Psychiatry Research[JOURNAL]
Sun
200 papers
Ternary pattern-driven feature extraction and self-attending GRU for clinical score prediction in Alzheimer's disease.
Ramabharathi TG, Subramaniam K
Psychiatry Res Neuroimaging · 2026 Jun · PMID 42364284 · Publisher ↗
This article presents a unique deep learning technique to identify AD using data from magnetic resonance imaging (MRI). However, deep learning models' lack of interpretability prevents them from being used in clinical se...
This article presents a unique deep learning technique to identify AD using data from magnetic resonance imaging (MRI). However, deep learning models' lack of interpretability prevents them from being used in clinical settings, where explainability is crucial for winning over medical personnel. In order to diagnose AD, this work proposes a self-attending bidirectional gated recurrent unit (SA-Bi-GRU) method based on explainable AI (XAI) that makes use of a deep learning model. Before the diagnosis process, an integrated Ternary pattern and Fourier-Bessel series expansion based empirical wavelet transform (TP-FBSE-EWT) method is used to extract features. Then, a hybrid binary teaching learning and Horse herd optimization (H-BTL-HHO) algorithm is presented to minimize the dimensions and screen properties of brain regions associated with AD. Additionally, by using the Gradient-weighted Class Activation Mapping (Grad-CAM) technique, the proposed structure seeks to improve the interpretability of deep learning models, giving clinicians important insights into disease diagnosis and an understanding of the decision-making process. The process is implemented using the MATLAB tool. The simulation findings reveal that the proposed CAD system for clinical score prediction outperforms prevailing systems by boosting accuracy, sensitivity, and specificity to 99.97%, 99.34%, and 98.89% for multi-class problems, respectively.
Light exposure at night and subjective and objective sleep parameters in patients with schizophrenia: A cross-sectional analysis of the LENS study.
Miyake R, Esaki Y, Taniguchi R … +6 more , Obayashi K, Saeki K, Tsuboi S, Fujita K, Iwata N, Kitajima T
Psychiatry Res · 2026 Jun · PMID 42361629 · Publisher ↗
INTRODUCTION: Nighttime light exposure has been reported to be associated with sleep problems in the general population. This study aimed to investigate the association between nighttime light exposure and both subjectiv...
INTRODUCTION: Nighttime light exposure has been reported to be associated with sleep problems in the general population. This study aimed to investigate the association between nighttime light exposure and both subjective and objective sleep parameters in patients with schizophrenia, who often experience sleep disturbances. METHODS: This cross-sectional study included 225 outpatients with schizophrenia who participated in the Light Exposure and Neurobiology in Schizophrenia (LENS) study. Sleep was subjectively measured using the Pittsburgh Sleep Quality Index and objectively evaluated over 7 consecutive days using a wrist-worn actigraphy, respectively. Nighttime light exposure (from bedtime to rising time) was measured using an actigraphy and a portable photometer placed at the patient's bedside. RESULTS: The median nighttime illuminance measured using the actigraphy and photometer was 1.4 lux (interquartile range [IQR], 0.5-4.5) and 4.1 lux (IQR, 1.0-15.4), respectively. After adjusting for potential confounding factors, the highest quartile of nighttime illuminance measured using the actigraphy was significantly associated with lower sleep efficiency by 10.0%, lower total sleep time by 55.6 minutes, longer sleep onset time by 0.2 log minutes, and longer wake after sleep onset by 31.0 minutes, than the lowest quartile. Similarly, an association was observed between nighttime illuminance measured using the photometer and each sleep parameter. Whereas, subjective sleep parameter was not significantly associated with nighttime light exposure. CONCLUSIONS: Nighttime light exposure was significantly associated with objective sleep parameters in patients with schizophrenia. Further longitudinal studies are needed to clarify this association.
Heterogeneity in the network dynamics of psychopathological symptoms among adolescents: A cross-lagged panel network analysis.
Zhang C, Lei H, Wang Y … +3 more , Zhang Z, Ling F, Wang X
Psychiatry Res · 2026 Jun · PMID 42361628 · Publisher ↗
INTRODUCTION: Network theory conceptualizes psychopathology as dynamic interactions among symptoms within interconnected networks. The network dynamics of psychopathological symptoms among adolescents may vary substantia...
INTRODUCTION: Network theory conceptualizes psychopathology as dynamic interactions among symptoms within interconnected networks. The network dynamics of psychopathological symptoms among adolescents may vary substantially across individuals, yet this heterogeneity remains underexplored. Depression, anxiety, and problematic smartphone use (PSU) are common and frequently co-occurring indicators of psychopathology during adolescence and may mutually reinforce one another over time. Based on these three indicators, this study investigated distinct developmental trajectories of adolescent psychopathology and characterized their heterogeneous network structures, longitudinal associations, and core symptoms. METHODS: 9653 Chinese fifth-grade students (49.7% female; M = 10.14 ± 0.36 years) completed self-reported measures of depressive symptoms, anxiety symptoms, and PSU across four waves with one-year intervals. Group-based multi-trajectory modeling was used to identify heterogeneous developmental trajectories of psychopathological symptoms, and cross-lagged panel network analysis was applied to examine network dynamics of each group. RESULTS: Three developmental trajectories were identified: a low-risk group (34.8%), a potential-risk group (49.9%), and a high-risk group (15.2%). Network structures differed substantially across subgroups: the low-risk group showed a stable resilient network with low connectivity, the potential-risk group exhibited a transitional and highly spreading network with weak connections, and the high-risk group demonstrated a stable active network with strong connectivity. Comparison worry, depressed mood, and worthlessness emerged as central symptoms, especially in the potential- and high-risk groups. CONCLUSIONS: These findings enhance understanding of how symptoms spread and sustain in adolescent psychopathology, highlight heterogeneity in network dynamics, and offer implications for explaining comorbidity, and informing risk identification and targeted prevention strategies.
The impact of childhood maltreatment experiences on the structural covariance network of amygdala subregions in adolescents with major depressive disorder.
Shen J, Chen Y, Luo Z … +16 more , Chen Z, Li W, Wang C, Lan X, Mai S, Chen Y, Hu Z, Liu G, Zhang F, Chen X, You Z, Zeng Y, Liang Y, Lu H, Ning Y, Zhou Y
Psychiatry Res Neuroimaging · 2026 Jun · PMID 42349103 · Publisher ↗
Background Childhood maltreatment (CM) and the amygdala are pivotal in the etiology of adolescents with major depressive disorder (MDD), but the neurobiological processes linking them remain ambiguous. Methods This study...
Background Childhood maltreatment (CM) and the amygdala are pivotal in the etiology of adolescents with major depressive disorder (MDD), but the neurobiological processes linking them remain ambiguous. Methods This study employed voxel based morphometry to quantify gray matter volume and examined the structural covariance networks (SCN) of amygdala subregions in 92 adolescents with MDD and 81 healthy controls (HCs), concurrently administering the Childhood Trauma Questionnaire-Short Form (CTQ-SF) to evaluate experiences of CM. Results The results demonstrated that, in contrast to healthy controls, adolescents with major depressive disorder displayed heightened developmental synchrony between the amygdala subregions and the parietal cortex. Moreover, CM may influence the top down regulation of the frontal cortex over the limbic system, which could contribute to atypical maturation of neural circuits and increase susceptibility to MDD. Conclusions This research demonstrates the influence of CM on brain development and mental health, highlighting the need for specific therapies for adolescents with a history of CM. Trial registration Prospective Registration, Chinese Clinical Trial Registry.
Lithium versus valproate in bipolar disorder: Associations with dementia, mortality, suicide attempt, and end-stage renal disease in adults aged 45 years and older - a propensity score-matched retrospective cohort study.
Changchien TC, Zul DD, Cheng KD … +6 more , Mathurin TV, Dagbue AC, Fang YY, Liang CS, Yeh WC, Hsu TW
Psychiatry Res · 2026 Jun · PMID 42349060 · Publisher ↗
BACKGROUND/OBJECTIVE: Patients with bipolar disorder (BD) are at increased risk of dementia. However, few studies have directly compared subsequent dementia risk between BD patients treated with lithium and valproate, th...
BACKGROUND/OBJECTIVE: Patients with bipolar disorder (BD) are at increased risk of dementia. However, few studies have directly compared subsequent dementia risk between BD patients treated with lithium and valproate, the two first-line mood stabilizers. METHODS: This retrospective cohort study used the TriNetX collaborative network, which aggregates de-identified electronic health records across the United States. Adults aged≧45 years with BD who initiated lithium or valproate for the first time between 2000 and 2025 were included. 1:1 propensity score matching was applied. The primary outcome was all-cause dementia, and secondary outcomes were Alzheimer's disease, vascular dementia, unspecified dementia (ICD10 code: F03), mortality, suicide attempt, and ESRD. RESULTS: After applying exclusion criteria and matching, 3056 patients remained in each group. Lithium use was associated with a lower risk of all-cause dementia than valproate use (207 [7.1%] vs 311 [10.8%]; Relative risk [RR], 0.658; 95% confidence interval [CI], 0.556-0.778; Hazard ratio [HR], 0.689; 95% CI, 0.578-0.822; both P<.001). Lithium use was also associated with lower risks of unspecified dementia (HR, 0.677; 95% CI, 0.530-0.865; P=.002) and suicide attempt (HR, 0.594; 95% CI, 0.399-0.885; P=.010). Although the relative risk of Alzheimer disease was lower in the lithium group, the adjusted hazard ratio did not reach statistical but marginal significance. No significant between-group differences were observed for vascular dementia, mortality, or ESRD. LIMITATIONS: Residual confounding may persist due to the observational design, and dementia diagnoses relied on clinical coding within electronic health records. CONCLUSIONS: In this large, compliance-verified cohort, lithium treatment was associated with lower risks of dementia compared to valproate, without excess ESRD or mortality risk. These findings support lithium as a preferred long-term mood stabilizer for preserving cognitive outcomes in older adults with bipolar disorder, though observational data preclude causality inferences.
Association between lifestyle patterns and suicidality in adolescents: SESSAMO Project.
Goñi-Sarriés A, Sulaiman-Rojas JP, Díez-Suárez A … +3 more , Yárnoz-Goñi N, Morata L, Sánchez-Villegas A
Psychiatry Res · 2026 Jun · PMID 42349059 · Publisher ↗
INTRODUCTION: Adolescent suicidality is a major public health concern. Lifestyle behaviors may be related to suicidality, yet evidence considering their combined effect is limited. This study aimed to examine the associa...
INTRODUCTION: Adolescent suicidality is a major public health concern. Lifestyle behaviors may be related to suicidality, yet evidence considering their combined effect is limited. This study aimed to examine the association between lifestyle behaviors, summarized through the Global Index of Lifestyle Quality (GILQ), and suicidality in a cohort of Spanish adolescents. METHODS: This cross-sectional analysis included 2042 adolescents aged 14-16 years from the SESSAMO project. Lifestyle behaviors (diet, physical activity, sleep quality, screen use, substance use, risky sexual behavior, gambling, and spend time with friends) were assessed. Suicidality was measured using the Columbia Suicide Severity Rating Scale. Multivariate logistic regression models were fitted to assess associations between lifestyle factors, the GILQ, and suicidality, adjusting for potential confounders and depressive symptoms. RESULTS: A total of 9.6% of participants reported suicidality. An inverse dose-response association was observed between the GILQ and suicidality. A higher lifestyle score was associated with lower odds of suicidality (OR for extreme quartiles of GILQ adherence=0.40; 95% CI=0.16-0.94). Sleep quality, adequate sleep duration, absence of daytime sleepiness, and higher diet quality showed inverse and statistically significant associations with the presence of suicidality; however, these associations lost statistical significance after adjustment for depressive symptoms. CONCLUSIONS: A healthy lifestyle was inversely associated with suicidality in this sample of Spanish adolescents, supporting the relevance of lifestyle patterns as potential risk markers. These findings highlight the close interrelationship between lifestyle and mental health and support their integration in prevention strategies.
Childhood maltreatment moderates associations between SKA2 DNA methylation and suicidal ideation in african american adults with bipolar disorder.
Vazquez AY, Lamis DA
Psychiatry Res · 2026 Jun · PMID 42341357 · Publisher ↗
Individuals with Bipolar Disorder experience disproportionately high rates of suicidal ideation and behavior, however, findings regarding biologically informed biomarkers of suicide risk have been inconsistent and have l...
Individuals with Bipolar Disorder experience disproportionately high rates of suicidal ideation and behavior, however, findings regarding biologically informed biomarkers of suicide risk have been inconsistent and have largely been studied without consideration to environmental context or potential population-level differences. Epigenetic mechanisms, such as DNA methylation, may capture genetic-environmental interactions relevant to suicide risk. The present study examined associations between suicidal ideation and DNA methylation of the spindle and kinetochore-associated protein 2 (SKA2) gene, a stress-related gene involved in the hypothalamic-pituitary-adrenal axis regulation. We also tested childhood maltreatment as a moderator of these associations. Participants included 127 under-resourced African American adults with Bipolar Disorder. No direct associations between SKA2 methylation and suicidal ideation were observed. However, childhood maltreatment significantly moderated the association between SKA2 methylation and suicidal ideation, specifically within the intronic region of the gene. Lower intronic SKA2 methylation was associated with greater levels of suicidal ideation among individuals exposed to extremely severe levels of childhood maltreatment. Sensitivity analyses revealed that this pattern was specific to emotional abuse and physical neglect. These findings suggest that intronic SKA2 methylation may represent a context-dependent correlate of suicidal ideation, with associations primarily observed among individuals reporting substantial early-life adversity. Results underscore the importance of considering developmental trauma history when evaluating epigenetic correlates of suicide risk in under-resourced, historically underrepresented populations.
Life-course psychological trauma and cardiovascular disease risk in patients with metabolic dysfunction-associated steatotic liver disease at early cardiovascular-kidney-metabolic stages.
Yang L, Dong Y, Zhang Z … +1 more , Zeng X
Psychiatry Res · 2026 Jun · PMID 42341356 · Publisher ↗
AIMS: To examine whether distinct life-course patterns of psychological trauma are associated with incident cardiovascular disease (CVD) among individuals with metabolic dysfunction-associated steatotic liver disease (MA...
AIMS: To examine whether distinct life-course patterns of psychological trauma are associated with incident cardiovascular disease (CVD) among individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) in early stages of the cardiovascular-kidney-metabolic (CKM) spectrum. MATERIALS AND METHODS: Prospective cohort of 34,815 UK Biobank participants with MASLD and without baseline CVD (CKM stages 0-3). Latent class analysis identified life-course psycho-trauma patterns from measures of adulthood psychological symptoms, adulthood stressful life events, and childhood adverse experiences. Incident CVD (coronary heart disease, stroke, atrial fibrillation, heart failure, peripheral arterial disease, and cardiovascular death) was ascertained via linked health records. Fine-Gray competing-risk models estimated subdistribution hazard ratios (sHRs) for CVD across trauma classes. Restricted cubic spline analyses evaluated the dose-response relationship between a cumulative psycho-trauma score and CVD risk. Median follow-up was 13.9 years. RESULTS: Three classes emerged: Asymptomatic; Life-course Psychopathology (high adulthood symptoms plus stressful events and childhood adversities); and Childhood Adversity (predominantly childhood exposures). Over follow-up, 6285 incident CVD events occurred. Compared with the Asymptomatic class, the Life-course Psychopathology class had sHR 1.298 (95% CI 1.142-1.475) and the Childhood Adversity class had sHR 1.175 (95% CI 1.087-1.271). The cumulative trauma score showed a positive, approximately linear association with CVD risk. CONCLUSIONS: Distinct life-course psychological trauma patterns (i.e. notably adulthood psychopathology and childhood adversity) are independently associated with higher CVD risk in MASLD patients at early CKM stages. Incorporating trauma-informed assessment into cardiometabolic care may improve risk stratification and prevention.
Global burden of bipolar disorder in 204 countries and territories, 1990-2021: a systematic analysis of temporal trends, demographic disparities, and SDI associations for the Global Burden of Disease Study 2021.
Wu Y, Yang G, Shen H … +6 more , Fan F, Sun Y, Xu JE, Wu Y, Wang W, Zhang L
Psychiatry Res · 2026 Jun · PMID 42335719 · Publisher ↗
BACKGROUND: Bipolar disorder is a chronic psychiatric disorder with recurrent manic/hypomanic and depressive episodes, posing substantial individual, family, and societal burdens as a critical global public health concer...
BACKGROUND: Bipolar disorder is a chronic psychiatric disorder with recurrent manic/hypomanic and depressive episodes, posing substantial individual, family, and societal burdens as a critical global public health concern. METHODS: We extracted bipolar disorder data (incidence, prevalence, and Disability-Adjusted Life Years (DALYs)) from the Global Burden of Disease Study 2021 (1990-2021). R software was used for analyses (trend quantification, Socio-Demographic Index (SDI) correlation), and the Autoregressive Integrated Moving Average (ARIMA) model forecasted 2022-2040 incidence in males/females. RESULTS: From 1990 to 2021, total incident cases, prevalent cases, and DALYs increased across genders and the overall population, while DALYs and prevalence rates decreased. Male and total incidence rates rose (female incidence stabilized); females consistently had higher age-standardized incidence and prevalence rates than males. Oceania and Brazil had a high burden, while Asia and North America had a lower burden. SDI correlated positively with age-standardized incidence. ARIMA projected decreasing male but increasing female incidence post-2021. CONCLUSION: This study provides the first integrated analysis of long-term trends, socioeconomic disparities, and gender-specific forecasts for bipolar disorder burden, offering evidence-based targets for precision public health interventions. The global bipolar disorder burden remains notable, with gender and regional disparities. Targeted interventions for high-risk groups (e.g., females) and under-resourced regions are vital to reduce their impact.
Risk factors associated with fever after modified electroconvulsive therapy: A session-level study.
Liu C, Cong W, Huang J … +1 more , Wang W
Psychiatry Res · 2026 Jun · PMID 42335718 · Publisher ↗
OBJECTIVE: To characterize fever within 24 h after modified electroconvulsive therapy (MECT) and to identify risk factors for post-MECT fever. METHODS: We retrospectively enrolled 451 patients with psychiatric disorders...
OBJECTIVE: To characterize fever within 24 h after modified electroconvulsive therapy (MECT) and to identify risk factors for post-MECT fever. METHODS: We retrospectively enrolled 451 patients with psychiatric disorders who underwent MECT at a single center between August 2021 and August 2022, comprising 3006 treatment sessions. Fever was defined as an axillary temperature ≥37.3 °C within 24 h after each session. Fever incidence and characteristics were summarized. Because multiple treatment sessions were nested within the same patient, a mixed-effects logistic regression model was used to evaluate associations of treatment session order, anesthetic regimen, demographic characteristics, and EEG seizure duration with post-MECT fever. RESULTS: The patient-level incidence of fever was 20.18% (91/451), and the session-level incidence was 3.89% (117/3006). Fever episodes clustered within the first three sessions and were predominantly low-grade (65.8%). Mixed-effects logistic regression analysis showed higher fever risk during the first (OR 2.185, 95% CI 1.416-3.371, P < 0.001) and second (OR 3.113, 95% CI 2.080-4.659, P < 0.001) treatment sessions compared with sessions after the third MECT. Additionally, longer EEG seizure duration was independently associated with post-MECT fever (OR 1.011, 95% CI 1.001-1.020; P = 0.032). CONCLUSIONS: Post-MECT fever was typically low-grade and more likely to occur during the early treatment sessions. Both treatment session order and EEG seizure duration were independently associated with post-MECT fever, highlighting the importance of balancing treatment adequacy with peri‑procedural safety, particularly during the early phase of MECT.
Temporal trends in the prevalence of psychiatric diagnoses among aging veterans in the U.S. Department of Veterans Affairs healthcare system: An analysis by sex, age, period, and cohort.
Beydoun HA, Beydoun MA, Nixdorff N … +2 more , Wallace R, Tsai J
Psychiatry Res · 2026 Jun · PMID 42330865 · Full text
Women and older adults represent rapidly growing segments of the US veteran population. Understanding sex-specific patterns in psychiatric diagnoses among aging veterans is essential for anticipating future healthcare se...
Women and older adults represent rapidly growing segments of the US veteran population. Understanding sex-specific patterns in psychiatric diagnoses among aging veterans is essential for anticipating future healthcare service needs within the Department of Veterans Affairs (VA). The purpose of this retrospective study was to estimate prevalence and evaluate age-period-cohort trends in overall and broadly defined psychiatric disorders among women and men veterans aged ≥50 years. Using VA Corporate Data Warehouse data, 254,138 women veterans ≥50 years were 1:1 matched to 254,138 men veterans ≥50 years who used VA healthcare between 2000 and 2023. Twelve-month prevalence of overall psychiatric diagnoses and major diagnostic categories, including substance use disorders (SUDs) (alcohol, drug) and mental health disorders (mood, anxiety, and psychotic), were examined by sex across age, period, and cohort axes using descriptive and age-period-cohort interaction analyses. In the overall population, psychiatric diagnoses were identified in 9.0% of women and 10.6% of men veterans. Women had lower SUDs prevalence than men, with SUD rates declining with age in both sexes. Mental health disorders, particularly mood and anxiety disorders, increased during 2015-2023. Psychotic disorders increased with age but declined across calendar periods. Cohort effects were observed for several diagnostic categories, though less pronounced for alcohol use and mood disorders in both sexes and for psychotic disorders among women. In conclusion, psychiatric disorders are increasingly prevalent among more recent cohorts of aging US veterans, with distinct sex-specific age-period-cohort patterns, underscoring the need for tailored strategies for older women and men veterans.
Long-term antipsychotic use and cardiometabolic adverse effects in adults with non-psychotic disorders: A systematic review.
Radha Krishnan RP, Dzidowska M, Zheng D … +6 more , Russell DJ, Rhaman A, Quintrell E, Chan CH, Buckley NA, Raubenheimer JE
Psychiatry Res · 2026 Jun · PMID 42330864 · Publisher ↗
BACKGROUND: Off-label antipsychotic prescribing for non-psychotic disorders is increasing, often at low doses and over extended periods. While cardiometabolic adverse effects are documented among individuals treated with...
BACKGROUND: Off-label antipsychotic prescribing for non-psychotic disorders is increasing, often at low doses and over extended periods. While cardiometabolic adverse effects are documented among individuals treated with antipsychotics for psychotic disorders, the consequences of long-term off-label antipsychotic use are not well-known. This systematic review synthesises evidence for cardiometabolic adverse effects of long-term antipsychotic therapy in adults and the elderly with non-psychotic disorders. METHODS: We searched electronic databases for randomised controlled trials or observational studies of ≥1 year duration. Adverse events included weight gain, hyperglycaemia, dyslipidaemia, hypertension, metabolic syndrome, ischaemic heart disease, thrombosis and cardiometabolic mortality. RESULTS: We found 13 observational studies with high heterogeneity. Among adults, antipsychotic-treated individuals displayed increased prevalence of weight gain (28.8-77.9%), hyperglycaemia (4.8-23.2%) and dyslipidaemia (15.8-47.5%) compared with untreated patients. Second-generation antipsychotics had a larger effect than first-generation agents. A weak association was observed for cardiometabolic mortality. Results were sparse for the elderly, with one study indicating increased prevalence of metabolic syndrome and its components, and an inverse correlation of treatment duration with the risk for myocardial infarction. Studies were judged to have moderate-high methodological quality using suitable standardised risk of bias assessment tools. CONCLUSIONS: Despite heterogeneity in included studies, this review highlights adverse cardiometabolic outcomes associated with long-term antipsychotic use in adults with non-psychotic disorders, which is concerning given the high proportion of off-label use. Clinicians should exercise caution when prescribing antipsychotics off-label, especially where alternative options are available, and support even low-dose use with regular metabolic monitoring.
Menopausal status-specific association between the triglyceride-glucose index and a body shape index (TyG-ABSI) and depression in U.S. women.
Li G, Bai X, Wang S … +1 more , Feng X
Psychiatry Res · 2026 Jun · PMID 42330863 · Publisher ↗
BACKGROUND: Depression disproportionately affects women, particularly during the menopausal transition, a period of significant endocrine and metabolic changes. The triglyceride-glucose index and a body shape index (TyG-...
BACKGROUND: Depression disproportionately affects women, particularly during the menopausal transition, a period of significant endocrine and metabolic changes. The triglyceride-glucose index and a body shape index (TyG-ABSI), a novel metabolic indicator, has been associated with depressive symptoms. However, its role across different menopausal statuses requires further characterization. METHODS: This cross-sectional study included 2707 premenopausal and 3119 postmenopausal women from the National Health and Nutrition Examination Survey (NHANES) 2007-2020. Depressive symptoms were defined as a Patient Health Questionnaire-9 (PHQ-9) score ≥10. Multivariable logistic regression analyses and restricted cubic spline (RCS) were applied to evaluate the associations between TyG-ABSI and depression. Subgroup and sensitivity analyses were conducted to assess potential effect modification and verify robustness. RESULTS: Significantly positive associations between TyG-ABSI and depression were observed exclusively among postmenopausal women (OR = 1.29, 95%CI: 1.09-1.52), whereas no such relationship existed in premenopausal women. Within the postmenopausal group, participants in the lowest quartile exhibited reduced odds of depression compared with the highest quartile (OR = 0.44, 95%CI: 0.27-0.73). RCS analysis confirmed a linear dose-response relationship in postmenopausal women. Subgroup analyses identified a significant interaction with LTPA, with the association remaining significant only among physically inactive individuals. Sensitivity analyses further validated the robustness of the association. CONCLUSION: This study highlights a menopausal status-specific association between TyG-ABSI and depression. Elevated TyG-ABSI is independently associated with higher odds of depression among postmenopausal women, with the association varying according to LTPA levels. Our findings extend current understanding of the relationship between metabolic dysfunction and depression in women.
Antidepressant use and worsening of non-suicidal self-injury and suicidality in bipolar disorder: A multicenter retrospective cohort study.
Deng Y, Xu N, Huang J … +21 more , Hu X, Huang S, Cui Z, Li Y, Wang L, Zhang Y, Sun P, Su Z, Yao Z, An C, Jia Y, Wang Z, Rong H, Lin K, He Z, Hu S, Wang C, Bao J, Xu X, Lv X, Yu X
Psychiatry Res · 2026 Jun · PMID 42330862 · Publisher ↗
The safety of antidepressants in bipolar disorder (BD) remains controversial, particularly regarding the risk of behavioral activation and worsening Non-Suicidal Self-Injury (NSSI). This multi-center retrospective cohort...
The safety of antidepressants in bipolar disorder (BD) remains controversial, particularly regarding the risk of behavioral activation and worsening Non-Suicidal Self-Injury (NSSI). This multi-center retrospective cohort study included 575 patients with BD from 15 medical centers in China to evaluate the association between antidepressant use and NSSI frequency, suicidal ideation (SI), and suicidal behavior (SB) over a one-year period. Multivariable logistic regression revealed that antidepressant use was associated with higher odds of the worsening of NSSI (OR=1.90, p = 0.030), as well as the presence of SI (OR=1.70, p = 0.016) and SB (OR=1.80, p = 0.010). In exploratory subgroup analyses, point estimates were larger in patients with low household income (OR=2.74, p = 0.038) and non-depressive dominant polarity (OR=7.05, p < 0.001), and the association reached significance only in patients not receiving concurrent lithium (OR=2.29, p = 0.032) but not in lithium-treated patients (OR=1.38, p = 0.462); however, none of the formal interaction tests was statistically significant (all interaction p > 0.05). These findings indicate that antidepressant use in BD is associated with higher odds of worsening NSSI and suicidality. The observed subgroup differences did not reach statistical significance on interaction testing and should be regarded as hypothesis-generating.
Long-range temporal dependencies in EEG as a biomarker of depression.
Vr S, Ramasamy S, Joseph J
Psychiatry Res Neuroimaging · 2026 Jun · PMID 42330683 · Publisher ↗
Signal complexity measures computed from electroencephalogram (EEG) are widely used as feature descriptors for the diagnosing major depressive disorder (MDD). Because of their intricate formulations, it is not so straigh...
Signal complexity measures computed from electroencephalogram (EEG) are widely used as feature descriptors for the diagnosing major depressive disorder (MDD). Because of their intricate formulations, it is not so straightforward to back track and infer the changes in the pattern of EEG that have caused the deflections. We define aperiodic nature of EEG in MDD patients with the help of mean square of autocorrelation function (ACF) coefficients (MSACFC) as a feature descriptor. MSACFC quantifies changes in the long-range dependencies in a signal via an easily explainable formulation compared to the traditional signal complexity measures. We analysed the MSACFC computed from EEG recordings of 5minute duration within 1 Hz to 30 Hz band in eyes closed state obtained from an age and gender-matched cohort of 28 healthy controls (HCs) and 30 MDD patients at 19 scalp electrodes. From Wilcoxon rank-sum test MSACFC at F8 electrode is found to be significantly higher in HCs (0.0027±0.0035) than in MDD patients (2.9313 × 10± 2.7236 × 10) with a p-value of 3.7 × 10. At the F8 electrode, MSACFC has a large effect size (Cohen's d) of 0.99563 > 0.8 for 95% confidence interval signifying a substantially strong difference between the groups. The EEG in MDD patients is more aperiodic and the ACF has lower magnitude compared to HCs.
Characteristics of self-harm in patients with first episode psychosis.
Solberg AC, Ottesen AA, Barrett EA … +3 more , Mork E, Qin P, Melle I
Psychiatry Res · 2026 Jun · PMID 42322928 · Publisher ↗
BACKGROUND: Suicide is a leading cause of premature death in schizophrenia spectrum disorders (SSD). Self-harm (SH)-including suicide attempts (SA) and non-suicidal self-harm (NSSH)-is highly prevalent, especially in fir...
BACKGROUND: Suicide is a leading cause of premature death in schizophrenia spectrum disorders (SSD). Self-harm (SH)-including suicide attempts (SA) and non-suicidal self-harm (NSSH)-is highly prevalent, especially in first-episode psychosis (FEP). Detailed knowledge of SH characteristics before and at treatment start is limited. OBJECTIVES: In a FEP SSD sample, we aimed to: (I) estimate SH prevalence, distinguishing NSSH and SA; (II) describe characteristics of the most recent SH at first treatment, including planning and motives; (III) examine the most recent SA, including violent versus non-violent methods; and (IV) investigate associations between clinical characteristics and current suicidal behavior (SB) at treatment start. METHODS: We included 252 patients aged 18-65 years with DSM-IV SSD from the Thematically Organized Psychosis study, all within their first year of adequate treatment. Assessments included SCID, PANSS, GFS, BIS, PAS, AUDIT/DUDIT, detailed SH interviews, the Scale for Suicidal Ideation, and CGI-SS. Analyses comprised bivariate tests and logistic regressions. RESULTS: Of 251 participants with SH data, 85 (34%) reported lifetime SH and 32 (13%) at least one SA. Multiple SH episodes were associated with younger age, poorer premorbid social adjustment, longer duration of untreated psychosis, fewer negative symptoms, and higher alcohol use. NSSH typically occurred closer to treatment start, with planning under one day and rarely leading to hospitalization. Among SA, 57% used violent methods, more common in men and those with schizophrenia. At baseline, 33% showed current SB, associated with depressive symptoms and higher self-reported insight. CONCLUSIONS: SH and SB are common and often severe in early SSD, with frequent violent SA and short planning times.
Intranasal esketamine in treatment-resistant depression with and without comorbid borderline personality disorder: A multicenter real-world longitudinal study.
Mazzoni F, Raffone F, De Ciechi A … +6 more , Girone N, Macellaro M, Martinotti G, Dell'Osso B, Martiadis V, Olivola M
Psychiatry Res · 2026 Jun · PMID 42322927 · Publisher ↗
BACKGROUND: Borderline personality disorder (BPD) often occurs alongside treatment-resistant depression (TRD), but the impact of BPD on real-world outcomes with intranasal esketamine is unclear. METHODS: Consecutive TRD...
BACKGROUND: Borderline personality disorder (BPD) often occurs alongside treatment-resistant depression (TRD), but the impact of BPD on real-world outcomes with intranasal esketamine is unclear. METHODS: Consecutive TRD outpatients initiating intranasal esketamine treatment at four Italian centres between 1 September 2024 and 30 September 2025 were enrolled in the study (n = 90): 45 with comorbid BPD and 45 without any personality disorder. The primary outcome was the trajectory of depressive symptoms on the Montgomery-Åsberg Depression Rating Scale (MADRS) from baseline (T0) to 2 weeks (T1), 1 month (T2), 3 months (T3) and 6 months (T4). A response was defined as a ≥ 50% reduction in MADRS score, and remission as a MADRS score of ≤10 at T4. Secondary outcomes (exploratory) included anxiety (HAM-A), impulsivity (BIS-11) and cognitive function (MoCA). RESULTS: MADRS scores decreased over time (F(2.45, 215.50)=365.10, p < 0.001, ηp²=0.81), with a significant time × BPD interaction (F(2.45, 215.50)=17.31, p < 0.001), indicating faster early improvement in the BPD group. Remission at six months was 53.3%, with no difference by BPD status (48.9%vs. 57.8%, p = 0.398). However, response rates were higher in the BPD group from month one onwards (T4 OR=12.57, p = 0.004). Sensitivity analyses adjusting for baseline psychotherapy/medications and excluding patients with a history of hypomanic episodes yielded consistent results. Across the whole sample, anxiety and impulsivity decreased, and there was no evidence of worsening of the MoCA score over six months, supporting cognitive safety. No serious adverse events occurred and no patients dropped out. CONCLUSIONS: In routine care, intranasal esketamine was associated with sustained improvement in TRD over six months, and comorbid BPD did not affect remission outcomes.
Psychiatric readmissions following Soteria versus traditional inpatient care: a propensity score-matched cohort study.
Friedlander A, Oren S, Sinai D … +4 more , Bitan DT, Yoffe R, Eitan R, Lichtenberg P
Psychiatry Res · 2026 Jun · PMID 42322926 · Publisher ↗
The Soteria model offers a community-based, recovery-oriented alternative to traditional psychiatric hospitalization, yet long-term evidence regarding its association with readmission remains limited. This study evaluate...
The Soteria model offers a community-based, recovery-oriented alternative to traditional psychiatric hospitalization, yet long-term evidence regarding its association with readmission remains limited. This study evaluated whether treatment in a Soteria home is associated with lower psychiatric readmission rates compared to traditional hospital care. A retrospective analysis was conducted using Israel Ministry of Health records for patients admitted to Soteria or traditional wards in 2018, with follow-up through May 2021 (N = 164). Outcomes included readmission proportion, frequency, time-to-first readmission, and length of stay. Analysis employed propensity score matching (PSM), logistic regression, and Cox proportional hazards modelling. Soteria patients were significantly less likely to be readmitted at 24 months (41.5%vs. 61.0%) and 30 months (45.1%vs. 63.4%). They also experienced longer times to first readmission. Moderation analyses suggested that the association between Soteria care and delayed readmission was more pronounced among younger patients (≤30 years). To address diagnostic imbalances, a stratified PSM sensitivity analysis was conducted; the reduction in readmission hazard remained statistically significant (HR=0.65, 95% CI: 0.43-1.00, p = 0.048), providing partial support for the primary time-to-readmission findings. Treatment in a Soteria home was associated with lower long-term psychiatric rehospitalization, particularly among younger individuals. While the observational design precludes causal conclusions, these findings suggest that Soteria-based residential alternatives may be associated with reduced long-term psychiatric readmission compared with traditional inpatient treatment.
Depressive symptoms and pornography use: A census-matched longitudinal study.
Engelhardt R, Geppert R, Trommer D … +3 more , Grubbs JB, Maes J, Kraus SW
Psychiatry Res · 2026 Jun · PMID 42322925 · Publisher ↗
BACKGROUND: Depressive symptoms and pornography use are both common in the United States. Prior cross-sectional research has consistently reported positive associations between these variables, while longitudinal evidenc...
BACKGROUND: Depressive symptoms and pornography use are both common in the United States. Prior cross-sectional research has consistently reported positive associations between these variables, while longitudinal evidence remains limited and often relies on only two measurement waves. METHOD: We conducted a five-wave longitudinal study based on a census-matched sample of American adults (N = 2806, 53% women, M = 51, SD = 16). Associations between depressive symptoms and frequency of pornography use were examined via partial correlations and a random-intercept cross-lagged panel model (RI-CLPM). All analyses were adjusted for age, gender, and moral disapproval of pornography use. RESULTS: Across all five waves, depressive symptoms were positively associated with frequency of pornography use, independently of age, gender, and moral disapproval. The RI-CLPM indicated that these associations were stable over time and reflected between-person differences rather than reciprocal effects across six-month intervals. CONCLUSION: Among American adults, depressive symptoms and frequency of pornography use are positively related at the population level. This association appears to reflect a stable between-person link that is not accounted for by demographics, moral attitudes or interactions across waves. Future research should use ecological momentary assessment and multi-wave longitudinal designs with varying intervals to further examine temporal dynamics of depressive symptoms and frequency of pornography use.
Predicting relapse risk from patients' perceptions of family functioning in early psychosis: A three-year longitudinal study.
Morejón AJV, Reyes AV, Muñoz-Caracuel MA … +1 more , Vázquez-Morejón R
Psychiatry Res · 2026 Jun · PMID 42322924 · Publisher ↗
This study examines the predictive capacity of the Spanish adaptation of the Influential Relationships Questionnaire (IRQ) in the clinical course of patients with first-episode psychosis. A total of 119 patients diagnose...
This study examines the predictive capacity of the Spanish adaptation of the Influential Relationships Questionnaire (IRQ) in the clinical course of patients with first-episode psychosis. A total of 119 patients diagnosed with psychotic disorders (ICD-10 F20-F31), aged 18 to 35 years and living with one or both parents, were recruited from a Community Mental Health Unit and followed for three years. During initial evaluations, patients completed the short version of the IRQ, in addition to routine clinical assessments. Outcome variables included the number of relapses, hospital admissions, and time to relapse/admission, obtained from clinical records and follow-up databases. The criticism dimension of the IRQ showed the strongest predictive power, with significant and moderate-to-strong correlations with all outcome measures, particularly when referred to fathers. Care was negatively correlated with relapses and admissions, suggesting a protective effect, although with smaller effect sizes. Overinvolvement showed weak and inconsistent associations, while restriction was not significantly related to outcomes. Regression analyses confirmed the explanatory capacity of criticism, accounting for up to 23% of the variance in admissions in the paternal subgroup. Patients in the highest-criticism tertile showed markedly higher rates of relapse and admission compared to those in the lowest tertile. These findings confirm the predictive validity of the Spanish adaptation of the IRQ and highlight the importance of perceived criticism as a key dimension in the family emotional climate of first-episode psychosis. The results underscore the clinical relevance of incorporating the assessment of perceived criticism into routine practice and of including parents, particularly fathers, in therapeutic interventions.
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