Psychiatria Danubina[JOURNAL]
Sun
200 papers
SELF-REPORTING OF PAIN IN PEOPLE WITH MILD TO MODERATE INTELLECTUAL DISABILITY: IS IT FEASIBLE?
Ciccone O, Lepri A, Zaffini O … +7 more , Camanni G, Vallasciani M, Baglioni A, Tinarelli C, Jenkner A, Salata M, Elisei S
Psychiatr Danub · 2025 Sep · PMID 40982843
The assessment of pain in people with intellectual disabilities (individuals with ID) represents a clinical challenge due to the variability in communicative and cognitive skills. This study explores the feasibility of p...
The assessment of pain in people with intellectual disabilities (individuals with ID) represents a clinical challenge due to the variability in communicative and cognitive skills. This study explores the feasibility of pain self-reporting in individuals with mild to moderate intellectual disability using validated self-assessment scales. Our findings suggest that, under appropriate conditions, self-reporting can be a reliable and empowering method for pain evaluation in this population. This approach may foster autonomy, improve care, and counteract the undervaluation of subjective pain reports.
IMPLEMENTATION OF PAIN SCALE USE IN PEOPLE WITH INTELLECTUAL DISABILITIES IN CLINICAL PRACTICE: A POST-STUDY FOLLOW-UP.
Ciccone O, Zaffini O, Lepri A … +5 more , Camanni G, Vallasciani M, Baglioni A, Tinarelli C, Elisei S
Psychiatr Danub · 2025 Sep · PMID 40982842
Assessing pain in people with intellectual disabilities (PWID), particularly those with multiple sensory and motor impairments, is a complex clinical challenge often overlooked, leading to the risk of underestimating pai...
Assessing pain in people with intellectual disabilities (PWID), particularly those with multiple sensory and motor impairments, is a complex clinical challenge often overlooked, leading to the risk of underestimating pain. The Serafico Institute in Assisi investigated pain assessment in this population using the revised Face, Legs, Activity, Cry, Consolability (R-FLACC) scale and self-report tools. This follow-up study examined the reporting of unexplained behavioral changes and the use of pain scales in routine clinical practice one year after the initial research. A total of 110 participants (72% male; mean age 27 years, range 2-54) were enrolled, including 27 children (25%) and 83 adults (75%). Over seven months, 252 episodes of unexplained behavioral changes were recorded: 227 (90%) assessed with R-FLACC and 25 (10%) via self-report. Of these, 148 (59%) were classified as pain-related, 83 (33%) as distress episodes, and 21 (7%) remained unexplained. The number of episodes reported and consistent use of pain scales, indicate heightened awareness among healthcare and educational staff towards unexplained behaviors that might signal pain, prompting appropriate evaluation and treatment. Pain assessment has now become an integral component of Serafico Institute's clinical practice and operational guidelines for PWID.
SUICIDALITY IN YOUTH POPULATIONS: DATA FROM A CONSULTATION SETTING.
Cinesi G, Sciolto A, Carioti CM … +5 more , Maio FD, Gaias ES, Scopetta F, Giorgi F, Menculini G
Psychiatr Danub · 2025 Sep · PMID 40982841
BACKGROUND: Adolescents and young adults present elevated suicide risk, which remains a major public health concern. This study aims to characterize the clinical and psychosocial features of adolescents and young adults...
BACKGROUND: Adolescents and young adults present elevated suicide risk, which remains a major public health concern. This study aims to characterize the clinical and psychosocial features of adolescents and young adults referred for psychiatric consultation after a suicide attempt. SUBJECTS AND METHODS: We conducted a retrospective observational study at the University Hospital of Perugia, Italy, analyzing 72 patients aged 14-35 who received their first psychiatric evaluation during medical hospitalization. Patients were divided into two groups: those referred after a suicide attempt (SA group, n=36) and those referred for other psychiatric concerns (non-SA group, n=36). Data were extracted from structured consultation reports and included sociodemographic, clinical, and psychopathological variables. Bivariate analyses compared the two groups using appropriate statistical tests. RESULTS: Compared to the non-SA group, the SA group had significantly higher rates of unemployment, positive psychiatric family history, previous suicide attempts, insomnia prior to admission, anxiety symptoms with both psychic and somatic features, personality disorders, and mood stabilizer use. SA patients also showed lower cooperativeness during interviews and were more likely to be assessed with suicidal ideation. More than one third of SA patients were assessed as euthymic post-attempt. CONCLUSIONS: Key clinical markers of suicide risk in youths may include unemployment, family psychiatric history, insomnia, anxiety with somatic and psychic features, and personality disorders. The clinical profile of suicide attempters suggests a possible contribution of bipolar spectrum diathesis and affective dysregulation. Early, multidimensional risk assessment and integrated intervention strategies in liaison psychiatry are essential to improve detection and prevention of suicidality in youth.
AT THE EDGE OF THE SELF: DISSOCIATION AS A TRANSDIAGNOSTIC MARKER IN YOUTH PSYCHOPATHOLOGY.
Scopetta F, Barbi M, Cinesi G … +2 more , Giorgi F, Menculini G
Psychiatr Danub · 2025 Sep · PMID 40982840
BACKGROUND: Dissociative symptoms are increasingly recognised as early indicators of psychopathological vulnerability in adolescence and young adulthood. This study investigates the correlates of dissociation in a sample...
BACKGROUND: Dissociative symptoms are increasingly recognised as early indicators of psychopathological vulnerability in adolescence and young adulthood. This study investigates the correlates of dissociation in a sample of youths referred to a psychiatric outpatient service. SUBJECTS AND METHODS: This study was conducted on a sample of 45 patients aged 14-25 referred to the second-level outpatient clinic for adolescent and young adult psychopathology at the University Hospital of Perugia, Italy. Patients were grouped based on their Dissociative Experiences Scale-II (DES-II) scores (≤30% vs. >30%), and data were analysed using bivariate comparisons. RESULTS: Youths with clinically significant dissociation showed earlier psychiatric onset, reduced social connectedness, increased rates of social withdrawal and non-suicidal self-injury, and elevated attentional impulsivity. Higher scores on depressive, cyclothymic, and anxious temperaments were also observed, along with more severe depressive and anxiety symptoms. The high dissociation group reported greater psychological distress and a broader range of psychotic-like experiences on the Prodromal Questionnaire-Brief (PQ-B). CONCLUSIONS: These findings suggest that dissociation in youths is linked to two partially overlapping trajectories: one involving emotional dysregulation and behavioural impulsivity, and another marked by cognitive-perceptual anomalies and unreality experiences. Dissociation may thus act as a transdiagnostic risk factor across mood and psychotic-spectrum vulnerability. Early identification and integrated treatment strategies focusing on affect regulation, cognitive control, and interpersonal functioning may help prevent the progression to more severe psychopathological states.
PSYCHOTIC SYMPTOMS IN ANOREXIA NERVOSA.
Chieppa AG, Bellucci F, Moretti P … +2 more , Raspa V, Tortorella A
Psychiatr Danub · 2025 Sep · PMID 40982839
BACKGROUND: Recent studies suggest an overlap and mutual influence between Anorexia Nervosa (AN) and psychotic symptoms, with the anorexic voice proposed as a clinically significant marker within this spectrum. This cros...
BACKGROUND: Recent studies suggest an overlap and mutual influence between Anorexia Nervosa (AN) and psychotic symptoms, with the anorexic voice proposed as a clinically significant marker within this spectrum. This cross-sectional observational study aimed to assess the prevalence and characteristics of psychotic symptoms, focusing on the anorexic voice, in patients with AN. Secondary objectives included exploring associations with dissociation, body image disturbance (BID), sociodemographic and clinical factors. SUBJECTS AND METHODS: Forty-three patients were recruited from specialized outpatient and inpatient Services. Anamnestic history was collected, participants completed psychometric assessments, including Positive and Negative Syndrome Scale (PANSS), Brown Assessment of Beliefs Scale (BABS/BABS-A), Eating Disorder Examination (EDE-Q), Eating Disorder Inventory (EDI-3), Body Uneasiness Test (BUT), Body Shape Questionnaire (BSQ), Symptom Checklist-90 Revised (SCL-90-R), Dissociative Experience Scale (DES/A-DES), Community Assessment of Psychic Experiences (CAPE-42), Multidimensional Assessment of Interoceptive Awareness (MAIA). RESULTS: The anorexic voice was significantly associated with clinically relevant dissociation, not with BID. Subthreshold psychotic symptoms were common and significantly linked to body dissatisfaction, eating psychopathology and dissociation. Psychoticism was associated with BID, higher psychiatric comorbidity (especially personality and anxiety disorders), lower ideal BMI and greater general psychopathology. Adolescents showed higher levels of persecutory ideation, interpersonal alienation and general psychopathology. CONCLUSIONS: Psychotic-like symptoms are highly prevalent in AN. The anorexic voice appears more closely related to dissociative processes than psychotic phenomena. Conversely, BID may play a significant role in the onset of predominant ideation about body shape and weight. Larger longitudinal studies are needed to clarify these relationships and their prognostic implications.
Clinical risk factors for suicidality in young males with schizophrenia spectrum disorders.
Belei N, Sharipova R, Pavlichenko A
Psychiatr Danub · 2025 Sep · PMID 40982838
BACKGROUND: Schizophrenia spectrum disorders (SSD) are linked to a higher risk of suicidality, especially among young adults. Despite progress in psychiatric treatments, suicidality remains a leading cause of early death...
BACKGROUND: Schizophrenia spectrum disorders (SSD) are linked to a higher risk of suicidality, especially among young adults. Despite progress in psychiatric treatments, suicidality remains a leading cause of early death in this group. Symptoms like depression and anxiety are increasingly seen as major contributors to this risk. This study aims to explore clinical risk factors for suicidality in young males inpatients diagnosed with SSD, focusing on the roles of depression, anxiety, and previous suicidal behavior. METHODS: This cross-sectional study was conducted at the Psychiatric Hospital no. 1 named after N.A. Alexeev of the Department of Health of Moscow, involving 40 male inpatients aged 18-35 years. Participants were divided into two groups: those with suicidal behavior (n=20) and those without (n=20). Psychometric assessments included the Columbia Suicide Severity Rating Scale (C-SSRS), Calgary Depression Scale for Schizophrenia (CDSS), Positive and Negative Syndrome Scale (PANSS), and Personal and Social Performance scale (PSP). Descriptive statistics, correlation analysis, regression analysis, and Student's t-tests were used. RESULTS: The group with suicidal behavior had significantly higher scores on the C-SSRS and CDSS, as well as on the PANSS anxiety/depression subscale, compared to the control group. Regression analysis indicated that depression and anxiety accounted for 74% of the variance in suicidality scores. No significant differences in social functioning (PSP) were found between the groups. A history of suicide attempts was not a significant predictor in this sample. CONCLUSION: Depression and anxiety are significant predictors of suicidality in young males with SSD. Historical suicide attempts showed no significant effect in this sample. The findings underscore the importance of regular screening and timely intervention to lower suicide risk in young adults with SSD.
THE EFFECTS OF THIRD-GENERATION ANTIPSYCHOTIC DRUGS ON THE PSYCHOSOCIAL FUNCTIONING OF PATIENTS WITH SCHIZOPHRENIA.
Spikina A, Savelyev A, Odinets A … +3 more , Korman T, Musatov S, Spikin A
Psychiatr Danub · 2025 Sep · PMID 40982837
BACKGROUND: The degree of cognitive impairment and verbal fluency are more important predictors of a patient's social rehabilitation than the severity of negative or positive symptoms. At the same time, researchers have...
BACKGROUND: The degree of cognitive impairment and verbal fluency are more important predictors of a patient's social rehabilitation than the severity of negative or positive symptoms. At the same time, researchers have confirmed and rejected linkages between linguistic functioning and certain cognitive functions in various studies. In several cases these correlations were observed, but did not reach any statistical significance. The aim of this study was to investigate and understand the effects of cognitive decline and impaired fluency on the social functioning of patients with schizophrenia, using a set of experimental psychological techniques on a homogeneous group of patients. METHODS: The study involved 30 patients with paranoid schizophrenia. The average age of the patients was around 22 years. All patients received cariprazine in doses of 1.5, 3.0, and 4.5 mg per day. Assessment was performed at baseline and after 8 months using a battery of neurocognitive tests, verbal fluency tests, social functioning scales, PANSS scale and adverse effect scales. RESULTS: Assessment of higher cognitive functions through verbal fluency may provide a new approach to assessing social functioning. Since social engagement and social involvement usually require considerable effort, the ability of verbal fluency tests may help assess social functioning in a time-constrained clinical setting by both psychologists and psychiatrists, without additional training in clinical psychology. Subsequently, the impact of both antipsychotic treatment and neurocognitive training in improving social outcomes in patients with schizophrenia may be assessed. Comparisons of different antipsychotic medications and combination treatments and a longer-term assessment after 2-3 years of treatment are also needed. CONCLUSIONS: Verbal fluency deficits can serve as early indicators of cognitive decline and indicators of the success of psychosocial interventions, characterizing the clinical condition of patients and their social functioning.
IS SOCIAL ANXIETY ALWAYS «SOCIAL»? AN INVESTIGATION OF PERSONALITY COGNITIVE AND AUTISTIC FACTORS.
Gradskova A, Pavlichenko A, Karpenko O
Psychiatr Danub · 2025 Sep · PMID 40982836
BACKGROUND: Social anxiety (SA) disorder is a common psychological condition; however, its boundaries with autism spectrum disorder remain a subject of debate. This study examines the contribution of personality, cogniti...
BACKGROUND: Social anxiety (SA) disorder is a common psychological condition; however, its boundaries with autism spectrum disorder remain a subject of debate. This study examines the contribution of personality, cognitive, and autistic traits to manifestations of SA in adults. To assess how personality, cognitive, and autistic traits affect SA and to define the impact of autistic features on its development. METHODS: The study included 72 adults (42 women, 30 men) over 18, with different levels of SA and autistic traits. Participants completed several questionnaires: Social Anxiety and Social Phobia Questionnaire, HEXACO-60-PI-R60 Personality Questionnaire, Hostility Scale, Cognitive Styles Questionnaire, Autism Spectrum Quotient, Behavior Self-Regulation Style Questionnaire, and an Emotional Intelligence Test. RESULTS: Two groups were studied: (A) high SA with low autistic traits, and (B) high SA with high autistic traits. T-tests and regression analyses were used. No significant differences in overall SA were found between the groups; however, individuals with pronounced autistic traits exhibited greater anxiety in situations requiring initiative and being under observation. Group B demonstrated higher scores on all autism spectrum scales and distinctive personality profiles (low extraversion, high honesty/humility, vigilance, and negativism. Regression analysis revealed distinct predictive factors for SA in the two groups. For Group A this included the following parameters: Liveliness, lower Sociability, decreased Modeling of Conditions, heightened Sentimentality and increased Attention to Detail (89% of the variance in SA scores). For Group B they included low Social Self-Esteem, reduced Flexibility, diminished Reliability, elevated Dependence, and stronger Field Independence (92% of the variance in SA scores). CONCLUSION: Personality and cognitive predictors of SA differ depending on the presence of autistic traits. The data confirm the necessity of a differentiated diagnostic and therapeutic approach. Future studies should employ longitudinal research designs to investigate causal relationships between variables.
RELATION BETWEEN CLINICAL AND SOCIAL CHARACTERISTICS OF PATIENTS HOSPITALIZED FOR A DEPRESSIVE EPISODE AND SELF-EFFICACY: A STUDY USING A NEW RESEARCH DOMAIN CRITERIA (RDOCS) INSPIRED EVALUATION BATTERY.
Amory A, Haverbeke SV, Timary P … +1 more , Petit G
Psychiatr Danub · 2025 Sep · PMID 40982835
BACKGROUND: Depression is a common disabling disease. Self-efficacy has been identified as a key factor in the prognosis of depression, as it influences how affected individuals cope and manage depressive symptoms. SUBJE...
BACKGROUND: Depression is a common disabling disease. Self-efficacy has been identified as a key factor in the prognosis of depression, as it influences how affected individuals cope and manage depressive symptoms. SUBJECTS AND METHODS: This study aims to gain a deeper understanding of the factors that contribute to the development of personal self-efficacy by using a framework inspired by the Research Domain Criteria (RDoC). A total of 41 adult inpatients meeting DSM-5 criteria for major depressive disorder were assessed on a comprehensive battery of measures spanning emotional, cognitive, and social domains. RESULTS: Multiple linear regression analyses revealed that trait emotional intelligence and particularly its well-being and self-control subscales, was the most robust predictor of self-efficacy. Satisfaction with social support emerged as a secondary contributor. CONCLUSIONS: These findings underscore the importance of targeting emotional intelligence and social support in therapeutic interventions for depression, suggesting that fostering adaptive emotion regulation and enhancing perceived support may bolster patients' confidence in their ability to manage depressive challenges.
REAL-LIFE FUNCTIONING DOMAINS IN PATIENTS WITH AFFECTIVE DISORDERS.
Fisenko O, Popova T, Pavlichenko A
Psychiatr Danub · 2025 Sep · PMID 40982834
BACKGROUND: This study investigates impairments in real-life functioning domains among patients with affective disorders (depression and mania), addressing gaps in understanding the relationship between symptom severity...
BACKGROUND: This study investigates impairments in real-life functioning domains among patients with affective disorders (depression and mania), addressing gaps in understanding the relationship between symptom severity and functional outcomes. The research aims to assess real-life functioning domains in clinical populations exhibiting varying degrees of affective disorder severity. SUBJECTS AND METHODS: A cross-sectional study was conducted with 23 outpatients (16 with depression, 7 with mania) and 44 healthy controls. Participants were assessed using the Hamilton Depression Rating Scale (HDRS), Young Mania Rating Scale (YMRS), and Specific Levels of Functioning Scale (SLOF). Statistical analyses included Chi-square tests for functional impairments and Pearson's correlations to examine associations between symptom severity and functioning. RESULTS: Key findings demonstrate significant functional deficits in depressive patients across all measured domains (physical functioning, personal care, interpersonal relationships, social acceptability, activities, and work skills), with particularly pronounced impairments in physical functioning (χ²=12.25, p<0.001) and personal care skills (universally low scores). Manic patients exhibited comparable domain-specific impairments, though with less pronounced severity differentiation. Notably, symptom severity (measured via HDRS/YMRS scales) showed minimal correlation with functional outcomes, with the exception of an inverse relationship between depression severity and social acceptability (r=-0.56, p<0.03). Limitations include modest sample sizes and cross-sectional design, warranting future longitudinal research with larger cohorts. CONCLUSIONS: Affective disorders broadly impair real-life functioning irrespective of symptom severity, except for depression's inverse relationship with social acceptability. This finding suggests that functional impairments in affective disorders may represent independent disease dimensions rather than simple byproducts of symptom intensity, emphasizing the need for targeted psychosocial interventions alongside symptom management.
ON SOLITUDE AND LONELINESS IN TODAY'S WORLD.
Urlić I
Psychiatr Danub · 2025 Sep · PMID 40982833
The phenomena of solitude and loneliness the author of this essay describes as two etiologically different states of mind. They are approached by the neuroscientific, psychodynamic, artistic expressive, philosophical and...
The phenomena of solitude and loneliness the author of this essay describes as two etiologically different states of mind. They are approached by the neuroscientific, psychodynamic, artistic expressive, philosophical and psychotherapeutic points of view. With some clinical examples and artistic illustrations the author tries to clarify his approach to the topic.
MAPPING AFFECTIVE PROFILES IN DEPRESSION, BURNOUT, NORMAL SADNESS, AND EUTHYMIC STATE: A SELF-REPORT SCREENING TOOL DEVELOPED THROUGH A MACHINE LEARNING APPROACH.
Trofimov D, Zapriy M, Khomenko A … +3 more , Sloeva E, Kotilevets I, Smirnova D
Psychiatr Danub · 2025 Sep · PMID 40982832
BACKGROUND: Modern post-industrial society is facing a complex of challenges, such as including epidemiological threats, high demands from employers, aggressive forms of corporations' management, stress at the work place...
BACKGROUND: Modern post-industrial society is facing a complex of challenges, such as including epidemiological threats, high demands from employers, aggressive forms of corporations' management, stress at the work place, as well as geopolitical and economic instability worldwide. These factors bring a significant impact on mental health of the general population, contributing to an increased prevalence of mental disorders, particularly, affective states. The aim of this study was to develop a sensitive screening tool based on a self-questionnaire approach for accurate differentiation of affective spectrum state, from preclinical / at-risk to severe clinical conditions. To achieve this goal, we focused on identifying key affective symptoms' domains and application of machine learning (ML) methods to perform a comprehensive data analysis on classifying the respondents into preclinical and clinical subgroups. SUBJECTS AND METHODS: The study consisted of two stages. At the first stage, we developed and conducted an online survey among the experimental population consisting of university staff and students. This survey version included 19 questions. The study was interrupted to make adjustments. At the second stage, the survey was finalized based on data analysis (descriptive and inferential) and classification tasks. The revised survey was redistributed with additional criteria for inclusion and exclusion of the respondents applied to the study design. The final version contained 34 questions, excluding unreliable questions characterized by p > .05. 381 individuals (269 employees and 112 students) were interviewed, of whom 99 showed signs of depression, normal sadness or emotional burnout. We conducted correlation, descriptive, and inferential analyses and classification of respondents using ML-based methods. RESULTS: The results confirmed the presence of significant differences (p < .001) between the groups with euthymia, normal sadness, emotional burnout and depression. However, there were no statistically significant differences for respondents with a pre-known emotional state and for respondents whose condition has been classified using machine learning technologies. The final distribution by category was as follows: euthymia - 38.8%, normal sadness - 27.3%, emotional burnout - 25.2%, depression - 8.7%. Our developed self-report tool has demonstrated statistical benefit, but requires further clinical research to clarify sensitive symptoms' domains for updating its items content. CONCLUSIONS: ML-based analysis of the self-report screening tool-related data demonstrated its sensitivity to classify affective states spectrum onto the separate states of depression, emotional burnout, normal sadness and euthymia (i.e. affective or emotional profiles of the respondents) with 100% accuracy at the final iteration. The problem of assessing mental health lies in the difficulty of obtaining fast, accurate, and emotionally neutral determination of the affective state in individual respondents and across populations. Development of a sensitive self-questionnaire / screening benefits from the the integration of clinical assessments along with the modern ML-based algorithms, as well as targeting the approach that helps to reduce costs and increase the diagnostic accuracy of existing psychometric tools.
WINSTON'S DYSTHYMIA: UNDERSTANDING THE CONNECTION BETWEEN CHILDHOOD TRAUMA, WORKPLACE STRAIN, AND COMMUNITY LACK OF EMPATHY IN CHRONIC DEPRESSION.
Fursov S, Sloeva E, Smirnova D
Psychiatr Danub · 2025 Sep · PMID 40982831
BACKGROUND: Characters in George Orwell's novel "1984" have certain behavioral features which may be taken as pathological. We hypothesized that Winston Smith in particular suffers from chronic mild depression, which is...
BACKGROUND: Characters in George Orwell's novel "1984" have certain behavioral features which may be taken as pathological. We hypothesized that Winston Smith in particular suffers from chronic mild depression, which is a result of external pressure from the fictional dystopian society (i.e., multimodal stress of childhood trauma, workplace strain, disrupted close relationships, emotional deprivation, feeling of loneliness, and unempathetic community). To confirm the hypothesis, we conducted a number of analyses of the English text of the novel "1984". SUBJECTS AND METHODS: Taking the full English text of "1984", we analyzed its fragments of first-person narrative, such as Winston's diary remarks and his speech during spoken communications as described in the novel. We then used the psycholinguistic method of clinical psycholinguistic analysis to analyze the text of Winston's diary from the perspective of psycholinguistic typology of literary texts based on emotional-semantic dominance as developed by the philologist Valery Belyanin (2000). The Belyanin method entailed placing a focus on the fragments of the first-person narratives representing descriptions of characters' emotions and feelings with subsequent determination of their type. RESULTS: In the first diary excerpt, Winston's writing consists of short, exclamatory phrases. He repeatedly uses the first-person singular pronouns and self-referential sentences, with simple and complex sentence structures. Lexical repetition is high, and emotional vocabulary emphasizes defiance and apathy. The second excerpt is purely declarative and reasoning-focused. It contains minimal stylistic markers, with present-tense verbs, no personal pronouns, and no emotional or figurative language. Key themes revolve around existential values, mortality, truth, and defiance against oppression. There is a notable absence of hedonic, familial, or self-realization themes, reinforcing a limited semantic focus aligned with existential distress. Winston Smith exhibits classic dysthymic markers, such as pervasive self-criticism, preoccupation with mortality, emotional heaviness, repetitive confessional style, and an undercurrent of hopeless defiance. CONCLUSIONS: According to our psycholinguistic analysis of Winston Smiths' diary text and dialogues, his language reflects depressive processing of personal and life experiences, reduced semantic productivity, fragmented meanings, and an emotionally negative dominant tone. Application of the psycholinguistic diagnostic model for mild depression confirms that his diary entries exhibit pronounced markers of mild depression of the melancholic and astheno-hypodynamic types. This analysis affirms the psychological insight applied by the author in developing his characters.
EMPLOYING COMPUTATIONAL LINGUISTIC TECHNOLOGIES AND OCULOGRAPHY TO DEVELOP DIAGNOSTIC TOOL FOR DETECTING AUTOAGGRESSIVE TENDENCIES IN YOUNG PEOPLE: A RIVETED GAZE INTO "GET RID OF THE SHACKLES OF THIS WORLD".
Khomenko A, Kasimova L, Sychugov E … +8 more , Svyatogor M, Komratova A, Domozhirova P, Aisina A, Trofimov D, Bikbaeva K, Sloeva E, Smirnova D
Psychiatr Danub · 2025 Sep · PMID 40982830
BACKGROUND: Early recognition of autoaggressive tendencies in young people is essential for diagnostic screening and reducing suicidality risks. This can be achieved through psycholinguistic approaches such as corpus ana...
BACKGROUND: Early recognition of autoaggressive tendencies in young people is essential for diagnostic screening and reducing suicidality risks. This can be achieved through psycholinguistic approaches such as corpus analysis and eye-tracking studies. Corpus research helps to develop generalized speech patterns of those at risk of suicide, while oculographic methods examine perceptual cues linked to suicidal tendencies. METHODS: We formulated an algorithmic framework for constructing verbal, visual, and multimodal material to identify autoaggressive tendencies among youth. The stimuli material was created following the idiolect paradigm of forensic authorship attribution. The first stage involved analyzing corpus data including materials from social networks and social media, the Rusentiment database, and a text collection from the Privolzhsky Research Medical University. Python's NLTK and SpaCy libraries for automated text processing were used to extract corpus statistics, n-grams, keywords, and collocations for identifying linguistic markers of autoaggression. Keywords were statistically ranked using Log-likelihood, T-score, and mutual information, while collocations were derived via T-score analysis. Sentiment analysis for the Dostoevsky Python library and stylistic indices (lexical diversity, readability) were also applied. The total analyzed material comprised more than 100 million tokens. We next integrated, stimulus and filler materials into an eye-tracking application (developed by LLC Lad IT Group) using standard laptop video cameras. Oculographic data quantified gaze delay differences via a percentage excess formula to pinpoint the most diagnostically relevant stimuli. In two iterations of the pilot experiment, 66 youths from the control group and 29 from the target group participated in the oculographic experiments. RESULTS: In multimodal texts, most stimuli derived from corpus statistics were relevant, and all individuals in the target group showed a prolonged gaze delay; visual stimuli (pseudo-self-portraits, anime/game characters) elicited 26-36% longer gaze delay in the target group. Verbal stimuli analysis revealed prolonged gaze fixations on self-referential pronouns (12-25%) and metaphorical death expressions, although direct terms, like "suicide" showed the gaze avoidance (-11.9 to -129% deviation). We then developed a system of weighted coefficients for an automated diagnostic model. The algorithm showed 72 % accuracy in identifying autoaggression, presenting a promising tool for early diagnostic screening of this phenomenon. CONCLUSIONS: The present methodology focuses on creating and employing a novel selective dataset consisting of visual, linguistic, and multimodal text stimuli integrated into the oculographic examination protocol. The oculographic detection of eye movement perceptual cues in response to exposure to the stimuli dataset may identify objective markers for evidence-based diagnostics of mental disorders (e.g., depression) and fundamental psychopathological phenomena (e.g., suicidality), including at-risk states (e.g., autoaggression). Furthermore, this approach may contribute to the enhancement of suicide prevention programs, particularly targeted interventions for the vulnerable population of young people who experience autoaggressive tendencies (i.e., self-aggression).
AI AND ALTERNATIVE SYMPTOMS IN THE DIAGNOSIS OF MDD: The role of forgiveness, hopelessness, mixity and diminished drive.
Franza F, Franza A, Calabrese L … +4 more , Iannaccone AN, Ricca A, Solomita B, Tavormina G
Psychiatr Danub · 2025 Sep · PMID 40982829
The explosion of the use of artificial intelligence (AI) in medical practice has shaken the foundations of clinical assessment and management. In our study, we conducted structured interviews with 43 patients (23 female,...
The explosion of the use of artificial intelligence (AI) in medical practice has shaken the foundations of clinical assessment and management. In our study, we conducted structured interviews with 43 patients (23 female, 15 male) affected by MMD (DSM-5-TR criteria). We sent the recorded and transcribed semi-structured interviews to the analysis of appropriately trained AI programs. We evaluated the predictive weight of symptoms described by patients beyond those present among the DSM-5-TR diagnostic criteria. We also analyzed the relationship with forgiveness, hopelessness, and diminished drive. The results revealed a positive predictive factor in patients with higher levels of somatization and physical oppression, ambivalent and blocked anhedonia, distress and agitated restlessness, mixed states, and subthreshold symptomatic oscillations.
CYBERBULLYING ON SOCIAL MEDIA AMONG YOUNG ADULTS: UNRAVELING ONLINE DYNAMICS.
Nappa MR, Ragona A, Sciabica GM … +2 more , Juli L, Morelli M
Psychiatr Danub · 2025 Sep · PMID 40982828
This study examined individual and relational predictors of cyberbully-victim involvement among young adults, focusing on social connectedness (offline, mixed offline-online, and exclusively online), parasocial relations...
This study examined individual and relational predictors of cyberbully-victim involvement among young adults, focusing on social connectedness (offline, mixed offline-online, and exclusively online), parasocial relationships (PSRs) with social media influencers (SMIs), and social media addiction. Using a generalized logistic regression model, results revealed that being female and younger significantly increased the likelihood of dual-role involvement. Offline social connectedness emerged as a significant protective factor, while offline-online and exclusively online ties were not associated with cyberbully-victim status. Notably, stronger PSRs with influencers were linked to a decreased likelihood of dual-role involvement, suggesting a possible compensatory or protective role for vulnerable individuals. Social media addiction was confirmed as a strong risk factor, more than doubling the odds of cyberbully-victim involvement. These findings underscore the complex interplay between psychosocial vulnerabilities and digital relational dynamics, highlighting the need for prevention strategies that foster offline relationships, promote digital resilience, and address problematic social media use among young adults.
THE USE OF ARTIFICIAL INTELLIGENCE IN VISUALISING RECOVERY OF PSYCHIATRIC REHABILITATION PATIENTS: CREATING GRAPHICS AS A THERAPEUTIC TOOL.
Łosiewicz A, Loska M, Kwaśnica B … +2 more , Kożuch A, Krysta K
Psychiatr Danub · 2025 Sep · PMID 40982827
BACKGROUND: Many psychiatric patients struggle to visualise their recovery, decreasing treatment motivation. Globally, 280 million people live with depression, 24 million with schizophrenia, and 40 million with bipolar d...
BACKGROUND: Many psychiatric patients struggle to visualise their recovery, decreasing treatment motivation. Globally, 280 million people live with depression, 24 million with schizophrenia, and 40 million with bipolar disorder. First-line treatments achieve remission in only 30-45% of depression cases and 20-60% of schizophrenia cases, with full recovery rates at 10-20%. Artificial intelligence (AI) is increasingly applied in psychiatry for psychoeducation, symptom monitoring, and therapy support. GPT-4o is a generative AI tool producing personalised text, speech, and images. No studies have explored its use for creating recovery-focused visuals to motivate psychiatric patients. This study investigated the potential of ChatGPT-generated visuals as potential therapeutic tools. SUBJECTS AND METHODS: Twenty psychiatric outpatients in remission (schizophrenia, affective, developmental disorders) completed a structured questionnaire with demographic and open-ended questions on recovery expectations. Based on responses, AI-generated recovery visuals were created using GPT-4o and presented for evaluation. Attitudes towards AI were assessed before and after. Participants rated how strongly each image reflected their recovery vision and motivational impact (0-4 scale). Data were analysed using descriptive statistics, paired t-tests, Spearman's correlations, and cluster analysis (Excel, Jamovi, Python). RESULTS: Attitudes towards AI improved post-intervention (M=1.70, SD=0.80 vs. M=2.15, SD=0.67). Ratings indicated moderate to strong reflection of personal visions (Graphic 1: M=2.80, SD=1.15; Graphic 2: M=3.25, SD=0.91). No significant differences occurred across demographic groups (p>0.05). A strong positive correlation was found between attitudes towards AI and openness to using AI visuals clinically (ρ=0.65, p=0.002). Cluster analysis identified three profiles: positive adopters (60%), sceptics (25%), and emotionally engaged but technologically sceptical (15%). CONCLUSIONS: AI-generated images were well-received, improved attitudes towards AI, and enhanced patient motivation. Integrating generative AI images into psychiatric rehabilitation may support engagement and personalised care.
HOARDING DISORDER: HOLD YOUR HORSES! A NEURODIVERGENT AND SOCIALLY MEDIATED CONDITION REQUIRING RETHINK AND REFORM.
Naviaux AF
Psychiatr Danub · 2025 Sep · PMID 40982826
BACKGROUND: Hoarding disorder (HD) is increasingly recognized as a distinct, multifactorial condition. Recent findings in neuroimaging, psychopathology, compulsive acquisition, suicidality, stigma, and social context cal...
BACKGROUND: Hoarding disorder (HD) is increasingly recognized as a distinct, multifactorial condition. Recent findings in neuroimaging, psychopathology, compulsive acquisition, suicidality, stigma, and social context call for a redefinition of HD beyond its traditional association with obsessive-compulsive disorder. SUBJECTS AND METHODS: This narrative review synthesizes recent clinical, neurobiological, and sociocultural literature, including latent class analysis and resting-state fMRI studies, exploring cognitive dysfunction, comorbidities, suicidality, stigma, and environmental context. RESULTS: HD is characterized by impaired executive functioning, frequently comorbid with ADHD and compulsive buying-shopping disorder. Subtype profiles identified through latent class analysis reveal complex multisymptomatic presentations. High rates of suicidality, social exclusion, and stigma - especially among individuals hoarding purchased items - suggest a need for a broader clinical and public health framework. CONCLUSIONS: HD should be conceptualized within a neurodivergent and socially mediated model. Treatment and policy should address neurocognitive deficits, emotional regulation, social determinants, and stigma through interdisciplinary and person-centered interventions.
PURPLE DRANK: AN OLD PHENOMENON RETURNS.
Juli R, Juli G, Juli A … +1 more , Juli L
Psychiatr Danub · 2025 Sep · PMID 40982825
Purple drank (PD) also known as "lean" or "sizzurp", is a recreational drug typically containing codeine and promethazine hydrochloride, often mixed with soda or alcohol. This drug is not new, in fact it was used in Texa...
Purple drank (PD) also known as "lean" or "sizzurp", is a recreational drug typically containing codeine and promethazine hydrochloride, often mixed with soda or alcohol. This drug is not new, in fact it was used in Texas in the 1960s, and became widely popular in the 1990s especially among adolescents and young adults, becoming the "poor man's drug" because it was readily available and not expensive. Several studies suggest that the number of PD abusers today is increasing, and the underestimation of this phenomenon may be related to the fact that PD components are easily available in pharmacies.
THE MYTH OF SEROTONIN THEORY OF DEPRESSION: AN ANALYSIS OF UMBRELLA REVIEW METHODOLOGIES AND CLINICAL IMPLICATIONS.
Lepri A
Psychiatr Danub · 2025 Sep · PMID 40982824
The serotonin theory of depression, long a dominant paradigm in psychiatry, has been recently challenged by a comprehensive umbrella review by, which concludes that there is no consistent evidence linking serotonin activ...
The serotonin theory of depression, long a dominant paradigm in psychiatry, has been recently challenged by a comprehensive umbrella review by, which concludes that there is no consistent evidence linking serotonin activity to depressive disorders. This article critically analyzes that review alongside two major commentaries that raise substantial methodological and interpretative concerns. Focusing on review design, inclusion criteria, quality assessment tools, and neuropharmacological interpretations, we highlight the extent to which methodological limitations can shape the conclusions of evidence syntheses. While Moncrieff's work provokes valuable scientific debate, its post-hoc protocol amendments, selective reporting, and down-weighting of serotonergic findings weaken its conclusiveness. We argue for a more nuanced understanding of serotonin's role in depression, not as a sole cause but as a potential modulatory factor in vulnerable populations. The implications for clinical practice and public communication are discussed.
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