General hospital psychiatry最新文献

{"title":"Assessing state optimism in cardiac patients: A comparison of two validated measures in three prospective cohorts","authors":"Daniel A. Schaefer , Emmett McGranaghan , Rachel A. Millstein , Wei-Jean Chung , Jeff C. Huffman , Emily H. Feig","doi":"10.1016/j.genhosppsych.2025.10.003","DOIUrl":"10.1016/j.genhosppsych.2025.10.003","url":null,"abstract":"","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 105-106"},"PeriodicalIF":3.7,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267324","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 mobile app-based interventions on quality of life in patients with breast cancer: a systematic review and meta-analysis","authors":"Ju Hyun Ahn ,&nbsp;Myoungsuk Kim","doi":"10.1016/j.genhosppsych.2025.10.002","DOIUrl":"10.1016/j.genhosppsych.2025.10.002","url":null,"abstract":"<div><h3>Objective</h3><div>This review assessed the effectiveness of mobile app-based interventions on the quality of life (QoL) of patients with breast cancer.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) using six databases (PubMed, Cochrane Library, Embase, CINAHL, MEDLINE, and Web of Science) to evaluate the effects of mobile app-based interventions on patients with breast cancer. The standardized mean difference (SMD) was used to measure the intervention effect using a random-effects model. The updated Cochrane Risk-of-Bias tool was used to assess the quality of the included studies.</div></div><div><h3>Results</h3><div>Twenty-one RCTs were included in the meta-analysis. Overall, mobile app-based interventions had a moderate effect on overall QoL in patients with breast cancer (SMD = 0.61, 95 % confidence interval [CI]: 0.38–0.85). Among QoL subdomains, the interventions had moderate effects on emotional functioning (SMD = 0.54, 95 % CI: 0.22–0.86) and small effects on social functioning (SMD = 0.46, 95 % CI: 0.17–0.74). Educational programs, multimodal programs, and shorter interventions (&lt;12 weeks) showed greater effectiveness, particularly in patients undergoing treatment. The type of intervention program was an important moderator of the intervention effect.</div></div><div><h3>Conclusions</h3><div>Mobile app-based interventions can improve overall QoL in patients with breast cancer, including emotional and social functioning. However, limited data in some areas indicate a need for further research.</div></div><div><h3>Implications for patients with cancer</h3><div>Mobile app-based interventions can be used as tools to enhance the QoL of patients with breast cancer.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 107-117"},"PeriodicalIF":3.7,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267325","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":"Possible association of statin use with the risk of depression: An up-to-date systematic review and meta-analysis","authors":"Pei-Yun Tsai ,&nbsp;Shih-Ming Chen ,&nbsp;Chia-Yu Lin ,&nbsp;Ming-Chia Lee ,&nbsp;Pin-Hao Huang ,&nbsp;Chih-Pin Hsing ,&nbsp;Tzu-Rong Peng ,&nbsp;Jen-Ai Lee","doi":"10.1016/j.genhosppsych.2025.10.001","DOIUrl":"10.1016/j.genhosppsych.2025.10.001","url":null,"abstract":"<div><h3>Background</h3><div>Although the potential effect of statins on depression has been investigated, the evidence remains inconsistent. We conducted a meta-analysis to determine whether statin use is associated with depression.</div></div><div><h3>Methods</h3><div>A systematic search was performed in PubMed, the Cochrane Library, and EMBASE and by reviewing the reference lists of included articles. Papers published up to Sep 11, 2025, were identified, and no language restrictions were applied. Pooled odds ratios (ORs) with 95 % confidence intervals (CIs) were estimated using a random-effects model.</div></div><div><h3>Results</h3><div>Fifteen studies (10 countries, 5,403,692 participants) met the inclusion criteria. Statin use was associated with significantly lower depression risk than was statin nonuse (pooled OR = 0.84, 95 % CI: 0.74–0.96, <em>p</em> = 0.009), although the interstudy heterogeneity was discovered to be substantial (<em>I</em>² = 85 %). Sensitivity analyses confirmed the robustness of the results. Subgroup analyses revealed significant associations in cohort studies (OR = 0.86, 95 % CI: 0.76–0.98, <em>p</em> = 0.02), studies using a validated questionnaire or scale (OR = 0.71, 95 % CI: 0.54–0.94, <em>p</em> = 0.02), individuals with comorbidities (OR = 0.74, 95 % CI: 0.55–0.98, <em>p</em> = 0.04), and those concurrently using an anti-inflammatory or antidepressant drug (OR = 0.82, 95 % CI: 0.71–0.95, <em>p</em> = 0.009). Preventive effects were discovered for North American populations (OR = 0.63, 95 % CI: 0.51–0.78, <em>p</em> &lt; 0.001) and among individuals adhering to a Western (OR = 0.61, 95 % CI: 0.45–0.81, <em>p</em> &lt; 0.001) or Asian (OR = 0.75, 95 % CI: 0.64–0.89, <em>p</em> = 0.001) dietary pattern.</div></div><div><h3>Conclusion</h3><div>Statin use appears to be associated with a lower depression risk, particularly in specific populations and under certain clinical or lifestyle conditions. However, the substantial heterogeneity observed across studies highlights the need for cautious interpretation. Further research is needed to clarify the causal relationship and to identify factors that may affect this association.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 118-125"},"PeriodicalIF":3.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267326","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":"The schizo-obsessive spectrum: Mapping clinical phenotypes, neurobiological mechanisms, and treatment considerations in first-episode psychosis - An updated systematic review","authors":"Valerio Ricci ,&nbsp;Giovanni Martinotti ,&nbsp;Giuseppe Maina","doi":"10.1016/j.genhosppsych.2025.09.011","DOIUrl":"10.1016/j.genhosppsych.2025.09.011","url":null,"abstract":"<div><h3>Objectives</h3><div>Obsessive-compulsive symptoms (OCS) represent a prevalent comorbidity in first-episode psychosis (FEP) with significant implications for clinical presentation and treatment outcomes. This systematic review examines OCS prevalence, clinical characteristics, neurobiological correlates, and treatment approaches in FEP populations.</div></div><div><h3>Methods</h3><div>Following PRISMA guidelines, we searched PubMed, Embase, PsycINFO, Web of Science, and Cochrane databases from inception to May 2025. Studies examining OCS in FEP patients (≤5 years from first episode) were included. Meta-analysis used random-effects models with Freeman-Tukey transformation. Quality assessment employed Newcastle-Ottawa Scale and Cochrane Risk of Bias Tool.</div></div><div><h3>Results</h3><div>Twenty-one studies encompassing 3989 participants were included. Meta-analysis revealed clinically significant OCS in 26.8 % (95 % CI: 18.2–37.1 %) of FEP patients and formal OCD diagnosis in 8.3 % (95 % CI: 6.1–11.2 %)—representing 3–4 fold elevations versus general population. OCS typically emerged 8–12 months before psychotic symptoms in 65 % of patients. Comorbid OCS patients demonstrated significantly higher positive symptom severity, depression scores, and functional impairment. Neuroimaging identified frontostriatothalamic abnormalities, including reduced orbitofrontal (Cohen's d: 0.48) and anterior cingulate cortex volume (Cohen's d: 0.43). Social cognitive deficits, particularly theory of mind impairments (58.3 % vs 71.2 % accuracy, <em>p</em> = 0.024), were enhanced in OCS patients. Treatment challenges included antipsychotic-induced OCS (38.9 % with clozapine vs 20.1 % olanzapine) and SSRI-related psychotic symptom exacerbation (16.7 %).</div></div><div><h3>Conclusions</h3><div>OCS affect one in four FEP patients, supporting a distinct “schizo-obsessive” subtype with specific neurobiological abnormalities and treatment considerations. Routine screening and integrated management protocols are essential for optimizing outcomes.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 146-160"},"PeriodicalIF":3.7,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307616","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 a mindfulness- and compassion-based online intervention for physician burnout: A randomized controlled trial with mediation and clinical outcome analyses","authors":"Francisco Villalón ,&nbsp;Alejandro Hirmas ,&nbsp;Adrian P. Mundt ,&nbsp;Danilo Quiroz","doi":"10.1016/j.genhosppsych.2025.09.012","DOIUrl":"10.1016/j.genhosppsych.2025.09.012","url":null,"abstract":"<div><h3>Background</h3><div>Physician burnout remains a persistent global challenge, yet most mindfulness-based interventions are limited by small samples, short follow-up, and lack of ethical integration. This study evaluated the efficacy of a culturally adapted, ethically grounded mindfulness- and compassion-based program (IBAP) in reducing burnout among physicians.</div></div><div><h3>Methods</h3><div>In a randomized controlled trial, 474 Chilean physicians were assigned to an eight-week online IBAP program (<em>n</em> = 120) or a waitlist control (<em>n</em> = 354). Assessments were conducted at baseline, post-intervention, and 6-month follow-up. The primary outcome was burnout (MBI-HSS); secondary outcomes included mindfulness, self-compassion, well-being, and perceived medical errors. Analyses used linear mixed-effects models (LMMs), Bonferroni-adjusted <em>p</em>-values, and Cohen's <em>d</em>. Sensitivity analyses included multiple imputation, per-protocol, and tipping-point models.</div></div><div><h3>Results</h3><div>IBAP significantly reduced total burnout at post-intervention (B = −9.74, SE = 1.77, <em>p</em> &lt; 0.001; <em>d</em> = −0.91) and follow-up (B = −11.55, SE = 1.84, <em>p</em> &lt; 0.001; <em>d</em> = −1.08). Improvements were also observed in emotional exhaustion (<em>p</em> &lt; 0.001), depersonalization (<em>p</em> = 0.030), and personal accomplishment (<em>p</em> = 0.008). Gains in mindfulness, self-compassion, and psychological well-being remained significant after Bonferroni correction. Mediation analyses showed that mindfulness and self-compassion each accounted for ∼30 % of the burnout reduction. Additionally, reductions in burnout significantly mediated lower self-reported medical errors.</div></div><div><h3>Conclusion</h3><div>IBAP produced large, sustained reductions in physician burnout, with effects confirmed across sensitivity analyses. The program also reduced perceived medical errors via burnout reduction, supporting its clinical relevance and scalability.</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 96-104"},"PeriodicalIF":3.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257907","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":"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":"Social factors related to untreated post stroke depression","authors":"Alexandra Balshi ,&nbsp;John Dempsey ,&nbsp;Matthew Z. Farber ,&nbsp;Adam Jiadi ,&nbsp;Harish Babu","doi":"10.1016/j.genhosppsych.2025.09.007","DOIUrl":"10.1016/j.genhosppsych.2025.09.007","url":null,"abstract":"","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"97 ","pages":"Pages 94-95"},"PeriodicalIF":3.7,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250597","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}