Philippa Ditton-Phare , Tina Fox , Kristen Vallender , Jose Cuenca , Sally Fitzpatrick
{"title":"Pilot implementation of an online program for family and friends supporting the mental health of paramedics in Australia: Lessons learned.","authors":"Philippa Ditton-Phare , Tina Fox , Kristen Vallender , Jose Cuenca , Sally Fitzpatrick","doi":"10.1016/j.comppsych.2025.152614","DOIUrl":"10.1016/j.comppsych.2025.152614","url":null,"abstract":"<div><h3>Introduction</h3><div>Paramedics experience disproportionately high rates of mental health concerns, often relying on informal support from family and friends. While this support is vital, it can impose significant strain on family and friends, who frequently lack the necessary resources and skills for their role. To address this, a novel online program, <em>Minds Together,</em> was developed specifically for family and friends to enhance their ability to support the mental health of paramedics while prioritizing their own mental health and wellbeing.</div></div><div><h3>Methods</h3><div>The feasibility and acceptability of the program was evaluated through a pilot study involving 53 participants randomized to either program or waitlist groups. Data collection included pre- and post-intervention surveys, program usage metrics, post-project surveys, and feedback from user testing. The Global Impact Analytics Framework (GIAF) guided analysis of planning, pre-engagement, pre-readiness, usability, dissemination, adoption, and contextual factors.</div></div><div><h3>Results</h3><div>Participants valued the program for its lived-experience content and self-paced format. Broad dissemination reached over one million individuals, and usability and relevance were rated highly. However, low engagement and completion rates reflected challenges common to online interventions. Barriers included limited access duration, participants' time constraints, and difficulties in reaching the target audience. Suggestions included flexible access, advanced content options, and targeted outreach strategies.</div></div><div><h3>Conclusion</h3><div><em>Minds Together</em> shows promise as a scalable intervention for family and friends of paramedics. Future research will address barriers, explore long-term outcomes, and refine the program to better meet family and friends' diverse needs, improving mental health support for paramedics and their support network.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152614"},"PeriodicalIF":4.3,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144307302","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}
Jessica L. Campbell , Josh Darby , Paul Oswald , Lisa Mackay , Grant Schofield
{"title":"Shifting organizational sentiment: Qualitative insights from a mental ill-health prevention program for New Zealand firefighters","authors":"Jessica L. Campbell , Josh Darby , Paul Oswald , Lisa Mackay , Grant Schofield","doi":"10.1016/j.comppsych.2025.152615","DOIUrl":"10.1016/j.comppsych.2025.152615","url":null,"abstract":"<div><h3>Background</h3><div>Firefighters are regularly exposed to potentially psychologically traumatic events (PPTEs), significantly increasing their risk of mental ill-health. Organizational factors such as leadership, support, and workload also influence these outcomes.</div></div><div><h3>Purpose</h3><div>This study evaluates the Whanaungatanga Program, a participatory initiative designed to address organizational factors affecting firefighter well-being, focusing on early changes in sentiment.</div></div><div><h3>Methods</h3><div>We conducted a qualitative analysis of open-text responses from two surveys (embedded within broader mental health questionnaires) with firefighters and commanders, and semi-structured interviews with commanders. Thematic and sentiment analyses explored perceptions of organizational interventions and the emotional tone in responses across two time points.</div></div><div><h3>Main Findings</h3><div>In the pilot region receiving interventions, organizational sentiment shifted substantially: positive sentiment increased from 13 % to 48 %, negative sentiment decreased over 20 % (from 66 % to 40 %), and themes such as improved leadership visibility emerged, reflecting rapid cultural progress.</div></div><div><h3>Conclusions</h3><div>The results highlight the effectiveness of targeted, participatory interventions in fostering positive organizational change. Marked improvements in sentiment indicate that even in high-stress environments, well-designed interventions can lead to substantial benefits in employee sentiment and organizational culture.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152615"},"PeriodicalIF":4.3,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144298138","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":"The role of attachment anxiety and intolerance of uncertainty in gaming during adolescence: A two-wave longitudinal study","authors":"Camilla Gregorini , Claudia Marino , Alessandro Giardina , Joël Billieux , Gioia Bottesi , Chiara Sacchi , Erika Pivetta , Alessio Vieno , Natale Canale","doi":"10.1016/j.comppsych.2025.152613","DOIUrl":"10.1016/j.comppsych.2025.152613","url":null,"abstract":"<div><div>Adolescents with attachment anxiety can compensate via gaming for their unmet needs of closeness, reassurance, and emotion regulation. However, individual factors linking attachment anxiety to compensation via gaming are still unclear. In this two-wave longitudinal study (Wave 1, W1 = baseline; Wave 2, W2 = 6 months later), we aimed to determine whether intolerance of uncertainty (IU) mediates the link between attachment anxiety and gaming behaviours (gaming compensation, gaming frequency, and problematic gaming). Online questionnaires were administered to Italian adolescent gamers (<em>N</em> = 570; M<sub>age</sub> = 15.60; SD<sub>age</sub> = 1.56; 68.8 % males). First, via path analyses, we tested whether attachment anxiety towards mother and father (W1) and IU (W1) would predict gaming behaviours (W2). Second, we tested whether IU would mediate the link between attachment anxiety and gaming compensation specifically. Multigroup analysis was used to explore gender differences. We found that attachment anxiety towards the mother and father was positively associated with IU, whereas attachment anxiety towards only the mother predicted gaming compensation at W2 both directly and via IU. Moreover, IU positively predicted gaming compensation and problematic gaming at W2. Multigroup analysis further revealed that for females, attachment anxiety towards the mother positively predicted gaming compensation at W2. Findings revealed small/modest effect sizes. Overall, attachment anxiety and IU may boost individuals to compensate via gaming, increasing the risk of problematic gaming. These results hold implications for future prevention interventions, emphasizing the quality of the parent-child relationship and IU as potential targets to foster adaptive coping strategies in adolescence.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152613"},"PeriodicalIF":4.3,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144279344","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}
Alexandra Pham-Scottez , Isabelle Sabbah-Lim , Jean Chambry , Valérie Dao , Raphael Gourevitch , David Barruel Ing , Valérie Dauriac-Le Masson
{"title":"Characteristics of adolescents hospitalised in adult psychiatric units. Retrospective study in the largest psychiatric hospital in France","authors":"Alexandra Pham-Scottez , Isabelle Sabbah-Lim , Jean Chambry , Valérie Dao , Raphael Gourevitch , David Barruel Ing , Valérie Dauriac-Le Masson","doi":"10.1016/j.comppsych.2025.152612","DOIUrl":"10.1016/j.comppsych.2025.152612","url":null,"abstract":"<div><div>Although psychiatrists working with adolescents know that sometimes they need to be hospitalised in emergency, few studies have described the hospitalisation of adolescents in adult psychiatric wards. We aimed to estimate the prevalence of adolescents hospitalised in adult psychiatric wards (characteristics, gender comparison, subtypes).</div><div>We conducted a monocentric retrospective study in the largest psychiatric hospital in France. All patients aged 15 to <18 years hospitalised in adult psychiatric wards were included, with different variables: socio-demographic and family information, history of inpatient / outpatient treatment, clinical data (like ICD-10 diagnoses, care pathway before / after hospitalisation…).</div><div>We included 332 hospitalisations (70 % girls), representing 2.8 % of all psychiatric hospitalisations. For 37 hospitalisations (11.1 %), this was the first psychiatric contact; for 54.2 %, patients had no previous psychiatric hospitalisation, for 87.3 %, patients had previous outpatient treatment. Mood disorders was the diagnosis for 47 % of the admissions, suicide attempts and suicidal ideation accounted for 69 % of the clinical situations leading to hospitalisation. Boys and girls differed significantly on many variables. Cluster analyses revealed two subgroups: cluster 1 patients (62 %) more frequently were girls, had previous hospitalisations in child psychiatry, came from home, had suicide attempts / suicidal ideation, had personality disorders, whereas cluster 2 patients (38 %) more frequently had substance use disorders, psychotic episodes, clastic crisis / hetero-aggression, longer hospital stays. Emergency admission of an adolescent with psychiatric issues to an adult psychiatric ward is not uncommon, especially in the context of a suicidal crisis or psychotic episode. Our results suggest the need for establishing unscheduled hospital beds for such adolescents.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152612"},"PeriodicalIF":4.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144298091","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":"The double-edged sword of distress tolerance: Exploring the role of distress overtolerance in nonsuicidal self-injury","authors":"Harin Chung, Gyumyoung Kim, Da-In Kim, Ji-Won Hur","doi":"10.1016/j.comppsych.2025.152610","DOIUrl":"10.1016/j.comppsych.2025.152610","url":null,"abstract":"<div><h3>Background</h3><div>While low distress tolerance has been widely studied as a risk factor for nonsuicidal self-injury (NSSI), recent attention has shifted toward distress overtolerance—an individual's excessive endurance to distress despite severe adverse effects. Understanding this double-edged nature of distress tolerance is critical for developing effective intervention strategies to address the growing burden of NSSI. This study investigated the role of distress overtolerance in NSSI pathology.</div></div><div><h3>Methods</h3><div>The study comprised 1818 female participants, including 918 and 900 participants with and without a history of NSSI, respectively. Binary logistic regression models were utilized to analyze distress overtolerance as a predictor of NSSI engagement, versatility, and frequency while controlling for demographic variables, depression, anxiety, and emotion dysregulation. Among the participants with a history of NSSI, Pearson's correlation analyses were conducted to identify the functions of NSSI that were the most associated with distress overtolerance.</div></div><div><h3>Results</h3><div>Distress overtolerance was identified as a significant predictor of NSSI engagement, versatility, and frequency even after controlling for other risk factors. Distress overtolerance was most strongly linked to self-punishment function in individuals with a history of NSSI.</div></div><div><h3>Conclusions</h3><div>Distress overtolerance is a distinct and significant risk factor for NSSI, highlighting the need for its inclusion in mechanisms and intervention models for NSSI. Addressing distress overtolerance in therapeutic settings to achieve an optimal balance in distress regulation could provide innovative and more effective strategies for the treatment of NSSI.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"141 ","pages":"Article 152610"},"PeriodicalIF":4.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144239686","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}
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}