Psychiatry Research[JOURNAL]
Sun
200 papers
Corrigendum to "Effect of computerized cognitive remediation therapy combined with individualized occupational therapy on cognitive function and functional outcomes in patients with schizophrenia: A randomized controlled trial" [Psychiatry Research 354 (2025) 116789].
Hu G, Wei D, Zhang J … +7 more , Liu J, Liao L, Zheng L, Wu H, Wu X, Wei B, Wan J
Psychiatry Res · 2026 Jul · PMID 42014217 · Publisher ↗
Abstract loading — click title to view on PubMed.
Nationwide trends in antipsychotic and co-medication prescribing for schizophrenia: analysis of National Health Insurance data (2011-2023).
Kim KH, Kim C, Song I … +1 more , Kim DS
Psychiatry Res · 2026 Jul · PMID 42013778 · Publisher ↗
INTRODUCTION: Schizophrenia treatment has increasingly shifted toward the use of second-generation antipsychotics (SGAs), yet real-world prescribing often involves complex polypharmacy. Evidence from Asian countries, par...
INTRODUCTION: Schizophrenia treatment has increasingly shifted toward the use of second-generation antipsychotics (SGAs), yet real-world prescribing often involves complex polypharmacy. Evidence from Asian countries, particularly regarding adjunctive psychotropic use at treatment initiation, remains insufficient. This study aimed to describe changes in antipsychotic prescribing patterns among newly diagnosed patients with schizophrenia in South Korea from 2012 to 2023 and to examine socioeconomic and clinical factors. METHODS: We analyzed nationwide National Health Insurance (NHI) claims data covering 2012-2023. Adults aged 20-65 years with newly diagnosed schizophrenia (ICD-10 F20.0-F20.9) were included (n = 320,591). Annual prescription rates were examined for antipsychotics, benzodiazepines, anticonvulsants, and antidepressants. Logistic regression was conducted to identify sociodemographic and clinical correlates of drug use. RESULTS: SGA use increased steadily from 84.0% in 2012 to 94.2% in 2023 (p for trend <0.0001), indicating a shift toward guideline-recommended treatment at initiation. In contrast, benzodiazepine use remained persistently high (72.5-73.7%) with no significant trend, while anticonvulsant use remained stable (∼21-23%). Antidepressant use increased from 32.4% to 45.1% (p for trend <0.0001). Medical Aid beneficiaries were less likely to receive SGAs (adjusted OR = 0.55, 95% CI 0.53-0.56). CONCLUSION: Over the past decade, initial treatment of schizophrenia in Korea has increasingly shifted toward SGA-based therapy. However, persistent use of benzodiazepines and early socioeconomic disparities highlight ongoing challenges in achieving rational and equitable pharmacotherapy. These findings highlight the importance of continued monitoring and targeted policy efforts to improve the appropriateness and equity of psychotropic prescribing.
Impaired central methylation capacity in drug-naïve first-episode psychosis: Evidence from cerebrospinal fluid one-carbon metabolism.
Hira S, Özcan Ö, Ipçioğlu OM … +4 more , Hatipoğlu M, Karagöz E, Balibey H, Gültepe M
Psychiatry Res · 2026 Jul · PMID 42013777 · Publisher ↗
BACKGROUND: One-carbon metabolism is implicated in psychotic disorders, yet most evidence relies on peripheral markers that are susceptible to confounding by antipsychotic exposure and illness chronicity. Direct cerebros...
BACKGROUND: One-carbon metabolism is implicated in psychotic disorders, yet most evidence relies on peripheral markers that are susceptible to confounding by antipsychotic exposure and illness chronicity. Direct cerebrospinal fluid (CSF)-based assessment at the onset of psychosis provides insight into central metabolic alterations largely independent of peripheral confounding; however, such evidence remains limited. We examined CSF markers of methylation capacity in patients with drug-naïve first-episode psychosis (FEP). METHODS: In this cross-sectional comparative study, CSF concentrations of S-adenosylmethionine (SAM), S-adenosylhomocysteine (SAH), the SAM/SAH ratio, and 5-methyltetrahydrofolate (5-MTHF) were measured in 17 drug-naïve male patients with FEP and 17 controls. A broad CSF amino acid panel was quantified to assess global amino acid availability and coordination with methylation-related metabolites. RESULTS: Patients with FEP showed markedly lower CSF SAM and a substantially reduced SAM/SAH ratio compared with controls (both p < 0.001), indicating constrained central methylation capacity at first clinical presentation. CSF 5-MTHF was also lower in patients (p = 0.014), consistent with reduced folate-dependent remethylation support. CSF SAH and absolute CSF amino acid concentrations were largely comparable between groups. Secondary analyses suggested altered associations between methylation-related metabolites and select amino acids in FEP. CONCLUSIONS: CSF evidence indicates that impaired central methylation capacity and reduced folate-dependent remethylation support are already present at the onset of psychosis, independent of antipsychotic treatment. These findings suggest that alterations in central one-carbon metabolism may already be present at the onset of psychosis rather than representing solely downstream consequences of chronic illness or long-term treatment exposure.
Extrapyramidal symptom severity across machine learning-derived neuroanatomical subtypes of schizophrenia.
Selek S, Sungur I, Erdogan Y … +1 more , Gonul AS
Psychiatry Res Neuroimaging · 2026 Aug · PMID 42001872 · Publisher ↗
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Letter to the editor regarding: "Cortical thickness associated with past year mood episode in major depressive and bipolar disorders" by Mackenzie et al. (2026).
Hudaib AR
Psychiatry Res Neuroimaging · 2026 Aug · PMID 42001871 · Publisher ↗
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The efficacy of virtual reality interventions for depressive disorder due to another medical condition: A three-level meta-analysis.
He X, Wang Z, Yang X … +2 more , Zhou Y, Yang J
Psychiatry Res · 2026 Jul · PMID 42000599 · Publisher ↗
BACKGROUND: Depressive Disorder Due to Another Medical Condition significantly impairs treatment adherence and quality of life. While established treatments face limitations like adverse drug reactions and poor adherence...
BACKGROUND: Depressive Disorder Due to Another Medical Condition significantly impairs treatment adherence and quality of life. While established treatments face limitations like adverse drug reactions and poor adherence, Virtual Reality (VR) has emerged as a promising tool due to its immersive and controllable nature. However, systematic evidence on its efficacy and optimal parameters is insufficient. METHODS: A systematic search was conducted across multiple databases from inception to July 31, 2025. Following PRISMA guidelines, 21 randomized controlled trials (27 effect sizes) were included. A three-level meta-analysis using Hedges' g was performed in R, employing a random-effects model to pool effect sizes, followed by heterogeneity, publication bias, and moderator analyses. RESULTS: VR intervention demonstrated a moderate and significant therapeutic effect (g = -0. 446, 95% CI [-0. 727, -0. 166], p = 0. 0036). Moderator analyses showed significantly greater effects for patients under 60 years (g = -0. 595) than for older patients (g = -0. 295). High-frequency intervention (≥5 sessions/week, g = -0. 743) was superior to low-frequency (<5 sessions/week, g = -0. 207). Short-duration sessions (≤20 min, g = -0. 529) outperformed longer sessions (>20 min, g = -0. 344). Gamified design (g = -0. 688) yielded larger effects than virtual scene construction (g = -0. 242). All between-group differences were significant (p < 0. 05). CONCLUSIONS: VR effectively alleviates this depressive disorder. Optimal outcomes are achieved with high-frequency, short-duration, game-based protocols, particularly for younger patients (<60 years), supporting personalized VR strategies in clinical practice.
Domain-specific hopelessness and near-term suicide risk: Evidence from ecological momentary assessment in a high-risk clinical sample.
Zank A, Knetter J, Rogers ML … +3 more , Sharma P, Peck R, Muehlenkamp JJ
Psychiatry Res · 2026 Jul · PMID 42000598 · Publisher ↗
INTRODUCTION: Hopelessness is a well-established correlate of suicidal thoughts and behaviors, yet most research conceptualizes it as a global construct. Less is known about how hopelessness within specific life domains...
INTRODUCTION: Hopelessness is a well-established correlate of suicidal thoughts and behaviors, yet most research conceptualizes it as a global construct. Less is known about how hopelessness within specific life domains relates to near-term suicide risk and whether general hopelessness accounts for these associations. This study examined these relationships using ecological momentary assessment (EMA). METHODS: Twenty-six adults (M age = 35.6, SD = 14.36) receiving outpatient therapy who reported suicidal ideation in the past two weeks completed EMA prompts three times daily for 21 days, yielding 1309 observations. At each prompt, participants rated hopelessness across six domains (work, partner, social/friends, home/family, finances, health), general hopelessness, and suicidal urge intensity. Within-person multi-level indirect effect models tested whether general hopelessness accounted for associations between domain-specific hopelessness and concurrent suicidal urges. RESULTS: Hopelessness specific to work, partner, social/friends, home/family, and health were positively concurrently associated with both general hopelessness and suicidal urges. General hopelessness also predicted suicidal urges. After adjusting for general hopelessness, direct effects persisted for social/friends and home/family, whereas effects for work, health, and partner became nonsignificant. Financial hopelessness was not significantly related to concurrent suicidal urges. CONCLUSION: Findings suggest that domain-specific hopelessness fluctuates proximally with suicidal urges and contributes to general hopelessness in shaping suicide risk. Assessing both general and domain-specific hopelessness may improve short-term risk evaluation and inform targeted interventions for high-risk clinical populations.
Digital self-harm among adolescents in China: Latent profiles, correlates, and its relationship with suicidal behaviors.
Sun M, Wu C, Xu B … +1 more , Wang D
Psychiatry Res · 2026 Jul · PMID 42000597 · Publisher ↗
BACKGROUND: To explore the latent profiles of digital self-harm among Chinese adolescents and to examine between-profile differences in sample characteristics and psychological variables, as well as their associations wi...
BACKGROUND: To explore the latent profiles of digital self-harm among Chinese adolescents and to examine between-profile differences in sample characteristics and psychological variables, as well as their associations with suicidal behaviors. METHODS: A total of 5655 adolescents (mean age = 16.26 ± 0.82 years; 53.2% male) were recruited from 27 April to 19 May 2025. All participants completed self-report web-based questionnaires covering demographic characteristics, lifestyle variables, depressive symptoms, cyber-victimization, digital self-harm, physical self-harm, and suicidal behaviors. Latent profile analysis and logistic regression analysis were used to analyze the data. RESULTS: Three latent profiles of digital self-harm in adolescents were identified: high digital self-harm (7.0%), inner self-emotion harm (11.2%), and low digital self-harm (81.8%). Multivariate logistic regression indicated that sex, grade, parental marital status, history of mental disorders, and smoking status distinguished the digital self-harm subtypes. Short sleep duration, depressive symptoms, and cyber-victimization were risk factors for digital self-harm (p < 0.05). After controlling for covariates, both high digital self-harm and inner self-emotional harm were associated with physical self-harm and suicidal behaviors. Notably, inner self-emotional harm demonstrated a unique association with suicidal ideation (OR = 2.00, 95% CI = 1.60-2.51) and suicide attempts (OR = 1.70, 95% CI = 1.10-2.61) even after additionally controlling for physical self-harm. CONCLUSIONS: Healthcare and educational professionals should prioritize early screening for digital self-harm, promptly identify high-risk groups, and provide targeted psychological counselling and support to safeguard adolescent mental health and prevent suicide.
Characterization of medical and recreational cannabis use among U.S. adults: Results from a nationally representative sample.
Secades-Villa R, González-Roz A, Belisario KL … +2 more , Martins SS, MacKillop J
Psychiatry Res · 2026 Jul · PMID 42000596 · Publisher ↗
This study estimates the prevalence and correlates of medical cannabis use (MCU), recreational cannabis use (RCU) and combined medical + recreational cannabis use (MRCU) among U.S. adults. We analyzed data from the sub-s...
This study estimates the prevalence and correlates of medical cannabis use (MCU), recreational cannabis use (RCU) and combined medical + recreational cannabis use (MRCU) among U.S. adults. We analyzed data from the sub-sample of adults aged 18 or older who had used cannabis in the past year (N = 12,706), drawn from the 2022 National Survey on Drug Use and Health (NSDUH). Descriptive and bivariate analyses were conducted to identify the correlates of MCU, RCU and MRCU. A total of 11.14% reported MCU, 83.02% RCU, and 5.83% MRCU. Past-year cannabis use disorder (CUD) prevalence was higher for MRCU (43.61%) compared to MCU (34.43%) and RCU (28.85%), and for MCU compared to RCU (ps<0.001). Individuals reporting MRCU were more likely to report past year serious psychological distress and any past year illegal drug use in comparison to those reporting strictly recreational or medical use (ps<0.05), and were also more likely to report past year major depressive episode (p<.05), receiving treatment for mental health in the past year (p<.05), and more days of cannabis use in the past month than people who only used cannabis recreationally (p<.001). In summary, adults who reported MRCU have a higher prevalence of CUD and endorsed worse mental health relative to people reported RCU and MCU, especially in comparison with RCU. This underscores the importance of physicians accurately selecting patients who will be good candidates for medical cannabis, regularly conducting assessments for CUD and other mental disorders, and, when necessary, referring patients to appropriate services.
Corrigendum to ''Analysis of the Application Value of Multi-slice Spiral CT and Multimodal MRI in Screening Patients with Bipolar Disorder'' Psychiatry research. Neuroimaging, 358, 112178.
Si Y, Yu Y, Fan H … +1 more , Xing Z
Psychiatry Res Neuroimaging · 2026 Aug · PMID 42000234 · Publisher ↗
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Speech-in-noise perception and spectro-temporal resolution in obsessive-compulsive disorder.
Çağal Karabulut E, Çetin Kara H, Yaman AY … +2 more , Kılıç A, Özcebe E
Psychiatry Res · 2026 Jul · PMID 41997035 · Publisher ↗
AIM: This study aimed to evaluate speech-in-noise perception and spectro-temporal resolution skills in individuals with obsessive-compulsive disorder (OCD). METHOD: A total of 84 adults participated: 42 individuals with...
AIM: This study aimed to evaluate speech-in-noise perception and spectro-temporal resolution skills in individuals with obsessive-compulsive disorder (OCD). METHOD: A total of 84 adults participated: 42 individuals with OCD and 42 healthy controls. Participants had an OCD diagnosis for at least six months and no additional neurological, psychiatric, or organic conditions. All had normal hearing. Speech-in-noise perception was assessed with the Turkish Matrix Test (TURMatrix), spectral resolution with the Spectral-Temporally Modulated Ripple Test (SMRT), and temporal resolution with the Gap-In-Noise Test (GIN). OCD severity was measured using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), while depression and anxiety levels were evaluated with the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). Independent t-tests were used for between-group comparisons, multiple linear regression examined predictors of auditory performance, and ANCOVA assessed the effects of group and auditory factors on TURMatrix outcomes. RESULTS: Significant differences were observed between groups in TURMatrix adaptive SNR scores and in both GIN threshold and GIN performance (p < 0.05), while SMRT scores did not differ between groups. Within the OCD group, OCD duration significantly predicted GIN thresholds, whereas Y-BOCS, BDI, and BAI scores showed no significant influence. ANCOVA indicated that both group and SMRT scores significantly predicted TURMatrix critical SNR values, explaining 26% of the variance. CONCLUSION: This study demonstrates that individuals with OCD exhibit deficits in speech perception in noise alongside a selective weakness in temporal resolution; however, spectral resolution appears to remain intact. This selectivity offers a compelling explanation for why speech perception in noise is particularly challenging in OCD and suggests that the commonly reported sensitivity to background noise may stem, at least in part, from an objective timing-related processing deficit. These findings delineate potential targets for auditory-cognitive rehabilitation and highlighting the need for further large-scale studies.
Autistic children and their parents during war - A mixed-methods study.
Aviran SG, Nitzan T, Rozenblat S … +6 more , Graucher T, Ophir S, Vaisman TM, Lifshits TM, Rum Y, Koller J
Psychiatry Res · 2026 Jul · PMID 41997034 · Publisher ↗
This mixed-methods study examined the psychological effects of war exposure on autistic and non-autistic children and their parents following the October 7th, 2023, terrorist attack and the ensuing Israel-Hamas War. Prio...
This mixed-methods study examined the psychological effects of war exposure on autistic and non-autistic children and their parents following the October 7th, 2023, terrorist attack and the ensuing Israel-Hamas War. Prior research shows that children exposed to war have elevated risk for post-traumatic stress symptoms (PTSS), with autistic children being particularly vulnerable. In this study, 72 parents of children aged 3-17 (38 of autistic children, 34 of non-autistic children) completed standardized measures assessing child PTSS, parental PTSS, depression, anxiety, stress, and resilience. A subsample of 22 parents (12 of autistic children) also answered open-ended questions, which were analyzed qualitatively. Quantitative findings indicated that parents of autistic children reported significantly higher levels of depression, anxiety, and PTSS than parents of non-autistic children. Similarly, autistic children showed higher PTSS than non-autistic children. In the full sample, parental PTSS and anxiety significantly predicted child PTSS. When analyzed separately, parental PTSS was the strongest predictor among families of autistic children, while parental stress predicted child PTSS in families of non-autistic children. Qualitative analysis identified four themes in parents' and their children's experiences: Difficulties, Coping Resources, Routine, and Functioning. Parents of autistic children emphasized their children's behavioral regression, emotional distress, and reliance on routine and specialized support, while parents of non-autistic children described their own psychological challenges. These findings emphasize the unique vulnerabilities faced by autistic children and their parents in times of war and highlight the need for tailored mental health and community-based support that address the specific needs of those families.
Social disconnection and health among refugees in a low-resource setting: A longitudinal study.
Kurt G, Specker P, Liddell B … +6 more , Keegan D, Nandyatama R, Yuanita A, Rachmah RA, Hoffman J, Nickerson A
Psychiatry Res · 2026 Jul · PMID 41997033 · Publisher ↗
BACKGROUND: Social disconnection- social isolation and loneliness- is global public health concern, adversely impacting mental and physical health. There is an urgent need to expand the evidence base with studies focused...
BACKGROUND: Social disconnection- social isolation and loneliness- is global public health concern, adversely impacting mental and physical health. There is an urgent need to expand the evidence base with studies focused on at-risk populations in low-resource contexts. This study aimed to examine the longitudinal association of social disconnection and health outcomes (probable depression and post-traumatic stress disorder (PTSD), and general health), and to identify its individual and social determinants among refugees in a low-resource context. METHOD: A longitudinal study involving 1235 culturally and linguistically diverse refugees was conducted over a 2-year period across four time points. Social disconnection, probable depression and PTSD, and general health were measured using self-report instruments across four time points over two years (six-month intervals). Generalised Linear Mixed Models were used to examine whether social disconnection at the previous time point predicts health outcomes at the subsequent time point over a 2-year period. Linear regression was used to identify individual, social, and contextual factors associated with experiencing greater social disconnection. RESULTS: Social disconnection at the previous time-point was associated with increased odds of probable depression (OR = 1.41, 95% CI 1.32, 1.51), PTSD (OR = 1.29, 95% CI 1.20, 1.39), and poor health (OR = 0.86, 95% CI 0.81, 0.92) at the subsequent time point, after adjusting for the prior levels of these outcomes. Younger age (β = - 0.01, p = 0.031), higher education (β = - 0.23, p = 0.026), family separation (β = 0.29, p < 0.001), traumatic experiences (β = 0.03, p = 0.003), longer time in the protracted displacement settings (β = 0.05, p = 0.030), and post-displacement stressors (β = 0.99, p < 0.001) significantly predicted higher social disconnection at baseline. CONCLUSION: This study highlights the significant health risk associated with social disconnection among refugees in a low-resource setting. Multilevel interventions addressing individual, social, and contextual factors are needed to tackle social disconnection and improve health among refugees.
What would feeling better mean to you? Understanding patient language used for PTSD treatment improvement.
Grubbs KM, Matteo RA, Ranney RM … +2 more , Hamblen JL, Larsen SE
Psychiatry Res · 2026 Jul · PMID 41997032 · Publisher ↗
Patients undergoing shared decision-making (SDM) for posttraumatic stress disorder (PTSD) treatment rank treatment effectiveness as a top consideration, yet little is known about how clinicians can best convey this infor...
Patients undergoing shared decision-making (SDM) for posttraumatic stress disorder (PTSD) treatment rank treatment effectiveness as a top consideration, yet little is known about how clinicians can best convey this information. The goal of this study is to explore preferences for language around "getting better" from PTSD. Survey participants who screened positive for PTSD (n = 887) completed open- and closed-ended questions about ways of describing PTSD recovery. Half of the sample rated terminology like "no longer meets criteria for PTSD" or "PTSD remission" based on how well the language captured their general views of recovery and then rated how these terms would apply to their own experiences. The other half of the sample rated specific indicators of recovery (e.g., no longer have a PTSD diagnosis) and completed an open-ended question asking them to describe what recovery would look like. Participants rated the terms "no longer have PTSD" and "cured" as showing the most recovery and endorsed "PTSD recovery" and "symptom reduction" as terms they would more often use to describe their own recovery. When asked about which recovery terms would help them to choose a treatment, participants rated most examples very positively; however, fewer than half endorsed "no longer have a PTSD diagnosis." Open-ended responses focused on symptom reduction, quality of life, and functioning, with a small subset noting uncertainty about their potential to "get better." The majority of respondents focused on dimensional rather than categorical descriptions of improvement, valuing symptom reductions, better quality of life, and improved functioning.
An arterial spin-labeled magnetic resonance imaging study of brain activation in patients with major depressive disorder during acupuncture stimulation: An exploratory study.
Matsuura Y, Kikuchi T, Yamaguchi S … +6 more , Yoshimasu H, Matsuda H, Okudaira T, Yasuno F, Sakai T, Tsuchiya K
Psychiatry Res Neuroimaging · 2026 Aug · PMID 41990725 · Publisher ↗
BACKGROUND: Acupuncture has demonstrated antidepressant efficacy; however, the brain's immediate response to stimulation in patients with major depressive disorder (MDD) remains unclear. We investigated cerebral blood fl...
BACKGROUND: Acupuncture has demonstrated antidepressant efficacy; however, the brain's immediate response to stimulation in patients with major depressive disorder (MDD) remains unclear. We investigated cerebral blood flow (CBF) dynamics during and after acupuncture in patients with MDD via arterial spin labeling (ASL)-MRI. METHODS: Eleven patients with recurrent MDD and 14 healthy controls (HCs) underwent ASL-MRI at baseline, during, and after acupuncture (LI4, PC6, ST36, LV3). As an exploratory study, absolute CBF changes were analyzed using a flexible factorial design (voxelwise uncorrected P 〈 0.01; cluster-size 〉 350 voxels). RESULTS: In patients with MDD, acupuncture elicited increased CBF in the postcentral and prefrontal regions, with sustained activation in the middle frontal gyrus (DLPFC) poststimulation. Conversely, CBF decreased in the amygdala and posterior cingulate cortex following stimulation. Compared with HCs, patients with MDD exhibited a distinct neural perfusion pattern characterized by significantly greater recruitment of somatosensory-cognitive networks and attenuated activation in emotion-memory circuits. CONCLUSION: Acupuncture elicited distinct perfusion responses in MDD, shifting from maladaptive limbic dominance toward enhanced prefrontal engagement. These findings suggest that acupuncture stimulation is associated with perfusion patterns consistent with potential modulation of limbic-cortical networks in MDD.
Neural underpinnings of verbal memory encoding and recognition impairments in individuals with clinically stable mood or schizophrenia spectrum disorders.
Segerlin SV, Damgaard V, Jespersen AE … +6 more , Schandorff JM, Thommesen KK, Sankar A, Fisher PM, Macoveanu J, Miskowiak KW
Psychiatry Res Neuroimaging · 2026 Aug · PMID 41990724 · Publisher ↗
BACKGROUND: Verbal memory impairment is prevalent in mood and schizophrenia spectrum disorders and contributes to poor functional outcomes. The neural correlates of these memory difficulties remain unclear due to a scarc...
BACKGROUND: Verbal memory impairment is prevalent in mood and schizophrenia spectrum disorders and contributes to poor functional outcomes. The neural correlates of these memory difficulties remain unclear due to a scarcity of neuroimaging studies assessing verbal memory and low ecological validity of current paradigms. The aim of this study was to examine neurocircuitry abnormalities across mood and schizophrenia spectrum disorders using a new verbal memory task simulating everyday grocery shopping. METHODS: Fifty-seven cognitively impaired individuals with clinically stable mood or schizophrenia spectrum disorders and 52 matched healthy controls were included. We compared task-related activation between patients and controls and the associations between encoding- and recognition-related activity with memory recall and recognition performance. RESULTS: Patients recalled fewer words and had a lower recognition accuracy than controls (ps≤.01). Both encoding and recognition elicited activation in regions typically associated with episodic memory. Patients showed encoding-related hyperactivation in a large cluster within the supracalcarine part of the occipital cortex (p<.001), although this did not correlate with recall performance. Recall performance correlated with encoding-related activation in frontal and occipital areas across all participants, but there was no group difference in neural response in these clusters. The recognition task yielded no group differences in neural activation. CONCLUSIONS: While the paradigm elicited robust activation of expected memory-relevant networks, it was not sensitive to capture patients' memory impairments at the neural level. Our findings suggest that patients successfully engage memory-relevant networks during encoding, with their difficulties possibly emerging during later free recall stages not captured by the paradigm.
A diffusion MRI-derived perivascular metric related to glymphatic-associated processes in bipolar disorder vulnerability: Multimodal correlates across emotion dysregulation patients and offspring.
Pascucci A, Delavari F, Ville DV … +3 more , Eliez S, Piguet C, Saccaro LF
Psychiatry Res · 2026 Jul · PMID 41990523 · Publisher ↗
Bipolar disorder (BD) is characterized by marked emotion dysregulation and high familial risk. Identifying early biological markers of vulnerability in BD, including unaffected offspring, is critical to improve risk stra...
Bipolar disorder (BD) is characterized by marked emotion dysregulation and high familial risk. Identifying early biological markers of vulnerability in BD, including unaffected offspring, is critical to improve risk stratification and intervention, and glymphatic-associated processes may contribute to this vulnerability. We examined 237 participants, including 97 patients with emotion dysregulation disorders (EDD; 34 BD, 33 borderline personality disorder [BPD], 30 attention-deficit/hyperactivity disorder [ADHD]), 67 offspring of EDD patients (EDDoff; including 23 BD offspring [BDoff]), and 73 healthy controls (CTRL). All participants underwent clinical assessments, diffusion and resting-state functional MRI, and serum immune and neurotrophic biomarker sampling. Perivascular diffusion was estimated using diffusion tensor imaging analysis along the perivascular space (DTI-ALPS), a diffusion-derived perivascular metric proposed to relate to glymphatic-associated processes, and compared across groups. To explore multimodal correlates of DTI-ALPS, principal component analyses (PCA) were conducted across clinical, biological, and neuroimaging domains. BD patients and BDoff showed significantly reduced DTI-ALPS compared with CTRL, ADHD, and BPD, supporting its potential role as a vulnerability-related imaging feature for BD. By contrast, ADHD and BPD showed comparable or higher DTI-ALPS relative to controls. Across participants, DTI-ALPS was associated with components reflecting white matter integrity and serum immune and neurotrophic markers. Within BD, lower DTI-ALPS correlated with more manic episodes and poorer working memory. Reduced DTI-ALPS may represent a BD-specific vulnerability-related feature, observable in both patients and at-risk offspring, and not shared by other emotion dysregulation disorders. Multimodal associations with white matter, inflammation, and symptoms underscore its relevance for risk stratification in high-risk populations.
Alcohol use disorder and emotional processing patterns: Insights from a systematic review.
Camacho-Ruiz JA, Galvez-Sánchez CM, Martins AT … +2 more , Ros A, Limiñana-Gras RM
Psychiatry Res · 2026 Jul · PMID 41990522 · Publisher ↗
BACKGROUND: Alcohol use and misuse represent a significant public health issue associated with physical, psychological, emotional, and neurological risks. This systematic review aims to explore emotional processing in in...
BACKGROUND: Alcohol use and misuse represent a significant public health issue associated with physical, psychological, emotional, and neurological risks. This systematic review aims to explore emotional processing in individuals with alcohol use disorder (AUD) through both a gender-informed perspective and an intersectional approach, to identify potential targets for intervention. METHODS: This systematic review was conducted following the Cochrane Collaboration guidelines and reported based on the PRISMA guidelines. The review protocol was previously registered in PROSPERO. The literature search was carried out across the PubMed, Scopus, and Web of Science databases, resulting in the inclusion of 11 studies after the screening process. RESULTS: Individuals with AUD consistently exhibit impairments in social and emotional cognition, particularly in tasks involving emotional facial recognition. These deficits extend to broader neuropsychological domains, such as working memory and spatial frequency processing. They demonstrate attentional biases, including difficulties disengaging from alcohol-related cues and reduced accuracy in interpreting emotional facial expressions. Theory of Mind (ToM) -especially its affective components- and empathy are significantly impaired in individuals with AUD, with the duration of problematic alcohol use being the strongest predictor of impaired ToM reasoning. Neuroimaging studies corroborate these findings, revealing decreased fusiform gyrus activity in response to emotional faces, increased pallidum activation to alcohol-related cues, reduced hippocampal network efficiency, lower occipito-temporal sensitivity to emotional stimuli, heightened striatal reactivity to alcohol cues, and diminished activation in the inferior frontal gyrus. Although gender-specific neural differences in the processing of emotional facial expressions in individuals with AUD have been reported, there is a lack of studies in this field, and social and cultural variable are often overlooked in the analysis. CONCLUSIONS: Deficits in social and emotional processing among individuals with AUD may present significant barriers to achieving and maintaining abstinence, ultimately diminishing the effectiveness of therapeutic interventions. These findings underscore the need for comprehensive treatment approaches that address social and emotional cognitive impairments as integral components of recovery, incorporating both a gender perspective and an intersectional framework.
Multivariate machine learning regression approaches to predict adolescent suicide risk.
Liu Y, Pan Y, Wang F … +3 more , Li W, Gao L, Zhao G
Psychiatry Res · 2026 Jul · PMID 41990521 · Publisher ↗
BACKGROUND: Suicide is a leading cause of death among adolescents, yet most prediction models rely on binary classification and limited predictors, failing to capture the complexity of suicide risk. This study aimed to d...
BACKGROUND: Suicide is a leading cause of death among adolescents, yet most prediction models rely on binary classification and limited predictors, failing to capture the complexity of suicide risk. This study aimed to develop a more accurate and comprehensive prediction model using machine learning regression with a broad set of psychological and behavioral variables. METHOD: A total of 2241 adolescents were recruited from school settings and completed self-report questionnaires assessing 31 variables. Three machine learning regression algorithms: Lasso regression, support vector regression, and random forest regression were applied. Model performance was evaluated using the coefficient of determination (R²). To obtain robust estimates of predictive performance, all three models were evaluated using a 10-fold cross-validation procedure. RESULTS: (1) 13 features were selected by the Lasso regression from the original set of 31 suicide risk-related variables; (2) Among the three models tested, the random forest regression model demonstrated the best predictive performance, with an R² of 0.61 [95 % CI: 0.60, 0.62]; (3) Further analysis revealed that the five most important predictors of suicide risk were depression, emotion regulation, perceived burdensomeness, non-suicidal self-injury, and family function. CONCLUSION: A multivariate, integrative approach significantly improves the accuracy and precision of suicide risk prediction among school-based community sample. Beyond depression and emotion-related factors, perceived burdensomeness, non-suicidal self-injury, and family function also played important roles in predicting suicide risk, suggesting that these variables should be considered in future screening frameworks to improve early detection and targeted intervention.
Glymphatic Dysfunction in bipolar disorder: A scoping review and integrative pathophysiological framework.
Shan Z, Zhu Q, Wang S … +3 more , Xia Y, Yang Y, Tian L
Psychiatry Res · 2026 Jul · PMID 41985281 · Publisher ↗
The glymphatic system is a brain-wide perivascular clearance pathway increasingly implicated in neurodegenerative and neuropsychiatric disorders. This scoping review examines its potential role in bipolar disorder (BD),...
The glymphatic system is a brain-wide perivascular clearance pathway increasingly implicated in neurodegenerative and neuropsychiatric disorders. This scoping review examines its potential role in bipolar disorder (BD), synthesizes evidence linking glymphatic function to BD, and outlines a testable integrative framework connecting glymphatic disruption with key clinical and biological features of the disorder. Preliminary neuroimaging work indicates that individuals with BD show alterations in glymphatic-related indices, including diffusion-based and volumetric measures, some of which correlate with illness duration and regional gray matter volumes. Complementary molecular and cellular findings suggest that activation of the hypothalamic-pituitary-adrenal (HPA) axis, neuroimmune signaling, and neuroinflammatory activity may perturb astrocytic aquaporin-4 (AQP4) and related markers in cerebrospinal fluid (CSF) and choroid plexus (CP), providing a mechanistically plausible link between chronic stress biology and impaired brain waste clearance. AQP4-bearing extracellular vesicles in CSF have emerged as a putative indicator of astrocyte stress in BD. Preclinical work further indicates that lithium can modulate circadian properties of the CP clock, blood-brain barrier (BBB) integrity, and AQP4-related indices, raising the possibility that aspects of its therapeutic profile are mediated through effects on glymphatic pathways. Although indirect and methodologically heterogeneous, current evidence supports glymphatic dysfunction as a candidate mechanism integrating sleep-wake cycle, stress-related and immune processes, astrocytic pathology, and progressive structural and cognitive changes in BD. The framework proposed here is intended to guide hypothesis generation and future longitudinal, multimodal, and mechanistic studies aimed at developing glymphatic-informed biomarkers and intervention targets.
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