Comprehensive psychiatry最新文献

Prevalence of depression, anxiety, and post-traumatic stress symptoms among black post-secondary students in North America: A systematic review and meta-analysis. 抑郁、焦虑和创伤后应激症状在北美黑人大学生中的流行：一项系统回顾和荟萃分析

IF 4.8 2区医学 Q1 PSYCHIATRY

Comprehensive psychiatry

Pub Date : 2026-08-26 DOI: 10.1016/j.comppsych.2026.152742

Joana Mukunzi Ntunga, Seyed Mohammad Mahdi Moshirian Farahi, Jude Mary Cénat

Background: Black post-secondary students in minority contexts face academic pressures and race-related stressors that may elevate risk for mental health difficulties. Although prior research suggests heightened vulnerability, findings on the prevalence of depression, anxiety, and PTSD symptoms are mixed. This study synthesized existing evidence to estimate pooled symptom prevalence among Black post-secondary students in North America and identify associated factors.

Methods: Following PRISMA 2020 guidelines, systematic searches were conducted in June 2023 and updated in June 2025 across seven databases. The protocol was registered in PROSPERO (CRD42023406838). Eligible studies reported prevalence estimates of depression, anxiety, or PTSD among Black post-secondary students in the United States or Canada. Random-effects meta-analyses using Freeman-Tukey double arcsine transformations estimated pooled prevalence. Subgroup analyses examined differences by race, measure, and publication year.

Results: Thirty independent samples from 25 studies were included; none were conducted in Canada. Pooled prevalence estimates were 20.1% for anxiety (95% CI: 12.4-29.2), 22.2% for depression (95% CI: 16.8-28.0), and 19.3% for PTSD (95% CI: 16.9-21.8). No significant differences were observed for depression across racial groups, though students identifying as "other" or multiracial showed slightly higher odds of anxiety. Prevalence did not vary by measurement tool or publication year. Correlates included structural, sociodemographic, psychological, and behavioural factors.

Conclusions: Black students experience a substantial burden of depression, anxiety, and PTSD, with pooled symptom prevalence estimates comparable to those of other racial groups. Post-secondary institutions can play a critical role in fostering equitable environments and improving mental health and academic outcomes for Black students.

背景：少数民族背景下的黑人高等教育学生面临学业压力和种族相关的压力源，可能会增加心理健康困难的风险。尽管先前的研究表明易受伤害程度增加，但关于抑郁、焦虑和创伤后应激障碍症状的患病率的研究结果却参差不齐。本研究综合了现有的证据来估计北美黑人高等教育学生的综合症状患病率，并确定相关因素。方法：遵循PRISMA 2020指南，于2023年6月对7个数据库进行系统检索，并于2025年6月更新。该协议在PROSPERO （CRD42023406838）中注册。符合条件的研究报告了美国或加拿大黑人大专学生中抑郁、焦虑或创伤后应激障碍的患病率估计。使用Freeman-Tukey双反正弦变换的随机效应荟萃分析估计了合并患病率。亚组分析考察了种族、测量和出版年份的差异。结果：纳入25项研究的30个独立样本；没有在加拿大进行。合并患病率估计焦虑为20.1% (95% CI: 12.4-29.2)，抑郁为22.2% (95% CI: 16.8-28.0)， PTSD为19.3% （95% CI: 16.9-21.8）。不同种族的学生在抑郁方面没有显著差异，尽管被认为是“其他”或多种族的学生表现出略高的焦虑几率。患病率不因测量工具或出版年份而异。相关因素包括结构、社会人口、心理和行为因素。结论：黑人学生经历了抑郁、焦虑和创伤后应激障碍的沉重负担，其综合症状患病率估计与其他种族群体相当。高等教育机构可以在促进公平的环境和改善黑人学生的心理健康和学业成绩方面发挥关键作用。

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引用次数: 0

Default mode network hub disruption links problematic use of the Internet to brain network disorganization 默认模式网络集线器中断将有问题的互联网使用与大脑网络紊乱联系起来。

IF 4.8 2区医学 Q1 PSYCHIATRY

Comprehensive psychiatry

Pub Date : 2026-07-01 Epub Date: 2026-06-11 DOI: 10.1016/j.comppsych.2026.152725

Nagara Takao, Naoya Oishi, Qi Dai, Lichang Yao, Sayaka Yoshimura, Mami Shibata, Morio Aki, Saki Akahori, Michael Spantios, Toshiya Murai, Hironobu Fujiwara

Background

Problematic Use of the Internet (PUI) has been associated with functional alterations in the default mode network (DMN), which contains critical hubs in the entire brain network. Previous studies have predicted that hub disruption leads to widespread network alterations; however, whether DMN functional connectivity mediates the relationship between PUI and global network topology remains unclear. This study examined whether DMN connectivity mediates PUI-related brain network topology.

Methods

Resting-state functional magnetic resonance imaging data were collected from 190 healthy participants aged 20–69 years. DMN functional connectivity was assessed using region of interest (ROI)-to-ROI analyses with the Generalized Problematic Internet Use Scale-2 (GPIUS-2) as the primary predictor, controlling for age, sex, and mean framewise displacement. Graph-theoretical analyses quantified whole-brain network properties, including the clustering coefficient (Cp), shortest path length (Lp), global efficiency (Eg), and local efficiency (Eloc). Mediation analyses were performed to determine whether DMN functional connectivity mediates the relationship between GPIUS-2 and each metric.

Results

The functional connectivity values of all 17 DMN cluster pairs showed negative partial correlations with PUI severity (p-FDR < 0.05). Mean DMN connectivity strongly predicted global network topology (|ρ| = 0.36–0.41, all p-FDR < 1 × 10⁻⁶). Mediation analyses revealed that DMN functional connectivity substantially mediated the relationship between PUI severity and each metric (indirect effects: all p-FDR < 0.001; all direct effects p > 0.49). Reduced DMN connectivity was associated with decreased Cp and Eloc, increased Eg, and decreased Lp, indicating a deviation from optimal small-world organization.

Conclusion

DMN hub connectivity serves as a critical neurobiological pathway through which the PUI influences the whole-brain network organization.

背景：有问题的互联网使用（PUI）与默认模式网络（DMN）的功能改变有关，默认模式网络包含整个大脑网络中的关键枢纽。先前的研究预测，枢纽中断会导致广泛的网络改变；然而，DMN功能连通性是否介导PUI与全局网络拓扑之间的关系尚不清楚。本研究考察DMN连接是否介导pui相关的脑网络拓扑结构。方法：收集190例20 ~ 69岁健康受试者静息态功能磁共振成像资料。DMN功能连通性评估使用感兴趣区域（ROI）到ROI分析，通用问题互联网使用量表-2 （GPIUS-2）作为主要预测因子，控制年龄，性别和平均帧位移。图理论分析量化了全脑网络的特性，包括聚类系数（Cp）、最短路径长度（Lp）、全局效率（Eg）和局部效率（Eloc）。进行中介分析以确定DMN功能连通性是否介导GPIUS-2与每个指标之间的关系。结果：所有17个DMN簇对的功能连通性值与PUI严重程度呈负偏相关（p-FDR -6）。中介分析显示，DMN功能连通性实质上介导了PUI严重程度与各指标之间的关系（间接效应：所有p-FDR均为0.49）。DMN连通性降低与Cp和Eloc降低、Eg增加和Lp降低相关，表明偏离了最佳小世界组织。结论：DMN中枢连通性是PUI影响全脑网络组织的重要神经生物学通路。

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引用次数: 0

Comorbidity patterns and immune-metabolic differences in patients with acute depressive episodes 急性抑郁发作患者的共病模式和免疫代谢差异。

IF 4.8 2区医学 Q1 PSYCHIATRY

Comprehensive psychiatry

Pub Date : 2026-07-01 Epub Date: 2026-06-11 DOI: 10.1016/j.comppsych.2026.152729

Sai Chen, Xingning Long, Shaoyang Chen, Yuqing Zhang, Bin Bi, Zhe Dong

Background

Depression is frequently complicated by physical and psychiatric comorbidities. These conditions are closely linked to immune and metabolic alterations. Identifying comorbidity patterns and their distinct biological signatures is crucial for optimizing clinical stratification and treatment strategies.

Methods

This retrospective cross-sectional study analyzed electronic medical records of 7541 inpatients diagnosed with depressive episodes or recurrent depressive disorder at a tertiary psychiatric hospital in China. LCA was used to identify comorbidity patterns based on the 30 most common conditions. Generalized linear models examined differences in 12 peripheral blood immune and metabolic indicators across these patterns. P values were corrected using the FDR.

Results

Comorbidity was observed in 71.81% of the study population. The study identified four distinct comorbidity classes which were compared to a non-comorbid depression-only reference group. The profiles revealed a clear biological bifurcation. The metabolic abnormalities cluster exhibited profound systemic inflammation with a significantly elevated SII (β = 92.697, P < 0.001). The mixed cardiovascular cluster displayed the most severe profile and was characterized by significantly reduced HDL-C (β = −0.071, P < 0.001) and elevated SII (β = 53.685, P = 0.017). Conversely, the anxiety and thyroid cluster was defined by endocrine dysfunction with elevated TSH (β = 1.142, P < 0.001) but a significantly suppressed SII (β = −56.312, P = 0.029). The anxiety-only cluster represented the largest subgroup and showed widespread downregulation of immune markers including white blood cell count (β = −0.266, P < 0.001).

Conclusion

Comorbidities in depression cluster into four patterns with divergent immune and metabolic signatures. Patients with metabolic and cardiovascular comorbidities showed a higher inflammatory profile, highlighting the necessity of cardiometabolic assessment. These findings suggest the potential utility of routine blood biomarkers for characterizing clinical heterogeneity among patients with depression.

背景：抑郁症常伴有身体和精神疾病。这些疾病与免疫和代谢变化密切相关。确定合并症模式及其独特的生物学特征对于优化临床分层和治疗策略至关重要。方法：本回顾性横断面研究分析了中国某三级精神病院诊断为抑郁发作或复发性抑郁症的7541例住院患者的电子病历。LCA用于根据30种最常见的情况确定合并症模式。广义线性模型检验了这些模式中12种外周血免疫和代谢指标的差异。使用FDR校正P值。结果：71.81%的研究人群存在合并症。该研究确定了四种不同的共病类别，并将其与非共病抑郁对照组进行了比较。这些侧面图显示出明显的生物学分化。代谢异常集群表现为深度全身性炎症，SII显著升高（β = 92.697， P）。结论：抑郁症合并症分为四种类型，具有不同的免疫和代谢特征。有代谢和心血管合并症的患者显示出更高的炎症特征，强调了心脏代谢评估的必要性。这些发现提示常规血液生物标志物在抑郁症患者临床异质性表征中的潜在效用。

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引用次数: 0

The silent struggle: Barriers, delays, and missed opportunities in the treatment of body-focused repetitive behaviors 无声的斗争：在治疗以身体为中心的重复行为时遇到的障碍、延误和错失的机会。

IF 4.8 2区医学 Q1 PSYCHIATRY

Comprehensive psychiatry

Pub Date : 2026-07-01 Epub Date: 2026-07-02 DOI: 10.1016/j.comppsych.2026.152733

Steffen Moritz, Lisa Borgmann, Kim M. Rojahn, Lena Jelinek, Stella Schmotz

Background

Despite the high prevalence of body-focused repetitive behaviors (BFRBs; e.g., skin picking, trichotillomania, nail biting, cavitadaxia/lip-cheek biting), many affected individuals neither seek nor receive adequate treatment. This study investigates treatment-seeking behaviors and experience with self-help strategies as well as professional interventions among individuals with BFRBs.

Methods

A total of 971 participants with BFRBs were recruited via online platforms and self-help organizations. Participants completed the Generic Body-Focused Repetitive Behavior Scale (GBS-8) and answered questions regarding age of onset, perceived causes of their condition, prior self-help attempts, professional treatment history, and reasons for not seeking help.

Results

Only 13.5% of participants with BFRBs had sought professional help (mainly psychologists) for their BFRB. Barriers included lack of awareness, perceived low symptom severity, shame, and distrust of treatment. Use of self-help was common (72.2%). However, only a minority used structured and evidence-based techniques like habit reversal training or decoupling. The average duration of untreated BFRBs for those who eventually sought help was approximately 11 years, with cavitadaxia showing the longest delay. Among those who underwent professional care, around 40% received no evidence-based advice. Habit reversal training was the most frequently recommended technique, followed by medication and habit replacement.

Conclusions

Despite the significant burden of BFRBs, treatment-seeking remains low. Shame, misinformation, and limited access to professionals with specific expertise remain key barriers. These findings highlight the urgent need for increased awareness, accessible interventions, and low-threshold professional training opportunities (e.g., www.uke.de/e-bfrb-en) to improve care of individuals with BFRBs.

背景：尽管以身体为中心的重复性行为（bfrb，如抠皮、拔毛癖、咬指甲、咬牙/咬唇）的患病率很高，但许多患者既没有寻求也没有得到适当的治疗。本研究探讨了bfrb患者的寻求治疗行为、自助策略和专业干预经验。方法：通过网络平台和自助组织共招募971名bfrb参与者。参与者完成了通用身体聚焦重复行为量表（GBS-8），并回答了有关发病年龄、症状的感知原因、先前的自助尝试、专业治疗史和不寻求帮助的原因等问题。结果：仅有13.5%的BFRB患者曾就其BFRB寻求专业帮助（主要是心理学家）。障碍包括缺乏意识、感觉症状严重程度低、羞耻和对治疗的不信任。自助的使用很常见（72.2%）。然而，只有少数人使用结构化和基于证据的技术，如习惯逆转训练或脱钩。对于那些最终寻求帮助的人来说，未经治疗的bfrb平均持续时间约为11年，其中cavitadaxia显示出最长的延迟。在接受专业护理的患者中，约40%的人没有得到循证建议。习惯逆转训练是最常被推荐的方法，其次是药物治疗和习惯替代。结论：尽管bfrb带来了巨大的负担，但寻求治疗的人数仍然很低。羞耻感、错误信息以及接触专业人士的机会有限仍然是主要障碍。这些发现突出表明，迫切需要提高认识，提供可获得的干预措施和低门槛的专业培训机会（例如www.uke.de/e-bfrb-en），以改善对bfrb患者的护理。

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引用次数: 0

Intolerance of uncertainty and symptom-level associations between generalized anxiety and depression in adolescence: A large-scale subgroup network analysis 青少年广泛性焦虑和抑郁之间的症状水平相关性：大规模亚群网络分析。

IF 4.8 2区医学 Q1 PSYCHIATRY

Comprehensive psychiatry

Pub Date : 2026-07-01 Epub Date: 2026-06-15 DOI: 10.1016/j.comppsych.2026.152730

Haoxian Ye, Dan Chen, Shiyi Lin, Zifan Cai, Sisi He, Fang Fan

Background

Intolerance of uncertainty (IU), defined as a dispositional tendency to perceive uncertain situations as distressing and unacceptable, is increasingly recognized as a transdiagnostic risk factor for internalizing psychopathology such as generalized anxiety and depression, particularly during adolescence. However, its role in the organization of symptom-level associations between these conditions remains unclear. This study examined whether generalized anxiety-depression symptom networks differed between adolescents with high versus low levels of IU using a network analytic framework.

Methods

A large-scale longitudinal sample of 53,872 school-aged youths from southern China (M _age-baseline = 13.00 years, SD _age-baseline = 1.79, aged 9–19; 46.8% were girls) completed assessments of generalized anxiety and depressive symptoms at two time points over a six-month interval. Participants were categorized into high- and low-IU groups based on their IU scale scores. Cross-sectional symptom networks and cross-lagged panel networks were estimated separately for the two groups to compare symptom-level associations between generalized anxiety and depression across IU-defined subgroups.

Results

Compared with the low-IU group, adolescents with high IU exhibited more densely connected cross-sectional symptom networks and stronger longitudinal associations between generalized anxiety and depressive symptoms. Within the high-IU network, uncontrollable worry demonstrated the strongest outgoing temporal connectivity, whereas excessive worry showed the strongest incoming temporal connectivity.

Conclusions

These findings suggest that generalized anxiety-depression symptom networks differ across adolescents with high versus low levels of IU. Adolescents with high IU exhibited more strongly interconnected internalizing symptom networks and more pronounced longitudinal symptom associations over time, which highlights IU as a potentially important factor related to the organization of internalizing symptom networks during adolescence. Findings may help inform future prevention and intervention efforts targeting IU and worry-related cognitive processes (e.g., uncontrollable worry).

背景：不确定性不耐受（IU），被定义为一种将不确定情境视为痛苦和不可接受的性格倾向，越来越被认为是内化精神病理（如广泛性焦虑和抑郁）的一种跨诊断风险因素，尤其是在青春期。然而，它在这些疾病之间的症状水平关联的组织中的作用仍不清楚。本研究使用网络分析框架检查了高IU水平和低IU水平的青少年之间的广义焦虑-抑郁症状网络是否存在差异。方法：对53,872名来自中国南方的学龄青少年（M年龄基线= 13.00岁，SD年龄基线= 1.79，年龄9-19岁，其中46.8%为女孩）进行大规模纵向抽样，在6个月间隔的两个时间点完成广泛性焦虑和抑郁症状的评估。参与者根据IU量表得分分为高IU组和低IU组。分别估计两组的横截面症状网络和交叉滞后面板网络，以比较iu定义的亚组中广泛性焦虑和抑郁之间的症状水平关联。结果：与低IU组相比，高IU组的青少年表现出更紧密连接的横截面症状网络，以及更强的广泛性焦虑和抑郁症状之间的纵向关联。在高iu网络中，不可控的担忧表现出最强的输出时间连接，而过度的担忧表现出最强的输入时间连接。结论：这些发现表明，在高IU水平和低IU水平的青少年中，广泛性焦虑-抑郁症状网络是不同的。随着时间的推移，高IU的青少年表现出更强的内化症状网络的相互联系和更明显的纵向症状关联，这表明IU是一个潜在的重要因素，与青春期内化症状网络的组织有关。研究结果可能有助于为未来针对IU和焦虑相关认知过程（例如，无法控制的担忧）的预防和干预工作提供信息。

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引用次数: 0

Neuroimaging insights on sleep disturbances and risk for major depressive disorder in youth: A systematic review 青少年睡眠障碍和重度抑郁症风险的神经影像学研究：一项系统综述。

IF 4.8 2区医学 Q1 PSYCHIATRY

Comprehensive psychiatry

Pub Date : 2026-07-01 Epub Date: 2026-06-13 DOI: 10.1016/j.comppsych.2026.152728

Nicolas Gauthier, Laiba Irfan Butt, Sidney H. Kennedy, Venkat Bhat, Andre C. Tonon, Katharine Dunlop

Background

Sleep is critical for brain function and cognitive development, especially in children and adolescents. Sleep disturbances or insufficient sleep may pose a risk for poor long-term health outcomes, including major depressive disorder (MDD). This systematic review sought to the neurobiological relationship between sleep and risk for future depressive disorders or symptoms.

Methods

A pre-registered, systematic search was conducted using MEDLINE, PsychInfo, and Embase databases from January 2000 to February 2025. Studies included investigated neurobiological changes related to sleep in predicting subsequent risk for first episode MDD or depressive symptoms in children, adolescents, and young adults (mean age < 30 years). We narratively synthesized the results and completed a quality assessment using a modified Newcastle-Ottawa scale.

Results

The search yielded four cross-sectional studies comparing high and low MDD risk individuals, and seven longitudinal studies predicting risk of future depressive symptoms. Sleep neurophysiological markers like rapid eye movement latency and sleep spindle density, white matter integrity in the cingulum bundle and superior longitudinal fasciculus, and activity within the salience network and dorsomedial prefrontal cortex associated with sleep quality and differed in individuals with an increased risk for MDD. A low-to-moderate risk of bias was detected among all studies.

Conclusions

Due to the limited number of studies and methodological heterogeneity, the highlighted evidence remains preliminary. This review emphasizes the importance of addressing sleep problems in youth before they potentially contribute to lasting changes in emotional and mental health, as well as the need to further study the relationship between sleep disturbances and risk for MDD.

背景：睡眠对大脑功能和认知发展至关重要，尤其是儿童和青少年。睡眠障碍或睡眠不足可能对不良的长期健康结果构成风险，包括重度抑郁症（MDD）。这篇系统综述试图找出睡眠与未来抑郁障碍或症状风险之间的神经生物学关系。方法：2000年1月至2025年2月，采用MEDLINE、PsychInfo和Embase数据库进行预登记、系统检索。研究包括调查了与睡眠相关的神经生物学变化，以预测儿童、青少年和年轻人（平均年龄）首次发作MDD或抑郁症状的后续风险。结果：搜索产生了四项比较高和低MDD风险个体的横断面研究，以及七项预测未来抑郁症状风险的纵向研究。睡眠神经生理指标，如快速眼动潜伏期和睡眠纺锤体密度，扣带束和上纵束的白质完整性，以及突出网络和背内侧前额叶皮层的活动与睡眠质量相关，并且在MDD风险增加的个体中有所不同。所有研究均存在低至中等偏倚风险。结论：由于研究数量有限和方法异质性，突出的证据仍然是初步的。这篇综述强调了解决青少年睡眠问题的重要性，在它们可能导致情绪和心理健康的持久变化之前，以及进一步研究睡眠障碍与重度抑郁症风险之间的关系的必要性。

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引用次数: 0

Interpersonal problems across anxiety and depressive disorders 人际关系问题跨越焦虑和抑郁障碍。

IF 4.8 2区医学 Q1 PSYCHIATRY

Comprehensive psychiatry

Pub Date : 2026-07-01 Epub Date: 2026-06-11 DOI: 10.1016/j.comppsych.2026.152726

Jacqueline Peters, Marije aan het Rot

Individuals with a Diagnostic and Statistical Manual of Mental Disorders (DSM) anxiety or depressive disorder tend to report a lack of agency in social situations. Agency represents one dimension in the interpersonal circumplex model while communion represents the other dimension. In the present study, we mapped six anxiety and depressive disorders examined within the Netherlands Study of Depression and Anxiety (NESDA) onto this model. To this end, we used the structural summary method to reduce Inventory of Interpersonal Problems scores of NESDA Wave 6 participants with a current diagnosis (n = 412) to interpersonal profiles for each of the six examined disorders. The Displacement parameter represents the blend of agency and communion and provided insight into which interpersonal problem theme is most characteristic for a disorder. Amplitude represents the distinctiveness of this theme, and Elevation provides an indication of the level of general interpersonal distress associated with the disorder. Unexpectedly, general interpersonal distress was highest for dysthymia, not major depressive disorder. As expected, however, all disorders (social phobia, generalized anxiety disorder, panic disorder, agoraphobia, dysthymia, and major depressive disorder) were primarily characterized by a submissive interpersonal style. Additionally, we found greater general interpersonal distress among participants with comorbid anxiety and depression than among participants with depression or anxiety alone. The main finding was that the different anxiety and depressive disorders had comparable interpersonal profiles. This supports the notion that interpersonal style may be a transdiagnostic factor in the emergence and maintenance of these disorders, contributing to interpersonal distress particularly in individuals with comorbid disorders.

患有精神障碍诊断与统计手册（DSM）焦虑症或抑郁症的个体倾向于报告在社交场合缺乏能动性。在人际循环模型中，代理代表一个维度，交流代表另一个维度。在本研究中，我们将荷兰抑郁与焦虑研究（NESDA）中检测的六种焦虑和抑郁障碍映射到该模型上。为此，我们使用结构总结方法将NESDA第6波当前诊断的参与者（n = 412）的人际关系问题量表得分降低到六种被检查障碍的人际关系概况。位移参数代表代理和交流的混合，并提供洞察哪种人际问题主题是最典型的障碍。振幅代表了这个主题的独特性，而海拔提供了与该障碍相关的一般人际困扰水平的指示。出乎意料的是，一般人际关系困扰在心境恶劣中最高，而不是重度抑郁症。然而，正如预期的那样，所有的障碍（社交恐惧症、广泛性焦虑障碍、恐慌障碍、广场恐怖症、心境恶劣和重度抑郁症）主要以顺从的人际关系方式为特征。此外，我们发现，与单独患有抑郁或抑郁的参与者相比，同时患有焦虑和抑郁的参与者更普遍的人际关系困扰。主要的发现是，不同的焦虑和抑郁障碍有相似的人际关系特征。这支持了这样一种观点，即人际关系风格可能是这些疾病出现和维持的一个跨诊断因素，尤其是在患有共病疾病的个体中，它会导致人际关系困扰。

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引用次数: 0

Stroop task data does not improve prediction of CBT partial hospital treatment outcomes beyond routine clinical data: An elastic net analysis Stroop任务数据在常规临床数据之外并不能改善CBT部分医院治疗结果的预测：弹性网分析。

IF 4.8 2区医学 Q1 PSYCHIATRY

Comprehensive psychiatry

Pub Date : 2026-07-01 Epub Date: 2026-07-02 DOI: 10.1016/j.comppsych.2026.152732

Jenna M. Traynor, Chloe C. Hudson, Boyu Ren, Courtney Beard, Throstur Bjorgvinsson, Marie Forgeard, Kean J. Hsu

Background

Partial hospitalization is a psychiatric treatment for patients who require structured, intensive outpatient intervention, many of whom present with features of borderline personality disorder (BPD). Findings to date suggest that baseline clinical severity and demographic characteristics are predictive of partial hospital outcomes, but it is possible that prediction could be further improved by including cognitive data into predictive models.

Methods

Naturalistic data from 113 patients admitted to a brief CBT partial hospital were analyzed. Elastic net regression was employed to compare prediction of four outcomes using i) baseline severity and demographics only and ii) models that included cognitive data derived from Classic and Emotional Stroop Tasks. Interactions between BPD trait severity and Stroop performance were also included as predictors in the Stroop Task models. Predicted outcomes included depression, interpersonal functioning, emotional lability, and self-harm ideation.

Results

Including Stroop Task data did not improve the prediction outcomes. RMSE values for models with and without data from the Stroop Tasks were virtually equivalent or differed in magnitude by only 0.1 on the five-point outcome scale. Baseline symptom severity was the most robust predictor of all outcomes.

Conclusions

The addition of Stroop Task data did not improve prediction of partial hospital outcomes in a naturalistic sample. Findings underscore the importance of examining clinical data routinely collected at admission when considering who may benefit from a partial hospital treatment.

背景：部分住院治疗是一种精神病学治疗方法，用于需要有组织的、密集的门诊干预的患者，其中许多人表现出边缘性人格障碍（BPD）的特征。迄今为止的研究结果表明，基线临床严重程度和人口统计学特征可以预测部分医院结果，但通过将认知数据纳入预测模型，预测可能会进一步改善。方法：对113例短期CBT住院患者的自然资料进行分析。采用弹性网络回归来比较四种结果的预测：i)仅使用基线严重程度和人口统计数据，ii)包括来自经典和情感Stroop任务的认知数据的模型。BPD特质严重程度与Stroop表现之间的相互作用也被纳入Stroop任务模型作为预测因子。预测结果包括抑郁、人际功能、情绪不稳定和自残想法。结果：纳入Stroop任务数据并没有改善预测结果。在五分制结果量表上，有和没有Stroop任务数据的模型的RMSE值实际上相等或仅相差0.1。基线症状严重程度是所有结果中最可靠的预测因子。结论：Stroop任务数据的增加并没有改善自然样本中部分医院预后的预测。研究结果强调了在考虑谁可能从部分医院治疗中受益时，检查入院时常规收集的临床数据的重要性。

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引用次数: 0

Probable obsessive-compulsive disorder among youth in Singapore: Prevalence, sociodemographic correlates, and the association with psychological distress, harmful alcohol use and functional impairment 新加坡青少年中可能的强迫症：患病率、社会人口学相关性以及与心理困扰、有害酒精使用和功能障碍的关系

IF 4.8 2区医学 Q1 PSYCHIATRY

Comprehensive psychiatry

Pub Date : 2026-07-01 Epub Date: 2026-06-30 DOI: 10.1016/j.comppsych.2026.152731

S. Archana, J.A. Vaingankar, B.C.W. Tan, S. Chang, Y.W.B. Tan, E. Samari, Y.C. Chua, Y.P. Lee, C. Tang, S.A. Chong, K.R.R. Krishnan, M. Subramaniam, S. Verma

Background

Obsessive-compulsive disorder (OCD) is a debilitating mental health condition with comparatively increased prevalence in Singapore. However, little is known about the prevalence of OCD among youth. Therefore, this study aims to examine the prevalence of probable OCD, explore its sociodemographic correlates, and investigate its associations with psychological distress (depression, anxiety, and stress), harmful alcohol use, and functional impairment among youth in Singapore.

Methods

2600 youth aged 15–35 were recruited via convenience sampling for the National Youth Mental Health Study, a cross-sectional nationwide survey. Information on sociodemographic background, probable OCD, psychological distress, harmful alcohol use and functional impairment was collected using a self-administered questionnaire. Associations were examined using logistic regression.

Results

The point prevalence of probable OCD was 22.1% among youth in Singapore. Significantly higher odds of probable OCD were observed among youths aged 15–19 and 20–24 (vs. 30–35), of Indian, Malay and other ethnicities (vs. Chinese), and those with educational attainment below university level (vs. university and above). Economically inactive youth had significantly lower odds of probable OCD. Youth with severe to very severe symptoms of psychological distress and functional impairment were also significantly more likely to exhibit probable OCD.

Conclusion

Probable OCD is highly prevalent among youth in Singapore, with elevated risk among specific sub-populations. Our findings emphasize the urgent need for comprehensive screening and tailored intervention, particularly for those with severe to very severe symptoms of psychological distress and functional impairment.

背景：强迫症（OCD）是一种使人衰弱的精神健康状况，在新加坡的患病率相对较高。然而，人们对青少年强迫症的患病率知之甚少。因此，本研究旨在研究新加坡青少年中可能的强迫症的患病率，探讨其社会人口学相关性，并调查其与心理困扰（抑郁、焦虑和压力）、有害酒精使用和功能障碍的关系。方法：采用方便抽样的方法，在全国青少年心理健康调查中招募了2600名15-35岁的青少年。通过自我管理的问卷收集了社会人口背景、可能的强迫症、心理困扰、有害酒精使用和功能障碍方面的信息。使用逻辑回归检验相关性。结果：新加坡青少年疑似强迫症的点患病率为22.1%。在15-19岁和20-24岁的年轻人（30-35岁），印度人、马来人和其他种族的年轻人（与华人相比），以及受教育程度低于大学水平的年轻人（与大学及以上）中，可能出现强迫症的几率明显更高。不从事经济活动的年轻人患强迫症的几率明显较低。有严重到非常严重的心理困扰和功能障碍症状的青少年也更有可能表现出可能的强迫症。结论：可能的强迫症在新加坡年轻人中非常普遍，在特定亚人群中风险较高。我们的研究结果强调，迫切需要进行全面的筛查和量身定制的干预，特别是对那些有严重到非常严重的心理困扰和功能障碍症状的人。

{"title":"Probable obsessive-compulsive disorder among youth in Singapore: Prevalence, sociodemographic correlates, and the association with psychological distress, harmful alcohol use and functional impairment","authors":"S. Archana, J.A. Vaingankar, B.C.W. Tan, S. Chang, Y.W.B. Tan, E. Samari, Y.C. Chua, Y.P. Lee, C. Tang, S.A. Chong, K.R.R. Krishnan, M. Subramaniam, S. Verma","doi":"10.1016/j.comppsych.2026.152731","DOIUrl":"10.1016/j.comppsych.2026.152731","url":null,"abstract":"<div><h3>Background</h3><div>Obsessive-compulsive disorder (OCD) is a debilitating mental health condition with comparatively increased prevalence in Singapore. However, little is known about the prevalence of OCD among youth. Therefore, this study aims to examine the prevalence of probable OCD, explore its sociodemographic correlates, and investigate its associations with psychological distress (depression, anxiety, and stress), harmful alcohol use, and functional impairment among youth in Singapore.</div></div><div><h3>Methods</h3><div>2600 youth aged 15–35 were recruited via convenience sampling for the National Youth Mental Health Study, a cross-sectional nationwide survey. Information on sociodemographic background, probable OCD, psychological distress, harmful alcohol use and functional impairment was collected using a self-administered questionnaire. Associations were examined using logistic regression.</div></div><div><h3>Results</h3><div>The point prevalence of probable OCD was 22.1% among youth in Singapore. Significantly higher odds of probable OCD were observed among youths aged 15–19 and 20–24 (vs. 30–35), of Indian, Malay and other ethnicities (vs. Chinese), and those with educational attainment below university level (vs. university and above). Economically inactive youth had significantly lower odds of probable OCD. Youth with severe to very severe symptoms of psychological distress and functional impairment were also significantly more likely to exhibit probable OCD.</div></div><div><h3>Conclusion</h3><div>Probable OCD is highly prevalent among youth in Singapore, with elevated risk among specific sub-populations. Our findings emphasize the urgent need for comprehensive screening and tailored intervention, particularly for those with severe to very severe symptoms of psychological distress and functional impairment.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"149 ","pages":"Article 152731"},"PeriodicalIF":4.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148387391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effectiveness of electroconvulsive therapy for depression: comparing research studies with real-world clinical data from the Dutch ECT consortium 电痉挛治疗抑郁症的有效性：比较研究与荷兰电痉挛联盟的真实临床数据。

IF 4.2 2区医学 Q1 PSYCHIATRY

Comprehensive psychiatry

Pub Date : 2026-06-01 Epub Date: 2026-05-26 DOI: 10.1016/j.comppsych.2026.152723

Robin C. Cobben , Dore Loef , Edwin van Dellen , Karin Hagoort , Peter M. van de Ven , Bart Schut , Anja Lok , Roel J.T. Mocking , Karel W.F. Scheepstra , Eric van Exel , Mardien L. Oudega , Birit F.P. Broekman , Anton C.M. Vergouwen , Thomas J.C. Zoon , Rob M. Kok , Milou Angevaare , Esmée Verwijk , Jordy J.E. Rovers , Indira Tendolkar , Julia C.M. Pottkämper , Annemiek Dols

Background

Electroconvulsive therapy (ECT) is an effective treatment for major depressive disorder, yet real-world outcomes may differ from research studies. We compared ECT effectiveness in research versus real-world cohorts and examined whether in- and exclusion criteria and treatment characteristics explain potential differences.

Method

1892 patients with MDD from the Dutch ECT Consortium (12 research, 10 real-world cohorts) were included. Outcomes were response (≥50% HDRS reduction), remission (HDRS <8), and change in depression severity (Δ-HDRS). Cohorts were compared on effectiveness and demographic, clinical and treatment characteristics. Logistic and linear regression estimated associations between cohort type and outcomes, unadjusted and adjusted for in- and exclusion criteria and additional clinical confounders.

Results

Research cohorts demonstrated higher response rates (66.8% vs. 58.9%, OR 1.46, 95% CI [1.09–1.95]) and greater symptom reduction (B 2.88, 95% CI [1.86–3.90]), while remission rates did not differ significantly. Cohorts differed on several clinical and treatment characteristics, partly reflecting in- and exclusion criteria used in research cohorts. After adjusting for these selection criteria, differences in response and Δ-HDRS were no longer significant (OR 1.20, 95% CI [0.86–1.69]; B 0.61, 95% CI [−0.29–1.51]). Adjustment for additional confounders marginally changed these estimates. In sensitivity analyses restricted to mixed-sites, differences were not significant in unadjusted and adjusted models.

Conclusion

In the Dutch ECT consortium, ECT demonstrates comparable effectiveness across research and real-world settings once patient selection is accounted for. These findings underscore the importance of considering cohort composition when interpreting treatment outcomes.

背景：电痉挛疗法（ECT）是一种治疗重度抑郁症的有效方法，但实际结果可能与研究结果不同。我们比较了研究中的ECT疗效与现实世界中的ECT疗效，并检查了入选标准和排除标准以及治疗特征是否能解释潜在的差异。方法：1892例重度抑郁症患者来自荷兰电痉挛疗法协会（Dutch ECT Consortium）（12项研究，10个现实世界队列）。结果为缓解（HDRS降低≥50%）、缓解(HDRS结果：研究队列显示更高的缓解率（66.8% vs. 58.9%, OR 1.46, 95% CI[1.09-1.95]）和更大的症状减轻（b2.88, 95% CI[1.86-3.90]），而缓解率无显著差异。队列在一些临床和治疗特征上存在差异，部分反映了研究队列中使用的纳入标准和排除标准。调整这些选择标准后，反应和Δ-HDRS的差异不再显著（OR为1.20,95% CI [0.86-1.69]； B为0.61,95% CI[-0.29-1.51]）。对其他混杂因素的调整略微改变了这些估计。在仅限于混合站点的敏感性分析中，未调整和调整模型的差异不显著。结论：在荷兰ECT联盟中，一旦考虑到患者的选择，ECT在研究和现实环境中都显示出相当的有效性。这些发现强调了在解释治疗结果时考虑队列组成的重要性。

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引用次数: 0