Annals Of General Psychiatry[JOURNAL]
Sun
200 papers
The role of mindfulness training supported by virtual reality in the nonpharmacological treatment of schizophrenia-research design.
Cechnicki A, Chrobak A, Plencler I … +9 more , Stankiewicz P, Kalisz A, Błądziński P, Kruk D, Radoń S, Szewczyk B, Faron-Górecka A, Korostyński M, Siwek M
Ann Gen Psychiatry · 2025 Aug · PMID 40804390 · Full text
This paper presents the outcome of a clinical trial planning process developed during multicenter, multidisciplinary seminars with prospective collaborators. The study protocol, designed according to the Oxford Quality A...
This paper presents the outcome of a clinical trial planning process developed during multicenter, multidisciplinary seminars with prospective collaborators. The study protocol, designed according to the Oxford Quality Assessment System, outlines a randomized controlled trial (RCT) evaluating a novel Virtual Reality-based Mindfulness Skills Training (VR-MST) versus standard, non-VR MST in patients with schizophrenia (SZ). The trial aims to assess the effects of VR-MST on clinical outcomes, stress-related biomarkers, and gene expression.Eligibility criteria include: (1) SZ diagnosis based on ICD-10 and DSM-5 (2), psychotic symptom severity below 75 on the PANSS (moderately ill), and (3) age between 25 and 50 years. The protocol defines procedures for participant withdrawal and managing adverse events. The design tests both specific and general hypotheses, with pre- and post-intervention assessments in both groups, and additional pre-/post-session measurements in the VR group. Assessments span biological, symptomatic, and cognitive domains, using both objective and subjective measures.This study may inform clinical practice by introducing a novel, engaging, evidence-based, nonpharmacological intervention. VR-MST could support stress reduction, enhance cognitive functioning, and improve daily life in SZ patients. The design is grounded in prior pilot studies, literature reviews, and clinical expertise, aiming to provide a scalable and impactful therapeutic tool.
Effects of proinflammatory cytokines and programmed cell death on cognitive domains in older age patients with bipolar disorder.
Lee PY, Chiu CC, Kuo PH … +4 more , Huang CY, Tsai SY, Kuo CJ, Chen WY
Ann Gen Psychiatry · 2025 Aug · PMID 40797218 · Full text
OBJECTIVES: Proinflammatory cytokines are linked to cognitive deficits in bipolar disorder (BD). The programmed cell death (PD) pathway, involved in immune regulation, may impact mood disorders and dementia. Older age BD...
OBJECTIVES: Proinflammatory cytokines are linked to cognitive deficits in bipolar disorder (BD). The programmed cell death (PD) pathway, involved in immune regulation, may impact mood disorders and dementia. Older age BD (OABD) patients face a heightened risk of cognitive decline, yet studies exploring the underlying mechanisms in this population are scarce. Aim of this study is to investigate proinflammatory cytokines and the PD pathway in OABD, for their correlation with clinical features and neuroaxonal integrity, and the impact on cognitive domains. METHODS: Eighty-seven euthymic OABD patients were assessed using the Brief Assessment of Cognition in Affective Disorders. We measured CRP, IL-6, TNF-α, TNF-R1, TNF-R2, PD-1, and PD-L1. Neurofilament light chain (NfL) was used to gauge neuroaxonal integrity. Associations between cytokines, PD-1/PD-L1, and cognition were examined using linear regression models. RESULTS: The average age of the OABD patients was 59.64 with a mean illness duration of 27.19 years. NfL levels positively correlated with TNF-R2 levels. Regression analysis revealed a negative association between TNF-R1 and motor speed and verbal fluency, while TNF-R2 showed positive associations with these cognitive domains. PD-1 was negatively associated with composite score, especially in motor speed and working memory, while PD-L1 was positively associated with executive function. CONCLUSION: This is the first study to simultaneously examine the proinflammatory system and the PD-1/PD-L1 pathway in a clinical OABD sample, with findings suggesting that both systems impact cognitive function in OABD patients. Further research is needed to explore the neuroinflammatory mechanisms underlying BD's neurodegenerative course.
The global burden of depression attributable to childhood sexual abuse, intimate partner violence, and bullying victimization from 1990 to 2021: an analysis based on the global burden of disease study.
Liu Z, Mao G
Ann Gen Psychiatry · 2025 Aug · PMID 40770343 · Full text
BACKGROUND: Depression is a leading cause of global disability, and among the behavioral risks defined in the Global Burden of Disease (GBD) framework, childhood sexual abuse (CSA), intimate partner violence (IPV) agains...
BACKGROUND: Depression is a leading cause of global disability, and among the behavioral risks defined in the Global Burden of Disease (GBD) framework, childhood sexual abuse (CSA), intimate partner violence (IPV) against women, and bullying victimization have emerged as key contributors to depressive disorders. However, long-term, comprehensive assessments of their combined impact on depression burden-by region, age group, and socio-demographic context-are lacking. This study quantifies trends in depression burden attributable specifically to CSA, IPV, and bullying from 1990 to 2021. METHODS: We extracted age-standardized rates and disability-adjusted life years (DALYs) attributable to CSA, IPV, and bullying for 204 countries and territories from the GBD 2021 database (1990-2021). We computed estimated annual percentage changes (EAPCs) for each risk factor, applied decomposition analysis to separate demographic vs. exposure effects, conducted frontier analysis to benchmark national performance, and used inequality metrics to assess disparities across Socio-demographic Index (SDI) quintiles. RESULTS: CSA-attributable DALYs remained largely stable or declined slightly (global EAPC of age-standardized DALY rate: - 0.12, 95% CI: - 0.20 to - 0.04), while IPV and bullying-related DALYs increased modestly (IPV EAPC: 0.45, 95% CI: 0.37-0.53; bullying EAPC: 0.88, 95% CI: 0.80-0.96).The largest relative increases were observed in adolescents aged 15-19 for bullying (EAPC 1.25, 95% CI: 1.12-1.38) and in young adults 20-24 for IPV (EAPC 0.78, 95% CI: 0.65-0.91).In 2021, CSA contributed the highest age-standardized DALY rates in low-SDI regions, high-income North America, and Greenland; IPV burden peaked in low-SDI and Central Sub-Saharan African settings (notably Uganda); bullying burden was greatest in high-SDI regions, high-income North America, and Greenland.Together, these three interpersonal risks accounted for 13.12% of global depression DALYs in 2021-bullying 6.12%, IPV 4.94%, CSA 2.65%-a figure we explicitly modelled from GBD attributable fractions.Frontier analysis highlighted Switzerland, Norway, Monaco, and Germany as leaders in minimizing trauma-related depression burden. Decomposition analysis showed that population aging and growth drove most burden increases in middle- to low-SDI regions, while changes in exposure levels explained regional rises in bullying and IPV. Inequality measures confirmed widening gaps between high- and low-SDI settings. CONCLUSIONS: Between 1990 and 2021, depression burden attributable to CSA has stabilized or declined, but IPV and bullying burdens have risen-especially among adolescents and in lower-SDI regions. These results underscore the urgency of age- and context-specific violence prevention, child protection, and school-based anti-bullying initiatives to reduce trauma-related depression worldwide. Further research should integrate subnational data and evaluate the effectiveness of targeted interventions.
Prevalence and associated factors of somatic symptoms among adolescents in Singapore: a cross-sectional study.
Mahirah D, Lim JM, Chew MS … +7 more , Peddapalli N, Ho CZ, Marimuttu VJ, Chen HY, Sung SC, Ho YL, Loh CB
Ann Gen Psychiatry · 2025 Jul · PMID 40671106 · Full text
BACKGROUND: Somatic symptoms are physical symptoms that often arise in response to emotional distress and can significantly impact well-being. Understanding the prevalence and interplay of these symptoms with anxiety and...
BACKGROUND: Somatic symptoms are physical symptoms that often arise in response to emotional distress and can significantly impact well-being. Understanding the prevalence and interplay of these symptoms with anxiety and depression is crucial for understanding adolescent health outcomes in Singapore. This study aimed to determine the prevalence of somatic symptoms among adolescents in Singapore and examine their associations with demographic characteristics, life stressors, anxiety, and depression. METHODS: We conducted a cross-sectional online survey with 601 Singaporean adolescents aged 12 to 19, using the Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptoms Scales (PHQ-SADS) to assess somatic symptoms, anxiety, and depression levels. Demographic information and experiences with stressful life events were also collected. Both descriptive and regression analyses were used to understand the relationships between participants' sociodemographic factors, mental health symptoms, and the presence of somatic symptoms. RESULTS: 32.3% of the adolescents reported clinically significant levels of somatic symptoms, with a higher prevalence observed among those who were females and older. While no significant associations were found between somatic symptoms and demographic factors, adolescents with anxiety or depressive symptoms presented significantly increased odds of reporting somatic symptoms. Specifically, the odds of reporting somatic symptoms were 2.91 times greater for those with anxiety (95%CI: 1.55-5.45, p < 0.001) and 6.54 times greater for those with depression (95%CI: 3.75-11.6, p < 0.001) than for those without these mental health concerns. Furthermore, those with somatic symptoms reported a greater number of stressful life events, with academic pressure emerging as the most prominent stressor. CONCLUSIONS: This study highlights the prevalence of somatic symptoms among adolescents in Singapore, emphasising the interconnectedness of mental and physical health during this developmental stage. The strong associations between somatic symptoms, anxiety, depression, and life stressors underscore the need for a holistic approach to adolescent healthcare. Early identification and intervention strategies should focus on addressing mental health concerns, building resilience against stressors, and promoting healthy coping mechanisms to mitigate the burden of somatic symptoms and foster overall well-being in Singaporean adolescents.
The relationship between cognitive disengagement syndrome and misophonia in children with attention deficit hyperactivity disorder: the mediating role of cognitive disengagement syndrome symptoms.
Gercek HG, Gurbuz Ozgur B, Hayta Z … +2 more , Sapanca A, Aksu H
Ann Gen Psychiatry · 2025 Jul · PMID 40671029 · Full text
BACKGROUND: Misophonia is a condition characterized by a reduced tolerance to certain sounds and strong emotional, physiological, and behavioral responses. Existing research on the relationship between misophonia and psy...
BACKGROUND: Misophonia is a condition characterized by a reduced tolerance to certain sounds and strong emotional, physiological, and behavioral responses. Existing research on the relationship between misophonia and psychopathologies in children remains limited. To our knowledge, the relationship between Cognitive Disengagement Syndrome (CDS), formerly known as sluggish cognitive tempo, and attention deficit hyperactivity disorder (ADHD) and misophonia has not been investigated to date. In this study, we examined the relationship between misophonia and ADHD and CDS symptoms and possible mediating factors. METHOD: The study included 53 adolescents diagnosed with ADHD and a control group of 50 adolescents without ADHD. All participants underwent a semi-structured clinical interview using the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version, Turkish version (K-SADS-PL). Misophonia symptoms were assessed with the Amsterdam Misophonia Scale-Revised (AMISOS-R). In contrast, CDS symptoms were measured using the Sluggish Cognitive Tempo Self-Report Scale (SCT-SR). ADHD symptom severity was evaluated using the Turgay DSM-IV-Based Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S), which the participants' parents completed. RESULTS: AMISOS-R scores were higher in adolescents with ADHD compared to the control group. The AMISOS-R revealed significant correlations with ADHD-hyperactivity/impulsivity (r = 0.291), ADHD-inattention (r = 0.513), and SCT-SR (r = 0.661) symptoms. As a result of regression analysis, ADHD-inattention severity (β = 0.745, p < 0.001) emerged as the variable that was significant with adolescent misophonia severity, independently of other variables.The mediation test using the bootstrap method showed that the indirect coefficient for SCT-SR in the relationship between T-DSM-IV-S Inattention and AMISOS-R was significant, and consistent with partial mediation. CONCLUSION: Our findings indicate that symptoms of misophonia are significantly associated with ADHD and CDS symptoms, and the importance of recognizing the comorbidity of misophonia in ADHD patients. Notably, although ADHD-inattention was associated considerably with misophonia, this association was mediated by CDS severity. Therefore, when assessing individuals with symptoms of misophonia, it is important to screen specifically for ADHD-inattention and CDS symptoms as well. Further research is needed to explore these relationships in more detail and to expand our knowledge of the underlying mechanisms.
Italian validation of the Orbach and Mikulincer Mental Pain Scale-8 (OMMP-8).
Landi G, Boccolini G, Chinali G … +2 more , Grandi S, Tossani E
Ann Gen Psychiatry · 2025 Jul · PMID 40671021 · Full text
BACKGROUND: Mental pain is increasingly recognized in clinical settings as a significant transdiagnostic construct that can exacerbate the condition of individuals suffering from it. It is also widely acknowledged as one...
BACKGROUND: Mental pain is increasingly recognized in clinical settings as a significant transdiagnostic construct that can exacerbate the condition of individuals suffering from it. It is also widely acknowledged as one of the strongest indicators of suicide risk. This study focuses on the Italian validation of the Orbach and Mikulincer Mental Pain Scale-8 (OMMP-8). METHODS: A total of 1,546 participants responded to an online cross-sectional survey assessing sociodemographic and clinically relevant variables, mental pain and other mental health variables (i.e., tolerance for mental pain, current physical pain, anxiety and depression, and wellbeing). RESULTS: The Italian version of the OMMP-8 maintained the same factorial structure as the original instrument and demonstrated excellent convergent validity. Moreover, the instrument showed strong criterion validity, effectively distinguishing between individuals receiving mental health treatment, those with recent suicidal ideation, and those with a history of suicide attempts. ROC curve analyses indicated good discrimination for recent suicidal ideation (AUC = 0.81) and acceptable discrimination for suicide attempt history (AUC = 0.71), with an optimal cut-off score of ≥ 21.5. In addition, the Italian OMMP-8 demonstrated incremental validity, predicting suicidal ideation and past suicide attempts after controlling for depressive symptoms. It also exhibited scale measurement invariance for gender, age, current mental health treatment, and current suicidal ideation while residual invariance was established for gender, age, and treatment status. CONCLUSION: The Italian OMMP-8 is an agile, valid, and reliable instrument for assessing mental pain and shows promise in identifying individuals at risk of suicide.
The relationship among hopelessness, suicide risk, body mass index and eating motivations in major depressive disorder comorbid with obesity: a case-control study.
Helvacı Çelik FG, Şimşek MH, Puşuroğlu M … +1 more , Korkmaz U
Ann Gen Psychiatry · 2025 Jul · PMID 40611297 · Full text
OBJECTIVE: Major Depressive Disorder (MDD) is a significant mental health problem, frequently comorbid with both physical and psychiatric disorders. The association between MDD and obesity is not fully understood. Eating...
OBJECTIVE: Major Depressive Disorder (MDD) is a significant mental health problem, frequently comorbid with both physical and psychiatric disorders. The association between MDD and obesity is not fully understood. Eating motivations (EMs), which relate to why and how individuals choose to eat, may be associated with disorders like obesity and MDD. Hopelessness and suicidal ideation are common symptoms of MDD. This study aimed to evaluate the relationship between EMs, depression, body mass index (BMI), hopelessness, and suicidal ideation in normal-weight and obese MDD groups compared to healthy controls. METHOD: The study included 50 patients with MDD and normal weight (BMI 18.5-24.9), 50 patients with MDD and obesity (BMI > 30), and 50 healthy control participants (BMI 18.5-24.9). The majority of participants were women (74% in obese MDD, 70% in normal-weight MDD, 56% in the control group). The age of the groups was similar for the normal-weight MDD and control groups, but the obese MDD group was older (control: 32.72 ± 10.07, normal-weight MDD 33.42 ± 10.24, obese MDD 39.52 ± 10.67, p = 0.002). Regarding BMI, it was as follows: control: 21.61 ± 1.92, normal-weight MDD 23.54 ± 3.60, and obese MDD 35.30 ± 5.07. Sociodemographic data form, Beck Depression Inventory, Beck Hopelessness Inventory, Suicide Ideation Scale and Eating Motivation Questionnaire were administered. RESULTS: No significant differences were found between the MDD groups in terms of Beck Depression Inventory (BDI), Beck Hopelessness Inventory (BHI), and Suicidal Ideation Scale (SIS) scores. Significant differences were observed among all groups in most subtypes of EMs. In the obese MDD group, habits, traditional eating, price, visual appeal, and affect regulation were correlated with suicide attempts. Only traditional eating remained associated with suicide attempts, where a one-unit increase in the traditional eating score explained a 0.724-unit increase in suicide attempts. Additionally, emotion regulation was a significant predictor of suicidal ideation in the obese MDD group, where a one-unit increase in emotion regulation explained a 0.885-unit increase in suicidal ideation. CONCLUSIONS: The differentiation between suicidal ideation and EMs in obese and normal-weight MDD groups is crucial. The observed differences in EMs among the three groups with similar sociocultural characteristics are noteworthy. Clinicians should assess eating motivations as part of suicide risk evaluations in patients with comorbid MDD and obesity. Longitudinal studies are needed to clarify causal relationships between these variables.
Association between keloid and mental disorders: perspective from genetic evidence.
Zhan Y, Tong Y, Wu X … +2 more , Wang Z, Zhang G
Ann Gen Psychiatry · 2025 Jul · PMID 40611270 · Full text
BACKGROUND: The causal relationship between keloid and mental disorders remains unclear. The aim of this study was to investigate whether keloid was causally associated with the risk of bipolar disorder (BD), anxiety, sc...
BACKGROUND: The causal relationship between keloid and mental disorders remains unclear. The aim of this study was to investigate whether keloid was causally associated with the risk of bipolar disorder (BD), anxiety, schizophrenia (SCZ), major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) using a bidirectional Mendelian randomization (MR) analysis. METHODS: The large available genome-wide association study (GWAS) dataset of keloid, BD, anxiety, SCZ, MDD and PTSD was used for summary statistics. The bidirectional MR analyses were performed using a variety of methods of analysis including inverse variance weighting, MR-Egger regression, weighted median, simple modal and weighted modal methods. Sensitivity analyses were conducted using Cochran's Q to estimate heterogeneity, and the MR-Egger method was used to estimate horizontal pleiotropy. RESULTS: MR analysis showed that keloid susceptibility was associated with an increased risk of BD (OR = 1.027, 95% CI: 1.005-1.049, p = 0.015) and SCZ (OR = 1.023 (95% CI: 1.006-1.040, p = 0.006). We also observed a negative association between keloid and PTSD (OR = 0.903, 95% CI: [0.835-0.977], p = 0.011). There was no evidence for a causal relationship between keloid and anxiety (OR = 0.982, 95% CI: 0.961-1.004, p = 0.110) and MDD (OR = 0.997, 95% CI: 0.987-1.006, p = 0.476). Reverse MR analysis revealed that there was no causal relationship between keloid and the mental disorders. CONCLUSION: This study provides evidence that there is a link between BD, SCZ, PTSD and keloid. However, there was no causal relationship between anxiety, MDD and keloid. This study may provide important clues and references for the study of keloid and mental disorders. We urge that the mental conditions of keloid patients should be taken into account in clinical practice and that necessary psychological support should be provided.
Abnormal static and dynamic regional homogeneity in adolescent major depressive disorder with somatic symptoms: a resting-state fMRI study.
Yu S, Shu C, Wang G
Ann Gen Psychiatry · 2025 Jul · PMID 40611142 · Full text
BACKGROUND: Somatic symptoms are common in adolescent major depressive disorder (MDD) and related to severity of depression and clinical outcomes. However, the neurological mechanism of somatic symptoms in adolescent MDD...
BACKGROUND: Somatic symptoms are common in adolescent major depressive disorder (MDD) and related to severity of depression and clinical outcomes. However, the neurological mechanism of somatic symptoms in adolescent MDD remains unknown. In this study, we aimed to explore the functional alterations of intrinsic brain local connectivity in adolescent MDD with somatic symptoms based on static and dynamic reginal homogeneity (ReHo). METHODS: This study included 50 first-episode, drug naïve adolescent MDD patients and 34 healthy controls (HCs) matched for age, gender and years of education. Patients were categorized into somatic depression (SD) group (n = 21) and non-somatic depression (NSD) group (n = 29) based on the presence of somatic symptoms or not. All participants underwent resting-state functional magnetic resonance imaging (rs-fMRI), and static and dynamic ReHo were calculated and compared among SD, NSD and HC groups. Correlation analysis was performed to evaluate the relationship between altered ReHo values and severity of clinical symptoms. RESULTS: Adolescent MDD patients with somatic symptoms showed higher total scores of the 17-items Hamilton Depression Scale (HAMD-17). Moreover, increased static ReHo in left inferior parietal gyrus (IPG), left superior parietal gyrus (SPG) and left triangular part of inferior frontal gyrus (IFGtriang) were observed in SD group compared with NSD group. The SD group also exhibited decreased dynamic ReHo in bilateral IPG, bilateral SPG, and left IFGtriang. Moreover, there were significant correlations between static and dynamic ReHo values in these abnormal brain regions and the weight factor scores of HAMD-17. CONCLUSIONS: Our findings suggested that there may be abnormal patterns of functional local connectivity in SPG, IPG and IFGtriang in adolescent MDD patients with somatic symptoms, enriching the knowledge of neurological mechanism concerning somatic symptoms in adolescent MDD.
Association of sleep problems with suicidal behaviors and healthcare utilization in adults with chronic diseases: the role of mental illness.
Wen C, Wei Z, Chalghaf N … +4 more , Woldegerima WA, Wu J, Bragazzi NL, Garbarino S
Ann Gen Psychiatry · 2025 Jun · PMID 40544278 · Full text
OBJECTIVES: This study aimed to investigate the association between sleep problems and suicidal behaviors as well as healthcare utilization in Canadian adults with chronic diseases, while also examining the mediating rol...
OBJECTIVES: This study aimed to investigate the association between sleep problems and suicidal behaviors as well as healthcare utilization in Canadian adults with chronic diseases, while also examining the mediating role of mental illness. METHODS: Data were drawn from the 2015-16 cycle of the Canadian Community Health Survey, specifically from Ontario, Manitoba, and Saskatchewan - the provinces that included the optional sleep module. A total of 22,700 participants aged ≥ 18 years and diagnosed with at least one chronic disease were included in the analysis. Sleep problems were defined as extreme sleep durations (either < 5 or ≥ 10 h) and insomnia. Mental illness was classified as a self-reported mood or anxiety disorder. RESULTS: Participants with extreme sleep durations (compared to 7 to < 8 h) and those with insomnia (compared to no insomnia) showed a higher prevalence of suicidal ideation, suicidal plans, and increased healthcare utilization. After adjusting for multiple covariates, both extreme sleep durations and insomnia remained significantly associated with increased odds of suicidal ideation, suicidal plans, and healthcare utilization. Mediation analyses indicated that mental illness partially mediated these associations. CONCLUSIONS: Both extreme sleep durations and insomnia were independently associated with higher odds of suicidal behaviors and increased healthcare utilization in adults with chronic diseases, with mental illness playing a partial mediating role in these relationships.
Incidence and risk factors of hypothyroidism in psychiatric outpatients with long-term lithium treatment: a 10-year retrospective hospital-based study.
Anantapong K, Jittpratoom C, Pitanupong J
Ann Gen Psychiatry · 2025 Jun · PMID 40542381 · Full text
BACKGROUND: The study aimed to assess the incidence of lithium-induced hypothyroidism and its associated factors in psychiatric outpatients on long-term lithium therapy. METHODS: A retrospective study at Songklanagarind...
BACKGROUND: The study aimed to assess the incidence of lithium-induced hypothyroidism and its associated factors in psychiatric outpatients on long-term lithium therapy. METHODS: A retrospective study at Songklanagarind Hospital (January 1, 2013, to September 30, 2022) focused on clinical (overt) and subclinical forms of lithium-induced hypothyroidism. Subclinical hypothyroidism, characterised by elevated thyroid stimulating hormone (TSH) but normal thyroxine (FT4) levels, and clinical hypothyroidism, by low FT4 and high TSH, were analysed. Patients with less than 3 months of lithium therapy or prior thyroid conditions were excluded. We used survival analysis and logistic regression to investigate incidence and factors. RESULTS: Among 461 on lithium maintenance therapy, 279 outpatients met the inclusion criteria; however, only 166 (59%) were monitored for thyroid functions during the study period and included in the final analyses, mostly female (53.6%) with bipolar disorder (72.9%), median age 42.0 years. The median duration of maintenance therapy was 3.7 years (IQR = 1.0-9.3). Over a decade, 30 patients developed lithium-induced hypothyroidism, primarily subclinical (28 cases), at an incidence rate of 0.0212 cases per patient-year. Hypothyroidism manifested after 14.4 months of lithium therapy (IQR = 5.2-53.2), with a prominent decline of survival curve within the first year. Younger age (adjusted OR = 0.95, P = 0.001), presence of physical comorbidities (adjusted OR = 2.69, P = 0.039), and higher lithium levels (P = 0.003) were associated with hypothyroidism. CONCLUSIONS: Despite low incidence, regular thyroid monitoring is advised for patients on lithium. The study identifies risk factors for lithium-induced hypothyroidism, aiding in patient risk assessment and monitoring protocols.
Suicide risk in persons with polycystic ovarian syndrome: a systematic review.
Wong S, Le GH, Lo HKY … +10 more , Cao B, Lim PK, Rhee TG, Ho R, Guillen-Burgos HF, Teopiz KM, Phan L, Rosenblat JD, Zhang M, McIntyre RS
Ann Gen Psychiatry · 2025 Jun · PMID 40457354 · Full text
BACKGROUND: Polycystic ovarian syndrome (PCOS) is a common and increasingly prevalent reproductive and metabolic endocrine disorder that is characterized by metabolic alterations, hyperandrogenism, menstrual irregulariti...
BACKGROUND: Polycystic ovarian syndrome (PCOS) is a common and increasingly prevalent reproductive and metabolic endocrine disorder that is characterized by metabolic alterations, hyperandrogenism, menstrual irregularities as well as an increased risk of depression. Available evidence suggests PCOS may also be associated with disparate aspects of suicidality. Herein, we sought to determine the prevalence of suicidal ideation, suicidal behaviours and completed suicide in the PCOS population. METHODS: We systematically searched PubMed, Ovid and Scopus databases from inception to January 7, 2024. A manual search was conducted on Google Scholar. Two reviewers independently screened the retrieved studies against the eligibility criteria (S.W. and G.H.L.). Human studies investigating suicide outcomes in women of reproductive age with a confirmed diagnosis of PCOS were included. RESULTS: Eleven studies meeting our eligibility criteria were included. Although results were mixed, available evidence suggests that persons with PCOS are at an increased risk of suicidal ideation, self-harm and suicide attempts and are also differentially affected by psychiatric comorbidities (e.g., depressive disorders). Notwithstanding, suicide risk was not fully accounted for by the presence of mental illness, which suggests that PCOS may also be contributory. CONCLUSION: PCOS is associated with an increased risk of suicidal ideation and behaviour and associated psychiatric comorbidities. Persons with PCOS should be routinely evaluated for the presence of clinically significant suicidality. Whether increased suicidality in PCOS populations is a direct effect of the disease state and/or is largely moderated by psychiatric comorbidity is a future research vista.
Inflammatory chemokines in adolescents' suicide state with depressive disorders.
Zheng H, Liu W, Chen B … +7 more , Hu S, Mo D, Guo P, Jiang X, Yang R, Wang S, Zhong H
Ann Gen Psychiatry · 2025 May · PMID 40450340 · Full text
Suicide has become one of the leading causes of death in adolescents and is a direct consequence in patients with depressive disorders. Recently, neuroinflammation has been shown to play a role in the development of depr...
Suicide has become one of the leading causes of death in adolescents and is a direct consequence in patients with depressive disorders. Recently, neuroinflammation has been shown to play a role in the development of depression. This study examined serum chemokine levels in adolescents with depressive disorders at different suicide stages to identify chemokines that discriminate between suicidal behaviors. This study enrolled 111 adolescent patients with depressive disorders who were further subdivided into three groups based on the presence of suicidal behavior or ideation: suicide attempt group (n = 45), suicidal ideation group (n = 44), and non-suicidal depression group (n = 22), along with 23 healthy controls. Eight inflammatory chemokines were detected using the mesoscale discovery method. Patients in the suicide attempters group had higher levels of IL8, MCP-1, Eotaxin, and Eotaxin-3 than those in the non-suicide depression group. Eotaxin-2 had the greatest effect on suicidal behaviors of all factors.
Validation of the Mild Behavioral Impairment Scale (MBI-S) for brief self-assessment of Mild Behavioral Impairment in people without dementia.
Hinkl P, Graessel E, Rohleder N … +4 more , Landendoerfer P, Kuehlein T, Lauer N, Pendergrass A
Ann Gen Psychiatry · 2025 May · PMID 40442725 · Full text
BACKGROUND: Mild Cognitive Impairment (MCI) and Mild Behavioral Impairment (MBI) are important constructs in the context of cognitive decline. MBI can be assessed with the Mild Behavioral Impairment Checklist (MBI-C). Ho...
BACKGROUND: Mild Cognitive Impairment (MCI) and Mild Behavioral Impairment (MBI) are important constructs in the context of cognitive decline. MBI can be assessed with the Mild Behavioral Impairment Checklist (MBI-C). However, the instrument has deficits in psychometrics and content, thus indicating a need for improvement. The aim of this study was to develop a complementary short instrument, the Mild Behavioral Impairment Scale (MBI-S), designed to measure MBI as a short-term modifiable state criterion, and to validate it in a non-clinical sample of people 18 years of age or older. METHODS: Most of the items on the MBI-S stem from the MBI-C and were chosen to represent the dimensions of the Neuropsychiatric Inventory Questionnaire. The MBI-S was validated on self-reported data from 175 individuals. In an item analysis, the discriminatory power and item difficulties were examined. Cronbach's alpha was calculated to assess the internal consistency, and a principal component analysis was conducted to determine the structure of the instrument. Construct validity was established by testing four hypotheses about relationships between the MBI-S and other instruments by calculating correlation coefficients. RESULTS: After the item analysis, two items were removed from the final version of the scale on the basis of insufficient discriminatory power and the finding that the internal consistency of the total score increased when the items were deleted. The principal component analysis yielded a single-component structure for the MBI-S. Two more items were excluded from the scale due to insufficiently low loadings on the extracted component. Cronbach's alpha for the final eight-item scale was 0.79. The final MBI-S score was strongly related to that of the MBI-C and a loneliness score as well as moderately related to maladaptive coping. There was no association with respondents' level of education. CONCLUSION: The MBI-S is a valid short instrument for the assessment of MBI. It has high test economy and measures current neuropsychiatric symptoms and their intensity as a state criterion. Therefore, the MBI-S can be used for the longitudinal measurement of MBI.
Inflammatory markers and suicidal behavior: A comprehensive review of emerging evidence.
Baldini V, Gnazzo M, Varallo G … +4 more , Atti AR, De Ronchi D, Fiorillo A, Plazzi G
Ann Gen Psychiatry · 2025 May · PMID 40442662 · Full text
BACKGROUND: Suicidal behavior represents a significant public health challenge, and identifying biological markers associated with its risk is critical for prevention and intervention. Emerging evidence suggests a link b...
BACKGROUND: Suicidal behavior represents a significant public health challenge, and identifying biological markers associated with its risk is critical for prevention and intervention. Emerging evidence suggests a link between inflammation and suicidality, highlighting the role of inflammatory markers as potential biomarkers and therapeutic targets. METHODS: We conducted a systematic search across four electronic databases, including PubMed, Web of Science, EMBASE, and PsycINFO, to identify studies examining the association between inflammatory markers (e.g., C-reactive protein, interleukin-6, tumor necrosis factor-alpha) and suicidal ideation or behavior. RESULTS: 31 studies met the inclusion criteria. Elevated levels of inflammatory markers were consistently associated with an increased risk of suicidal behavior across diverse populations. This relationship's mechanisms likely involve cytokine-mediated alterations in neurotransmitter systems, neuroplasticity, and stress response pathways. Though robust clinical trials are scarce, preliminary evidence suggests that anti-inflammatory interventions may reduce suicidality. CONCLUSIONS: Inflammation appears to play a significant role in the pathophysiology of suicidal behavior, offering promising avenues for biomarker development and novel therapeutic strategies. Future research should prioritize longitudinal studies, standardized methodologies, and exploration of personalized anti-inflammatory treatments to better elucidate the inflammation-suicidality link and enhance clinical applicability.
Crafting wellness: exploring the effectiveness of a single-item mental health measure for young children and their mothers.
Yalçın SS, Tezol Ö, Erat Nergiz M … +6 more , Güneş B, Barutçu A, Kabakoğlu Ünsür E, Karabayır N, Yılmaz Öztorun Z, Almiş H
Ann Gen Psychiatry · 2025 May · PMID 40413525 · Full text
BACKGROUND: Recognizing the integral role of parental emotional and behavioral health in shaping a supportive family environment crucial for a child's emotional well-being, a practical tool for evaluating mental health i...
BACKGROUND: Recognizing the integral role of parental emotional and behavioral health in shaping a supportive family environment crucial for a child's emotional well-being, a practical tool for evaluating mental health in both preschool children and their mothers are necessary. In this methodological study conducted across eight provinces in Turkey, we aimed to develop and assess the psychometric properties of a single-item mental health measure for physically healthy children aged 2-5 years and their mothers. METHOD: The study included 411 child-mother pairs recruited from tertiary care hospitals, with subjects selected from well-child departments. Various psychometric assessments were employed, including the Strengths and Difficulties Questionnaire (SDQ) for children, Depression, Anxiety, and Stress Scale (DASS-21), Patient Health Questionnaire-4 (PHQ-4) for mothers, and single-item measures for both child and maternal mental health [mother-reported mental health of child (MRCMH) and self-reported mental health of mother (SRMH)]. Data were collected at two time points: baseline evaluation for validity testing and test-retest evaluation at the 3rd week. RESULTS: The MRCMH indicated excellent validity, with sensitivity and specificity for detecting borderline and abnormal mental health difficulties in children at 90%, 100%, and 83%, respectively. The SRMH revealed sensitivity and specificity of 62% and 78% for identifying maternal depression, 57% and 76% for anxiety, 63% and 76% for stress, and 54% and 87% for psychological distress, respectively. Construct validity analyses revealed significant correlations between MRCMH and SDQ scores, as well as between SRMH and DASS-21 and PHQ-4 scores. Test-retest reliability, assessed through intraclass correlation coefficients, indicated varying agreement levels, with the highest agreement observed for SDQ total difficulties and the lowest for SRMH. Further exploration of the measures' sensitivity and specificity revealed noteworthy accuracy in detecting child mental difficulties and maternal psychological distress. Correlational analyses between baseline and 3-week scores highlighted the stability of MRCMH and SRMH over time. CONCLUSION: This research contributes valuable insights into the psychometric properties of single-item measures for child and maternal mental health, offering a potential tool for clinicians and researchers. The outcomes can inform public health strategies and interventions aimed at promoting positive mental health outcomes in preschool children and their mothers.
Prevalence of eating disorders in aquatic athletes: a systematic review and meta-analysis.
Satapathy P, Sahu SS, Khatib MN … +18 more , Rekha MM, Kaur M, Sharma GC, Sudan P, Naidu KS, Singh R, Kushwaha B, Desai T, Shabil M, Chauhan SS, Verma L, Sidhu A, Mehta R, Sah S, Gaidhane AM, Daniel AS, Chipeta JC, Bushi G
Ann Gen Psychiatry · 2025 May · PMID 40413498 · Full text
BACKGROUND: Aquatic athletes may face unique pressures related to body aesthetics and weight management, potentially increasing their risk of eating disorders (EDs). This systematic review and meta-analysis aimed to esti...
BACKGROUND: Aquatic athletes may face unique pressures related to body aesthetics and weight management, potentially increasing their risk of eating disorders (EDs). This systematic review and meta-analysis aimed to estimate the prevalence of EDs in aquatic athletes and assess the quality of the available evidence. METHODS: A systematic search was conducted in PubMed, Embase, and Web of Science for studies published in English that reported on the prevalence of EDs among aquatic athletes. After screening and eligibility assessments, eight studies met the inclusion criteria, comprising a total of 715 athletes from various countries, including Poland, Canada, Brazil, Norway, the United States, and the United Kingdom. Quality assessment was performed using an adapted Newcastle-Ottawa Scale (NOS), and a random-effects meta-analysis was conducted to estimate pooled prevalence. Sensitivity analysis and a Doi plot were utilized to evaluate the publication bias. RESULTS: The meta-analysis estimated a pooled prevalence of EDs in aquatic athletes at 27.56% (95% CI: 14.27-46.50%), with a heterogeneity (I²) of 76%, indicating substantial variability in study designs and participant characteristics. Sensitivity analysis confirmed the robustness of the findings, and the Doi plot indicated significant asymmetry (LFK index = -3.44), suggesting potential publication bias or variability across studies. CONCLUSION: This study revealed a high prevalence of EDs among aquatic athletes. Further research is required on the factors associated with these disorders. Standardized assessment tools and routine screening in aquatic sports settings are recommended to promote early detection and prevention of EDs, ultimately enhancing athlete well-being and performance.
Parental dysfunction and adolescent mental health: AI-aided content analysis of suicide notes on social media.
Wu J, Liu Y, Hung T … +2 more , Liu S, Hu SX
Ann Gen Psychiatry · 2025 May · PMID 40410879 · Full text
Adolescent suicide represents a critical global health issue. While research has identified numerous risk factors, the specific impact of parental dysfunction on adolescent suicide remains understudied, especially in Chi...
Adolescent suicide represents a critical global health issue. While research has identified numerous risk factors, the specific impact of parental dysfunction on adolescent suicide remains understudied, especially in Chinese contexts. This study explores how parental dysfunction manifests in suicide notes and affects adolescent mental health. We collected data from Chinese social media platforms using web crawlers, yielding 30 valid suicide notes for analysis. Using the AI-aided content analysis platform DiVoMiner, we conducted high-frequency word and semantic network analyses. Our findings reveal that parents are a central concern for suicidal youth. We identified three primary patterns of parental dysfunction: excessive emphasis on instrumental goals, neglect of basic emotional needs, and inadequate protection from life traumas. These dysfunctions contribute to severe psychological distress, identity loss, and negative coping behaviors among youth. The research highlights two significant phenomena in contemporary Chinese family dynamics: the "short-sightedness" of prioritizing short-term instrumental goals over long-term social-emotional development, and the remarkably high prevalence of "lack of autonomy" in parenting approaches. Our study extends the literature by exploring mechanisms through which parental dysfunctions contribute to suicidal behaviors in young people. These findings emphasize the need for collaborative efforts among parents, educators, policymakers, and mental health professionals to foster nurturing environments characterized by emotional support, autonomy encouragement, and balanced academic expectations-all crucial for adolescent well-being.
Targeting heterogeneous depression with trazodone prolonged release: from neuropharmacology to clinical application.
Fagiolini A, Grošelj LD, Šagud M … +4 more , Silić A, Latas M, Miljević ČD, Cuomo A
Ann Gen Psychiatry · 2025 May · PMID 40405210 · Full text
AIM: This paper evaluates the clinical efficacy, safety, and practical implications of Trazodone Prolonged Release (PR) in managing depression, anxiety, and sleep disorders, with a focus on its multimodal mechanism of ac...
AIM: This paper evaluates the clinical efficacy, safety, and practical implications of Trazodone Prolonged Release (PR) in managing depression, anxiety, and sleep disorders, with a focus on its multimodal mechanism of action and advantages over traditional therapies. METHODOLOGY: A critical review of recent literature (2020-2024) [1-3] was conducted, analyzing data from clinical trials, real-world studies, and European treatment guidelines to assess the pharmacodynamics, pharmacokinetics, and therapeutic outcomes of Trazodone PR. RESULTS: Trazodone PR demonstrates efficacy in addressing complex symptoms of depression, anxiety, and sleep disturbances, with a favorable safety profile and reduced risk of sexual dysfunction and weight gain compared to other antidepressants. Its ability to modulate serotonin, norepinephrine, dopamine, and histamine systems enhances mood, sleep quality, and cognitive recovery. CONCLUSION: Trazodone PR is a versatile and well-tolerated treatment option for patients with comorbid conditions and treatment-resistant cases. Its multimodal action, combined with benefits like improved neuroplasticity through BDNF production, makes it a suitable choice for the long-term management of mood disorders and associated conditions [4-6].
Evaluating the PCL-5 in China: new insights from its assessments over time and gender invariance.
Yang T, Chen W, Lu Q … +2 more , Meng Q, Liu H
Ann Gen Psychiatry · 2025 May · PMID 40389973 · Full text
BACKGROUND: In the latest research, it is proposed that the intrusions symptoms of the structure of post-traumatic stress disorder (PTSD) were divided into internally-generated and externally-generated. Additional resear...
BACKGROUND: In the latest research, it is proposed that the intrusions symptoms of the structure of post-traumatic stress disorder (PTSD) were divided into internally-generated and externally-generated. Additional research is required to validate this emerging theory. Moreover, few studies have employed longitudinal data to further validate the novel 8-factor model. AIM: This study aims to explore the factor structure, gender invariance, and longitudinal invariance of the PTSD Checklist for DSM-5 (PCL-5) among children in post-pandemic era. METHODS: A survey was conducted on 1861 children using the PTSD Checklist for DSM-5 (PCL-5), and 590 children were re-investigated over three months interval. The statistical analysis includes: Kolmogorov-Smirnov normality test, the missing rates and descriptive statistics of the study variables, confirmatory factor analysis, the gender measurement invariance, longitudinal measurement invariance, and correlation of each factor within the PCL-5. RESULTS: Based on the DSM-5 criteria, the results indicated that 6.8% of the children in the sample exhibited symptoms suggestive of possible PTSD. The novel 8-factor model fits better than the DSM-5 model, DSM-5 dysphoric model, Dysphoric arousal model, Anhedonia model, Externalizing behaviors model, and Hybrid model. The measurement invariance results further indicated that the PCL-5 has strict invariance across gender and strong invariance across time. CONCLUSION: This study validated the novel 8-factor model of DSM-5 PTSD among children in the post-pandemic era and assessed the gender and longitudinal measurement invariance of the PCL-5. The novel 8-factor model of the PCL-5 is the best DSM-5 model of PTSD symptoms and has strict measurement invariance across gender and strong measurement invariance across time. The research results extended the theoretical framework and empirical research on the DSM-5 PTSD novel 8-factor model. Through this analysis, we hope to provide more accurate tools and strategies for the evaluation and intervention of post-traumatic stress disorder in children.
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