Early Intervention in Psychiatry最新文献

{"title":"French Validation of the Self-Screening Prodrome, an Early Detection Tool for Psychosis","authors":"Aurore Legoux--Pierre,&nbsp;Mélissa Fenot,&nbsp;William Dalfin,&nbsp;Vincent Ory,&nbsp;Frédéric Verhaegen,&nbsp;Anita Riecher-Rössler,&nbsp;Vincent Laprevote,&nbsp;Florent Bernardin","doi":"10.1111/eip.70220","DOIUrl":"https://doi.org/10.1111/eip.70220","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Preventive actions for individuals with clinical high risk for psychosis (CHR) are highly effective in reducing the risk of transition to psychosis. Improving the identification of at-risk individuals could enable earlier access to care and reduce both the personal and societal burden of psychotic disorders. In this context, screening questionnaires are essential tools for identifying early signs of psychosis in the general population and referring individuals with a CHR to specialised centres. The Self-Screen Prodrome questionnaire (S-PRO) is a screening questionnaire designed for this purpose. The first aim of this study is to validate the French version of this instrument. Secondly, we will explore the reduction of its items to improve precision and reduce administration time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following international guidelines, items were translated and pre-tested for clarity and relevance. Seventy-two CHR patients or patients experiencing a first psychotic episode according to the Comprehensive Assessment of At-Risk Mental States (CAARMS) criteria were included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Cronbach's alpha score of the French version of the S-PRO was 0.893, and specificity/sensitivity were respectively 0.86 and 0.61 with an optimal cut-off point at 15 positive items. Using logistic regression, we reduced the S-PRO to a 12-items version. Cronbach's alpha score of the S-PRO12 was 0.71, and specificity/sensitivity remains the same, respectively 0.86 and 0.61.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>These results suggest that the 12-item version of the S-PRO could be an effective screening instrument for use by general health practitioners in primary care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"20 7","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148386949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insomnia Symptoms and Psychopathology in Individuals at Clinical High Risk for Psychosis","authors":"Brian J. Miller,&nbsp;Madelyn Granat,&nbsp;William V. McCall","doi":"10.1111/eip.70209","DOIUrl":"10.1111/eip.70209","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Insomnia is common in the clinical course of schizophrenia, including in individuals at clinical high risk for psychosis (CHR-P). We previously found associations between insomnia and psychosis-risk symptoms in CHR-P. We attempted to replicate findings in an independent cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We explored associations between insomnia and psychosis-risk symptoms in CHR-P individuals in the Accelerating Medicines Partnership Schizophrenia (AMP SCZ) program (<i>n</i> = 269). We investigated relationships between insomnia and psychosis-risk symptoms (Brief Psychiatric Rating Scale [BPRS]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of any terminal and initial insomnia at AMP SCZ baseline was 28% and 38%, respectively. After controlling for potential confounders, insomnia was a significant indicator of higher BPRS total (<i>β</i> = 0.33) and positive (<i>β</i> = 0.22), affect (<i>β</i> = 0.34), and activation (<i>β</i> = 0.13) subscale scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Insomnia is prevalent and associated with psychosis-risk symptoms in CHR-P individuals. Findings are clinically relevant and highlight the need for more rigorous assessment and treatment of insomnia in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"20 7","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148344244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Public Health Service Clinical Journeys of Patients With Primary Substance Use Disorders Who Are Subsequently Diagnosed With Non-Affective Psychotic Disorders","authors":"Kevin E. K. Chai,&nbsp;Elvis Rapoo,&nbsp;Crystal M. Y. Lee,&nbsp;Peter M. McEvoy,&nbsp;Kyran Graham-Schmidt,&nbsp;Daniel Rock,&nbsp;Kim S. Betts,&nbsp;Suzanne Robinson,&nbsp;Mathew Coleman","doi":"10.1111/eip.70211","DOIUrl":"10.1111/eip.70211","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Psychosis is a debilitating condition and prompt treatment is a key prognostic factor. Early intervention services aim to provide timely care, but co-occurring substance use disorders (SUDs) complicate treatment, leading to poorer outcomes. This study examined the clinical journey of individuals with SUD who were subsequently diagnosed with a psychotic disorder, focusing on the interval between diagnoses to understand this issue.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patient pathways were constructed using linked health data (2005–2022) from Western Australia for individuals aged ≥ 18 years with a diagnosis of SUD followed by a primary psychotic disorder. Service events across emergency departments (EDs), inpatient and community mental health services were analysed. Descriptive statistics and subgroup analyses examined variations based on the time between diagnoses, sex, remoteness and socioeconomic status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Analysis of 7568 patient pathways revealed a median diagnostic interval of 1.9 years. Initial SUD diagnoses occurred most frequently in inpatient settings (62%), whilst psychoses diagnoses were most common in EDs (46%). Common diagnostic pathways included inpatient to ED (28%) and inpatient to inpatient (24%). Subgroup analyses showed women had a 7-month longer diagnostic interval and six more mental health service events than men. Remoteness and socioeconomic disadvantage correlated with increased diagnosis in inpatient settings and decreased diagnosis in EDs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A significant delay between diagnoses is likely associated with poorer outcomes. Integrated service delivery, particularly between EDs and specialised mental health services, is important for early intervention. Patient demographics and geographic location influence diagnostic pathways, suggesting targeted interventions to improve access to prompt, appropriate care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"20 7","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/eip.70211","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148344225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mobile Technology for Real-Life Assessment of Positive and Negative Symptoms as well as Stress Among Individuals With Early Psychosis: A Scoping Review","authors":"Azusa Ishii,&nbsp;Keisuke Takano,&nbsp;Chihiro Moriishi,&nbsp;Alexander MacLellan,&nbsp;Kenta Kimura","doi":"10.1111/eip.70217","DOIUrl":"10.1111/eip.70217","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This scoping review aimed to systematically provide an overview of existing findings on the use of ecological momentary assessment (EMA) and related mobile sensing to assess positive and negative symptoms, as well as stress, in individuals at clinical high risk for psychosis (CHR-P) and those with first-episode psychosis (FEP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following the PRISMA-ScR guidelines, PubMed, PsycINFO, and Web of Science were searched for empirical studies published up to October 2025. Eligible studies assessed positive and negative symptoms and stress in daily life using EMA or related mobile sensing implemented on contemporary devices. Data were extracted on study characteristics, EMA design (sampling schedule, prompting logic, duration, completion rates), and domains assessed and were summarised descriptively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ten studies (14 records) met the inclusion criteria. Most used smartphone-based EMA with semi-random prompts 4–10 times daily over 6–28 days. Six assessed positive symptoms, three negative symptoms and two stress. Symptoms were all assessed through self-report EMA, while stress was assessed through self-report EMA in one study and objectively through skin conductance in one. The reporting of completion, item validity, and incentive structure was inconsistent, limiting comparability across studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Self-report EMA offers a feasible method for real-world assessment of symptoms and stress; however, mobile sensing remains underutilised.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>Future research should integrate EMA and related mobile sensing, employ validated indicators and standardise reporting practises to enhance methodological transparency and clinical utility.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"20 7","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148344282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Social Functioning in Youth at Clinical High Risk for Psychotic Disorders With a Virtual Reality Based Cognitive Behavioural Therapy: The Feasibility and Acceptability of REVIVE","authors":"R. Pot-Kolder,&nbsp;M. Reinoso,&nbsp;Y. Liu,&nbsp;C. Ellinghaus,&nbsp;J. Spark,&nbsp;I. Macmillan,&nbsp;L. Hopkins,&nbsp;D. Kolovos,&nbsp;C. Li,&nbsp;L. Valmaggia,&nbsp;A. Thompson","doi":"10.1111/eip.70192","DOIUrl":"https://doi.org/10.1111/eip.70192","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Adolescence is when mental disorders such as psychosis frequently emerge, with long-term impacts on social functioning if left untreated. Early intervention, including cognitive behavioural therapy (CBT) and innovative approaches like virtual reality (VR)-assisted therapy, can help young people in their social recovery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>During the development phase of REVIVE therapy, input was gathered through group consultations with 10 youth advisors aged 16–25 who had lived experience. Their insights informed the design of the virtual social environments. A feasibility and acceptability study was conducted with eight participants at clinical high risk (CHR) for psychosis. Participants received up to 10 VR-assisted CBT sessions focused on enhancing social recovery. Feasibility and acceptability were assessed through structured evaluations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of the 13 eligible service users with clinical high risk for psychosis (CHR) status, 10 expressed interest in enrolling in the REVIVE study, leading to eight participants being included. The recruitment conversion rate was 77%, while retention rates showed 38% for therapy and 63% for the study. Therapy completers achieved an average of 74% toward their personal social goal by the end of treatment. Participants reported overall positive experiences with the VR therapy and suggested improvements for program flexibility, personalisation, and content variety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>While the REVIVE VR-CBT therapy is deemed moderately feasible and acceptable for young people with clinical high risk (CHR) status, significant barriers underscore existing challenges and the necessity for a personalised and supportive approach. The small sample size restricts the ability to generalise findings and precludes robust statistical analyses.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"20 7","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148325014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parental Psychiatric Symptoms and Child Emotional and Behavioural Difficulties: Exploring the Mediating Role of Parental Reflective Functioning in Parents With Mental Disorders","authors":"Amanda Kaas,&nbsp;Olivia Pepin,&nbsp;Sebastian Simonsen,&nbsp;Per Sørensen,&nbsp;Mette Væver,&nbsp;Ida Egmose,&nbsp;Emilie Hestbaek","doi":"10.1111/eip.70208","DOIUrl":"https://doi.org/10.1111/eip.70208","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Children of parents with a mental disorder are at increased risk of developing mental health problems. A potentially important construct in the intergenerational transmission of mental health problems is parental mentalizing, referred to as parental reflective functioning (PRF). The aim of this study was to examine the links between parental psychiatric symptom severity, PRF, and child emotional and behavioural difficulties among parents with a mental disorder. Furthermore, we sought to explore the potential mediating role of PRF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study involved parents with various diagnosed mental disorders (<i>N</i> = 70) with a child aged 0–17. Psychiatric symptom severity was assessed using the Brief Symptom Inventory, PRF was assessed with the Parental Reflective Functioning Questionnaire, and child emotional and behavioural difficulties were assessed with the Strengths and Difficulties Questionnaire. Linear regressions and Hayes PROCESS macro were utilised to examine the links between the variables and test for the mediating role of PRF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Parental psychiatric symptom severity was significantly related to higher levels of child emotional and behavioural difficulties. Parental psychiatric symptom severity was closely associated with maladaptive PRF, as indicated by higher levels of pre-mentalizing, which in turn was related to child emotional and behavioural difficulties. PRF did not mediate the relationship between parental psychiatric symptom severity and child emotional and behavioural difficulties.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Parental psychiatric symptom severity and PRF are important for child emotional and behavioural difficulties. However, the relationship between parental psychiatric symptom severity and child emotional and behavioural difficulties was not mediated by PRF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"20 7","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/eip.70208","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148324484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disentangling the Neurobiological Underpinnings of Anorexia Nervosa From the Neurobiological Consequences of Starvation","authors":"Andrea Phillipou","doi":"10.1111/eip.70219","DOIUrl":"10.1111/eip.70219","url":null,"abstract":"","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"20 7","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148316345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening Performance of the DSM-5 Level 1 Cross-Cutting Symptom Measure to Detect Psychiatric Comorbidity Among Youth: A Community-Based Study","authors":"João Pedro Gonçalves Pacheco,&nbsp;Christian Kieling,&nbsp;João Villanova do Amaral,&nbsp;Pedro H. Manfro,&nbsp;Ana M. B. Menezes,&nbsp;Fernando C. Barros,&nbsp;Isabel O. Oliveira,&nbsp;Fernando C. Wehrmeister,&nbsp;Luis Augusto Rohde,&nbsp;Maurício Scopel Hoffmann","doi":"10.1111/eip.70201","DOIUrl":"https://doi.org/10.1111/eip.70201","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Detection of psychiatric comorbidity is essential given its high burden and frequent under-recognition. The DSM-5 Level 1 Cross-Cutting Symptom Measure (DSM-XC) is a multidimensional screener designed to capture relevant psychopathological domains, yet its ability to detect comorbid conditions remains unclear. In this study, we evaluated the DSM-XC's capacity to screen additional psychiatric comorbidity in individuals with an existing psychiatric diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cross-sectional data from 796 individuals aged 22 years (60.8% female) from the 1993 Pelotas birth cohort in Brazil were analysed. Participants were included if they met criteria for at least one of seven psychiatric diagnoses based on structured clinical interviews. Screening accuracy metrics were calculated for targeted DSM-XC domains in identifying secondary diagnoses (e.g., depression domain for major depressive disorder [MDD]), using standard and Youden-optimized thresholds. Non-targeted performance assessments (e.g., anxiety domain for MDD) were also performed. Additionally, all 13 domains and the total score were evaluated for detecting any comorbidity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For the targeted domain assessment, high sensitivity and negative predictive values were observed using original thresholds, supporting rule-out utility, but specificity and positive likelihood ratios were low. The application of optimized thresholds increased specificity, with positive likelihood ratios reaching ~2 across domains. Non-targeted domains frequently outperformed targeted domains. Good discrimination for detecting any comorbidity was achieved using the DSM-XC total score (AUC = 0.75), with a cutoff of ≥ 21 providing the best balance between sensitivity (0.71) and specificity (0.69) and acceptable likelihood ratios.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>DSM-XC domains are useful for excluding comorbidities but have limited confirmatory value. The total score provides a global indicator of comorbidity. These findings support the DSM-XC primarily as a rule-out transdiagnostic triage tool for improving comorbidity detection in community settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"20 7","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148324483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Client Engagement With an Early Psychosis Program and Post-Program Health Service Use: A Retrospective Cohort Study","authors":"Nathan K. Smith,&nbsp;Leslie Anne Campbell,&nbsp;Candice E. Crocker,&nbsp;Philip G. Tibbo","doi":"10.1111/eip.70205","DOIUrl":"https://doi.org/10.1111/eip.70205","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Poor engagement with Early Intervention Services (EIS) for first-episode psychosis threatens program effectiveness, yet research often reduces engagement to a binary measure (engaged/disengaged), limiting understanding of those who disengage and re-engage. This study examined demographics, clinical characteristics, and health service utilisation patterns among engaged, intermittently engaged, and disengaged patients of the Nova Scotia Early Psychosis Program (NSEPP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort comprised of 331 individuals enrolled in NSEPP between July 22, 2005, and October 9, 2015, was constructed by linking clinical and administrative datasets. Engagement types (engaged, intermittently engaged, disengaged) were characterised in terms of baseline demographics and clinical factors, along with patterns of health service utilisation before, during, and after program enrollment. Crude and adjusted associations between program engagement and post-program health service utilisation (emergency department (ED) use and mental health-related hospital admissions) were assessed using negative binomial regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During program enrollment, the intermittently engaged group had the greatest illness severity (35% spent 30+ days in hospital), and the highest proportion of individuals with at least one ED visit (85%) and one hospital admission (55%). These during-program health service use factors were the strongest predictors of post-program health service use outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The three engagement types show distinct health service utilisation patterns, which may reflect differences in need, access, or program effectiveness. These results provide evidence that dichotomisation of engagement may mask important heterogeneity. Further characterisation of the engagement continuum to include intermittent engagement may provide insights to reducing barriers and improving access to and uptake of EIS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"20 7","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/eip.70205","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148324646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct and Indirect Effects of Body Dysmorphic Concern on Psychotic Symptoms Through Suicidal Ideation in Patients With First-Episode Schizophrenia","authors":"Feten Fekih-Romdhane,&nbsp;Nour Bouallègue,&nbsp;Majda Cheour,&nbsp;Souheil Hallit","doi":"10.1111/eip.70222","DOIUrl":"https://doi.org/10.1111/eip.70222","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Body dysmorphic concerns (BDC) are closely connected to the severity of psychotic symptoms in people diagnosed with schizophrenia. At the same time, there is evidence suggesting that BDC is related to alarmingly increased rates of suicidality, and suicidality is a predictor of increased psychotic symptoms. Investigating these pathways may provide insight into the complex interaction between psychopathology and psychotic symptoms, and inform future intervention strategies. Using a clinical sample of outpatients with first-episode schizophrenia and a non-clinical sample of healthy adults, the objectives of this study were twofold: (1) to explore the nature and prevalence of BDC symptoms in both samples and (2) to examine the mediating influence of suicidal thoughts on the association between BDC and psychotic symptoms in the patients' sample.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The research was cross-sectional, performed over a period of 6 months, from 1 July 2024 to 31 December 2024. Our target population consisted of two groups: (1) a group of clinically-stable outpatients recruited at the first episode of schizophrenia and who have less than 3 months of lifetime exposure to antipsychotic medication and (2) a group of healthy controls. A total of 103 patients and 109 controls were included for final analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our results indicated that patients were at higher risk for experiencing body dysmorphic disorder (41.7%) than controls (16.5%). Mediation analysis showed that the effect of BDC on psychotic symptoms severity was partially mediated by suicidal ideation (indirect effect: Beta = 0.281; Boot SE = 0.122; Boot CI 0.034; 0.520). On one hand, BDC directly correlated with greater levels of psychotic symptoms. On the other hand, dysmorphic concerns significantly correlated with more suicidality, which was, in turn, correlated with more intense psychotic symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings suggest that the improvement of BDC symptoms coupled with suicide risk assessment and intervention should be integrated into strategies designed to aid the management of psychotic symptoms in schizophrenia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11385,"journal":{"name":"Early Intervention in Psychiatry","volume":"20 7","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148324508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}