General hospital psychiatry最新文献

{"title":"Falls and fractures associated with ramelteon use: A systematic review and meta-analysis","authors":"Rintaro Sogawa ,&nbsp;Yuki Nakano ,&nbsp;Kazumasa Kotake ,&nbsp;Hiroshi Tateishi ,&nbsp;Yoshito Mizoguchi ,&nbsp;Akira Monji ,&nbsp;Chisato Shimanoe","doi":"10.1016/j.genhosppsych.2025.09.009","DOIUrl":"10.1016/j.genhosppsych.2025.09.009","url":null,"abstract":"<div><h3>Introduction</h3><div>Hypnotics are associated with increased risk of falls and fractures. However, most studies evaluating the association between ramelteon, and these outcomes, are single-center and lack comprehensive analysis. We aimed to evaluate the association between ramelteon use and the risk of falls and fractures.</div></div><div><h3>Methods</h3><div>We systematically searched for the term “ramelteon” in the Medical Literature Analysis and Retrieval System Online via PubMed, Cochrane Central Register of Controlled Trials, International Clinical Trials Registry Platform, and <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>. in January 7, 2025. Retrieved studies were assessed for risk of bias and analyzed for the association between ramelteon use and falls or fractures using a random-effects model based on the Sidik–Jonkman method, as well as inter-study heterogeneity using the I² statistic. Meta-analyses were conducted on seven observational studies and three randomized controlled trials.</div></div><div><h3>Results</h3><div>Ramelteon use was not significantly associated with an increased fall risk (odds ratio: 1.26; 95 % confidence interval: 0.83–1.92; I² = 0 %). Analysis of fractures showed a potential increased risk with ramelteon use (risk ratio: 3.29; 95 % confidence interval: 0.53–20.45; I² = 0 %), although this was not statistically significant.</div></div><div><h3>Conclusion</h3><div>Ramelteon was not associated with a statistically significant increase in the risk of falls or fractures, regardless of the study design.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 72-78"},"PeriodicalIF":3.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of the Norwegian IAPT model (PMHC) on dispensed psychotropic medication","authors":"Otto Robert Frans Smith ,&nbsp;Marit Knapstad ,&nbsp;Leif Edvard Aarø","doi":"10.1016/j.genhosppsych.2025.09.010","DOIUrl":"10.1016/j.genhosppsych.2025.09.010","url":null,"abstract":"","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 79-81"},"PeriodicalIF":3.7,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145217521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosis in Huntington's disease: A systematic review of case reports","authors":"Aliu Opeyemi Yakubu ,&nbsp;Oluwakemi Eunice Olalude ,&nbsp;Olorungbami Kolade Anifalaje ,&nbsp;Moses Gregory Effiong ,&nbsp;Francess Oluwaferanmi Adeyemi ,&nbsp;Maryam Abubakar","doi":"10.1016/j.genhosppsych.2025.09.008","DOIUrl":"10.1016/j.genhosppsych.2025.09.008","url":null,"abstract":"<div><h3>Background</h3><div>Huntington's disease (HD) is a neurodegenerative disorder characterized by motor, cognitive, and psychiatric symptoms. Psychosis is an uncommon but debilitating psychiatric manifestation in HD. This systematic review synthesizes published case reports to characterize the clinical presentation and management of psychosis in HD.</div></div><div><h3>Methods</h3><div>We searched the literature for case reports (including small case series) of HD patients with psychosis. Eligible publications (English, 1980–2024) were reviewed, and data on demographics, HD onset, timing of psychosis, family history, psychotic symptomatology, treatments, and outcomes were extracted.</div></div><div><h3>Results</h3><div>Forty-eight case reports, encompassing 55 HD patients with psychosis. The mean age of psychosis is lower than the mean age of HD diagnosis and motor symptom onset. Psychosis in HD typically presents delusions and hallucinations. Nearly all patients were treated with antipsychotics, predominantly atypical agents; only a few received first-generation antipsychotics. Most patients showed good responses to medication. Common adverse effects of antipsychotics included extrapyramidal symptoms and sedation. Nine reports (13 patients) described the use of ECT for severe or refractory psychosis, with the majority achieving significant reduction in psychotic symptoms and only minimal side effects.</div></div><div><h3>Conclusions</h3><div>Psychosis in HD can manifest across a wide spectrum of ages and disease stages. Atypical antipsychotics are generally effective for symptom control, and ECT appears to be a safe and effective adjunct for refractory cases. Clinicians should be vigilant for psychosis as a potential early sign of HD and consider a tailored, multidisciplinary treatment approach. Further research is needed to guide management.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 82-93"},"PeriodicalIF":3.7,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145217526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of applet-based acceptance and commitment therapy focused on repetitive negative thinking for adults with comorbid anxiety and depression: A randomized controlled trial with mediation analysis","authors":"Qizheng Cao ,&nbsp;Xiayu Du ,&nbsp;Francisco J. Ruiz ,&nbsp;Marge A. sierra ,&nbsp;Xianglian Yu ,&nbsp;Zhihong Ren","doi":"10.1016/j.genhosppsych.2025.09.006","DOIUrl":"10.1016/j.genhosppsych.2025.09.006","url":null,"abstract":"<div><h3>Objective</h3><div>This study examines the effects of an applet-based Acceptance and Commitment Therapy focused on Repetitive Negative Thinking (RNT-ACT) for adults with comorbid anxiety and depression, and explores the mediating role of Repetitive Negative Thinking (RNT) in its efficacy.</div></div><div><h3>Methods</h3><div>In a randomized controlled trial, participants with the co-occurrence of elevated anxiety and depressive symptoms (GAD-7 and PHQ-9 scores ≥10; <em>N</em> = 94) were randomly assigned to either the RNT-ACT intervention group (<em>N</em> = 49) or a wait-list control group (<em>N</em> = 45). The intervention group completed a 14-day online RNT-ACT program, while the wait-list group received no intervention. Assessments of RNT, anxiety, and depression were conducted at baseline, mid-intervention, post-intervention for both groups, with an additional one-month follow-up assessment for the intervention group.</div></div><div><h3>Results</h3><div>The RNT-ACT intervention led to significant reductions in RNT (<em>F</em>_{(2, 272)} = 45.44, <em>p</em> &lt; 0.001), anxiety (<em>F</em>_{(2, 174)} = 25.43, <em>p</em> &lt; 0.001), and depression (<em>F</em>_{(2, 174)} = 25.43, <em>p</em> &lt; 0.001) symptoms post-intervention compared to the control group, with sustained improvements at follow-up. Longitudinal mediation analysis revealed that reductions in RNT mediated improvements in anxiety and depression.</div></div><div><h3>Conclusions</h3><div>These findings provide empirical support for transdiagnostic interventions and highlight the potential for optimizing treatment strategies for comorbid anxiety and depression. Future research should explore additional mediators to further elucidate the mechanisms underlying comorbidity.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 56-63"},"PeriodicalIF":3.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145155170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global estimates of natural, unnatural, and all-cause mortality in patients with personality disorders: A meta-analysis of longitudinal studies and meta-regression of potential moderators in a sample of 34 million people","authors":"Saeid Komasi ,&nbsp;Ali Zakiei ,&nbsp;Gerald J. Haeffel ,&nbsp;Federico Amianto ,&nbsp;Jouko Miettunen ,&nbsp;Carla Sharp","doi":"10.1016/j.genhosppsych.2025.09.005","DOIUrl":"10.1016/j.genhosppsych.2025.09.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Personality disorders (PDs) influence various life aspects and health outcomes, necessitating a deeper understanding of how they affect mortality rates and the factors that contribute to these differences. This meta-analysis aims to make global estimates of natural, unnatural, and all-cause mortality in patients with PD by synthesizing data from longitudinal studies and identifying potential moderators influencing these outcomes</div></div><div><h3>Methods</h3><div>This meta-analysis followed PRISMA guidelines (PROSPERO-CRD42025636341), including a systematic search of English-language records from PubMed, Scopus, PsycNET, and Google scholar. Standardized mortality ratio (SMR) for natural, unnatural, and all-cause mortality was calculated using the random-effects method. We used meta-regression and subgroup analyses to explore potential sources of heterogeneity. Publication bias and the risk of bias also were evaluated</div></div><div><h3>Results</h3><div>Approximately 2,368,000 deaths were reported by 35 eligible studies. The pooled SMR for all-cause mortality was 4.16 (95 % CI: 3.74–4.62), indicating a significantly elevated risk. The SMR for natural causes of death was 2.95 (95 % CI: 2.70–3.21) whereas the SMR for unnatural causes of death (suicide being the primary contributor = 22.69) was 14.27 (95 % CI: 12.79–15.92). We found that 12 potential moderators differentially affected each of the natural, unnatural, and all causes of death</div></div><div><h3>Conclusions</h3><div>This meta-analysis highlights a significantly elevated mortality risk in patients with PD, particularly from unnatural causes like suicide. Identifying key moderators can guide targeted interventions and inform health policies to enhance care and prevention strategies for this vulnerable population, emphasizing the need for ongoing research into mortality trends</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 44-55"},"PeriodicalIF":3.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of depression with all-cause and cardiovascular mortality among maintenance hemodialysis patients in China: a retrospective cohort study","authors":"Shuang Zhang ,&nbsp;Xue-Na Wang ,&nbsp;Qi-Jun Wu ,&nbsp;Ping Xiao ,&nbsp;Zhi-Hong Wang ,&nbsp;Yan Lu ,&nbsp;Hong Liu ,&nbsp;Shu-Xin Liu","doi":"10.1016/j.genhosppsych.2025.09.004","DOIUrl":"10.1016/j.genhosppsych.2025.09.004","url":null,"abstract":"<div><h3>Background</h3><div>Depression is not uncommon among patients with end-stage renal disease being treated by hemodialysis (HD). However, the relationship between depression and mortality is inconclusive. This study aims to investigate the above relationship in maintenance hemodialysis (MHD) patients.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study involving 746 adults who were treated with long-term HD within a single dialysis center. Depression was assessed with the self-reported Patient Health Questionnaire-9 (PHQ-9). Kaplan-Meier survival analysis, multivariable Cox regression models, restricted cubic splines, subgroup and sensitivity analyses were used to assess the relationship between depression and mortality risks.</div></div><div><h3>Results</h3><div>Among 746 patients (median follow-up: 30.47 months), 211 deaths (28.28 %) occurred, including 149 (19.97 %) cardiovascular deaths. Compared to the non-depression group, the depression was positively associated with all-cause mortality (HR = 1.34, 95 % = 1.01–1.77) and cardiovascular mortality (HR = 1.55, 95 % = 1.11–2.17) after multivariate adjustments. Similarly, we detected a significant positive association when PHQ-9 score was a continuous variable. Besides, the risk of all-cause and cardiovascular mortality in MHD patients increased by 13 % (HR = 1.13, 95 %CI = 1.00–1.27) and by 19 % (HR = 1.19, 95 %CI = 1.03–1.36) for each standard deviation increase in PHQ-9 score, respectively. The findings were robust in all the subgroup and sensitivity analyses. Kaplan-Meier analysis revealed significantly lower cumulative survival in the depression group compared to the non-depression group (<em>p</em> &lt; 0.05). Furthermore, a positive linear dose-response relationship was observed between PHQ-9 scores and the risk of all-cause and cardiovascular mortality (<em>p</em> _{non-linearity} &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>Depression is a heterogeneous disorder and may be associated with increased mortality for MHD patients. Future research needs to assess whether early identification and treatment of depression may help to improve quality of life and survival in MHD patients.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 37-43"},"PeriodicalIF":3.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Key competencies for psychedelic treatment in real-world mental health care settings","authors":"Max Wolff ,&nbsp;Hans Rutrecht ,&nbsp;Gerhard Gründer ,&nbsp;Andrea Jungaberle ,&nbsp;Henrik Jungaberle","doi":"10.1016/j.genhosppsych.2025.09.003","DOIUrl":"10.1016/j.genhosppsych.2025.09.003","url":null,"abstract":"<div><div>Psychedelic treatments are extending beyond research units and into hospitals, outpatient clinics, and community practices. Contrasting the constrained procedures of clinical trials with the realities of routine practice, this article outlines the competencies needed for safe, effective, and ethically sound psychedelic therapy in everyday mental health care. To accommodate mainstream adoption of these treatments, the competencies framework we present respects the distinctive contextual and cultural sensitivities of psychedelic care while remaining anchored in established psychotherapeutic, medical, and scientific paradigms. Designed for varied service models, the framework is substance-unspecific (i.e., covering various classical and atypical psychedelic agents) and transtheoretical (i.e., compatible with cognitive-behavioral, psychodynamic, humanistic-experiential, systemic and other psychotherapeutic orientations). Developed within the MIND Foundation's Augmented Psychotherapy Training (APT) program, the framework spans foundational psychotherapeutic, biomedical, philosophical, socio-cultural, existential, legal, and self-experiential domains and translates them into practical competencies for multi-professional cooperation, screening, preparation, dosing, integration, and harm-reduction. While the framework awaits systematic evaluation across diverse clinical contexts, it offers an initial blueprint for future accredited certification pathways and for the ongoing refinement of clinician training as these treatments enter mainstream care.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 11-24"},"PeriodicalIF":3.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical evidence for acupuncture-assisted treatment of depression: A systematic review and meta-analysis with meta-regression","authors":"Lei Yang ,&nbsp;Qin Zhang ,&nbsp;Min Wen ,&nbsp;Sini Li ,&nbsp;Aijuan Lu ,&nbsp;Kang Li ,&nbsp;Ciyan Peng ,&nbsp;Jing Chen","doi":"10.1016/j.genhosppsych.2025.09.002","DOIUrl":"10.1016/j.genhosppsych.2025.09.002","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Research exploring the clinical application of acupuncture-assisted drug treatment for depression is expanding, yet the findings remain inconsistent, and the moderating factors between the two approaches remain unclear.To assess the efficacy and safety of acupuncture-assisted treatment combined with selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) for depression compared with antidepressant medication alone and to identify the moderating effects of acupuncture-assisted treatment on depression and the presence of publication bias.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We conducted a comprehensive search of seven English-language databases and four Chinese-language biomedical databases from inception to December 2024 (INPLASY202420002), without language restrictions.Randomized controlled trials (RCTs) involving participants aged ≥18 years diagnosed with depression and investigating the effects of acupuncture-assisted medication (SSRIs/SNRIs) versus SSRIs/SNRIs alone were included. Random-effects models were used to calculate effect sizes for the included RCTs, and meta-regression was used to analyse potential moderators of acupuncture-assisted interventions. Primary outcomes included depression severity before and after acupuncture-assisted intervention, change measured by self-rating or clinical scales and adverse effects. Secondary outcomes were treatment response rate and remission rate post-intervention.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Our meta-analysis incorporated 66 studies with 5744 participants. Acupuncture-assisted interventions with SSRIs or SNRIs significantly reduced the Hamilton Depression (HAMD) scores (standardised mean difference [SMD] = −1.185, 95 % confidence interval [CI] [−1.43, −0.94]), as well as the Side Effects Rating Scale [SERS] and Treatment-Emergent Symptoms Scale (TESS) scores (SERS: SMD = −0.896, 95 % CI [−1.39, −0.94]; TESS: SMD = −1.469, 95 % CI [−2.18, −0.76]), while effectively increasing the treatment response (RR = 1.391, 95 % CI [1.28, 1.51]) and remission (RR = 1.597, 95 % CI [1.45, 1.76]) rates compared with controls. Regression analyses indicated that baseline HAMD score (b = 0.405, β = 0.405, 95 % CI [0.15, 0.66], &lt;em&gt;p&lt;/em&gt; = 0.002, R&lt;sup&gt;2&lt;/sup&gt; = 0.164), treatment duration (b = 0.056, β = 0.324, 95 % CI [0.01, 0.10], &lt;em&gt;p&lt;/em&gt; = 0.016, R&lt;sup&gt;2&lt;/sup&gt; = 0.105) and disease duration (b = 0.045, β = 0.245, 95 % CI [−0.01, 0.10], &lt;em&gt;p&lt;/em&gt; = 0.009, R&lt;sup&gt;2&lt;/sup&gt; = 0.060) appear to be effective moderators of acupuncture-assisted treatment.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;This systematic review and meta-analysis demonstrate the efficacy of acupuncture interventions for depression, suggesting it as a viable evidence-based treatment option. However, the high heterogeneity of the studies, the presence of publication bias, and the lack of sham acupuncture controls in many studies limit the strength of these conclusions.","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 64-71"},"PeriodicalIF":3.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and safety of repetitive transcranial magnetic stimulation for generalized anxiety disorder: A meta-analysis and trial sequential analysis of randomized controlled trials","authors":"Bo Jiang ,&nbsp;Chen Xue ,&nbsp;Xian-Jun Xiao ,&nbsp;Jia-Ming Zhang ,&nbsp;Chen Xie ,&nbsp;Yu-Xi Li ,&nbsp;Dong-Ling Zhong ,&nbsp;Zhong Zheng ,&nbsp;Dong-Chuan Pan ,&nbsp;Juan Li ,&nbsp;Rong-Jiang Jin","doi":"10.1016/j.genhosppsych.2025.08.015","DOIUrl":"10.1016/j.genhosppsych.2025.08.015","url":null,"abstract":"<div><h3>Background</h3><div>Generalized anxiety disorder (GAD) is a chronic disorder characterized by uncontrollable, excessive, widespread anxiety lasting for over six months. Repetitive transcranial magnetic stimulation (rTMS) has been used in treating anxiety disorders, but previous studies have yielded contradictory results. We performed a meta-analysis and trial sequential analysis to investigate the effectiveness and safety of rTMS for GAD and explore the optimal treatment protocol of rTMS for GAD.</div></div><div><h3>Methods</h3><div>Eight databases were systematically searched to identify randomized controlled trials (RCTs) of rTMS for GAD. The primary outcome was the Hamilton Anxiety Scale. Secondary outcomes included a self-rating anxiety scale, clinical global impression-severity of illness, and incidence of adverse events. Data synthesis was conducted using Review Manager (version 5.4) and Stata software (version 12.0).</div></div><div><h3>Results</h3><div>A total of 29 eligible trials were included. The rTMS combined with medication was more effective than the medication alone in alleviating symptoms of patients with GAD (mean difference [MD] = −3.38, 95 % confidence interval [CI]: from −4.47 to −2.28). Compared with sham-rTMS combined with medication, rTMS combined with medication exhibited a significant effect in improving symptoms of GAD (MD = −2.80, 95 % CI: from −3.71 to −1.89). No serious adverse events were reported between rTMS treatment and medication therapy.</div></div><div><h3>Conclusion</h3><div>The rTMS could be an effective and safe treatment for patients with GAD. However, these findings should be interpreted with caution due to high heterogeneity and limited number of RCTs.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 25-36"},"PeriodicalIF":3.7,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145096988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric validation of the German version of the somatic symptom disorder – B criteria scale (SSD-12) in a primary care population with depression and anxiety: A COSMIN-guided analysis","authors":"Deborah van Eickels ,&nbsp;Klara Henning ,&nbsp;Michel Wensing ,&nbsp;Hans-Christoph Friederich ,&nbsp;Markus W. Haun","doi":"10.1016/j.genhosppsych.2025.09.001","DOIUrl":"10.1016/j.genhosppsych.2025.09.001","url":null,"abstract":"<div><h3>Objective</h3><div>Somatic Symptom Disorder (SSD) is common and often underdiagnosed in primary care, especially in patients with depression and anxiety. The SSD-12 is a self-report questionnaire assessing psychological features of SSD. This study aimed to validate the SSD-12 longitudinally in a primary care sample with depressive and/or anxiety symptoms, following COSMIN guidelines.</div></div><div><h3>Methods</h3><div>We conducted a secondary analysis of the PROVIDE-C trial, including 365 adults with moderate depressive and/or anxiety symptoms. Psychometric evaluation of the SSD-12 used data from three time points (baseline, 6, and 12 months). Factorial validity was assessed via confirmatory factor analysis (CFA) comparing unidimensional and three-factor models. Measurement invariance was examined across gender, age, chronic illness, and study arms using multi-group and longitudinal CFA. Additional analyses included internal consistency (McDonald's Omega), test-retest reliability (ICC), measurement error (SEM, SDC), convergent validity (correlations with PHQ-9, GAD-7, RAS-G, SF-12, EQ-5D), and responsiveness (correlations of SSD-12 change scores with PHQ-ADS change).</div></div><div><h3>Results</h3><div>CFA supported a three-factor structure (cognitive, affective, behavioral) at all time points. Measurement invariance was confirmed across subgroups and longitudinally. The SSD-12 showed high internal consistency, adequate test-retest reliability, and good responsiveness. Construct validity showed moderate positive correlations with anxiety, and small positive correlations with depression.</div></div><div><h3>Conclusion</h3><div>The SSD-12 exhibits strong psychometric properties in psychologically burdened primary care patients and is suitable for screening and monitoring somatic symptom burden in both cross-sectional and longitudinal examinations. Further research should refine thresholds for clinically meaningful change and cut-off points across diverse patient groups to enhance clinical interpretability.</div><div><strong>Trial registration:</strong> <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> <span><span>NCT04316572</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 3-10"},"PeriodicalIF":3.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145046791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}