{"title":"The association between maladaptive daydreaming and eating and obsessive-compulsive disorders in the general population: the mediating role of alexithymia.","authors":"Alessia Renzi, Bleona Bytyqi, Rachele Mariani","doi":"10.1007/s00406-025-02083-z","DOIUrl":"https://doi.org/10.1007/s00406-025-02083-z","url":null,"abstract":"<p><p>Maladaptive daydreaming (MD) is a recently defined clinical condition characterized by an excessively immersive utilization of fantasy and imagination which can significantly impact both professional and social life. International literature has linked MD to obsessive-compulsive symptoms, but its association with alexithymia remains largely unexplored, and its connection to eating disorder symptoms is even more neglected. As a marker of affect regulation difficulties, alexithymia may heighten the risk and severity of MD, eating disorders, and obsessive-compulsive symptoms. Therefore, the general aim of the present study is to contribute to the study of MD in the general population, by examining potential associations between MD levels, eating disorders, obsessive-compulsive symptoms, and affect regulation capabilities. Additionally, the study aims to examine whether alexithymia mediates the relationship between eating and obsessive-compulsive symptoms, respectively, and MD levels. 562 participants (mean age = 27.16 years; SD = 10.21; 68% females) completed an online survey comprising: a socio-demographic questionnaire, the Maladaptive Daydreaming Scale (MDS), the 20-item Toronto Alexithymia Scale (TAS-20), the Eating Attitude Test (EAT-26), and the Obsessional Beliefs Questionnaire (OBQ-44). MDS score was positively related to TAS-20 total, difficulties in identifying and describing feelings as well as with eating disorders and obsessive-compulsive symptoms. Age showed a weak negative association with MDS. Regarding the mediation models, alexithymia significantly amplified the impact of eating/obsessive-compulsive symptoms on MD. The associations emerging by present study seem to support a common functioning of these clinical conditions based on maladaptive/compulsive behaviours/thought/fantasy, as strategy to regulate painful emotions. Further studies comparing these clinical populations are still needed.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947462","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}
Lorenzo Pelizza, Andrea Berti, Alessandro Di Lisi, Michele La Maida, Emanuela Leuci, Emanuela Quattrone, Derna Palmisano, Simona Pupo, Giuseppina Paulillo, Clara Pellegrini, Pietro Pellegrini, Marco Menchetti
{"title":"Subjective language disturbances in young patients at ultra-high risk for psychosis (UHR): what relevance for clinical prognosis? A 2-year follow-up study.","authors":"Lorenzo Pelizza, Andrea Berti, Alessandro Di Lisi, Michele La Maida, Emanuela Leuci, Emanuela Quattrone, Derna Palmisano, Simona Pupo, Giuseppina Paulillo, Clara Pellegrini, Pietro Pellegrini, Marco Menchetti","doi":"10.1007/s00406-025-02094-w","DOIUrl":"https://doi.org/10.1007/s00406-025-02094-w","url":null,"abstract":"<p><strong>Introduction: </strong>Language impairment has the potential to predict the onset and progression of psychosis. However, it was mainly examined using automated extraction of quantitative linguistic features and their associations with observable psychopathological aspects of psychosis (e.g., formal thought disorders). Little interest has been paid to subjective language disturbances that should phenomenologically anticipate these more objective clinical features. Therefore, the aim of this examination was to investigate subjective language disorders in a Ultra-High Risk (UHR) sample and their associations with clinical and functional outcomes along 2 years of follow-up.</p><p><strong>Methods: </strong>170 UHR participants (88 [51.8%] females; mean age = 19.52 ± 6.03 years) were assessed for a broad range of clinical outcomes, including psychosis transition, clinical and functional remission measured with the Positive and Negative Syndrome Scale and the Social and Occupational Functioning Assessment Scale. Comparisons between patients with or without baseline subjective language disorders (specifically explored with the Schizophrenia Proneness Instrument) were analyzed using Chi-Square and Mann-Whitney tests, Kaplan-Meier survival analysis, and binary logistic regression analysis.</p><p><strong>Results: </strong>Across the follow-up, the UHR subgroup with language disorders at entry (n = 80) showed higher and more enduring severity in psychopathology (especially negative and disorganized features), as well as poorer socio-occupational functioning over time.</p><p><strong>Conclusion: </strong>The presence of subjective language disturbances at baseline identifies a subgroup of UHR youths with poorer psychopathological and functional prognosis. Further studies examining their association with quantitative linguistic biomarkers are needed, especially to better predict the onset and progression of psychosis.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947442","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}
Theresa Halms, Martina Strasser, Alkomiet Hasan, Tobias Rüther, Andrea Rabenstein, Martin Trepel, Stephan Raab, Marcus Gertzen
{"title":"Determinants of quality of life among lung cancer patients: insights from a cross-sectional study.","authors":"Theresa Halms, Martina Strasser, Alkomiet Hasan, Tobias Rüther, Andrea Rabenstein, Martin Trepel, Stephan Raab, Marcus Gertzen","doi":"10.1007/s00406-025-02086-w","DOIUrl":"https://doi.org/10.1007/s00406-025-02086-w","url":null,"abstract":"<p><strong>Purpose: </strong>Lung cancer (LC) is a leading cause of cancer-related mortality, with smoking being a major risk factor. Despite the benefits of smoking cessation, many LC patients continue to smoke, potentially impacting their quality of life (QoL). This study aimed to explore factors influencing QoL among LC patients, with a focus on smoking status and mental health.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at the University Hospital of Augsburg from December 2021 to December 2023. A total of 56 LC patients were categorized into active smokers (AS), ex-smokers (ES), or never-smokers (NS). Participants completed validated questionnaires assessing QoL, depression, anxiety, stress, borderline personality disorder symptoms, and pain. Statistical analyses, including one-way ANOVA and Pearson's correlation, were employed to examine group differences and the relationship between QoL and mental health factors.</p><p><strong>Results: </strong>No significant differences in overall QoL were observed among AS, ES, and NS. However, mental health indicators-including depression, anxiety, stress, and borderline personality disorder symptoms-were significantly negatively correlated with QoL across all groups. Pain was also a key factor affecting QoL. These findings suggest that while smoking cessation is critical for improving prognosis in LC patients, mental health and pain management are more pivotal in determining QoL.</p><p><strong>Conclusion: </strong>This study emphasizes the need for a holistic approach to LC patient care, addressing both physical and mental health. Future research should focus on longitudinal studies to better understand the long-term effects of smoking and other influencing factors on QoL in this patient population.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947381","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}
Fang Ye, Jixin Luan, Pianpian Hu, Aocai Yang, Jing Liu, Manxi Xu, Kuan Lv, Kundi Wang, Yunfeng Wang, Ni Shu, Gaoxiang Ouyang, Hongwei Yu, Yuli Wang, Zhen Yuan, Shijun Li, Pengfei Xu, Qi Zhang, Guolin Ma
{"title":"Cerebral blood flow changes and their genetic mechanisms in autism spectrum disorder: a combined neuroimaging and transcriptome study.","authors":"Fang Ye, Jixin Luan, Pianpian Hu, Aocai Yang, Jing Liu, Manxi Xu, Kuan Lv, Kundi Wang, Yunfeng Wang, Ni Shu, Gaoxiang Ouyang, Hongwei Yu, Yuli Wang, Zhen Yuan, Shijun Li, Pengfei Xu, Qi Zhang, Guolin Ma","doi":"10.1007/s00406-025-02077-x","DOIUrl":"https://doi.org/10.1007/s00406-025-02077-x","url":null,"abstract":"<p><strong>Background: </strong>Autism spectrum disorder (ASD), a disorder with high heritability, is linked to abnormal cerebral blood flow (CBF) in patients. The present study focuses on exploring the genetic mechanisms behind CBF in ASD.</p><p><strong>Methods: </strong>A total of 34 children with ASD and 31 typically developing (TD) children were examined to find the inter - group differences in CBF. In combination with the Allen Human Brain Atlas (AHBA), an analysis of transcriptome - neuroimaging spatial association was carried out. This was done to identify genes whose expression was related to CBF changes in ASD, and then gene function characteristics were analyzed.</p><p><strong>Results: </strong>In comparison with TD children, children with ASD had elevated CBF values in the frontal pole, temporal pole, and thalamus, while having lower CBF values in the superior parietal and caudal middle frontal regions. There were 2,759 genes whose expression was spatially correlated with the CBF changes. Functions such as \"Inorganic ion transmembrane transport\", \"adrenergic signaling in cardiomyocytes\", and \"neuronal system\" were significantly enriched. Significantly down - weighted genes had significant correlations with gamma - aminobutyric acid in the AHBA - seq and DrONc - seq databases.</p><p><strong>Conclusion: </strong>The transcription - neuroimaging associations arising from cerebral perfusion redistribution in ASD are supplemented in an additional way, which helps in enhancing the understanding of the ASD brain.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947344","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}
François A M Jean, Ilaria Montagni, Ashlyn N Schwartz, Marie C Navarro, Charline Galesne, Mélissa Macalli, Lucie Cherruaud, Marion Lerouge-Bailhache, Sylvana M Côté, Christophe Tzourio, Cédric Galéra
{"title":"Illicit substance use and attention deficit hyperactivity disorder symptoms among French university students: a multiple correspondence analysis and a cluster analysis.","authors":"François A M Jean, Ilaria Montagni, Ashlyn N Schwartz, Marie C Navarro, Charline Galesne, Mélissa Macalli, Lucie Cherruaud, Marion Lerouge-Bailhache, Sylvana M Côté, Christophe Tzourio, Cédric Galéra","doi":"10.1007/s00406-025-02092-y","DOIUrl":"https://doi.org/10.1007/s00406-025-02092-y","url":null,"abstract":"","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947349","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":"Measuring implicit bias in height-fearful participants with the Approach-Avoidance Task.","authors":"Kayleigh Piovesan, Mike Rinck, Armin Zlomuzica","doi":"10.1007/s00406-025-02096-8","DOIUrl":"https://doi.org/10.1007/s00406-025-02096-8","url":null,"abstract":"<p><p>Height fear might involve dysfunctional, implicit biases in attention and avoidance in the presence of height-related stimuli. The present study used an Approach-Avoidance Task (AAT) for fear of heights to investigate the association between height fear and alterations in attention and approach-avoidance tendencies. The AAT for height-related stimuli assessed individuals' response times when pulling or pushing height-related vs. control images. Self-reported and interview-based measures of height fear were used to measure associations with selective attention and implicit avoidance in a height-related AAT. Self-reported height avoidance was associated with slower responses to height-related images relative to control images, suggesting changes in selective attention for height-related stimuli. A similar pattern of findings was found when using interview-based measures of height fear. We did not find associations between subjective measures of height fear and implicit avoidance bias in the AAT. Our results provide initial support for alterations in selective attention for height-related stimuli in height-fearful individuals. While the AAT may be effective in identifying biased attentional processing, further research is required to draw conclusions about potential avoidance biases in the AAT related to height-fear.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947393","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}
Anastasia Pavlidou, Avram Tolev, Daniela Reinhold, Gerrit Steinberg, Thomas J Müller, Sebastian Walther
{"title":"Aberrant gesture use in autism spectrum disorders is unrelated to motor abnormalities.","authors":"Anastasia Pavlidou, Avram Tolev, Daniela Reinhold, Gerrit Steinberg, Thomas J Müller, Sebastian Walther","doi":"10.1007/s00406-025-02093-x","DOIUrl":"https://doi.org/10.1007/s00406-025-02093-x","url":null,"abstract":"<p><strong>Background: </strong> Gesture deficits are well-documented in youth with autism spectrum disorder (ASD), yet research in adults with ASD remains limited. Understanding the nature of gesture deficits in adulthood is essential for identifying their underlying mechanisms and potential impact on communication and daily functioning. The aim of the current study examines gesture performance in adults with ASD to explore whether these deficits persist beyond childhood and how they relate to motor impairments.</p><p><strong>Methods: </strong> We included 19 patients diagnosed with ASD and 19 age-and-gender matched controls. Gesture performance accuracy was assessed in both groups using the Test of Upper Limb Apraxia (TULIA) which was subjectively rated according to the manual by an independent single rater who was blinded to the group allocations, while manual dexterity was assessed using the performance-based coin-rotation task. We further assessed motor impairments in patients using standardized well-established motor scales to examine their potential contributions to gesture accuracy.</p><p><strong>Results: </strong> Individuals with ASD exhibited significant gesture deficits compared to controls, while manual dexterity remained preserved. Tool-based gestures appeared to be the most affected. Though ASD individuals exhibited numerous motor impairments they were not associated with gesture deficits.</p><p><strong>Conclusions: </strong> Our findings suggest that gesture deficits in ASD are not driven by the presence of motor impairments. However, given the small sample size, these results should be interpreted with caution. Future studies with larger and more diverse samples are needed to further investigate the mechanisms contributing to gesture difficulties in ASD.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946497","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}
Chiara Gramegna, Barbara Barbieri, Nadia Bolognini
{"title":"Dissociating prefrontal contribution to reactive and proactive aggression: a transcranial direct current stimulation study.","authors":"Chiara Gramegna, Barbara Barbieri, Nadia Bolognini","doi":"10.1007/s00406-025-02087-9","DOIUrl":"https://doi.org/10.1007/s00406-025-02087-9","url":null,"abstract":"<p><p>Increasing evidence suggests that the dorsolateral prefrontal cortex (dlPFC) plays a crucial role in aggression and that it may be possible to modulate this behavior using transcranial direct current stimulation (tDCS). Nevertheless, no previous study has specifically examined the differential effects of bilateral tDCS on reactive and proactive aggression, making the present research the first to explore this distinction using neuromodulation. With this aim, we examined the effect of bi-hemispheric prefrontal tDCS in 30 healthy adults using a double-blind, sham-controlled design. All participants received three types of stimulation over the dlPFC: right anodal/left cathodal, right cathodal/left anodal, and sham tDCS. During the stimulation, participants underwent a modified version of the Taylor Aggression Paradigm, which included two different tasks: one for measuring proactive aggression (i.e., pTAP) and one for reactive aggression (i.e., rTAP). They were also given self-report questionnaires measuring individual levels of aggression, impulsivity, and empathy to test whether these constructs were associated with aggressive responses at the pTAP and rTAP. Results showed increased proactive aggression in males with both active montages, while reactive aggression increased only with right cathodal/left anodal tDCS. Females exhibited increased proactive aggression during right cathodal/left anodal tDCS, but decreased reactive aggression during right anodal/left cathodal stimulation. These findings suggest sex-dependent modulation of aggression via dlPFC stimulation. The relevance of these results extends beyond healthy individuals, as dlPFC dysfunction is a common feature in several psychiatric disorders associated with aggressive behavior. Understanding how tDCS modulates these distinct forms of aggression in healthy populations can inform future research on its therapeutic potential within clinical settings.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947312","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}
Shutong Yang, Ke Zhang, Rui Jiang, Yuanyuan Liu, Cui Li, Guoshuai Luo, Xiangyang Zhang
{"title":"Thyroid hormones and cognitive function in chronic schizophrenia: a large-scale cross-sectional study.","authors":"Shutong Yang, Ke Zhang, Rui Jiang, Yuanyuan Liu, Cui Li, Guoshuai Luo, Xiangyang Zhang","doi":"10.1007/s00406-025-02085-x","DOIUrl":"10.1007/s00406-025-02085-x","url":null,"abstract":"<p><strong>Background: </strong>Cognitive dysfunction is a core symptom in chronic schizophrenia, yet the mechanisms underlying these impairments remain poorly understood. Thyroid hormones have been suggested to influence cognitive function in various psychiatric disorders, but their role in schizophrenia remains unclear. This study aimed to explore the relationship between thyroid hormone levels and cognitive performance in patients with chronic schizophrenia.</p><p><strong>Methods: </strong>A total of 1271 patients with chronic schizophrenia were included in this cross-sectional study. Cognitive function was assessed using the repeatable battery for the assessment of neuropsychological status (RBANS), while thyroid hormone levels (total triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3), and free thyroxine (FT4)) were measured. Data analysis included linear correlation and regression models to examine the relationships between thyroid hormones and cognitive performance.</p><p><strong>Results: </strong>Significant associations were found between thyroid hormone levels and cognitive function. FT3 was positively correlated with visuospatial (r = 0.055, p < 0.05), while TT4 showed a negative correlation with immediate memory, visuospatial, language, and attention (r = -0.109 to -0.068, p < 0.05). Regression analysis further confirmed that TT4 was a negative predictor for immediate memory, visuospatial, language, and attention, while FT3 emerged as a positive predictor for visuospatial.</p><p><strong>Conclusions: </strong>This study provides evidence for the role of thyroid hormones in cognitive dysfunction in chronic schizophrenia, with TT4 negatively related to multiple cognitive domains, and FT3 positively associated with visuospatial ability. These findings suggest that thyroid hormone imbalances may contribute to cognitive impairments in schizophrenia and warrant further investigation into potential therapeutic interventions.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144872027","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}
Selina Hiller, Laura Emde, Denise Jais, Soňa Nevická Sikorová, Eduard Bakstein, Filip Španiel, Kateřina Urbanová, Eric Hahn, Marco Zierhut, Daniel Fürstenau, Markus Bühner, Lukas Junker, Isabel Maurus, Oliver Pogarell, Peter Falkai, Wolfgang Strube, Ingrid Bauer, Tobias Skuban-Eiseler, Josef Priller, Peter Brieger, Stephan Heres, Alkomiet Hasan, Kerem Böge, Stefan Leucht
{"title":"The ILIA study: protocol for a randomized-controlled multicenter clinical trial on smartphone- and web-based relapse monitoring for patients with schizophrenia or schizoaffective disorder.","authors":"Selina Hiller, Laura Emde, Denise Jais, Soňa Nevická Sikorová, Eduard Bakstein, Filip Španiel, Kateřina Urbanová, Eric Hahn, Marco Zierhut, Daniel Fürstenau, Markus Bühner, Lukas Junker, Isabel Maurus, Oliver Pogarell, Peter Falkai, Wolfgang Strube, Ingrid Bauer, Tobias Skuban-Eiseler, Josef Priller, Peter Brieger, Stephan Heres, Alkomiet Hasan, Kerem Böge, Stefan Leucht","doi":"10.1007/s00406-025-02089-7","DOIUrl":"10.1007/s00406-025-02089-7","url":null,"abstract":"<p><strong>Background: </strong>Despite the proven efficacy of antipsychotics in relapse prevention in schizophrenia and schizoaffective disorder, every third patient experiences a relapse within less than one year. Relapses can worsen psychosocial and treatment related outcomes and lead to substantial economic costs, primarily due to frequent and prolonged hospitalizations. The aim of this project is to evaluate a smartphone- and web-based digital solution for detecting early warning signs of schizophrenia and schizoaffective disorder to reduce relapses and subsequent hospitalizations.</p><p><strong>Methods: </strong>This randomized controlled trial compares the add-on use of a smartphone-based app for monitoring relapse warning signs in patients with schizophrenia and schizoaffective disorders (ICD-10 F20/F25) used within the routine psychiatric outpatient treatment against treatment as usual (TAU) without any further study-related intervention. Patients in the intervention group use the app for one year, fill in the weekly ten-item Early Warning Signs Questionnaire (EWSQ-10P) and obtain in-app feedback. Clinicians can access the symptom trajectory via a browser-accessible dashboard. If a threshold is exceeded in the inbuilt automatic algorithm, an alert is sent to both, the clinician and patient, enabling timely contact and, as part of a shared decision-making process, an optional adjustment of treatment decision. A total of 110 outpatients are recruited across eight study sites.</p><p><strong>Discussion: </strong>Continuous monitoring of early warning signs is expected to lead to behavioral changes and to decrease the necessity and duration of psychiatric hospital stays, thereby lowering healthcare costs. Additionally, the intervention could reduce symptom severity, alleviate medication adherence, shared decision-making, patient activation or quality of life. Qualitative data is collected to better understand patient needs and preferences regarding app usage and relapses. Insights gained from this study can be integrated into routine psychiatric care, improving the long-term treatment of patients with schizophrenia or schizoaffective disorder.</p><p><strong>Trial registration: </strong>German Clinical Trials Register (ID: DRKS00034991; registration date: 30.08.2024).</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144872026","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}