European Journal of Psychiatry最新文献

{"title":"Cognitive reserve and brain plasticity in cannabis-using psychosis patients: A systematic review of neuroimaging and intervention studies","authors":"Valerio Ricci ,&nbsp;Giovanni Martinotti ,&nbsp;Giuseppe Maina","doi":"10.1016/j.ejpsy.2025.100332","DOIUrl":"10.1016/j.ejpsy.2025.100332","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive reserve—the brain's capacity to maintain function despite neural damage—and brain plasticity—the capacity for neural reorganization—represent critical factors influencing outcomes in psychotic disorders. Their interaction with cannabis use in patients with psychotic disorders remains poorly understood.</div></div><div><h3>Objective</h3><div>To examine relationships between cognitive reserve, brain plasticity, and cannabis use in patients with psychotic disorders specifically investigating neuroimaging outcomes including brain structure (gray matter volume, white matter integrity) and function (neural network connectivity).</div></div><div><h3>Methods</h3><div>Following PRISMA guidelines, we searched four databases from 2010–2025. Studies examining patients with psychotic disorders (schizophrenia, schizoaffective disorder, first-episode psychosis) with documented cannabis use were included, encompassing the full spectrum of exposure patterns from occasional to daily use. Participants were predominantly male (69 %) with mean age 28.7 ± 8.4 years. Cognitive reserve was assessed through educational attainment, premorbid intellectual functioning (estimated IQ), or composite measures combining these indicators. Brain plasticity was measured via training-induced neuroimaging changes.</div></div><div><h3>Results</h3><div>Twenty-seven studies representing 3164 participants met inclusion criteria. In observational studies (n = 20), higher cognitive reserve was consistently associated with preserved gray matter volume and white matter integrity despite cannabis exposure (effect sizes d = 0.41–0.52). Intervention studies (n = 7) demonstrated that cognitive training produced measurable neuroplastic changes (d = 0.38–0.62 for structural; d = 0.45–0.59 for functional improvements). Cognitive reserve maintained network integrity specifically in cannabis-using patients. Females showed greater training-induced changes, while neuroprotection was most evident in daily cannabis users.</div></div><div><h3>Conclusions</h3><div>Cognitive reserve provides neuroprotection against cannabis-related brain alterations in psychotic disorders, while neuroplasticity interventions induce significant brain changes. Findings support precision medicine approaches targeting cognitive enhancement based on individual characteristics.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"40 1","pages":"Article 100332"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145876953","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":"Pharmacogenetics in refractory psychiatric disorders: Clinical utility in two consanguineous patients","authors":"Mar Panisello-Cardona ,&nbsp;Ivan Martin da Silva ,&nbsp;Pau Riera ,&nbsp;Sara Bernal ,&nbsp;David Almenta ,&nbsp;María Gámez Lechuga","doi":"10.1016/j.ejpsy.2025.100335","DOIUrl":"10.1016/j.ejpsy.2025.100335","url":null,"abstract":"","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"40 1","pages":"Article 100335"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145940144","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":"Exploring the nexus of cognition and insight in euthymic bipolar patients","authors":"Carmen Massons ,&nbsp;Jesus Cobo ,&nbsp;Guillem Navarra-Ventura ,&nbsp;Muriel Vicent-Gil ,&nbsp;Maria Serra-Blasco ,&nbsp;Abigail Jubert ,&nbsp;Mireia Agut ,&nbsp;Diego J Palao ,&nbsp;Narcís Cardoner","doi":"10.1016/j.ejpsy.2025.100336","DOIUrl":"10.1016/j.ejpsy.2025.100336","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>Although the relationship between clinical and cognitive insight in individuals with bipolar disorder remains unclear, both concepts are potentially related to cognitive performance, particularly to executive function. We aimed to explore associations among cognitive variables, cognitive insight, and clinical insight.</div></div><div><h3>Methods</h3><div>We assessed 64 clinically stable bipolar patients with a battery of clinical and cognitive tests, the Insight Scale for Affective Disorders to assess clinical insight, and the Beck Cognitive Insight Scale (BCIS) to assess cognitive insight. We used bivariate linear regression models to explore associations between cognitive insight, clinical insight, cognition, and sociodemographic and clinical variables, followed by stepwise multiple regression analyses to account for potential confounders.</div></div><div><h3>Results</h3><div>Global (<em>F</em> = 4.149; <em>B</em> = 0.201; <em>p</em> = 0.047; R2=0.071) and self-reflectiveness BCIS subscale (<em>F</em> = 4.690; <em>B</em> = 0.265; <em>p</em> = 0.043; R2=0.153) scores were positively associated with executive functions. Self-reflectiveness was negatively associated with premorbid intelligence quotient (<em>F</em> = 4.156; <em>B</em>=-0.170; <em>p</em> = 0.046; R2=0.071). Clinical insight was associated only with the self-certainty subscale of the BCIS (<em>F</em> = 4.120; <em>B</em> = 0.360; <em>p</em> = 0.047; R2=0.063).</div></div><div><h3>Conclusions</h3><div>Reduced cognitive insight is associated with cognitive impairment, especially diminished executive functioning. Elevated self-certainty scores are associated with diminished clinical insight.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"40 1","pages":"Article 100336"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145876949","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":"The role of 6-lead mobile ECG devices in monitoring QT interval in routine psychiatry clinics: A clozapine cohort survey","authors":"Leticia-Irene Muñoz-Manchado ,&nbsp;Natalia Jagodzinska ,&nbsp;Rudolf N. Cardinal ,&nbsp;Jose-Ildefonso Perez-Revuelta ,&nbsp;Julia B. Deakin ,&nbsp;Jose-María Villagrán-Moreno ,&nbsp;Emilio Fernández-Egea","doi":"10.1016/j.ejpsy.2026.100346","DOIUrl":"10.1016/j.ejpsy.2026.100346","url":null,"abstract":"<div><h3>Background and objetives</h3><div>Cardiovascular risk assessment is crucial to reduce excess mortality in schizophrenia. We aimed to evaluate the use of a recently developed portable electrocardiography (ECG) device to measure the corrected QT interval (QTc) in a United Kingdom National Health Service (UK NHS) clinical setting and to explore its relationship with clozapine plasma levels.</div></div><div><h3>Methods</h3><div>Electronic health records were reviewed over one year of routine clinical practice (Sep 2022–Sep 2023) in a cohort of clozapine-treated patients. Use of the portable ECG device and data from different QTc correction formulae were analysed. Correlations between QTc, clozapine dose, and plasma levels were tested.</div></div><div><h3>Results</h3><div>A total of 300 consecutive clinical appointments were included, covering 184 patients. QTc was recorded in 75% (<em>N</em> = 138) of patients. The prevalence of prolonged QTc varied by formula, ranging from 3% to 9.3% (<em>N</em> = 9–28 patients depending on the QTc used formula). In 63 patients with plasma clozapine concentrations measured within two months of ECG, no significant correlation was found between clozapine levels and QTc interval (<em>p</em> = 0.1).</div></div><div><h3>Conclusions</h3><div>Portable ECG devices provide a simple and accessible tool for cardiac monitoring in patients on antipsychotics in routine clinical care. Our findings indicate a non-significant trend towards an association between QTc duration and plasma clozapine levels, highlighting the value of integrated monitoring strategies.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"40 1","pages":"Article 100346"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146184902","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":"Risk of severe bacterial infection among offspring of patients with bipolar disorder: A family-linkage study","authors":"Dian-Jeng Li ,&nbsp;Shih-Jen Tsai ,&nbsp;Ya-Mei Bai ,&nbsp;Tung-Ping Su ,&nbsp;Tzeng-Ji Chen ,&nbsp;Mu-Hong Chen ,&nbsp;Chih-Sung Liang","doi":"10.1016/j.ejpsy.2025.100340","DOIUrl":"10.1016/j.ejpsy.2025.100340","url":null,"abstract":"<div><h3>Background and objectives</h3><div>The medical comorbidities associated with bipolar disorder (BD) impose a heavy burden on society. We aimed to investigate the association between parental BD and severe bacterial infection among their offspring.</div></div><div><h3>Methods</h3><div>We used data from the Taiwan National Health Insurance Research Database. Individuals whose parents were diagnosed with BD were identified as the index group, and a demographically matched control group was also selected. The primary outcome was hospitalization due to bacterial infection, and the bacterial pathogens were recorded. Cox regression models with multiple adjustments were used to estimate the hazard ratios (HRs) with 95 % confidence intervals (CIs).</div></div><div><h3>Results</h3><div>The study included 8707 offspring of parents with BD and 87,070 offspring of parents without severe mental disorders. After adjustments, the offspring of parents with BD had higher risks of severe bacterial infection (HR: 1.2, 95 % CI: 1.03–1.39), meningitis (HR: 1.45, 95 % CI: 1.02–2.06), and Klebsiella infection (HR: 3.76, 95 % CI: 1.58–8.94) than the controls. In addition, the offspring of fathers with BD had higher risks of severe bacterial infection, repeated severe bacterial infection, and septicemia than the offspring of fathers without a severe mental disorder.</div></div><div><h3>Conclusions</h3><div>We identified an association between parental BD and an increased risk of bacterial infection in their offspring. Further research is warranted to better clarify the detailed mechanisms behind it.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"40 1","pages":"Article 100340"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146034313","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":"Factors involved in working memory in patients with schizophrenia and bipolar disorder: The role of peripheral biomarkers","authors":"Gonzalo Paniagua ,&nbsp;Julia Rodríguez-Revuelta ,&nbsp;Leticia González-Blanco ,&nbsp;Manuel Couce-Sánchez ,&nbsp;Ainoa García-Fernández ,&nbsp;Francesco Dal Santo ,&nbsp;Pilar A. Sáiz ,&nbsp;M.Paz García-Portilla","doi":"10.1016/j.ejpsy.2025.100334","DOIUrl":"10.1016/j.ejpsy.2025.100334","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Cognitive impairment, especially working memory (WM) dysfunction, is a core feature of schizophrenia (SZ) and bipolar disorder (BD), influenced by various factors including lifestyle, psychopathology, pharmacological factors, inflammation, and metabolic dysfunction. This study aimed to investigate the role of metabolic, inflammatory, and intestinal permeability biomarkers in WM impairments in SZ and BD patients.</div></div><div><h3>Methods</h3><div>A cross-sectional, observational study included 146 outpatients (SZ=96, BD=50). We assessed sociodemographic, clinical, metabolic, and inflammatory markers. Cognitive performance was evaluated using the Screen for Cognitive Impairment in Psychiatry. Biomarkers included glycohemoglobin, C-reactive protein, and lipopolysaccharide-binding protein/soluble CD14. Multivariate analyses identified factors associated with WM dysfunction and, secondarily, with other cognitive deficits.</div></div><div><h3>Results</h3><div>WM impairment was present in 56.3 % of SZ and 52 % of BD patients, without inter-group differences. Independent predictors of WM dysfunction were antipsychotic polypharmacy (OR=2.415, <em>p</em> = 0.011), abdominal obesity (OR=2.884, <em>p</em> = 0.016), and elevated glycohemoglobin (OR=1.126, <em>p</em> = 0.020). While inflammatory and intestinal permeability markers correlated with metabolic parameters, they were not independent predictors of WM impairment.</div></div><div><h3>Conclusion</h3><div>WM deficits in SZ and BD are primarily associated with metabolic and pharmacological factors. Addressing modifiable metabolic factors, optimizing antipsychotic treatment, and exploring interventions such as metformin and lifestyle modifications may improve cognitive outcomes in these populations.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"40 1","pages":"Article 100334"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145882875","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":"Mild motor signs in major depressive disorder: prevalence and clinical profile","authors":"Antonina Luca ,&nbsp;Alessandro Serretti ,&nbsp;Stefano Barlati ,&nbsp;Lisa Buson ,&nbsp;Valentina Menesello ,&nbsp;Anna Magistrali ,&nbsp;Rosana Carvalho Silva ,&nbsp;Giulia Perusi ,&nbsp;Gabriele Nibbio ,&nbsp;Stefano Bignotti ,&nbsp;Giovanni Battista Tura ,&nbsp;Raffaele Ferri ,&nbsp;Massimo Gennarelli ,&nbsp;Antonio Vita ,&nbsp;Alessandra Minelli ,&nbsp;PANDORA study group","doi":"10.1016/j.ejpsy.2026.100342","DOIUrl":"10.1016/j.ejpsy.2026.100342","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Motor abnormalities are recognized features of major depressive disorder (MDD). However, subtle forms of motor dysfunction are still largely unexamined in adults with MDD. The aims of the present study were to: 1) assess the prevalence of mild motor signs (MMS) in adults with moderate to severe depression, and 2) evaluate whether patients with MMS exhibit specific depressive symptom profiles.</div></div><div><h3>Methods</h3><div>Two-hundred forty-four participants (172 (70.5 %) women, mean age 46.8 ± 14.5, mean education 12.5 ± 3.6 years) from the PANDORA trial were enrolled. All the participants were assessed using the Hamilton Depression Rating Scale (HAM-D). MMS were assessed using the UKU Side Effects Rating Scale.</div></div><div><h3>Results</h3><div>Out of the 244 participants, 34 (13.9 %) were MMS+: 20 (58.8 %) had myoclonus, 11 (32.3 %) hyperkinesia, 7 (20.6 %) rigidity, 6 (17.6 %) tremor, and 3 (8.8 %) hypokinesia. The percentage of patients reaching <em>a</em> <strong>≥</strong> 20 % improvement in the HAM-D total score was higher in the MMS- group than in the MMS+ (95.1 % vs. 75.0 %, respectively). MMS+ participants had higher HAM-D total score and sub-items exploring work and abilities, psychomotor retardation, agitation, and hypochondriasis. These associations between MMS and depression severity, as well as the specific symptomatology profile, were confirmed in the multivariate analysis, adjusted for age and sex.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that MMS may reflect a distinct subgroup within MDD, potentially characterized by greater sensitivity to motor adverse effects and subtle differences in treatment response.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"40 1","pages":"Article 100342"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146034312","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":"Discriminative utility and limitations of the strengths and difficulties questionnaire for ADHD in a referred clinical pediatric sample","authors":"Erica Fongaro ,&nbsp;Arnaud Carlier ,&nbsp;Alexandra Vauclare ,&nbsp;Judith Brisot-Dubois ,&nbsp;Damien Huzard ,&nbsp;Hervé Caci ,&nbsp;Hala Kerbage ,&nbsp;Diane Purper-Ouakil","doi":"10.1016/j.ejpsy.2025.100333","DOIUrl":"10.1016/j.ejpsy.2025.100333","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder. However, access to diagnosis and treatment remains limited, requiring improved screening strategies. This study evaluates the discriminative utility of the Strengths and Difficulties Questionnaire (SDQ) for ADHD diagnosis in a clinical sample and explores group differences and the contribution of different informants.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of 496 children aged 6–16 referred to a mental health clinic; 358 (72.2 %) received a clinical ADHD diagnosis. Baseline SDQ-Parent (SDQ-P) and SDQ-Teacher (SDQ-T) ratings were analyzed. Logistic regression and receiver operating characteristic (ROC) curve analyses were used to assess the diagnostic performance of SDQ subscales against clinical ADHD diagnoses.</div></div><div><h3>Results</h3><div>ADHD diagnoses were more frequent in males (65.6 %) and in younger children (mean age = 9.53 ± 2.59). Hyperactivity/Inattention showed the highest discrimination (AUC = 0.806 for SDQ-P; 0.883 for SDQ-T). Sensitivity was high but specificity low (.21 (95 % CI [.09, .43]) for SDQ-P; .30 (95 % CI [.07, .65]) for SDQ-T), limiting differential diagnosis. Teacher ratings outperformed parent ratings (higher AUC and specificity), underscoring informant complementarity.</div></div><div><h3>Conclusion</h3><div>The SDQ—especially Hyperactivity/Inattention—offers useful screening discrimination in referred youth, with teacher ratings outperforming parent ratings; however, low specificity limits differential diagnosis, so confirmation requires structured clinical interviews using multiple informants.</div><div>Future work should test calibrated subscale thresholds and local norms to boost discrimination and clarify context effects on SDQ ratings.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"40 1","pages":"Article 100333"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145876950","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":"Subjective and objective assessment of negative symptoms in patients with schizophrenia and their clinical and functional associations","authors":"Jozef Dragasek,&nbsp;Matus Hrebenar,&nbsp;Martina Ruzickova","doi":"10.1016/j.ejpsy.2025.100331","DOIUrl":"10.1016/j.ejpsy.2025.100331","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>Negative symptoms significantly affect psychosocial functioning and prognosis in schizophrenia. While clinician-rated scales are standard practice, the clinical value of patient-reported subjective assessments remains underexplored. This study investigated associations between subjective (Self-evaluation of Negative Symptoms, SNS) and objective clinician-rated (modified Short Assessment of Negative Domain-negative subscale, m-SAND-N) assessments, their predictive relationships, and links with psychosocial functioning (Personal and Social Performance, PSP).</div></div><div><h3>Methods</h3><div>This cross-sectional analysis included 188 outpatients with schizophrenia from 20 psychiatric clinics in Slovakia. Participants completed the SNS, followed by structured clinical interviews assessing negative symptoms (m-SAND), clinical severity (CGI-S), PSP, insight, and adherence. Correlation analyses and hierarchical multiple regressions examined the relationships among demographic, clinical, subjective/objective negative symptoms, as well as psychosocial functioning.</div></div><div><h3>Results</h3><div>Clinician-rated negative symptoms (m-SAND-N) showed significant correlations with patient-reported negative symptoms (SNS; <em>r</em> = 0.38, <em>p</em> &lt; 0.001) and with poorer psychosocial functioning (PSP; <em>r</em> = 0.68, <em>p</em> &lt; 0.001). In hierarchical regression, objective negative symptoms were the principal factor associated with higher subjective ratings (β = 0.332, <em>p</em> &lt; 0.001). Conversely, higher SNS scores (β = 0.179, <em>p</em> &lt; 0.001), greater overall illness severity (CGI-S; β = 0.156, <em>p</em> &lt; 0.05) and poorer psychosocial functioning (PSP; β = 0.583, <em>p</em> &lt; 0.001) were jointly related to more severe clinician-rated negative symptoms, together accounting for 50.7 % of their variance. Subjective ratings of affective blunting did not correlate significantly with clinician assessments, highlighting a divergence between patient- and clinician-reported measures.</div></div><div><h3>Conclusions</h3><div>Integrating subjective patient assessments with objective clinician ratings provides a comprehensive understanding of negative symptoms, facilitating improved treatment approaches and psychosocial outcomes in schizophrenia. Clinicians should consider patient insight when interpreting discrepancies, especially in affective blunting.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"40 1","pages":"Article 100331"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145974146","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":"The paradox of empathy for pain: Personality, adversity, and affective resonance in psychiatry","authors":"Mathilde Souchon ,&nbsp;Raffaella Calati ,&nbsp;Lissa Garcia Segui ,&nbsp;Madison Roopchand ,&nbsp;Adriana Foster ,&nbsp;Marta Maisto ,&nbsp;Daniele Romano ,&nbsp;Giuseppe Delvecchio ,&nbsp;Paolo Brambilla ,&nbsp;Fabio Madeddu ,&nbsp;Jorge Lopez-Castroman","doi":"10.1016/j.ejpsy.2026.100343","DOIUrl":"10.1016/j.ejpsy.2026.100343","url":null,"abstract":"<div><div>Empathy for pain (EfP) refers to the capacity to experience and understand others’ pain and represents a fundamental process for psychosocial functioning. Psychiatric literature on EfP remains at times paradoxical, reflecting both intra- and interindividual variability. Notably, EfP appears either diminished or heightened across various psychiatric conditions. This scoping review aims to synthesize current findings to identify unifying patterns, focusing specifically on the influence of early life adversity (ELA), adulthood stressors, and personality traits on EfP processes. The literature was reviewed across two core domains: the neurobiological mechanisms underlying EfP and psychiatric diagnoses characterized by empathic dysfunction. Therapeutic implications are also discussed.</div><div>EfP consistently recruits the anterior insula and anterior cingulate cortex. Exposure to stressors results in differential patterns of activation in this core network, depending on the nature and severity of the experienced stress. Severe ELA heightens sensitivity to negative emotional cues and disrupts the balance between emotional and cognitive components of empathy, while moderate ELA induces a global decrease in both. Stressors encountered in adulthood tend to blunt empathic responses overall. Personality traits and disorders show specific EfP patterns: individuals with borderline personality disorder tend to display heightened emotional responses to others’ pain, while those with psychopathic traits exhibit reduced emotional signal processing. Mentalization-based treatment has shown promising results in improving empathy deficits in personality disorders. Other approaches, such as mindfulness-based interventions and behavioral empathy training, may also support empathic functioning but remain under-investigated.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"40 1","pages":"Article 100343"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090393","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}