European Archives of Psychiatry and Clinical Neuroscience最新文献

{"title":"We like to move it - patients with schizophrenia spectrum disorders are impaired in estimating their physical fitness levels and benefit from individualized exercise.","authors":"Wido Rippe, L Weisner, J Ewen, P Mench, T Koppius, S Borgwardt, B Tari, M Heath, A Sprenger, B Wilms, R Lencer","doi":"10.1007/s00406-024-01844-6","DOIUrl":"10.1007/s00406-024-01844-6","url":null,"abstract":"<p><strong>Background: </strong>People with schizophrenia spectrum disorders (SSD) engage less in physical activity than healthy individuals. The impact of subjectively assessed physical fitness levels on motivation for sports engagement and its relation to objective fitness parameters in SSD is unclear.</p><p><strong>Methods: </strong>25 patients with SSD (P-SSD) and 24 healthy controls (H-CON) participated in a randomized controlled study. Individual anaerobic thresholds (AT) were determined by an incremental exercise test and on separate days, aerobic exercise (cycling at 80% of workload at AT) and non-exercise control (sitting on an ergometer without cycling) sessions were performed. Demographic, clinical and objective physical fitness data (i.e., weekly physical activity, workload at AT, heart rate) were collected. Subjective physical fitness parameters were assessed before and after exercise and control sessions.</p><p><strong>Results: </strong>Weekly physical activity in P-SSD was lower than in H-CON (p < 0.05) attributed to reduced engagement in sport activities (p < 0.001). Workload and percentage of predicted maximal heart rate at AT were also reduced in P-SSD compared to H-CON (both p < 0.05). Although objective and subjective physical fitness parameters were related in H-CON (p < 0.01), this relationship was absent in P-SSD. However, during exercise sessions subjective physical fitness ratings increased to a stronger extent in P-SSD than H-CON (p < 0.05).</p><p><strong>Conclusion: </strong>The missing relationship between subjective and objective physical fitness parameters in people with SSD may represent a barrier for stronger engagement in physical activity. Accordingly, supervised exercise interventions with individually adjusted workload intensity may support realistic subjective fitness estimations and enhance motivation for sports activity in individuals with SSD.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":"629-640"},"PeriodicalIF":3.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141491369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrastructural disturbances in microglia-neuron interactions in the head of the caudate nucleus in schizophrenia.","authors":"Natalya A Uranova, Olga V Vikhreva, Valentina I Rakhmanova","doi":"10.1007/s00406-024-01956-z","DOIUrl":"10.1007/s00406-024-01956-z","url":null,"abstract":"<p><p>Previously we found altered microglia-neuron interactions in the prefrontal cortex in schizophrenia. We hypothesized that microglia-neuron interactions may be dysregulated in the caudate nucleus in schizophrenia. A postmortem ultrastructural morphometric study was performed to investigate satellite microglia (SatMg) and adjacent neurons in the head of the caudate nucleus in 21 cases of schizophrenia and 20 healthy controls. We found increased microglial density in young schizophrenia patients compared to elderly controls. Volume density (Vv) and the number (N) of mitochondria were lower and total area of vacuoles of endoplasmic reticulum was higher in SatMg in the schizophrenia group compared to controls. The mitochondrial decline has progressed with age and illness duration. Areas of neuronal somata, nucleus, mitochondria and vacuoles of endoplasmic reticulum were significantly higher in schizophrenia compared to controls. These neuronal parameters were positively correlated with area and Vv of vacuoles of endoplasmic reticulum in SatMg in the schizophrenia group but not in the control group. Besides, area of mitochondria in neurons was negatively correlated with N of mitochondria in SatMg. Vv of lipofuscin granules in neurons was higher in elderly patients compared to young patients and was positively correlated with age, illness duration and Vv of lipofuscin granules in SatMg in the schizophrenia group. The disturbances of SatMg-neuronal interactions may be related to the endoplasmic reticulum stress, alterations and deficit of mitochondria in SatMg due to chronic stress, activation and priming of SatMg followed by neurotoxicity. SatMg may participate in neuronal aging in schizophrenia.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":"823-838"},"PeriodicalIF":3.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Excess mortality and its causes among older adults with schizophrenia versus those with bipolar disorder and major depressive disorder: a 5-year prospective multicenter study.","authors":"Nicolas Hoertel, Marina Sánchez-Rico, Sandra Abou Kassm, Benjamin Brami, Mark Olfson, Katayoun Rezaei, Valentin Scheer, Frédéric Limosin","doi":"10.1007/s00406-023-01752-1","DOIUrl":"10.1007/s00406-023-01752-1","url":null,"abstract":"<p><p>Excess mortality observed in people with schizophrenia may persist in later life. The specific causes of increased mortality observed in older adults with schizophrenia and the potential influence of psychotropic medications remain partly unknown. We compared 5-year mortality and its causes of older adults with schizophrenia to bipolar disorder (BD) or major depressive disorder (MDD). We used a 5-year prospective cohort, including 564 older inpatients and outpatients with schizophrenia, BD or MDD (mean age: 67.9 years, SD = 7.2 years). Causes of death were cardiovascular disorder (CVD) mortality, non-CVD disease-related mortality (e.g., infections), suicide, and unintentional injury. The primary analysis was a multivariable logistic model with inverse probability weighting (IPW) to reduce the effects of confounders, including sociodemographic factors, duration and severity of the disorder, and psychiatric and non-psychiatric comorbidity. Five-year all-cause mortality among older participants with schizophrenia and with BD or MDD were 29.4% (n = 89) and 18.4% (n = 45), respectively. Following adjustments, schizophrenia compared to MDD or BD was significantly associated with increased all-cause mortality (AOR = 1.35; 95%CI = 1.04-1.76; p = 0.024) and cardiovascular mortality (AOR = 1.50; 95%CI = 1.13-1.99; p = 0.005). These associations were significantly reduced among patients taking antidepressants [interaction odds ratio (IOR) = 0.42; 95%CI = 0.22-0.79; p = 0.008 and IOR = 0.39: 95%CI = 0.16-0.94; p = 0.035, respectively]. Schizophrenia was associated with higher mortality compared to BD or MDD. Cardiovascular diseases explained most of this excess mortality. Exploratory analyses suggested that psychotropic medications did not influence this excess mortality, except for antidepressants, which were associated with significantly reduced between-group difference in all-cause and cardiovascular mortality.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":"595-605"},"PeriodicalIF":3.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139641909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disorganization in individuals at clinical high risk for psychosis: psychopathology and treatment response.","authors":"Arianna Biancalani, Michele Occhionero, Emanuela Leuci, Emanuela Quattrone, Silvia Azzali, Giuseppina Paulillo, Simona Pupo, Pietro Pellegrini, Marco Menchetti, Lorenzo Pelizza","doi":"10.1007/s00406-024-01855-3","DOIUrl":"10.1007/s00406-024-01855-3","url":null,"abstract":"<p><p>Disorganization is a nuclear dimension of psychosis, especially in schizophrenia. Despite its relevant association with poor prognosis and negative outcomes, it is still under-investigated compared to positive and negative symptoms, in particular at the onset of illness. This study explored disorganization in youth at Clinical High Risk for Psychosis (CHR-P) over a 2-year period. A sample of 180 CHR-P participants (50% males; 51.1% with baseline second-generation antipsychotic medication) recruited within a specialized CHR-P service completed the Positive and Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning (GAF) scale. Across the follow-up, we examined key associations of disorganization with other domains of psychopathology, functioning, and treatment response using Spearman's rank correlation coefficients and linear regression analyses. Our results showed a significant longitudinal reduction in disorganization severity levels across the follow-up. This decrease was significantly associated with improvements in negative symptoms and daily functioning, with a shorter duration of untreated psychiatric symptoms, and with baseline equivalent dose of antipsychotic medication. No significant longitudinal associations with other treatment component of the PARMS program were found. Our findings suggest a longitudinal improvement in disorganization dimension in CHR-P individuals, especially in the context of early interventions targeting reduction in the duration of untreated psychiatric symptoms and favoring a prompt antipsychotic therapy.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":"921-935"},"PeriodicalIF":3.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141445931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mentalizing impairments and hypermentalizing bias in individuals with first-episode schizophrenia-spectrum disorder and at-risk mental state: the differential roles of neurocognition and social anxiety.","authors":"Harry Kam Hung Tsui, Yingqi Liao, Janet Hsiao, Yi Nam Suen, Eric Wai Ching Yan, Lap-Tak Poon, Man Wah Siu, Christy Lai Ming Hui, Wing Chung Chang, Edwin Ho Ming Lee, Eric Yu Hai Chen, Sherry Kit Wa Chan","doi":"10.1007/s00406-024-01830-y","DOIUrl":"10.1007/s00406-024-01830-y","url":null,"abstract":"<p><p>Mentalizing, or theory of mind (ToM), impairments and self-referential hypermentalizing bias are well-evident in schizophrenia. However, findings compared to individuals with at-risk mental states (ARMS) are inconsistent, and investigations into the relationship between social cognitive impairments and social anxiety in the two populations are scarce. This study aimed to examine and compare these deficits in first-episode schizophrenia-spectrum disorder (FES) and ARMS, and to explore potential specific associations with neurocognition and symptomatology. Forty patients with FES, 40 individuals with ARMS, and 40 healthy controls (HC) completed clinical assessments, a battery of neurocognitive tasks, and three social cognitive tasks. The comic strip and hinting tasks were used to measure non-verbal and verbal mentalizing abilities, and the gaze perception task was employed to assess self-referential hypermentalizing bias. FES and ARMS showed comparable mentalizing impairments and self-referential hypermentalizing bias compared to HC. However, only ambiguous self-referential gaze perception (SRGP) bias remained significantly different between three groups after controlling for covariates. Findings suggested that self-referential hypermentalizing bias could be a specific deficit and may be considered a potential behavioral indicator in early-stage and prodromal psychosis. Moreover, working memory and social anxiety were related to the social cognitive impairments in ARMS, whereas higher-order executive functions and positive symptoms were associated with the impairments in FES. The current study indicates the presence of stage-specific mechanisms of mentalizing impairments and self-referential hypermentalizing bias, providing insights into the importance of personalized interventions to improve specific neurocognitive domains, social cognition, and clinical outcomes for FES and ARMS.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":"907-919"},"PeriodicalIF":3.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141497494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Memory deficits in children and adolescents with a psychotic disorder: a systematic review and meta-analysis.","authors":"Pilar de-la-Higuera-Gonzalez, Elisa Rodriguez-Toscano, Patricia Diaz-Carracedo, Maria Juliana Gonzalez-Urrea, Geraldine Padilla-Quiles, Marina Diaz-Marsa, Alejandro de la Torre-Luque","doi":"10.1007/s00406-025-01961-w","DOIUrl":"10.1007/s00406-025-01961-w","url":null,"abstract":"<p><p>Early-onset psychosis (EOP) is a severe disorder which takes place before 18 years. It entails diverse clinical and functional implications, and it may lead to critical impairments in neurocognitive functions. Although deficits in memory are well described in adult populations and they appear to be clinically related with psychosis, impairments in memory in EOP show inconsistencies between studies. This study aimed to gain insight into the relationship between EOP and memory impairments, studying the potential contribution of moderators (storage source and memory content) on the observed memory deficits. This systematic review and meta-analysis was conducted following the PRISMA-2020 guidelines. Search was conducted in English and Spanish in five databases. Case-control studies which met all requirements were selected. Overall effect size was calculated under the random-effects model and Z-based tests were used. Heterogeneity was analysed by the I² statistic. Mixed-effects meta-regression analysis was used to study the influence of methodological quality of studies, mean age, proportion of female participants within sample, mean diagnosis, memory storage type, memory content as moderators on individual effect size variability. As a result, 32 articles were finally selected, pooling data from 2636 participants (49.29% EOP participants). Overall effect size was Hedges' g =  - 1.01, CI₉₅ = [ - 1.35,  - 0.67], p < .01, indicating lower memory performance in the EOP group in comparison to healthy controls. Diagnosis and memory storage were found as significant moderators in the memory performance variance: larger deficits were found in children with psychosis and in working memory tasks.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":"715-732"},"PeriodicalIF":3.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex difference in alexithymia and cognitive impairment in chronic schizophrenia: a large sample study based on Chinese Han population.","authors":"Kan Yang, Yunhui Zhong, Jiamei Yuan, Yuhua Xie, Hong Tang, Xiang-Yang Zhang","doi":"10.1007/s00406-024-01954-1","DOIUrl":"10.1007/s00406-024-01954-1","url":null,"abstract":"<p><p>Sex differences in schizophrenia have been noted across domains such as alexithymia and cognitive function; however, how they interact remains unclear. This study aimed to explore sex differences in the relationship between alexithymia and cognitive function in patients with chronic schizophrenia. A total of 695 patients (464 males and 231 females) who met the DSM-IV diagnostic criteria for schizophrenia were recruited in this cross-sectional study. Demographic and clinical data were collected using self-reported questionnaires. We assessed alexithymia using the Toronto Alexithymia Scale (TAS-20), cognitive function using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and psychiatric symptoms using the Positive and Negative Syndrome Scale (PANSS). Male schizophrenic patients have to read 56.7% of the alexithymia rate, and higher scores on the RBANS visuospatial/constructional, language and total score than female patients (all P < 0.05).Alexithymia patients had lower language than non-alexithymia patients(P = 0.001). In addition, there were significant differences of the correlation scores for men and women in immediate memory and delayed memory (P < 0.001). Our results indicate that there are sex differences in the prevalence comorbid alexithymia symptoms, as well as their association with cognitive function, in patients with schizophrenia. However, a cross-sectional design could not establish definitive causative associations between sex and alexithymia or cognitive function.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":"733-742"},"PeriodicalIF":3.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impairment of the GABAergic system in the anterior midcingulate cortex of heroin-addicted males.","authors":"Apollonia von Gilsa, Johann Steiner, Anna Gos, Kurt Trübner, Christian Mawrin, Michał Kaliszan, Thomas Nickl-Jockschat, Tomasz Gos","doi":"10.1007/s00406-025-01992-3","DOIUrl":"https://doi.org/10.1007/s00406-025-01992-3","url":null,"abstract":"<p><p>Opioid addiction is a global concern and the largest health burden among drug use disorders. The multifunctional anterior midcingulate cortex (aMCC) is critical for processing nociceptive input and negative emotions, which play a prominent role in the maintenance of opioid addiction. GABAergic interneurons regulate the output of the aMCC, whose dysfunction has been linked to the behavioural abnormalities observed in addiction. In these neurons, glutamate decarboxylase (GAD), with its isoforms GAD 65 and 67, is a key enzyme in the synthesis of GABA. However, there is a lack of research investigating the role of the GABAergic system in the aMCC in the context of opioid addiction. Our study, which was performed on paraffin-embedded brains from the Magdeburg Brain Bank, aimed to investigate abnormalities in the GABAergic function of the aMCC in opioid addiction by densitometric evaluation of GAD 65/67-immunostained neuropil. Assessment of neuropil was performed in parallel with assessment of density of immunostained somata. The study showed decreased neuropil density in layers III and V in the left MCC of 13 heroin-addicted males compared to 12 healthy controls, with a significant U-test P value for layer V. In contrast, the density of GAD-immunostained somata was increased bilaterally in MCC layers III and V, but not significantly. Analysis of confounding variables showed that age, brain volume and duration of formalin fixation did not confound the results. Our findings are the first to suggest a dysregulation of GABAergic system in the aMCC in opioid-addicted individuals, contributing to the understanding of opioid addiction.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cannabidiol attenuates precuneus activation during appetitive cue exposure in individuals with alcohol use disorder.","authors":"Tristan Hurzeler, Warren Logge, Joshua Watt, I S McGregor, Anastasia Suraev, Paul S Haber, Kirsten C Morley","doi":"10.1007/s00406-025-01983-4","DOIUrl":"https://doi.org/10.1007/s00406-025-01983-4","url":null,"abstract":"<p><p>Alcohol use disorder (AUD) is a prevalent psychiatric condition characterised by problematic alcohol consumption and craving, necessitating the exploration of novel therapeutic interventions. Cannabidiol (CBD), a non-psychoactive component of cannabis, has shown potential in modulating neural processes associated with substance use disorders including AUD. This study aimed to investigate the effect of CBD on alcohol cue-induced activation of neurocircuitry associated with alcohol craving, and impact on mood, craving, and cognitive functioning in individuals with AUD. In a cross-over, double-blind, randomized trial, 22 non-treatment seeking individuals (M = 29 years) diagnosed with AUD (DSM-V) received either 800 mg of CBD or a matched placebo, completing two respective fMRI sessions. The primary outcome was neural activation in response to alcohol versus control visual cues, measured using a functional magnetic resonance imaging (fMRI) alcohol cue reactivity task. Secondary outcomes included assessments of mood, craving, and cognitive functioning. Region of interest analyses showed no differences in alcohol cue-elicited activation between the CBD and placebo conditions. However, exploratory whole-brain analysis indicated a significant treatment effect of CBD in the precuneus which was independent of cue specificity. There were no significant treatment effects of CBD compared to placebo on acute craving, mood, or cognitive functioning. In non treatment seeking individuals with AUD, CBD modulates precuneus activity during alcohol cue exposure. Further studies examining the effect of CBD on treatment-seeking AUD individuals are warranted.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antidepressants, relapse-prevention medications and both combined to reduce alcohol-related hospitalizations in individuals with severe alcohol use disorder.","authors":"Patrick Bach, Johan Franck, Jonas Hällgren, Härje Widing, Mika Gissler, Jeanette Westman","doi":"10.1007/s00406-025-01988-z","DOIUrl":"https://doi.org/10.1007/s00406-025-01988-z","url":null,"abstract":"<p><p>Data on the comparative usefulness of medications commonly prescribed to individuals with alcohol use disorder (AUD) are scarce. This study compared the association between antidepressants, relapse-preventive AUD medication, both, and neither on the risk of subsequent alcohol-related hospitalization in individuals with severe AUD. This retrospective analysis of Swedish nationwide register data used Cox (primary analysis) and logistic (sensitivity analysis) regression models to assess the associations between medication exposure (antidepressants, AUD medication, both, neither) and risk of subsequent alcohol-related hospitalization. The analysis included data on 14,026 individuals who were admitted to the hospital for severe AUD between 2009 and 2020. Antidepressants were not significantly associated with a lower risk of subsequent alcohol-related hospitalization (hazard ratio [HR] = 0.94, 95% confidence interval [CI] = 0.82-1.08), but AUD medication was (HR = 0.61, 95% CI = 0.54-0.69), as were antidepressants plus AUD medication (HR = 0.63, 95% CI = 0.45-0.87) (reference: exposure to neither). Pairwise comparisons showed that AUD medication was associated with a lower risk of hospitalization than antidepressants (HR = 0.65, 95% CI = 0.54-0.78). Antidepressants alone were associated with a higher risk than antidepressants plus AUD medication (HR = 1.50, 95% CI = 1.05-2.15). The sensitivity analysis confirmed the association between AUD medication and lower hospitalization risk. Antidepressant monotherapy was not associated with a lower risk of subsequent alcohol-related hospitalization, but relapse-preventive medication for AUD was, both alone and in combination with antidepressants. These findings support the use of relapse-preventive medication to reduce hospitalization risk in individuals with severe AUD and raise questions about the benefit of antidepressant monotherapy for this purpose.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}