European Journal of Psychiatry最新文献

{"title":"Telehealth group parent training for children with autism spectrum disorder and behavioral difficulties: feasibility, acceptability and preliminary efficacy","authors":"Imanol Setien-Ramos ,&nbsp;Teresa Alonzo-Castillo ,&nbsp;Aina García-Martínez ,&nbsp;Jorge Lugo-Marín ,&nbsp;María Martínez-Ramírez ,&nbsp;Josep Antoni Ramos-Quiroga ,&nbsp;Laura Gisbert-Gustemps","doi":"10.1016/j.ejpsy.2025.100319","DOIUrl":"10.1016/j.ejpsy.2025.100319","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Children with Autism Spectrum Disorder (ASD) frequently experience significant behavioral challenges that hinder adaptive functioning and increase caregiver stress. This study assesses the feasibility, acceptability, and preliminary efficacy of a telehealth-delivered group parent training program designed to address behavioral difficulties in children with ASD.</div></div><div><h3>Method</h3><div>An open-label, single-arm trial was conducted with children aged 3–12 years diagnosed with ASD and behavioral difficulties, recruited from a tertiary hospital’s autism care program. Program effectiveness was evaluated using parent-reported measures on their children and on themselves assessing behavior problems, parental stress, and quality of life. Data analysis included pre-post comparisons and follow-up assessments at 3 and 6 months.</div></div><div><h3>Results</h3><div>Twenty dyads parent-children were analyzed. Satisfaction with the program was moderate, with especially favorable feedback on the \"planned ignoring\" unit. Preferences for delivery mode and format varied, with suggestions to reduce the number of tasks and tailor content to individual needs. Significant reductions in irritability, lethargy, hyperactivity were observed immediately after treatment, with improvements in irritability and hyperactivity sustained at the 3- and 6-month follow-ups. Parental stress decreased significantly post-treatment but did not persist over time. Quality of life improved significantly compared to baseline, both immediately post-treatment and during follow-up evaluations.</div></div><div><h3>Conclusions</h3><div>The telehealth-delivered group parent training program demonstrated feasibility and moderate acceptability, with significant improvements in child behavior and caregiver quality of life. However, the reduction in parental stress was not sustained over time. These findings underscore the potential of telehealth-delivered group interventions for managing ASD-related behavioral issues and indicate areas for program refinement to enhance adherence and long-term effectiveness.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 4","pages":"Article 100319"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886724","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":"Measuring referentiality in psychiatric disorders: Psychometric properties of the Spanish version of the Ideas of Reference and Interview Scale (IRIS-S)","authors":"Isabel Argila-Plaza ,&nbsp;Ana Aquino-Servín ,&nbsp;María Ángeles García-León ,&nbsp;Paola Fuentes-Claramonte ,&nbsp;Núria Ramiro ,&nbsp;Pilar Salgado-Pineda ,&nbsp;Joan Soler-Vidal ,&nbsp;María Llanos Torres ,&nbsp;Amalia Guerrero-Pedraza ,&nbsp;Manel Sánchez ,&nbsp;Salvador Sarró ,&nbsp;Raymond Salvador ,&nbsp;Peter J McKenna ,&nbsp;Ana Barajas ,&nbsp;Edith Pomarol-Clotet","doi":"10.1016/j.ejpsy.2025.100329","DOIUrl":"10.1016/j.ejpsy.2025.100329","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Referentiality is a common symptom in psychotic and also some non-psychotic disorders, but there are few existing measures for assessing it. A recently developed detailed measure for this purpose is the Ideas of Reference Interview Scale (IRIS), which however has only been validated in a Chinese population of first episode psychosis patients.</div></div><div><h3>Methods</h3><div>We examined the reliability and validity of a Spanish version of the IRIS (IRIS-S) in 185 patients aged between 18 and 65 with schizophrenia or schizoaffective disorder.</div></div><div><h3>Results</h3><div>The IRIS-S showed internal consistency, with this being good or acceptable for the presence scale and its three subsidiary measures. Inter-rater reliability was good and test-retest reliability was also good, except for one subsidiary measure. Convergent reliability was demonstrated but was lower than expected.</div></div><div><h3>Conclusion</h3><div>The IRIS-S has acceptable psychometric properties when employed in patients with schizophrenia/schizoaffective disorder. Caution is necessary for its use outside psychotic disorders as it has not been examined in such populations.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 4","pages":"Article 100329"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145358593","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":"Self-reported and performance-based emotional intelligence and its associations with psychopathological dimensions and insight dimensions in psychosis","authors":"Esther Rosado ,&nbsp;Amalia Zarzuela ,&nbsp;Gustavo J. Gil-Berrozpe ,&nbsp;Xabier Ansorena ,&nbsp;Julen Chato ,&nbsp;Victor Peralta ,&nbsp;Manuel J. Cuesta ,&nbsp;Ana M. Sánchez-Torres","doi":"10.1016/j.ejpsy.2025.100328","DOIUrl":"10.1016/j.ejpsy.2025.100328","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Individuals with psychotic disorders may display over the illness course a wide range of core deficits in clinical and cognitive domains, including social cognition (SC). One of the main domains of SC is emotional processing, a key component of emotional intelligence (EI). However, the extent to which EI, as self-perceived or performance-based, is related to psychopathological domains has been scarcely studied. This study aimed to examine the relationships between self-reported EI and performance-based EI with psychopathological and insight dimensions as well as to explore the correspondence between both types of EI assessments.</div></div><div><h3>Methods</h3><div>Seventy patients with psychotic disorders who were consecutively admitted to a psychiatric hospitalization unit were included. Psychotic, affective, and insight dimensions, as well as EI, were evaluated once psychopathological stability had been achieved.</div></div><div><h3>Results</h3><div>Manic symptoms were associated with greater emotional clarity (<em>r</em> = 0.25, <em>p</em> &lt; 0.05) and regulation (<em>r</em> = 0.30, <em>p</em> &lt; 0.05), whereas depressive symptoms were associated with lower emotional regulation (<em>r</em>=-0.25, <em>p</em> &lt; 0.05). No significant relationships were found between the EI measures and psychotic dimensions. Lack of feeling sick and lack of insight were related to worse performance-based EI (emotional management, <em>r</em>=-0.29 and <em>r</em>=-0.25, <em>p</em> &lt; 0.05) and self-reported EI (emotional attention, <em>r</em>=-0.24, <em>p</em> &lt; 0.05 and <em>r</em>=-0.31, <em>p</em> &lt; 0.01), and the former was also related to better emotional regulation (<em>r</em> = 0.26, <em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>The discrepancy between self-reported and performance-based EI regarding their associations with psychopathological domains might be due to the different sources of assessment but may also add evidence to the need to integrate patient-reported outcome measures in the assessment of social cognition.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 4","pages":"Article 100328"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265961","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":"Features of Spanish non-commercial non-pharmacological completed clinical trials in psychiatry","authors":"Rafael Dal-Ré ,&nbsp;Elena García-Méndez ,&nbsp;Ignacio Mahillo-Fernández","doi":"10.1016/j.ejpsy.2025.100330","DOIUrl":"10.1016/j.ejpsy.2025.100330","url":null,"abstract":"","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 4","pages":"Article 100330"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145412778","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":"Spanish validation of “The Awareness of Social Inference Test” (TASIT)","authors":"Lorena García-Fernández ,&nbsp;Nuria Cabot Iborra ,&nbsp;Verónica Romero-Ferreiro ,&nbsp;Miguel A. Álvarez-Mon ,&nbsp;Estela Jiménez López ,&nbsp;Guillermo Lahera ,&nbsp;Skye McDonald ,&nbsp;Roberto Rodriguez-Jimenez","doi":"10.1016/j.ejpsy.2025.100324","DOIUrl":"10.1016/j.ejpsy.2025.100324","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Social cognition (SC) plays a fundamental role in interpersonal functioning and is often impaired in severe mental disorders like schizophrenia. The Awareness of Social Inference Test (TASIT) is a reliable tool for assessing SC through audiovisual vignettes, but a validated Spanish version was lacking. This study aimed to translate, adapt, and validate TASIT for Spanish-speaking populations.</div></div><div><h3>Method</h3><div>A cross-sectional study was conducted with 659 participants, including healthy individuals and people with schizophrenia. The TASIT was translated and adapted following a rigorous procedure with the participation and guidance of the original author. Reliability, convergent, and discriminant validity were assessed using established psychometric tools.</div></div><div><h3>Results</h3><div>The Spanish version of TASIT demonstrated strong internal consistency across all sections, with McDonald’s omega coefficients ranging from ω = 0.71 to 0.89. Test-retest reliability was excellent, with correlation coefficients ranging from <em>r</em> = 0.81 to 0.87 (all <em>p</em> &lt; .001). Convergent validity was supported by significant correlations with established social cognition measures (<em>p</em> &lt; .05), and discriminant validity was confirmed by significant performance differences between healthy participants and those with schizophrenia (<em>p</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>The Spanish TASIT is a valid and reliable tool for assessing SC, with strong psychometric properties. It is suitable for both clinical and research settings.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 4","pages":"Article 100324"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095330","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":"Self-efficacy for coping with cancer among cancer survivors with preexisting mental health conditions versus a control group","authors":"Miri Cohen ,&nbsp;Marc Gelkopf","doi":"10.1016/j.ejpsy.2025.100318","DOIUrl":"10.1016/j.ejpsy.2025.100318","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Self-efficacy for coping with cancer is a significant factor for cancer survivors’ quality of life, but it has not been examined among individuals with preexisting severe mental health conditions (SMHC). This study compared perceptions of self-efficacy for coping with cancer among cancer survivors with and without precancer SMHC; quality of communication with the oncology team and depressive symptoms as antecedents of self-efficacy; and the mediating role of self-regulation (cognitive reappraisal and expressive suppression) between antecedents and perceived self-efficacy for coping with cancer.</div></div><div><h3>Methods</h3><div>Participants were 170 adult cancer survivors with preexisting SMHC and 80 with no SMHC, aged 20–71, and 1–5 years since diagnosis. They filled out questionnaires in a face-to-face meeting. Multigroup path analysis was conducted using structural equation modeling.</div></div><div><h3>Results</h3><div>Individuals with SMHC reported lower self-efficacy for coping with cancer and higher levels of depressive symptoms. In the SMHC group, cognitive reappraisal mediated the association between perceived communication quality and self-efficacy, and expressive suppression mediated the relationship between depressive symptoms and self-efficacy.</div></div><div><h3>Conclusions</h3><div>The results highlight the deficiency in self-efficacy for coping with cancer in individuals with SMHC, a prominent factor for treatment adherence and quality of life among cancer survivors. Findings suggest self-efficacy may be strengthened via more emphatic and attentive communication with the oncology team and fostering effective emotion regulation strategies.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 4","pages":"Article 100318"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144704829","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":"Impact of suicide and COVID-19 in different countries: Epidemiological data for 2020","authors":"Jimena María Merayo-Cano ,&nbsp;Alejandro Porras-Segovia ,&nbsp;Luis Gutiérrez-Rojas ,&nbsp;Enrique Baca-García","doi":"10.1016/j.ejpsy.2025.100316","DOIUrl":"10.1016/j.ejpsy.2025.100316","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>Suicide is a major public health problem. The number of years of potential life lost (YPLL) provides a complementary perspective for mortality assessment and health policy development. Previous studies have compared YPLL due to suicide with YPLL due to COVID-19 in the United States and Spain. However, no previous studies have explored these data worldwide to establish an adequate comparison. We believe that suicide deaths do not receive adequate attention when compared, for example, to deaths attributable to COVID-19. 1 In this case we have performed a comparative analysis of the years of life lost due to suicide and the pandemic, based on data that have been published in recent years. This study aims to quantify the global impact of suicide versus COVID-19 in terms of YPLL.</div></div><div><h3>Methods</h3><div>Our source was the World Health Organization mortality database as of September 2023. We included countries that had data on all-cause mortality for ages 0-75, presented by age groups in 2020. For suicide and COVID-19, YPLL and the percentage of YPLL over total causes of death were analyzed.</div></div><div><h3>Results</h3><div>In 10 out of 22 countries (45 %), YPLL due to suicide exceeded those due to COVID-19.</div></div><div><h3>Conclusions</h3><div>The countries where the impact of suicide was greater than that produced by COVID-19 were Australia and Germany. Although all countries in the world for which data was available were analyzed, Europe was the region with the highest representation. In the case of Europe, the world region with the largest number of countries for which data are available, half of the countries analyzed have a higher number of years of potential life lost as a result of suicide than those lost due to COVID-19, the disease that became one of the leading causes of death in record time, with devastating socio-economic impact and damage. It is necessary to raise awareness about the impact of suicide. Suicide prevention requires a coordinated effort worldwide.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 4","pages":"Article 100316"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665998","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":"Functional brain imaging of negative symptoms in schizophrenia: further evidence of prefrontal dysfunction","authors":"Paola Fuentes-Claramonte ,&nbsp;Ana Aquino-Servín ,&nbsp;María Ángeles Garcia-León ,&nbsp;Jordi Ortiz-Gil ,&nbsp;Pilar Salgado-Pineda ,&nbsp;Amalia Guerrero-Pedraza ,&nbsp;Salvador Sarró ,&nbsp;Emilio J. Inarejos-Clemente ,&nbsp;Raymond Salvador ,&nbsp;Peter J. McKenna ,&nbsp;Edith Pomarol-Clotet","doi":"10.1016/j.ejpsy.2025.100322","DOIUrl":"10.1016/j.ejpsy.2025.100322","url":null,"abstract":"<div><h3>Background and objectives</h3><div>An influential theory of negative symptoms in schizophrenia is that they are due to frontal lobe dysfunction, although this has not been consistently supported by functional imaging studies to date. Recently, our group found evidence of an association between negative symptoms and prefrontal hypoactivation during a novel executive task sensitive to goal neglect. The present study sought to extend this finding using a different functional imaging paradigm, the n-back working memory task.</div></div><div><h3>Methods</h3><div>Ninety-six medicated patients with schizophrenia were divided according to the Positive and Negative Symptoms Scale (PANSS) scores into groups with high negative symptom scores (HNS, N=70, negative symptom score range 15-34), and with low negative symptom scores (LNS, N=26, negative symptom score range 6-14). Along with 50 matched healthy controls, they underwent fMRI while performing the 2-back and 1-back versions of the n-back task.</div></div><div><h3>Results</h3><div>In the 2-back vs 1-back comparison, working memory-related activation was observed in lateral prefrontal and inferior parietal areas in all groups. The HNS patients, but not the LNS patients showed reduced activation in these task-related regions compared to the healthy controls. The HNS patients also showed hypoactivation in the right dorsolateral prefrontal cortex relative to the LNS patients, although this finding was no longer statistically significant when disorganization scores were added as a covariate.</div></div><div><h3>Conclusion</h3><div>Our results provide further evidence supporting the prefrontal hypothesis of negative symptoms, but also highlight the potential role of disorganization in modulating prefrontal activity.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 4","pages":"Article 100322"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886653","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":"Effectiveness of bright light therapy in patients suffering from unipolar or bipolar depression; A naturalistic study","authors":"M.A. Riedinger ,&nbsp;G.E. van Son ,&nbsp;N.J.A. van der Wee ,&nbsp;E.J. Giltay ,&nbsp;M. de Leeuw","doi":"10.1016/j.ejpsy.2025.100294","DOIUrl":"10.1016/j.ejpsy.2025.100294","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Depressive disorders, both unipolar (MDD) and bipolar (BD), impact patients and society greatly. In bipolar depression and seasonal affective disorder the episodic nature and periodicity relate to changes in circadian rhythms. Bright light therapy (BLT) is thought to ameliorate symptoms of depression through its influence on circadian rhythms. Effectiveness of BLT has not been thoroughly established in real-world clinical samples.</div></div><div><h3>Methods</h3><div>For seventy-four patients with depression Inventory of Depressive Symptoms – Self Rated (IDS-SR) scores were available through Routine Outcome Monitoring (ROM) used in BLT in the outpatient clinic for mood disorders. Patients received one or two weeks of add-on BLT as usual care. Patients suffering from MDD (<em>n</em> = 33, 60.6 % female, mean age 36.1 ± 11.5 years) were compared to patients suffering from BD (<em>n</em> = 41, 70.7 % female, mean age 45.0 ± 14.5 years) and changes in individual symptoms were analyzed for these two groups as well as the whole cohort.</div></div><div><h3>Results</h3><div>IDS-SR scores decreased significantly in both groups of patients and did not differ in effect size between the groups. Explorative analyses of the effects on individual items of the IDS-SR showed that items related to core symptoms of depression such a as mood, concentration and energy level showed the largest improvements.</div></div><div><h3>Conclusion</h3><div>Self-report depressive symptoms in patients suffering from either MDD or BD decreased in this naturalistic cohort after receiving BLT.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 3","pages":"Article 100294"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143136440","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":"Association between neutrophil-to-lymphocyte ratio and bipolar disorder: A systematic review and meta-analysis","authors":"Ling Gui ,&nbsp;Haiyan Yu ,&nbsp;Yuxin Wei ,&nbsp;Qichao Huang ,&nbsp;Yuyao Liu ,&nbsp;Yixiao Fu","doi":"10.1016/j.ejpsy.2025.100308","DOIUrl":"10.1016/j.ejpsy.2025.100308","url":null,"abstract":"<div><h3>Objective</h3><div>The neutrophil-to-lymphocyte ratio (NLR), a systemic indicator of inflammation and stress, shows inconsistent associations with bipolar disorder (BD). This meta-analysis will investigate NLR's diagnostic, prognostic, and therapeutic relevance in BD.</div></div><div><h3>Methods</h3><div>A systematic search across PubMed, Embase, Web of Science, PsycINFO, and Cochrane Library, using key terms ‘bipolar disorder’, ‘neutrophils’, ‘lymphocytes’, and ‘ratio’ yielded 31 studies assessed via Newcastle-Ottawa Scale. Sensitivity analyses, subgroup analyses and publication bias assessments were conducted to explore heterogeneity sources and result stability.</div></div><div><h3>Results</h3><div>The NLR values in BDs were significantly higher than those in healthy controls (HCs) (standardized mean difference [SMD] = 0.51, 95 % confidence interval [CI]: 0.40–0.62, <em>p</em> &lt; 0.0001; odds ratio [OR] = 1.87, 95 % CI: 1.27–2.74, <em>p</em> = 0.001). The association was most pronounced between bipolar mania (BDM) and HC (SMD = 0.67, 95 % CI: 0.57–0.76, <em>p</em> &lt; 0.0001, I² = 47 %). Additionally, BDM exhibited higher NLR than bipolar depression (BDD) and bipolar patients in euthymic episode (BDE) (SMD = 0.22, 95 % CI: 0.07–0.38, <em>p</em> = 0.04, I² = 42 %; SMD = 0.31, 95 % CI: 0.15–0.48, <em>p</em> = 0.0001, I² = 60 %, respectively). No significant differences were observed between BDD and HC (SMD = 0.30, 95 % CI: -0.05–0.64, <em>p</em> = 0.09). Subgroup analyses suggested that age may influence the association between NLR and BD.</div></div><div><h3>Conclusion</h3><div>An elevated NLR value is found in BD, particularly in BDM. However, the difference between BDD and HC is not statistically significant. NLR may be a potent biomarker for the identification and evaluation of BD.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 3","pages":"Article 100308"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747856","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}