Acta Psychiatrica Scandinavica最新文献

{"title":"Neural Correlates of Cognitive Improvement After Virtual Reality-Based Cognitive Remediation in Psychosis and Mood Disorders: A Randomized Controlled Trial","authors":"Viktoria Damgaard,&nbsp;Andreas Elleby Jespersen,&nbsp;Ida Kruse Søndergaard,&nbsp;Anders Lumbye,&nbsp;Maj Vinberg,&nbsp;Louise Birkedal Glenthøj,&nbsp;Merete Nordentoft,&nbsp;Anjali Sankar,&nbsp;Gitte Moos Knudsen,&nbsp;Julian Macoveanu,&nbsp;Kamilla Woznica Miskowiak","doi":"10.1111/acps.70004","DOIUrl":"10.1111/acps.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Cognitive impairment in mood disorders and schizophrenia spectrum disorders hampers patients' clinical and functional outcomes. A key challenge in pro-cognitive treatment development is the limited insight into the underlying neurocircuitry correlates of cognitive changes. This longitudinal functional magnetic resonance imaging (fMRI) study aimed to investigate the neural underpinnings of the cognitive benefits of virtual reality-based cognitive remediation therapy (VR-CRT) and their association with treatment-related cognitive improvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study includes data from a subsample of 31 symptomatically stable, cognitively impaired patients with mood disorder or schizophrenia spectrum disorder (VR-CRT: <i>n</i> = 18; VR control: <i>n</i> = 13) with complete fMRI data. Participants underwent a strategic memory encoding fMRI task and neuropsychological assessment outside the scanner before and after four weeks of bi-weekly VR-CRT vs. VR control treatment and an additional neuropsychological assessment three months after treatment completion. Twenty-eight matched healthy controls (HC) underwent a single fMRI and neuropsychological assessment for baseline comparisons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>VR-CRT vs. VR control treatment increased encoding-related neural activity in the left dorsal prefrontal cortex, bilateral occipital cortex, left inferior temporal gyrus, left frontal pole, and intracalcarine cortex (<i>ps</i> ≤ 0.03). Moreover, prefrontal and occipital cortex activity increases correlated with treatment-related cognitive improvement at treatment completion and at the three-month follow-up (<i>ps</i> ≤ 0.02).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The encoding-related dorsal prefrontal and occipital activity increase and its association with cognitive benefits of VR-CRT highlights a potential transdiagnostic neurocircuitry biomarker for pro-cognitive interventions. If replicated in larger samples, the findings highlight VR-CRT as a promising pro-cognitive treatment candidate.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"153 5","pages":"553-562"},"PeriodicalIF":5.0,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.70004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147683910","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":"Formulating Cognitive Functioning to Guide Personalised Treatment for People Diagnosed With Mental Disorders","authors":"Kelly Allott,&nbsp;Shayden Bryce,&nbsp;Katie Douglas,&nbsp;Alexandra Stainton,&nbsp;Stephen J. Wood,&nbsp;Christopher R. Bowie","doi":"10.1111/acps.13811","DOIUrl":"10.1111/acps.13811","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Objective and subjective cognitive impairment are highly prevalent in mental disorders and transdiagnostic phenomena. Cognitive impairment is associated with poorer functional outcomes and therefore requires treatment, but little guidance is available for clinicians. The aim of this article is to provide guidance for formulating an individual's cognitive profile and how this can be used to personalise treatments for optimum cognitive and functional outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We first critique current models of psychopathology in relation to assessing and addressing cognitive functioning in the clinic. This is followed by a description of key methods for assessing objective and subjective cognitive functioning and how this information can be used to formulate a patient's cognitive profile and tailor treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Within current models of psychopathology, cognition is inadequately or simplistically represented, is only viewed from a deficit lens without considering strengths, does not consider subjective perceptions of cognitive functioning, and therefore, generally does not provide utility for guiding clinical practice. Both the profile of cognitive functioning (strengths and weaknesses) and estimated change from premorbid levels are key considerations for tailoring cognitive and functional treatments. Cognitive profile and change can be assessed using standardised cognitive tests through normative and idiographic methods, respectively. Subjective perception of cognitive functioning is a neglected but important additional aspect of cognitive functioning that warrants assessment. The complete cognitive profile can be used to guide the selection of cognition-focused treatments, including psychoeducation, lifestyle adaptations, cognitive remediation, compensatory strategies, environmental supports, psychological therapy, and medication review.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We propose that cognition should be assessed in addition to presenting psychopathology because it is an independent transdiagnostic predictor of functional outcomes, which can enhance personalised clinical care. We recommend assessing both objective and subjective cognitive functioning to formulate the personalised treatment for optimal functional outcomes and promote a culture of recovery that includes cognitive health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"153 5","pages":"573-587"},"PeriodicalIF":5.0,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.13811","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147683550","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":"Cognitive and Psychomotor Processing Speed in Medication-Naïve Individuals With First-Episode of Psychosis: The Role of Peripheral Inflammatory Markers","authors":"Ángel Yorca-Ruiz,&nbsp;Carlos Martínez Asensi,&nbsp;Rebeca Magdaleno Herrero,&nbsp;Alexandre Díaz-Pons,&nbsp;Víctor Ortiz-García de la Foz,&nbsp;Luis Manuel Fernández Cacho,&nbsp;Ana Catalán Alcantara,&nbsp;Benedicto Crespo-Facorro,&nbsp;Rosa Ayesa-Arriola","doi":"10.1111/acps.70006","DOIUrl":"10.1111/acps.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Hypothesis</h3>\u0000 \u0000 <p>Deficits in processing speed (PS) and psychomotor speed (PMS) are core cognitive impairments in schizophrenia spectrum disorders, including first-episode psychosis (FEP). Neuroinflammation has been proposed as a potential contributor to these deficits. However, the relationship between specific proinflammatory and anti-inflammatory markers and PS/PMS performance in medication-naïve FEP patients remains unclear. We hypothesize that altered levels of inflammatory markers are associated with PS/PMS impairments in FEP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Seventy-five medication-naïve FEP patients and 75 healthy controls (HC) were assessed. PS/PMS was measured using a neuropsychological battery, including the Continuous Performance Test (CPT), Grooved Pegboard Test (GPT), Trail Making Test (TMT), and Stroop. Serum levels of proinflammatory and anti-inflammatory markers (MIP-1β, IL-8, IL-5, IL-7, IL-21, IL-23) were quantified via multiplex immunoassay. An analysis of covariance (ANCOVA) and multiple linear regression analyses were conducted, adjusting for age, sex, years of education, and metabolic index.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>FEP patients exhibited significantly higher IL-8 and MIP-1β levels compared to HC (<i>p</i> &lt; 0.05). Significant interactions between group and inflammatory markers (IL-5, IL-7, IL-21, IL-23) were found in PS/PMS tasks. However, IL-8 and MIP-1β levels were not directly associated with PS/PMS performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings highlight the involvement of neuroinflammation, particularly IL-5, IL-7, IL-21, and IL-23, in PS/PMS deficits in FEP. Targeting inflammatory pathways may represent a novel therapeutic approach to improve cognitive outcomes in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"153 5","pages":"477-489"},"PeriodicalIF":5.0,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/acps.70006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147683956","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":"Relationships of Cognitive Function With Subsequent Device-Measured Physical Activity and Sedentary Time in Healthy Individuals and Those With Bipolar Disorder: Findings From the UK Biobank","authors":"Elysha Ringin,&nbsp;David W. Dunstan,&nbsp;Denny Meyer,&nbsp;Roger S. McIntyre,&nbsp;Neville Owen,&nbsp;Michael Berk,&nbsp;Susan L. Rossell,&nbsp;Mats Hallgren,&nbsp;Tamsyn E. Van Rheenen","doi":"10.1111/acps.70011","DOIUrl":"10.1111/acps.70011","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In bipolar disorder (BD), physical inactivity and sedentary behaviour are prevalent and have been linked to BD's cognitive symptoms, although the directionality of these links is not clear. This proof-of-concept study examined whether cognitive function during mid- and later-life was prospectively related to physical activity and sedentary time, and whether the association differed in presence or extent between those with BD and healthy controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Relevant UK Biobank data were available for 646 BD participants and 18,041 psychiatrically healthy controls, aged 40–69 years at baseline. Cognition was assessed during a baseline assessment, and wrist-worn accelerometry data were collected at a follow-up assessment 2.8–6.6 years later. Regression analyses examined prospective relationships of global cognition, diagnostic group, and their interaction, with physical activity (total, light, and moderate to vigorous) and sedentary time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Baseline cognitive function was inversely associated with light physical activity (coeff. = −5.64, 95% CI: −6.30 to −4.98) and positively associated with sedentary time (coeff. = 5.17, 95% CI: 4.48–5.86) and moderate-to-vigorous physical activity (coeff. = 0.48, 95% CI: 0.28–0.68) at follow-up. Observed effect sizes were small but significant. In general, associations were not moderated by age or diagnostic group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The current study provides preliminary evidence that cognitive function may influence subsequent physical activity and sedentary time similarly in those with BD and healthy controls; however, further research is needed to confirm and further explore this findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"153 5","pages":"490-499"},"PeriodicalIF":5.0,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13050600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacological and Mechanistic Interventions for Cognitive Impairment Associated With Schizophrenia: A Review of Registered Clinical Trials","authors":"Bahareh Peyrovian,&nbsp;Lena Palaniyappan,&nbsp;Theodore T. Kolivakis,&nbsp;Howard C. Margolese","doi":"10.1111/acps.70034","DOIUrl":"10.1111/acps.70034","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Schizophrenia is characterized by positive, negative, and cognitive symptoms. Current pharmacological treatments often fail to address cognitive deficits. In this review of clinical trials, we aim to identify studies that explore neurobiological (non-psychological) strategies to address Cognitive Impairment Associated with Schizophrenia (CIAS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A search of clinical trial databases was conducted through US National Institutes of Health's ClinicalTrials.gov and the World Health Organization's International Clinical Trials Registry Platform (ICTRP) on August 2, 2024, with complementary searches performed on July 4 and 10, 2025, for each respective database to update the results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 510 relevant interventional studies that objectively measured cognitive performance. Most trials were conducted in the United States (36.4%) and focused on treatment (79%), with randomized designs (88%), investigating drugs (56%), devices (33%), and dietary supplements (10%). Of these trials, 17% reported positive pro-cognitive evidence. Glutamate modulators were the most studied drug category (63 trials), with positive results for sarcosine, BI425809 (Iclepertin), <span>d</span>-serine, <span>d</span>-cycloserine, and minocycline in small-scale trials, although the results were not replicated in larger studies. Nicotinic receptor modulators like ABT-126 and encenicline also showed some cognitive benefits. Device-based interventions, particularly rTMS and iTBS, demonstrated improvements in global cognition, working memory, attention, and processing speed in a subset of trials.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this comprehensive overview of clinical trials on pro-cognitive agents in schizophrenia, we identify emerging opportunities but also acknowledge a lack of replicated evidence. Despite extensive attempts to address CIAS, it remains an undertreated domain, and future trials should explore better ways to treat this important condition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"153 5","pages":"402-431"},"PeriodicalIF":5.0,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13050601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144999213","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":"Cognition Assessment in Virtual Reality (CAVIR)—English Version: Validation of a Novel Virtual Reality Test for Daily Life Cognitive Functions in Patients With Affective Disorders","authors":"Kathryn E. Lewandowski,&nbsp;Jintian Luo,&nbsp;Josie Kolstad,&nbsp;Kaylee Chang,&nbsp;Anders Lumbye,&nbsp;Andreas E. Jespersen,&nbsp;Kamilla W. Miskowiak","doi":"10.1111/acps.70077","DOIUrl":"10.1111/acps.70077","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Cognition is a common symptom dimension in major mood disorders and is associated with impairments in daily life functioning. Assessments that capture cognitive difficulties reflective of those that people experience in the real world are therefore much needed; however, most cognitive assessments lack ecological validity. A recently developed, fully immersive VR platform for cognitive assessment (CAVIR) has proven to be feasible, well-tolerated, sensitive to cognitive impairment in psychiatric populations, and associated with measures of daily functioning. Here we aimed to assess the validity of a newly developed English language version of CAVIR in people with primary mood disorders (PMD) and controls (HC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We enrolled 40 people with PMD including Bipolar I Disorder, Bipolar II Disorder, and Major Depressive Disorder, and 40 healthy controls. Participants were administered the CAVIR, the MATRICS Consensus Cognitive Battery (MCCB), symptom ratings, and measures of daily functioning (FAST, UPSA-B).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients scored worse than controls on the CAVIR composite and all subtests (<i>p</i> = 0.02–<i>p</i> &lt; 0.0001), except the executive functioning task (<i>p</i> = 0.85). Comparing the composite and domain scores of CAVIR to their corresponding domains on the MCCB revealed modest to moderate, significant correlations on the composite and all domains except executive functioning. The CAVIR was associated with both performance-based (UPSA-B) and interview rated (FAST) measures of functioning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This newly translated English language version of CAVIR performed very similarly to the original version and was sensitive to cognitive impairments in people with PMD. CAVIR composite and most subtests were correlated with an established paper and pencil cognitive battery and were associated with measures of functioning. The CAVIR is self-administered, quick, and requires minimal training, making it a useful tool for assessing cognition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"153 5","pages":"544-552"},"PeriodicalIF":5.0,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146163111","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 and Mood Changes in Pregnancy: Timing and Childhood Maltreatment Histories","authors":"Natalia E. Fares-Otero,&nbsp;Sarah L. Halligan,&nbsp;Nora K. Moog,&nbsp;Antje Horsch,&nbsp;Eduard Vieta,&nbsp;Soraya Seedat,&nbsp;Kamilla W. Miskowiak","doi":"10.1111/acps.70003","DOIUrl":"10.1111/acps.70003","url":null,"abstract":"","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"153 5","pages":"588-590"},"PeriodicalIF":5.0,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147683720","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":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148096011","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":"610-626"},"PeriodicalIF":5.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148072741","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":"Lifetime Mixed Depression and Childhood Trauma in Individuals With Bipolar Disorders","authors":"Francesca Bardi,&nbsp;Mario Pinto,&nbsp;Alessio Simonetti,&nbsp;Marco Di Nicola,&nbsp;Marianna Mazza,&nbsp;Giovanni Manfredi,&nbsp;Georgios D. Kotzalidis,&nbsp;Gabriele Sani,&nbsp;Delfina Janiri","doi":"10.1111/acps.70071","DOIUrl":"10.1111/acps.70071","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Mixed Depression (MxD), characterized by the co-occurrence of depressive and excitatory symptoms, is a prevalent yet often underdiagnosed presentation in bipolar disorders (BD), with significant implications for prognosis and treatment. Childhood trauma is a key environmental risk factor associated with a more severe course of BD, as it influences its onset, progression, and clinical presentation. To date, no studies have specifically investigated the relationship between lifetime childhood trauma and lifetime MxD in individuals with BD. The aim of our study was to address this gap in a large and well-characterized sample of patients with BD type I and type II.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 376 individuals, 220 euthymic outpatients with BD (MxD = 100, non-MxD = 120) and 156 healthy controls (HC), were enrolled. Childhood trauma was assessed using the Childhood Trauma Questionnaire (CTQ). Lifetime MxD was identified according to the Koukopoulos criteria. The relationship between childhood trauma and MxD was evaluated using two different multivariate models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The first model (Wilks' Lambda = 0.834, <i>p</i> &lt; 0.001) revealed that BD patients with lifetime MxD reported significantly higher CTQ total scores compared to both non-MxD (<i>p</i> = 0.029) and HC (<i>p</i> &lt; 0.001). When examining childhood trauma subtypes, BD patients with MxD reported significantly higher emotional abuse scores than those without MxD (<i>p</i> &lt; 0.001). Furthermore, compared to HC, the MxD group showed significantly elevated scores in emotional abuse, emotional neglect, and physical abuse (all <i>p</i> &lt; 0.001). The non-MxD group scored higher than HC on physical abuse (<i>p</i> = 0.008) and physical neglect (<i>p</i> &lt; 0.001). Regression analyses confirmed specifically emotional abuse as a significant predictor of lifetime MxD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings demonstrate a strong association between childhood trauma, particularly emotional abuse, and lifetime MxD. These results underscore the significance of childhood trauma as a key predictor of clinical outcomes in BD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":108,"journal":{"name":"Acta Psychiatrica Scandinavica","volume":"153 4","pages":"290-300"},"PeriodicalIF":5.0,"publicationDate":"2026-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12967745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146045747","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}