Comprehensive psychiatryPub Date : 2025-11-01Epub Date: 2025-08-20DOI: 10.1016/j.comppsych.2025.152629
Friederike S. David , Josef Frank , Frederike Stein , Susanne Meinert , Lea Zillich , Lea Sirignano , Fabian Streit , Eva C. Beins , Lisa Sindermann , Paula Usemann , Janik Goltermann , Elisabeth J. Leehr , Sugirthan Sivalingam , Stefan Herms , Per Hoffmann , Tim Hahn , Stephanie H. Witt , Nina Alexander , Tilo Kircher , Udo Dannlowski , Andreas J. Forstner
{"title":"Blood-based DNA methylation profiles in major depressive disorder, bipolar disorder, and schizophrenia spectrum disorders","authors":"Friederike S. David , Josef Frank , Frederike Stein , Susanne Meinert , Lea Zillich , Lea Sirignano , Fabian Streit , Eva C. Beins , Lisa Sindermann , Paula Usemann , Janik Goltermann , Elisabeth J. Leehr , Sugirthan Sivalingam , Stefan Herms , Per Hoffmann , Tim Hahn , Stephanie H. Witt , Nina Alexander , Tilo Kircher , Udo Dannlowski , Andreas J. Forstner","doi":"10.1016/j.comppsych.2025.152629","DOIUrl":"10.1016/j.comppsych.2025.152629","url":null,"abstract":"<div><div>Alterations in DNA methylation (DNAm) profiles have been implicated in affective and psychotic disorders. However, no comprehensive understanding of peripheral DNAm profiles associated with diagnostic groups, course of illness, and other clinical variables has emerged yet. In particular, studies exploring commonalities and differences across diagnoses are lacking. Here we conducted a systematic epigenetic characterization of the transdiagnostic German FOR2107 cohort, including individuals with major depressive disorder (MDD, <em>n</em> = 342), bipolar disorder (BD, <em>n</em> = 99), or a schizophrenia spectrum disorder (SSD, <em>n</em> = 101) and healthy controls (HC, <em>n</em> = 339). For 183 MDD cases and 178 HC, we assessed additional DNAm data from the two-year follow-up study visit. To explore DNAm differences between and across diagnostic groups, case-control and case-case methylome-wide association studies were performed. Our sample was further characterized using methylation risk scores (MRS) for MDD and SSD. Finally, epigenetic age acceleration was examined and compared to a measure of brain age acceleration. We identified few methylome-wide significant associations with diagnostic groups. MRS for MDD did not differ between diagnostic groups, and an increase in MRS for SSD in SSD compared to HC did not remain significant when adjusting for smoking behavior and BMI. An increase in epigenetic age acceleration was most evident for SSD compared to HC, which did not remain significant when adjusting for covariates. No correlation between epigenetic and brain age acceleration was observed. Our findings emphasize the relevance of potential confounding factors in epigenetics research in psychiatry and contribute to a growing body of studies on DNAm profiles across affective and psychotic disorders.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"143 ","pages":"Article 152629"},"PeriodicalIF":4.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144895277","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}
Comprehensive psychiatryPub Date : 2025-11-01Epub Date: 2025-10-06DOI: 10.1016/j.comppsych.2025.152640
Jannis Engel , Maria Veit , Laura Budnik , Stephanie Antons , Christopher Sinke , Tillmann H.C. Kruger
{"title":"Approach tendencies towards pornographic material in compulsive sexual behavior disorder: insights from the sex@brain study","authors":"Jannis Engel , Maria Veit , Laura Budnik , Stephanie Antons , Christopher Sinke , Tillmann H.C. Kruger","doi":"10.1016/j.comppsych.2025.152640","DOIUrl":"10.1016/j.comppsych.2025.152640","url":null,"abstract":"<div><h3>Background</h3><div>Compulsive Sexual Behavior Disorder (CSBD) is a new category in the 11th version of the International Classification of Diseases and has neuropsychological similarities with those disorders due to addictive behaviors. Initial automatic approach tendencies and an attentional bias towards preferred stimuli may be crucial to the maintenance of addictive behavior disorders.</div></div><div><h3>Aims</h3><div>This experimental study aims to further our knowledge on approach-avoidance tendencies by examining a clinical sample with compulsive sexual behavior CSBD compared to a control-group.</div></div><div><h3>Methods</h3><div>Participants completed the approach avoidance task (AAT) modified with pornographic pictures.</div></div><div><h3>Outcomes</h3><div>We collected data on approach-avoidance tendencies from 43 heterosexual men with CSBD (age, M = 36.26, SD = 11.47) and a control group of 37 men without CSBD (age: M = 38.24, SD = 12.33).</div></div><div><h3>Results</h3><div>Reaction times of the onset of cue presentation to initial hand movement show significantly more approach tendencies towards pornographic stimuli in men with CSBD vs. men without CSBD. Negative values of movement times (MT) suggested longer viewing times when enlarging the stimulus compared to shrinking the image for pornographic and neutral material with a larger difference in the CSBD group. The overall effect scores for RT show a faster reaction time in men without CSBD towards pornographic material, while the MT scores indicates that men with CSBD show longer viewing times for pornographic material.</div></div><div><h3>Conclusion</h3><div>Our results emphasize previous findings in subclinical samples and show that CSBD is associated with approach tendencies at the time of stimulus presentation. These approach tendencies can be addressed therapeutically.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"143 ","pages":"Article 152640"},"PeriodicalIF":4.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312539","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 HAART in mitigating neurocognitive decline among HIV-positive Africans: Systematic review and meta-analysis","authors":"Mulualem Kelebie , Getasew Kibralew , Gebresilassie Tadesse , Girum Nakie , Mulu Muche , Dawed Ali , Birtukan Fasil , Gidey Rtbey , Biruk Fanta , Nega Gedefaw Agmase , Girmaw Medfu Takelle , Melese Gobezie , Mequanente Dagnaw , Setegn Fentahun","doi":"10.1016/j.comppsych.2025.152639","DOIUrl":"10.1016/j.comppsych.2025.152639","url":null,"abstract":"<div><h3>Background</h3><div>HIV-associated neurocognitive disorders (HAND) remain a significant public health concern among people living with HIV (PWH) in Africa, despite the widespread implementation of highly active antiretroviral therapy (HAART). While HAART has been effective in reducing the incidence of severe neurocognitive disorder, milder forms of neurocognitive impairment continue to be observed even among individuals receiving active antiretroviral therapy. These subtle deficits, particularly prevalent in low-resource and low-literacy contexts, are associated with adverse outcomes such as diminished functional capacity, poor adherence to antiretroviral therapy, and reduced quality of life. This systematic review and meta-analysis aims to synthesize the current evidence on the effectiveness of HAART on neurocognitive outcomes among HIV-positive individuals in Africa.</div></div><div><h3>Methods</h3><div>A comprehensive systematic search was conducted across multiple electronic databases—including PubMed/MEDLINE, Scopus, African Journals Online, PsycINFO, EMBASE, CINAHL, and the Cochrane Library—to identify primary research studies that examined the prevalence and clinical impact of HIV-associated neurocognitive disorders (HAND) among HIV-infected populations in Africa. Study selection and data extraction were performed independently by two reviewers using predefined standardized protocols to ensure methodological rigor and minimize the risk of bias. The review protocol was prospectively registered with PROSPERO (CRD420251017353).</div></div><div><h3>Results</h3><div>This meta-analysis, which included 62 primary studies with a combined sample of 19,831 individuals living with HIV, estimated a pooled prevalence of HIV-associated neurocognitive disorders was 47.18% (95% CI: 39.94%–54.42%). In contrast, among 2,176 HIV-negative individuals in the control group, the prevalence of neurocognitive disorder was 13.48% (95% CI: 10.9%–15.32%). Sub-regional stratification revealed the highest HAND prevalence in Eastern Africa (50.85%), followed by Southern Africa (48.12%) and Western Africa (43.67%), while Central Africa reported the lowest prevalence at 34.68%. Among individuals receiving antiretroviral therapy (ART), the prevalence of HAND was 46.96%, compared to 50.22% in ART-naïve participants, indicating only a modest reduction in neurocognitive impairment associated with ART exposure. Meta-regression analyses identified several independent predictors significantly associated with increased odds of HAND, including advanced HIV disease stage (odds ratio [OR] 3.59; 95% CI: 2.81–4.59), lower educational attainment (3.13, 2.19–4.48), older age (2.05, 1.51–2.78), being female (2.18, 1.79-2.64), history of substance use (2.70, 2.65–2.75), reduced CD4+ T-cell counts (2.49, 1.42–4.36) and comorbid medical illness (2.05, 1.57-2.67).</div></div><div><h3>Conclusion</h3><div>HIV-associated neurocognitive disorders affect nearly half of people living with","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"143 ","pages":"Article 152639"},"PeriodicalIF":4.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145262340","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}
Comprehensive psychiatryPub Date : 2025-11-01Epub Date: 2025-09-10DOI: 10.1016/j.comppsych.2025.152633
Anna Magi , Zsolt Horváth , Cristina Villalba-García , Borbála Paksi , Andrea Eisinger , Katalin Felvinczi , Sherry H Stewart , Beáta Bőthe , Gyöngyi Kökönyei , Zsolt Demetrovics , Andrea Czakó
{"title":"An extended model of gambling motives: The first results with the long and short versions of the gambling motives questionnaire-revised","authors":"Anna Magi , Zsolt Horváth , Cristina Villalba-García , Borbála Paksi , Andrea Eisinger , Katalin Felvinczi , Sherry H Stewart , Beáta Bőthe , Gyöngyi Kökönyei , Zsolt Demetrovics , Andrea Czakó","doi":"10.1016/j.comppsych.2025.152633","DOIUrl":"10.1016/j.comppsych.2025.152633","url":null,"abstract":"<div><h3>Background</h3><div>Motives underlying addictions have been widely studied, using validated tools such as the Gambling Motives Questionnaire (GMQ) (Stewart and Zack, 2008). Nevertheless, subsequent studies have suggested the need to extend this model. The present paper aimed to identify potential additional factors, such as escapism, omnipotence, pleasure and financial motives, in addition to the social, enhancement and coping aspects already included.</div></div><div><h3>Methods</h3><div>A total of 40 motivational items (adding 25 additional items to the original GMQ items) were analysed within two datasets. Sample 1 was a player panel from a gambling service provider (<em>N</em> = 1829; mean age: 42.4 [SD = 13.3]; Females: 30 % [<em>n</em> = 548]), while Sample 2 consisted of a nationally representative sample of the Hungarian population (<em>N</em> = 437; mean age: 42.9 [SD = 13.55]; Females: 49.2 % [<em>N</em> = 215]).</div></div><div><h3>Results</h3><div>Exploratory Factor Analysis on Sample 1 identified four factors (including a total of 27 items): coping/escapism, social motives, enhancement/pleasure, and financial motives. The four-factor structure was confirmed on Sample 2 with confirmatory factor analysis showing adequate model fit (CFI = 0.987; TLI = 0.986; RMSEA[CI] = 0.047 [0.041–0.052]); however, high inter-factor correlations were evident in the general population sample. A shorter, 14-item version of the scale was also suggested.</div></div><div><h3>Conclusions</h3><div>Although the newly identified motives overlap with the original ones, the content of the factors enables the inclusion of certain aspects, like escapism within the coping factor, that proved to be the most important in relation to other potentially addictive behaviours. This suggests that examining the role of motives in gambling may be crucial in differentiating between problem gambling and recreational gambling.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"143 ","pages":"Article 152633"},"PeriodicalIF":4.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148063","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}
Comprehensive psychiatryPub Date : 2025-11-01Epub Date: 2025-09-19DOI: 10.1016/j.comppsych.2025.152635
Amir Pakpour , Marit Eriksson , Daniel Kwasi Ahorsu , Gunilla Björling , Anders Broström , Staffan Bengtsson , Malin Jakobsson , Karina Huus
{"title":"Gaming disorder among Swedish adolescents: Measurement, risk factors, and classification","authors":"Amir Pakpour , Marit Eriksson , Daniel Kwasi Ahorsu , Gunilla Björling , Anders Broström , Staffan Bengtsson , Malin Jakobsson , Karina Huus","doi":"10.1016/j.comppsych.2025.152635","DOIUrl":"10.1016/j.comppsych.2025.152635","url":null,"abstract":"<div><h3>Objectives</h3><div>This study examined the 1) psychometric properties of an independently translated Swedish version of the gaming disorder test (GDT) among Swedish adolescents based on two psychometric theories, 2) measurement invariance across age (i.e., 15 vs 16–17), gender (i.e., males vs females), and gaming time (i.e., < 2 h vs ≥ 2 h), and 3) factors that predict gaming disorder. The findings will help researchers understand and ascertain the use of the GDT among Swedish adolescents.</div></div><div><h3>Methods</h3><div>A total of 5320 Swedish adolescents were recruited and responded to measures including gaming disorder, gaming duration, sleep duration, physical activity, mental well-being, and self-esteem. Statistical analyses were conducted using confirmatory factor analysis, regression analysis, latent class analysis, classical test theory, and Rasch analysis.</div></div><div><h3>Results</h3><div>Satisfactory and unidimensional psychometric properties for the independently translated Swedish version of the GDT were found. Specifically, the factor structure, internal consistencies, separation reliability and separation index were supported, but not the person separation reliability and index. Also, the GDT was invariant across ages but only partially so across gender and gaming time. The GDT can classify adolescents as having a high or low risk of gaming disorder. Lastly, factors that predicted gaming disorder were poorer mental well-being and longer gaming time among males and low physical activity and longer gaming time among females.</div></div><div><h3>Conclusion</h3><div>Due to its conciseness, researchers may use the independently translated Swedish version of the GDT for screening people for gaming issues even in busy settings like schools. Moreover, attention must be paid to males, those with poorer mental well-being, those who are physically inactive, and those with a longer gaming time to help curb gaming disorder. Future research may focus on examining the test-retest reliability and clinical validity of the GDT among adolescents.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"143 ","pages":"Article 152635"},"PeriodicalIF":4.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154212","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}
Comprehensive psychiatryPub Date : 2025-11-01Epub Date: 2025-10-06DOI: 10.1016/j.comppsych.2025.152641
Youna McGowan , Bilikis Banire , Hailey Burns , Dawson Sutherland , Sherry H. Stewart , Raymond M. Klein , Sandra Meier
{"title":"Attention to Instagram features in female youth with anxiety symptoms","authors":"Youna McGowan , Bilikis Banire , Hailey Burns , Dawson Sutherland , Sherry H. Stewart , Raymond M. Klein , Sandra Meier","doi":"10.1016/j.comppsych.2025.152641","DOIUrl":"10.1016/j.comppsych.2025.152641","url":null,"abstract":"<div><div>Social media's highly visual and interactive nature fosters social comparisons and can thereby exacerbate feelings of inadequacy, especially among youth with anxiety. Compared to their non-anxious peers, anxious youth are more likely to use social media and may be more susceptible to engaging in social comparison, as suggested by prior literature. Anxious youth are also more attentive to indicators of social status and threats. Thus, this study explored the attention bias mechanisms underlying anxiety in response to social media status cues (e.g., follower counts, likes). We predicted that with increasing anxiety symptoms, youth would avoid allocating their attention to these cues. We recruited 69 shy or anxious young females with anxiety symptoms to view Instagram profiles [<em>M</em><sub>age</sub> = 20.44 years, <em>SD</em><sub>age</sub> = 1.84 years]. We recorded participants' eye movements with a high degree of spatial and temporal resolution while participants freely engaged with these profiles. Results showed that with increasing anxiety symptoms, youths' first fixation latency was significantly longer and their fixation duration shorter for social media status cues compared to the overall profile, representing an attentional avoidance pattern. This pattern was observed for both popular and less-popular profiles. These findings add to evidence that anxiety symptoms are linked to differences in visual attention to social media status cues. Further research is needed to examine these effects across genders, platforms, and in relation to other psychological constructs.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"143 ","pages":"Article 152641"},"PeriodicalIF":4.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145262341","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}
Comprehensive psychiatryPub Date : 2025-11-01Epub Date: 2025-10-02DOI: 10.1016/j.comppsych.2025.152638
Yingzhe He , Siu-Man Ng , Mao-Sheng Ran , Cong Wang , Yi-Yue Yang , Lie Zhou , Jia Cai
{"title":"Beyond criticism, hostility, and emotional overinvolvement: Development and psychometric validation of the Comprehensive Expressed Emotion Scale (CEES) in schizophrenia","authors":"Yingzhe He , Siu-Man Ng , Mao-Sheng Ran , Cong Wang , Yi-Yue Yang , Lie Zhou , Jia Cai","doi":"10.1016/j.comppsych.2025.152638","DOIUrl":"10.1016/j.comppsych.2025.152638","url":null,"abstract":"<div><h3>Background</h3><div>Expressed Emotion (EE) is a well-established predictor of schizophrenia relapse, but concerns remain regarding the content validity of its traditional components—criticism, hostility, and emotional overinvolvement (EOI). Recent research suggests a covert EE dimension (disassociation, apathy) unmeasured by current scales. This study developed and validated a self-report EE scale, the Comprehensive Expressed Emotion Scale (CEES), to reconceptualize EE.</div></div><div><h3>Methods</h3><div>319 adults with schizophrenia in Mainland China completed CEES, relevant Family Environment Scale—Chinese Version (FES-CV) subscales, and SF-12. Ten patient–family dyads also underwent the Camberwell Family Interview (CFI). Exploratory and confirmatory factor analyses determined factor structure; reliability and validity were evaluated using established indices and correlations.</div></div><div><h3>Results</h3><div>EFA supported a three-factor model—overt (criticism, hostility), covert (disassociation, apathy), and EOI—explaining 64 % of variance. CFA confirmed strong loadings for overt and covert items (0.70–0.91 and 0.72–0.90; all <em>p</em> < 0.001), but weaker, mostly non-significant loadings for EOI items. The three-factor model showed good fit (χ<sup>2</sup>(402) = 657.17, CFI = 0.971, TLI = 0.968, RMSEA = 0.061, SRMR = 0.079). The total scale and overt and covert subscales showed high internal consistency and strong construct and concurrent validity; EOI subscale reliability was moderate.</div></div><div><h3>Conclusions</h3><div>CEES operationalizes covert EE in Chinese families, broadening EE assessment to include implicit conflict. It demonstrates strong psychometric properties and potential for targeted interventions, though EOI subscale reliability and generalizability remain limitations.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"143 ","pages":"Article 152638"},"PeriodicalIF":4.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257684","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}
Comprehensive psychiatryPub Date : 2025-11-01Epub Date: 2025-09-08DOI: 10.1016/j.comppsych.2025.152634
Shanna van Trigt , Mariana Mendoza-Alvarez , Tanja van der Zweerde , Livia De Picker , Annemieke van Straten , Arnoud Arntz , Hein J.F. van Marle
{"title":"Psychometric properties of the 4-week version of the Borderline Personality Disorder Severity Index-5","authors":"Shanna van Trigt , Mariana Mendoza-Alvarez , Tanja van der Zweerde , Livia De Picker , Annemieke van Straten , Arnoud Arntz , Hein J.F. van Marle","doi":"10.1016/j.comppsych.2025.152634","DOIUrl":"10.1016/j.comppsych.2025.152634","url":null,"abstract":"<div><div>This study evaluated the psychometric properties of a new version of the Borderline Personality Disorder Severity Index-5 that assesses BPD symptom severity over the course of 4 weeks instead of the standard 3 months: the BPDSI-5-4wk. Reliability and validity were evaluated in a mixed sample of patients with BPD (<em>n</em> = 92), patients with avoidant personality disorder (APD) as clinical control group (<em>n</em> = 16), and a non-patient control group (<em>n</em> = 20). The study demonstrated very high interrater agreement and test-retest reliability and acceptable to excellent internal consistencies of the BPDSI-5-4wk. Confirmatory factor analysis supported its assumed nine-factor structure. The BPDSI-5-4wk also showed very good construct (i.e. known-group) validity, as well as criterion-related (i.e. concurrent) validity when correlating the BPDSI-5-4wk with the BPDSI-5 (3-month version), the structured clinical interview for DSM personality disorders (SCID-5-P), and several other BPD- and other mental health-related self-report questionnaires. We additionally derived cut-off scores with high sensitivity and specificity for distinguishing BPD from clinical controls (21.02, 85 % sensitivity, 94 % specificity), from non-patient controls (10.50, 98 % sensitivity, 100 % specificity), and from both control groups combined (17.26, 93 % sensitivity, 92 % specificity). A reliable change criterion of 5.88 was established. Preliminary trial data additionally showed the BPDSI-5-4wk's sensitivity to change. The strong reliability and validity of the BPDSI-5-4wk support its value for detailed, dimensional assessment of BPD symptom severity over shorter time frames. This will facilitate frequent treatment response evaluations, rapid indication of follow-up treatment, and better alignment with shorter intervention and follow-up periods in clinical trials.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"143 ","pages":"Article 152634"},"PeriodicalIF":4.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145045662","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}
Comprehensive psychiatryPub Date : 2025-10-01Epub Date: 2025-06-06DOI: 10.1016/j.comppsych.2025.152612
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":"2025-10-01","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}
Comprehensive psychiatryPub Date : 2025-10-01Epub Date: 2025-06-23DOI: 10.1016/j.comppsych.2025.152618
Raphaela J. Gaertner , Elea S.C. Klink , Annika B.E. Benz , Bernadette F. Denk , Maria Meier , Stella Wienhold , Nina Volkmer , Katharina E. Kossmann , Jens C. Pruessner
{"title":"Patients with borderline personality disorder show initially reduced psychophysiological relaxation levels but intact relaxation response","authors":"Raphaela J. Gaertner , Elea S.C. Klink , Annika B.E. Benz , Bernadette F. Denk , Maria Meier , Stella Wienhold , Nina Volkmer , Katharina E. Kossmann , Jens C. Pruessner","doi":"10.1016/j.comppsych.2025.152618","DOIUrl":"10.1016/j.comppsych.2025.152618","url":null,"abstract":"<div><h3>Introduction</h3><div>Borderline Personality Disorder (BPD) is associated with psychological as well as physiological dysregulation in patients, including reduced parasympathetic activity at baseline and difficulties returning to baseline after a stressor. Whether this impacts the relaxation response independent of a stressor has so far not been investigated.</div></div><div><h3>Methods</h3><div>In a within-subject design, we compared two relaxation interventions, a virtual reality nature video, and a paced breathing intervention. We assessed a female-only sample, with 20 BPD patients (mean<sub>age</sub> = 23.75 ± 4.39) during their inpatient treatment and 22 matched healthy controls (HC; mean<sub>age</sub> = 22.68 ± 2.68). Psychological relaxation was assessed with the Relaxation State Questionnaire (RSQ) and physiological relaxation with vagally mediated heart rate variability (HRV).</div></div><div><h3>Results</h3><div>We employed multilevel models to test whether BPD significantly influenced the psychophysiological relaxation response. For psychological relaxation, we found an increase in RSQ scores in both groups in response to both interventions. The HC showed overall higher RSQ scores. For physiological relaxation, we found overall higher HRV values in the HC group but no differences in the relaxation response.</div></div><div><h3>Conclusion</h3><div>BPD patients exhibit lower psychophysiological relaxation levels at baseline and throughout the experiment, while there was no significant difference in response to relaxation interventions when compared to HC. Future studies should focus on interventions targeting baseline psychophysiological relaxation in BPD patients.</div></div>","PeriodicalId":10554,"journal":{"name":"Comprehensive psychiatry","volume":"142 ","pages":"Article 152618"},"PeriodicalIF":4.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144492173","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}