Acta Psychiatrica Scandinavica最新文献

{"title":"The Swedish National Quality Register for Repetitive Transcranial Magnetic Stimulation.","authors":"S Melker Hagsäter, Axel Nordenskjöld, Pia Nordanskog, Johan Lundberg, Carl Johan Ekman, Fredrik Hieronymus, Robert Bodén","doi":"10.1111/acps.70082","DOIUrl":"10.1111/acps.70082","url":null,"abstract":"<p><strong>Objective: </strong>Repetitive transcranial magnetic stimulation (rTMS) has been demonstrated to be an effective and well tolerated treatment for depression, and it is being investigated also for other indications. This study presents the Swedish National Quality Register for rTMS (Q-rTMS). The registry comprises epidemiological data, data from standardized rating scales, details on treatment settings, and a registry-specific patient questionnaire.</p><p><strong>Methods: </strong>A presentation of the Q-rTMS including the types of data collected, the organizational structure of the register, as well as a brief overview of the volume of data accumulated between the registry's inception in 2018 and the end of 2024.</p><p><strong>Results: </strong>As of 2024, the register contained data from a total of 3083 unique individuals and 3842 treatment series, collected from 27 different rTMS providers. The most common indication for rTMS was depression (International Classification of Diseases, Tenth Revision diagnoses (ICD-10): F32-F34, 74.1%) followed by bipolar affective disorder (ICD-10: F31, 14.2%). The average age was 43.2 years, and 56.5% were women. The register included matched pre- and post-treatment data exceeding 60% completeness for the Montgomery-Åsberg Depression Rating Scale-Self Assessment (MADRS-S), the Clinical Global Impression-Severity (CGI-S), and the EuroQol five-dimensional questionnaire (EQ-5D-5L).</p><p><strong>Conclusion: </strong>The Q-rTMS combines high coverage with longitudinal documentation of clinically relevant outcome measures and may hence contribute to population-based real-world effectiveness research in rTMS for depression.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":"649-655"},"PeriodicalIF":4.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147300287","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":"Correction to \"Recovery and Recurrence From Major Depression in Adolescence and Adulthood\".","authors":"","doi":"10.1111/acps.70081","DOIUrl":"10.1111/acps.70081","url":null,"abstract":"","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":"669"},"PeriodicalIF":4.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147342990","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":"Acute-Phase Interventions After Self-Harm for Preventing Suicide and Recurrence: A Systematic Review and Meta-Analysis.","authors":"Guilherme Pimenta Roncete, Luis C Farhat, Loren Beiram, Bianca Besteti Fernandes Damiano, Craig J Bryan, Karina L Ramirez, Euripedes Constantino Miguel, Rodolfo Furlan Damiano","doi":"10.1111/acps.70085","DOIUrl":"10.1111/acps.70085","url":null,"abstract":"<p><strong>Introduction: </strong>Suicide risk is markedly elevated following presentation after self-harm, yet the evidence base for interventions initiated in the immediate post-presentation period has not been synthesized with specific attention to this high-risk window. Clarifying which early interventions may reduce adverse outcomes is essential for informing psychiatric care and prevention strategies.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of randomized clinical trials enrolling individuals presenting to clinical services after self-harm, with interventions initiated within 1 month of the index episode. PubMed, Embase, PsycINFO, the WHO International Clinical Trials Registry Platform (ICTRP), and ClinicalTrials.gov were searched from inception through April 24, 2025. Two reviewers independently screened studies and extracted data using standardized forms. Risk of bias was assessed using the Cochrane RoB 2 tool, and certainty of evidence was evaluated with GRADE. Random-effects meta-analyses with Hartung-Knapp adjustment were conducted for intervention categories with at least three trials, and prediction intervals were calculated. Prespecified meta-regressions examined participant- and intervention-level moderators.</p><p><strong>Results: </strong>Sixty randomized clinical trials, including 22,654 participants, met the inclusion criteria. Across pooled analyses, no intervention category was associated with a statistically significant reduction in repeat self-harm at any follow-up interval. For suicide deaths, problem-solving therapy was associated with lower mortality at medium-term follow-up (6-12 months; OR 0.45, 95% CI 0.29-0.70; I ² = 0%), and brief intervention and contact was associated with lower mortality at long-term follow-up (> 12 months; OR 0.34, 95% CI 0.15-0.79; I ² = 0%). Meta-regression analyses indicated that younger mean sample age and trial inclusion based on suicidal intent moderated effects on repeat self-harm at > 6-12 months.</p><p><strong>Conclusions: </strong>Among trials initiating treatment within 1 month of self-harm presentation, effects on repeat self-harm were small and not statistically significant, likely reflecting outcome heterogeneity in the acute post-presentation period. In contrast, structured problem-solving and brief contact-based interventions were associated with lower suicide mortality at medium- and long-term follow-up. These findings support the use of scalable early interventions in psychiatric services and highlight priorities for future trials powered to detect effects on suicide mortality.</p><p><strong>Trial registration: </strong>PROSPERO: CRD42023458233.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":"610-626"},"PeriodicalIF":4.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388849","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":"Correction to \"Associations of Antenatal Corticosteroids and Maternal Postpartum Mental Health-A Cohort Study\".","authors":"","doi":"10.1111/acps.70088","DOIUrl":"10.1111/acps.70088","url":null,"abstract":"","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":"670"},"PeriodicalIF":5.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147519416","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":"Generative Artificial Intelligence (AI) and the Outsourcing of Scientific Reasoning: Perils of the Rising Cognitive Debt in Academia and Beyond.","authors":"Søren Dinesen Østergaard","doi":"10.1111/acps.70069","DOIUrl":"10.1111/acps.70069","url":null,"abstract":"","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":"665-666"},"PeriodicalIF":5.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146016721","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":"Clinical Implications of Autistic Features in Patients With a First Episode of Psychosis.","authors":"Miquel Bioque, Anaid Pérez-Ramos, Vicent Llorca-Bofí, Rafael Penadés, M Florencia Forte, Clemente García-Rizo, Silvia Amoretti, Laura Pina-Camacho, Mara Parellada, Manuel J Cuesta, Laura Martinez-Sadurní, Elena de la Serna, Olga Puig, Gisela Mezquida","doi":"10.1111/acps.70079","DOIUrl":"10.1111/acps.70079","url":null,"abstract":"<p><strong>Introduction: </strong>Schizophrenia and autism share neurobiological mechanisms and overlapping clinical features, often resulting in the emergence of autistic traits in early stages of psychosis. The PANSS Autism Severity Score (PAUSS) provides a rapid measure of autistic features within the standard PANSS assessment. We aimed to determine the prevalence of autistic features in first-episode psychosis (FEP), characterise their clinical, cognitive, and functional profile, and examine their impact on 2-year outcomes.</p><p><strong>Methods: </strong>A total of 328 FEP patients were included from the PEPs multicentre cohort, followed for 2 years. Autistic features were rated using PAUSS (cut-off ≥ 30), yielding autistic (n = 38) and non-autistic (n = 290) groups. Sociodemographic, clinical, cognitive, and functional variables were analysed. Longitudinal analyses examined symptomatic remission rates and trajectories of psychopathology and functioning using logistic regression and mixed-model ANOVA.</p><p><strong>Results: </strong>The autistic group represented 11.6% of the sample. At baseline, they exhibited lower birth weight, greater medication side effects, higher general psychopathology and depressive severity, and poorer global functioning. Cognitively, they showed significant deficits in working memory, social cognition, and cognitive reserve compared to the non-autistic group. Over 2 years, this group was 3.6 times less likely to achieve symptomatic remission and consistently exhibited higher symptom severity and lower functioning across all follow-ups.</p><p><strong>Conclusions: </strong>Autistic features in FEP identify a subgroup with a possible distinct profile of neurodevelopmental markers, greater cognitive and functional impairments, and poorer clinical outcomes. Early identification may guide more personalised interventions, although further research is needed to refine PAUSS specificity and develop targeted, tailored treatments.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":" ","pages":"636-648"},"PeriodicalIF":4.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147281232","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":"Clinical Outcomes of Dantrolene in Neuroleptic Malignant Syndrome: A Nationwide Retrospective Study.","authors":"Akira Suekane, Atsushi Senda, Koji Morishita, Kiyohide Fushimi","doi":"10.1111/acps.70073","DOIUrl":"10.1111/acps.70073","url":null,"abstract":"<p><strong>Introduction: </strong>Neuroleptic malignant syndrome (NMS) is a life-threatening adverse reaction to antipsychotic medications. Dantrolene is commonly used to manage NMS; however, supportive evidence from large-scale clinical studies remains limited. This study aimed to evaluate the clinical impact of early dantrolene administration in intensive care unit (ICU)-admitted patients with NMS using a nationwide inpatient database in Japan.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using the Japanese Diagnosis Procedure Combination database from April 2010 to March 2023. Patients aged ≥ 16 years diagnosed with NMS and admitted to the ICU were included. The exposure of interest was dantrolene administration within the first 2 days of admission. The primary outcome was in-hospital mortality; secondary outcomes included ICU and hospital length of stay. Baseline adjustment between the dantrolene-treated and untreated groups was performed using two methods: propensity score matching (PSM) and generalized linear mixed models (GLMMs).</p><p><strong>Results: </strong>A total of 2234 patients met the inclusion criteria, including 1475 treated with dantrolene and 759 without. In both analyses, dantrolene use was associated with an increase in in-hospital mortality (adjusted OR: 2.03, 95% CI: 1.16-3.54; p = 0.01 in GLMM, adjusted OR: 1.92, 95% CI: 1.17-3.24; p = 0.01 in PSM). Dantrolene was also associated with prolonged ICU stay (mean difference: 1.66, 95% CI: 1.05-2.26; p < 0.001 in GLMM and 2.03, 95% CI: 1.31-2.76; p < 0.001 in PSM) and hospital stay (mean difference: 6.85, 95% CI: 3.48-10.21; p < 0.001 in GLMM and 6.81 days, 95% CI: 3.46-10.16; p < 0.001 in PSM). Subgroup analyses stratified by age (< 65 vs. ≥ 65 years) yielded similar trends.</p><p><strong>Conclusions: </strong>In the largest study of NMS to date, early initiation of dantrolene was associated with higher in-hospital mortality and prolonged ICU/hospital stay. These findings suggest that routine use of dantrolene in NMS should be reevaluated.</p>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"153 6","pages":"627-635"},"PeriodicalIF":4.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147757629","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":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148098084","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}