Guifeng Li , Mengya Li , Xin Xu , Junhong Zhang , Qifang Li , Qing Cai
{"title":"Inpatient vs outpatient cognitive behavioral therapy for insomnia: A two-arm parallel randomized controlled trial","authors":"Guifeng Li , Mengya Li , Xin Xu , Junhong Zhang , Qifang Li , Qing Cai","doi":"10.1016/j.comppsych.2025.152609","DOIUrl":"10.1016/j.comppsych.2025.152609","url":null,"abstract":"<div><h3>Objective</h3><div>While outpatient cognitive behavioral therapy for insomnia (CBT-I) represents the most efficacious delivery method, approximately 50 % of patients are unable to achieve clinical remission. There is a pressing need to develop more effective approaches to CBT-I delivery. This study assessed the comparative efficacy of one-week inpatient CBT-I and eight-week standard outpatient CBT-I.</div></div><div><h3>Methods</h3><div>A randomized controlled trial was conducted with 200 adults with chronic insomnia disorder. These participants were randomly allocated to either the inpatient group (<em>n</em> = 100) or the outpatient group (n = 100). The inpatient group underwent a one-week intensive inpatient CBT-I followed by weekly follow-ups program. The outpatient group participated in a standard outpatient CBT-I program conducted on an individual basis over an eight-week period. The primary outcome was the insomnia severity index score at 9 weeks after the start of intervention. Linear mixed effects model was employed for the intention-to-treat analysis.</div></div><div><h3>Results</h3><div>At the 9-week assessment, the inpatient CBT-I group demonstrated a mean change in insomnia severity index score of −13.31 (95 % confidence interval [CI], −14.47 to −12.16; Cohen's <em>d =</em> −3.18; <em>P</em> < .001). The outpatient group showed a mean change of −11.14 (95 % CI, −12.30 to −9.98; Cohen's <em>d</em> = −2.66; <em>P</em> < .001). The mean difference between groups was −2.03 (95 % CI, −3.21 to −0.85; Cohen's <em>d</em> = −0.48; <em>P</em> < .001), indicating a statistically significant improvement in the inpatient group compared to the outpatient group.</div></div><div><h3>Conclusions</h3><div>This study demonstrated that inpatient CBT-I exhibited superior efficacy compared to outpatient CBT-I in alleviating insomnia severity.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"141 ","pages":"Article 152609"},"PeriodicalIF":4.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154929","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":"Mapping psychiatric comorbidity network: A pilot multi-method weighted network analysis with a focus on key disorders","authors":"Yu Chang , Si-Sheng Huang , Wen-Yu Hsu , Yi-Chun Liu","doi":"10.1016/j.comppsych.2025.152608","DOIUrl":"10.1016/j.comppsych.2025.152608","url":null,"abstract":"<div><h3>Background</h3><div>Psychiatric comorbidity is a prevalent phenomenon that imposes a significant burden on patients, healthcare systems, and society. However, current research on psychiatric comorbidity is often limited to single disorders or partial associations. This study aims to utilize network analysis methods to construct a psychiatric comorbidity network and explore the network structural characteristics under different network weight definitions.</div></div><div><h3>Method</h3><div>Based on the psychiatric outpatient data from Changhua Christian Hospital in Taiwan from January 1, 2016, to June 30, 2024, the ICD-10 diagnostic codes (F00-F99) of all patients that appeared at least three times were extracted. Three different comorbidity networks were constructed using co-occurrence counts, Jaccard index, and partial correlation coefficient estimated by the mixed graphical model (MGM) as the weights of the network edges. Network structure was analyzed using indicators such as degree centrality, modularity, and community detection.</div></div><div><h3>Results</h3><div>The dataset included 16,954 patients. The comorbidity frequency network showed that mood disorders (F34) and anxiety disorders (F41) had the highest weighted degree centrality. In the Jaccard coefficient network, the weighted degree centrality of developmental disorders (F8x) increased. The MGM network highlighted the central role of substance use disorders (F1x).</div></div><div><h3>Conclusion</h3><div>Our findings suggested the roles and interrelationships of different disease categories in the comorbidity network. The results provide new perspectives and data support for clinical practice and future research.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"141 ","pages":"Article 152608"},"PeriodicalIF":4.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144139535","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}
M.W. Stratmann , J. Heeg , M. Härter , L. Kriston , U. Verthein , C. Lindemann
{"title":"Screening accuracy of the German version of the benzodiazepine self-report questionnaire","authors":"M.W. Stratmann , J. Heeg , M. Härter , L. Kriston , U. Verthein , C. Lindemann","doi":"10.1016/j.comppsych.2025.152607","DOIUrl":"10.1016/j.comppsych.2025.152607","url":null,"abstract":"<div><h3>Background and aims</h3><div>We aimed to assess the accuracy for the German version of the Benzodiazepine Dependence Self-Report Questionnaire (Bendep-SRQ-GV) as a possible screening instrument for benzodiazepine or <em>Z</em>-drug substance use disorder.</div></div><div><h3>Method</h3><div>This study includes a convenience sample of adults who had used benzodiazepines or <em>Z</em>-drugs at least once in the last year. Participants were recruited through notice boards, social media, newspaper, and a digital health information platform. All participants answered the Bendep-SRQ-GV and were assessed for benzodiazepine or <em>Z</em>-drug substance use disorder using the Structured Clinical Interview for DSM-5 Disorders – Clinical Version. We performed receiver operating characteristics curve analyses and calculated the area under the curve (AUC).</div></div><div><h3>Results</h3><div>42 out of 60 participants fulfilled the criteria for benzodiazepine or <em>Z</em>-drug substance use disorder according to Structured Clinical Interview. AUCs varied among the 4 subscales of the Bendep-SRQ-GV: Problematic Use (0.893 [0.819–0.975]), Preoccupation (0.751 [0.609–0.892]), Lack of Compliance (0.804 [0.699–0.919]), Withdrawal (0.743 [0.622–0.864]) and Total Score (0.860 [0.762–0.963]). For Problematic Use and Total Score selected cut-offs (5.5 and 16.5) showed best results: sensitivity (83 % [71–93 %] and 79 % [67–90 %]), high specificity (83 % [61–100 %] and 83 % [67–100 %], positive predictive value (92 % [84–100 %] and 92 % [83–100 %]), and negative predictive value (68 % [54–85 %] and 63 % [50–77 %]).</div></div><div><h3>Discussion</h3><div>The subscale Problematic Use and the Total Score seem promising for detecting benzodiazepine or <em>Z</em>-drug substance use disorder in adults. Precise cut-offs should be determined with a larger sample. The Bendep-SRQ-GV could be of great value as a screening questionnaire in clinical settings, counselling sites, and for scientific purposes.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"141 ","pages":"Article 152607"},"PeriodicalIF":4.3,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144107116","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}
Nora M. Laskowski , Christopher Zaiser , Roland Müller , Gerrit Brandt , Georgios Paslakis
{"title":"Mapping the pathway to anabolic-androgenic steroids (AAS) use","authors":"Nora M. Laskowski , Christopher Zaiser , Roland Müller , Gerrit Brandt , Georgios Paslakis","doi":"10.1016/j.comppsych.2025.152602","DOIUrl":"10.1016/j.comppsych.2025.152602","url":null,"abstract":"<div><div>This short communication introduces a model for the use of anabolic-androgenic steroids (AAS), with body dissatisfaction as the central factor, shaped by sociocultural, psychological, and behavioral influences. Media-driven body ideals, gender, and sexual orientation may significantly influence body image, while low self-esteem and certain personality traits also contribute to dissatisfaction. Disordered eating behaviors (DEB) and intense physical exercise act as indirect contributors, particularly in fitness communities, where “conventional” body modification methods (i.e., exercise and diet) may fail to meet internalized ideals.</div><div>The model highlights a vicious cycle: body dissatisfaction drives AAS use, which, in turn, worsens dissatisfaction. Social media amplify this cycle by promoting unrealistic standards, while marginalized groups, including LGBTQI+ populations, face additional pressures to conform to heteronormative beauty norms. The overlap between body dissatisfaction, DEB, and intense physical exercise underscores the need for nuanced research to disentangle these inferences.</div><div>The model predominantly reflects Western body ideals, limiting its applicability across cultures. Addressing body dissatisfaction through early interventions targeting both societal standards and individual vulnerabilities is critical. Also, approaches accounting for aspects of sex and gender diversity are essential to promote body acceptance and reduce the risk of AAS use and DEB.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"141 ","pages":"Article 152602"},"PeriodicalIF":4.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071475","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}
S. Lukersmith , C. Woods , L. Salvador-Carulla , T. Niyonsenga , I. Mohanty , M.R. Gutierrez-Colosia , D. Diaz-Milanes , C.R. Garcia-Alonso , C.J. Büsst
{"title":"A comparative evaluation of 23 projects on mental health and wellbeing for veterans and first responders","authors":"S. Lukersmith , C. Woods , L. Salvador-Carulla , T. Niyonsenga , I. Mohanty , M.R. Gutierrez-Colosia , D. Diaz-Milanes , C.R. Garcia-Alonso , C.J. Büsst","doi":"10.1016/j.comppsych.2025.152599","DOIUrl":"10.1016/j.comppsych.2025.152599","url":null,"abstract":"<div><h3>Background</h3><div>Veterans and First Responders (VFR) are at risk of developing a range of mental health disorders because of cumulative exposure to critical incidents at work. Two Philanthropic organisations funded 15 organisations, which collectively implemented 23 highly heterogeneous and international early intervention mental ill-health and suicide prevention Projects. The aim was identify and collaborate with Projects with a multi-project evaluation. The evaluation examined multiple domains including intervention effectiveness but critically the implementation processes impacts for potential replication or scale up. This paper reports on the methods and evaluation results of implementation processes, impact analysis and sustainability.</div></div><div><h3>Method</h3><div>The evaluation involved ecosystems and complex systems approaches using novel methods and tools. There was multiple preparatory evaluation steps including developing indices for complexity and context. The Global Impact Analytics Framework (GIAF) toolkit was used to evaluate the implementation processes. Methodological tools included qualitative analysis, descriptive statistics, GIAF ladders/scales and checklists (qualitative and quantitative data).</div></div><div><h3>Results</h3><div>We provide the results on characteristics (organisational, Project and participants), GIAF process components (planning, pre-engagement, pre-readiness/readiness, dissemination/diffusion, usability/sustainability, adoption and uptake). All Project interventions were assessed as usable, adoptable and have capacity to be sustained, with financial resources. Uptake of the intervention was mostly high.</div></div><div><h3>Conclusion</h3><div>Complex multi-project evaluation of highly heterogenous Projects implemented in the real world across different countries is possible and provides valuable information and learnings. The evaluation results establish benchmarks including Project pre-engagement with potential end-users, continuous, frequent collaboration between Project and evaluation teams, adequate contract duration for sufficient recruitment and intervention.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"141 ","pages":"Article 152599"},"PeriodicalIF":4.3,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143928331","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}
Juliette S. Mojgani , Anna M. Rzepka , Yejin Kang , Hashim Al-Bya , Beth Patterson , Michael Van Ameringen
{"title":"Obsessive-compulsive spectrum disorders and the menstrual cycle: A scoping review","authors":"Juliette S. Mojgani , Anna M. Rzepka , Yejin Kang , Hashim Al-Bya , Beth Patterson , Michael Van Ameringen","doi":"10.1016/j.comppsych.2024.152554","DOIUrl":"10.1016/j.comppsych.2024.152554","url":null,"abstract":"","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"139 ","pages":"Article 152554"},"PeriodicalIF":4.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143885956","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":"Immuno-moodulin (Imood) and its potential role in OCD","authors":"Fulvio D'Acquisto","doi":"10.1016/j.comppsych.2024.152550","DOIUrl":"10.1016/j.comppsych.2024.152550","url":null,"abstract":"","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"139 ","pages":"Article 152550"},"PeriodicalIF":4.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887153","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}
V. Hühne , S. dos Santos-Ribeiro , M.E. Moreira-de-Oliveira , L.D. Laurito , C.P. Loureiro , G.B. de Menezes , L.F. Fontenelle
{"title":"Association of dimension-specific stressful life events with obsessive-compulsive disorder compared to social anxiety disorder","authors":"V. Hühne , S. dos Santos-Ribeiro , M.E. Moreira-de-Oliveira , L.D. Laurito , C.P. Loureiro , G.B. de Menezes , L.F. Fontenelle","doi":"10.1016/j.comppsych.2024.152558","DOIUrl":"10.1016/j.comppsych.2024.152558","url":null,"abstract":"","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"139 ","pages":"Article 152558"},"PeriodicalIF":4.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143885552","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}
Kevin La Monica , Matteo Vismara , Sara Torriero , Beatrice Benatti , Luca Larini , Chiara Bucca , Nicolaja Girone , Monica Bosi , Bernardo Dell'Osso
{"title":"Augmentative transcranial magnetic stimulation over the left orbitofrontal cortex in patients with treatment-resistant obsessive-compulsive disorder: An acute and follow-up study","authors":"Kevin La Monica , Matteo Vismara , Sara Torriero , Beatrice Benatti , Luca Larini , Chiara Bucca , Nicolaja Girone , Monica Bosi , Bernardo Dell'Osso","doi":"10.1016/j.comppsych.2024.152559","DOIUrl":"10.1016/j.comppsych.2024.152559","url":null,"abstract":"","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"139 ","pages":"Article 152559"},"PeriodicalIF":4.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143885553","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}