Comprehensive psychiatry最新文献

{"title":"Machine learning analysis of clinical, psychological and sociodemographic factors predicting mental well-being in patients with severe mental illness: Insights from the French REHABase cohort","authors":"Quentin Adrian ,&nbsp;Renaud F. Cohen ,&nbsp;Julien Plasse ,&nbsp;Isabelle Chéreau-Boudet ,&nbsp;Benjamin Gouache ,&nbsp;Emilie Legros-Lafarge ,&nbsp;Catherine Massoubre ,&nbsp;Nathalie Guillard-Bouhet ,&nbsp;Léon Temblay ,&nbsp;Nicolas Franck ,&nbsp;Guillaume Barbalat","doi":"10.1016/j.comppsych.2025.152651","DOIUrl":"10.1016/j.comppsych.2025.152651","url":null,"abstract":"<div><h3>Purpose</h3><div>Mental well-being is a cornerstone of recovery for people with mental disorders. Unfortunately, despite many studies on the topic, the literature still lacks results from large samples processed using advanced models capable of taking numerous variables into account. This study aims to leverage robust machine learning techniques on data from the REHABase cohort to identify key predictors of mental well-being in patients with severe mental disorders, with a particular focus on schizophrenia.</div></div><div><h3>Methods</h3><div>In all, 47 clinical, psychological, and sociodemographic variables were selected. Three distinct samples were analyzed: all patients (<em>n</em> = 2206), schizophrenia patients (<em>n</em> = 1136) and non-schizophrenia patients (<em>n</em> = 1070). The performances of 3 machine learning algorithms were compared: regularized linear regression, random forest, and gradient boosting with tenfold cross-validation.</div></div><div><h3>Results</h3><div>The regularized linear regression model was found to be the best performing in terms of generalizability. Results highlighted the influence of the internalized stigmatization subscales of resistance, resilience, and alienation alongside the resilience dimension of quality of life in predicting mental well-being across all of the disorders. For schizophrenia patients, mental well-being was primarily predicted by social withdrawal.</div></div><div><h3>Conclusion</h3><div>Using advanced machine learning methodology on a large sample of patients with transdiagnostic exploration, our results showed both the crucial role of resilience and resistance to stigma in overall mental well-being and the critical importance of social contact in schizophrenia. These insights should help improve care trajectories for individuals with severe psychopathologies, particularly by promoting social cognitive remediation in schizophrenia.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"145 ","pages":"Article 152651"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research protocol for BootStRaP assessment phase: A nine-nation study on boosting societal adaptation and mental health in a rapidly digitalising, post-pandemic Europe","authors":"Naomi A. Fineberg ,&nbsp;Annika Brandtner ,&nbsp;Nana Löchner ,&nbsp;Christopher Kannen ,&nbsp;Megan Smith ,&nbsp;Simon Foster ,&nbsp;Anita Meinke ,&nbsp;Kristin Mosler ,&nbsp;Shai Fine ,&nbsp;Lior Carmi ,&nbsp;Talia Friedman ,&nbsp;Zsolt Demetrovics ,&nbsp;Célia Sales ,&nbsp;Julia Jones ,&nbsp;Hernâni Oliveira ,&nbsp;Samuel R. Chamberlain ,&nbsp;Konstantinos Ioannidis ,&nbsp;Katalin Felvinczi ,&nbsp;Joseph Zohar ,&nbsp;Andres Roman-Urrestarazu ,&nbsp;Matthias Brand","doi":"10.1016/j.comppsych.2025.152653","DOIUrl":"10.1016/j.comppsych.2025.152653","url":null,"abstract":"<div><h3>Background</h3><div>There is increasing global concern about the harms associated with problematic usage of the internet (PUI) affecting young people. Various risk factors have been proposed, but there is a scarcity of reliable evidence on the extent of the problem, who is most at risk of developing PUI and why, and how best to tackle it.</div></div><div><h3>Objectives</h3><div>BootStRaP (ISRCTN59576080) is a five-year multinational research programme designed to boost young people's health and resilience by determining, through prospective longitudinal assessment, the risk factors associated with PUI and its health economic impact and designing and testing preventative self-management interventions tailored to individual risk factors.</div></div><div><h3>Methods</h3><div>This paper describes the first phase of the project (i.e., Cohort 1). A sample of over 2500 schoolchildren aged 12–16 years was recruited across nine European countries. They were prospectively monitored over a 6-month period using a dedicated smartphone application (<em>BootstrApp</em>), through which their internet use habits, health and wellbeing were measured. Young people were involved in the co-design of aspects of the protocol including the recruitment plan and elements of the app design. The components of the assessment battery were chosen to investigate specific individual, clinical, cognitive and environmental risk determinants as defined a priori in an evidence-based logic-model. Participants were assessed using a combination of standardised demographic and clinical questionnaires, ambulatory assessment techniques, cognitive testing and passive digital monitoring. Multimodal data is analysed according to machine learning and structured equation modelling.</div></div><div><h3>Expected outcomes</h3><div>Our findings will contribute toward A) developing algorithms for predicting individuals at risk for PUI, B) identifying actionable variables for application to subjects as interventions for testing in the second phase of the project, C) validating risk hypotheses stated in the logic model of PUI including the interplay between predisposing risk factors (e.g., impulsivity, compulsivity), affective and cognitive processes (e.g., reward-related attentional biases), and executive functions (e.g., inhibitory control), D) calculating the health economic cost and impact of PUI in young people across Europe.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"145 ","pages":"Article 152653"},"PeriodicalIF":4.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A remotely-applied, cognitive control-based video game intervention to reduce depressive symptoms in a sub-clinical population: A randomized controlled trial (RCT)","authors":"Noa Givon Schacham ,&nbsp;Angela Pasqualotto ,&nbsp;Naamah Lerner ,&nbsp;Marios Fanourakis ,&nbsp;Zeno Menestrina ,&nbsp;Daphne Bavelier ,&nbsp;Mor Nahum","doi":"10.1016/j.comppsych.2025.152645","DOIUrl":"10.1016/j.comppsych.2025.152645","url":null,"abstract":"<div><div>Depressive symptoms are prevalent among young adults, with cognitive theories suggesting that impaired cognitive control contributes to sustained negative mood and depressive symptoms. This study investigated the feasibility and efficacy of a remotely-applied, tablet-based cognitive control video game, <em>Legends of Hoa'manu</em> (LoH), for reducing depressive symptoms in subclinical adults.</div><div>A randomized controlled trial (<span><span>NCT05447091</span><svg><path></path></svg></span>) was conducted with 173 participants (mean age 33 ± 11.6 years; 75.1 % female) exhibiting at least a minimal level of depressive symptoms (PHQ-8 ≥ 5). Participants were randomized into three groups: high-dose experimental game (HD_EG; <em>N</em> = 58), low-dose experimental game (LD_EG; <em>N</em> = 61), and high-dose control game (HD_CG; <em>N</em> = 54), with interventions spanning three weeks.</div><div>The intervention demonstrated high feasibility and adherence (69.5–76.5 % of sessions completed) without direct study contact. Overall depressive symptoms (BDI-II total score) improved across all groups, with a significant main effect of time, but no significant group differences. Still, group differences were found for the cognitive-affective BDI-II subscale, where the HD_EG group showed the largest reduction (4.5 points vs. 2.3 and 2.1 in the LD_EG and HD_CG, respectively). These improvements were maintained at 3-week and 3-month follow-ups. Secondary outcomes, including anxiety and rumination, also improved across all groups. Overall cognitive control performance did not differ between groups; however, significant improvements in inhibitory control emerged exclusively in the HD_EG group.</div><div>The results highlight the feasibility of this novel, cost-effective, and remotely-applied cognitive control-based intervention. These findings underscore the potential of LoH as a scalable solution for addressing depressive symptoms in subclinical populations.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"144 ","pages":"Article 152645"},"PeriodicalIF":4.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145444367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Loneliness and the emergence of problematic online behaviours in young adults: A cross-lagged panel network analysis","authors":"Marta Błoch,&nbsp;Błażej Misiak","doi":"10.1016/j.comppsych.2025.152646","DOIUrl":"10.1016/j.comppsych.2025.152646","url":null,"abstract":"<div><h3>Background</h3><div>Loneliness is a public health priority due to its high prevalence and impact on various health outcomes. It might be associated with problematic internet use that is highly prevalent in young adults. However, its associations with specific problematic online behaviours (POBs) at their early stages of development remains unknown. The present study explored longitudinal associations between loneliness and various POBs in a general population sample of young adults without a history of psychiatric treatment.</div></div><div><h3>Methods</h3><div>Altogether, 1441 individuals were assessed at baseline (aged 29.5 ± 6.3 years, 51.4 % women). The follow-up assessment was scheduled after 6 months and was completed by 733 individuals (aged 30.5 ± 6.0 years, 49.1 % women, retention rate of 50.9 %). The data were collected using self-reports and analyzed using a cross-lagged panel network model.</div></div><div><h3>Results</h3><div>Higher baseline levels of loneliness predicted higher levels of problematic cybersex, depressive symptoms, and anxiety symptoms at the follow-up. In turn, higher levels of loneliness were predicted by higher baseline levels of problematic online gaming, cyberchondria, and depressive symptoms. The highest output centrality was found for problematic online gaming and shopping. Loneliness was ranked among the nodes with the lowest output centrality in the network. However, it showed the highest auto-regressive effect suggesting its high stability over time.</div></div><div><h3>Conclusions</h3><div>The findings indicate that loneliness is bidirectionally associated with POBs with problematic online gaming, cyberchondria, and cybersex playing the most important roles in these associations. These observations indicate the necessity to consider loneliness among therapeutic targets among individuals with POBs.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"144 ","pages":"Article 152646"},"PeriodicalIF":4.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145573395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trichotillomania, skin picking disorder, and pregnancy","authors":"Jon E. Grant ,&nbsp;Megha Neelapu ,&nbsp;Laurie Avila ,&nbsp;Sophia Boutouis ,&nbsp;Samuel R. Chamberlain","doi":"10.1016/j.comppsych.2025.152647","DOIUrl":"10.1016/j.comppsych.2025.152647","url":null,"abstract":"<div><h3>Background</h3><div>Trichotillomania (hair pulling disorder) and skin picking disorder have typical age of onset around puberty, and appear more common in women than in men, suggesting the possibility that hormonal systems may relate to symptoms. Yet virtually no research has explored relationships between pregnancy (and the post-partum period) and symptom severity in people affected by these conditions.</div></div><div><h3>Methods</h3><div>People with trichotillomania and/or skin picking disorder were recruited from the general community if they had previously experienced at least one pregnancy during their lifetimes. Data were collected regarding perceived relationships between symptom severity, pregnancy, and the post-partum period.</div></div><div><h3>Results</h3><div>Whilst some women reported an exacerbation of hair pulling and/or skin picking during pregnancy or in the perinatal period, the majority of women reported no change or even reductions in such symptoms during these times.</div></div><div><h3>Conclusions</h3><div>These data suggest that relationships between pregnancy and hair pulling plus skin picking symptoms can vary depending on the individual. Future work could examine these relationships at the time of pregnancy and afterwards, rather than using retrospective questionnaires; and could also collect biological measures to help explore any underlying mechanisms that may account for this variation in symptoms.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"144 ","pages":"Article 152647"},"PeriodicalIF":4.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145548623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adaptation, implementation, and evaluation of a protective mental health intervention (Resilient minds) for Canadian volunteer firefighters","authors":"Joy C. MacDermid ,&nbsp;Shannon C. Killip ,&nbsp;Amanda Brazil ,&nbsp;Margaret Lomotan ,&nbsp;Steve Fraser ,&nbsp;Dianne Bryant ,&nbsp;Heidi Cramm ,&nbsp;R. Nicholas Carleton","doi":"10.1016/j.comppsych.2025.152643","DOIUrl":"10.1016/j.comppsych.2025.152643","url":null,"abstract":"<div><h3>Purpose</h3><div>The study was designed to assess the adaptation, implementation, and delivery of the Resilient Minds program for volunteer firefighters in Prince Edward Island.</div></div><div><h3>Methods</h3><div>A concurrent triangulation mixed-methods approach was used. Survey data were collected from firefighters who participated in the training, and semi-structured interviews were performed with peer trainers, members of leadership, and firefighters who participated in the implementation. Summary statistics were performed to summarize the survey data, and thematic analysis was performed to analyze the qualitative data following interpretive description methods. We followed the Consolidated Framework for Implementation Research to guide our data collection and analyses.</div></div><div><h3>Results</h3><div>The relative advantage of Resilient Minds (i.e., created for firefighters) and the high-priority need for mental health training promoted buy-in from stakeholders and facilitated program implementation. Most participants described the training as helpful (84 %), and reported high intention to use the information (86 %). At three-month follow-up, most reported being able to recall the training (83 %), and reported increased support from colleagues (59 %) and leadership (50 %). Our qualitative data identified improvements in coping and awareness of mental health issues, and decreases in mental health stigma. Suggestions were provided to improve the adaptation and implementation (e.g., simplifying the content, obtaining funding).</div></div><div><h3>Conclusion</h3><div>Our results support the adaptation, implementation, and delivery of Resilient Minds among Canadian volunteer firefighters. Scaled delivery of the training across Canada will require collaborations among the developers, local implementation leads, and other stakeholders in the local fire services to adapt the course content and implementation procedures for the needs of each fire department.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"144 ","pages":"Article 152643"},"PeriodicalIF":4.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic and clinical characteristics associated with antidepressant-induced mania in depression patients","authors":"Shiau-Shian Huang ,&nbsp;Ying-Ting Chao ,&nbsp;Yu-Ning Chen ,&nbsp;Mei-Hsin Su ,&nbsp;Chiao-Erh Chang ,&nbsp;Shih-Jen Tsai ,&nbsp;Po-Hsiu Kuo","doi":"10.1016/j.comppsych.2025.152648","DOIUrl":"10.1016/j.comppsych.2025.152648","url":null,"abstract":"<div><h3>Introduction</h3><div>Antidepressant-induced mania (AIM) is a significant clinical concern, primarily studied in bipolar disorder patients. Limited research exists on AIM in unipolar depression, with reported incidence rates of 3.0–8.2 %.</div></div><div><h3>Methods</h3><div>Using data from the Taiwan's National Health Insurance Research Database merged with Taiwan Biobank (2001–2017), we analyzed 772 depression patients who were prescribed antidepressants and had available genotype data. A genome-wide association study (GWAS) was performed to investigate potential genetic factors associated with AIM. Single-marker association analysis and polygenic risk scores were calculated using PLINK.</div></div><div><h3>Results</h3><div>AIM developed in 145 (19.65 %) of depressive patients within 28 days of medication use or discontinuation. Significant associated clinical characteristics included female gender, postpartum depression, comorbid obsessive-compulsive disorder, severe depression, substance use disorders, and other non-organic psychosis. Eight single nucleotide polymorphisms were identified as potential genetic markers associated with AIM in this GWAS, and higher polygenic risk scores for bipolar disorder were associated with increased AIM risk.</div></div><div><h3>Conclusion</h3><div>AIM was observed in one-fifth of depressive patients of the Han Chinese origin, with female gender and psychiatric comorbidities as significant clinical characteristics. This GWAS of AIM in depressive patients identified potential genetic markers and suggested that a genetic predisposition to bipolar disorder may increase the likelihood of developing AIM, although this association did not reach statistical significance. Future research should aim to increase sample size and further investigate genotype-AIM associations.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"144 ","pages":"Article 152648"},"PeriodicalIF":4.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145577144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term risk of psychiatric disorders in women with endometriosis: A retrospective cohort study","authors":"Yu-Hsiang Shih ,&nbsp;Shao-Jing Wang ,&nbsp;Chun-Ting Fan ,&nbsp;Ting-Fang Lu ,&nbsp;Yen-Fu Chen ,&nbsp;Lou Sun ,&nbsp;Shih-Tien Hsu ,&nbsp;Jenn-Jhy Tseng ,&nbsp;Chien-Hsing Lu","doi":"10.1016/j.comppsych.2025.152649","DOIUrl":"10.1016/j.comppsych.2025.152649","url":null,"abstract":"<div><h3>Background</h3><div>Endometriosis is a chronic, estrogen-dependent condition associated with substantial physical and psychological burden. Although psychiatric comorbidities are frequently reported, large-scale real-world data remain limited.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using the TriNetX U.S. Collaborative Network, including women aged 21–60 diagnosed with endometriosis between 2001 and 2020. Patients were matched 1:1 with controls without endometriosis using propensity score matching (PSM) based on age, race, nicotine dependence, alcohol abuse, obesity, infertility, delivery history, insomnia, and menopause. Psychiatric outcomes included depressive episodes, recurrent major depressive disorder, anxiety disorders, and substance use disorders. Subgroup analyses assessed differences by race, age, and postoperative hormonal therapy use.</div></div><div><h3>Results</h3><div>After PSM, each group included 7563 patients. Endometriosis was significantly associated with increased risks of several psychiatric disorders, including depressive episodes (HR = 1.35, 95 % CI: 1.24–1.47), recurrent major depressive disorder (HR = 1.30, 95 % CI: 1.10–1.53), anxiety disorders (HR = 1.39, 95 % CI: 1.29–1.49), phobic anxiety disorder (HR = 1.47, 95 % CI: 1.01–2.13), and substance use disorders (HR = 1.43, 95 % CI: 1.30–1.56). The composite outcome of all assessed psychiatric disorders—including depressive episodes, recurrent major depressive disorder, anxiety disorders, phobic anxiety disorder, mental and behavioral disorders due to psychoactive substance use, and suicidal ideation—was also significantly elevated in the endometriosis group (HR = 1.38, 95 % CI: 1.30–1.46). These associations were most pronounced among White patients, while Black patients showed elevated risks for recurrent depression and anxiety disorders only. No significant associations were observed among Asian patients. Additionally, postoperative hormonal therapy did not significantly reduce the risk of psychiatric disorders compared to surgery alone.</div></div><div><h3>Conclusions</h3><div>Women with endometriosis face elevated risks of psychiatric disorders, with notable racial disparities. Hormonal therapy may not mitigate these mental health risks. Our findings underscore the importance of integrated gynecologic and psychological care in the management of endometriosis.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"144 ","pages":"Article 152649"},"PeriodicalIF":4.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145621028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What goes around comes around? Holding racist attitudes predicts increased psychological distress over time","authors":"Tegan Cruwys ,&nbsp;Olivia Evans ,&nbsp;Michael J. Platow ,&nbsp;Iain Walker ,&nbsp;Katherine J. Reynolds ,&nbsp;Christienne Javier ,&nbsp;Catherine Haslam ,&nbsp;S. Alexander Haslam ,&nbsp;Hema Preya Selvanathan","doi":"10.1016/j.comppsych.2025.152644","DOIUrl":"10.1016/j.comppsych.2025.152644","url":null,"abstract":"<div><h3>Background</h3><div>There has been a tendency for the academic literature, media, and practitioners to attribute prejudice — particularly extreme beliefs and the violence they can engender — to mental ill-health. Meta-analyses have found relationships (albeit weak) among these variables, but they rely primarily on correlational evidence. The reverse pathway, from holding prejudice to mental ill-health, has rarely been considered. Moreover, a third, unexplored, variable might cause both. To address these gaps, we investigate reciprocal relationships between holding racist beliefs – one form of prejudice – and mental ill-health over time. We further consider the possible operation of a third variable: social connectedness (or lack thereof, in the form of ostracism, alienation, etc).</div></div><div><h3>Methods</h3><div>The bidirectional link between racism and mental ill-health (operationalised as psychological distress) was assessed in three longitudinal Australian studies, each with over 2000 participants and three timepoints spanning approximately six months.</div></div><div><h3>Results</h3><div>The cross-sectional associations between racism and psychological distress were small and unreliable. However, longitudinally, an increase in racist beliefs consistently preceded and predicted increased psychological distress. Social connectedness strongly predicted less racism and less psychological distress.</div></div><div><h3>Conclusions</h3><div>These findings suggest that people who hold prejudiced beliefs are at increased risk of psychological distress over time. This challenges common claims that it is mental ill-health that leads to prejudiced beliefs. Implications are discussed with an emphasis on the potentially undervalued contribution of positive social connection as a counterforce to both prejudice and mental ill-health.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"144 ","pages":"Article 152644"},"PeriodicalIF":4.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145444334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HUGS@Home - An initial evaluation of a psychological first aid programme for families and friends of first responders","authors":"Michelle O'Toole ,&nbsp;Brian Doyle ,&nbsp;Walter Eppich ,&nbsp;Brett Williams ,&nbsp;Alan M. Batt","doi":"10.1016/j.comppsych.2025.152636","DOIUrl":"10.1016/j.comppsych.2025.152636","url":null,"abstract":"<div><h3>Background</h3><div>First responders such as paramedics and firefighters increasingly rely on their family and friends for psychosocial support due to workplace barriers such as culture and stigma. Despite many benefits, such support is often perceived as placing a burden on family and friends. The ability to provide Psychological First Aid (PFA) has not yet been explored in the context of family members and friends providing support to first responders. In this study, we explored the impacts of PFA on first responders and family members/friends.</div></div><div><h3>Methods</h3><div>This pre-post study design was informed by a wider programme of research adopting a Community Based Participatory Research approach. We co-designed a simulation enhanced PFA training intervention -the HUGS@Home programme. We collected survey data over three time points from family member/friend participants and their corresponding first responders. We analysed the data using descriptive and comparative statistical analysis. External evaluation of the intervention occurred simultaneously.</div></div><div><h3>Findings</h3><div>Ten family member/friend cohorts (<em>n</em> = 82) completed the training in Ireland and the United Kingdom. Results indicate they experienced increased quality of life, improved social support, maintenance of high resilience scores, a slight increase in anxiety levels and most notably, enhanced post traumatic growth. Their related first responders (<em>n</em> = 33) noted similar results, in addition to demonstrating improved help-seeking and post-traumatic growth, specifically in the ‘improved relationships’ subdomain. Both groups found the intervention significant, meaningful, and valuable. External evaluation considered the programme mature and ready for wider implementation.</div></div><div><h3>Conclusions</h3><div>HUGS@Home contributes significantly to the international PFA evidence base as the first evaluation of a PFA intervention in Ireland. This is the first study to demonstrate that family members and friends can effectively provide PFA to first responders. Further planned and ongoing work will explore our findings in detail and evaluate programme implementation in volunteer first responder populations.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"143 ","pages":"Article 152636"},"PeriodicalIF":4.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}