Psychiatry Res [JOURNAL]
Sun
200 papers
Comparative efficacy and acceptability of pharmacological interventions for postpartum depression: a systematic review and network meta-analysis.
Xiao Y, Xie P, Li D … +2 more , Zhao T, Nie J
Psychiatry Res · 2026 Jul · PMID 42401022 · Publisher ↗
BACKGROUND: Pharmacological treatment for postpartum depression (PPD) have mainly involved conventional antidepressants, RCTs have also evaluated rapid-acting glutamatergic agents, neuroactive steroids, hormonal therapie...
BACKGROUND: Pharmacological treatment for postpartum depression (PPD) have mainly involved conventional antidepressants, RCTs have also evaluated rapid-acting glutamatergic agents, neuroactive steroids, hormonal therapies, and botanical preparations. An updated comparative synthesis of these treatments is therefore needed. OBJECTIVES: To synthesize RCT evidence and compare the efficacy, response, remission, acceptability, and safety of pharmacological interventions for PPD. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and assessed risk of bias. A frequentist random-effects network meta-analysis was conducted to integrate direct and indirect evidence across interventions. MAIN RESULTS: 18 trials (N = 1722) were included. Compared with placebo, saffron (SMD -1.07, 95% CI -1.52 to -0.61), fluoxetine (SMD -0.95, 95% CI -1.43 to -0.47), esketamine (SMD -0.63, 95% CI -0.89 to -0.37), brexanolone, and zuranolone showed signals of improvement in depressive symptom severity. Fluoxetine, saffron, and zuranolone were associated with higher response rates, although the estimates for fluoxetine and saffron were imprecise. Brexanolone was the only intervention showing a statistically significant improvement in remission. Based on all-cause discontinuation, brexanolone may have a potentially unfavourable acceptability signal. Zuranolone was associated with an increased incidence of adverse events. Given the sparse networks and mostly low-to-moderate certainty of evidence, SUCRA rankings should be interpreted cautiously as exploratory findings. CONCLUSIONS: Current RCT evidence suggests that saffron, fluoxetine, esketamine, brexanolone, and zuranolone may improve symptoms of PPD. Brexanolone may have a potentially unfavourable acceptability signal, while zuranolone was associated with increased adverse event incidence. However, the evidence is limited by sparse networks, limited active-comparator evidence, imprecision in some estimates, and clinical heterogeneity, and should therefore be interpreted with caution.
Measurements of suicidal ideation in ecological momentary assessment based on smartphone: a systematic review.
Zhu J, Pan H, Zhou J … +7 more , Gao Y, Xie Z, Zhang C, Li Y, Liu Q, Shen M, Niu L
Psychiatry Res · 2026 Jun · PMID 42401021 · Publisher ↗
BACKGROUND: Understanding suicidal ideation (SI) in real time has become a growing focus in suicide research, leading to an increasing use of ecological momentary assessment (EMA). However, substantial heterogeneity in h...
BACKGROUND: Understanding suicidal ideation (SI) in real time has become a growing focus in suicide research, leading to an increasing use of ecological momentary assessment (EMA). However, substantial heterogeneity in how SI is measured, together with limited psychometric evidence for EMA-based SI measures, poses methodological challenges for consistency, interpretation, and validity. METHODS: This systematic review followed PRISMA guidelines and searched 9 databases (5 international and 4 Chinese) through August 2025. Peer-reviewed studies employing smartphone-based EMA to assess SI were included. Data were extracted on measurement characteristics, item content, and reported psychometric evidence. RESULTS: A total of 89 studies met the inclusion criteria. SI items originated from three main sources: adapted from standardized scales (51.7%, n = 46), custom-developed items (21.3%, n = 19), and hybrid approaches (27.0%, n = 24). Conceptualizations of SI varied substantially, with over half of the studies (57.3%) distinguishing multiple dimensions of SI. More than one-third of studies (n = 29) relied on single-item assessments. Fifteen studies reported at least one form of psychometric evidence. CONCLUSIONS: This review provides a comprehensive synthesis of current practices in measuring SI using smartphone-based EMA. The findings highlight substantial methodological variability and limited psychometric reporting, underscoring the need for clearer construct definitions, greater transparency in measurement design, and strengthened validation efforts to improve comparability and interpretability in future EMA research. PROSPERO REGISTRATION NUMBER: CRD420251112259.
Effect of Australian telepsychiatry services on attention-deficit hyperactivity disorder prescriptions.
Woon LS, Bastiampillai T, Looi JC … +1 more , Liu WM
Psychiatry Res · 2026 Jun · PMID 42391981 · Publisher ↗
OBJECTIVES: Telepsychiatry expansion has facilitated patient access to ADHD assessments in Australia, yet the determinants of access remain underexplored. We examined provider- and patient-level factors associated with A...
OBJECTIVES: Telepsychiatry expansion has facilitated patient access to ADHD assessments in Australia, yet the determinants of access remain underexplored. We examined provider- and patient-level factors associated with ADHD-related video consultations and assessed policy impacts on ADHD-linked video consultations. We hypothesised that the expansion and consolidation of telepsychiatry policies led to a preferential, market-driven increase in video-mode consultations for ADHD prescriptions, shaped by sociodemographic and geographical factors. METHODS: We analysed nearly 4 million psychiatric consultations (2017-2023) by linking Medicare, Pharmaceutical Benefits Schedule, and 2021 Census data. We compared psychotropic and ADHD prescription rates across consultation modes (face-to-face, video, and telephone). Fractional logit regressions modelled the video fraction of ADHD prescriptions, while a Difference-in-Differences analysis assessed the causal impact of telehealth consolidation on ADHD- versus other psychotropic-linked video consultations. RESULTS: ADHD prescriptions increased from 4.3% (pre-expansion) to 11.8% post-consolidation, with ADHD prescription-linked video consultations surging from 1.8% to 23.4%. The video-consultation fraction of ADHD prescriptions rose by 12.9% during consolidation. Higher proportions of female patients and greater patient remoteness-but not provider remoteness-were associated with higher video prescribing. Growth in video prescribing following telehealth consolidation was markedly higher for ADHD medications than for other psychotropics, particularly for one-off initial assessments. CONCLUSION: Video-based ADHD prescribing has become widespread in Australia, improving accessibility but raising concerns about health equity and sustainability in psychiatric care. Parallel rises in online ADHD interest and increased video prescribing, in the context of stagnant overall video-telehealth-related psychotropic prescribing, may indicate market-driven influences within telepsychiatry.
Cognitive correlates of Antisaccade Task performance in bipolar disorder.
Dyer R, Rossell SL, Phillipou A … +8 more , Cropley V, Karantonis JA, Furlong LS, Ringin E, Caruana GF, Thomas EHX, Gurvich C, Van Rheenen TE
Psychiatry Res · 2026 Jun · PMID 42391980 · Publisher ↗
BACKGROUND: The Antisaccade Task is often used to measure inhibitory control. While pooled effects in meta-analyses demonstrate antisaccade impairments in bipolar disorder (BD), individual studies show considerable varia...
BACKGROUND: The Antisaccade Task is often used to measure inhibitory control. While pooled effects in meta-analyses demonstrate antisaccade impairments in bipolar disorder (BD), individual studies show considerable variability in effect sizes and case-control significance, particularly in euthymic samples. This variability may reflect cognitive heterogeneity across BD samples. In this exploratory study we investigated whether antisaccade performance correlated with other cognitive domains in BD, and whether impairments were confined to specific cognitive subgroups. METHOD: 152 individuals (44 BD outpatients and 108 healthy controls [HC]) completed the Antisaccade Task. Participants also completed traditional cognitive measures assessing working memory, immediate and sustained attention, processing speed, cognitive flexibility, and inhibitory control. Correlations between antisaccade performance (error rate, latency) and these cognitive measures were examined. BD participants were also stratified into cognitively equivalent versus cognitively reduced subgroups based on their cognitive performance relative to HCs, and antisaccade performance compared between these subgroups and HCs. RESULTS: The BD group did not differ significantly from HCs on antisaccade error rate or latency. Antisaccade latency in BD correlated with working memory, while error rate correlated with immediate attention and processing speed. When stratified by correlated cognitive measures, cognitively reduced BD showed significantly worse performance than cognitively equivalent BD and HCs. These group differences were attenuated when BD was stratified by global cognitive performance. CONCLUSIONS: Our findings suggest that antisaccade task underperformance in BD may be confined to individuals with reductions in other specific cognitive domains; with error rate associated with immediate attention and processing speed, and latency with working memory.
National estimates of exposure to potentially traumatic events among individuals with obsessive-compulsive disorder: Findings from The National OCD Survey.
Pinciotti CM, Foshee KL, Storch EA
Psychiatry Res · 2026 Jun · PMID 42385289 · Publisher ↗
Epidemiological research suggests that most individuals in the U.S. will be exposed to potentially traumatic events (PTEs) at some point in their lifetime. Despite this, published rates of PTE exposure among individuals...
Epidemiological research suggests that most individuals in the U.S. will be exposed to potentially traumatic events (PTEs) at some point in their lifetime. Despite this, published rates of PTE exposure among individuals with obsessive-compulsive disorder (OCD) vary widely, ranging from 34-82%. Thus, presently available PTE estimates are too wide to be clinically informative and are incongruent with general population estimates, where the rate of PTE exposure would be expected to be comparable if not higher. Using data from The National OCD Survey, a large geographically representative study of adults with OCD across the U.S., demographically weighted PTE estimates were computed in a sample of 2808 participants with OCD (M age = 33.6 years). PTE rates were notably higher than previously reported in OCD research and better aligned with general population estimates. Nearly all participants endorsed at least one PTE (97.9%), including, most commonly, transportation accidents, sexual assault, physical assault, natural disaster, and life-threatening illness or injury. The present study is the first to provide robust PTE estimates among individuals with OCD, supporting the frequency of these experiences and highlighting the need for adequate assessment of trauma in clinical practice.
Digitally delivered cognitive bias modification for interpretation targeting hostile interpretation bias in compulsory drug rehabilitation: A feasibility randomized trial.
Yalikun S, Ye Z, Qiao J … +4 more , Du X, Isak G, Liu L, Ren Z
Psychiatry Res · 2026 Jun · PMID 42385288 · Publisher ↗
BACKGROUND: Hostile interpretation bias (HIB) is a cognitive correlate of aggression. Cognitive bias modification for interpretation (CBM-I) has shown mixed effects on HIB and aggressive behavior, but its feasibility amo...
BACKGROUND: Hostile interpretation bias (HIB) is a cognitive correlate of aggression. Cognitive bias modification for interpretation (CBM-I) has shown mixed effects on HIB and aggressive behavior, but its feasibility among people who use drugs (PWUD) in compulsory rehabilitation settings remains unclear. This feasibility trial evaluated a digitally delivered CBM-I (dCBM-I) program for PWUD and explored whether changes in HIB were associated with aggression change. METHODS: In this assessor-blinded feasibility randomized controlled trial, 60 PWUD from a compulsory rehabilitation facility were randomized to dCBM-I or a no-treatment control group. The dCBM-I program comprised four 20-minute sessions over two weeks, completed on researcher-provided tablets with on-site support. Outcomes were assessed at baseline, mid-intervention, post-intervention, and one-month follow-up. Linear mixed models tested intervention effects, and exploratory mediation analysis examined whether HIB change was associated with an indirect pathway from intervention condition to aggression change. RESULTS: The program showed high feasibility and acceptability. A significant group × time interaction was observed for HIB, indicating reduced HIB in the dCBM-I group at post-intervention and one-month follow-up. No significant group × time interactions were observed for aggression or secondary symptom outcomes, including anxiety, depression, anger, and craving. Exploratory mediation analysis showed a significant indirect effect through HIB change; however, this finding should be interpreted as hypothesis-generating. CONCLUSION: dCBM-I was feasible and acceptable in this supervised institutional setting and showed evidence of proximal target engagement. Definitive conclusions about behavioral efficacy require adequately powered active-controlled trials.
Association of TyG-RFM with depressive symptoms: a nationally representative study enhanced by interpretable machine learning.
Chen Y, Xiao N, Kong X … +3 more , Zhou Q, Xie K, Zhao X
Psychiatry Res · 2026 Jun · PMID 42378910 · Publisher ↗
BACKGROUND: The association between the triglyceride-glucose index-relative fat mass (TyG-RFM) and prevalent depressive symptoms remains unclear. This study aimed to examine this association and to develop an interpretab...
BACKGROUND: The association between the triglyceride-glucose index-relative fat mass (TyG-RFM) and prevalent depressive symptoms remains unclear. This study aimed to examine this association and to develop an interpretable machine-learning model for screening-oriented assessment of depressive symptoms in US adults. METHODS: A total of 12,600 participants from the National Health and Nutrition Examination Survey 2005-2018 were included in this study. Weighted logistic regression, restricted cubic spline (RCS), and subgroup were performed to evaluate the association between TyG-RFM and depressive symptoms. In addition, nine machine-learning models were developed and internally evaluated to estimate the individualized probability of depressive symptoms. RESULTS: Weighted multivariable regression analysis showed that TyG-RFM was positively associated with depressive symptoms (OR = 1.97, 95% CI: 1.10-3.53), and RCS analysis showed a similar positive relationship. In the machine-learning analysis, LightGBM showed the best overall internal performance based on five-fold cross-validated out-of-fold estimates, with an AUC of 0.747 (95% CI: 0.732-0.762), the lowest Brier score (0.070), and the greatest net benefit on decision curve analysis. SHAP analysis showed that TyG-RFM was the most influential feature in the LightGBM model for estimating the probability of depressive symptoms. CONCLUSIONS: TyG-RFM was positively associated with depressive symptoms and was identified as the most important feature in the best-performing LightGBM model, with the accompanying online calculator providing an exploratory approach for the assessment of depressive symptoms. However, longitudinal studies and external validation are still needed before broader clinical application.
Cross-national patterns of probable complex PTSD in post-communist Europe: A network analysis of five countries.
Levin Y, Mor-Ben-Ishai S, Hyland P … +11 more , Karatzias T, Shevlin M, Unoka ZS, Preiss M, Błachnio A, Stanculete MF, Adamkovic M, Salgo E, Przepiórka A, Chmielik M, Ben-Ezra M
Psychiatry Res · 2026 Jun · PMID 42378909 · Publisher ↗
BACKGROUND: Central and Eastern European (CEE) populations share historical challenges, including communist-era governance and post-transition changes, yet cross-national comparisons of trauma and stress related symptoms...
BACKGROUND: Central and Eastern European (CEE) populations share historical challenges, including communist-era governance and post-transition changes, yet cross-national comparisons of trauma and stress related symptoms remain limited. This study examined trauma exposure, post-traumatic stress disorder (PTSD), and Complex PTSD (CPTSD) prevalence and symptom networks across five CEE countries. METHODS: A cross-sectional study of 5070 adults from five CEE countries assessed trauma exposure using the International Trauma Exposure Measure (ITEM). Of these, 4012 (79.1%) reporting trauma completed the International Trauma Questionnaire (ITQ). Cross-national comparisons used chi-square and ANOVA. Network analysis identified symptom centrality and structural differences using Gaussian Graphical Models with comparison tests. RESULTS: Trauma exposure patterns were similar across countries (η²=0.003-0.009), but disorder prevalence differed substantially. CPTSD consistently exceeded PTSD, with Poland showing highest rates (CPTSD: 23.6%, PTSD: 14.4%). Network structures were broadly comparable, with Self-Organization symptoms, particularly negative self-concept, most central. Czech Republic and Slovakia uniquely showed additional central PTSD symptoms. Structural differences were most pronounced involving these countries. Bridge symptoms (startle response, affective dysregulation) were consistent cross-nationally. CONCLUSIONS: CEE countries demonstrate distinct profiles with CPTSD predominating. Country-specific symptom networks suggest tailored interventions targeting DSO symptoms in most countries, while also addressing PTSD symptoms in Czech Republic and Slovakia. Findings support the ICD-11 PTSD/CPTSD distinction and highlight the importance of country-specific interventions.
The overlooked majority of hikikomori: Latent profiles reveal a discrepancy between social anxiety and life functioning.
Nonaka S, Kubo H, Takeda T … +1 more , Sakai M
Psychiatry Res · 2026 Jun · PMID 42372696 · Publisher ↗
Hikikomori is increasingly recognized as heterogeneous; however, how behavioral functions relate to clinically important targets (e.g., functional impairment and social-evaluative anxiety) remains unclear. We identified...
Hikikomori is increasingly recognized as heterogeneous; however, how behavioral functions relate to clinically important targets (e.g., functional impairment and social-evaluative anxiety) remains unclear. We identified latent hikikomori profiles by integrating behavioral topography and functions and characterized their clinical profiles. The study recruited Japanese adults aged 18-59 using an online panel, comprising 200 participants each in the hikikomori and control groups, respectively. Latent profile analysis was conducted using three functional indicators from the Hikikomori Functional Assessment Scale (social negative reinforcement, intrapersonal positive reinforcement, intrapersonal negative reinforcement) and an indicator of hikikomori behavior from the Adaptive Behaviors Scale for Hikikomori. Group differences were examined using Welch's ANOVA with Games-Howell post hoc tests. A three-profile solution was selected: Mild (11%), Moderate-withdrawal (52%), and Social-avoidance (37%). The Moderate-withdrawal profile showed clinically significant functional impairment without elevated social-evaluative anxiety compared to controls, indicating a paradoxical presentation of impairment without heightened fear of negative evaluation. The Social-avoidance profile showed the greatest withdrawal severity, elevated social-evaluative anxiety, lowest social support, and higher daily stressors. The Mild profile showed relatively lower impairment, reduced support quantity, and preserved support satisfaction. Hikikomori is thus not a unitary anxiety-avoidance condition. Profile-informed assessment may improve intervention selection, with anxiety-focused approaches being most relevant for the Social-avoidance profile, whereas reinforcement- and values-oriented behavioral strategies may be more appropriate for the Moderate-withdrawal profile. Longitudinal and multi-informant studies are needed to test profile stability and differential treatment responsiveness.
Promoting self-compassion meditation with intranasal oxytocin in borderline personality disorder: a pilot study.
Arqueros M, Soler J, Almenta D … +3 more , Soria-Madrid A, Schmidt C, Pascual JC
Psychiatry Res · 2026 Jun · PMID 42372695 · Publisher ↗
BACKGROUND: Borderline personality disorder (BPD) is characterized by emotion dysregulation, interpersonal difficulties, and high levels of self-criticism, which may hinder engagement with compassion-based therapeutic pr...
BACKGROUND: Borderline personality disorder (BPD) is characterized by emotion dysregulation, interpersonal difficulties, and high levels of self-criticism, which may hinder engagement with compassion-based therapeutic practices. Oxytocin has been proposed as a modulator of social-affective processes and may facilitate specific mechanisms involved in psychotherapy. METHODS: In this pilot study, 18 individuals with BPD received intranasal oxytocin (24 IU) or placebo prior to a guided compassion-based meditation practice over five weekly sessions. Compassion practice quality was assessed at baseline (T1) and endpoint (T5). Endpoint differences were examined using ANCOVA models controlling for baseline values. RESULTS: Compared with placebo, oxytocin was associated with higher endpoint scores on the imagination dimension of compassion practice quality. No significant differences were observed for the total score or the somatic dimension, and no adverse effects related to oxytocin administration were reported. CONCLUSIONS: Oxytocin may facilitate specific aspects of the subjective experience during compassion-based practices in individuals with BPD, particularly those related to imagery processes. Further controlled studies with larger samples are needed to clarify the mechanisms of action and to determine whether these effects translate into clinically meaningful outcomes when oxytocin is used as an adjunct to psychotherapy.
Low-dose lithium vs valproate and incident dementia diagnoses in older adults: A propensity-matched cohort study using electronic health record data.
da Silva AMP, Santos DH, Júnior DVSL … +3 more , Cardoso LJC, Perry G, Kishi T
Psychiatry Res · 2026 Jun · PMID 42372694 · Publisher ↗
BACKGROUND: Whether low-dose lithium lowers dementia incidence in older adults, relative to an active comparator, is unestablished in real-world data. We compared incident dementia in older adults receiving low-dose lith...
BACKGROUND: Whether low-dose lithium lowers dementia incidence in older adults, relative to an active comparator, is unestablished in real-world data. We compared incident dementia in older adults receiving low-dose lithium versus valproate using a target trial emulation of multicenter electronic health record data. METHODS: Adults aged ≥60 years receiving lithium carbonate (all serum measurements ≤0.40 mmol/L) or valproate between 2015 and 2025 in the TriNetX network, free of prior dementia, mild cognitive impairment, bipolar disorder, Parkinson's disease, or related neurological conditions, were eligible. Cohorts were balanced by 1:1 propensity score matching on 23 covariates. The primary outcome was incident all-cause dementia at 730 days; secondary outcomes were mortality and hospitalization. Cause-specific hazard ratios (HRs), Aalen-Johansen cumulative incidence, and an E-value were computed, with prespecified sensitivity analyses. RESULTS: After matching, 853 patients per cohort remained (all standardized mean differences <0.10). All-cause dementia occurred in 25/795 (3.1%) lithium versus 69/832 (8.3%) valproate users (HR, 0.38; 95% CI, 0.24-0.60; P < .001). Mortality was lower with lithium (HR, 0.56; 95% CI, 0.39-0.80), whereas hospitalization did not differ (HR, 0.81; 95% CI, 0.58-1.13). The E-value was 4.69 (2.71 for the upper bound). Sensitivity analyses (90-day lag, 0.36; 180-day lag, 0.40; non-AD subtype, 0.23; 3-year follow-up, 0.47) were directionally consistent. CONCLUSION: Low-dose lithium was associated with a lower observed incidence of dementia diagnoses than valproate. These observational findings cannot distinguish a direct effect from prescribing or surveillance bias, depletion of susceptibles, or differential healthcare engagement; they are hypothesis-generating, and randomized trials are required before causal interpretation.
Association between depressive symptoms and hepatic steatosis in young adults: a nationwide study.
Huh Y, Oh S, Nam GE
Psychiatry Res · 2026 Jun · PMID 42372693 · Publisher ↗
BACKGROUND: Hepatic steatosis is a growing global health concern associated with cardiometabolic diseases. There is limited evidence regarding the association between depressive symptoms and hepatic steatosis in young ad...
BACKGROUND: Hepatic steatosis is a growing global health concern associated with cardiometabolic diseases. There is limited evidence regarding the association between depressive symptoms and hepatic steatosis in young adults. We aimed to investigate these associations in young Korean adults. METHODS: This cross-sectional study included 7,831 adults aged 19-44 years who participated in the Korea National Health and Nutrition Examination Survey between 2014 and 2022. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) and categorized as no elevated depressive symptoms or elevated depressive symptoms and into four severity groups (minimal, mild, moderate, and severe). Hepatic steatosis was defined as a hepatic steatosis index of ≥36. Multivariable logistic regression analyses were performed to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: The prevalence of hepatic steatosis was 23.8% and 33.9% in individuals without and with elevated depressive symptoms, respectively. After adjusting for potential confounders, the presence of elevated depressive symptoms was found to be associated with higher odds of hepatic steatosis (OR 2.01, 95% CI 1.54-2.64). Compared with individuals with minimal depressive symptoms, the ORs for hepatic steatosis increased with greater depressive symptom severity (1.95, 95% CI 1.41-2.70 for moderate and 2.41, 95% CI 1.49-3.88 for severe symptoms; P for trend <.001). CONCLUSIONS: Elevated depressive symptoms and greater symptom severity were associated with increased odds of hepatic steatosis in young adults. These findings suggest that the assessment and management of metabolic and liver health are warranted in young adults presenting with depressive symptoms.
Growing up with ADHD: findings from an 18-year longitudinal follow-up study of adults with childhood ADHD, their siblings, and controls.
van der Plas NE, Noordermeer SDS, Franke B … +6 more , Hartman CA, Hoekstra PJ, Rommelse NNJ, Sprooten E, Luman M, Oosterlaan J
Psychiatry Res · 2026 Jun · PMID 42365682 · Publisher ↗
BACKGROUND: The prevalent childhood-onset disorder attention-deficit/hyperactivity disorder (ADHD) (5-7%) poses risks for adult functioning, which should be identified with long-term prospective follow-up studies includi...
BACKGROUND: The prevalent childhood-onset disorder attention-deficit/hyperactivity disorder (ADHD) (5-7%) poses risks for adult functioning, which should be identified with long-term prospective follow-up studies including a broad range of outcomes. METHODS: Differences in outcomes (measures of psychiatric status, behavioural/emotional problems, academic/professional functioning, adaptive functioning, neurocognition, physical health, healthcare service use) were investigated in an 18-year follow-up study of adults with childhood ADHD (n=154, M±SD age=27.4±3.7, 68% males), their siblings without childhood ADHD (n=138, M±SD age=29.6±4.4, 35% males), and controls (n=129, M±SD age=28.2±3.5, 40% males). Post-hoc tests investigated whether observed differences between the ADHD group and controls may be driven by a current ADHD diagnosis, by comparing persistent ADHD, remitted ADHD, and control groups. RESULTS: Childhood ADHD was related to worse functioning in adulthood on >60% of outcomes across all domains with small to large-sized effects (e.g., moderate/large differences in increased rates of ADHD and depression, externalizing problems, autistic traits, and worse neurocognitive outcomes). Siblings showed comparable functioning to controls. Persistent ADHD showed worse functioning on specific outcomes in the psychiatric, behavioural/emotional, adaptive, and physical health domains, as compared to remitted ADHD. Both ADHD groups had worse functioning compared to controls. CONCLUSIONS: Childhood ADHD increased the risk for worse functioning in adulthood. Siblings of the childhood ADHD group were not at risk for adverse outcomes. The current study identifies childhood ADHD as a risk condition for poorer long-term functioning, although substantial heterogeneity in outcomes across groups was noted. Heterogeneity within the childhood ADHD group seemed partly attributable to a current ADHD diagnosis.
Prevalence and regional patterns of identity-related OCD across the United States: Findings from The National OCD Survey.
Pinciotti CM, Foshee KL, Upshaw B … +5 more , Spencer SD, Hershfield J, Park JM, Franklin ME, Storch EA
Psychiatry Res · 2026 Jun · PMID 42365681 · Publisher ↗
Obsessive-compulsive disorder (OCD) is often understood to manifest based on individuals' core values, with symptom themes reflecting that which is personally meaningful and therefore threatening. Identity-related OCD th...
Obsessive-compulsive disorder (OCD) is often understood to manifest based on individuals' core values, with symptom themes reflecting that which is personally meaningful and therefore threatening. Identity-related OCD themes - including pathological fears or doubts related to sexual orientation, gender identity, racism, disability/diagnostic status, aging, and poverty - may be particularly shaped by the values guided by sociocultural contexts. The United States provides a useful context for examining these cultural intersections, as culturally similar communities have historically clustered across eleven distinct sociocultural regions. Moreover, despite clinical observation suggesting increased frequency of identity-related OCD themes in recent years, their prevalence remains unclear. Using data from The National OCD Survey (N = 2917), the present study examined the prevalence and regional patterning of identity-related OCD themes across the United States. Overall, obsessions about disability/diagnostic status were most common, followed by racism, sexual orientation, aging, poverty, and lastly, gender identity. Notably, the prevalence of sexual orientation obsessions exceeded prior estimates, potentially reflecting a shift in the presentation and function of these symptoms. Regionally, identity-related OCD themes clustered in culturally meaningful ways, ostensibly reflecting regional differences in the centrality, stigmatization, and status loss associated with different identities or personal characteristics. Findings highlight the importance of sociocultural context in the emergence and presentation of OCD symptoms.
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.
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.
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