Acta Psychiatrica Scandinavica最新文献

{"title":"Repetitive Transcranial Magnetic Stimulation (rTMS) for Adolescent Depression: A Systematic Review and Meta-Analysis of Treatment Response and Suicidal Ideation Reduction","authors":"Lidija Rakic,&nbsp;Floris Tas,&nbsp;Miao Chen,&nbsp;Indira Tendolkar,&nbsp;Philip van Eijndhoven,&nbsp;Jozarni Dlabac-de Lange,&nbsp;Mieke Klein Hofmeijer,&nbsp;Adriaan Hoogendoorn,&nbsp;Didi Rhebergen","doi":"10.1111/acps.70110","DOIUrl":"10.1111/acps.70110","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Major depressive disorder (MDD) affects 11%–19% of adolescents globally. Early treatment is vital, but the risk of relapse is high, with 46% relapse within 5 years, which threatens a chronic course. Hence, better solutions are needed. Repetitive transcranial magnetic stimulation (rTMS) is effective in adults, but its use in adolescents is limited. While studies—including trials and meta-analyses—exist, their generalizability is unclear. This review evaluates rTMS's efficacy and safety for adolescent MDD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following PRISMA guidelines, a comprehensive literature review was conducted using English-language databases Embase, PubMed, PsycINFO, and the Cochrane Database of Systematic Reviews. We included studies published up to February 2025. Data were pooled to calculate standardized mean change (SMC), proportions, log odds ratios, and their respective 95% confidence intervals (CI), measuring effectiveness, response rate, and suicidality. We systematically described adverse effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 687 studies, 42 underwent full-text assessment, and 19 were included. The within-intervention group pooled SMC between pre-post scores of depression severity was −2.15 (95% CI [−2.58, −1.73]), indicating a strong effect but with high heterogeneity (<i>I</i>\u0000 ² = 87.13%). For RCT-only studies, the pooled SMC was −0.90 (95% CI [−1.90, 0.11]), showing a smaller effect. The pooled response rate was 54% (95% CI [42%; 66%]) with similarly high heterogeneity (<i>I</i>\u0000 ² = 82.25%). A large reduction in suicidal ideation was observed (pooled SMC = −2.78, 95% CI [−5.98, 0.42]), albeit this was based on a limited number of studies (<i>n</i> = 3) and the SMC was not statistically significant. Mild and transient adverse effects were reported. The majority of studies were rated as having a high risk of bias.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings demonstrated that rTMS is effective, safe, and well-tolerated by adolescents with MDD. However, high heterogeneity of methods, bias, and inclusion of uncontrolled trials demand more rigorous trials, whereby adaptive designs could potentially increase the empirical availability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"154 3","pages":"187-202"},"PeriodicalIF":4.7,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.70110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136053","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":"Socioeconomic Position and Somatic Comorbidity in Mental Disorders","authors":"Martin Tesli,&nbsp;Vidar Hjellvik,&nbsp;Simon Lergenmuller,&nbsp;Gabriela Hjell,&nbsp;Andreas Jangmo,&nbsp;Marit Haram,&nbsp;Ingvild Odsbu,&nbsp;Inger Ariansen,&nbsp;Steinar Krokstad,&nbsp;Øyvind Næss,&nbsp;Lars J. Kjerpeseth,&nbsp;Wenche Nystad,&nbsp;Jørgen G. Bramness","doi":"10.1111/acps.70113","DOIUrl":"10.1111/acps.70113","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Individuals with mental disorders face an elevated risk for somatic noncommunicable diseases (NCD), such as cardiovascular disease (CVDs), chronic obstructive pulmonary disease (COPD), diabetes, and cancer. Low socioeconomic position (SEP) is linked to both mental disorders and somatic NCDs, but its role in this association remains unclear. Here, we provide a comprehensive overview of how associations between mental disorders and somatic NCDs vary by SEP indicators.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data on all adult individuals resident in Norway from 01.01.2008 to 01.01.2010 (<i>N</i> = 3,589,719) were derived from a nationwide registry linkage including information on primary and secondary health care, dispensed drugs, causes of death, and socioeconomic factors. We assessed four broad types of mental disorders (psychotic, bipolar, depressive and anxiety disorders) and four categories of somatic NCDs (CVD, COPD, diabetes, cancer) diagnosed during follow-up from 01.01.2010 to 31.12.2020. Educational attainment and household income were used as SEP indicators, in addition to parental educational attainment. Cox regression models estimated hazard ratios for somatic NCDs among individuals with mental disorders compared to the general population, adjusting for and stratifying by SEP, sex, and age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All mental disorders were associated with an increased risk of somatic NCDs, strongest for COPD and weakest for cancer. Risk increased with disorder severity, with psychotic and bipolar disorders showing the strongest associations. Young adults with psychosis had a 4–5-fold increased risk of diabetes and COPD. Low SEP was associated with both mental disorders and somatic NCDs with moderate attenuating effects in their co-occurrence and little variation across SEP strata.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We found an increased risk of somatic NCDs in individuals with mental disorders and identified young adults with psychosis as a particularly vulnerable subgroup. Low SEP compounds this burden, underscoring the need for integrated mental and somatic healthcare strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"154 3","pages":"234-243"},"PeriodicalIF":4.7,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148025196","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":"Psychiatric History and Postpartum Depression: The Mediating Role of Obstetric Complications","authors":"Mette-Marie Zacher Kjeldsen,&nbsp;Katrine Holde,&nbsp;Line Bager,&nbsp;Veerle Bergink,&nbsp;Emely Ek Blæhr,&nbsp;Janne Tidselbak Larsen,&nbsp;Kathrine Bang Madsen,&nbsp;Merete Lund Mægbæk,&nbsp;Liselotte Vogdrup Petersen,&nbsp;Trine Munk-Olsen","doi":"10.1111/acps.70105","DOIUrl":"10.1111/acps.70105","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Psychiatric history is the strongest risk factor for postpartum depression (PPD). Obstetric complications, more prevalent among women with a psychiatric history, are also independent risk factors. However, the mechanisms linking these factors to PPD remain unclear. We examined whether obstetric complications mediate the association between psychiatric history and PPD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cohort study utilized Danish nationwide Edinburgh Postnatal Depression Scale (EPDS) screenings (2015–2021) linked with register data. Psychiatric history was defined as psychiatric diagnoses (ICD-10: F00-99) or filled psychotropic prescriptions (ATC: N05A, N05BE01, N06A, N06BA) from 1995 until conception. Complications were defined as a composite measure of complications occurring between conception and delivery. <i>PPD symptoms</i> were defined as a positive EPDS score (≥ 11), and <i>PPD diagnosis</i> was defined as a depression diagnosis (ICD-10: F32-33) or antidepressant prescription fill (ATC: N06A indicated for depression).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 170,218 mothers (163,326 in analyses), 23.9% had a psychiatric history. These mothers had higher levels of PPD symptoms (13.4% vs. 6.1%), PPD diagnosis (7.0% vs. 0.4%), and complications (34.1% vs. 28.5%) compared to those without. (A) Psychiatric history (PPD symptoms: OR = 2.32 [95% CI, 2.22; 2.41]; PPD diagnosis: OR = 5.09 [95% CI, 4.48; 5.79]) and complications (PPD symptoms: OR = 1.16 [95% CI, 1.11; 1.21]; PPD diagnosis: OR = 1.18 [95% CI, 1.04; 1.34]) were independently associated with PPD. (B) Psychiatric history did not modify the association between complications and PPD (PPD symptoms: OR = 1.20 [95% CI, 1.14; 1.26] vs. 1.09 [95% CI, 1.02; 1.17]; PPD diagnosis: OR = 1.22 [95% CI, 1.00; 1.49] vs. 1.15 [95% CI, 0.97; 1.36]). (C) Complications mediated only a small fraction of the association between psychiatric history and PPD (proportion mediated: PPD symptoms = 0.68% [95% CI, 0.50%; 1.00%], PPD diagnosis = 0.42% [95% CI, 0.14%; 0.79%]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Psychiatric history and complications are independently associated with PPD, but complications explain only a negligible portion. These findings suggest that the link between psychiatric vulnerability and PPD is primarily driven by direct mechanisms rather than mediation through complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"154 3","pages":"223-233"},"PeriodicalIF":4.7,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.70105","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147830767","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":"Perception of ADHD and Compliance in Relation to ADHD Medication","authors":"Kim Berg Johannessen,&nbsp;Pelle Lau Ishøy,&nbsp;Tine Houmann,&nbsp;Eline Levin,&nbsp;Per Hove Thomsen","doi":"10.1111/acps.70106","DOIUrl":"10.1111/acps.70106","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;ADHD medication has proven effective for treating ADHD in adults. Large registry-based studies have generally reported high discontinuation rates over time and focused on different risk factors, including comorbidity, gender, and socioeconomic status. The present mixed-model study examines self-reported factors related to the discontinuation of ADHD medication in Danish adults. It specifically focuses on themes such as the perception of ADHD and the perceived beneficial and adverse effects of the medication, with the aim of identifying patients' reasons either for continuing or discontinuing the prescribed medication overall and in relation to gender.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The present study explores patients' self-reported reasons for continuing or discontinuing ADHD medication, as well as the factors that influence their decision to live with or without medication despite having ADHD.&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 present study employed a mixed-model design and consisted of 1050 Danish adults who redeemed a prescription for ADHD medication for the first time between 2017 and 2019. Questionnaires were distributed by Statistics Denmark to 4748 adults, a representative sample of the 16,284 Danish adults who redeemed a prescription within that period. Discontinuation was defined as a gap of 12 months between redemptions, and questionnaires were sent to an equal number of patients who continued or discontinued ADHD medication. A series of 2 (continuation vs. discontinuation) × 2 (male vs. female) two-way ANOVA was conducted for different main themes, all of which were derived from six patient interviews.&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 patients who continued medical treatment were more likely to perceive ADHD as a biological illness, whereas those who discontinued treatment were more likely to perceive ADHD as an illness constructed by society. Furthermore, patients who continued medical treatment reported that the medication had a more positive influence on their lives, whereas those who discontinued the medication reported experiencing more negative feelings. Finally, males were more likely than females to perceive ADHD as a socially created illness, while females reported higher scores than males for taking ADHD medication for themselves, being able to work or attend school, being social, and being able to enjoy peaceful alone.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 ","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"154 3","pages":"212-222"},"PeriodicalIF":4.7,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.70106","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147968796","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":"Childhood Maltreatment and Biomarkers in Neuropsychiatric Disorders","authors":"Natalia E. Fares-Otero,&nbsp;Soraya Seedat","doi":"10.1111/acps.70107","DOIUrl":"10.1111/acps.70107","url":null,"abstract":"","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"154 3","pages":"244-246"},"PeriodicalIF":4.7,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147947290","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":"Use of Attention Deficit Hyperactivity Disorder Medication Among Danish Children and Adolescents From 2010 to 2023","authors":"Maria Højgaard Stoltz-Andersen,&nbsp;Martin Thomsen Ernst,&nbsp;Søren Dalsgaard,&nbsp;Lotte Rasmussen,&nbsp;Rikke Wesselhoeft","doi":"10.1111/acps.70103","DOIUrl":"10.1111/acps.70103","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Pharmacological treatment is an important component in the multimodal management of <i>attention deficit hyperactivity disorder</i> (ADHD), but contemporary trends in ADHD medication use among boys and girls in Denmark have not been fully characterized. This study aimed to provide an updated and detailed description of ADHD medication use among Danish children and adolescents during 2010–2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed filled prescriptions for ADHD medication in youths aged 5–17 years in Denmark (2010–2023), calculating incidence rates, prevalence proportions, male/female ratios, treatment persistence, age at initiation, and prescriber setting. Analyses were stratified by sex and age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The incidence rates of ADHD medication use followed a u-shaped pattern for boys, declining from 0.59 per 100 person-years in 2010 to 0.34 in 2014, before rising to 1.0 in 2023. Among girls, incidence rates increased continuously from 0.20 per 100 person-years in 2010 to 0.67 per 100 person-years in 2023. Prevalence proportions were stable until 2018, where an increase was observed for both sexes, reaching 3.4% for boys and 1.8% for girls in 2023. The male/female incidence and prevalence ratios decreased consistently from 2010 to 2023. ADHD medication was initiated at a median age of 13 years for girls and 11 years for boys. The share of index prescriptions from child and adolescent psychiatry increased, reaching 87% in 2023. Most 5–9-year-olds (65%) and almost half of 10–13-year-olds (45%) were covered by an ADHD medication prescription 5 years after treatment initiation, as opposed to 29% of 14–17-year-olds.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ADHD medication use in Denmark increased from 2010 to 2023, particularly among girls, where the prevalence tripled compared to a 1.5-fold increase in boys. This likely reflects greater awareness of ADHD in girls, although their 2-year treatment delay compared to boys warrants clinical attention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"154 3","pages":"203-211"},"PeriodicalIF":4.7,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.70103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147727848","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":"Antidepressants and Psychosis Risk: Disentangling Causal Effects From Prognostic Signals","authors":"Andrea Raballo,&nbsp;Michele Poletti,&nbsp;Antonio Preti","doi":"10.1111/acps.70108","DOIUrl":"10.1111/acps.70108","url":null,"abstract":"","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"154 3","pages":"247-249"},"PeriodicalIF":4.7,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147939444","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":"Transcranial Magnetic Stimulation Retreatment for Recurrent Depression: A Large Real-World Multisite Cohort Study.","authors":"Stanley Lyndon, Jason B Gibbons, Loreen Straub, Meekang Sung, Jacob C Jameson, David B Hathaway, Denise H Mulcahy, Cason Elliott, Rachel Wood, Matthew Ruble, Alejandro G Szmulewicz, Jie Yang, Rajendra Aldis, Richard Wyss, Philip S Wang, Shan H Siddiqi","doi":"10.1111/acps.70130","DOIUrl":"10.1111/acps.70130","url":null,"abstract":"<p><strong>Introduction: </strong>When depressive symptoms return after an initial response to transcranial magnetic stimulation (TMS), evidence to guide use of a second acute course is strikingly limited. We aimed to estimate how often and how quickly patients with recurrent major depressive disorder benefit from a second course of transcranial magnetic stimulation after they previously improved with TMS.</p><p><strong>Methods: </strong>A retrospective cohort study across 20 outpatient centres included 259 patients who received ≥ 2 TMS courses between January 1, 2023 and October 1, 2025, and had clinically significant depressive symptoms at the start of course 2; 177 prior responders formed the primary cohort. Treatment used standard 10-Hz left dorsolateral prefrontal cortex TMS. Response and remission were assessed using the PHQ-9 and/or BDI-II; response was defined as a ≥ 50% reduction and remission as PHQ-9 ≤ 4 and/or BDI-II ≤ 9. Symptom change from baseline to end of course 2 and time to first response by session were compared between courses.</p><p><strong>Results: </strong>Among past responders, 146 of 177 patients (82.5%; 95% CI, 76.1%-87.8%) responded again during course 2 and 96 of 177 (54.2%; 95% CI, 46.6%-61.7%) achieved remission. PHQ-9 scores decreased by a median of 65.0% (p < 0.001), and BDI-II scores decreased by a mean of 12.0 points (95% CI, -14.0 to -10.0; p < 0.001). Among responders, the first session meeting response criteria occurred earlier during retreatment than during the initial course on both PHQ-9 (median session, 12 vs. 16; hazard ratio = 1.40, 95% CI, 1.14-1.72; p = 0.001) and BDI-II (13.5 vs. 22.5; hazard ratio = 1.46, 95% CI, 1.07-2.00; p = 0.018).</p><p><strong>Conclusions: </strong>Most patients who previously benefited from acute TMS improved again when symptoms recurred, and among responders, the first session meeting response criteria often occurred earlier during retreatment than during the initial course.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13505613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148628917","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":"Prognostic Factors for Postictal Agitation After Electroconvulsive Therapy in Older Adults With Depression.","authors":"Thomas C Feenstra, Natascha den Bleijker, Adriaan W Hoogendoorn, Huda Gafer, Nathalie Denayer, Eric van Exel, Rob M Kok, Karina Somers, Anton C M Vergouwen, Adriano van der Loo, Esmée Verwijk, Filip Bouckaert, Aartjan T F Beekman, Pascal Sienaert, Didi Rhebergen","doi":"10.1111/acps.70128","DOIUrl":"https://doi.org/10.1111/acps.70128","url":null,"abstract":"<p><strong>Introduction: </strong>Postictal agitation (PIA) is an impactful confusional state occasionally occurring after electroconvulsive therapy (ECT). PIA creates dangerous situations for caregivers and patients, prolongs lead times, and sometimes leads to the premature discontinuation of ECT. Despite the impact PIA can have on patients and caregivers, little is known about its incidence and the factors associated with its occurrence. This study aims to investigate putative prognostic factors for PIA.</p><p><strong>Methods: </strong>We utilized data from the \"Rivastigmine for ECT-induced Cognitive Adverse effects in Late-Life depression\" (RECALL) prospective cohort study; a study on older adults (≥ 55 years) with a major depressive episode receiving ECT. We investigated several putative prognostic factors based on previous research, biological plausibility, and availability. PIA was defined by either a Richmond Agitation-Sedation score ≥ 2 or the administration of emergency medication specifically for PIA. Mixed-effects logistic regression was used to analyze univariate and adjusted odds ratios for the prognostic factors.</p><p><strong>Results: </strong>We included 142 patients who received 1838 ECT sessions. The incidence of PIA was 34.5% at the patient-level and 9.2% at the session-level. A small subset of older adults (19.7%) accounted for 87.5% of all PIA occurrences. We found that male sex, flumazenil use, and a longer seizure duration were associated with higher odds of developing PIA. Multi-seizure sessions and a higher level of education were associated with lower occurrence of PIA.</p><p><strong>Conclusion: </strong>This study identified sex, flumazenil use, seizure duration, the amount of seizures during a session, and education level as prognostic factors for PIA. The pronounced clustering of PIA events within a small subset of patients suggests meaningful interindividual vulnerability, but should be replicated in future studies. If confirmed, these findings could provide actionable insights for preventive treatment strategies. In particular, the use of flumazenil should be critically reconsidered in persons experiencing PIA.</p><p><strong>Trial registration: </strong>EudraCT 2014-003385-24.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454103","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":"Reevaluating the Role of ADHD Perceptions in Medication Continuation: Methodological and Interpretative Considerations.","authors":"Yingjie Gao, Cong Zhou, Sen Li","doi":"10.1111/acps.70125","DOIUrl":"https://doi.org/10.1111/acps.70125","url":null,"abstract":"","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148395418","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}