International Journal of Social Psychiatry最新文献

{"title":"Hikikomori and Peer-Supported Virtual Hangouts: A Cross-Sectional Survey of Web-Based Peer Support in a Japanese Sample.","authors":"Akiko Funakoshi, Roseline Yong, Eri Sekiguchi","doi":"10.1177/00207640261446111","DOIUrl":"10.1177/00207640261446111","url":null,"abstract":"<p><strong>Background: </strong>Hikikomori, a globally emerging psychiatric syndrome, is characterised by near-complete withdrawal from social interaction. While various interventions exist, research on the effectiveness of peer support for psychological recovery remains limited. Furthermore, many individuals with hikikomori struggle to access or regularly attend traditional face-to-face support because of fears of going out or social anxiety, creating a critical gap in support provision that digital solutions are uniquely positioned to address.</p><p><strong>Aims: </strong>This study clarified the experiences of individuals with hikikomori who received web-based peer support in virtual hangouts, focussing on their satisfaction with the service and the influencing factors.</p><p><strong>Method: </strong>A web-based, self-administered questionnaire survey was conducted from October 2020 to September 2021 in Japan. The sample comprised 80 people with hikikomori. Participants reported sociodemographic and hikikomori-related information, psychological distress (Kessler 6, K6), reasons for hangout participation, service satisfaction level (Client Satisfaction Questionnaire with eight items-Japanese version, CSQ-8J), and hangout participation frequency. CSQ-8J scores were used to group participants as highly or less satisfied. Data were analysed using t-tests and chi-squared tests.</p><p><strong>Results: </strong>Participants in the highly satisfied group were significantly younger and reported an earlier onset of hikikomori or school non-attendance. The most common reason for hangout participation in the highly satisfied group was 'referral from a support organisation or self-help group'. Participants in the less satisfied group tended to have higher mean K6 scores, but no statistically significant difference was found.</p><p><strong>Conclusions: </strong>The findings suggest that virtual hangouts are effective in supporting people with hikikomori, particularly the youth, with high levels of satisfaction reported. This study highlights the significant potential of web-based peer support in overcoming traditional barriers, offering a more accessible and inclusive model for supporting individuals experiencing social withdrawal. To further increase efficacy, virtual hangouts could be combined with individual counselling and visiting support.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"1689-1699"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147948440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of Depression Trajectories and Acculturation Strategies Among Multicultural Adolescents: A 9-Year Longitudinal Study in South Korea.","authors":"Changmin Yoo","doi":"10.1177/00207640261461742","DOIUrl":"10.1177/00207640261461742","url":null,"abstract":"<p><strong>Background: </strong>Multicultural adolescents in South Korea may face unique challenges related to acculturation that can affect their mental health over time.</p><p><strong>Aims: </strong>This study examined developmental trajectories of depression among multicultural adolescents in South Korea over a 9-year period and investigated how acculturation strategies and contextual factors influence these trajectories.</p><p><strong>Methods: </strong>Participants were 1,500 multicultural adolescents (50.7% female; Mage = 10.98 years at baseline) from the Multicultural Adolescents Panel Study (2012-2020). The sample included adolescents with mothers from various countries (Japan 33.4%, Philippines 25.1%, Chinese Korean 19.1%, China 7.3%, others 15.1%). Using latent class growth analysis, we examined depression trajectories and their associations with individual factors (acculturation strategies, self-esteem, acculturative stress), parental acculturative stress, and friend support.</p><p><strong>Results: </strong>We identified three distinct depression trajectories (low-level: 38.7%, mid-level: 44.9%, and high-level: 16.4%). Integration acculturation strategy showed advantages over assimilation in predicting more favorable depression trajectories. However, contrary to traditional expectations, results tentatively suggest that marginalization may not necessarily be associated with worse outcomes compared to separation strategies, although this finding should be interpreted with caution given the dichotomized measurement of acculturation strategies. Higher self-esteem, lower acculturative stress, and stronger friend support significantly predicted membership in more favorable trajectory groups.</p><p><strong>Conclusions: </strong>These findings challenge assumptions about uniform vulnerability to depression among multicultural adolescents and suggest more complex relationships between acculturation strategies and mental health than previously recognized.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"1757-1772"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148329788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-Cultural Comparison of Perceived Stigma in Major Depressive Disorder: The Role of Spiritual Well-Being, Resilience, and Quality of Life in Austria and Japan.","authors":"Nataliia Maronchuk, Kie Nomoto, Maya Shirakura, Sota Tomiyama, Jean Lillian Paul, Fabienne Post, Ellen B Rubinstein, Timo Schurr, Yuya Mizuno, Franziska Tutzer, Hiroyuki Uchida, Alex Hofer","doi":"10.1177/00207640261473300","DOIUrl":"10.1177/00207640261473300","url":null,"abstract":"<p><strong>Background: </strong>Perceived stigma in Major Depressive Disorder (MDD) is a well-established barrier to help-seeking, social functioning, and quality of life. However, little is known about how stigma is shaped by cultural context and which psychosocial resources may buffer its effects.</p><p><strong>Aims: </strong>This study aimed to examine the relationship between perceived stigma and key protective factors - spirituality, resilience, quality of life, and social functioning - in patients with MDD from Austria and Japan.</p><p><strong>Method: </strong>A total of 101 patients diagnosed with MDD (51 from Austria, 50 from Japan) completed validated measures of perceived stigma, spirituality, resilience, quality of life, and social functioning. Correlational analyses, multiple regression, and interaction term models were used to assess the predictive value of psychosocial variables and country moderation effects.</p><p><strong>Results: </strong>Spirituality and resilience were negatively associated with perceived stigma across both samples, though only spirituality significantly predicted stigma in regression analyses, increasing to 48% after controlling for age and depression severity. Country-specific models revealed a stronger predictive power in the Japanese sample. While stigma correlated strongly with reduced quality of life in both groups, its association with social functioning varied by stigma dimension and country. The relationship between resilience and financial insecurity was stronger among Japanese study participants than among Austrian participants.</p><p><strong>Conclusions: </strong>In summary, spirituality emerged as a central protective factor against stigma in MDD patients, particularly in Japan, underscoring its cultural significance. Additionally, our findings reveal a context-specific relationship between economic stress and psychosocial coping strategies. Despite differences in how stigma is expressed across countries, its adverse impact on quality of life was universal. These results suggest that culturally informed approaches can effectively reduce stigma associated with depression.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"1569-1583"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depression and Social Capital Among High-Altitude Residents in Ladakh: A Cross-Sectional Study.","authors":"Motonao Ishikawa","doi":"10.1177/00207640261428862","DOIUrl":"10.1177/00207640261428862","url":null,"abstract":"<p><strong>Background: </strong>Depression and social capital (SC) have been increasingly studied in diverse cultural settings, yet little is known about their relationship in high-altitude regions such as Ladakh, India.</p><p><strong>Aims: </strong>This study examines the association between social capital and depressive tendencies among Ladakhi residents.</p><p><strong>Method: </strong>We conducted a cross-sectional survey of 140 residents of Domkhar village, Ladakh, during community medical camps in 2018 to 2019. Depressive tendencies were assessed using the PHQ-9 (cutoff ⩾5, selected to capture mild depressive states based on Asian literature). Social capital was measured with structural and cognitive SC indices, along with the Multidimensional Scale of Perceived Social Support (MSPSS) and the Religious Commitment Inventory (RCI-10). Personality traits were assessed using the Ten-Item Personality Inventory (TIPI).</p><p><strong>Results: </strong>Depressive tendencies were identified in 12 participants (8.6%). Univariate logistic regression revealed that age ⩾60 years and living alone were significant risk factors, while being married, good subjective well-being, good health, good economic satisfaction, and engagement in structural SC were protective. Cognitive SC showed a protective trend. Extraversion scores were significantly lower among those with depressive tendencies. MSPSS and RCI-10 demonstrated a strong positive correlation. In multivariate analysis including all predictors simultaneously, only subjective well-being remained statistically significant (OR = 0.89, 95% CI [0.80, 0.98]).</p><p><strong>Conclusions: </strong>Our findings suggest that both social capital and personality traits, particularly extraversion, play protective roles against depressive tendencies in Ladakh. Practical implications include leveraging community and religious structures, such as monasteries and local leaders, to enhance resilience in high-altitude populations.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"1584-1592"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147443501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Socio-Clinical Factors With Psychological Distress in Parents or Caregivers of Children With Mental Illness.","authors":"Zeruiah Bensingh, Zukiswa Tsolekile De Wet, Marinda Joubert","doi":"10.1177/00207640261438843","DOIUrl":"10.1177/00207640261438843","url":null,"abstract":"<p><p>The COVID-19 pandemic has had a strong psychological impact on family units. This study investigated the contribution of sociodemographic and clinical factors to psychological distress in parents or caregivers of children with a mental illness at a specialist tertiary hospital in Gauteng, South Africa. A structured sociodemographic and clinical questionnaire measuring psychological distress was self-administered to 150 participants. The Perceived Stress Scale (PSS) was used to measure the severity of stress, the Patient Health Questionnaire-9 (PHQ-9) was used to measure the severity of depression, and the Generalized Anxiety Disorder-7 (GAD-7) was used to measure the severity of anxiety. Significant predictors of mental health status include loss of home due to COVID-19 (odds ratio [<i>OR</i>: 46.61], 95% confidence interval [CI: 5.81, 1,089.92]), history of psychiatric treatment (<i>OR</i>: 11.98, [3.16, 57.22]), perceived decline in quality of life (<i>OR</i>: 11.88, [1.20, 185.28]), female sex (<i>OR</i>: 3.83, [1.00, 17.7]), and difficulty spending time with extended family (<i>OR</i>: 3.09, [1.10, 9.29]). The mental health status of caregivers of children with mental illness during the COVID-19 pandemic was likely influenced by the loss of a home due to COVID-19, a history of psychiatric treatment, a perceived decline in quality of life, the female gender, and difficulty spending time with extended family. Our study demonstrated the intricate interplay of socioclinical factors with depression, anxiety, and perceived stress.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"1786-1795"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analyzing the Impact of Depression on All-Cause Mortality in Different Sex and Age Groups: A 11-Year Follow-Up Study of Spanish Population.","authors":"Cristina Rodríguez-Prada, María Cabello, Francisco Félix Caballero, Blanca Dolz-Del-Castellar, Lea Francia, Marta Miret, Josep María Haro, Joan Domènech-Abella, Beatriz Olaya, José Luis Ayuso-Mateos","doi":"10.1177/00207640261430311","DOIUrl":"10.1177/00207640261430311","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have shown that depression has a significant impact on all-cause mortality, particularly in men. However, the link between depression and mortality across different age and gender groups is inconsistent. This study aims to explore the relationship between depression and all-cause mortality in various age and gender categories within a Spanish national cohort, while also accounting for other influencing factors over an 11-year follow-up period.</p><p><strong>Methods: </strong>A nationally representative sample of the Spanish adult population (<i>n</i> = 4,582) was followed up for 11 years. Kaplan-Meier estimates, unadjusted and adjusted Cox proportional hazard regression models were conducted to test whether baseline depression and sociodemographic characteristics (educational level, low income, marital status, feelings of loneliness, alcohol and tobacco use, and having chronic conditions) were associated with all-cause mortality for different gender and age-specific groups, separately.</p><p><strong>Results: </strong>Unadjusted analysis by age and gender indicated that depression had a significant relationship with all-cause mortality in young-and-middle-aged women (HR = 1.75; <i>p</i> < .01) and men (18-64 years old; HR = 2.96; <i>p</i> < .001) and old men (+65; HR = 1.92; <i>p</i> < .001). Adjusted analysis by age and gender revealed that depression was only a significant factor for all-cause mortality in men aged 65+ (HR = 1.60; <i>p</i> = .025).</p><p><strong>Limitations: </strong>Cause-specific mortality was not examined. Young adults and middle-aged participants were not analyzed separately.</p><p><strong>Conclusions: </strong>The depression and all-cause mortality relationship was found only in +65 men. These differences may be driven by gender-specific factors such as delayed help-seeking, higher levels of social isolation, and the accumulation of chronic comorbidities. Therefore, preventive interventions must prioritize age- and gender-specific strategies to address these risk patterns.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"1499-1509"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147493579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 20-Year Longitudinal Study of Homelessness Among 333 Psychiatric Patients in Portugal: From Initial Episodes to Chronic Trajectories.","authors":"Joana Henriques-Calado, Nathalia Garcia, João Gama-Marques","doi":"10.1177/00207640261468246","DOIUrl":"10.1177/00207640261468246","url":null,"abstract":"<p><strong>Background: </strong>Homelessness is closely related to psychiatric disorders, substance abuse, and premature mortality; however, in-depth analyses of long-term trajectories are lacking.</p><p><strong>Aims: </strong>The objective was to analyze psychiatric diagnoses, clinical patterns and survival outcomes of homelessness trajectories during a 20-year follow-up.</p><p><strong>Method: </strong>A retrospective sample of 333 psychiatric patients experiencing homelessness in Portugal. Cox survival analyses defined the cohorts: Recent (⩽1 year; <i>n</i> = 92), Early-stage (1-5 years; <i>n</i> = 52), Prolonged (5-15 years; <i>n</i> = 93), and Persistent (>15 years; <i>n</i> = 96). Analyses included analysis of variance (ANOVA), Chi-square tests, and logistic regression.</p><p><strong>Results: </strong>Mortality was 31.2%, decreasing after 18 years of homelessness, indicating a survivor effect. Recent cohort and younger patients, and those with alcohol misuse, anxiety, and personality disorders had minimal hospitalization. Early-stage and Prolonged groups had the highest mortality (50%), linked to alcohol-related disorders and organic psychosis, mainly in Prolonged. Persistent cohort, with the longest psychiatric follow-up (18.8 years), more hospitalizations, and higher comorbidity with drug use and intellectual disability, had the lowest mortality (14.6%) and the highest mean age at death (67.3 years). Unspecified psychosis, substance use, and intellectual disability were the key predictors of Persistent group. Alcohol use, psychosis, and personality disorders influenced survival varying by cohort.</p><p><strong>Conclusions: </strong>Patient psychiatric homelessness cohorts have heterogeneous trajectories for clinical, sociodemographic, service use, and survival. Early and mid-stages of homelessness show higher mortality. Findings highlight the Persistent cohort as long-term homelessness survivors. It is stressed that the duration of homelessness is a critical determinant of diagnostic patterns, comorbidities, and survival outcomes, which require differentiated psychiatric and social interventions tailored to cohort-specific risks among people experiencing homelessness.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"1485-1498"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148619852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gamification in Psychiatry: A Systematic Evaluation of Its Clinical Utility, Methodological Rigor, and Translational Potential.","authors":"Ernesta Panarello, Annarita Vignapiano, Francesco Monaco, Stefania Landi, Anna Longobardi, Benedetta di Gruttola, Valeria Di Stefano, Ilaria Pullano, Raffaele Malvone, Alessandra Marenna, Giulio Corrivetti, Luca Steardo","doi":"10.1177/00207640251400797","DOIUrl":"10.1177/00207640251400797","url":null,"abstract":"<p><strong>Background: </strong>Gamification, the strategic application of game design elements in non-game environments, has become increasingly prominent in digital mental health. It aims to enhance user engagement, motivation, and adherence through mechanisms such as points, feedback systems, rewards, and narrative frameworks. While it shows promise in promoting therapeutic engagement, the empirical foundation of its use in psychiatric treatment remains limited.</p><p><strong>Aims: </strong>This section aims to explore the current state of evidence supporting gamification in psychiatric care, identify gaps in research, and highlight its potential role in improving treatment outcomes and user experience within digital mental health interventions.</p><p><strong>Method: </strong>We performed a comprehensive search of the PubMed database, covering articles published between January 1, 2014, and May 31, 2025. The search included only empirical studies that employed gamified interventions in mental health contexts. Articles were screened and selected following PRISMA guidelines. Quality assessment was conducted using the GRADE framework, while risk of bias in randomized controlled trials (RCTs) was assessed using the Cochrane RoB 2.0 tool. Due to heterogeneity in study designs and outcome measures, findings were synthesized narratively.</p><p><strong>Results: </strong>The review identified 7 eligible studies from an initial 109, all of which were randomized controlled trials (RCTs). These studies primarily used mobile or app-based platforms featuring gamified elements such as badges, levels, storylines, and points. The participants were largely adolescents and young adults experiencing mental health conditions, including depression, anxiety, and eating disorders. The studies reported positive effects on user engagement, adherence to therapeutic exercises, and symptom reduction.</p><p><strong>Conclusions: </strong>Gamification appears to be a viable and potentially effective adjunctive strategy for psychiatric and mental health interventions. Despite encouraging initial evidence, further research is needed to solidify its clinical relevance and optimize its theoretical integration.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"1475-1484"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145833887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Public Knowledge, Stigma, and Discrimination Toward Schizophrenia: Results From a National Survey in Türkiye.","authors":"Haldun Soygür, Köksal Alptekin, Mustafa Yıldız, Muazzez Merve Avcıoğlu, Çiğdem Penn, Alp Üçok","doi":"10.1177/00207640261426476","DOIUrl":"10.1177/00207640261426476","url":null,"abstract":"<p><strong>Purpose: </strong>In light of the limited and predominantly regional evidence on public stigma toward schizophrenia in Türkiye, this study aimed to address the lack of nationally representative data by investigating public perceptions of schizophrenia, levels of knowledge, and attitudes toward social distance and related factors in a large, nationally representative sample from Türkiye. In doing so, the research questions were explicitly derived from this gap, focusing on how education, socioeconomic status, gender, and familiarity with mental illness are associated with knowledge and social distance.</p><p><strong>Methods: </strong>A total of 1,030 adults were surveyed between 4 and 26 September 2019. Data were collected through Computer-Assisted Personal Interviewing (CAPI) conducted by 32 trained interviewers who had received sensitivity training on mental illness before fieldwork. The questionnaire was developed by an expert academic committee with extensive experience in stigma research. Data analysis included frequency distributions, cross-tabulations, and significance testing.</p><p><strong>Results: </strong>Overall, 63.7% of participants recognized schizophrenia as a brain disorder, although 27% still attributed it to character weakness, reflecting ongoing stigma. Approximately 40% acknowledged psychosocial factors (e.g. poverty) in the etiology of schizophrenia, 54% recognized its association with cannabis use, and 39.4% considered individuals with schizophrenia to be dangerous. More negative beliefs were observed among lower socioeconomic and educational groups, whereas participants with personal or familial experience of mental illness demonstrated greater knowledge and less stigmatizing attitudes.</p><p><strong>Conclusion: </strong>This study provides the first nationally representative evidence on public knowledge, stigma, and discriminatory attitudes toward schizophrenia in Türkiye. While a majority of respondents endorsed biomedical explanations, substantial proportions continued to express stigmatizing beliefs and social distance, particularly among individuals with lower socioeconomic status and educational attainment. These findings highlight persistent structural and informational inequalities shaping public stigma and underscore the need for targeted, culturally sensitive educational and anti-stigma interventions to promote social inclusion and reduce discrimination.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"1807-1818"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147528704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anxiety-Depression Symptoms Mediate the Connections Between Nightmares to War and Psychotic Experiences Among Internally Displaced Lebanese Citizens During the 2025 Southern Lebanon Attacks.","authors":"Carla Hokayem, Georges Haddad, Mirna Fawaz, Rabih Hallit, Diana Malaeb, Sahar Obeid, Souheil Hallit, Feten Fekih-Romdhane","doi":"10.1177/00207640261433235","DOIUrl":"10.1177/00207640261433235","url":null,"abstract":"<p><strong>Background: </strong>The psychological mechanisms linking war-related nightmares to psychotic experiences remain insufficiently elucidated, especially among the vulnerable displaced population. The present study investigated the mediating effect of anxiety-depression symptoms in the association between war-related nightmares and psychotic experiences within a sample of internally displaced Lebanese citizens during the 2025 southern Lebanon attack.</p><p><strong>Methods: </strong>A cross-sectional study was performed on displaced Lebanese citizens between October 2024 and March 2025 and included 249 displaced Lebanese citizens. Three scales were used: The Community Assessment of Psychic Experiences scale-9, the Patient Health Questionnaire-4 and the Nightmares to War scale.</p><p><strong>Results: </strong>The indirect effect analysis taking psychotic experiences as the dependent variable was accommodated for the subsequent covariates: education, age and nightmares to war. Psychological distress (indirect effect: Beta = .07; Boot <i>SE</i> = 0.03; Boot CI [0.01, 0.13]) partially mediated the association between nightmares to war and psychotic experiences. Greater levels of nightmares to war were notably linked to higher psychological distress and higher psychological distress was significantly associated with higher psychotic experiences. Moreover, higher nightmares to war were directly associated with more psychotic experiences. The effect size was 0.08 [0.01; 0.15]. The sensitivity analyses showed that anxiety (indirect effect: Beta = .07; Boot <i>SE</i> = 0.03; Boot CI [0.02, 0.13]; effect size = 0.08; 95% CI [0.02, 0.15], but not depression (indirect effect: Beta = .03; Boot <i>SE</i> = 0.02; Boot CI [-0.01, 0.08]; effect size = 0.04; 95% CI [-0.01, 0.10], played an indirect role in the association between nightmares to war and psychotic experiences.</p><p><strong>Conclusion: </strong>This study established a significant connection between war-related nightmares and psychotic experiences, with psychological distress partially mediating this relationship and anxiety playing an indirect role in the association. Therefore, our findings highlighted the importance of routine assessment for trauma-related nightmares and affective symptomatology to detect individuals at heightened risk of developing psychotic experiences and thus facilitate timely, evidence-based interventions.</p>","PeriodicalId":14304,"journal":{"name":"International Journal of Social Psychiatry","volume":" ","pages":"1510-1523"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}