Acta Psychiatrica Scandinavica最新文献

{"title":"Stimulant Persistence in Adult ADHD: A Retrospective Analysis of a Large Clinical Cohort.","authors":"R Wettstein, E Pirgon, J Kroesen, V Navarro-Ovando, J C Kroesen, R Mathôt, G Dumont","doi":"10.1111/acps.70150","DOIUrl":"https://doi.org/10.1111/acps.70150","url":null,"abstract":"<p><strong>Introduction: </strong>Network meta-analyses suggest dexamphetamines (dAMP) may yield more favourable short-term outcomes than methylphenidate (MPH) in adults with ADHD, yet evidence on long-term comparative persistence remains scarce. This study compared 12-month treatment persistence between MPH and dAMP in a large multicentre cohort and explored associations with ADHD clinical presentations and objectively measured core symptoms.</p><p><strong>Methods: </strong>Stimulant persistence was defined by the primary outcome, 'time-to-transition', the interval from initiation to switching stimulant classes, transitioning to non-stimulants or complete discontinuation. Patients were censored at 12 months or at last clinical contact. A multivariable mixed-effects Cox proportional hazard model with a random intercept for clinicians was used to estimate hazard ratios (HR) and assess the relative impact of stimulant class on persistence, including its interactions with DSM-based clinical presentations and objective indices.</p><p><strong>Results: </strong>Among 12,995 participants (49% female), 62% initiated dAMP and 38% MPH. Median time-to-transition was 33.1 weeks for dAMP versus 15.0 weeks for MPH. MPH was associated with a 45% increased hazard for non-persistence compared to dAMP (HR = 1.45, 95% CI [1.36-1.55]). Regarding clinical and objective factors, hyperactive/impulsive presentation (HR = 1.14, p = 0.025) and objective impulsivity (HR = 1.05, p = 0.002) were independently associated with non-persistence. A significant interaction was observed between stimulant class and objective hyperactivity (p = 0.003), indicating that dAMP's persistence advantage became more pronounced with increasing motor activity (HR = 1.09). Nevertheless, these associations were secondary to the overarching effect of the stimulant class itself.</p><p><strong>Conclusion: </strong>Treatment with dAMP demonstrates significantly superior 12-month persistence compared to MPH in adults with ADHD. While clinical and objective measures of impulsivity and hyperactivity identify patients at higher risk for treatment non-persistence, dAMP's advantage remains consistent across all presentations. These findings suggest that prioritizing dAMP may enhance long-term treatment persistence in adult ADHD clinical practice.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149190203","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":"Sociodemographic, Criminological and Clinical Determinants in Suicide After Release From Prison: A 23-Year National Cohort Study.","authors":"Anne Bukten, Lars Mehlum, Seena Fazel, Nicoline Toresen Lokdam, Torill Tverborgvik, Svetlana Skurtveit, Øystein Bruun Ericson, Louis Favril, Morgan Scarth, Gabriela Rolová, Thomas Clausen, Marianne Riksheim Stavseth","doi":"10.1111/acps.70148","DOIUrl":"https://doi.org/10.1111/acps.70148","url":null,"abstract":"<p><strong>Background: </strong>Suicide risk is elevated after prison release, but population-level evidence on temporal risk patterns and associated factors remains limited. We aimed to describe characteristics of individuals who die by suicide after release from Norwegian prisons, compare their suicide mortality with the general population, and examine risk factors over time.</p><p><strong>Material and methods: </strong>Data from the Norwegian Prison Release Study (nPRIS), including all people in prison in Norway (2000-2022), were linked to the Norwegian Cause of Death Registry, the Norwegian Prison Registry, the Norwegian Patient Registry, and Statistics Norway. We calculated crude mortality rates (CMR) per 100,000 person-years, standardized mortality ratios (SMR), annual age-standardized years of life lost rate (ASYR), and Cox proportional hazards models.</p><p><strong>Results: </strong>From 2000 to 2022, 1183 suicides (9.1% of all deaths; CMR 81; 95% CI 76-85) occurred after release (90% male). The SMR was higher in women (SMR 8.64; 95% CI 7.17-10.34) than men (SMR 3.98; 95% CI 3.76-4.22). In multivariable models (2009-2022; n = 57,034; 516 suicides), strong independent associations with suicide 6 months post-release included self-harm (adjusted HR [aHR] 4.76; 95% CI 2.60-8.72), severe mental illness (aHR 1.95; 95% CI 1.16-3.27), release from high-security prisons (aHR 1.93; 95% CI 1.12-3.33), and pretrial detention (aHR 1.82; 95% CI 1.06-3.13).</p><p><strong>Conclusions: </strong>Suicide risk is substantially and persistently elevated relative to the general population, peaks immediately after release, and is concentrated among people with prior self-harm, severe mental illness, and those released from high-security settings.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149163307","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":"Risk-Stratified Cardiac Monitoring During Antipsychotic Treatment in Adolescents and Young Adults.","authors":"Alessandro Cuomo, Mario Pinzi, Andrea Fagiolini","doi":"10.1111/acps.70146","DOIUrl":"https://doi.org/10.1111/acps.70146","url":null,"abstract":"<p><strong>Introduction: </strong>Antipsychotic-associated heart rate-corrected QT (QTc) prolongation and sudden cardiac death are uncommon in young people, but risk is concentrated in patients with identifiable clinical vulnerability and during selected drug- or exposure-related situations. We mapped the evidence and developed a risk-stratified framework for clinical monitoring.</p><p><strong>Methods: </strong>This structured narrative review searched PubMed in August 2026 using one comprehensive query and 41 targeted subqueries. After PMID-based deduplication, 934 unique records underwent title screening, 382 abstract review, and 158 full-text relevance assessment; 104 database-derived sources met broad relevance criteria. Backward citation checking and author-identified sources added 58 articles. Overall, 162 sources were considered and 100 providing direct, non-redundant support were cited from the original search; three further sources were incorporated during peer review to address reviewer comments, for a final total of 103 cited references. Two authors independently assessed full-text relevance. Youth evidence was prioritized; adult evidence was used for adult-only agents or when youth-specific data were unavailable. Findings were synthesized narratively without formal risk-of-bias or certainty assessment.</p><p><strong>Results: </strong>Patient-level factors, particularly electrolyte disturbance, bradycardia, restrictive eating disorder or medical instability, thyroid dysfunction, inherited channelopathy, structural disease, and interacting drugs, were more consistently associated with QTc risk than drug identity for many commonly used agents. Ziprasidone and pimozide had the strongest youth-specific drug-related signals. Adult evidence supported heightened caution with sertindole and iloperidone; high-dose phenothiazines and amisulpride in overdose or renal impairment represented exposure- or context-dependent risks. Clozapine required separate myocarditis-focused surveillance. The evidence supports structured baseline risk assessment and targeted ECG and electrolyte testing, with repeat monitoring driven by risk factors, treatment changes, and agent-specific warnings.</p><p><strong>Conclusion: </strong>Monitoring should be tiered rather than uniformly scheduled for all patients. The proposed framework distinguishes core clinical risk assessment from targeted cardiac testing and identifies precautionary intervals that require prospective validation.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149101376","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":"Side Effects of Electroconvulsive Therapy (ECT).","authors":"Alexander Sartorius, Charles H Kellner, Randall T Espinoza","doi":"10.1111/acps.70147","DOIUrl":"https://doi.org/10.1111/acps.70147","url":null,"abstract":"","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149101359","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":"Obstructive Sleep Apnea in Psychiatric Practice: An Overlooked, Treatable Comorbidity","authors":"Seiji Nishino","doi":"10.1111/acps.70140","DOIUrl":"10.1111/acps.70140","url":null,"abstract":"&lt;p&gt;Obstructive sleep apnea (OSA) is a sleep-related breathing disorder characterized by recurrent upper-airway obstruction during sleep, resulting in apnea or hypopnea, intermittent hypoxemia, sleep fragmentation, and fluctuations in intrathoracic pressure. OSA is highly prevalent in the general population; when mild disease is included, it is estimated to affect approximately 9%–38% of adults [&lt;span&gt;1&lt;/span&gt;]. Common manifestations include habitual snoring, witnessed apneas, gasping or choking during sleep, nocturia, morning headache, dry mouth, excessive daytime sleepiness, fatigue, impaired concentration, and non-restorative sleep.&lt;/p&gt;&lt;p&gt;Untreated OSA is associated with hypertension, atrial fibrillation, stroke, coronary artery disease, metabolic abnormalities, obesity, accident risk, and cognitive impairment [&lt;span&gt;2-4&lt;/span&gt;]. Intermittent hypoxia, sleep fragmentation, sympathetic activation, oxidative stress, and inflammatory responses have all been implicated in the cardiovascular and metabolic consequences of OSA. However, the extent to which these biological mechanisms contribute directly to the onset, persistence, or exacerbation of psychiatric symptoms remains insufficiently understood.&lt;/p&gt;&lt;p&gt;In this issue, Sommerhoff et al. report a timely systematic review and meta-analysis examining the prevalence of OSA in individuals with schizophrenia, bipolar disorder, and major depressive disorder [&lt;span&gt;5&lt;/span&gt;]. Their review included 55 studies in the systematic review, of which 47 were included in the meta-analysis. The importance of this work lies not only in quantifying the frequency of OSA and elevated OSA risk in these populations, but also in highlighting a practical clinical message: sleep-disordered breathing should be routinely considered as part of comprehensive assessment in people with severe mental illness.&lt;/p&gt;&lt;p&gt;Importantly, these findings should not be interpreted as demonstrating that OSA causes psychiatric disorders, or conversely that psychiatric disorders cause OSA. Much of the available evidence derives from cross-sectional observational studies, and the temporal and causal relationships remain uncertain. The association between OSA and psychiatric disorders is likely to be influenced by multiple shared factors, including obesity, age, sex, smoking, alcohol use, diabetes, cardiovascular disease, lifestyle factors, and the effects of psychotropic medications.&lt;/p&gt;&lt;p&gt;Nevertheless, uncertainty regarding causality does not diminish the importance of detecting and treating OSA. Hypertension, atrial fibrillation, stroke, coronary artery disease, metabolic disorders, accident risk, and cognitive impairment—conditions associated with OSA—are already disproportionately common among people with severe mental illness. These physical health inequalities contribute substantially to the marked excess mortality observed in this population [&lt;span&gt;6, 7&lt;/span&gt;]. Identifying a treatable sleep-related breathing disorder may therefore offer an","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"154 5","pages":"319-321"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.70140","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023331","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":"Patients With Atypical Symptoms of Depression Respond Better to Lithium Augmentation Than Patients Without Atypical Symptoms","authors":"Hannah Buchbauer,&nbsp;Mazda Adli,&nbsp;Peter Schlattmann,&nbsp;Maximilian Berger,&nbsp;Tom Bschor,&nbsp;Thomas Stamm,&nbsp;Joachim Behr,&nbsp;Roland Ricken,&nbsp;Pichit Buspavanich","doi":"10.1111/acps.70127","DOIUrl":"10.1111/acps.70127","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Understanding the differences in treatment response between subtypes of major depressive disorder (MDD) may help to prevent lengthy trial-and-error processes by identifying effective treatment options. The aim of the study was to investigate the impact of atypical features of MDD (MDD-A) on the response to lithium augmentation (LA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a multicenter prospective cohort study, response to LA was compared between patients with atypical symptoms of MDD (MDD-A, <i>n</i> = 24) versus patients without atypical symptoms (MDD-nA; <i>n</i> = 94) using a Cox regression analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 62.5% of patients with MDD-A and 36.2% of patients with MDD-nA responded to LA. Analysis adjusted for age, sex, sufficient lithium serum concentration, and symptom severity at baseline showed a significantly higher probability of patients with atypical symptoms to respond to LA (HR 2.20, <i>p</i> = 0.02).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This is the first study investigating lithium-response in patients with MDD-A. The MDD-A subtype may help to predict response to LA.</p>\u0000 \u0000 <p>\u0000 <b>Trial Registration:</b> EudraCT number: 2008-004182-26; ClinicalTrials.gov identifier: DRKS00026205</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"154 5","pages":"376-383"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.70127","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148467910","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":"Validation of the Catatonia Quick Screen in the Original Bush-Francis Catatonia Rating Scale Cohort","authors":"James Luccarelli,&nbsp;Joshua Ryan Smith,&nbsp;Mark Kalinich,&nbsp;Jo Ellen Wilson,&nbsp;Jonathan P. Rogers,&nbsp;Stephan Heckers,&nbsp;Andrew Francis","doi":"10.1111/acps.70135","DOIUrl":"10.1111/acps.70135","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Delayed catatonia diagnosis may cause preventable harm. The 4-item Catatonia Quick Screen (CQS) allows rapid screening, but its specificity requires evaluation. We assessed CQS sensitivity and specificity using the original Bush Francis Catatonia Rating Scale (BFCRS) cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective reanalysis of data from 215 consecutive inpatient psychiatric admissions. CQS classifications were compared against BFCRS, DSM-5-TR, and ICD-11 criteria. 95% confidence intervals (CIs) were calculated via Clopper-Pearson exact methods, treating the eight single-sign patients conservatively as false positives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All 15 catatonia cases screened positive (true positives). The CQS demonstrated 100% sensitivity (95% CI: 78.2% to 100%), 96.0% specificity (95% CI: 92.3% to 98.3%), 65.2% positive predictive value (95% CI: 42.7% to 83.6%), and 100% negative predictive value (95% CI: 98.1% to 100%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The CQS showed excellent sensitivity and high specificity in this psychiatric cohort. It serves as a rapid, low-burden screening tool to accelerate clinical recognition, though positive results require formal diagnostic confirmation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"154 5","pages":"384-387"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.70135","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757453","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":"AI-Associated Psychotic Phenomena: Collect Before You Classify","authors":"Marc Augustin,&nbsp;John Torous","doi":"10.1111/acps.70123","DOIUrl":"10.1111/acps.70123","url":null,"abstract":"","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"154 5","pages":"388-389"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148381209","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":"Cardiometabolic Treatment Gap in Routine Psychiatric Care: A Cross-Sectional Study of 1553 Patients","authors":"Vincent Achour,&nbsp;Melanie Faugere,&nbsp;Laurent Boyer,&nbsp;Christophe Lançon,&nbsp;Theo Korchia","doi":"10.1111/acps.70124","DOIUrl":"10.1111/acps.70124","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;People with severe mental illness (SMI) have elevated cardiometabolic morbidity and mortality, with similar concerns increasingly reported in other psychiatric conditions including anxiety disorders and ADHD. Somatic conditions are often underdiagnosed and pharmacologically undermanaged in this population. We aimed to quantify the alignment between objectively measured cardiometabolic abnormalities and reported pharmacological treatments in a large transdiagnostic psychiatric cohort.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We conducted a monocentric cross-sectional observational study in a specialized psychiatric outpatient setting in France between 2018 and 2023. Adults (18–65 years) with schizophrenia, major depressive disorder, bipolar disorder, anxiety disorders, or attention-deficit and hyperactivity disorder were included. Standardized clinical and laboratory assessments captured blood pressure, fasting plasma glucose, lipid profile, waist circumference, metabolic syndrome, and HbA1c. Somatic medications (antihypertensives, statins, metformin) and self-reported hypertension/diabetes were recorded. The discordance between measured cardiometabolic abnormalities and reported pharmacological treatments was estimated using a bounding approach within the intersection of available data for each pair of variables.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Among 1553 patients (mean age 38.8 ± 14.2 years; 58.5% women), elevated blood pressure was present in 35.2% whereas 5.7% reported antihypertensive treatment. Hypercholesterolemia was observed in 50.5% while 2.5% reported statin use. High FPG (≥ 5.6 mmol/L) occurred in 12.6%, HbA1c ≥ 48 mmol/mol (≥ 6.5%) in 2.3%, and 1.8% reported metformin treatment. Abdominal obesity was observed in 59.8%, and metabolic syndrome in 20.9%. Applying a bounding approach within complete-case subsamples, between 29.5% and 35.3% of patients had elevated blood pressure without reporting antihypertensive treatment, between 47.9% and 50.7% had hypercholesterolemia without statins, and between 10.8% and 12.6% had high FPG without metformin.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In this large monocentric psychiatric cohort, cardiometabolic abnormalities were frequent yet poorly reflected in patient-reported pharmacological treatment. These findings highlight the need to better understand and address the gap between detection and treatment of cardiometabolic conditions in psychiatric care, and to ensure that abnormal findings translate into appropriate clinical foll","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"154 5","pages":"361-375"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.70124","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148402938","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":"Developmental Trauma as a Prognostic Factor for Later Psychotic Disorder in an Adolescent Clinical Cohort: A 20-Year Follow Up Study","authors":"Valentina Kieseppä,&nbsp;Covadonga M. Díaz-Caneja,&nbsp;Bart P. F. Rutten,&nbsp;Pirkko Riipinen,&nbsp;Sinan Gülöksüz,&nbsp;Ian Kelleher","doi":"10.1111/acps.70122","DOIUrl":"10.1111/acps.70122","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Hypothesis</h3>\u0000 \u0000 <p>Recent studies demonstrate that individuals who attend psychiatric services in adolescence, especially inpatient care, have an increased risk of psychotic disorders in adulthood. Given the extensive literature demonstrating a relationship between developmental trauma and psychosis, we investigated whether trauma history would help to identify elevated psychosis risk within a clinical cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Design</h3>\u0000 \u0000 <p>The sample consisted of patients admitted to a regional adolescent inpatient psychiatric unit (Oulu, Finland) between April 2001 and March 2006. The Kiddie Schedule for Affective Disorders and Schizophrenia was used to assess history of developmental trauma. Primary analyses investigated childhood sexual and/or physical abuse and secondary analyses investigated other types of traumatic events (car accident, other accident, fire, witness of a disaster, witness of a violent crime, victim of a violent crime, confronted with traumatic news, witness to domestic violence, other). Diagnoses from specialist healthcare were followed up in the national healthcare register until June 2023. Logistic regression was used to assess the relationship between childhood trauma and subsequent schizophrenia-spectrum disorders (SSDs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Results</h3>\u0000 \u0000 <p>Of 404 adolescent inpatients admitted with non-psychotic mental disorders, 14% reported a history of childhood sexual abuse and 27% reported a history of childhood physical abuse. Exposure to childhood sexual or physical abuse was not associated with a subsequently increased risk of SSDs (adjusted OR = 1.05, 95% CI = 0.59–1.83). Similarly, none of the other developmental adversities were associated with a subsequently increased risk of SSDs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In a clinical cohort made up of non-psychotic adolescent psychiatry inpatients, a group known to be at elevated risk of psychosis, none of the assessed developmental adversities were prognostic factors for subsequent psychotic disorders.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"154 5","pages":"352-360"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.70122","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148366173","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}