Acta Psychiatrica Scandinavica最新文献

{"title":"Potentially Harmful Consequences of Artificial Intelligence (AI) Chatbot Use Among Patients With Mental Illness: Early Data From a Large Psychiatric Service System","authors":"Sidse Godske Olsen, Christian Jon Reinecke-Tellefsen, Søren Dinesen Østergaard","doi":"10.1111/acps.70068","DOIUrl":"10.1111/acps.70068","url":null,"abstract":"<p>Chatbots driven by generative artificial intelligence (AI chatbots) have become ubiquitous [<span>1</span>]. While the large language model technology underlying these tools may have a huge potential for societies at large, concerns—and substantial anecdotal evidence [<span>2</span>]—have risen over the possibility that use of AI chatbots may be harmful for people prone to mental illness [<span>3-5</span>]. Specifically, it seems that interaction with AI chatbots, especially if intense/of long duration, may contribute to onset or worsening of delusions or mania, with severe or even fatal consequences [<span>2-5</span>]. Given the large uptake of this technology, ChatGPT—the clear market leader—passed 900 million downloads in July 2025 [<span>1</span>], this could pose a tangible threat to public mental health. At this stage, however, almost all reports on potentially harmful consequences of AI chatbots stems from news media or online fora [<span>2</span>]—and should be interpreted with the inherent limitations of these outlets in mind. Conversely, to our knowledge, there are very few accounts of this phenomenon from psychiatric services - with the first case report on delusions developed in relation to use of ChatGPT being published recently [<span>6</span>]. Therefore, we aimed to investigate whether there are reports compatible with potentially harmful consequences of AI chatbot use on mental health among patients with mental illness receiving care in a large psychiatric service system.</p><p>This study was conducted in accordance with the method used to assess the potential impact of the COVID-19 pandemic [<span>7</span>] and the 2022 Russian invasion of Ukraine [<span>8</span>] on the mental health of patients with mental illness. Specifically, we identified all patients registered with at least one contact with the Psychiatric Services of the Central Denmark Region (CDR)—one of five Danish regions providing inpatient, outpatient and emergency psychiatric care to its approximately 1.4 million inhabitants—in the period from September 1, 2022, to June 12, 2025 (ChatGPT was launched publicly on November 30, 2022). Subsequently, we searched all clinical notes in the electronic health records of these patients for the words “chatbot” and “ChatGPT” (not case sensitive) along with the following 10 alternative spellings/misspellings for each: “chat bot,” “chat-bot,” “chattbot,” “chatboot,” “chatbott,” “chatbotts,” “chatbote,” “chatbox,” “chabot,” “chatpot,” “Chat GTP,” “ChatGBT,” “ChatGRT,” “ChatGPTT,” “Chat GPT,” “Chat-GPT,” “ChattGPT,” “ChatJPT,” “ChatGBT,” and “ChatGPT3.” These 20 alternatives were provided by ChatGPT based on the following prompt: “Please create a list of the top 20 likely misspellings or variations of the words <i>ChatGPT</i> and <i>chatbot</i> that might arise from common human spelling errors, typos, or misunderstandings of the correct terms. Provide 10 variations for each word.” We chose to include only ChatGPT and no othe","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"153 4","pages":"301-303"},"PeriodicalIF":5.0,"publicationDate":"2026-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12967755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123027","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":"Examining Social Barriers in Adults With ADHD: The Role of Autistic Traits, Empathy, Theory of Mind in Social Anxiety and Avoidance","authors":"Ali Kandeğer,&nbsp;Carrie Allison,&nbsp;M. Ediz Çelik,&nbsp;Hacer Söylemez,&nbsp;Ömer Bayırlı,&nbsp;Yavuz Selvi,&nbsp;Simon Baron-Cohen","doi":"10.1111/acps.70067","DOIUrl":"10.1111/acps.70067","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This case–control study examined social barriers in adults with ADHD compared to non-neurodivergent adults, focusing on autistic traits, cognitive/affective empathy, theory of mind (ToM), and social anxiety/avoidance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 142 adults with ADHD and 104 non-neurodivergent groups were assessed using the following self-report measures: the Adult ADHD Self-Report Scale, the Hospital Anxiety Depression Scale, the Autism Spectrum Quotient, the Empathy Quotient, and the Liebowitz Social Anxiety Scale. ToM was evaluated using the Reading the Mind in the Eyes Test. Additionally, psychiatric interviews were conducted, incorporating diagnostic evaluation via the Structured Clinical Interview for DSM-5 Disorders—Clinician Version, along with collection of sociodemographic and clinical data, and documentation of real-life narratives of social struggles to contextualize and deepen the interpretation of the quantitative findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Adults with ADHD exhibited significantly higher levels of autistic traits and social anxiety/avoidance, along with lower cognitive and affective empathy scores, compared to controls, while ToM abilities did not differ significantly between groups. Moreover, regression analyses indicated that challenges in social skills and communication, low cognitive empathy, heightened affective empathy, and difficulties in attention switching accounted for variance in social anxiety/avoidance, independent of confounding sociodemographic and clinical factors, including the presence of co-occurring psychiatric conditions and the severity of ADHD, depression, and anxiety symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>While adults with ADHD exhibit intact basic ToM abilities, challenges in social-cognitive processes are associated with their social barriers. Targeted interventions such as social skills training, executive function coaching, and anxiety management may improve social outcomes and quality of life, as also highlighted by the real-life narratives—although further longitudinal, multi-method research is warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"153 4","pages":"279-289"},"PeriodicalIF":5.0,"publicationDate":"2026-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145950930","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":"Correction to “Clinical and Societal Burden of Incident Major Depressive Disorder: A Population-Wide Cohort Study in Stockholm”","authors":"","doi":"10.1111/acps.70074","DOIUrl":"10.1111/acps.70074","url":null,"abstract":"<p>J. Lundberg, T. Cars, S.-Å. Lööv, et al., “Clinical and Societal Burden of Incident Major Depressive Disorder: A Population-Wide Cohort Study in Stockholm,” <i>Acta Psychiatrica Scandinavica</i> 146 (2022): 51–63, https://doi.org/10.1111/acps.13414.</p><p>In the original publication, under the sub-heading “RESEARCH PROJECT ORGANIZATION AND ROLES AND FUNDING” the following is written:</p><p>“This research project is part of a framework aimed to facilitate research collaborations between the public healthcare authorities in Stockholm County, Sweden, and research-based companies. All pharmaceutical companies in Sweden were invited to participate in this depression research program via the pharmaceutical industry trade association. Region Stockholm was the initiator of this research project and governed all research data. Region Stockholm further supported this project with scientific and clinical expertise. In this research program, Janssen-Cilag AB Sweden participated and in addition to providing scientific expertise, Janssen-Cilag AB also supported the analytic work for this project via an external company in biostatistics (Sence Research AB). No financial transfers were made between Janssen-Cilag AB and Region Stockholm.”</p><p>There is an omission in the paragraph above. Specifically, at the time of the publication, author Thomas Cars was an employee of and a shareholder in Sence Research AB, the external company providing biostatistical support to the project. This represents a potential conflict of interest.</p><p>We apologize for this error.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"153 4","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.70074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146049573","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":"Psychological and Mental Effects of Artificial Intelligence: Experiments First Targeting Doctors and Authors","authors":"Shigeki Matsubara","doi":"10.1111/acps.70066","DOIUrl":"10.1111/acps.70066","url":null,"abstract":"","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"153 4","pages":"304-305"},"PeriodicalIF":5.0,"publicationDate":"2026-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145898694","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":"Digital Social Cognition Training Enhancing Social Cognition in Patients With Schizophrenia: A Systematic Review and Meta-Analysis","authors":"Ching-Ming Wang,&nbsp;Sriyani Padmalatha Konara Mudiyanselage,&nbsp;Pei Chi Wang,&nbsp;Chia-Fen Hsu,&nbsp;Huai-Hsuan Tseng","doi":"10.1111/acps.70060","DOIUrl":"10.1111/acps.70060","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Social cognition deficits, such as impaired emotion recognition, theory of mind (ToM), and empathy are central to schizophrenia-spectrum disorders and predict poor functional outcomes. Conventional therapies often lack scalability. Technology-based social cognition training (TBSCT), using computerized, web-based, or virtual reality (VR) formats, offers an accessible and adaptive solution.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following PRISMA guidelines (PROSPEROCRD420251021242), databases including Embase, MEDLINE, Cochrane, CINAHL, Web of Science, and PsycArticles were searched up to May 2025. Eligible randomized or quasi-experimental studies involved adults with schizophrenia-spectrum disorders receiving TBSCT targeting emotion recognition, ToM, or empathy. Methodological quality was assessed using Joanna Briggs Institute tools. Random-effects meta-analyses estimated pooled effect sizes (Hedges' g), with subgroup analyses by technology type, clinical setting, and intervention focus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-one studies (17 in meta-analysis) met inclusion criteria. TBSCT significantly enhanced facial emotion recognition (FER; g = 0.92, <i>p</i> &lt; 0.001) and showed a small effect on ToM (g = 0.22, <i>p</i> = 0.05); empathy improved pre–post (g = 0.58, <i>p</i> = 0.04). FER benefits were strongest in web-based (g = 1.35), followed by VR (g = 0.87) and computerized programs (g = 0.75). ToM gains were significant only among outpatients. Methodological quality was moderate to high, with mild, transient adverse effects and comparable dropout rates (risk difference = −0.03, <i>p</i> = 0.21).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>TBSCT effectively improves social cognition, particularly emotion recognition in schizophrenia-spectrum disorders. The interventions are safe, feasible, and scalable, supporting clinical implementation. Future studies should examine long-term efficacy and optimize engagement across diverse psychiatric populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"153 4","pages":"231-256"},"PeriodicalIF":5.0,"publicationDate":"2026-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145848577","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":"Family History and Solar Insolation in Bipolar I Disorder","authors":"M. Bauer,&nbsp;T. Glenn,&nbsp;E. D. Achtyes,&nbsp;M. Alda,&nbsp;E. Agaoglu,&nbsp;K. Altınbaş,&nbsp;O. A. Andreassen,&nbsp;E. Angelopoulos,&nbsp;R. Ardau,&nbsp;M. Aydin,&nbsp;Y. Ayhan,&nbsp;C. Baethge,&nbsp;R. Bauer,&nbsp;B. T. Baune,&nbsp;C. Balaban,&nbsp;C. Becerra-Palars,&nbsp;A. P. Behere,&nbsp;H. Belete,&nbsp;T. Belete,&nbsp;G. Okawa Belizario,&nbsp;F. Bellivier,&nbsp;R. H. Belmaker,&nbsp;F. Benedetti,&nbsp;M. Berk,&nbsp;Y. Bersudsky,&nbsp;Ş. Bicakci,&nbsp;H. Birabwa-Oketcho,&nbsp;T. D. Bjella,&nbsp;C. Brady,&nbsp;J. Cabrera,&nbsp;M. Cappucciati,&nbsp;A. M. Paredes Castro,&nbsp;W. Chen,&nbsp;E. Y. W. Cheung,&nbsp;S. Chiesa,&nbsp;M. Chanopoulou,&nbsp;M. Crowe,&nbsp;A. Cuomo,&nbsp;S. Dallaspezia,&nbsp;P. Desai,&nbsp;S. Dodd,&nbsp;B. Etain,&nbsp;A. Fagiolini,&nbsp;F. T. Fellendorf,&nbsp;E. Ferensztajn-Rochowiak,&nbsp;J. G. Fiedorowicz,&nbsp;K. N. Fountoulakis,&nbsp;M. A. Frye,&nbsp;P. A. Geoffroy,&nbsp;M. J. Gitlin,&nbsp;A. Gonzalez-Pinto,&nbsp;J. F. Gottlieb,&nbsp;P. Grof,&nbsp;B. C. M. Haarman,&nbsp;H. Harima,&nbsp;M. Hasse-Sousa,&nbsp;C. Henry,&nbsp;L. Hoffding,&nbsp;J. Houenou,&nbsp;M. Imbesi,&nbsp;E. T. Isometsä,&nbsp;M. Ivkovic,&nbsp;S. Janno,&nbsp;S. Johnsen,&nbsp;F. Kapczinski,&nbsp;G. N. Karakatsoulis,&nbsp;M. Kardell,&nbsp;L. V. Kessing,&nbsp;S. J. Kim,&nbsp;B. König,&nbsp;T. L. Kot,&nbsp;M. Koval,&nbsp;M. Kunz,&nbsp;B. Lafer,&nbsp;M. Landén,&nbsp;E. R. Larsen,&nbsp;R. W. Licht,&nbsp;V. M. Ludwig,&nbsp;C. Lopez-Jaramillo,&nbsp;A. MacKenzie,&nbsp;H. Østergaard Madsen,&nbsp;S. Alberte Kongstad A. Madsen,&nbsp;J. Mahadevan,&nbsp;A. Mahardika,&nbsp;K. Mahfoudh,&nbsp;M. Manchia,&nbsp;W. Marsh,&nbsp;M. Martinez-Cengotitabengoa,&nbsp;J. Martini,&nbsp;K. Martiny,&nbsp;Y. Mashima,&nbsp;D. M. McLoughlin,&nbsp;A. N. R. Meesters,&nbsp;Y. Meesters,&nbsp;I. Melle,&nbsp;F. Meza-Urzúa,&nbsp;E. Michaelis,&nbsp;P. Mikolas,&nbsp;Y. Ming Mok,&nbsp;S. Monteith,&nbsp;M. Moorthy,&nbsp;G. Morken,&nbsp;E. Mosca,&nbsp;A. A. Mozzhegorov,&nbsp;R. Munoz,&nbsp;S. V. Mythri,&nbsp;R. K. Nadella,&nbsp;T. Nakanotani,&nbsp;R. Ernst Nielsen,&nbsp;C. O'Donovan,&nbsp;A. Omrani,&nbsp;Y. Osher,&nbsp;U. Ouali,&nbsp;M. Pantovic-Stefanovic,&nbsp;P. Pariwatcharakul,&nbsp;J. Petite,&nbsp;A. Pfennig,&nbsp;M. Pilhatsch,&nbsp;Y. Pica Ruiz,&nbsp;M. Pinna,&nbsp;M. Pompili,&nbsp;R. Porter,&nbsp;D. Quiroz,&nbsp;F. Diego Rabelo-da-Ponte,&nbsp;R. Ramesar,&nbsp;N. Rasgon,&nbsp;W. Ratta-apha,&nbsp;M. Redahan,&nbsp;M. S. Reddy,&nbsp;A. Reif,&nbsp;E. Z. Reininghaus,&nbsp;J. Gringer Richards,&nbsp;P. Ritter,&nbsp;J. K. Rybakowski,&nbsp;L. Sathyaputri,&nbsp;A. M. Scippa,&nbsp;C. Simhandl,&nbsp;D. Smith,&nbsp;J. Smith,&nbsp;P. W. Stackhouse Jr,&nbsp;D. J. Stein,&nbsp;K. Stilwell,&nbsp;S. Strejilevich,&nbsp;K.-P. Su,&nbsp;M. Subramaniam,&nbsp;A. Hatim Sulaiman,&nbsp;K. Suominen,&nbsp;A. J. Tanra,&nbsp;Y. Tatebayashi,&nbsp;W. Lin Teh,&nbsp;L. Tondo,&nbsp;C. Torrent,&nbsp;D. Tuinstra,&nbsp;T. Uchida,&nbsp;A. E. Vaaler,&nbsp;E. Vieta,&nbsp;B. Viswanath,&nbsp;C. Volf,&nbsp;K.-J. Yang,&nbsp;M. Yoldi-Negrete,&nbsp;O. Kaan Yalcinkaya,&nbsp;A. H. Young,&nbsp;Y. Zgueb,&nbsp;P. C. Whybrow","doi":"10.1111/acps.70075","DOIUrl":"10.1111/acps.70075","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sunlight has profound impacts on physical and mental health, beyond vision, including effects on circadian rhythms, alertness, mood, and sleep. A family history of any mood disorders is strongly associated with psychiatric disorders including bipolar disorder. The purpose of this study was to evaluate the association between a family history of any mood disorder in patients with bipolar I disorder and solar insolation at varied international onset locations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data for this analysis were available from 5842 patients with a diagnosis of bipolar I disorder obtained at 83 collection sites in both hemispheres. This included 4752 patients from 71 collection sites in the northern hemisphere and 1090 patients from 12 collection sites in the southern hemisphere. Patient data variables were obtained from records or interviews. Solar insolation data were obtained from The National Aeronautics and Space Administration (NASA) Power database for each onset location, and the ratio of the mean monthly minimum/mean monthly maximum solar insolation was calculated. Typically, the ratio is largest near the equator (little yearly change in solar insolation) and smallest near the poles (large yearly change in solar insolation).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A significant relationship was found between a family history of any mood disorder, the ratio of the mean monthly minimum/mean monthly maximum solar insolation, and gender. The odds of a family history of mood disorder increased as patient location nears the poles and decreased near the equator. Female gender also increased the odds of having a family history of a mood disorder.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study highlighted the association between family history, solar insolation, and gender in international patients with bipolar I disorder. Given the profound effects of sunlight on human health, the family of patients with bipolar disorder who live in the same location with the same solar insolation, and especially females, may be at increased risk for a mood disorder.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"153 4","pages":"270-278"},"PeriodicalIF":5.0,"publicationDate":"2026-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12967720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147281234","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":"Seasonality Patterns in Bipolar Disorder: Associations With Clinical Phenotypes and Treatment-Related Outcomes","authors":"Siralp Bostan,&nbsp;Lindsay M. Melhuish Beaupre,&nbsp;Mete Ercis,&nbsp;Brandon J. Coombes,&nbsp;Francisco Romo-Nava,&nbsp;Miguel L. Prieto,&nbsp;Alfredo B. Cuellar Barboza,&nbsp;Susan L. McElroy,&nbsp;Mark A. Frye,&nbsp;Joanna M. Biernacka,&nbsp;Aysegul Ozerdem","doi":"10.1111/acps.70063","DOIUrl":"10.1111/acps.70063","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Mood episodes in bipolar disorder (BD) follow a seasonal pattern in approximately 25% of patients. We aimed to examine the associations of specific seasonality patterns in BD with various clinical phenotypes and treatment-related outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients from the Mayo Clinic Bipolar Disorder Biobank with available seasonality data were included in the study. Among those reporting any seasonality, participants were further categorized into four seasonality groups: fall/winter depression, spring/summer (hypo)mania, biphasic (fall/winter depression with spring/summer (hypo)mania), and equinoctial seasonality (any mood episode occurring in spring or fall). Regression models were used, treating seasonality patterns as the predictor of clinical phenotypes (BD subtype, early onset, history of psychosis, suicide attempt, rapid cycling), lifetime medication exposure (number of unique antidepressants, antipsychotics, and any psychotropics) and treatment response to mood stabilizers (Alda A score).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1702 patients with BD (61.5% female, mean age = 41.43 ± 14.73 years), 44.6% reported seasonal mood episodes. Individuals with any seasonality were more likely to have BD-I (OR = 1.29, <i>p</i> = 0.024), early onset (OR = 1.29, <i>p</i> = 0.026), exposure to higher lifetime number of antipsychotics (IRR = 1.20, <i>p</i> &lt; 0.001) and any psychotropics (IRR = 1.13, <i>p</i> &lt; 0.001). Fall/winter depression was associated with a higher lifetime number of antidepressants (IRR = 1.18, <i>p</i> = 0.021), any psychotropics (IRR = 1.14, <i>p</i> = 0.013), worse response to lithium (<i>β</i> = −0.82, <i>p</i> = 0.029) and all mood stabilizers (<i>β</i> = −0.69, <i>p</i> = 0.014). Spring/summer (hypo)mania showed negative associations with rapid cycling (OR = 0.36, <i>p</i> &lt; 0.001) and lifetime number of antidepressants (IRR = 0.70, <i>p</i> = 0.013). Equinoctial seasonality was linked to a history of psychosis (OR = 1.76, <i>p</i> = 0.004).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Seasonality in BD is associated with distinct clinical features and treatment-related outcomes. Specific seasonality patterns, particularly fall/winter depression, may reflect a more complex and difficult-to-treat illness course. These findings highlight the need for research to better characterize seasonality subtypes beyond a binary “seasonal” vs. “non-seasonal” classification and to explore how these patterns influence the illness course and management of BD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"153 4","pages":"257-269"},"PeriodicalIF":5.0,"publicationDate":"2026-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145831718","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"153 6","pages":"656-664"},"PeriodicalIF":5.0,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148065507","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"153 6","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148064001","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"153 6","pages":"649-655"},"PeriodicalIF":5.0,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148093027","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}