Acta Psychiatrica Scandinavica最新文献

{"title":"Selective Serotonin Reuptake Inhibitor Treatment in Adolescence and Subsequent Risk of Nonaffective Psychosis: A Quasi-Experimental Study.","authors":"Ioanna Kougianou, Animesh Talukder, Kirstie O Hare, Colm Healy, Ian Kelleher","doi":"10.1111/acps.70098","DOIUrl":"https://doi.org/10.1111/acps.70098","url":null,"abstract":"<p><strong>Objective: </strong>Psychotic disorders are frequently preceded by common mental disorders (CMDs), like depression and anxiety. It remains unclear whether treating CMDs in adolescence can reduce subsequent psychosis risk. We applied quasi-experimental methods to national register data to assess whether a causal relationship exists between selective serotonin reuptake inhibitor (SSRI) treatment in adolescence and subsequent risk of psychosis.</p><p><strong>Methods: </strong>Using the secure anonymized information linkage databank, we identified individuals living in Wales (born between 1991 and 1998) with depression who attended Child and Adolescent Mental Health Services. We employed an instrumental variable (IV) analysis, using regional variation in SSRI prescribing practice to estimate the causal effect of cumulative SSRI treatment on psychosis risk, applying two-stage least squares and IV probit models.</p><p><strong>Results: </strong>Our cohort included n = 6615 individuals with adolescent depression. We found no evidence that cumulative SSRI prescription influenced the psychosis risk across intervention windows (1 year: β: 0.114, CI: -0.049, 0.276; 2 years: β 0.062, CI: -0.114, 0.239; 3 years: β 0.021, CI: -0.125, 0.168).</p><p><strong>Conclusion: </strong>This quasi-experimental study found no evidence of a causal relationship between SSRI treatment in adolescence and later psychosis risk. Our findings do not support the hypothesis that SSRI treatment of CMDs in adolescence prevents later psychosis.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147626545","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":"Educational Differences in Treatment of Individuals Diagnosed With Major Depression: A Register-Based Cohort Study.","authors":"Thomas Wolff Rosenqvist, Terese Sara Høj Jørgensen, Anders Jørgensen, Martin Balslev Jørgensen, Frederikke Hørdam Gronemann, Merete Osler","doi":"10.1111/acps.70096","DOIUrl":"https://doi.org/10.1111/acps.70096","url":null,"abstract":"<p><strong>Background: </strong>In individuals with depression, lower socioeconomic position is associated with poorer prognostic outcomes, which may be attributed to inequitable care. We investigated educational differences in treatment of individuals diagnosed with depression at a psychiatric hospital.</p><p><strong>Methods: </strong>This nationwide register-based cohort study included 156,922 Danish citizens with a first-time psychiatric hospital diagnosis of depression (ICD-10: F32-F33) between 2000 and 2022. Highest attained educational level was categorized as short, medium, or long. Treatment data included antidepressant prescriptions, electroconvulsive therapy (ECT), and contacts with private practicing psychiatrists or psychologists. Logistic regression and Cox proportional hazard regression models with adjustments for covariates were used to estimate associations between educational level and treatment before and after diagnosis.</p><p><strong>Results: </strong>Within 2 years before diagnosis, 72.0% of individuals had redeemed at least one antidepressant prescription, and 83.8% had initiated or continued pharmacological treatment within 2 years after diagnosis. Education was not associated with redeemed prescriptions of antidepressants regardless of type before diagnosis, whereas long education was associated with higher rates of treatment with any type of antidepressants after diagnosis. For specific antidepressants, individuals with long education were less likely to redeem prescriptions for noradrenergic and specific serotonergic antidepressants (NaSSAs) and more likely to redeem monoamine oxidase inhibitors (MAOIs) and newer antidepressants such as vortioxetine. Longer educated also more often consulted private practicing mental health specialists both before and after diagnosis, respectively. After diagnosis, individuals with long education were also more likely to receive ECT.</p><p><strong>Conclusion: </strong>Educational differences in pharmacological treatment and private specialist visits among individuals with depression are present both before and after their first hospital contact. Individuals with long education seem more likely to receive specialized and high-value care (ECT, MAOIs, newer antidepressants, and consultations with private psychiatrists and psychologists) compared to individuals with short or medium education.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147626579","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,&nbsp;Jennifer Jordan,&nbsp;Cameron J. Lacey,&nbsp;Christopher M. Frampton,&nbsp;Richard J. Porter,&nbsp;Katie M. Douglas","doi":"10.1111/acps.70030","DOIUrl":"10.1111/acps.70030","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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).</p>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-eight individuals completed baseline and follow-up cognitive testing assessments in the RCT (AT, <i>n</i> = 32, TAU, <i>n</i> = 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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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>\u0000 \u0000 <p>\u0000 <b>Clinical Registration:</b> Australian New Zealand Clinical Trials Registry [ANZCTR], ACTRN12617000024347p.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"153 5","pages":"563-572"},"PeriodicalIF":5.0,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13050592/pdf/","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":"OA","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,&nbsp;Tine Nordgreen,&nbsp;Eivind Haga Ronold,&nbsp;Aleksander Heltne,&nbsp;Åsa Hammar","doi":"10.1111/acps.70019","DOIUrl":"10.1111/acps.70019","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results showed that shorter lifetime depression duration predicted greater improvements in subjective executive functioning (<i>p</i> = 0.031). Higher levels of treatment expectancy and credibility were related to greater improvements in subjective cognitive functioning (<i>p</i> = 0.024). Participants with a partner showed better treatment response than those without a partner (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"153 5","pages":"525-533"},"PeriodicalIF":5.0,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13050589/pdf/","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":"OA","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,&nbsp;Gunnar Morken,&nbsp;Tor Ivar Hansen,&nbsp;Anne Engum","doi":"10.1111/acps.70031","DOIUrl":"10.1111/acps.70031","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Objective measurements showed fewer cognitive problems than subjective reports. Additionally, anxiety symptoms may contribute to overreporting cognitive complaints.</p>\u0000 \u0000 <p>\u0000 <b>Clinical Registration:</b> ClinicalTrials.gov identifier: NCT04454073.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"153 5","pages":"515-524"},"PeriodicalIF":5.0,"publicationDate":"2026-04-05","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":"Childhood Maltreatment and Cognitive Performance in Bipolar Disorder: The Potential Role of Inflammation","authors":"Marzieh Majd,&nbsp;Jennifer Nicoloro-SantaBarbara,&nbsp;Katharine Burns,&nbsp;Maura De Laney,&nbsp;Emma V. Galante,&nbsp;Julia Lebovitz,&nbsp;Megan Shanahan,&nbsp;Katherine E. Burdick","doi":"10.1111/acps.70033","DOIUrl":"10.1111/acps.70033","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;Cognitive deficits are common in individuals with bipolar disorder (BD), but there is considerable variability in cognitive functioning. Childhood maltreatment (CM), which is frequently reported in BD, has been linked to poorer cognitive performance, potentially through mechanisms such as inflammation. However, the relationship between CM and global cognition and the mediating role of inflammation in BD warrant further investigation.&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;The study sample consisted of 112 BD individuals and 83 healthy controls (HCs). Participants completed the MATRICS Consensus Cognitive Battery (MCCB), the Wisconsin Card Sorting Test, and the Childhood Trauma Questionnaire (CTQ). A composite inflammation index was created using blood levels of C-reactive protein (CRP), interleukin (IL)-6, and tumor necrosis factor (TNF)-α, and was used in primary analyses.&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;The BD group, compared to HC, showed higher levels of inflammation and CM. Across the entire sample, higher total CM was associated with poorer global cognitive performance, with a medium effect size, even after accounting for diagnostic status. The associations were evident across all CM subscales. Specific cognitive domains affected included speed of processing, working memory, visual learning, and reasoning and problem solving. The association between CM and poorer global cognitive performance was partially mediated by inflammation (indirect effect: &lt;i&gt;β&lt;/i&gt; = −0.048, CI = −0.10, −0.009). Within the BD group, higher total CM was similarly associated with worse global cognitive performance. The associations were evident across all CM subscales, except for physical neglect. Significant associations were observed between total CM and MCCB domains of speed of processing, attention and vigilance, working memory, visual learning, reasoning and problem solving, as well as cognitive flexibility. Within the HC group, only emotional neglect and physical neglect were associated with poorer global cognition.&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;This study provides evidence that total CM and its subscales are associated with poorer global cognitive performance in a sample of individuals with BD and HC, with stronger associations found within the BD group. In addition, inflammation partially mediated the relationship between CM and global cognition. These findings highlight the importance of trauma-informed and cognition-focused interventions aimed at enhancing cognitive outcomes and slowing cognitive decline in individuals with BD who have a history of CM. Furthermor","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"153 5","pages":"500-514"},"PeriodicalIF":5.0,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136001","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,&nbsp;Maria Heilbronner,&nbsp;Brisa Solé,&nbsp;Roger Borràs,&nbsp;Anabel Martinez-Arán,&nbsp;Kristina Adorjan,&nbsp;Alba Navarro-Flores,&nbsp;Mojtaba Oraki Kohshour,&nbsp;Daniela Reich-Erkelenz,&nbsp;Eva C. Schulte,&nbsp;Fanny Senner,&nbsp;Ion-George Anghelescu,&nbsp;Volker Arolt,&nbsp;Bernhard T. Baune,&nbsp;Udo Dannlowski,&nbsp;Detlef E. Dietrich,&nbsp;Andreas J. Fallgatter,&nbsp;Christian Figge,&nbsp;Markus Jäger,&nbsp;Georg Juckel,&nbsp;Carsten Konrad,&nbsp;Jens Reimer,&nbsp;Eva Z. Reininghaus,&nbsp;Max Schmauß,&nbsp;Andrea Schmitt,&nbsp;Carsten Spitzer,&nbsp;Jens Wiltfang,&nbsp;Jörg Zimmermann,&nbsp;Sergi Papiol,&nbsp;Urs Heilbronner,&nbsp;Peter Falkai,&nbsp;Thomas G. Schulze,&nbsp;Eduard Vieta,&nbsp;Carla Torrent,&nbsp;Monika Budde,&nbsp;Silvia Amoretti","doi":"10.1111/acps.70026","DOIUrl":"10.1111/acps.70026","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 1516 individuals were included in a cross-sectional study using baseline data from the multicenter PsyCourse Study, including BD (<i>n</i> = 543), SZ (<i>n</i> = 517), and healthy controls (HC) (<i>n</i> = 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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significant interactions were identified in age (<i>p</i> = 0.001), age at treatment (<i>p</i> = 0.05), illness duration (<i>p</i> = 0.03), illicit drug use (<i>p</i> = 0.01), and smoking (<i>p</i> = 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 (<i>p</i> = 0.003) and psychomotor speed (<i>p</i> &lt; 0.001) than males. Moreover, both females and males with SMI showed higher rates of thyroid alterations compared with HC (<i>p</i> = 0.01 for females and <i>p</i> = 0.002 for males).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"153 5","pages":"449-467"},"PeriodicalIF":5.0,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13050599/pdf/","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":"OA","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,&nbsp;Jennifer Nicoloro Santabarbara,&nbsp;Marzieh Majd,&nbsp;Willians Fernando Vieira,&nbsp;Maura De Laney,&nbsp;Melis Lydston,&nbsp;Olindo Assis Martins-Filho,&nbsp;Lilian Maria Garcia Bahia-Oliveira,&nbsp;Joshua D. Salvi,&nbsp;Paolo Cassano,&nbsp;Katherine E. Burdick","doi":"10.1111/acps.13824","DOIUrl":"10.1111/acps.13824","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"153 5","pages":"339-373"},"PeriodicalIF":5.0,"publicationDate":"2026-04-05","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}

{"title":"Cognition in Psychiatry: Treatment Targets, Mechanisms, and Assessment Innovations","authors":"Kamilla W. Miskowiak,&nbsp;Katherine E. Burdick","doi":"10.1111/acps.70015","DOIUrl":"10.1111/acps.70015","url":null,"abstract":"&lt;p&gt;Over the past two decades, psychiatry has undergone a paradigm shift from focusing solely on symptom remission - such as reducing hallucinations and delusions in psychosis or depressive or mania symptoms in mood disorders - to a broader emphasis on functional recovery and quality of life. Patients do not just want to feel well; they want to do well in order to be well [&lt;span&gt;1&lt;/span&gt;]. This shift has placed cognition at the center of psychiatric research and treatment because cognitive function is a key determinant of real-world outcomes, including social integration, employment, and independent living.&lt;/p&gt;&lt;p&gt;Cognitive impairment is a core feature across major psychiatric disorders, including major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SZ), often persisting even in remission. The cognitive deficits significantly contribute to disability, reduced treatment adherence, and greater relapse and psychiatric hospitalization risk [&lt;span&gt;2-4&lt;/span&gt;]. Despite growing recognition of the role of cognition in mental health, treatments with robust, replicable efficacy remain scarce [&lt;span&gt;5&lt;/span&gt;]. This is due to several challenges in cognition research, including (I) incomplete understanding of the neurobiological origins of cognitive impairments and their interaction with early-life adversity, (II) methodological limitations in assessment and intervention, and (III) the lack of objective biomarkers to guide treatment development [&lt;span&gt;5, 6&lt;/span&gt;]. This Special Issue of Acta Psychiatrica Scandinavica explores these challenges and presents novel research addressing key gaps in the field.&lt;/p&gt;&lt;p&gt;Evidence indicates considerable heterogeneity in cognitive trajectories among individuals with major psychiatric disorders. While some experience marked decline following illness onset, others remain resilient to these changes [&lt;span&gt;7&lt;/span&gt;]. Biological contributors to cognitive impairment include neuroinflammation, impaired neuroplasticity, and genetic factors, while environmental influences, such as early-life adversity, sleep, diet, and physical activity, further modulate outcomes. Identifying sensitive and specific biomarkers and physiological indicators to predict and monitor cognitive change is essential for developing and targeting effective interventions to those at most risk.&lt;/p&gt;&lt;p&gt;This Special Issue includes several papers that examine these mechanisms: One study leverages a twin-based design, allowing the authors to differentiate the aspects of cognitive impairment and cognitive decline that are related to familial risk for illness from those that are more directly linked to disease expression [&lt;span&gt;8&lt;/span&gt;]. Other included studies investigated sex differences in key clinical, cognitive, and functional outcomes [&lt;span&gt;9&lt;/span&gt;]; the importance of considering premorbid status when determining the extent of deficit after onset [&lt;span&gt;10&lt;/span&gt;]; and the impact of inflammation [&lt;span&gt;11, 12&lt;/span&gt;]; physical activity [&lt;spa","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"153 5","pages":"311-314"},"PeriodicalIF":5.0,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.70015","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Cognitive Functions and Subsequent Mood Disorder Prognosis in Low-Risk, High-Risk and Affected Monozygotic Twins: A Seven-Year Follow-Up Study","authors":"Kamilla Miskowiak,&nbsp;Hanne Lie Kjærstad,&nbsp;Stella Lystlund,&nbsp;Anjali Sankar,&nbsp;Lars Kessing,&nbsp;Maj Vinberg","doi":"10.1111/acps.70025","DOIUrl":"10.1111/acps.70025","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Aberrant cognition is common among individuals at familial risk for mood disorders (MD) and those already affected. However, long-term prospective studies are needed to determine whether specific cognitive features predict illness onset and relapse; and whether cognitive impairments reflect neurodevelopmental traits or neuroprogressive decline.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This seven-year prospective study examined the relationship between cognition and illness progression in monozygotic twins with mood disorders, their healthy high-risk monozygotic co-twins, and low-risk twins without a family history. Emotional and non-emotional cognition was assessed at baseline (<i>n</i> = 204) and follow-up (<i>n</i> = 124). Cox regression models tested whether baseline cognition predicted future illness onset in unaffected individuals (<i>n</i> = 89) or relapse in affected ones (<i>n</i> = 112). Longitudinal cognitive changes were analyzed using mixed models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Greater attentional vigilance toward consciously processed happy faces at baseline was associated with a reduced risk of both illness onset (Exp(B) = 0.995, CI [0.990; 1.000], <i>p</i> = 0.03) and relapse (Exp(B) = 0.997, CI [0.995; 0.999], <i>p</i> = 0.003). Paradoxically, better verbal fluency at baseline was linked to an increased risk of illness onset (Exp(B) = 1.589, CI [1.204; 2.097], <i>p</i> &lt; 0.001). Over time, onset was associated with increasing avoidance of subliminal fearful faces (group-by-time interaction, <i>p</i> &lt; 0.001), whereas avoidance decreased in those who remained well. Verbal fluency declined in twins who developed a mood disorder (<i>p</i> = 0.02) but remained stable in those who stayed unaffected. No significant longitudinal cognitive differences emerged between affected twins with and without relapse.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Positive attentional biases may protect against illness onset and relapse, while greater baseline verbal fluency may unexpectedly signal vulnerability. Verbal fluency decline after illness onset likely reflects scar effects. The findings underscore the importance of early identification of cognitive-emotional vulnerabilities and suggest targets for preventive interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"153 5","pages":"432-448"},"PeriodicalIF":5.0,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13050597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144936486","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}