Comprehensive psychiatry最新文献

{"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, Seyed Mohammad Mahdi Moshirian Farahi, Jude Mary Cénat","doi":"10.1016/j.comppsych.2026.152742","DOIUrl":"https://doi.org/10.1016/j.comppsych.2026.152742","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"150 ","pages":"152742"},"PeriodicalIF":4.8,"publicationDate":"2026-08-26","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":"","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}

{"title":"Intolerance of uncertainty and symptom-level associations between generalized anxiety and depression in adolescence: A large-scale subgroup network analysis","authors":"Haoxian Ye,&nbsp;Dan Chen,&nbsp;Shiyi Lin,&nbsp;Zifan Cai,&nbsp;Sisi He,&nbsp;Fang Fan","doi":"10.1016/j.comppsych.2026.152730","DOIUrl":"10.1016/j.comppsych.2026.152730","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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).</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"149 ","pages":"Article 152730"},"PeriodicalIF":4.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307292","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":"Neuroimaging insights on sleep disturbances and risk for major depressive disorder in youth: A systematic review","authors":"Nicolas Gauthier,&nbsp;Laiba Irfan Butt,&nbsp;Sidney H. Kennedy,&nbsp;Venkat Bhat,&nbsp;Andre C. Tonon,&nbsp;Katharine Dunlop","doi":"10.1016/j.comppsych.2026.152728","DOIUrl":"10.1016/j.comppsych.2026.152728","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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 &lt; 30 years). We narratively synthesized the results and completed a quality assessment using a modified Newcastle-Ottawa scale.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"149 ","pages":"Article 152728"},"PeriodicalIF":4.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307342","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":"Interpersonal problems across anxiety and depressive disorders","authors":"Jacqueline Peters,&nbsp;Marije aan het Rot","doi":"10.1016/j.comppsych.2026.152726","DOIUrl":"10.1016/j.comppsych.2026.152726","url":null,"abstract":"<div><div>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 (<em>n</em> = 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.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"149 ","pages":"Article 152726"},"PeriodicalIF":4.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257469","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":"Stroop task data does not improve prediction of CBT partial hospital treatment outcomes beyond routine clinical data: An elastic net analysis","authors":"Jenna M. Traynor,&nbsp;Chloe C. Hudson,&nbsp;Boyu Ren,&nbsp;Courtney Beard,&nbsp;Throstur Bjorgvinsson,&nbsp;Marie Forgeard,&nbsp;Kean J. Hsu","doi":"10.1016/j.comppsych.2026.152732","DOIUrl":"10.1016/j.comppsych.2026.152732","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"149 ","pages":"Article 152732"},"PeriodicalIF":4.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396310","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":"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,&nbsp;J.A. Vaingankar,&nbsp;B.C.W. Tan,&nbsp;S. Chang,&nbsp;Y.W.B. Tan,&nbsp;E. Samari,&nbsp;Y.C. Chua,&nbsp;Y.P. Lee,&nbsp;C. Tang,&nbsp;S.A. Chong,&nbsp;K.R.R. Krishnan,&nbsp;M. Subramaniam,&nbsp;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}

{"title":"Effectiveness of electroconvulsive therapy for depression: comparing research studies with real-world clinical data from the Dutch ECT consortium","authors":"Robin C. Cobben ,&nbsp;Dore Loef ,&nbsp;Edwin van Dellen ,&nbsp;Karin Hagoort ,&nbsp;Peter M. van de Ven ,&nbsp;Bart Schut ,&nbsp;Anja Lok ,&nbsp;Roel J.T. Mocking ,&nbsp;Karel W.F. Scheepstra ,&nbsp;Eric van Exel ,&nbsp;Mardien L. Oudega ,&nbsp;Birit F.P. Broekman ,&nbsp;Anton C.M. Vergouwen ,&nbsp;Thomas J.C. Zoon ,&nbsp;Rob M. Kok ,&nbsp;Milou Angevaare ,&nbsp;Esmée Verwijk ,&nbsp;Jordy J.E. Rovers ,&nbsp;Indira Tendolkar ,&nbsp;Julia C.M. Pottkämper ,&nbsp;Annemiek Dols","doi":"10.1016/j.comppsych.2026.152723","DOIUrl":"10.1016/j.comppsych.2026.152723","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Method</h3><div>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 &lt;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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"148 ","pages":"Article 152723"},"PeriodicalIF":4.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148053169","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}