Psychiatry Research[JOURNAL]
Sun
200 papers
A real-world pharmacovigilance study of Xanomeline-Trospium events in the FDA adverse event reporting system (FAERS).
Song X, Feng T, Lin H … +2 more , Qian H, Ji J
Psychiatry Res · 2026 Jul · PMID 41985280 · Publisher ↗
BACKGROUND: Xanomeline-Trospium (Cobenfy®) improves cognitive function in schizophrenia, yet its post-marketing reporting patterns remain incompletely characterized. This hypothesis-generating pharmacovigilance study exp...
BACKGROUND: Xanomeline-Trospium (Cobenfy®) improves cognitive function in schizophrenia, yet its post-marketing reporting patterns remain incompletely characterized. This hypothesis-generating pharmacovigilance study explores adverse event associations during its first year on market. OBJECTIVE: To characterize disproportionate reporting patterns and generate hypotheses for clinical monitoring strategies, acknowledging the inherent limitations of spontaneous reporting data. METHODS: Adverse event reports from Q4 2024-Q3 2025 were analyzed using disproportionality methods (ROR, PRR, BCPNN) and temporal distribution analysis. A dual-track approach incorporated both statistical signal detection (n ≥ 3) and descriptive surveillance of rare serious events (n < 3). RESULTS: Of 1142 reports, urinary and neurological events exhibited the strongest statistical disproportionality: urinary retention (ROR=45.63, 95% CI: 35.97-57.87) and hypersalivation (ROR=64.39, 95% CI: 43.25-95.85). Psychiatric events were frequently reported but showed weaker specificity, likely reflecting disease confounding rather than drug-induced effects. Treatment non-adherence showed elevated reporting (ROR=7.58), potentially associated with psychiatric symptomatology. Time-to-onset analysis suggested acute-phase reporting concentration (median 2 days; 45.4% of non-day-0 events occurring within days 1-7). CONCLUSION: These findings suggest disproportionate reporting patterns for urinary, neurological, and psychiatric events associated with Xanomeline-Trospium. While these signals warrant further validation through prospective cohort studies, they offer complementary real-world context for clinical decision-making. Active monitoring during initial treatment weeks may be prudent, particularly among patients with renal impairment or concomitant anticholinergic use.
Cross-national comparison of depression and risk of diabetes in South Korea and the US: a nationwide representative comparative study.
Joo H, Choi T, Park S … +6 more , Oh J, Park J, Son Y, Fond G, Boyer L, Yon DK
Psychiatry Res · 2026 Jul · PMID 41967196 · Publisher ↗
BACKGROUND: Although a bidirectional relationship between depression and diabetes has been suggested, evidence remains limited across cultural contexts. This study compared the association between depression and diabetes...
BACKGROUND: Although a bidirectional relationship between depression and diabetes has been suggested, evidence remains limited across cultural contexts. This study compared the association between depression and diabetes in South Korea and the US. METHODS: We used data from the Korea National Health and Nutrition Examination Survey (KNHANES; 2014, 2016, 2018, and 2020) and the US National Health and Nutrition Examination Survey (NHANES; 2013-2020). Adults aged ≥20 years were included from KNHANES and NHANES. Depression was defined as a PHQ-9 score ≥10, and diabetes as fasting glucose ≥126 mg/dL, HbA1c ≥6.5%, or a physician diagnosis. Each dataset was analyzed independently using weighted quantile sum (WQS) regression and multivariable logistic regression to estimate weighted odds ratios (wORs) and 95% confidence intervals (CIs), incorporating subgroup interactions and restricted cubic spline analyses. RESULTS: This analysis included 16,964 adults from KNHANES (69.30% female) and 10,073 adults from NHANES (52.13%). Depression was associated with higher odds of diabetes in South Korea (wOR 1.46, [95% CI 1.19-1.80]) but not in the US (1.26, [0.96-1.64]). Across both cohorts, significant positive associations between depression and diabetes were consistently observed among females, adults aged 45-64 years, frequent alcohol consumers, never-smokers, individuals without CVD, and those with obesity. WQS regression revealed that sleep-related symptoms carried the greatest weight in both South Korea (weight=0.18) the US (weight=0.15). CONCLUSIONS: Depression is independently associated with higher odds of diabetes in South Korea, but not the US. In both countries, sleep problems showed the highest relative contribution among depressive symptoms, suggesting a potential target for future intervention research.
Are internally-cued and externally-cued intrusions distinct post-traumatic stress symptom dimensions? A pilot study of triple-network functional connectivity analysis.
Qian H, Cao C, Wang L
Psychiatry Res Neuroimaging · 2026 Aug · PMID 41962348 · Publisher ↗
Intrusion symptoms, a core dimension of PTSD, have recently been categorized into internally-cued intrusions (I-Int; comprising re-experiencing symptoms) and externally-cued intrusions (E-Int; comprising reactivity to ex...
Intrusion symptoms, a core dimension of PTSD, have recently been categorized into internally-cued intrusions (I-Int; comprising re-experiencing symptoms) and externally-cued intrusions (E-Int; comprising reactivity to external reminders), but it remains unclear whether these two symptom clusters have different neural underpinnings. We utilized the triple brain network model (comprising the default mode, central executive, and salience networks) to investigate this issue. We initially recruited 50 COVID-19 survivors from Wuhan (final sample N = 46), who underwent resting-state functional magnetic resonance imaging scans and completed self-report assessments. Based on intrusion symptom scores, participants were stratified into E-Int-positive and E-Int-negative subgroups, as well as I-Int-positive and I-Int-negative subgroups. Key findings revealed that within the I-Int subgroup classification, static triple-network analysis demonstrated significantly attenuated anti-correlation FC between the DMN and CEN in the I-Int positive group compared to the I-Int negative group. These differences were consistently replicated in dynamic states 2 (the 'Segregated State') and 5 (the 'Globally Hyper-connected State'). Within the E-Int subgroup classification, the E-Int positive group exhibited higher FC between the DMN-SN specifically in dynamic state 4 (the 'Transitional State'). Correlation analyses further indicated that I-Int scores within the I-Int positive subgroup were positively associated with DMNCEN FC in both static model and state 2 of dynamic model. These findings suggest that the two types of intrusions may have different neural underpinnings, which enhances our understanding of post-traumatic stress symptoms and offers potential directions for future targeted therapies. However, given the relatively small sample size, these findings are preliminary and require replication in larger cohorts with greater symptom severity.
Hybrid groupers-moray orangutan optimization algorithm-based dense-resolution network for autism spectrum disorder detection using multimodal data.
Bhagyalatha U, Sahoo BK, Muppidi S
Psychiatry Res Neuroimaging · 2026 Aug · PMID 41962347 · Publisher ↗
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder involving cognitive and social impairments. Precise diagnosis is vital for effective intervention. However, conventional diagnostic techniques exhibited poo...
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder involving cognitive and social impairments. Precise diagnosis is vital for effective intervention. However, conventional diagnostic techniques exhibited poor generalization, and high error rates while dealing with subtle patterns in neuroimaging or behavioral datasets. To resolve these concerns, this research introduces the Groupers and Moray Orangutan Optimization Algorithm based Dense-Resolution Network (GMOA-DRNet). The multimodal inputs consist of Magnetic Resonance Imaging (MRI) brain images and autism-related phenotypic data. Initially, input brain images are pre-processed by Geometric Mean filters and Region of Interest (RoI) extraction. Then, Functional connectivity-based pivotal region are identified using GMOA. After that, feature extraction is performed by Tamura features and Gradient Directional Pattern (GDP). Concurrently, autism-related data is normalized based on the hyperbolic tangent function, and relevant features are selected using ANOVA. Moreover, data augmentation is conducted using the Adaptive Synthetic Sampling Approach (ADASYN) technique. The extracted features and augmented data are used for ASD detection by the DRNet, trained using GMOA, which combines Groupers and Moray Eels Optimization (GMEO) and Orangutan Optimization Algorithm (OOA). Moreover, GMOA-DRNet achieved better performance with an accuracy of 92.77%, sensitivity of 92.52%, specificity of 92.77%, and a False Omission Rate (FOR) of 0.080.
Changes in serum Nogo-A and BDNF levels following treatment in drug-naive first-episode schizophrenia: A naturalistic prospective study.
Dudaklı BB, Uzel HK, Ocak MS … +3 more , Esen Öksüzoğlu M, Levent Çıraklı Z, Karamustafalıoğlu N
Psychiatry Res · 2026 Jul · PMID 41962339 · Publisher ↗
BACKGROUND: Neuroplasticity dysregulation is implicated in the early pathophysiology of schizophrenia. Nogo-A, a myelin- and neuron-associated inhibitor of structural plasticity, has been less studied in first-episode sc...
BACKGROUND: Neuroplasticity dysregulation is implicated in the early pathophysiology of schizophrenia. Nogo-A, a myelin- and neuron-associated inhibitor of structural plasticity, has been less studied in first-episode schizophrenia (FES) than brain-derived neurotrophic factor (BDNF). This study examined short-term changes in serum Nogo-A and BDNF in drug-naïve patients with FES. METHODS: Thirty-nine drug-naïve FES patients and 43 healthy controls (HC) were assessed. Serum Nogo-A and BDNF were measured at baseline in both groups and re-measured in FES after achieving ≥20 % reduction in Positive and Negative Syndrome Scale total score (PANSS). RESULTS: Baseline Nogo-A levels were higher in FES than HC (p = .022) and increased further after treatment (p < .001). Baseline BDNF did not differ between groups (p = .069) and showed no significant change after treatment (p = .094). PANSS total and subscale scores decreased significantly after treatment (all p < .001). Baseline Nogo-A modestly discriminated FES from HC (AUC = 0.648, 95 % CI = 0.53-0.77, sensitivity 66.7 %, specificity 60.5 %). In multivariable analysis, only smoking independently predicted FES (OR = 3.69, 95 % CI = 1.48-9.23, p = .005), whereas Nogo-A was not retained. CONCLUSIONS: Serum Nogo-A is elevated at illness onset in FES and increases during early treatment, suggesting that peripheral Nogo-A may be associated with early illness-related and/or treatment-related biological changes. Although Nogo-A does not show sufficient performance as a stand-alone diagnostic biomarker, these findings should be interpreted cautiously given the relatively small sample size and naturalistic treatment design. Nogo-A may warrant further investigation as part of broader multi-marker approaches in early schizophrenia.
Alcohol abuse by mood disorder patients.
Tondo L, Miola A, Baldessarini RJ
Psychiatry Res · 2026 Jul · PMID 41962338 · Publisher ↗
BACKGROUND: Abuse of alcohol is associated with psychiatric disorders but requires updating of risks, outcomes, and associated factors, particularly for patients with co-occurring major mood disorders. METHODS: A total o...
BACKGROUND: Abuse of alcohol is associated with psychiatric disorders but requires updating of risks, outcomes, and associated factors, particularly for patients with co-occurring major mood disorders. METHODS: A total of 1768 consecutive, consenting adult patients (1070 women, 698 men, aged 47.0 [CI: 46.4-47.5] years) with information about alcohol abuse and with a DSM-5-TR mood disorder (897 bipolar disorder [BD: 466 BD1, 431 BD2], 871 major depressive disorder [MDD]), ill for a total of 19.2 [18.5-19.9] years, were evaluated extensively and followed prospectively for 4.61 [4.25-5.00] years. RESULTS: Alcohol abuse was identified in 228/1768 subjects (12.9 % [11.4-14.5]); prevalence was greater with BD (18.8 % [16.3-21.6]) than MDD (6.77 % [5.20-8.65]), similar with BD1 (20.7 % [17.1-24.7]) and BD2 (17.0 % [13.5-20.9]), and 2.52-times greater among men (20.3 % [17.4-23.5]) than women (8.04 % [6.48-9.83]). Factors associated notably with alcohol abuse included: early sexual > physical abuse, earlier illness-onset, higher cyclothymic and irritable temperament ratings, unemployment, suicide attempt, separation or divorce and less marriage, fewer children, more smoking, less general medical morbidity, but not greater psychiatric morbidity (as depressive or [hypo]manic episodes/year, %-time-ill, -depressed, or-[hypo]manic, or hospitalizations/year). Multivariable logistic modeling found six factors to be significantly and independently associated with alcohol abuse, ranking: men > women, BD > MDD, suicide attempt, fewer children, early sexual abuse, and lack of somatic comorbidity. CONCLUSIONS: Alcohol abuse, as expected, was associated with more adverse social measures and outcomes but surprisingly, not greater psychiatric, and even less general medical morbidity.
The transdiagnostic role of emotional dysregulation and temperament in non suicidal self-injury: Cross sectional study among adolescents receiving intensive psychiatric care.
Maglio G, Pontillo M, Apicella M … +8 more , Minutolo A, Serra G, D'Amario G, Della Santa G, Andracchio E, Labonia M, Averna R, Vicari S
Psychiatry Res · 2026 Jul · PMID 41962337 · Publisher ↗
This study investigated dimensions of emotional dysregulation (ED) and cyclothymic temperamental traits in adolescents, focusing on their association with non-suicidal self-injury (NSSI) from a transdiagnostic perspectiv...
This study investigated dimensions of emotional dysregulation (ED) and cyclothymic temperamental traits in adolescents, focusing on their association with non-suicidal self-injury (NSSI) from a transdiagnostic perspective. A total of 208 adolescents undergoing treatment for acute psychiatric condition (aged 12-18) completed comprehensive diagnostic assessment and were divided into two groups: those meeting Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revised (DSM-5-TR) criteria for NSSI-D (NSSI group) and psychiatric controls (PC group). To assess ED and temperament participants completed the RIPoST-Y scale and the Cyclothymic Hypersensitive Temperament (CHT) questionnaire; depressive symptoms have been assessed by using the Children's Depression Inventory-2 (CDI-2). The NSSI group exhibited significantly higher levels of both ED and CHT compared to controls. Logistic regression analysis identified the interpersonal sensitivity domain of ED and depressive symptoms, as independent predictors of NSSI, regardless of DSM-5 diagnostic categories. These findings underscore the strong association between emotional dysregulation, temperamental affective instability and self-harm behaviors, highlighting these dimensions as potentially important clinical targets in prevention and treatment for adolescents with NSSI.
Psychedelics as a potential treatment for borderline personality disorder: A narrative review.
Artna E, Sandhu G, Chisamore N … +5 more , Lipsitz O, Kaczmarek ES, Johnson DE, Rosenblat JD, Sediqzadah S
Psychiatry Res · 2026 Jul · PMID 41955843 · Publisher ↗
Borderline personality disorder (BPD) is a serious mental illness with high rates of morbidity and stigma; however, successful remission is frequently limited by a paucity of accessible treatment options. In an era of gr...
Borderline personality disorder (BPD) is a serious mental illness with high rates of morbidity and stigma; however, successful remission is frequently limited by a paucity of accessible treatment options. In an era of growing interest in psychedelics as novel psychiatric treatment modalities, patients with BPD are often excluded from research due to perceived safety risks, particularly pertaining to suicide and substance misuse. However, there is evolving evidence that psychedelic treatment may effectively target core BPD symptoms, in addition to those of the mood and anxiety disorders frequently comorbid with BPD. As such, characterizing the therapeutic potential of psychedelics in BPD represents an important opportunity to enhance patient outcomes. This narrative review aims to broadly analyze the existing literature on experiences with psychedelics in this population. Data were coalesced from multiple electronic databases (Ovid MEDLINE, PsychInfo, and Embase) to characterize the current evidence for psychedelic safety and effectiveness in individuals with BPD. The 22 studies included in this review encompass a broad range of study designs and outcomes involving ketamine, esketamine, and psilocybin. There is some preliminary evidence that these psychedelics may be implemented as safe and effective treatments to improve core BPD symptoms and socio-occupational functioning. However, further high-quality evidence focusing on BPD-specific outcomes is needed to better elucidate their potential role as a treatment modality.
Development of a risk prediction model for relapse in patients with schizophrenia based on a systematic review and meta-analysis.
Tang W, Guan C, Ling Z … +2 more , Zhang X, Cui H
Psychiatry Res · 2026 Jul · PMID 41955842 · Publisher ↗
BACKGROUND: The high relapse rate in patients with schizophrenia imposes a significant burden on both families and society, hindering patients' recovery. Predictive modeling of relapse risk factors aids in early identifi...
BACKGROUND: The high relapse rate in patients with schizophrenia imposes a significant burden on both families and society, hindering patients' recovery. Predictive modeling of relapse risk factors aids in early identification of high-risk patients for timely intervention. METHODS: A comprehensive search of multiple databases was conducted to collect both domestic and international publications on factors influencing relapse in patients with schizophrenia, up to July 1, 2024. After literature screening, data extraction, and quality assessment by two researchers, meta-analysis was performed using RevMan 5.4 software to calculate combined odds ratios (OR) and 95% confidence intervals (CIs). A risk prediction model was constructed based on the natural logarithmic transformation of the composite hazard values. Inpatient medical records of patients with schizophrenia from Wuhu Fourth People's Hospital, collected between January 2022 and July 2024, were screened for analysis. The model's effectiveness in predicting relapse risk was validated through multiple curves and decision analysis. RESULTS: A total of 35 papers (27 cohort studies and 8 case-control studies), involving 159,973 participants and 5924 relapses, were included in the analysis. The meta-analysis identified 11 relapse risk factors. The corresponding logistic regression risk prediction model is: Logit(P) = α + 1.477X + 1.495X + 0.604X + 0.668X + 1.637X + 1.351X + 1.141X + 1.413X + 0.888X + 0.582X + 1.281X. The model was validated using an external dataset of 452 medical records, demonstrating good diagnostic performance. The Hosmer-Lemeshow test, calibration curves, and decision analysis further confirmed the model's accuracy and high clinical applicability. CONCLUSION: An evidence-based predictive model for relapse risk in patients with schizophrenia was developed, demonstrating moderate predictive ability. This model allows for early identification of high-risk patients and facilitates targeted interventions to improve outcomes.
Comparison of demographic and clinical features in adolescent-onset vs. adult-onset bipolar disorder an analysis of BIPAS Phase II data.
Zhao G, Wang Z, Zhu Y … +20 more , Wang X, Xu G, Pan M, Chen Z, Li W, Li M, Zhang Y, Chen J, Chen X, Li N, Sun J, Zhang J, Hu S, Gan Z, Qin Y, Wang Y, Ma Y, Li X, Jiao Z, Fang Y
Psychiatry Res · 2026 Jul · PMID 41955841 · Publisher ↗
OBJECTIVE: The literature on large-scale studies of Chinese patients with adolescent-onset bipolar disorder (adolescent-onset BD) was limited. Based on the analysis of the National Bipolar Mania Pathway Survey (BIPAS) Ph...
OBJECTIVE: The literature on large-scale studies of Chinese patients with adolescent-onset bipolar disorder (adolescent-onset BD) was limited. Based on the analysis of the National Bipolar Mania Pathway Survey (BIPAS) Phase II data, we examined the demographic and clinical characteristics of adults with adolescent-onset BD. METHODS: Among 899 participants diagnosed with BD from 20 mental health services, demographics and clinical data were collected at screening. Comparisons were made using chi-square (or Fisher's exact) tests and ANOVA. Multivariate logistic regression identified independent factors for adolescent-onset BD, and a CHAID decision tree analysis (SPSS) was constructed to detect risk factors. RESULTS: In the sample, 360 (40 %) had adolescent-onset BD and 539 (60 %) adult-onset BD. Significant differences between the two groups were observed in current age, number of episodes, years of education, gender, age of onset, education level, marital status, occupation, comorbid chronic physical illness, and first episode type. Stratified analysis also revealed significant differences between adolescent-onset BD I and BD II. Multivariate logistic regression identified younger onset age, more frequent episodes, lower education level, marital status, occupation, first episode type, and prior hospitalization as independent factors for adolescent-onset BD. The decision tree model selected current age as the first splitting variable, followed by occupation and marital status as the second, and years of education and prior hospitalization as the third. CONCLUSIONS: Adolescent-onset BD exhibits distinct demographic and clinical features compared to adult-onset BD. Early recognition and tailored treatment strategies may improve prognosis and outcomes in this population.
Post-traumatic stress in Israeli civilians following the October 7th attack: The roles of personality and resilience.
Zvi L, Bitton MS
Psychiatry Res · 2026 Jul · PMID 41955840 · Publisher ↗
AIMS: Following the unprecedented trauma and grief of the October 7 attacks and ensuing political violence, the Israeli population continues to experience significant psychological distress, the full scope of which is st...
AIMS: Following the unprecedented trauma and grief of the October 7 attacks and ensuing political violence, the Israeli population continues to experience significant psychological distress, the full scope of which is still being defined. Against this backdrop, the present study examined how personality traits and personal resilience contribute to post-traumatic stress (PTS) symptoms among Israeli civilians. METHODS: A total of 636 Israeli adults completed self-report measures assessing trauma exposure, personality traits, personal resilience, and post-traumatic stress symptoms. RESULTS: Findings revealed high rates of probable PTSD, with 38.7% of participants falling within the clinical range. Greater trauma exposure was associated with more severe symptoms. Higher levels of neuroticism and lower personal resilience emerged as significant risk factors. CONCLUSIONS: The findings highlight the substantial mental health impact of the October 7 attacks and ensuing political violence, as well as the importance of accounting for individual differences when developing targeted interventions to support psychological recovery following collective trauma.
Gray matter alterations across different dimensions of trauma exposure in post-traumatic stress disorder: A voxel-wise meta-analysis.
Pierce ZP, Nelson CC
Psychiatry Res Neuroimaging · 2026 Aug · PMID 41955644 · Publisher ↗
BACKGROUND: Post-traumatic stress disorder (PTSD) is associated with gray matter (GM) reductions in regions linked to impaired fear extinction, yet reported patterns remain inconsistent. Furthermore, the impact of specif...
BACKGROUND: Post-traumatic stress disorder (PTSD) is associated with gray matter (GM) reductions in regions linked to impaired fear extinction, yet reported patterns remain inconsistent. Furthermore, the impact of specific trauma characteristics on GM deficits is not well understood. We conducted a voxel-wise meta-analysis comparing structural brain differences in relational (interpersonal versus non-interpersonal) and temporal (acute versus chronic) aspects of trauma exposure. METHODS: This meta-analysis included 32 voxel-based morphometry (VBM) neuroimaging studies of adults with PTSD, trauma-exposed controls (TEC), and healthy controls (HC). RESULTS: PTSD patients showed consistent GM deficits in the pregenual anterior cingulate cortex (pgACC) compared to TEC and HC. Conversely, TEC exhibited increased GM in the insula. Unique GM alterations in frontal, temporal, and parietal regions differentiated interpersonal, acute, and chronic trauma subtypes, while non interpersonal trauma showed no significant peaks compared to TEC. CONCLUSION: Reduced pgACC GM is a consistent correlate of PTSD vulnerability, while increased insular GM may correlate with stress resilience. These cross-trauma and trauma-specific findings underscore the importance of personalized, culturally humble.
Depression, anxiety, and genetics shape smoking risk through salience networks.
Gunn MP, Rose GM, Whitton AE … +2 more , Pizzagalli DA, Gilbert DG
Psychiatry Res Neuroimaging · 2026 Aug · PMID 41950829 · Publisher ↗
BACKGROUND: Smoking trajectories in young adults vary, with some light smokers escalating to dependence while others reduce or quit. Depressive and anxious traits relate to altered large-scale network connectivity, inclu...
BACKGROUND: Smoking trajectories in young adults vary, with some light smokers escalating to dependence while others reduce or quit. Depressive and anxious traits relate to altered large-scale network connectivity, including the salience network (SN). Dopaminergic (DRD2 Taq1A) and serotonergic (5-HTTLPR) variants may further shape these trajectories, but trait-gene links to neural circuits and nicotine sensitivity remain unclear. METHODS: Sixty-eight young light smokers (18-24) completed nicotine and placebo sessions. Resting-state fMRI assessed functional connectivity; reward sensitivity was measured with the Probabilistic Reward Task. Depressive/anxious traits and DRD2/5-HTTLPR genotypes were obtained, and smoking progression was tracked. RESULTS: Depressive traits predicted weaker SN connectivity (insula-ACC; insula-dlPFC) but stronger insula-sgACC coupling. Anxious traits predicted weaker precentral-insula/dlPFC connectivity and stronger precentral-temporal-sgACC connectivity. Higher depressive traits combined with nicotine-enhanced reward sensitivity (NERS) predicted reduced prefrontal-limbic connectivity, whereas depression with smoking progression predicted increased insula-striatal-hippocampal connectivity. Gene × trait interactions suggested distinct endophenotypes: Depression × DRD2 predicted sgACC-insula and hippocampus-ACC connectivity; Anxiety × 5-HTTLPR predicted ACC-PCC and hippocampus-dlPFC connectivity. CONCLUSIONS: The sgACC within the SN may act as a convergence hub linking affective traits, genetic risk, and nicotine sensitivity: depression-related risk reflects hypo-salience/reward deficiency, whereas anxiety-related risk reflects hyper-salience/vigilance.
GLP-1 receptor agonists, psychiatric training, and metabo-psychiatric practice.
Gorman BL, Lemus Silva EG, Nickel GC … +1 more , Bojdani E
Psychiatry Res · 2026 Jul · PMID 41950541 · Publisher ↗
Abstract loading — click title to view on PubMed.
Using natural language processing to assess MDD psychotherapy patterns among Veterans Affairs patients with suicide risk.
Levis M, Dimambro M, Levy J … +3 more , Nerish M, Riblet N, Shiner B
Psychiatry Res · 2026 Jul · PMID 41946193 · Publisher ↗
Major depressive disorder (MDD) is a leading risk factor for suicide. Within the US Department of Veterans Affairs (VA), psychotherapy is widely used to treat MDD and prevent suicide. Little is known about how classified...
Major depressive disorder (MDD) is a leading risk factor for suicide. Within the US Department of Veterans Affairs (VA), psychotherapy is widely used to treat MDD and prevent suicide. Little is known about how classified suicide risk impacts this treatment. Addressing this gap, this study assesses patterns in MDD-diagnosed VA patients' unstructured electronic health record (EHR) notes using Latent Dirichlet Allocation, a methodology that evaluates textual patterns. We developed a suicide-risk-stratified sample (high-, moderate-, and low-) of MDD-diagnosed VA patients who died by suicide in 2017-2018 (cases) and risk-matched patients with similar demographics, diagnoses, and care who did not die by suicide (controls). After collecting all psychotherapy EHR notes within 1-year of case death, we derived topics, monitored topic differences across patient groups, and evaluated clinical relevance. We identified five topics: Disclosure, Suicide Risk, Treatment Goals, Symptoms, and Medication. Risk-matched cases and controls' topic patterns were consistently significantly different except for the Disclosure and Medication topics for high-risk patients and the Suicide Risk and Symptoms topics for low-risk patients. Our analyses highlighted how classified suicide risk-tier may impact psychotherapy delivery and utilization for suicide-risk-matched cases and controls. Most topics displayed decreased prominence for higher-risk versus lower-risk patients, with cases tending to receive more illness-focused care and controls tending to receive more supportive care. Identified differences offer to enhance risk modeling and improve suicide prevention psychotherapy.
Care trajectories of Quebec patients with substance-related disorders within five years before death.
Fleury MJ, Cao Z, Grenier G
Psychiatry Res · 2026 Jul · PMID 41936158 · Publisher ↗
AIMS: This study identifies care trajectories five years before death of 1468 patients with substance-related disorders (SRDs), associated with the patients' social and clinical characteristics, quality of care received,...
AIMS: This study identifies care trajectories five years before death of 1468 patients with substance-related disorders (SRDs), associated with the patients' social and clinical characteristics, quality of care received, and causes of death. METHODS: Care trajectories integrated outpatient SRD, mental health (MH) and physical health care, and acute care. Group-based multi-trajectory modeling identified service use patterns in three-month intervals across the five years preceding death. Multinomial logistic regression assessed associations between trajectory membership, patient characteristics, quality of care received, and causes of death. RESULTS: Four distinct trajectories emerged: "Low service users" (Profile 1, 34 % of sample, the reference group), "High physical health service users" (Profile 2, 30 %), "High but decreasing SRD service users" (Profile 3, 15 %), and "High but decreasing mental disorder (MD) service users, high users of other services" (Profile 4, 21 %). Profile 1 comprised mostly younger men with better health but poor continuity and regularity of care. Profile 3 patients had the most severe conditions, received the most intensive care, but had more accidental/intentional deaths than Profile 1. Profile 2 included older patients with severe chronic physical illnesses, injection drug use, and more emergency department users than Profile 1. Profile 4 had older patients reporting more MDs, suicidal behaviors, lower functioning, and greater use of specialized MH care. CONCLUSION: Service use was low overall and remained low even near death. Physical health care was the most used, followed by acute care. SRD and MH care declined before death across all profiles. Tailored interventions for each profile are suggested.
Qualitative analysis of long-term clozapine adherence in schizophrenia: An exploratory study.
Daniel DTG, Choi JJ, Aluri J … +4 more , McCaulley C, Brandt AS, Nucifora FC, Margolis RL
Psychiatry Res · 2026 Jul · PMID 41936157 · Publisher ↗
Clozapine is the most effective antipsychotic for treatment-resistant schizophrenia, yet patients face substantial challenges in maintaining long-term adherence. In this investigation, we used a qualitative approach to u...
Clozapine is the most effective antipsychotic for treatment-resistant schizophrenia, yet patients face substantial challenges in maintaining long-term adherence. In this investigation, we used a qualitative approach to understand how patients overcome obstacles to clozapine use. We conducted semi-structured interviews with 14 patients at the Johns Hopkins Bayview Clozapine Clinic who had been receiving clozapine for at least one year (mean = 5.7 years). Participants reflected a diverse sample across gender (five women and nine men), self-identified race (White = 8, Black = 3, biracial = 3), and age (range 24-68 years, mean = 35.5 years). Thematic analysis identified three key themes: barriers to adherence, facilitators of adherence, and rationale for adherence. Most participants reported difficulty managing side effects of clozapine, while routine blood monitoring was generally not perceived as a significant barrier. When discussing facilitators, many participants emphasized the importance of collaborative dose titration to balance side effects and symptom control. Nearly all participants described family members as providing substantial support through medication management, transportation, and encouragement. In a novel finding, avoidance of withdrawal-like symptoms following missed doses of clozapine was a major motivator for adherence. These findings highlight the importance of individualized care plans, proactive management of side effects, and family engagement. To our knowledge, this is the first qualitative study of factors affecting long-term clozapine use. Our findings may facilitate clinician conversations with patients uncertain about clozapine initiation or continuation.
Sertraline blood concentrations and clinical efficacy in depression: a retrospective, exploratory determination of optimal therapeutic range.
Tapia-Alzuguren B, Canga-Espina C, Molero P … +1 more , Aldaz A
Psychiatry Res · 2026 Jul · PMID 41936156 · Publisher ↗
PURPOSE: To establish, in patients with depression, the baseline sertraline concentration range associated with optimal antidepressant response in clinical practice and compare it with previously proposed therapeutic ran...
PURPOSE: To establish, in patients with depression, the baseline sertraline concentration range associated with optimal antidepressant response in clinical practice and compare it with previously proposed therapeutic ranges to improve interpretation of pharmacokinetic monitoring. METHODS: This retrospective naturalistic study analyzed inpatient serum sertraline concentrations paired with Hamilton Depression Rating Scale (HAMD) scores collected at admission and discharge. Concentration was the primary unit of analysis due to marked intra- and inter-individual variability. RESULTS: A total of 115 sertraline concentrations from 62 patients were obtained, each measured at any point during hospitalization and paired with HAMD scores at admission and discharge. Non-responders (< 50% HAMD improvement; n = 22) showed concentrations < 25 ng/mL, longer admissions, higher doses, and more adverse effects. Responders (≥ 50% HAMD improvement; n = 93) had a median of 39 ng/mL (IQR: 25-62). A subgroup with discharge-day measurements (n = 47) exhibited a median of 48 ng/mL (IQR: 35-65). Patients with psychotic depression (n = 19) had higher concentrations (median 67 ng/mL, IQR: 44-95) and greater clinical improvement. Responder concentrations aligned with literature HAMD and Brief Psychiatric Rating Scale (BPRS)-based studies. While the 10-150 ng/mL range proposed by guidelines encompasses most real-world values, concentrations < 25 ng/mL were associated with non-response. CONCLUSIONS: Therapeutic response to sertraline was achieved with concentrations > 25 ng/mL. Optimal response was associated with 35-65 ng/mL in the overall sample, and 45-95 ng/mL in patients with depressive and psychotic symptoms.
Early life adversity, inhibitory control, and behavioral dysregulation among individuals with OCD.
Fedorenko EJ, Sherman AL, Nestadt G … +6 more , Grados M, Samuels J, McCracken JT, Chang S, Greenberg BD, McLaughlin NCR
Psychiatry Res · 2026 Jul · PMID 41936155 · Publisher ↗
INTRODUCTION: Individuals with OCD exhibit poorer inhibitory control on behavioral tasks, such as the stop signal task. Early life adversity (ELA; e.g., childhood abuse, parental divorce) might further diminish inhibitor...
INTRODUCTION: Individuals with OCD exhibit poorer inhibitory control on behavioral tasks, such as the stop signal task. Early life adversity (ELA; e.g., childhood abuse, parental divorce) might further diminish inhibitory control, however, the relationship between ELA and inhibitory control has not yet been examined in individuals with OCD. We hypothesized that greater ELA would predict poorer inhibitory control and poorer self-reported behavioral regulation ability among individuals with OCD. METHODS: Participants were 78 adults with OCD. The total number of adverse experiences reported by participants on a dichotomous scale indexed ELA. Inhibitory control was indexed by reaction time on the stop signal task (SSRT), wherein greater SSRTs indicated poorer inhibitory control. Behavioral dysregulations were self-reported on the Behavioral Regulation Index (BRI) of the Behavior Rating Inventory of Executive Function and peak lifetime OCD severity was clinician-assessed. RESULTS: ELA was associated with SSRT in a univariable model (b = 0.287, p = 0.028), but not in a multivariable model with age and OCD severity. Additionally, ELA was associated with the BRI (b = 0.365, p = 0.018), and in subscale analyses, ELA related to inhibition (b = 0.327, p = 0.023) and self-monitoring (b = 0.375, p = 0.008) subscales. CONCLUSION: These results suggest that, among individuals with OCD, greater ELA is associated with poorer inhibitory control, but not when controlling for age, and that greater ELA is associated with poorer behavioral regulation ability, particularly in inhibition and self-monitoring. Limitations of this study include the use of a noncomprehensive ELA measure. Future studies should clarify the mechanisms by which ELA can degrade inhibitory control among people with OCD.
Reconsidering resilience in war contexts: Integrating conflict resolution counselling into socioecological mental health frameworks.
Purwoko B, Sujarwanto, Sa'idah I … +1 more , Ghozali MA
Psychiatry Res · 2026 Jul · PMID 41935508 · Publisher ↗
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