Comprehensive psychiatry最新文献

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

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

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

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

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

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

{"title":"Aberrant anterior insula underlies interoceptive deficits in alexithymia among schizophrenia patients","authors":"Haoran Shen ,&nbsp;Yaping He ,&nbsp;Renjie Zeng ,&nbsp;Likun Ge ,&nbsp;Jingang Dai ,&nbsp;Juanhua Li ,&nbsp;Zezhi Li ,&nbsp;Gao-Xia Wei","doi":"10.1016/j.comppsych.2025.152630","DOIUrl":"10.1016/j.comppsych.2025.152630","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to investigate the unique neural mechanisms underpinning abnormal interoception in schizophrenia patients with comorbid alexithymia. The focus is on identifying aberrant activation patterns and functional connectivities of the insula cortex with regions involved in emotional processing.</div></div><div><h3>Methods</h3><div>Fifty schizophrenia patients were assessed using the Toronto Alexithymia Scale (TAS) and the Multidimensional Assessment of Interoceptive Awareness (MAIA). Task-based fMRI scans were conducted to observe brain activation patterns during interoceptive conditions.</div></div><div><h3>Results</h3><div>Alexithymic patients showed higher alexithymia and lower interoception compared to non-alexithymic patients. During the interoceptive task, alexithymic patients exhibited reduced activation in the anterior insula (AI), while no difference was observed in the posterior insula (PI). Functional connectivity analysis revealed reduced connectivity between the AI and the anterior cingulate cortex (ACC) as well as the superior frontal gyrus (SFG) in alexithymic patients. Moreover, the connection between the AI and the ACC mediated the relationship between interoception and alexithymia.</div></div><div><h3>Conclusion</h3><div>These results suggested that alexithymic schizophrenia patients struggle to integrate interoceptive afferents with emotional salience, and highlighted AI's role in the interplay between interoceptive awareness and emotional articulation in alexithymic schizophrenia, suggesting a potential neurobiological pathway for targeted interventions.</div><div><strong>Trial registration:</strong> The research is registered with the China Clinical Trials Registry (CCTR), under the registration number ChiCTR2400080313 on January 15, 2024.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"143 ","pages":"Article 152630"},"PeriodicalIF":4.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903955","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 power of youth: Long-term differential effects of developmental functioning trajectory on social functioning, quality of life and personal recovery across the schizophrenia spectrum","authors":"Jiasi Hao ,&nbsp;Richard Bruggeman ,&nbsp;Wim Veling ,&nbsp;Behrooz Z. Alizadeh","doi":"10.1016/j.comppsych.2025.152637","DOIUrl":"10.1016/j.comppsych.2025.152637","url":null,"abstract":"<div><h3>Background</h3><div>Compromised developmental functioning is frequently observed in patients with schizophrenia spectrum disorder (SSD) and is associated with poor outcomes, which remains understudied in individuals at varying risk of SSD. This study aimed to investigate the course of developmental functioning and its relationship with long-term outcomes within a population across the vulnerability spectrum of SSD. We hypothesized that developmental functioning negatively correlated with SSD vulnerability, and was positively associated with worse outcomes, regardless of disease status.</div></div><div><h3>Methods</h3><div>We used data of 1119 patients, 1059 siblings, and 586 controls from the Dutch Genetic Risk and Outcome in Psychosis (GROUP) cohort. Group-based trajectory modelling and linear mixed models were employed to investigate the course of developmental functioning (measured by the Premorbid Adjustment Scale) and its associations with the outcomes, including social functioning (SF), personal recovery (PR), and quality of life (QoL).</div></div><div><h3>Results</h3><div>In the combined sample, six developmental trajectories were identified: <em>normal-stable</em> (12.4 %), <em>normal-slow decrease</em> (12.3 %), <em>mild-stable</em> (46.9 %), all dominated by controls and siblings; and <em>mild-rapid decrease</em> (5.1 %), <em>moderate-stable</em> (16.5 %), and <em>severe-slow decrease</em> (6.8 %) more prevalent in patients. Compared to <em>normal-stable</em>, all other trajectories in developmental functioning were correlated with decreased SF; <em>mild-rapid decrease</em> and <em>severe-slow decrease</em> were linked to lower QoL. No association with PR was observed.</div></div><div><h3>Conclusion</h3><div>Impaired developmental functioning variably lowers prolonged SF and QoL but not PR. Potentially influenced by factors encompassing environment, cognition, resilience and disease status, this finding demands screening for developmental deviance among youths and early preventive interventions to achieve normal functioning through a public health salutogenic approach.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"143 ","pages":"Article 152637"},"PeriodicalIF":4.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243474","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":"An exploratory analysis of obsessive-compulsive personality traits, pathologic anger and quality of life among trauma-exposed veterans","authors":"Meghan J. Kulak ,&nbsp;Meghan A. Gonsalves ,&nbsp;Timothy Y. Mariano ,&nbsp;Anthony Pinto ,&nbsp;Benjamin D. Greenberg ,&nbsp;Jennifer Barredo ,&nbsp;Zachary Kunicki ,&nbsp;M. Tracie Shea","doi":"10.1016/j.comppsych.2025.152628","DOIUrl":"10.1016/j.comppsych.2025.152628","url":null,"abstract":"<div><h3>Introduction</h3><div>Trauma exposure and post-traumatic stress disorder (PTSD) are associated with high rates of co-occurring personality pathology, including Obsessive Compulsive Personality Disorder (OCPD). OCPD is characterized by rigidity and perfectionism, leading to internalized distress, interpersonal difficulties, and lower quality of life (QOL). Individuals with OCPD often report high levels of anger, which may exacerbate distress and interpersonal issues. However, the relationship between OCPD, anger, and QOL in trauma-exposed Veterans remains understudied.</div></div><div><h3>Materials and methods</h3><div>92 Veterans with warzone trauma, hyperarousal symptoms, and moderate to severe problems with anger were recruited from a VA Medical Center for a study on cognitive-behavioral therapy for anger. Assessments included standardized interviews on demographics and trauma history, as well as self-reports on OCPD and borderline personality disorder (BPD) traits, anger, and QOL.</div></div><div><h3>Results</h3><div>OCPD scores were significantly correlated with higher state anger (<em>r</em> = 0.276, <em>p</em> = 0.013), trait anger (<em>r</em> = 0.275, <em>p</em> = 0.016), and lower social QOL (<em>r</em> = −0.344, <em>p</em> = 0.002). BPD scores were similarly associated with higher state (<em>r</em> = 0.242, <em>p</em> = 0.031) and trait anger (<em>r</em> = 0.291, <em>p</em> = 0.011), but had lower QOL in all domains.</div></div><div><h3>Conclusion</h3><div>In this exploratory analysis, OCPD traits in trauma-exposed Veterans were linked to higher anger and lower social QOL, with effect sizes comparable to BPD traits. This highlights the importance of screening for OCPD traits to inform treatment strategies and improve outcomes, especially given that OCPD traits receive less clinical attention than BPD traits.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"143 ","pages":"Article 152628"},"PeriodicalIF":4.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144892077","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":"Comparative effects of pharmacological treatment for weight gain in patients treated with antipsychotics. A systematic review and network meta-analysis","authors":"Zuzanna Goetz-Kundera ,&nbsp;Bogusława Przekopińska ,&nbsp;Patryk Walichniewicz ,&nbsp;Maciej Niewada ,&nbsp;Michał Lew-Starowicz","doi":"10.1016/j.comppsych.2025.152632","DOIUrl":"10.1016/j.comppsych.2025.152632","url":null,"abstract":"<div><h3>Background</h3><div>Weight gain induced by antipsychotic treatment is a significant cardiometabolic risk factor associated with increased mortality.</div></div><div><h3>Methods</h3><div>Following PRISMA criteria Medline, Cochrane Central Register of Clinical Trials and Science Direct were systematically searched. Only randomised placebo-controlled trials evaluating pharmacological interventions to reduce antipsychotic drug-induced weight gain in adults were included.</div><div>Data on mean change in weight from baseline were extracted, together with parameters defining variability or dispersion. A fixed effects model and random effects mode were used. Treatments were ranked using SUCRA.</div></div><div><h3>Outcomes</h3><div>27 studies including 17 medications were included. The studies were divided into two groups with a time horizon of less or more than 12 weeks. A comparison of the short-term interventions showed significant advantages of nizatidine (MD -6,82; CI -13,36 to −0,55) and metformin (MD -4,17; CI -8,02 to −0,64) over placebo. For longer-term interventions, significant benefits were shown for liraglutide (MD -5,3; Cl −6,93 to −3,75), exenatide (MD -4,17; Cl −7,4 to −1,14), metformin (MD -2,08; Cl −2,86 to −1,35) and samidorphan (MD -1,91; CL −3,31 to −0,51) as compared to placebo. Liraglutide was superior to other drugs according to the SUCRA analysis.</div></div><div><h3>Interpretation</h3><div>Our network meta-analysis presents a comparison of pharmacological interventions to address weight gain associated with antipsychotic treatment. Metformin and liraglutide appear to have the strongest evidence for treating weight gain in the target group.</div></div><div><h3>Funding</h3><div>This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sector.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"143 ","pages":"Article 152632"},"PeriodicalIF":4.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145026460","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}