Acta Psychiatrica Scandinavica最新文献

{"title":"Pediatric Somatic and Psychiatric Hospital Contacts in Denmark: A National Overview of Risk Factors, Admissions, and Mortality.","authors":"Lone Graff Stensballe, Andreas Jensen","doi":"10.1111/acps.70036","DOIUrl":"https://doi.org/10.1111/acps.70036","url":null,"abstract":"<p><strong>Objectives: </strong>Prior studies have identified comorbidity between pediatric somatic and psychiatric diseases within specific diagnostic groups. However, population-level data on these associations and their impact on mortality and morbidity are limited. This study aimed to examine these associations in the Danish pediatric population.</p><p><strong>Methods: </strong>We conducted a national cohort study using Danish register data, including 1,413,177 children and adolescents from 2019 to 2023. We assessed background factors, mortality, and hospital contacts across three patient groups: somatic-only, psychiatric-only, and somatic-psychiatric. A new-user design classified patients as somatic-only or psychiatric-only if they had no hospital contacts in the preceding 12 months. Patients with subsequent contacts for the other condition were reclassified into the somatic-psychiatric group.</p><p><strong>Results: </strong>Most individuals were included in the somatic-only group (n = 532,324), with fewer in the psychiatric-only group (n = 21,501) or somatic-psychiatric group (n = 23,108). Psychiatric patients were more often boys and from lower socioeconomic backgrounds. Somatic hospital contacts often involved less severe symptoms. In contrast, psychiatric contacts involved specific diagnoses, including suicide attempts. Pediatric patients with both conditions had a higher 3-year readmission risk (12.1%, 95% CI: 11.6%-12.6%) compared to somatic-only patients (9.4%, 95% CI: 9.3%-9.5%), and longer average hospital stays (6.32 vs. 1.97 h). Psychiatric patients also had significantly higher all-cause mortality.</p><p><strong>Conclusion: </strong>Somatic hospital contacts were more common, but children with psychiatric conditions faced significantly higher mortality and morbidity. These findings are relevant amid rising pediatric psychiatric diagnoses and recent Danish policy to integrate psychiatric and somatic care. Further research is needed to replicate these findings and inform optimal resource allocation for pediatric psychiatric care.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038669","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":"Predicting Remission in Schizophrenia Using Machine Learning-Assessing the Impact of Sample Size and Predictor Overinclusion.","authors":"Fredrik Hieronymus, Magnus Hieronymus, Axel Sjöstedt, Staffan Nilsson, Jakob Näslund, Alexander Lisinski, Søren Dinesen Østergaard","doi":"10.1111/acps.70037","DOIUrl":"https://doi.org/10.1111/acps.70037","url":null,"abstract":"<p><strong>Introduction: </strong>Machine learning studies sometimes include a high number of predictors relative to the number of training cases. This increases the risk of overfitting and poor generalizability. A recent study hypothesized that between-trial heterogeneity precluded generalizable outcome prediction in schizophrenia from being achieved. However, an alternative explanation is that predictor overinclusion might explain the low generalizability in that analysis.</p><p><strong>Methods: </strong>Positive and Negative Syndrome Scale (PANSS) item-data, age, sex, and treatment allocation (antipsychotic/placebo) from 18 placebo-controlled trials of risperidone and paliperidone, in schizophrenia or schizoaffective disorder, were used as predictors for training five supervised learning models to predict symptom remission after 4 weeks of treatment. Sensitivity analyses varying the number of training cases and including simulated uninformative predictors were conducted to assess model performance, as were analyses on simulated data.</p><p><strong>Results: </strong>Better-than-chance predictions could be achieved for all models using as few as 384 training cases (BAC 0.60, SD 0.035 for an ensemble model). Model performance increased with the number of training cases (n = 4384, BAC 0.63, SD 0.041) and was higher when validated on a set of unseen trials without placebo controls (n = 1508, BAC 0.68, SD 0.013). Predictive performance was substantially decreased by including simulated uninformative predictors. Analyses of simulated data suggest that considerably larger sample sizes than commonly used might be required to effectively separate weakly informative from uninformative predictors.</p><p><strong>Conclusion: </strong>Supervised learning models can generate better-than-chance predictions in schizophrenia from small datasets, but this requires that not too many uninformative predictors are included. Since highly predictive models have not yet been established for schizophrenia-and since strong linear predictors are easy to identify-commonly collected clinical trial data likely do not contain predictors with strong linear relations to clinically relevant outcomes. If correct, future machine learning analyses should focus on maximizing the probability of identifying weakly predictive features.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145028636","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":"Pharmacological and Mechanistic Interventions for Cognitive Impairment Associated With Schizophrenia: A Review of Registered Clinical Trials.","authors":"Bahareh Peyrovian, Lena Palaniyappan, Theodore T Kolivakis, Howard C Margolese","doi":"10.1111/acps.70034","DOIUrl":"https://doi.org/10.1111/acps.70034","url":null,"abstract":"<p><strong>Background: </strong>Schizophrenia is characterized by positive, negative, and cognitive symptoms. Current pharmacological treatments often fail to address cognitive deficits. In this review of clinical trials, we aim to identify studies that explore neurobiological (non-psychological) strategies to address Cognitive Impairment Associated with Schizophrenia (CIAS).</p><p><strong>Methods: </strong>A search of clinical trial databases was conducted through US National Institutes of Health's ClinicalTrials.gov and the World Health Organization's International Clinical Trials Registry Platform (ICTRP) on August 2, 2024, with complementary searches performed on July 4 and 10, 2025, for each respective database to update the results.</p><p><strong>Results: </strong>We identified 510 relevant interventional studies that objectively measured cognitive performance. Most trials were conducted in the United States (36.4%) and focused on treatment (79%), with randomized designs (88%), investigating drugs (56%), devices (33%), and dietary supplements (10%). Of these trials, 17% reported positive pro-cognitive evidence. Glutamate modulators were the most studied drug category (63 trials), with positive results for sarcosine, BI425809 (Iclepertin), d-serine, d-cycloserine, and minocycline in small-scale trials, although the results were not replicated in larger studies. Nicotinic receptor modulators like ABT-126 and encenicline also showed some cognitive benefits. Device-based interventions, particularly rTMS and iTBS, demonstrated improvements in global cognition, working memory, attention, and processing speed in a subset of trials.</p><p><strong>Conclusion: </strong>In this comprehensive overview of clinical trials on pro-cognitive agents in schizophrenia, we identify emerging opportunities but also acknowledge a lack of replicated evidence. Despite extensive attempts to address CIAS, it remains an undertreated domain, and future trials should explore better ways to treat this important condition.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144999213","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":"Influence of Sex and Diagnosis on Clinical Variables and Neurocognitive Performance in Severe Mental Illness. Results From the PsyCourse Study.","authors":"Maria Serra-Navarro, Maria Heilbronner, Brisa Solé, Roger Borràs, Anabel Martinez-Arán, Kristina Adorjan, Alba Navarro-Flores, Mojtaba Oraki Kohshour, Daniela Reich-Erkelenz, Eva C Schulte, Fanny Senner, Ion-George Anghelescu, Volker Arolt, Bernhard T Baune, Udo Dannlowski, Detlef E Dietrich, Andreas J Fallgatter, Christian Figge, Markus Jäger, Georg Juckel, Carsten Konrad, Jens Reimer, Eva Z Reininghaus, Max Schmauß, Andrea Schmitt, Carsten Spitzer, Jens Wiltfang, Jörg Zimmermann, Sergi Papiol, Urs Heilbronner, Peter Falkai, Thomas G Schulze, Eduard Vieta, Carla Torrent, Monika Budde, Silvia Amoretti","doi":"10.1111/acps.70026","DOIUrl":"https://doi.org/10.1111/acps.70026","url":null,"abstract":"<p><strong>Introduction: </strong>Bipolar disorder (BD) and schizophrenia (SZ) are serious mental illnesses (SMI) with overlapping symptoms but distinct differences in onset and course. Sex differences are an area of growing interest in SMI. This study aims to examine potential interactions between sex and diagnosis across a broad range of variables, to compare males and females within SZ and BD, and to investigate sex-specific group differences.</p><p><strong>Methods: </strong>A total of 1516 individuals were included in a cross-sectional study using baseline data from the multicenter PsyCourse Study, including BD (n = 543), SZ (n = 517), and healthy controls (HC) (n = 456). Sociodemographic characteristics, clinical symptoms, psychosocial functioning, quality of life, neurocognitive performance, and somatic comorbidities were assessed. Generalized linear models were used to analyze differences between groups and sexes. False Discovery Rate (FDR) and Bonferroni post hoc comparisons were performed.</p><p><strong>Results: </strong>Significant interactions were identified in age (p = 0.001), age at treatment (p = 0.05), illness duration (p = 0.03), illicit drug use (p = 0.01), and smoking (p = 0.05). Differences in substance use were observed across groups and sexes, with the highest rates found in males with SZ. The BD group showed better functioning and neurocognitive performance compared with the SZ group. Within the BD group, females reported better performance in verbal memory (p = 0.003) and psychomotor speed (p < 0.001) than males. Moreover, both females and males with SMI showed higher rates of thyroid alterations compared with HC (p = 0.01 for females and p = 0.002 for males).</p><p><strong>Conclusions: </strong>Significant sex differences were observed in substance use and somatic comorbidities. Interactions between diagnosis and sex underscore the importance of considering both factors in clinical assessments. These findings highlight the need to tailor sex-specific treatment for each patient. Further research is needed to explore the role of sex hormones and other biological and societal factors in the presentation and course of these disorders.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144936578","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 Clinical Judgment in Psychiatry.","authors":"Giovanni A Fava, Jenny Guidi","doi":"10.1111/acps.70035","DOIUrl":"https://doi.org/10.1111/acps.70035","url":null,"abstract":"<p><p>Clinical judgment is currently perceived as an intuitive art that is going to be replaced by growing technology and artificial intelligence. Even though patients look for good clinical judgment when they seek medical attention and clinicians rely on it, the topic is seldom mentioned and discussed in the literature. In their everyday practice, psychiatrists use observation, description, and classification; test explanatory hypotheses; and formulate clinical decisions based on clinical judgment. The aim of this review was to examine the current role of clinical judgment in psychiatry. We first outline the importance of collecting information that supplements the use of diagnostic criteria (allostatic load, health attitudes and behavior, psychological well-being, personality and iatrogenic factors). Clinimetrics, the science of clinical measurements, provides an intellectual home for the reproduction and standardization of clinical intuitions. The clinimetric translation of clinical reasoning allows the organization of the material that has been collected (staging, building unitary concepts, subtyping, formulating pathophysiological links, and global judgments). Finally, we discuss how clinical judgment is the intermediate step between the general indications that derive from clinical trials and individualized treatment plans, encompassing patients' preferences, treatment articulation and selection, level of care, and interpretation of previous treatment response. Clinical judgment remains the basic method of medicine and psychiatry. Improving its features by clinimetric strategies is likely to yield a highly effective precision psychiatry that is available today to any practicing clinician.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991073","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":"Efficacy and Acceptability of Licensed and Off-Label Pharmacological Interventions for Insomnia in Patients With Severe Mental Illness: A Systematic Review and Meta-Analysis of Randomised Trials.","authors":"Nina Friis Bak Fuglsang, Nanna Marker Madsen, Søren Lundorff Jacobsen, Julie Eg Frøkjær, Nicolai Ladegaard, Marc Alberg Sørensen, Christoph U Correll, Christian Otte, Mikkel Højlund, Ole Köhler-Forsberg","doi":"10.1111/acps.70032","DOIUrl":"https://doi.org/10.1111/acps.70032","url":null,"abstract":"<p><strong>Background: </strong>A wide range of drugs is used to alleviate insomnia symptoms in individuals with severe mental illness (SMI), including licensed drugs and sedating drugs prescribed off-label. Yet, no review has gathered the evidence on illness-specific or transdiagnostic outcomes of pharmacological interventions for insomnia. We aimed to perform a systematic review and meta-analysis of randomised controlled trials (RCTs) studying the efficacy and acceptability of pharmacological interventions for insomnia among individuals with SMI, defined as schizophrenia, bipolar disorder (BD) or major depressive disorder (MDD).</p><p><strong>Methods: </strong>We searched for RCTs of pharmacological interventions for insomnia that used either placebo or another medication as inactive control or active comparator. Two independent reviewers performed the literature screening, data extraction and risk of bias assessment (RoB2). We performed random effects meta-analyses on the co-primary outcomes total sleep time (TST), sleep quality and acceptability (all-cause discontinuation) and the secondary outcomes safety and tolerability.</p><p><strong>Results: </strong>The search identified 3331 hits, of which 25 RCTs (n = 2476 individuals) were included, with 18 RCTs (n = 2199) in MDD, 4 RCTs (n = 162) in BD and 3 RCTs (n = 115) in schizophrenia. Of 25 RCTs, 22 had a high risk of bias. The most frequently studied drugs were agomelatine (RCTs = 3, n = 686), eszopiclone (RCTs = 3, n = 599) and zolpidem (RCTs = 3, n = 601). Compared to placebo, pharmacological interventions for insomnia were associated with improved sleep quality by a small effect size (RCTs = 8, g = 0.24, 95% CI = 0.05-0.43) and improved TST (RCTs = 10, MD = 30.82 min, 95% CI = 19.13-42.50), with similar acceptability (RCTs = 10, RR = 1.06, 95% CI = 0.90-1.25).</p><p><strong>Discussion: </strong>Despite their frequent use, many licensed and off-label pharmacological interventions for insomnia have never been investigated in patients with SMI. The studies that provided sufficient data for meta-analysis showed better efficacy with similar acceptability compared to placebo, but the generalizability of these results is limited by the high heterogeneity and low quality of the included studies. This underscores the need for high-quality RCTs to provide a better scientific basis for the pharmacological treatment of insomnia in SMI.</p><p><strong>Trial registration: </strong>CRD42023413787.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144936550","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":"Predicting Cognitive Change During Treatment for Inpatient Depression: Secondary Analysis From a Randomized Controlled Trial.","authors":"Zoe A Odering, Jennifer Jordan, Cameron J Lacey, Christopher M Frampton, Richard J Porter, Katie M Douglas","doi":"10.1111/acps.70030","DOIUrl":"https://doi.org/10.1111/acps.70030","url":null,"abstract":"<p><strong>Introduction: </strong>Individuals hospitalized with depression are particularly impacted by cognitive impairment. Identifying variables that predict improvements in cognition across treatment may inform more targeted and effective treatment approaches. We conducted secondary analyses to investigate baseline predictors of objective cognitive change in a severely depressed inpatient sample.</p><p><strong>Methods: </strong>A randomized controlled trial (RCT) comparing 2 weeks of Activation Therapy (AT; Cognitive Activation combined with Behavioural Activation) with treatment-as-usual (TAU) was conducted in inpatients with major depression. Research assessments were conducted at baseline (on admission) and at 14 weeks (12 weeks after treatment-end). A series of analyses of covariance models were conducted to examine associations between change in executive functioning/attention, verbal learning and memory, visuospatial learning and memory, and psychomotor speed, in global cognition, and a range of putative baseline predictor variables (e.g., demographic, mood, cognition, general functioning, childhood trauma) across the whole RCT sample. Treatment arm was included as a fixed factor in all models. Sensitivity analyses were run in the AT group only to examine predictors of cognitive change in those receiving this targeted cognitive treatment.</p><p><strong>Results: </strong>Sixty-eight individuals completed baseline and follow-up cognitive testing assessments in the RCT (AT, n = 32, TAU, n = 36). Significantly poorer domain-specific baseline cognitive functioning was associated with greater cognitive improvement in all four domains. Older age was associated with less cognitive change in verbal learning and memory, visuospatial learning and memory, psychomotor speed, and global cognition. Sensitivity analyses (AT group only) identified these same factors as significant predictors.</p><p><strong>Conclusion: </strong>Age and domain-specific baseline cognitive performance were consistently associated with cognitive change in this RCT. Findings suggest that cognition seems to recover better in younger inpatients with poorer baseline cognitive functioning.</p><p><strong>Clinical registration: </strong>Australian New Zealand Clinical Trials Registry [ANZCTR], ACTRN12617000024347p.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144936551","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":"Improving the Accuracy and Reliability of Ratings on the Hamilton Depression Rating Scale via a Video-Based Training Program.","authors":"Pernille Kølbæk, Botilla Dalsgaard Jensen, Erik Roj Larsen, Søren Dinesen Østergaard","doi":"10.1111/acps.70029","DOIUrl":"https://doi.org/10.1111/acps.70029","url":null,"abstract":"<p><strong>Introduction: </strong>The clinician-rated 17-item Hamilton Depression Rating Scale (HAM-D17) allows for a systematic severity assessment of depressive symptoms. Applying the HAM-D17 in clinical practice requires that staff members' ratings on the HAM-D17 are accurate and reliable. Here, we aimed to investigate whether such accuracy and reliability can be achieved through a brief video-based training program.</p><p><strong>Methods: </strong>One-hundred-and-ten psychiatric hospital staff members (psychologists, medical doctors, nurses, health care workers, physio-/occupational therapists, and social workers) performed baseline HAM-D17 ratings after watching a videotaped patient interview. Subsequently, a theoretical introduction video was displayed, followed by five successive videotaped patient interviews. After watching each interview, individual ratings were conducted before a video providing the gold standard rating was displayed. Accuracy was estimated by calculating the proportion of participants whose ratings did not display a deviation from the gold standard of > 1 point on all individual HAM-D17 items and > 6 points on the HAM-D17 total score. Reliability was calculated using Gwet's agreement coefficient (AC1).</p><p><strong>Results: </strong>At baseline and after the sixth rating session, 43% versus 70% of the staff members, respectively, rated within the acceptable deviation of the gold standard (p < 0.001). At the HAM-D17 item level, baseline reliability indices were highest for item 6 (Late Insomnia) and lowest for item 14 (Sexual Interest) (AC1 = 0.97 vs. 0.47), but both improved following training (AC1 = 0.99 vs. 0.84 at the sixth rating session).</p><p><strong>Conclusions: </strong>Most staff members conducted accurate and reliable HAM-D17 ratings after participating in a brief video-based training program.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144936543","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":"Internet-Based Cognitive Assessments During Remission in Bipolar Disorder: Subjective Cognitive Function and Clinical Severity.","authors":"Kristin Svee, Gunnar Morken, Tor Ivar Hansen, Anne Engum","doi":"10.1111/acps.70031","DOIUrl":"https://doi.org/10.1111/acps.70031","url":null,"abstract":"<p><strong>Introduction: </strong>Cognitive impairment is well-established in bipolar disorder and significantly impacts daily functioning. However, the relationship between self-evaluated cognitive functions and objective cognitive tests is inconsistent. This heterogeneity in cognitive function necessitates flexible and accessible testing methods. An Internet-based test platform can address this need. This study examines cognitive function in individuals with bipolar disorder in full or partial remission using an Internet-based test platform. It explores associations with subjective cognitive function and clinical severity.</p><p><strong>Methods: </strong>In this cross-sectional study, the Memoro Internet-based cognitive test platform was used to assess objective cognitive functions. We recruited 84 participants with bipolar disorder type I or II in full or partial remission at the time of assessment, aged 18 to 65 years, from a bipolar outpatient clinic at a university hospital. We examined the completion rates of cognitive tests, reported technical issues, and differences between cognitively normal and impaired groups. Subjective cognition was measured using Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA).</p><p><strong>Results: </strong>A total of 84 participants completed the Memoro assessment of objective cognitive performance. No significant differences were observed in the completion rates of cognitive subtests or reported technical issues across groups. Of the participants, 61.9% were classified as cognitively normal, while 38.1% had cognitive impairments. 86.9% reported cognitive complaints. Correlation analysis indicated relationships between cognitive complaints (COBRA), symptoms of anxiety, and verbal memory. Multiple regression analyses identify symptoms of anxiety and age as significant predictors of verbal immediate recall and cognitive complaints.</p><p><strong>Conclusion: </strong>Objective measurements showed fewer cognitive problems than subjective reports. Additionally, anxiety symptoms may contribute to overreporting cognitive complaints.</p><p><strong>Clinical registration: </strong>ClinicalTrials.gov identifier: NCT04454073.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144936575","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":"Unravelling the Link Between Body Mass Index and Cognitive Performance in Individuals With Bipolar Disorder and Exploration of PRS Moderation Effect: Findings From the PsyCourse Study.","authors":"B Solé, L Montejo, M Budde, M Valentí, R Borràs, S Martín-Parra, A Ruiz, A Martínez-Aran, K Adorjan, M Heilbronner, A Navarro-Flores, M Oraki Kohshour, D Reich-Erkelenz, E C Schulte, F Senner, I G Anghelescu, V Arolt, B T Baune, U Dannlowski, D E Dietrich, A J Fallgatter, C Figge, G Juckel, C Konrad, J Reimer, E Z Reininghaus, M Schmauß, C Spitzer, J Wiltfang, J Zimmermann, P Falkai, E Vieta, T G Schulze, C Torrent, U Heilbronner, S Papiol","doi":"10.1111/acps.70028","DOIUrl":"https://doi.org/10.1111/acps.70028","url":null,"abstract":"<p><strong>Introduction: </strong>Bipolar disorder (BD) is a severe mental disorder characterized by extreme mood swings, often accompanied by metabolic comorbidities, such as cardiovascular disease, which increase mortality and reduce quality of life. Both metabolic dysfunctions and BD are associated with cognitive dysfunction. Body mass index (BMI) is closely linked to metabolic health and cognitive performance. This study examined the link between BMI and cognitive function in individuals with BD and how genetic factors, namely polygenic risk scores (PRS) for BD and BMI, might influence this link.</p><p><strong>Methods: </strong>Genetic (PRS scores) and phenotypic data (sociodemographic factors, clinical symptoms and cognitive function) of 341 adult patients with BD diagnosis from the PsyCourse Study, a large, multi-site, and naturalistic longitudinal study, were utilized for this study. First, we performed univariate and multivariate regression analyses to investigate associations between BMI and cognitive performance. Second, moderation analyses were conducted to examine the potential moderator effects of BD-PRS or BMI-PRS in the relationship between BMI and different cognitive outcomes.</p><p><strong>Results: </strong>BMI was associated with processing speed (TMT-A) and executive function (TMT-B), with individuals with higher BMI showing poorer performance. Moderation analyses revealed that the effect of BMI on cognition was moderated by BD-PRS only regarding the processing speed. BMI-PRS did not moderate the association between BMI and cognitive variables.</p><p><strong>Conclusions: </strong>Our findings indicate that the relationship between BMI and cognitive impairment in BD is partially moderated by BD genetic liability but not by BMI genetic load.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144936571","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}