J Psychiatr Res [JOURNAL]
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200 papers
Baseline symptom severity and response to multisession cathodal transcranial direct current stimulation in adolescents and young adults with autism: an exploratory analysis.
Chan MMY, Wong KL, Shea CKS … +4 more , Saxena D, Cheung MC, Chan AS, Han YMY
J Psychiatr Res · 2026 Jul · PMID 41921246 · Publisher ↗
BACKGROUND: Identifying baseline clinical characteristics associated with treatment response is crucial for optimising intervention strategies in people with autism spectrum disorder (ASD). This study aimed to distinguis...
BACKGROUND: Identifying baseline clinical characteristics associated with treatment response is crucial for optimising intervention strategies in people with autism spectrum disorder (ASD). This study aimed to distinguish responders from non-responders to a multisession prefrontal transcranial direct current stimulation (tDCS) protocol and to explore how baseline individual characteristics relate to treatment outcomes. METHODS: Using complementary inferential statistics and predictive modelling approaches, we analysed baseline clinical characteristics of adolescents and young adults with ASD who underwent cathodal tDCS (1.5 mA) over the left dorsolateral prefrontal cortex, coupled with cognitive remediation training. Baseline symptom severity was assessed using the Autism Diagnostic Interview-Revised (ADI-R). Normalised feature importance and Shapley additive explanations (SHAP) were used to identify features associated with restricted and repetitive behaviour (RRB) reduction, and a model-derived classification threshold was estimated to stratify potential responders and non-responders within this protocol. RESULTS: Inferential statistics revealed that responders had significantly lower social interaction symptom severity than non-responders (p < .001; Cohen's d = 0.41). Predictive modelling further indicated that lower baseline verbal communication severity was associated with greater RRB reduction (averaged SHAP value across models = -0.017). A model-derived classification threshold of 19.6 on the ADI-R verbal communication sub-score was identified to differentiate responders and non-responders within this protocol. CONCLUSION: Lower baseline verbal communication severity is associated with greater behavioural improvement following this multisession prefrontal tDCS protocol. These findings should be interpreted as exploratory and hypothesis-generating. Replication in larger, independent cohorts is required to assess the robustness and generalisability of these findings. TRIAL REGISTRATION: ClinicalTrials.gov (ID: NCT05035511).
Interactions between mental health predictors on post-concussive depressive symptoms among service members and veterans with concussion.
Remigio-Baker RA, Reid MW, Nelson A … +1 more , Kennedy J
J Psychiatr Res · 2026 Jul · PMID 41921245 · Publisher ↗
PURPOSE: US service members and veterans (SMVs) are at an increased risk for both concussion and mental health disorders such as depression and post-traumatic stress disorders (PTSD). Although depression history has been...
PURPOSE: US service members and veterans (SMVs) are at an increased risk for both concussion and mental health disorders such as depression and post-traumatic stress disorders (PTSD). Although depression history has been shown associated with elevated post-concussive depressive symptoms, it is unclear whether this relationship changes in the presence of other mental health conditions such as PTSD. This study evaluated whether the relationship between depression history and the level of post-concussive depressive symptoms varied by pre-injury PTSD. METHODS: Data from 427 SMVs with concussion history from a US military medical center was used for this cross-sectional study. Concussion, pre-injury depression, and PTSD were assessed through medical record review and self-report, and the level of post-injury depressive symptoms was measured using the Center for Epidemiologic Studies- Depression Scale. Poisson regression with robust error variance was utilized to evaluate the association of pre-injury depression with clinically-elevated depressive symptoms post-injury, and interaction by pre-injury PTSD. RESULTS: Participants with (vs. without) pre-injury depression were significantly more likely to have clinically-elevated depressive symptoms post-injury, but only in the presence of pre-injury PTSD (PR = 2.02, CI = 1.45, 2.81) and not without (PR = 1.12, CI = 0.84, 1.50). Interaction by pre-injury PTSD was statistically significant (p < 0.001). CONCLUSIONS: Depression history has been shown to elevate post-concussive depressive symptoms; however, the findings of this study suggest that this association may exist only in the presence of pre-injury PTSD. Identification of SMVs with concomitant depression and PTSD history may further inform the concussion treatment of those who may likely have clinically-elevated post-concussive depressive symptoms.
Letter to the Editor: Comment on Wang et al., "Gambling disorder and suicide risk: A meta-epidemiology study".
Kristensen JH, Erevik EK, Pallesen S
J Psychiatr Res · 2026 Jul · PMID 41915998 · Publisher ↗
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Decreasing prevalence in youth depressive episodes: Evidence from the 2021-2024 national survey on drug use and health.
Andrew Yockey R, Apu A, Grigsby T … +3 more , Bleasdale J, Mattingly D, Hoopsick R
J Psychiatr Res · 2026 Jul · PMID 41911630 · Publisher ↗
BACKGROUND: Major depressive disorder (MDD) is a leading contributor to the global burden of disease and commonly develops during adolescence. The COVID-19 pandemic was linked to significant increases in depressive sympt...
BACKGROUND: Major depressive disorder (MDD) is a leading contributor to the global burden of disease and commonly develops during adolescence. The COVID-19 pandemic was linked to significant increases in depressive symptoms among youth, but less is known about whether these increases have continued in recent years. OBJECTIVE: Using the first four consecutive years of methodologically comparable national data since the pandemic, we examined changes in past-year major depressive episode (MDE) among U.S. adolescents aged 12-17 years from 2021 to 2024 and evaluated demographic and substance use factors. METHODS: We analyzed pooled, cross-sectional data from the 2021-2024 National Survey on Drug Use and Health (NSDUH), a nationally representative survey of non-institutionalized U.S. residents. The sample included 43,828 adolescents aged 12-17 years. Past-year MDE was assessed using DSM-5-based criteria. Survey-weighted logistic regression models estimated changes over time and adjusted associations with age, sex, race/ethnicity, and past-year tobacco, alcohol, and marijuana use. Predicted prevalences and 95% confidence intervals were calculated using post-estimation margins. RESULTS: The prevalence of past-year MDE decreased from 20.5% in 2021 to 14.8% in 2024, reflecting a 38.5% relative reduction. Adjusted models showed decreasing odds of MDE over time. Girls had significantly higher odds of MDE compared to boys, and older adolescents were at greatest risk. Compared with non-Hispanic White adolescents, non-Hispanic Black/African American, non-Hispanic Asian, and non-Hispanic Native Hawaiian/Other Pacific Islander adolescents had lower odds of MDE, while non-Hispanic multiracial adolescents had higher odds. Alcohol and marijuana use were linked to increased odds of MDE. CONCLUSIONS: Past-year MDE among U.S. adolescents declined from 2021 to 2024, indicating partial recovery following pandemic-related increases. Despite overall improvements, ongoing disparities based on sex, age, race/ethnicity, and substance use highlight the continued need for targeted adolescent mental health prevention and early intervention efforts.
Paraphilias and paraphilic disorders in Attention-Deficit/Hyperactivity Disorder: an observational study.
Soldati L, Deiber MP, Hasler R … +3 more , Meuleman B, Desseilles M, Perroud N
J Psychiatr Res · 2026 Jul · PMID 41905118 · Publisher ↗
Individuals with Attention-Deficit/Hyperactivity Disorder (ADHD) are more likely than the general population to exhibit increased sexual desire and to engage in risky sexual behaviors. Emerging evidence also links ADHD t...
Individuals with Attention-Deficit/Hyperactivity Disorder (ADHD) are more likely than the general population to exhibit increased sexual desire and to engage in risky sexual behaviors. Emerging evidence also links ADHD to a heightened risk of sexual offenses and recidivism. While certain paraphilias and paraphilic disorders are known risk factors for sexual offending, it remains unclear whether they are more prevalent in individuals with ADHD than in the general population. This preliminary study investigated the prevalence of paraphilias and paraphilic disorders among 50 adults with ADHD and 136 control subjects. Paraphilic disorders tended to be more prevalent among individuals with ADHD than among control subjects. Although several differences did not reach statistical significance, voyeurism, voyeuristic disorder, exhibitionism, sadism, and pedophilic disorder were more frequently observed in the ADHD group than in controls. The pattern of increased prevalence of paraphilic disorders suggests greater psychological distress related to paraphilic interests among individuals with ADHD. The increased occurrence of voyeurism, sadism, and exhibitionism-particularly among men-raises concerns about a potential risk of sexual offending. Clinically, it is essential to distinguish between individuals with ADHD and paraphilic interests who present no risk of sexual offending and those who may pose such a risk. For the former, clinicians should be trained to evaluate and discuss paraphilic interests sensitively to promote sexual health; when paraphilias cause psychological distress, psychotherapeutic support should be provided. For the latter, when a non-negligible risk is identified, targeted psychotherapeutic and/or psychopharmacological interventions should be implemented.
Who's getting care? Acute treatment utilization following an emergency department visit among adults with major psychiatric disorders and suicidal thoughts and behaviors.
Rabasco A, Choi J, Ladis I … +6 more , Arias SA, Weinstock LM, Miller I, Boudreaux ED, Camargo CA, Gaudiano BA
J Psychiatr Res · 2026 Jul · PMID 41905117 · Full text
INTRODUCTION: People with major psychiatric disorders (e.g., major depressive disorder [MDD], bipolar disorder [BD], and schizophrenia-spectrum disorders [SSD]) utilize acute treatment at high rates, while struggling to...
INTRODUCTION: People with major psychiatric disorders (e.g., major depressive disorder [MDD], bipolar disorder [BD], and schizophrenia-spectrum disorders [SSD]) utilize acute treatment at high rates, while struggling to engage in outpatient care. There is limited longitudinal research on differences in treatment utilization among people with different psychiatric diagnoses and concurrent suicidal thoughts and/or behaviors (STBs). The current study aimed to examine patterns of and factors associated with treatment utilization (outpatient treatment, psychiatric inpatient hospitalization, emergency department [ED visit]) among individuals with major psychiatric disorders and STBs presenting to the ED. METHODS: Adults with MDD (n = 347), BD (n = 298), and SSD (n = 100) and active STBs were recruited from eight EDs across the United States as part of a larger study on treatment for STBs. Chart reviews and participant assessments were conducted during the 52-weeks following participant ED discharge. RESULTS: Participants with BD and SSD had higher rates of, and shorter time to, inpatient hospitalization and ED visit over follow-up than people with MDD. There were no differences in rates of outpatient treatment between diagnostic groups. Lack of employment and outpatient mental health treatment utilization were associated with inpatient hospitalization over follow-up. Lack of employment, a substance use disorder, and chronic pain were associated with ED visit over follow-up. CONCLUSIONS: Results show that treatment utilization differs by major psychiatric diagnosis. These findings suggest that people with BD and SSD may benefit from additional supports, including vocational services, during and following ED visits to minimize future acute treatment utilization.
Effects of interpersonal psychotherapy on postpartum depression: A systematic review and meta-analysis of randomised controlled trials.
Uncu B, Doğan E
J Psychiatr Res · 2026 Jul · PMID 41905116 · Publisher ↗
BACKGROUND: Postpartum depression affects a significant proportion of women and can impair interpersonal functioning. Interpersonal difficulties may both contribute to and result from PPD, highlighting the importance of...
BACKGROUND: Postpartum depression affects a significant proportion of women and can impair interpersonal functioning. Interpersonal difficulties may both contribute to and result from PPD, highlighting the importance of interventions targeting interpersonal interactions. OBJECTIVE: The aim of this study was to systematically investigate the effect of interpersonal psychotherapy on postpartum depression symptoms. METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) published up to October 2025. PubMed, Embase, Web of Science, and the Cochrane Library were searched by two independent researchers using predefined search terms related to interpersonal psychotherapy and postpartum depression. Eligible studies included RCTs evaluating interpersonal psychotherapy (IPT) in women with postpartum depression, with outcomes measured within the first 12 months postpartum. Two researchers independently screened studies, extracted data, and assessed methodological quality using the Cochrane Risk of Bias tool (RoB 2). Data were synthesized using R software, and pooled effect sizes were calculated using a random-effects model (DerSimonian-Laird method). Subgroup and sensitivity analyses were performed to explore potential sources of heterogeneity. RESULTS: Out of 30,372 identified records, 9 RCTs met the inclusion criteria, encompassing a total of 1269 participants. Pooled analyses demonstrated that IPT significantly reduced postpartum depression symptoms compared with routine care across all follow-up periods from 4 weeks to 9 months postpartum (MD range = -1.91 to -4.05, p < 0.05). Sensitivity analyses and heterogeneity assessments supported the robustness of these findings, with stable effect sizes across studies and generally low to moderate variability (I = 0-88.7%). CONCLUSIONS: Interpersonal psychotherapy is more effective than routine care in reducing postpartum depression symptoms in the first 9 months of the postpartum period. These findings support IPT as a viable early intervention for women at risk of postpartum depression. REGISTRATION NUMBER: CRD42024607590.
Treatment interventions for emetophobia: An extensive scoping review.
Harbor MS, Harvey K, Jenkins PE
J Psychiatr Res · 2026 Jul · PMID 41905115 · Publisher ↗
A specific phobia of vomiting (SPOV), clinically known as emetophobia, is characterised by the severe fear of vomit and vomit-related stimuli. Whilst literature remains unequivocal on the detrimental effects of emetophob...
A specific phobia of vomiting (SPOV), clinically known as emetophobia, is characterised by the severe fear of vomit and vomit-related stimuli. Whilst literature remains unequivocal on the detrimental effects of emetophobia, treatment recommendations and outcomes for emetophobia vary. This scoping review synthesises and maps research on treatment interventions for emetophobia, identifies current trends and potential gaps in emetophobia research, and their outcomes. The purpose is providing a comprehensive summary of treatment interventions to guide researchers in the development of evidence-based interventions. The review was conducted in accordance with JBI Manual for Evidence Synthesis (2024). Five databases were searched (PubMed, SCOPUS, Google Scholar, PsycINFO and PsyArXiy), and a total of 37 studies met inclusion criteria. Results show CBT is the most frequently utilised treatment approach. Studies consisted predominantly of single-case studies (68%), with only two RCT's to date. Less than half of studies used assessment measurements specific to emetophobia to assess treatment outcomes. Findings show a range of therapeutic approaches have been used in the treatment of emetophobia, with CBT the most frequently utilised, although research remains in the early stages and is limited by small sample sizes. Future research should prioritise RCT's using emetophobia specific measures, with a particular emphasis on interventions identified in case studies, to more rigorously assess the effectiveness and generalisability of treatment.
Physical exercise as a catalyst for neuroimmune balance in schizophrenia: Targeting the kynurenine pathway in the PsyLetics project.
Rißmayer M, Fischer J, Hanssen R … +15 more , Kretschmer AC, Blaschke SJ, Jelic S, Annas S, Rihm A, Markser A, Krombholz S, Thevis M, Hohmann C, Schönau E, Hokamp NG, Bloch W, Kambeitz J, Javelle F, Lichtenstein T
J Psychiatr Res · 2026 Jul · PMID 41904841 · Publisher ↗
BACKGROUND: Altered tryptophan-kynurenine metabolism has been associated with schizophrenia. Beyond healthy-control differences, elevated brain kynurenic acid and reduced peripheral metabolites have been linked to sympto...
BACKGROUND: Altered tryptophan-kynurenine metabolism has been associated with schizophrenia. Beyond healthy-control differences, elevated brain kynurenic acid and reduced peripheral metabolites have been linked to symptoms and cognitive deficits. Nonetheless, exercise has been shown to rebalance this pathway by enhancing peripheral kynurenine turnover, with no clear evidence yet in schizophrenia. AIM: This pilot trial from the PsyLetics project investigated whether high-intensity exercise can alter kynurenine metabolism in patients with schizophrenia, and whether improvements in symptoms, psychosocial functioning, and physical health accompany such changes. METHODS: Ten patients with schizophrenia or schizoaffective disorder and ten matched healthy controls participated. Patients were randomly assigned to either high-intensity training or whole-body vibration training, which served as a control condition. Both interventions lasted eight weeks, three times per week. Pre- and post-intervention assessments included blood analysis of tryptophan metabolites, inflammation, psychiatric interviews, psychosocial functioning scales, physical fitness testing, and body composition. RESULTS: At baseline, patients had lower plasma kynurenine and picolinic acid levels than healthy controls. After the intervention, picolinic acid increased in both training groups, while other metabolites remained unchanged. High-intensity training led to greater improvements in psychosocial functioning and muscular strength than the control condition. Positive symptoms improved in both groups; negative symptoms showed no change. CONCLUSION: This pilot study suggests that exercise can modulate kynurenine metabolism in schizophrenia, with picolinic acid emerging as a potential marker of clinical improvement. Psychosocial and fitness gains support exercise as a feasible adjunctive intervention, warranting larger studies to clarify underlying mechanisms within the kynurenine pathway.
Characterization of altered brain functional activity in patients with hypomania.
Liu Y, Ji X, Xu P … +4 more , Yao J, Zhang H, Chen W, Shen Y
J Psychiatr Res · 2026 Jul · PMID 41894926 · Publisher ↗
Hypomania, a diagnostic phase of bipolar disorder (BD), has garnered considerable research attention regarding its underlying neurobiological mechanisms, which remain inadequately understood. This cross-sectional observa...
Hypomania, a diagnostic phase of bipolar disorder (BD), has garnered considerable research attention regarding its underlying neurobiological mechanisms, which remain inadequately understood. This cross-sectional observational study aimed to investigate the neurobiological correlates of hypomania by examining local brain activity and functional connectivity (FC) through resting-state functional magnetic resonance imaging (rs-fMRI) analyses. The results revealed abnormal local brain activity in the anterior orbital gyrus (OFCant) and superior frontal gyrus (SFG) in patients with hypomania. Additionally, FC analysis demonstrated disrupted connectivity between the right OFCant (R OFCant) and both the right putamen (R PUT) and right insula (R INS). Notably, these altered connectivity patterns showed significant correlations with clinical symptom severity. Collectively, these findings provide preliminary neuroimaging evidence for the neurobiological basis of hypomania, warranting replication and validation in larger and independent cohorts.
Predictive validity of the READMIT risk index and development of a prediction model for psychiatric readmission within 30 days among patients with major depressive disorder.
Grøntved S, Lillelund TL, Johnsen SP … +3 more , Mainz J, Kristensen PK, Valentin JB
J Psychiatr Res · 2026 Jul · PMID 41894925 · Publisher ↗
BACKGROUND: When discharging patients, identifying those with a high risk of short-term readmission is crucial, as these readmissions may disrupt patient recovery and increase healthcare costs. The READMIT risk index has...
BACKGROUND: When discharging patients, identifying those with a high risk of short-term readmission is crucial, as these readmissions may disrupt patient recovery and increase healthcare costs. The READMIT risk index has been developed to address this need across all psychiatric diagnoses. However, a broad model might not be applicable to specific diagnoses, e.g., major depressive disorder. OBJECTIVES: We aimed to investigate the predictive validity of the READMIT risk index in a cohort of Danish patients suffering from major depression, and to develop an alternative prediction model for the risk of readmission within 30 days. RESULTS: Based on national register data, we included 24,984 patients discharged from a Danish psychiatric hospital after treatment for major depression. The proportions of patients who experienced readmission within 30 days were 8% (n = 1969) with major depression, 13% (n = 3343) with any psychiatric diagnosis, and 19% (n = 4718) with all-cause readmission. For readmission related to major depression, the predictive performance of the READMIT index, defined as area under the receiver operating characteristic curve (AUC), was 0.48 (95% CI:0.47; 0.49), whereas the prediction model developed in this study showed an AUC of 0.58 (95% CI:0.57; 0.59). CONCLUSION: Neither the READMIT risk index nor a newly developed alternative prediction model based on individual-level variables, achieved an acceptable AUC, i.e., 0.70 or above, and were therefore not able to appropriately predict the risk of readmission within 30 days for patients with major depressive disorder. However, organizational factors and factors related to capacity in the Danish psychiatric system could potentially improve the results.
The association between depressive symptoms and cardiac interoceptive accuracy: A systematic review and meta-analysis.
Tan G, Yuan M, He W … +1 more , Zhang W
J Psychiatr Res · 2026 Jul · PMID 41894924 · Publisher ↗
INTRODUCTION: The relationship between cardiac interoception and mental illness, including depression, has attracted significant interest among neurocognitive scientists. The Interoceptive Bayesian Inference Model predic...
INTRODUCTION: The relationship between cardiac interoception and mental illness, including depression, has attracted significant interest among neurocognitive scientists. The Interoceptive Bayesian Inference Model predicts that interoception is associated with depression; however, clinical studies have yielded inconsistent findings. This meta-analysis aims to confirm the association between depressive symptoms and objectively measured cardiac interoceptive accuracy (IAcc), and to evaluate whether potential moderators influence this relationship. METHODS: According to the PRISMA guidelines, we identified relevant studies through PubMed, Web of Science, and Scopus databases as of April 2024. Using R version 4.3.0, we conducted a meta-analysis to quantitatively synthesize the association between depressive symptoms and cardiac IAcc, as assessed by the heartbeat counting tasks (HCT) and the heartbeat discrimination tasks (HDT), and further performed a moderator analysis. RESULTS: We found a small but significant negative correlation (k = 44 studies, r = -0.10, p < .001) between depressive symptoms and cardiac IAcc in the HCT, but neither in the HDT. There was low-moderate heterogeneity (Q = 60.04, p = .044, I = 28.4%), indicating subtle variation among HCT studies, with none of the potential moderators identified to influence this negative relationship. CONCLUSION: These findings may help uncover the disagreement about the effect size and direction of the association between depressive symptoms and cardiac interoception, and have potential implications for the treatment of depression.
Is comorbid Obsessive-compulsive Personality Disorder responsible for a longer duration of untreated illness in Obsessive-Compulsive Disorder?
Girone N, Bucca C, Benatti B … +5 more , Vismara MEM, Truzoli R, Priori A, Porta M, Dell'Osso BM
J Psychiatr Res · 2026 Jul · PMID 41880973 · Publisher ↗
BACKGROUND AND AIMS: Obsessive-Compulsive Personality Disorder (OCPD) is marked by a pervasive preoccupation with orderliness, perfectionism, and control, often overlapping with Obsessive-Compulsive Disorder (OCD) in ter...
BACKGROUND AND AIMS: Obsessive-Compulsive Personality Disorder (OCPD) is marked by a pervasive preoccupation with orderliness, perfectionism, and control, often overlapping with Obsessive-Compulsive Disorder (OCD) in terms of rigid and repetitive behaviors. While OCD behaviors are ego-dystonic and confined to specific areas of life, OCPD behaviors are ego-syntonic and affect overall functioning. Although the relationship between OCD and OCPD has been object of investigation, the impact of OCPD comorbidity on OCD remains underexplored. This study examines potential clinical differences between OCD patients with and without comorbid OCPD, with a specific focus on duration of untreated illness (DUI). METHODS: A sample of 300 patients diagnosed with OCD was consecutively recruited from a OCD Tertiary Clinic. Patients with OCD were divided into two groups: those with OCD-only and those with comorbid OCPD. Sociodemographic and clinical variables were collected and compared between groups. An additional age- and sex-matched sensitivity analysis was performed to further assess the robustness of the main findings. RESULTS: Out of the 300 patients with OCD, 18.6% (n = 56) were also diagnosed with OCPD. The age at first pharmacological treatment was significantly higher in the OCD with OCPD group compared to the OCD-only group (32.16 ± 17.06 years vs. 27.48 ± 11.17 years; p < .05). The DUI was significantly longer in the OCD with OCPD group (9.2 ± 12.4 years vs. 6.10 ± 8.06 years; p < .05). These findings remained significant after controlling for potential confounding by age and sex through a 1:1 matched sensitivity analysis. CONCLUSION: Almost one out of five patients with OCD has comorbid OCPD. The ego-syntonic nature of OCPD beliefs may contribute to treatment delays, underscoring the importance of early identification of this specific comorbidity in OCD patients to improve treatment outcomes.
Measuring ICD-11 bodily distress disorder symptoms: The development and initial validation of the bodily distress inventory (BoDI).
Levin Y, Rahamim T, Bachem R … +4 more , Hyland P, Karatzias T, Ben-Ezra M, Shevlin M
J Psychiatr Res · 2026 Jul · PMID 41880972 · Publisher ↗
Bodily Distress Disorder (BDD) is a newly introduced diagnosis in the International Classification of Diseases, 11th Revision (ICD-11) that aims to capture the interplay between somatic symptoms and psychological distres...
Bodily Distress Disorder (BDD) is a newly introduced diagnosis in the International Classification of Diseases, 11th Revision (ICD-11) that aims to capture the interplay between somatic symptoms and psychological distress. Existing diagnostic tools based on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the ICD-10 do not fully encompass BDD as defined in ICD-11, highlighting the need for a psychometrically robust assessment tool. To address this issue, the present study examines the psychometric properties of the newly constructed Bodily Distress Disorder Scale (BoDI) in continuously trauma exposed individuals. Data were collected from 3000 Israeli general population participants under conditions of collective trauma. The validation of the 10-item BoDI included factor analysis to test the BoDI's factor structure. In addition, tests of internal consistency, convergent, and discriminant validity were conducted to assess the psychometric properties of the scale. A two-factor structure was identified and showed excellent fit. The two factors - Persistent Preoccupation (cognitive-affective component) and Medical Reassurance-Seeking (behavioral component) showed adequate internal consistency. The BoDI exhibited high convergent validity with established measures of somatic symptoms and good discriminant validity, showing moderate correlations with measures of depression, anxiety, and adjustment disorder, and weaker associations with post-traumatic stress disorder (PTSD) and Complex PTSD. These findings provide initial support for the BoDI as a psychometric tool for assessing BDD. While the findings highlight the potential of the BoDI in trauma-exposed general populations, its practical application in general populations with no collective trauma in the background remains to be explored. The present results provide a valuable foundation for future studies to evaluate its real-world utility in guiding assessment and intervention.
Examining the relation between empathy and hair cortisol levels.
Kadosh-Laor T, Israeli-Ran L, Zelikovich-Moyal L … +2 more , Sultan LD, Uzefovsky F
J Psychiatr Res · 2026 Jul · PMID 41880971 · Publisher ↗
Empathy is essential for social communication, facilitating interpersonal relationships and well-being. While stress can influence social interactions, the biological relationship between chronic stress and empathy remai...
Empathy is essential for social communication, facilitating interpersonal relationships and well-being. While stress can influence social interactions, the biological relationship between chronic stress and empathy remains unclear, as prior research has primarily focused on acute stress. Here we aimed to address this gap by examining the link between hair cortisol levels, as a biomarker of chronic stress, and the different components of empathy. Participants were 42 mothers who provided hair samples, which were analyzed to assess cortisol levels. We focused on mothers due to their central caregiving role and the relevance of caregiving-related stress for cortisol regulation and empathy. Additionally, mothers filled out a battery of online questionnaires assessing different dimensions of empathy: cognitive empathy (the ability to understand others' emotions), empathic concern (compassion for others) and personal distress (self-focused emotional response to others' emotions). We found that maternal hair cortisol level is predicted by personal distress, suggesting that mothers experiencing higher stress levels may also be more emotionally overwhelmed when encountering others' distress. However, no significant associations were observed between cortisol levels and empathic concern or cognitive empathy. These results underscore the complex interplay between stress and empathy components. Physiologically, these distinct emotional components of empathy may alter stress responses in opposite directions.
Cognitive flexibility in adults with schizophrenia: A scoping review.
Palamwar MM, Kulkarni SU, Shingre SS … +1 more , Tendulkar TT
J Psychiatr Res · 2026 Jul · PMID 41880970 · Publisher ↗
BACKGROUND: Cognitive flexibility, defined as the ability to switch cognitive sets to adapt to changing environmental stimuli, is markedly impaired in schizophrenia, contributing to poor functional outcomes. However, res...
BACKGROUND: Cognitive flexibility, defined as the ability to switch cognitive sets to adapt to changing environmental stimuli, is markedly impaired in schizophrenia, contributing to poor functional outcomes. However, research on cognitive flexibility in schizophrenia remains fragmented. This scoping review aims to condense current literature by systematically mapping existing research on cognitive flexibility in adults with schizophrenia. STUDY DESIGN: This review was conducted in accordance with PRISMA-ScR guidelines, and included empirical studies from 2015 to 2025 in English on cognitive flexibility in adults with schizophrenia. It excluded animal studies, pediatric samples, books, narrative reviews, conference abstracts, and commentaries. Studies were screened using the TIT-ABS-KEY (title-abstract-keywords) method, followed by data extraction and analysis of the selected 47 studies. STUDY RESULTS: Cognitive flexibility has been found to be significantly impaired in schizophrenia; markedly so in certain illness presentations. It can be enhanced through cognitive remediation and physical activity. Neuroimaging findings in patients show brain activation in the frontoparietal regions while performing cognitive flexibility tasks. The Trail-Making Test was used most prominently throughout the studies. The major gaps identified were methodological and population-related in nature; specifically, methodological gaps include small sample size and study design limitations. CONCLUSION: This review helps us map the current frameworks underlying cognitive flexibility impairments in schizophrenia, and how that links to other psychopathological symptoms and interventions. The translational impact of this encourages outpatient clinics, inpatient psychiatric facilities, as well as rehabilitation centers to use cognitive remediation and physical exercise to improve cognitive flexibility in patients with schizophrenia.
Victimization stability, emotion dysregulation and suicidal ideation in adolescents.
Levantini V, De Luca L, Menesini E … +1 more , Nocentini A
J Psychiatr Res · 2026 Jul · PMID 41880969 · Publisher ↗
Studies have shown that bullying victimization and emotion regulation difficulties are associated with an increased risk for suicidal ideation and attempts among adolescents. Evidence also showed that these variables mig...
Studies have shown that bullying victimization and emotion regulation difficulties are associated with an increased risk for suicidal ideation and attempts among adolescents. Evidence also showed that these variables might interact in predicting negative outcomes, with emotion dysregulation being more strongly associated with suicide attempts when victimization is present. The current longitudinal study aimed to investigate, in a sample of Italian middle school students, the influence of bullying victimization frequency, emotion dysregulation (i.e., Emotional Reactivity, Interpersonal Sensitivity, and Affective Instability), and their interaction on suicidal ideation over four months. The sample included 321 middle-school students (49.50% females) aged 12-14 years (mean = 12.99, SD = .28). Results showed that both stable and intermittent victimizations were associated with suicidal ideation, with stable victims exhibiting the most significant risk. Also, affective instability was linked to suicidal ideation, but emotional reactivity and interpersonal sensitivity were not. Lastly, our results suggested a trend-level interaction effect between intermittent victimization and interpersonal sensitivity in predicting suicidal ideation; however, probing indicated that higher interpersonal sensitivity was significantly associated with greater suicidal ideation among intermittent victims only. Further analysis showed that higher interpersonal sensitivity was associated with greater suicidal ideation among intermittent victims, suggesting that the combination of intermittent bullying victimization and heightened sensitivity to social cues may characterize an important risk factor for suicidal ideation among adolescents.
Effect of aerobic exercise on sleep quality in patients with mental disorders: A systematic review and meta-analysis.
Xiang Y, Wang M, Feng Y
J Psychiatr Res · 2026 Jul · PMID 41880968 · Publisher ↗
BACKGROUND: Aerobic exercise represents a viable non-pharmacological approach for enhancing sleep quality. This meta-analysis quantitatively synthesizes evidence on its efficacy in adults with mental disorders. METHODS:...
BACKGROUND: Aerobic exercise represents a viable non-pharmacological approach for enhancing sleep quality. This meta-analysis quantitatively synthesizes evidence on its efficacy in adults with mental disorders. METHODS: Comprehensive searches of PubMed/MEDLINE, Web of Science, Embase, and Cochrane Library were conducted from database inception to June 10, 2025. This systematic review included randomized controlled trials (RCTs) evaluating aerobic exercise interventions on sleep quality in patients with mental disorders. Study quality was assessed using the Cochrane RoB 2 tool. Treatment effects were pooled using random-effects models, with Hedges' g estimating effect sizes. Subgroup analyses followed the FITT principle (frequency, intensity, time). RESULTS: Meta-analysis of 15 RCTs (n = 775 adults with mental disorders) demonstrated that aerobic exercise significantly improved sleep quality with a moderate effect size (g = -0.67, 95% CI: 0.95 to -0.40, p < 0.0001). Subgroup analysis by diagnostic category revealed that significant effects were observed in patients with depression (g = -0.73, p = 0.0008) and anxiety disorders (g = -0.36, p = 0.0396), but not in substance use disorder or schizophrenia subgroups. Subgroup analyses indicated larger effect sizes for interventions featuring: frequency ≥3 sessions/week (g = -0.68, p < 0.0001), low-to-moderate intensity (g = -0.73, p < 0.0001), exercise period ≥10 weeks (g = -0.64, p < 0.0001), session duration ≥30 min (g = -0.75, p = 0.0002), and weekly exercise volume >90 min (g = -0.68, p = 0.0007). CONCLUSIONS: Aerobic exercise demonstrates both efficacy and safety in improving sleep quality for patients with mental disorders. Exercise prescriptions suggest long-term (≥10 weeks) low-to-moderate intensity aerobic exercise, characterized by ≥ 3 sessions/week, ≥30 min/session, and >90 min weekly volume.
Schizophrenia in migrants and natives: clinical presentation, treatment patterns, and outcomes in a Spanish acute inpatient unit.
Albert C, Clougher D, Pàmpols-Pérez S … +9 more , Jiménez-Mayoral A, Nicolau-Subires E, Ibarra-Pertusa L, Buil-Reiné E, Adrados-Pérez M, De Prisco M, Bioque M, Llorca-Bofí V, Mur M
J Psychiatr Res · 2026 Jul · PMID 41865718 · Publisher ↗
PURPOSE: To examine differences in sociodemographic, clinical, and treatment-related variables between migrant and native patients with schizophrenia admitted to an acute psychiatric unit in Spain. METHODS: We conducted...
PURPOSE: To examine differences in sociodemographic, clinical, and treatment-related variables between migrant and native patients with schizophrenia admitted to an acute psychiatric unit in Spain. METHODS: We conducted a retrospective cohort study including 689 patients with schizophrenia admitted to the Acute Psychiatric Unit of Santa María University Hospital (Lleida, Spain) between 2010 and 2020. Patients were classified as natives (n = 475) or migrants (n = 214). Group differences were examined using unadjusted comparisons. Multivariable logistic regression analyses were performed for a priori selected outcomes, adjusting for age, sex, and key social factors. Adherence was defined as pharmacological adherence prior to admission and attendance at a scheduled outpatient psychiatric visit one year after discharge. RESULTS: Migrant patients were younger and experienced greater social disadvantage. In adjusted analyses, migrant status remained independently associated with higher odds of hallucinations at admission (OR 1.33, 95% CI 1.12-1.59), lower odds of suicidal ideation (OR 0.78, 95% CI 0.65-0.94), and a higher likelihood of initiation of long-acting injectable antipsychotics during hospitalization (OR 1.30, 95% CI 1.09-1.53). Differences in first-episode presentation, other symptom profiles, and one-year follow-up adherence were attenuated after adjustment. Treatment differences at admission largely converged by discharge, and overall functioning at discharge was comparable between groups. CONCLUSION: Migrant patients with schizophrenia experience social disadvantage and distinct care trajectories. Most differences were largely explained by social and structural factors rather than migrant status itself, although some clinically relevant differences persisted after adjustment, underscoring the importance of addressing social determinants of care.
Associations between childhood trauma and amygdala- and insula-centered resting-state functional connectivity in alcohol use disorder.
Spagnolo PA, Chholak R, Schwandt M … +3 more , Diazgranados N, Goldman D, Momenan R
J Psychiatr Res · 2026 Jul · PMID 41865717 · Full text
OBJECTIVES: Childhood trauma (CT) increases risk for alcohol use disorder (AUD) and is linked to alterations in several brain regions. However, it remains unclear whether CT is associated with network-level resting-state...
OBJECTIVES: Childhood trauma (CT) increases risk for alcohol use disorder (AUD) and is linked to alterations in several brain regions. However, it remains unclear whether CT is associated with network-level resting-state functional connectivity (rs-FC) alterations in adults with AUD, and whether trauma subtypes show dissociable neural signatures. We examined associations between cumulative and subtype-specific CT exposure and amygdala- and insula-seeded rs-FC in adults with AUD versus healthy controls (HC). METHODS: The sample included 214 adults (120 with AUD; 94 HC) who underwent resting-state fMRI and comprehensive clinical assessment. CT exposure was retrospectively assessed using the Childhood Trauma Questionnaire (CTQ). Whole-brain seed-to-voxel rs-FC analyses were conducted using bilateral amygdala and insula seeds to probe connectivity with large-scale brain networks. Linear mixed-effects models tested interactions between diagnostic group (AUD vs. HC) and CT exposure (total CTQ score and exploratory subtype scores). RESULTS: Greater cumulative CT exposure was associated with weaker amygdala- and insula-centered rs-FC in AUD relative to HC. The most consistent effects involved reduced connectivity between these seeds-core nodes of the fronto-limbic and salience networks-and regions within the default mode network (DMN) and ventral visual stream. Exploratory CT subtype analyses (emotional abuse, emotional neglect, physical neglect) revealed largely overlapping rs-FC patterns. CONCLUSIONS: CT is associated with a distinct pattern of network-level hypoconnectivity in adults with AUD, affecting circuits relevant to emotion regulation, memory, and socio-affective visual processing. The convergence of subtype-specific findings likely reflects high polytraumatization and widespread AUD-related network disruption and should be further investigated in future studies.
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