General hospital psychiatry最新文献

{"title":"A dose of therapy with psilocybin - A meta-analysis of the relationship between the amount of therapy hours and treatment outcomes in psychedelic-assisted therapy.","authors":"Jennie Hultgren, Matthias H Hafsteinsson, Joel Gruneau Brulin","doi":"10.1016/j.genhosppsych.2025.07.020","DOIUrl":"10.1016/j.genhosppsych.2025.07.020","url":null,"abstract":"<p><strong>Background: </strong>Psilocybin-assisted therapy (PAT) has shown promising effects in treating depressive symptoms, but the role of the therapeutic component remains unclear. While most research has focused on the pharmacological effects of psilocybin, the contribution of therapy has been largely overlooked.</p><p><strong>Objective: </strong>This meta-analysis investigated whether the amount of therapy hours provided is associated with treatment outcomes in psilocybin-assisted therapy for depression.</p><p><strong>Methods: </strong>A systematic search of PubMed and PsycINFO yielded 1095 records. Sixteen studies met inclusion criteria, providing sufficient data for analysis. A meta-regression was conducted to assess the relationship between therapy hours and treatment outcomes.</p><p><strong>Results: </strong>The overall treatment effect was large both in the short-term (Cohen's d = 1.69) and long-term follow-up (Cohen's d = 2.10). However, no significant association was found between the number of therapy hours and outcome in either the short-term (b = -0.05, p = .327) or long-term (b = -0.07, p = .340) analyses. All of the included studies provided some degree of therapy (4.5-18 h).</p><p><strong>Conclusions: </strong>Our findings did not support that the amount of therapy hours influence depressive outcomes in PAT. However, this interpretation should be made with caution due to small sample sizes, heterogeneity, and poor reporting of the therapeutic component across studies. Future research should apply greater methodological rigor and standardized reporting of therapy to clarify its role in PAT.</p>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"96 ","pages":"234-243"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811929","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":"Healthcare resource utilization of people with depressive disorder and co-occurring incident diabetes mellitus: A 20-year population-based propensity score-matched cohort study.","authors":"Matthew Tsz Ho Ho, Joe Kwun Nam Chan, Heidi Ka Ying Lo, Catherine Zhiqian Fang, Corine Sau Man Wong, Krystal Chi Kei Lee, Wing Chung Chang","doi":"10.1016/j.genhosppsych.2025.08.004","DOIUrl":"10.1016/j.genhosppsych.2025.08.004","url":null,"abstract":"<p><strong>Background: </strong>Depression with co-occurring diabetes is associated with elevated risk of diabetes complications, driving substantial healthcare expenditure. However, previous research investigating healthcare utilization associated with depression in patients with diabetes is hampered by important limitations. We examined whether pre-existing depression increased healthcare utilization and costs in patients with incident diabetes.</p><p><strong>Method: </strong>This population-based propensity score (PS)-matched (1:10) cohort study identified 12,165 patients with pre-existing depression and incident-diabetes (depression-diabetes group) and 116,853 patients with incident-diabetes only (diabetes-only group) between 2002 and 2021 in Hong Kong, using territory-wide medical-record database of public healthcare services. A comprehensive array of covariates was included in PS-matching, comprising age, sex, calendar-year period, catchment-area, physical and psychiatric comorbidities, and medication prescriptions. Service-specific utilization per patient-year was compared by negative binomial regression between groups, with stratified analyses by service types, sex, and age groups.</p><p><strong>Results: </strong>Depression-diabetes group was significantly associated with 38 % elevated healthcare utilization relative to diabetes-only group across emergency (Odds ratio 1.16, 95 %CI[1.12-1.20]; HK$1906[US$243] versus HK$1648[US$210]), inpatient (1.47[1.27-1.72]; HK$17,333[US$2208] versus HK$12,356[US$1574]), and outpatient services (1.29[1.27-1.31]; HK$11,974[US$1526] versus HK$8670[US$1105]), leading to additional HK$8540 annual healthcare costs per-patient. Additional analyses demonstrated that increased healthcare utilization was observed in both men and women with depression and co-occurring diabetes relative to their diabetes-only counterparts, across three age-groups, and in both psychiatric and non-psychiatric resources.</p><p><strong>Conclusion: </strong>Patients with pre-existing depression and co-occurring incident-diabetes are at heightened risk for increased healthcare resource utilization and cost compared to diabetes-only patients. Further research on effective interventions is warranted to alleviate the burden associated with both conditions.</p>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"96 ","pages":"244-250"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811930","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":"A novel nomogram incorporating time-to-event modeling for predicting postoperative delirium in cardiac surgery patients.","authors":"Zhengqin Liu, Lihua Zhu, Xiaohe Li, Qian Zhai","doi":"10.1016/j.genhosppsych.2025.08.005","DOIUrl":"10.1016/j.genhosppsych.2025.08.005","url":null,"abstract":"<p><p>Objective To develop and validate a predictive model of postoperative delirium (POD) for patients undergoing cardiac surgery. Methods 935 patients, admitted to the cardiovascular surgery intensive care unit between 2023.3.1 and 2023.12.31, were enrolled into this study. They were divided into the training set and the internal validation set at a ratio of 7:3. The least absolute shrinkage and selection operator (LASSO) cox regression analysis was used to detect potential risk factors for POD and multivariable cox regression analysis was then conducted to construct the final nomogram model in the training set. Finally, we assessed the nomogram performance in terms of discrimination and calibration, including area under the curve (AUC), calibration curve and decision curve analysis (DCA) both in the training set and the internal validation set. Results 108 (16.34 %)patients in the training group and 47 (16.51 %) patients in the validation group developed POD respectively. Four independent risk factors were integrated into the nomogram including postoperative AKI, hypoalbuminemia, PSQI and CPOT score. The nomogram showed a good discrimination efficacy with an AUC of 0.882 (95 % CI: 0.843-0.922) and 0.921 (95 % CI: 0.871-0.972) in the training and internal validation set respectively. Both calibration curve and DCA demonstrated that this nomogram was clinically useful. Conclusions The nomogram based on four clinically available factors has good ability to identify POD risk in patients undergoing cardiovascular surgery. This tool may help physicians to prevent the appearance of delirium in advance using various methods and improve prognosis. ABBREVIATIONS.</p>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"96 ","pages":"253-263"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816322","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":"Birth outcomes among pregnant people with treated and untreated perinatal mood and anxiety disorder (PMAD).","authors":"Stephanie V Hall, Andrea Pangori, Anca Tilea, Kara Zivin, Isabel S Platt, Ashlee J Vance, Vanessa K Dalton","doi":"10.1016/j.genhosppsych.2025.08.003","DOIUrl":"10.1016/j.genhosppsych.2025.08.003","url":null,"abstract":"","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"96 ","pages":"251-252"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816323","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 of the PHQ-9 for detecting depressive symptoms in peruvian Amazonian indigenous people","authors":"Wendy Bada ,&nbsp;Yolanda Ramírez Villacorta ,&nbsp;Oscar Novoa-Pallares ,&nbsp;Amelia Torres ,&nbsp;Carlos Gonzalez ,&nbsp;Ulises Wisum ,&nbsp;Nicole Caldichoury ,&nbsp;Daniela Ripoll-Córdoba ,&nbsp;Breiner Morales-Asencio ,&nbsp;Matilde Bolaño García ,&nbsp;Yuliana Flórez ,&nbsp;Norman López","doi":"10.1016/j.genhosppsych.2025.08.014","DOIUrl":"10.1016/j.genhosppsych.2025.08.014","url":null,"abstract":"","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 1-2"},"PeriodicalIF":3.7,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144989386","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":"NMDA receptor-modulating treatments for cognitive deficits in patients with bipolar disorder: A narrative review","authors":"Rahim Badrfam ,&nbsp;Atefeh Zandifar","doi":"10.1016/j.genhosppsych.2025.08.013","DOIUrl":"10.1016/j.genhosppsych.2025.08.013","url":null,"abstract":"<div><h3>Objective</h3><div>Cognitive impairment is a significant aspect of bipolar disorder, affecting both emotional and non-emotional domains, leading to ongoing challenges and poorer outcomes. Efforts to enhance cognitive functioning in these patients have intensified, yet effective treatments remain elusive. Existing bipolar disorder treatments often do not improve and can even worsen cognitive function. Recent studies have highlighted the link between the glutamatergic system and cognitive impairment, particularly through the activation of the <em>N</em>-methyl-<span>d</span>-aspartate receptor (NMDAR). This has sparked interest in NMDAR modulators as potential therapeutic agents. Currently, only a few have been approved for clinical use, and clinical studies are limited in scope. This review examines research on NMDAR modulation aimed at enhancing cognitive function in individuals with bipolar disorder, highlighting promising findings from animal studies and initial clinical trials.</div></div><div><h3>Methods</h3><div>A PubMed and Google Scholar search adhering to PRISMA guidelines was conducted for articles on NMDAR antagonists for the treatment of cognitive deficits in patients with bipolar disorder<strong>.</strong></div></div><div><h3>Results</h3><div>Memantine as an add-on therapy has been linked to improvements in cognitive issues, enhancing memory after traumatic brain injury (TBI), boosting cognitive functioning in treatment-resistant bipolar disorder (BD), and elevating cognitive status in patients with depression before electroconvulsive therapy (ECT) in patients with bipolar disorders. Ketamine infusions have also improved processing speed and verbal learning in bipolar disorder patients.</div></div><div><h3>Conclusion</h3><div>Evidence suggests that NMDA receptor-modulating agents play a significant role in improving cognitive function in patients with bipolar disorder. Researchers should consider recently identified NMDA receptor antagonists for potential benefits. It is also important to conduct longer and multicenter studies to address the persistent cognitive impairments, such as impairment in attention, executive function, and verbal memory, that patients with bipolar disorder experience throughout their illness, while also assessing the safety of these treatments.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"96 ","pages":"Pages 335-344"},"PeriodicalIF":3.7,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916408","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":"Temporal trends in youth emergency department visits involving suicidal ideation and deliberate self-harm, 2016–2023","authors":"Naomi Cruz ,&nbsp;Greta Bushnell ,&nbsp;Katherine Keyes ,&nbsp;Mark Olfson ,&nbsp;Hillary Samples","doi":"10.1016/j.genhosppsych.2025.08.012","DOIUrl":"10.1016/j.genhosppsych.2025.08.012","url":null,"abstract":"","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"96 ","pages":"Pages 332-334"},"PeriodicalIF":3.7,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144914099","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":"Sex-specific networks of depressive symptoms and cognitive deficits in major depressive disorder: A network analysis approach","authors":"Shuai Zhao ,&nbsp;Sifan Ji ,&nbsp;Yingying Liu ,&nbsp;Yuqin Han ,&nbsp;Anzhen Wang ,&nbsp;Wenmei Fang ,&nbsp;Hui Yuan ,&nbsp;Xialong Cheng ,&nbsp;Jianjun Guan ,&nbsp;Juan Chen ,&nbsp;Chenxia Song ,&nbsp;Yajie Yan ,&nbsp;Kongliang He","doi":"10.1016/j.genhosppsych.2025.08.009","DOIUrl":"10.1016/j.genhosppsych.2025.08.009","url":null,"abstract":"<div><h3>Background</h3><div>Major depressive disorder (MDD) represents a prevalent mental health condition characterized by profound cognitive and emotional disturbances. Emerging evidence suggests sex differences in how these symptoms interact with cognitive deficits, yet the mechanisms remain unclear. Traditional methods have limitations in capturing these complex interactions. This research employs network analysis to investigate and contrast the interrelationships between depressive symptoms and cognitive functions in male and female individuals diagnosed with MDD, offering new insights into sex-specific patterns within the disorder.</div></div><div><h3>Methods</h3><div>A cohort of 375 inpatients diagnosed with MDD, comprising 148 males and 227 females, was recruited for the study. Clinical evaluations encompassed the 24-item Hamilton Depression Rating Scale (HDRS-24) and an extensive array of neurocognitive assessments targeting domains such as attention, memory, processing speed, and executive function. Gaussian graphical models (GGMs) were employed to construct networks of depressive symptoms and cognitive functions, focusing on identifying central and bridge symptoms within these networks.</div></div><div><h3>Results</h3><div>The network analysis revealed distinct patterns in the interaction of depressive symptoms and cognitive functions between males and females. In males, sleep disturbance and processing speed emerged as central features, while in females, psychomotor retardation, working memory, and processing speed were more prominent. Sleep disturbance was identified as the key bridge symptom in males, whereas psychomotor retardation and working memory served as bridge symptoms in females. Despite these differences, no significant sex differences were found in global network strength or structure.</div></div><div><h3>Conclusion</h3><div>This study elucidated distinct patterns in the network relationships between depressive symptoms and cognitive functions among male and female patients diagnosed with MDD. These findings suggest that although the overall impact of MDD on cognitive function is consistent across sexes, the pathways through which these effects manifest differ. This underscores the need for tailored therapeutic strategies that target these sex-specific network features to optimize treatment outcomes in MDD patients.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"96 ","pages":"Pages 307-314"},"PeriodicalIF":3.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144893483","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":"Interventions to promote resilience in children and adolescents: A systematic review and meta-analysis of randomized controlled trials","authors":"Zhengyang Mei ,&nbsp;Chenyi Cai ,&nbsp;Tingfeng Wang ,&nbsp;Yang Yang ,&nbsp;Chifong Lam ,&nbsp;Yuanzhuo Zhang ,&nbsp;Wen Zhao ,&nbsp;Yu Shi ,&nbsp;Shulai Luo ,&nbsp;Shi Luo","doi":"10.1016/j.genhosppsych.2025.08.011","DOIUrl":"10.1016/j.genhosppsych.2025.08.011","url":null,"abstract":"<div><h3>Background</h3><div>Stressors can significantly threaten the physical and mental health of children and adolescents. While it has been demonstrated that fostering resilience to cope effectively with stressors benefits children and adolescents, research on the efficacy of interventions to promote resilience remains limited.</div></div><div><h3>Objective</h3><div>This study aimed to synthesize evidence from randomized controlled trials on the efficacy of interventions to promote resilience in enhancing child and adolescent stress coping abilities.</div></div><div><h3>Design</h3><div>A systematic review and meta-analysis of randomized controlled trials.</div></div><div><h3>Methods</h3><div>This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines 2020. Eligible randomized controlled trials were identified through searches of the PubMed, Embase, Web of Science, Scopus, EBSCOhost, and APA PsycINFO electronic databases. Additionally, Google Scholar and the reference lists of studies with similar designs were manually searched. Two independent researchers evaluated the risk of bias in the included trials using the revised Cochrane risk-of-bias tool for randomized trials. A narrative synthesis of the included trials was conducted, with a focus on the adequacy of intervention reporting, implementation parameters, and resilience factors of interventions.</div></div><div><h3>Results</h3><div>The review included 68 randomized controlled trials involving 16,623 participants, among which 30 were included in the meta-analyses. Four types of interventions to promote resilience were identified, with three showing small to moderate effects in improving stress coping abilities in children and adolescents and one not demonstrating any efficacy in this regard. The certainty of evidence for resilience ranged from moderate to very low based on Grading of Recommendations, Assessment, Development, and Evaluations ratings.</div></div><div><h3>Conclusions</h3><div>The review's findings support the positive effects of established interventions—specifically resilience-based, mindfulness-based, and sport-based approaches—in enhancing child and adolescent stress coping abilities. Interventions to promote resilience may represent a promising complementary approach to help children and adolescents cope effectively with stressors. However, future research must establish their clinical effectiveness, particularly among those with mental health conditions.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"96 ","pages":"Pages 295-306"},"PeriodicalIF":3.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889667","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":"Subject: “Ultra-resistant schizophrenia and early trauma: Toward an integrative paradigm beyond pharmacological limits”","authors":"Yassine Benhaddouch,&nbsp;Adil El Ammouri","doi":"10.1016/j.genhosppsych.2025.08.010","DOIUrl":"10.1016/j.genhosppsych.2025.08.010","url":null,"abstract":"","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"96 ","pages":"Pages 293-294"},"PeriodicalIF":3.7,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144878186","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}