Psychiatry Research[JOURNAL]
Sun
200 papers
Hierarchical disruptions of white matter rich-club organization in comorbid insomnia with anxiety: a diffusion tensor imaging study.
Yin X, Yin R, Hao Y … +4 more , Ma M, Tan Z, Yuan F, Guo J
Psychiatry Res Neuroimaging · 2026 Jun · PMID 42401109 · Publisher ↗
BACKGROUND: Rich-club organization is a fundamental topological feature supporting global information integration in the brain. However, its hierarchical alterations in comorbid insomnia with anxiety (CI-A) remain poorly...
BACKGROUND: Rich-club organization is a fundamental topological feature supporting global information integration in the brain. However, its hierarchical alterations in comorbid insomnia with anxiety (CI-A) remain poorly understood. METHODS: Diffusion tensor imaging was performed in 61 patients with CI-A and 35 matched healthy controls. Whole-brain structural networks were reconstructed and categorized into rich-club, feeder, and local connections. Group differences in diffusion metrics and connectivity strength were examined, and their associations with the Pittsburgh Sleep Quality Index (PSQI), Hamilton Anxiety Rating Scale (HAMA-14), Hyperarousal Scale (HAS), and Montreal Cognitive Assessment (MoCA) were evaluated. RESULTS: In feeder connections, CI-A patients showed elevated radial diffusivity, which correlated with HAS (r = 0.304, p = 0.003), and higher fiber number was associated with PSQI (r = 0.335, p = 0.001). In local connections, increased radial diffusivity correlated with HAS (r = 0.308, p = 0.002), and heightened axial diffusivity was linked to PSQI (r = 0.299, p = 0.003). CONCLUSION: These findings reveal a selective vulnerability pattern in CI-A, with peripheral connections showing more pronounced microstructural abnormalities than the rich-club connections, providing novel insights into the hierarchical disruption of white matter networks in this condition.
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.
The amygdala in bipolar disorder: A cross-sectional study examining the relevance of structural alterations of amygdala subfields for cognitive functioning in patients with bipolar disorder.
Karrer J, Fellendorf FT, Koschutnig K … +16 more , Dalkner N, Queissner R, Schönthaler E, Stross T, Bengesser SA, Ilic J, Finner A, Fleischmann E, Georgi J, Maget A, Lässer A, Popkova D, Smolle S, Tmava-Berisha A, Reininghaus EZ, Lenger M
Psychiatry Res Neuroimaging · 2026 Jun · PMID 42398295 · Publisher ↗
BACKGROUND: Bipolar disorder (BD) is associated with cognitive impairment. Structural alterations of the amygdala may contribute to these deficits, although evidence has been inconsistent. This study examined the relatio...
BACKGROUND: Bipolar disorder (BD) is associated with cognitive impairment. Structural alterations of the amygdala may contribute to these deficits, although evidence has been inconsistent. This study examined the relationship between amygdala subfield volumes and cognitive performance to understand the neurobiological basis of cognitive impairment in BD. METHODS: Amygdala volumes were measured in 42 patients with BD [16 female, 26 male; M = 44.33 ± 12.97 years] and 67 healthy controls [44 female, 23 male; M = 40.53 ± 16.21 years] using 3-Tesla MRI. Cognitive performance was assessed across verbal learning/memory, executive function, and attention. Statistical analysis included partial correlations, analysis of variance (ANOVA) and hierarchical regressions. RESULTS: Memory performance correlated significantly with left amygdala subfield volumes. No associations were observed for other cognitive functions. ANOVA revealed significantly smaller volumes in some left and right amygdala subfields in BD patients with more severe cognitive impairment, whereas others were not significant. Left amygdala subfield volumes significantly predicted memory performance in BD. CONCLUSION: Reduced volumes of left amygdala subfields are associated with impairment in verbal learning/memory. These findings highlight a potential role of amygdala structural alterations in BD-related cognitive deficits and suggest the amygdala as a potential biomarker for memory dysfunction in BD.
Combined transformer encoder-CNN architecture with texture features for MRI-based Alzheimer's disease detection.
Jyothi GD, Kumar CM, Kottala RK
Psychiatry Res Neuroimaging · 2026 Jun · PMID 42398294 · Publisher ↗
Alzheimer's disease (AD) develops long before clinical symptoms appear, which highlights the need for early diagnostic tools. Current diagnostic techniques often miss the subtle structural brain changes in the early stag...
Alzheimer's disease (AD) develops long before clinical symptoms appear, which highlights the need for early diagnostic tools. Current diagnostic techniques often miss the subtle structural brain changes in the early stages of AD, creating a critical gap in timely medical intervention. This paper proposes a combined modified Transformer Encoder-Convolutional Neural Network (CNN) architecture for AD detection using Magnetic Resonance Imaging (MRI). Data augmentation techniques, including rotation, zooming, brightness adjustment and flipping, are applied to increase the number of training images. Images are processed using a Modified Gaussian Filtering technique (modGFT) that implements a spatially adaptive variance to suppress noise while preserving critical anatomical edges and structural details. Relevant features, including shape features, Improved Median Robust Extended Local Binary Pattern (ImpMRELBP) and Pyramid Histogram of Oriented Gradients (PHOG) features, are extracted. The ImpMRELBP descriptor highlights boundaries and captures meaningful texture variations. These features are input into a hybrid modTransEncd-CNN detection model. The model incorporates batch normalization and an enhanced attention module, improving training speed, stability and generalization. The results from both models are merged using soft voting for AD classification. Experimental results demonstrate that the proposed modTransEncd-CNN method outperforms traditional models, achieving 96% accuracy.
Changes in EEG-derived entropy are associated with symptom improvement in major depressive disorder following electroconvulsive therapy.
Restrepo-Castro JC, Uribe-Laverde MÁ, Acero-González Á … +2 more , Silva-Ariza AV, Botero-Rosas DA
Psychiatry Res Neuroimaging · 2026 Jun · PMID 42398293 · Publisher ↗
BACKGROUND: Major Depressive Disorder (MDD) is associated with alterations in brain activity that are not fully captured by symptom-based diagnostic approaches. EEG-derived entropy measures have been proposed as potentia...
BACKGROUND: Major Depressive Disorder (MDD) is associated with alterations in brain activity that are not fully captured by symptom-based diagnostic approaches. EEG-derived entropy measures have been proposed as potential biomarkers of depressive symptomatology, although findings remain mixed and longitudinal evidence using clinically feasible EEG setups is limited. METHODS: Seventeen patients with MDD undergoing modified electroconvulsive therapy (mECT) and seventeen matched healthy controls were included. Resting-state EEG was recorded using a simplified two-electrode frontal montage prior to seizure induction. To maximize data usability, a signal patching procedure was applied to reconstruct segments affected by artifacts while preserving the fundamental properties of the original EEG signals. Entropy was computed across several frequency bands using a permutation entropy calculation with order 3. Changes in entropy between baseline and post-treatment were examined with respect to changes in depressive symptoms. RESULTS: At baseline, patients exhibited higher EEG entropy than controls, particularly in the beta frequency band. Following mECT, patients showed a significant reduction in beta-band entropy. Reductions in left frontal beta-band entropy accounted for variance in symptom improvement. CONCLUSIONS: Reductions in frontal beta-band entropy were associated with clinical improvement following mECT and may reflect normalization of cortical activity in MDD. The combination of entropy-based measures with signal patching may enhance the amount of useful information extracted from simplified EEG recordings, supporting their potential utility as biomarkers of treatment response in depression.
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.
P50 sensory gating in children with ADHD, autism spectrum disorder, and neurotypicals: Within-session test-retest reliability and evaluation of methodologies.
Mazhari-Jensen DS, Mørch CD, Davies PL … +4 more , Gavin WJ, Andreis FR, Lauritsen MB, Gervasio S
Psychiatry Res Neuroimaging · 2026 Jun · PMID 42385671 · Publisher ↗
The sensory gating paradigm has gained traction in child and adolescent psychiatry for assessing sensory processing deficits. However, its test-retest reliability in pediatric clinical populations remains unclear. This s...
The sensory gating paradigm has gained traction in child and adolescent psychiatry for assessing sensory processing deficits. However, its test-retest reliability in pediatric clinical populations remains unclear. This study evaluated the reliability of sensory gating measures in neurotypical and clinical children. Fifty-three children (26 females, ages 8-14) participated, including neurotypical children and children with attention-deficit/hyperactivity disorder or autism spectrum disorder. Auditory P50 event-related potentials were recorded at Cz using baseline-to-peak and peak-to-peak methodology. Difference and ratio scores between paired stimuli were computed. Generalized eigendecomposition (GED) was applied as an alternative to Cz-based extraction. Reliability was assessed using intraclass correlation coefficients (ICCs). The first stimulus showed moderate-to-good reliability with both Cz and GED. The second stimulus showed poor-to-moderate reliability for Cz, but moderate-to-good for GED. Difference scores yielded moderate-to-good reliability; ratio scores showed poor-to-moderate reliability. GED produced significantly higher ICCs than Cz (mean difference = 0.15, p = 0.018). Only GED-based measures for the first stimulus consistently revealed group differences. In sum, GED enhances the test-retest reliability of P50 gating outcomes while maintaining sensitivity to group differences. Sensory gating in children can achieve reliable short-term measurements. GED offers a robust alternative to Cz-based methods, potentially improving statistical power and reliability in clinical research.
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.
Effects of riluzole on excitation-inhibition imbalance and functional connectivity in 22q11.2 deletion syndrome: a multimodal 7-Tesla MRI study.
Sylvester AL, Spapens JC, Tse DH … +8 more , Serrarens C, Kappert S, Soons N, Poser BA, Linden DE, Ivanov D, van Amelsvoort T, Vingerhoets C
Psychiatry Res Neuroimaging · 2026 Jun · PMID 42379018 · Publisher ↗
22q11.2 deletion syndrome (22q11.2DS) is associated with several psychiatric pathologies, including psychosis and cognitive impairment. This may be partially attributable to genetically-mediated imbalance of glutamatergi...
22q11.2 deletion syndrome (22q11.2DS) is associated with several psychiatric pathologies, including psychosis and cognitive impairment. This may be partially attributable to genetically-mediated imbalance of glutamatergic (excitatory) to GABAergic (inhibitory) neurotransmission, which could also modulate functional connectivity. Modifying excitation-inhibition balance with the antiglutamatergic drug riluzole may therefore treat psychotic and cognitive symptoms. Eight individuals with 22q11.2DS experiencing cognitive and/or psychotic symptoms received eight-weeks of placebo followed by eight-weeks of riluzole. After each intervention period, 7 Tesla magnetic resonance spectroscopy of the dorsal anterior cingulate cortex (dACC) and resting-state functional connectivity measurements were acquired, alongside cognitive and psychiatric assessment. Riluzole did not significantly alter dACC glutamate or GABA concentrations, or functional connectivity of the dACC. However, the ratio of dACC glutamate to GABA was significantly correlated with dACC - left insula functional connectivity post-riluzole (ρ = -0.96, p = 0.033, FDR corrected). Participants with higher glutamate after placebo had greater trend-level reductions in glutamate (ρ = -0.71, p = 0.06) post-riluzole. Exploratory analyses suggested potential associations between MRI and clinical measurements. Despite a lack of significant findings on primary outcome measures, this study demonstrates the feasibility of a multimodal MRI approach in clinical trials within 22q11.2DS, and identifies potential avenues for further research.
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.
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