Comprehensive psychiatry最新文献

{"title":"21st Annual Scientific Meeting of the International College of Obsessive Compulsive Spectrum Disorders (ICOCS) and ECNP - Obsessive Compulsive and Related Disorders Network (OCRN) meeting.","authors":"Jose M Menchon, Bernardo Dell'Osso","doi":"10.1016/j.comppsych.2026.152749","DOIUrl":"https://doi.org/10.1016/j.comppsych.2026.152749","url":null,"abstract":"","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":" ","pages":"152749"},"PeriodicalIF":4.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219909","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":"Neural correlates of imbalanced habitual and goal-directed behaviors in obsessive-compulsive disorder","authors":"Zhiyan Wang,&nbsp;Xiang Wang,&nbsp;Quanhao Yu,&nbsp;Feng Gao,&nbsp;Qian Liu,&nbsp;Yan Han,&nbsp;Yuxuan Jiang,&nbsp;Chuting Li,&nbsp;Jie Fan,&nbsp;Xiongzhao Zhu","doi":"10.1016/j.comppsych.2026.152746","DOIUrl":"10.1016/j.comppsych.2026.152746","url":null,"abstract":"<div><h3>Background</h3><div>Compulsion is a core symptom of obsessive-compulsive disorder (OCD) and has been linked to an imbalance between habitual and goal-directed behaviors. However, the neural mechanisms underlying this imbalance, particularly the role of arbitration between habitual and goal-directed systems, remain unclear.</div></div><div><h3>Methods</h3><div>31 patients with OCD and 39 healthy controls (HCs) underwent structural and functional MRI while performing the slips-of-action test (SOAT). Behavioral performance, task-related brain activation, and functional connectivity were compared between groups across habitual, goal-directed, and goal-habit competition conditions.</div></div><div><h3>Results</h3><div>During the slips-of-action test phase, OCD patients showed higher response rates to devalued stimuli and longer reaction times than HCs. Neuroimaging results revealed increased activation in the bilateral putamen and left insula during the habitual condition and reduced activation in the left caudate during the goal-directed condition. During the goal-habit competition condition, widespread hyperactivation was observed in cortical and subcortical regions in the OCD group. Psychophysiological interaction analyses revealed reduced functional connectivity between the right inferior frontal gyrus (IFG) and the left putamen, anterior cingulate cortex, orbitofrontal cortex, and lateral occipital cortex during the goal-directed condition. Compulsion severity was associated with greater right putamen activation and reduced connectivity between the IFG and left anterior cingulate cortex.</div></div><div><h3>Conclusions</h3><div>These findings suggest that compulsive behavior in OCD is associated with impaired goal-directed behavior and excessive habitual responding, accompanied by alterations in IFG-centered regulatory networks that may contribute to impaired arbitration between habitual and goal-directed systems.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"151 ","pages":"Article 152746"},"PeriodicalIF":4.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079971","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}

{"title":"Emotional and social loneliness in the longitudinal association between alexithymia and depressive symptoms","authors":"Błażej Misiak,&nbsp;Tomasz Bielawski","doi":"10.1016/j.comppsych.2026.152752","DOIUrl":"10.1016/j.comppsych.2026.152752","url":null,"abstract":"<div><h3>Background</h3><div>Alexithymia has been linked to depressive symptoms, yet the mechanisms underlying this association remain unclear. We examined whether emotional loneliness (perceived lack of close, intimate bonds) and social loneliness (perceived deficits in broader social integration) represent distinct pathways linking alexithymia to depressive symptoms.</div></div><div><h3>Methods</h3><div>In a longitudinal study of 2628 adults aged 18–40 years, we examined whether emotional and social loneliness mediate the association between alexithymia and depressive symptoms. Participants were assessed over 10 months (T0–T2). A parallel mediation model controlling for baseline loneliness and depressive symptoms was followed by a covariate-adjusted model additionally accounting for age, gender, education, place of residence, income, and anxiety.</div></div><div><h3>Results</h3><div>In the model without additional covariate adjustment, baseline alexithymia was associated with emotional (β = 0.110, <em>p</em> &lt; 0.001) and social loneliness (β = 0.096, <em>p</em> &lt; 0.001) at T1. Emotional loneliness at T1 was associated with higher depressive symptoms at T2 (β = 0.157, <em>p</em> &lt; 0.001), whereas social loneliness was not (β = 0.015, <em>p</em> = 0.701). The indirect effect through emotional loneliness was significant (β = 0.017, <em>p</em> = 0.003), whereas that through social loneliness was not (β = 0.001, <em>p</em> = 0.709). The indirect effect through emotional loneliness was significantly stronger (difference: β = 0.016, <em>p</em> = 0.045). Findings remained robust after covariate adjustment.</div></div><div><h3>Conclusions</h3><div>The indirect prospective association between alexithymia and depressive symptoms was small but stronger through emotional than social loneliness. These findings highlight the potential relevance of qualitative aspects of loneliness to depressive symptoms.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"151 ","pages":"Article 152752"},"PeriodicalIF":4.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149160781","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}

{"title":"Interoception in psychiatry: A systematic scoping review on concepts, methods and clinical impact","authors":"Lisa Klein Haneveld,&nbsp;Luuk Lans,&nbsp;Yvonne H.A. Bouman,&nbsp;Youri Derks,&nbsp;Saskia M. Kelders,&nbsp;Hanneke Kip","doi":"10.1016/j.comppsych.2026.152747","DOIUrl":"10.1016/j.comppsych.2026.152747","url":null,"abstract":"<div><h3>Background</h3><div>Interoception – the perception and interpretation of internal bodily signals - is increasingly recognized as a transdiagnostic mechanism underlying emotion regulation and psychopathology. Although many psychiatric interventions implicitly or explicitly target interoceptive processes, there is limited clarity regarding how interoception is defined, measured, and applied in mental healthcare, as well as how effective interoception-focused interventions are across psychiatric populations.</div></div><div><h3>Methods</h3><div>A systematic scoping review was conducted of peer-reviewed studies published up to September 1, 2025, using Scopus, PsycINFO, and Web of Science. Studies were included if they evaluated interventions targeting interoception or related constructs in individuals with psychiatric disorders. Studies focusing on emotional awareness, emotion regulation, or alexithymia were excluded. Data were synthesized to map definitions, measurements, intervention types, effectiveness, and reported benefits and barriers.</div></div><div><h3>Results</h3><div>Forty-seven studies were included (37 quantitative; 13 qualitative/mixed). There was substantial heterogeneity in conceptualization and measurement, with most studies focusing on interoceptive awareness using self-report measures, particularly the Multidimensional Assessment of Interoceptive Awareness (MAIA). Interventions included mindfulness-based approaches, body-oriented therapies, structured protocols, and technology-supported methods. Of 37 (quasi-)experimental studies, 34 reported significant improvements in interoceptive outcomes. Qualitative findings highlighted benefits such as improved body awareness and emotion regulation, alongside barriers including skepticism, difficulty engaging with bodily focus, and feelings of being overwhelmed.</div></div><div><h3>Conclusions</h3><div>Interoception-focused interventions show consistent positive effects across psychiatric populations and represent a promising avenue for clinical practice. However, variability in definitions and measurement currently limits translation into standardized care. Future research should prioritize clearer conceptualization, multi-method assessment strategies, and greater attention to individual differences to support more personalized and effective interoception-based treatments.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"151 ","pages":"Article 152747"},"PeriodicalIF":4.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080008","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}

{"title":"Stress, coping, and alcohol use in wartime Ukraine: Findings from a national cross-sectional survey","authors":"Olha Myshakivska,&nbsp;John Marsden,&nbsp;Yuliia Yachnik,&nbsp;Michael Kelleher,&nbsp;Irina Pinchuk","doi":"10.1016/j.comppsych.2026.152748","DOIUrl":"10.1016/j.comppsych.2026.152748","url":null,"abstract":"<div><h3>Background</h3><div>Armed conflict creates highly stressful and traumatic conditions that may increase alcohol use. We aimed to examine how coping strategies and place of residence relate to alcohol consumption among adults in Ukraine during wartime.</div></div><div><h3>Methods</h3><div>In this nationwide online survey, adults (≥18 years) living in Ukraine or abroad were recruited between Oct 6, 2023, and July 6, 2024. Alcohol use was assessed using the Alcohol Use Disorders Identification Test (AUDIT).</div><div>A generalised linear mixed-effects model (GLMM) using the Tweedie family with a log link was fitted to model AUDIT total scores, with fixed effects for coping strategies, sociodemographic and socioeconomic variables, and trauma exposure, and a random intercept for region to account for geographic clustering.</div></div><div><h3>Findings</h3><div>Data were analysed from 10,226 respondents (19.3% women, 79.2% men, 0.6% non-binary/self-described, and 1.0% preferred not to say). Overall, 68.8% reported past-year alcohol use, including hazardous use in 7.9%, harmful use in 1.2%, and high-risk use in 1.3% of respondents. In the adjusted GLMM (<em>N</em> = 9995) avoidant coping (β = 0.081, SE = 0.003, <em>p</em> &lt; 0.001) and to a lesser extent emotion-focused coping (β = 0.025, SE = 0.003, <em>p</em> &lt; 0.001) were positively associated with higher AUDIT scores, whereas problem-focused coping was inversely associated with AUDIT scores (β = 0.020, SE = 0.003, <em>p</em> &lt; 0.001). Male gender was independently associated with higher alcohol use (β = 0.471, SE = 0.034, <em>p</em> &lt; 0.001), while the association between avoidant coping and alcohol use was stronger among women than men (β = 0.022, SE = 0.007, <em>p</em> = 0.002). Regional variation was small (variance = 0.02, SD = 0.14) and did not align with frontline proximity or intensity of attacks.</div></div><div><h3>Interpretation</h3><div>Alcohol use during wartime in Ukraine was more strongly associated with individual coping strategies and trauma exposure than with residence in high-risk areas. While men reported higher overall consumption, avoidant coping showed a stronger association with alcohol use among women. These findings highlight the importance of strengthening adaptive coping and trauma-informed, gender-sensitive interventions to prevent escalation of alcohol-related harm.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"151 ","pages":"Article 152748"},"PeriodicalIF":4.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105268","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}

{"title":"Pleasure and compulsion in gaming: distinct roles of hedonic and compulsive game use in gaming involvement","authors":"Lin-xuan Xu,&nbsp;Min-fang Kang,&nbsp;Zi-liang Wang,&nbsp;Xiao-min Geng,&nbsp;Chen-ran Pei,&nbsp;Jin-tao Zhang","doi":"10.1016/j.comppsych.2026.152750","DOIUrl":"10.1016/j.comppsych.2026.152750","url":null,"abstract":"<div><h3>Background and aims</h3><div>Stage-related models of problematic gaming suggest that the relative prominence of reward-oriented and compulsivity-related processes may vary across levels of gaming involvement. However, few studies have jointly examined hedonic and compulsive game use across different levels of gaming involvement while accounting for relevant trait-level vulnerabilities. This study investigated their distinct associations with gaming involvement.</div></div><div><h3>Methods</h3><div>A total of 2259 gamers were included in the cross-sectional analyses, of whom 725 completed a one-year follow-up. Hedonic and compulsive game use, gaming time, and IGD severity were assessed using self-report measures. Cross-sectional multiple regression analyses examined their unique associations after controlling for trait-level vulnerabilities, including reward sensitivity, obsessive-compulsive traits, and trait impulsivity. Two-wave cross-lagged panel models examined prospective longitudinal associations.</div></div><div><h3>Results</h3><div>Both hedonic and compulsive game use showed unique associations with gaming involvement. Hedonic game use was associated with gaming involvement among non-IGD participants, with a significant group difference observed for IGD severity. Compulsive game use was associated with both gaming time and IGD severity across gaming-status groups. Longitudinally, compulsive game use was associated with subsequent gaming time and IGD severity, whereas hedonic game use was not significantly associated with either outcome. In the opposite direction, greater baseline IGD severity was prospectively associated with greater subsequent compulsive game use.</div></div><div><h3>Discussion and conclusions</h3><div>Hedonic and compulsive game use showed distinct patterns of association with gaming involvement. The stronger relevance of hedonic game use among non-IGD gamers and the broader cross-sectional and prospective associations of compulsive game use are broadly compatible with stage-related theoretical accounts. These findings may help refine the behavioral characterization of problematic gaming and highlight the value of longitudinal research examining how different gaming-specific tendencies relate to the development and persistence of problematic gaming.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"151 ","pages":"Article 152750"},"PeriodicalIF":4.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165029","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}

{"title":"Prevalence of depression, anxiety, and post-traumatic stress symptoms among black post-secondary students in North America: A systematic review and meta-analysis","authors":"Joana Mukunzi Ntunga,&nbsp;Seyed Mohammad Mahdi Moshirian Farahi,&nbsp;Jude Mary Cénat","doi":"10.1016/j.comppsych.2026.152742","DOIUrl":"10.1016/j.comppsych.2026.152742","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"150 ","pages":"Article 152742"},"PeriodicalIF":4.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857027","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}

{"title":"Default mode network hub disruption links problematic use of the Internet to brain network disorganization","authors":"Nagara Takao,&nbsp;Naoya Oishi,&nbsp;Qi Dai,&nbsp;Lichang Yao,&nbsp;Sayaka Yoshimura,&nbsp;Mami Shibata,&nbsp;Morio Aki,&nbsp;Saki Akahori,&nbsp;Michael Spantios,&nbsp;Toshiya Murai,&nbsp;Hironobu Fujiwara","doi":"10.1016/j.comppsych.2026.152725","DOIUrl":"10.1016/j.comppsych.2026.152725","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>The functional connectivity values of all 17 DMN cluster pairs showed negative partial correlations with PUI severity (<em>p</em>-FDR &lt; 0.05). Mean DMN connectivity strongly predicted global network topology (|ρ| = 0.36–0.41, all <em>p</em>-FDR &lt; 1 × 10⁻⁶). Mediation analyses revealed that DMN functional connectivity substantially mediated the relationship between PUI severity and each metric (indirect effects: all <em>p</em>-FDR &lt;  0.001; all direct effects <em>p</em> &gt; 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.</div></div><div><h3>Conclusion</h3><div>DMN hub connectivity serves as a critical neurobiological pathway through which the PUI influences the whole-brain network organization.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"149 ","pages":"Article 152725"},"PeriodicalIF":4.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257394","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}

{"title":"Comorbidity patterns and immune-metabolic differences in patients with acute depressive episodes","authors":"Sai Chen,&nbsp;Xingning Long,&nbsp;Shaoyang Chen,&nbsp;Yuqing Zhang,&nbsp;Bin Bi,&nbsp;Zhe Dong","doi":"10.1016/j.comppsych.2026.152729","DOIUrl":"10.1016/j.comppsych.2026.152729","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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. <em>P</em> values were corrected using the FDR.</div></div><div><h3>Results</h3><div>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, <em>P</em> &lt; 0.001). The mixed cardiovascular cluster displayed the most severe profile and was characterized by significantly reduced HDL-C (β = −0.071, <em>P</em> &lt; 0.001) and elevated SII (β = 53.685, <em>P</em> = 0.017). Conversely, the anxiety and thyroid cluster was defined by endocrine dysfunction with elevated TSH (β = 1.142, <em>P</em> &lt; 0.001) but a significantly suppressed SII (β = −56.312, <em>P</em> = 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, <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"149 ","pages":"Article 152729"},"PeriodicalIF":4.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257441","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}

{"title":"The silent struggle: Barriers, delays, and missed opportunities in the treatment of body-focused repetitive behaviors","authors":"Steffen Moritz,&nbsp;Lisa Borgmann,&nbsp;Kim M. Rojahn,&nbsp;Lena Jelinek,&nbsp;Stella Schmotz","doi":"10.1016/j.comppsych.2026.152733","DOIUrl":"10.1016/j.comppsych.2026.152733","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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., <span><span>www.uke.de/e-bfrb-en</span><svg><path></path></svg></span>) to improve care of individuals with BFRBs.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"149 ","pages":"Article 152733"},"PeriodicalIF":4.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444865","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}