despite higher ADHD severity observed in the AC group (p < .001). Subgroup analyses were generally consistent, with some exceptions: a marginal difference in network structure between age groups (p = .07) and an elevated risk of developing comorbidities among older participants (12-16 years) and female participants. CONCLUSION: While comorbid conditions appear unrelated to the structure of caregiver-informed ADHD symptoms, further investigation is warranted to examine ADHD structure using multi-informant assessments, as well as the complex interactions between ADHD and comorbid symptom profiles. Variations in subgroups highlight the need for developmental and sociocultural considerations in managing comorbidities. These findings suggest that targeting central ADHD symptoms (e.g., hyperactivity) may offer benefits for ADHD improvement across comorbid presentations, though further validation is needed.
Effects of laughter therapy on depression and anxiety: A dose-response meta-analysis with trial sequential analysis.
Liu CY, Liu TH, Huang CW … +3 more , Lai CC, Lin CH, Su KP
J Psychiatr Res · 2026 Aug · PMID 42019364 · Publisher ↗
OBJECTIVE: Laughter therapy serves as a practical and efficient complementary alternative therapy for psychological distress. This meta-analysis aimed to further investigate the efficacy of laughter therapy by integratin...
OBJECTIVE: Laughter therapy serves as a practical and efficient complementary alternative therapy for psychological distress. This meta-analysis aimed to further investigate the efficacy of laughter therapy by integrating trial sequential analysis (TSA) and exploring the optimal treatment duration using a dose-response meta-analysis. DATA SOURCES: This systematic review conducted randomized controlled trials across major databases (PubMed, EMBASE, PsycINFO, and the Cochrane Library), from their inception to November 12, 2023. Included articles using laughter therapy for depression, anxiety, stress, pain, or quality of life. We employed TSA to assess evidence conclusiveness and the dose-response meta-analysis to explore optimal treatment length. STUDY SELECTION AND DATA EXTRACTION: Thirty-three studies were included in the analysis. The following information was extracted: information on publication, patients' characteristics, intervention type, intervention duration. Information on outcomes (e.g., type of outcome, measurement tool) and statistical data needed for effect size estimation were extracted independently by two authors (THL & CYL). RESULTS: Laughter therapy significantly reduced depression (standardized mean differences [SMD] = -0.9; 95% CI: -1.29 to -0.52), anxiety (SMD = -0.83; 95% CI: -1.16 to -0.50), and stress (SMD = -0.68; 95% CI: -1.02 to -0.33) (all p < .001). The dose-response meta-analysis revealed that longer cumulative treatment durations up to 400 min for depression and 600 min for anxiety yielded greater improvements, with benefits plateauing thereafter. Our subgroup analyses showed that laughter-inducing therapies significantly alleviate depression, anxiety and stress across various ages, patient conditions, and care settings. CONCLUSIONS: Laughter therapy effectively alleviates depression, anxiety, and stress, with optimal durations identified for these benefits. The study strengthens the evidence base for laughter therapy and provide supportive evidence for conducting more future RCTs to clinical implication.
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