Acta Psychiatrica Scandinavica最新文献

{"title":"Cognition in Psychiatry: Treatment Targets, Mechanisms, and Assessment Innovations.","authors":"Kamilla W Miskowiak, Katherine E Burdick","doi":"10.1111/acps.70015","DOIUrl":"https://doi.org/10.1111/acps.70015","url":null,"abstract":"","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688431","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":"Predictors of Improvement in Subjective Executive Functioning Following an Internet-Delivered Cognitive Enhancement Intervention for Adults in Remission From Depression.","authors":"Sunniva Brurok Myklebost, Tine Nordgreen, Eivind Haga Ronold, Aleksander Heltne, Åsa Hammar","doi":"10.1111/acps.70019","DOIUrl":"https://doi.org/10.1111/acps.70019","url":null,"abstract":"<p><strong>Introduction: </strong>Residual cognitive deficits are commonly reported by individuals in remission from depression, often affecting daily life functioning and mental health. To provide tailored and personalized cognitive enhancement interventions for this population, there is a need for a better understanding of the characteristics of those who benefit from such interventions. Therefore, this study aimed to identify predictors of changes in subjective executive functioning following an internet-delivered cognitive enhancement intervention for adults in remission from depression.</p><p><strong>Methods: </strong>Data were collected from a randomized controlled trial investigating the efficacy of an internet-delivered cognitive enhancement intervention. Changes in subjective executive functioning from pre-treatment to the six-month follow-up were assessed in 44 participants in remission from depression, using the Behavior Rating Inventory of Executive Function Adult Global Executive Composite. Linear mixed model analyses were conducted to investigate the impact of demographic, clinical, and treatment credibility variables on change in subjective cognitive functioning over time.</p><p><strong>Results: </strong>The results showed that shorter lifetime depression duration predicted greater improvements in subjective executive functioning (p = 0.031). Higher levels of treatment expectancy and credibility were related to greater improvements in subjective cognitive functioning (p = 0.024). Participants with a partner showed better treatment response than those without a partner (p < 0.001).</p><p><strong>Conclusion: </strong>This study builds on previous research on cognitive enhancement interventions in remitted depression, highlighting the impact of depression duration, treatment expectancy, and credibility on treatment response. Interventions targeting cognitive deficits appear most effective for those with a shorter lifetime duration of depression. Therefore, efforts should be made to enhance outcomes in those with a chronic course. To maximize engagement and outcomes, these interventions should be delivered in a way that individuals in remission from depression view them as credible and capable of reducing their deficits. Previous research has not found partner status to predict change in subjective executive functioning. The effect of partner status on treatment response should be investigated further.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673385","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":"Healthcare Occupations, Suicides, and Suicide Attempts: A Cohort Study Based on the Working Population in Sweden.","authors":"Alicia Nevriana, Emma Brulin, Tomas Hemmingsson, Melody Almroth, Kuan-Yu Pan, Theo Bodin, Katarina Kjellberg, Daniel Falkstedt","doi":"10.1111/acps.70018","DOIUrl":"https://doi.org/10.1111/acps.70018","url":null,"abstract":"<p><strong>Introduction: </strong>Many studies have examined physicians' risk of suicide, but studies of other healthcare occupations have been fewer. Suicide attempts have also rarely been studied. We aimed to determine the risks of suicide and suicide attempts among healthcare workers in comparison with non-healthcare workers, according to occupational qualification level.</p><p><strong>Methods: </strong>This population-based cohort study linking Swedish national registers included 243,183 healthcare workers in high-qualified occupations (e.g., physicians); 1,789,076 workers in other high-qualified occupations; 514,726 healthcare workers in low-qualified occupations (e.g., assistant nurses); and 2,026,890 workers in low-qualified occupations residing in Sweden in 2005 and followed them until the latest December 31, 2020. We estimated adjusted hazard ratios (aHR) for suicide and first suicide attempt.</p><p><strong>Results: </strong>Compared to non-healthcare workers, higher risks for suicide were observed for several healthcare occupations, primarily those working with patient care (e.g., aHR physicians 1.57, 95% CI: 1.23-2.00, registered nurses 1.61, 95% CI: 1.37-1.88, assistant nurses 1.25, 95% CI: 1.17-1.34), rather than those in administrative roles (aHR high-qualified healthcare administrators 1.01 95% CI: 0.76-1.35). Among physicians, the risk was most apparent for psychiatrists (aHR 2.70, 95% CI: 1.21-6.03). For suicide attempts, the risks were primarily observed among registered nurses (aHR 1.22, 95% CI: 1.15-1.29) and assistant nurses (aHR 1.15, 95% CI: 1.12-1.18). Among healthcare workers, assistant nurses had the highest incidence rates for suicide (18.7/100,000 person-years) and suicide attempts (175.1/100,000 person-years).</p><p><strong>Conclusions: </strong>Workers in several healthcare occupations showed a higher risk of suicide relative to non-healthcare workers with a similar occupational qualification level. Interventions may need to be developed to reduce the risk of suicidal behavior in these groups.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673384","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":"Bipolar Disorder and Poisoning due to Medicines or Illegal Substances.","authors":"Mikko Niskanen, Olli Kärkkäinen, Heidi Taipale, Johannes Lieslehto, Jari Tiihonen, Aleksi Hamina","doi":"10.1111/acps.70017","DOIUrl":"https://doi.org/10.1111/acps.70017","url":null,"abstract":"<p><strong>Background: </strong>Individuals with bipolar disorder face an elevated risk of premature death, often due to external causes such as accidental injuries, self-harm, and substance-related deaths. This study aimed to investigate the incidence of severe poisonings among individuals with bipolar disorder and to examine associated demographic and clinical factors.</p><p><strong>Methods: </strong>We conducted a cohort study using data from national registers in Finland, measuring hospitalizations and deaths due to poisoning by medicines or illegal substances in 1996-2018. Cox proportional hazards regression models were used to assess associations between predictor variables and poisoning outcomes.</p><p><strong>Results: </strong>The study population comprised 60,045 individuals aged 15-65 diagnosed with bipolar disorder in 1987-2018. During the study period, 13.1% (N = 7872) of the population experienced at least one poisoning resulting in hospitalization or death. The age-standardized rate of hospitalizations was 50.6 (95% CI, 49.5-51.7) per 1000 person-years and of deaths 1.8 (95% CI, 1.6-2.0) per 1000 person-years. The majority of poisonings leading to hospitalization (59.1%) or death (56.6%) were intentional and caused by pharmaceuticals (hospitalizations, 76.9%; deaths, 63.6%). Additionally, psychoactive narcotics and stimulants were the cause of 26.8% of the poisoning deaths. The strongest risk factors for hospitalization were substance use disorder (adjusted hazard ratio, aHR, 2.75, 95% CI, 2.61-2.90) and a history of suicide attempt (2.70, 2.52-2.88). The risk of poisoning death was most strongly associated with substance use disorder (3.02, 2.60-3.52) and a history of suicide attempt (2.38, 1.94-2.91). Female sex was associated with a higher risk of hospitalization (1.19, 1.14-1.25), but a lower risk of death (0.72, 0.62-0.82).</p><p><strong>Conclusion: </strong>Individuals with bipolar disorder face a substantial risk of poisoning by medicines or illegal substances, with notable sex differences in hospitalization and death rates. Key risk factors include substance use disorder and a history of suicide attempt.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144657913","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":"Life Expectancy, Loss of Life Expectancy, and Lifetime Costs in Bipolar Disorder: A Nationwide Population-Based Study.","authors":"Ikbal Andrian Malau, Ying-Ming Chiu, Hui-Chih Chang, Ya-Chu Yang, Jane Pei-Chen Chang, Christoph U Correll, Vieta Eduard, Kuan-Pin Su","doi":"10.1111/acps.70013","DOIUrl":"https://doi.org/10.1111/acps.70013","url":null,"abstract":"<p><strong>Introduction: </strong>Bipolar disorder (BD) significantly affects life expectancy (LE), results in substantial loss of LE, and contributes to high medical costs, with these impacts varying by age at onset and gender. Previous studies have often overlooked the significance of age at the onset when estimating LE in individuals with BD. This study aimed to address this limitation and assess the impacts of BD on LE, loss of LE, and medical costs for BD patients categorized by age and gender in Taiwan using a new semiparametric extrapolation method over an 11-year duration.</p><p><strong>Methods: </strong>A rolling-over algorithm estimated the survival function, with lifetime risk extrapolated. LE and loss of LE were calculated by comparing BD patients to matched non-BD referents by sex, age, and diagnosis year. Lifetime medical costs were determined by multiplying average monthly expenses by survival rates. Data from Taiwan's National Health Insurance (2009-2019) identified BD patients aged 5-84 with ≥ 2 outpatient or ≥ 1 inpatient BD diagnosis. The semiparametric survival extrapolation method was validated by comparing it with the Kaplan-Meier analysis.</p><p><strong>Results: </strong>The results indicate that following a BD diagnosis, patients have an LE of 26.79 years, reflecting a loss of 15.08 years compared to matched referents. On average, patients with BD incurred annual medical expenses of around $2516, with costs rising with age for both sexes. The mean estimated lifetime cost for the study population was about $55,015. The extrapolation method demonstrated high accuracy, with a less than 5% relative bias.</p><p><strong>Conclusion: </strong>Semiparametric extrapolation is an effective method for estimating LE, loss of LE, and lifetime costs in BD. Future work could refine semiparametric extrapolation and assess factors influencing LE loss and lifetime costs in BD.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641299","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":"Psychosis and Dementia-Disorders of Disadvantage.","authors":"Lucy Gibson, Christoph Mueller, Robert Stewart","doi":"10.1111/acps.70012","DOIUrl":"https://doi.org/10.1111/acps.70012","url":null,"abstract":"","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574523","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":"Transcriptomic and Neurotransmitter Insights Into Gray Matter Volume Changes From 1 Hz rTMS in Treating Schizophrenia With Auditory Verbal Hallucinations.","authors":"Yuanjun Xie, Chenxi Li, Muzhen Guan, Tian Zhang, Chaozong Ma, Lingling Wang, Xinxin Li, Yijun Li, Zhongheng Wang, Huaning Wang, Peng Fang","doi":"10.1111/acps.70014","DOIUrl":"https://doi.org/10.1111/acps.70014","url":null,"abstract":"<p><strong>Background: </strong>Auditory verbal hallucinations (AVH) are prominent positive symptoms of schizophrenia that frequently prove resistant to conventional antipsychotic treatments. Low-frequency repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising intervention for AVH; however, the underlying neurobiological mechanisms mediating its efficacy remain incompletely understood.</p><p><strong>Methods: </strong>In this study, schizophrenia patients with AVH were randomly assigned to either an active stimulation group or a sham control group. The active stimulation group received 1 Hz rTMS targeting the left temporoparietal junction (TPJ), while the sham group underwent an identical procedure without actual stimulation. Structural MRI scans were conducted before and after treatment to evaluate changes in gray matter volume (GMV). Further analyses examined associations between GMV changes and both gene expression profiles and neurotransmitter receptor densities.</p><p><strong>Results: </strong>Active rTMS stimulation resulted in a significant reduction in AVH symptoms and was associated with increased GMV in specific cortical regions related to sensory and cognitive processing. These structural changes correlated with gene sets enriched in neuroplasticity-related pathways, such as cell morphogenesis, chromatin remodeling, and vesicle cytoskeletal trafficking. Notable changes were also observed in neurotransmitter receptor densities, particularly for serotonin (5HT1a), dopamine (D1), and glutamate (mGluR5) receptors. Multiple linear regression analysis identified specific hub gene expressions, such as ANK1, and patterns of neurotransmitter density, especially mGluR5, as significant predictors of GMV changes following rTMS stimulation.</p><p><strong>Conclusion: </strong>Low-frequency rTMS induced GMV changes, coupled with alterations in gene expression and neurotransmitter receptor densities, contribute to symptom alleviation in schizophrenia patients with AVH. These findings support rTMS as a promising intervention for targeting the neurobiological substrates underlying AVH in schizophrenia.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574524","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":"Relationships of Cognitive Function With Subsequent Device-Measured Physical Activity and Sedentary Time in Healthy Individuals and Those With Bipolar Disorder: Findings From the UK Biobank.","authors":"Elysha Ringin, David W Dunstan, Denny Meyer, Roger S McIntyre, Neville Owen, Michael Berk, Susan L Rossell, Mats Hallgren, Tamsyn E Van Rheenen","doi":"10.1111/acps.70011","DOIUrl":"https://doi.org/10.1111/acps.70011","url":null,"abstract":"<p><strong>Background: </strong>In bipolar disorder (BD), physical inactivity and sedentary behaviour are prevalent and have been linked to BD's cognitive symptoms, although the directionality of these links is not clear. This proof-of-concept study examined whether cognitive function during mid- and later-life was prospectively related to physical activity and sedentary time, and whether the association differed in presence or extent between those with BD and healthy controls.</p><p><strong>Methods: </strong>Relevant UK Biobank data were available for 646 BD participants and 18,041 psychiatrically healthy controls, aged 40-69 years at baseline. Cognition was assessed during a baseline assessment, and wrist-worn accelerometry data were collected at a follow-up assessment 2.8-6.6 years later. Regression analyses examined prospective relationships of global cognition, diagnostic group, and their interaction, with physical activity (total, light, and moderate to vigorous) and sedentary time.</p><p><strong>Results: </strong>Baseline cognitive function was inversely associated with light physical activity (coeff. = -5.64, 95% CI: -6.30 to -4.98) and positively associated with sedentary time (coeff. = 5.17, 95% CI: 4.48-5.86) and moderate-to-vigorous physical activity (coeff. = 0.48, 95% CI: 0.28-0.68) at follow-up. Observed effect sizes were small but significant. In general, associations were not moderated by age or diagnostic group.</p><p><strong>Conclusions: </strong>The current study provides preliminary evidence that cognitive function may influence subsequent physical activity and sedentary time similarly in those with BD and healthy controls; however, further research is needed to confirm and further explore this findings.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558562","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":"Does Lithium Lower the Risk of Glaucoma-A Danish Nationwide Study.","authors":"Tomas Hajek, Orestes Forlenza, Marcelo Nicolela, Ann-Eva Christensen, Henrik Vorum, René Ernst Nielsen","doi":"10.1111/acps.70010","DOIUrl":"https://doi.org/10.1111/acps.70010","url":null,"abstract":"<p><strong>Background: </strong>Glaucoma is an optic neuropathy caused by neurodegenerative loss of retinal ganglion cells (RGC). Mechanisms that contribute to RGC death include some of the same mechanisms involved in bipolar disorders (BD) and are the same mechanisms which are targeted by lithium (Li). We conducted a pharmacoepidemiological, population study in Denmark testing the links between Li prescriptions and risk of glaucoma.</p><p><strong>Study design: </strong>A nationwide, register-based historical, prospective cohort study of participants who were alive and over the age of 18 between January 1, 1996 and December 31, 2019. Participants were followed from the start of study until censoring or glaucoma.</p><p><strong>Study results: </strong>A total of 7,683,398 individuals (51.3% females) contributing 121,366,461 person-years were included in the study. In the general population, Li exposure was associated with developing glaucoma (HR = 1.10, 95% CI = 1.02-1.19, p = 0.01), but this association was not present in the population with BD (HR = 1.07, 95% CI = 0.93-1.22, p = 0.34). In the cumulative dosage analyses of the entire population, people with no Li prescription (HR = 0.78 95% CI = 0.66-0.93, p = 0.01) and between 365 defined daily doses (DDDs) and 5 × 365 DDDs of Li showed significantly reduced risk of glaucoma, relative to at least one prescription (HR = 0.79, 95% CI = 0.64-0.99, p < 0.05).</p><p><strong>Conclusion: </strong>BDs as indexed by Li prescription are associated with a greater risk of glaucoma. This is in keeping with generally increased rates of medical comorbidities in BD. While there was no clear dose-response relationship, some of the higher cumulative exposures to Li might be protective relative to a single prescription.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558561","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":"Association Between Inflammatory Markers and Cognitive Function in Adults With Bipolar Disorder: A Systematic Review.","authors":"David R A Coelho, Jennifer Nicoloro Santabarbara, Marzieh Majd, Willians Fernando Vieira, Maura De Laney, Melis Lydston, Olindo Assis Martins-Filho, Lilian Maria Garcia Bahia-Oliveira, Joshua D Salvi, Paolo Cassano, Katherine E Burdick","doi":"10.1111/acps.13824","DOIUrl":"https://doi.org/10.1111/acps.13824","url":null,"abstract":"<p><strong>Introduction: </strong>Bipolar disorder (BD) is frequently associated with cognitive dysfunction, which can significantly impact the quality of life and functional recovery of affected individuals. Growing evidence suggests that inflammation may contribute to the cognitive dysfunction observed in BD.</p><p><strong>Methods: </strong>We conducted a systematic review following PRISMA guidelines, searching six databases on March 23, 2023 (PubMed, Embase, Cochrane Library, Web of Science, PsycINFO, and ClinicalTrials.gov), with the aim of identifying studies that examined the relationship between peripheral or central inflammatory markers and cognitive function in adults with BD. Studies involving animals, abstracts, protocols, reviews, and non-English publications were excluded. The quality of included studies was assessed using the Risk of Bias in Non-Randomized Studies-of Exposure (ROBINS-E). A narrative synthesis was completed, stratifying results based on the associations between inflammatory markers and cognitive domains in BD. The review protocol was pre-registered in PROSPERO (CRD42023415437).</p><p><strong>Results: </strong>Out of 2680 identified records, 25 studies involving 3567 adults with BD (mean age: 43.6 years; 1839 females and 1728 males) met the inclusion criteria. Seventeen studies were classified as low risk of bias, seven as having some concerns, and one as high risk. Elevated levels of C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interleukin-1 receptor antagonist (IL-1Ra) were most commonly associated with cognitive dysfunction in domains such as executive function, processing speed, and memory. Findings for other inflammatory markers were less consistent. Most studies relied on cross-sectional designs, which limit causal interpretations.</p><p><strong>Conclusion: </strong>This review found a consistent association between inflammation and cognitive dysfunction in BD, particularly involving CRP, TNF-α, IL-6, and IL-1RA in areas such as executive function, processing speed, and memory. Targeting inflammation may offer a promising approach to mitigating these cognitive challenges. Future studies should prioritize longitudinal designs, standardized cognitive assessments, and the exploration of central inflammatory markers to better understand the neurobiological processes underlying cognitive dysfunction in BD. These findings may help inform the development of adjunctive anti-inflammatory strategies to support cognitive health in individuals with BD.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688430","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}