Frontiers in Psychiatry最新文献

{"title":"Fight, flight, freeze, fawn: mapping emergency department staff stress responses to workplace violence - a mixed-methods study.","authors":"Jennifer Davids, Greg de Moore, Martin Brown, Margaret Murphy","doi":"10.3389/fpsyt.2026.1952758","DOIUrl":"10.3389/fpsyt.2026.1952758","url":null,"abstract":"<p><strong>Background: </strong>Workplace violence and aggression are escalating in emergency departments (EDs) globally, yet the self-reported psychological and behavioural responses in clinicians to such stressors remain underexplored. Trauma theory conceptualises stress responses as fight, flight, freeze, and fawn (4Fs); but how these responses manifest in ED staff before, during and after violent incidents has received limited empirical attention.</p><p><strong>Methods: </strong>This mixed-methods study analysed data collected between 2019 and 2023 across four emergency departments within one Australian local health district. Data sources included semi-structured interviews (2019; n = 20), focus groups (2021; n = 30 participants), a cross-sectional survey (2023; n = 61), and follow-up interviews (2023; n = 12). Qualitative data were analysed using Braun and Clarke's six-phase thematic analysis, applying a deductive framework informed by the 4Fs. Quantitative survey data were integrated to examine the distribution of stress responses across reported incidents.</p><p><strong>Results: </strong>Across all data sources, 123 ED staff described 145 coded instances of the 4F stress responses: fight (n=94); flight (n=24), freeze (n=15), and fawn (n=12). Four overarching themes that underpinned these responses were identified: 1) Moral and emotional impact on clinicians, 2) Safety systems interface, 3) Organisational constraints and environment and 4) Patient Complexity. Participants described sustained hyperarousal, anticipatory vigilance, moral distress, emotional withdrawal, and appeasement behaviours arising from repeated exposure to violence. While Code Black responses were viewed as a structured and effective \"organised fight\" mechanism, this was compromised by inconsistent training, role ambiguity, and limited post-incident support which contributed to burnout, disengagement, and workforce attrition.</p><p><strong>Conclusion: </strong>Emergency department clinicians operate in persistently threatening environments that drive recurrent activation of fight, flight, freeze, and fawn responses with cumulative individual and system-level consequences. Behavioural emergencies warrant the same level of preparation, standardisation, and organisational support as other high-risk clinical events, such as a Code Blue - a life-threatening medical event with a responding Medical Emergency Team. Trauma-informed education team-based training, and embedded post-incident support are critical to safeguarding staff wellbeing and sustaining the ED workforce.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"17 ","pages":"1952758"},"PeriodicalIF":3.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13680432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149230955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Case Report: The intersection of psychiatry and medicine: diagnostic and ethical insights from case studies.","authors":"Francesco Monaco, Annarita Vignapiano, Martina D'Angelo, Fabiola Raffone, Valeria Di Stefano, Antonella Boccia, Anna Longobardi, Benedetta Di Gruttola, Michele Fornaro, Giulio Corrivetti, Iolanda Martino, Luca Steardo, Luca Steardo Jr","doi":"10.3389/fpsyt.2026.1992650","DOIUrl":"https://doi.org/10.3389/fpsyt.2026.1992650","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fpsyt.2025.1576179.].</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"17 ","pages":"1992650"},"PeriodicalIF":3.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13681381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 affective temperaments and thalamic nuclei volumes.","authors":"Hirofumi Hirakawa, Hina Kohno, Masaaki Muronaga, Toshihiko Izumi, Takuya Ogawa, Yudai Nagano, Takahiro Abeyama, Kentaro Kohno","doi":"10.3389/fpsyt.2026.1947058","DOIUrl":"https://doi.org/10.3389/fpsyt.2026.1947058","url":null,"abstract":"<p><strong>Introduction: </strong>Affective temperaments are stable, biologically based traits that may represent subclinical manifestations or premorbid phenotypes of mood disorders. The thalamus is increasingly recognized as an active component of distributed neural networks involved in cognition, emotion, and behavioral regulation. We focused on the thalamus and conducted an exploratory analysis of the associations between affective temperaments and the volumes of thalamic nuclei in healthy participants.</p><p><strong>Method: </strong>This study included 43 healthy right-handed participants. Affective temperament was assessed using the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire. T1-weighted structural magnetic resonance imaging data were acquired using a 3T scanner and processed with FreeSurfer version 7.1.1 to obtain the estimated total intracranial volume (eTIV) and the volumes of 52 thalamic regions, comprising 25 bilateral thalamic nuclei and the bilateral whole thalamus. The primary analyses were partial Spearman correlations adjusted for age, sex, and eTIV. Given that 52 thalamic regions and five affective temperaments were examined, Bonferroni correction was applied to control the family-wise error rate for multiple comparisons. Statistical significance was defined as a Bonferroni-corrected threshold of P < 0.00019 (0.05/[52 × 5]). Additional analyses adjusted for age, sex, and ipsilateral whole thalamus volume were performed as sensitivity analyses.</p><p><strong>Results: </strong>In the primary analysis, higher cyclothymic temperament scores were significantly associated with smaller left paratenial nucleus (Pt) volume (partial ρ = -0.57, P = 0.00015, 95% CI [-0.72, -0.36]). In the sensitivity analysis adjusting for age, sex, and left whole thalamus volume, the association was attenuated (partial ρ = -0.42, P = 0.007, 95% CI [-0.62, -0.17]) and did not meet the Bonferroni-corrected significance threshold. None of the other affective temperaments were significantly associated with left Pt volume. Several other associations of comparable magnitude were observed, but none met the corrected threshold.</p><p><strong>Discussion: </strong>Higher cyclothymic temperament scores were associated with smaller left Pt volume in the primary analysis. However, the association only narrowly met the corrected significance threshold and was attenuated in the sensitivity analysis. Thus, its regional specificity and statistical robustness remain uncertain, and replication in larger independent samples is warranted.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"17 ","pages":"1947058"},"PeriodicalIF":3.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13680398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Limitations of PHQ-9 as a first line mental health screener in primary care.","authors":"Jennifer Jane Newson, Dhanya Parameshwaran, Jason Schweitzer, Tara C Thiagarajan","doi":"10.3389/fpsyt.2026.1823578","DOIUrl":"https://doi.org/10.3389/fpsyt.2026.1823578","url":null,"abstract":"<p><strong>Background: </strong>The PHQ-9, originally designed as an assessment for depression, is now widely used as a first line screener in primary care and is often the sole mental health screener used. However, it is currently unknown how well the PHQ-9 performs as a general screener for mental distress. Here we aim to determine the sensitivity and specificity of the (PHQ-9) for capturing general or transdiagnostic mental distress, defined as experiencing 5 or more severe mental health symptoms.</p><p><strong>Methods: </strong>PHQ-9 responses were collected alongside responses to the transdiagnostic Mental Health Quotient (MHQ) assessment that captures 47 symptoms spanning 10 disorders as well as additional elements from RDoC in a sample of 5,750 respondents collected in 2022. PHQ-9 sum scores were compared with those with 5 or more symptoms from the MHQ.</p><p><strong>Results: </strong>At a sum score cut-off corresponding to moderately severe depression, PHQ-9 had low sensitivity, capturing only 46% of those with general mental distress. At a cut-off corresponding to mild depression, sensitivity improved to 93%, while specificity dropped to 57%. Concurrently, the PHQ-9 missed several symptoms that were highly prevalent in the sample population and individuals with <i>Severe</i> PHQ-9 sum scores showed substantial heterogeneity in their overall symptom profiles.</p><p><strong>Conclusions: </strong>Altogether, the PHQ-9, due to its origin as a depression screener, is not appropriate as a screener for general mental distress. In the context of primary care triage, this highlights the need for an alternative disorder agnostic first line screener that enables the identification of severe mental distress regardless of the specific profile of symptoms.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"17 ","pages":"1823578"},"PeriodicalIF":3.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13680475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse childhood experiences and functional stability in the affective-to-psychotic spectrum: a longitudinal multistate analysis of employment and relationship outcomes.","authors":"Fanny Senner, Elena Merkle, Michael Lauseker, Eva C Schulte, Urs Heilbronner, Monika Budde, Daniela Reich-Erkelenz, Mojtaba Oraki Kohshour, Alba Navarro-Flores, Maria Heilbronner, Ion-George Anghelescu, Volker Arolt, Bernhard T Baune, Detlef E Dietrich, Andreas J Fallgatter, Christian Figge, Markus Jäger, Georg Juckel, Carsten Konrad, Nathalie Kühnen, Eva Z Reininghaus, Max Schmauß, Andrea Schmitt, Simon Senner, Carsten Spitzer, Alkomiet Hasan, Peter Falkai, Thomas G Schulze, Kristina Adorjan, Sergi Papiol, Sophie-Kathrin Greiner","doi":"10.3389/fpsyt.2026.1930635","DOIUrl":"https://doi.org/10.3389/fpsyt.2026.1930635","url":null,"abstract":"<p><strong>Background: </strong>Adverse childhood experiences (ACEs) exert transdiagnostic influences on disorders of the affective-to-psychotic spectrum which share genetic similarities. While ACEs are established risk factors for developing disorders across this spectrum, the impact of ACEs on functional outcomes in adulthood remains insufficiently understood. This study aims to investigate the impact of ACEs on functional outcomes such as relationship and employment stability.</p><p><strong>Methods: </strong>We used multistate Markov models to analyze data from the longitudinal PsyCourse Study (N = 810) to investigate whether ACEs and ACE subtypes influence relationship and employment stability in individuals with affective-to-psychotic spectrum disorders and neurotypical controls. We analyzed whether protective factors (e.g., experience of feeling loved in childhood and polygenic resilience score for schizophrenia) modify these associations.</p><p><strong>Results: </strong>ACEs significantly increased the hazard of job loss (hazard ratio [HR] = 2.02, p = 0.0005), even after controlling for disease status and illness severity. Feeling loved in childhood emerged as a protective factor against job loss (HR = 0.52, p = 0.0096). For personal relationships, illness severity overshadowed ACE effects, with higher clinical severity rating predicting a higher hazard ratio for partnership separation. Among ACE subtypes, emotional abuse significantly predicted a higher hazard for partnership separation and lower for re-employment. Polygenic resilience score of schizophrenia did not contribute significantly.</p><p><strong>Discussion: </strong>In participants of the PsyCourse Study, ACEs substantially impact employment stability, personal relationship stability appears to be predominantly influenced by illness severity. These findings suggest the need for ACE-guided approaches in vocational rehabilitation and tailored interventions for partnership support in this population.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"17 ","pages":"1930635"},"PeriodicalIF":3.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13680451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149238066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Auditory sustained potential as a biomarker of language functioning in children with autism and its implication in clinical trials.","authors":"Vardan Arutiunian, Saeideh Davoudi, Ghizlane Gaougaou, Inga Sophia Knoth, Rae Buckser, Valérie Marcil, Sarah Lippé","doi":"10.3389/fpsyt.2026.1892698","DOIUrl":"https://doi.org/10.3389/fpsyt.2026.1892698","url":null,"abstract":"<p><strong>Objective: </strong>Most children with autism have language impairment, however, its neural mechanisms are not well understood. A potential biomarker associated with language in autism is a 40Hz Auditory Steady-State Response (ASSR) triggered by periodic click-trains which in electroencephalogram (EEG) evokes two types of responses - <i>40Hz steady-state gamma response</i> (ASSR) and <i>sustained potential</i> (SP). Although these responses represent low-level auditory processing, they correspond to different stages of sound perception/analysis and are essential in processing of spectrally/temporally complex sounds. However, until now there were no studies focusing on the potentials of these responses in clinical trials.</p><p><strong>Methods: </strong>The present open-label pilot study evaluated the effects of the probiotic beverage supplement Bio-K+ in children with autism (<i>N</i> = 19). Participants were assessed at three timepoints: T0 (baseline), T14 (14 weeks after intervention), and T22 (8 weeks after intervention, post-supplementation follow-up assessment), including EEG 40Hz ASSR and behavioral phenotyping.</p><p><strong>Results: </strong>First, at T0 we showed a reduction of SP amplitude in children with autism compared to controls, and this reduction was associated with lower speech/language/communication scores. Second, the amplitude of SP became significantly more negative during the probiotic supplementation period and, by T14, was no longer significantly different from the observed in TD controls. Finally, these changes in the amplitude of SP were associated with improvement in speech/language/communication scores.</p><p><strong>Conclusions: </strong>This study showed that the SP as well as its change was related specifically to speech/language/communication but not to other behavioral measures and has a potential to be used in future clinical trials.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"17 ","pages":"1892698"},"PeriodicalIF":3.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13681214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychologists' knowledge, attitudes, and training experiences regarding mental illness in individuals with intellectual disabilities in Saudi Arabia: a cross-sectional study.","authors":"Abeer Al Lihabi","doi":"10.3389/fpsyt.2026.1764215","DOIUrl":"https://doi.org/10.3389/fpsyt.2026.1764215","url":null,"abstract":"<p><strong>Introduction: </strong>Intellectual disability (ID) impacts an estimated 1-3% of the population worldwide, with a higher incidence in regions with limited healthcare access. In Saudi Arabia, current prevalence data, especially for adults, are scarce. This cross-sectional study explores the systemic challenges psychologists perceived in the diagnosis and treatment of mental illnesses in individuals with intellectual disabilities.</p><p><strong>Methods: </strong>A standardized Arabic-language questionnaire was distributed to 144 licensed psychologists in Saudi Arabia to collect data on professional backgrounds, educational history, work experience, attitudes, and knowledge.</p><p><strong>Results: </strong>Data were analyzed using factorial ANOVA and Spearman's correlation tests. The analysis revealed that years of professional experience significantly influenced attitudes (F = 5.024, p =.008, partial η² =.073), while training experience had a pronounced effect on knowledge of mental comorbidities in ID (F = 75.83, p <.001, partial η² =.367). A strong correlation was identified between training experience and knowledge (ρ =.811, p <.001), whereas no significant correlation was found for attitudes.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"17 ","pages":"1764215"},"PeriodicalIF":3.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13681362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"XR-based bullying prevention interventions among K-12 students: a scoping review of design, theory, and outcomes.","authors":"Xiayu Li, Heng Luo, Zi Wang, Lele Li","doi":"10.3389/fpsyt.2026.1978530","DOIUrl":"https://doi.org/10.3389/fpsyt.2026.1978530","url":null,"abstract":"<p><strong>Background: </strong>Extended reality (XR) can present controlled and repeatable bullying scenarios, support perspective and role changes, and provide opportunities for response practice. However, how XR affordances have been connected to prevention mechanisms, learning activities, and outcomes remains unclear.</p><p><strong>Objective: </strong>This scoping review mapped the characteristics of XR-based bullying prevention interventions for K-12 students, examined the alignment among theoretical mechanisms, XR affordances, and learning activities, and synthesized reported outcome patterns.</p><p><strong>Methods: </strong>Four databases (Web of Science, Scopus, ERIC, and PsycINFO) were searched on March 13, 2026, for peer-reviewed articles published from 2005 through 2025. Targeted supplementary searching was also conducted. Eligible articles evaluated direct prevention programs or XR applications explicitly developed to inform bullying prevention through mechanism testing, scenario validation, or feasibility evaluation. Data from 17 articles were charted and synthesized descriptively in accordance with PRISMA-ScR guidance.</p><p><strong>Results: </strong>Fifteen articles used virtual reality or virtual environments and two used augmented reality. Twelve used high-immersion configurations, but nine of these provided limited learner interactivity. The evidence base comprised nine program evaluations, five mechanism-oriented studies, and three design or feasibility studies. Immersion was most consistently associated with presence, realism, and immediate emotional responses. Favorable or conditionally favorable intervention-related evidence patterns were reported in several studies incorporating meaningful learner interaction, although these findings varied across outcomes, study designs, and evaluation conditions. Evidence for knowledge, empathy, attitudes, self-efficacy, and behavioral intentions was mixed, and only a small subset of studies examined real-world bullying-related behavior or outcomes beyond the immediate post-intervention period. Two recurring instructional patterns were identified: experience followed by reflection and action followed by feedback and revision.</p><p><strong>Conclusions: </strong>XR can make bullying situations salient, controllable, and experientially accessible, but stronger immersion should not be equated with stronger prevention effects. Future interventions should specify the intended mechanism, select XR affordances and learning activities accordingly, and evaluate outcomes at the level and timescale supported by the intervention design. Such alignment may clarify when XR provides meaningful prevention value beyond less immersive or non-digital alternatives.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"17 ","pages":"1978530"},"PeriodicalIF":3.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13681256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149238058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benzodiazepine prescribing in chronic military-related PTSD: real-world patterns and correlates in specialized care.","authors":"Erin Collins, Jenny J W Liu, Mathieu Bilodeau, Amer M Burhan, Murray W Enns, Vicky Lavoie, Natalie Ein, Anthony Nazarov, Edouard Auger, Ken Balderson, Natalie Mota, Sonya Wanklyn, J Don Richardson","doi":"10.3389/fpsyt.2026.1931305","DOIUrl":"10.3389/fpsyt.2026.1931305","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the prevalence of benzodiazepine prescribing among patients with posttraumatic stress disorder (PTSD), identify patient- and practice-level correlates of benzodiazepine use, and examine the clinical rationale underlying prescribing decisions. We aimed to characterize real-world patterns and determinants of benzodiazepine use in a specialized tertiary care military and Veteran PTSD setting, where PTSD is often chronic and treatment-refractory, and to clarify the clinical factors associated with benzodiazepine prescribing.</p><p><strong>Methods: </strong>We conducted a cross-sectional study using clinician-reported data from 13 psychiatrists practicing in Canadian tertiary care Operational Stress Injury clinics. Psychiatrists provided current prescribing information for 438 military personnel and Veterans receiving treatment for a primary diagnosis of PTSD. Multivariable logistic regression examined associations between patient and provider characteristics, treatment history, and benzodiazepine prescribing. Analyses adjusted for age, sex, and clinical site, and accounted for clustering at the provider level.</p><p><strong>Results: </strong>Benzodiazepines were prescribed to 22% of patients. Use was more frequent among patients with longer PTSD duration and greater cumulative pharmacotherapy exposure. Each additional year of PTSD was associated with a 12% increase in adjusted odds of benzodiazepine use (OR 1.12, 95% CI 1.06-1.18). Patients with ≥ 5 years of pharmacotherapy exposure had two- to three-fold greater odds compared with those treated < 5 years. Benzodiazepine monotherapy was rare (< 1%), with most use occurring in combination with other psychotropic medications.</p><p><strong>Conclusions: </strong>In these specialized clinics, benzodiazepine use was more common among patients with persistent illness and extensive treatment histories. These patterns suggest use occurs primarily in the context of chronic and complex care, underscoring the importance of clear clinical guidance for real-world practice.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"17 ","pages":"1931305"},"PeriodicalIF":3.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 timing of psychological intervention and reconstruction of worldview, life perspective, and values in adolescents with depression.","authors":"Lin Chen","doi":"10.3389/fpsyt.2026.1786690","DOIUrl":"10.3389/fpsyt.2026.1786690","url":null,"abstract":"<p><strong>Background: </strong>Timely access to structured psycho-educational intervention is crucial for cognitive-motivational recovery in adolescents with depression, a population in a critical developmental stage of consolidating core belief systems. Drawing upon the theory of educational timing, the initiation of these interventions may represent a critical window for reshaping worldview, life perspective, and values. Therefore, this study aimed to examine the association between intervention timing and the reconstruction of these existential constructs, thereby providing an empirical basis for optimizing psycho-educational strategies in adolescent depression care.</p><p><strong>Methods: </strong>This retrospective cohort study included 244 adolescents with depressive disorder treated between January 2022 and December 2024. To operationalize the concept of \"optimal educational timing,\" the cohort was stratified based on intervention initiation: early intervention, defined as initiation of structured psycho-educational intervention within 14 days of the index clinical encounter, and delayed intervention, defined as initiation after 14 days. Outcomes were assessed using the Worldview, Life Perspective, and Values Reconstruction Questionnaire (WLVQ-22). Linear and logistic regression models were used to evaluate changes in WLVQ-22 scores and responder outcomes.</p><p><strong>Results: </strong>The cohort included 126 adolescents in the early-intervention group and 118 in the delayed-intervention group. Baseline WLVQ-22 scores were comparable between groups. After adjustment, early intervention initiation was associated with greater changes in worldview (β = 4.43, 95% confidence interval [CI]: 2.89 to 5.98; <i>p</i> < 0.001), life perspective (β = 3.93, 95% CI: 2.45 to 5.41; <i>p</i> < 0.001), and values total score (β = 2.07, 95% CI: 1.27 to 2.87; <i>p</i> < 0.001). Early intervention was also associated with higher odds of response for worldview (odds ratio [OR] = 2.96, 95% CI: 1.71 to 5.11), life perspective (OR = 2.51, 95% CI: 1.46 to 4.33), and values reconstruction (OR = 2.90, 95% CI: 1.37 to 6.13).</p><p><strong>Conclusions: </strong>Earlier initiation of structured psychological intervention was associated with more favorable short-term WLVQ-22-assessed reconstruction indicators in adolescents with depression. These findings highlight the need for prospective studies to further evaluate the role of intervention timing in adolescent depression care.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"17 ","pages":"1786690"},"PeriodicalIF":3.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}