Journal of psychiatric research最新文献

{"title":"Are adolescent males or females more proficient self-raters of symptoms of Attention-Deficit/Hyperactivity Disorder?","authors":"Matilda A. Frick ,&nbsp;Lin Lindman ,&nbsp;Jenny Meyer ,&nbsp;Johan Isaksson","doi":"10.1016/j.jpsychires.2025.05.026","DOIUrl":"10.1016/j.jpsychires.2025.05.026","url":null,"abstract":"<div><h3>Objectives</h3><div>The current study examined the relation between self-rated and parent- and clinician-rated symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD), by estimating rater agreement and rater differences, and whether these differed between the sexes.</div></div><div><h3>Method</h3><div>The sample included N = 159 adolescents with ADHD aged 15–18 years (M^age = 16.59 years, SD = .92) of which n = 58 (36.5 %) were males. Symptoms were assessed using self- and parent-ratings with the adult ADHD Self-Report Scale for Adolescents, whereas clinicians rated symptoms using the Mini International Neuropsychiatric Interview for children and adolescents conducted with the adolescents and their parent. We used intra-class correlation coefficients (ICC) to assess rater agreement and <em>t</em>-tests to assess differences.</div></div><div><h3>Results</h3><div>Males rated fewer symptoms compared to their parents and clinicians, whereas females’ self-ratings did not differ from parent and clinician ratings. Relatedly, females were in higher agreement with parents and clinicians compared to males. Females had a higher symptom severity than males in self-ratings and clinician-ratings, but not in parent-ratings. Adolescents were in higher agreement with clinicians than parents.</div></div><div><h3>Conclusions</h3><div>Our results indicate that adolescent males with ADHD may underestimate their symptoms whereas females may have more insight into their symptoms when compared to other raters. Adolescents are important raters of their own ADHD symptoms and their perspectives need to be taken into account in diagnostic assessments.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"187 ","pages":"Pages 248-253"},"PeriodicalIF":3.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072441","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":"Avoidant restrictive food intake disorder, traumatic events and PTSD in adolescents and adults admitted to residential treatment","authors":"Timothy D. Brewerton ,&nbsp;Giulia Suro ,&nbsp;Natalie Fernandez ,&nbsp;Khuslen Tulga ,&nbsp;Ismael Gavidia ,&nbsp;Molly M. Perlman","doi":"10.1016/j.jpsychires.2025.05.022","DOIUrl":"10.1016/j.jpsychires.2025.05.022","url":null,"abstract":"<div><h3>Objective</h3><div>Avoidant restrictive food intake disorder (ARFID) is a feeding and eating disorder linked to autism spectrum disorder (ASD) that has been associated with prior traumatic experiences, but its relationship to posttraumatic stress disorder (PTSD) has been relatively unexplored. Whether trauma and PTSD are more closely associated with specific clinical profiles of ARFID (fear of adverse consequences of eating, sensory sensitivity, and/or lack of interest in food/eating) is unclear.</div></div><div><h3>Method</h3><div>89 patients (25 adolescents, 64 adults) admitted to residential treatment (RT) with a DSM-5 diagnosis of ARFID completed initial assessments, including the PTSD Checklist for DSM-5. Trauma histories were identified via the Life Events Checklist for DSM-5 (adults), the Child Trauma Questionnaire (adolescents), and by detailed chart reviews.</div></div><div><h3>Results</h3><div>50 % of adults and 40 % of adolescents (47 % total) met criteria for PTSD, which was more prevalent in patients with sensory sensitivity (60 %) and pre-admission comorbid ASD (80 %). The most common types of traumatic experiences associated with PTSD were sexual assault, unwanted/uncomfortable sexual experiences, and physical assault. In most cases (61 %), traumas reportedly occurred before or at the same time as the eating disturbances, which began on average at 12.4 years of age. Patients with PTSD also had significantly more prior suicide attempts.</div></div><div><h3>Discussion</h3><div>Traumatic experiences and resultant PTSD were common in both adolescents and adults with ARFID, especially in those with sensory sensitivity and comorbid ASD. These findings need to be confirmed in larger, more representative samples. Development of treatment approaches that integrate trauma-focused treatments are indicated.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"187 ","pages":"Pages 174-180"},"PeriodicalIF":3.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143940973","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":"Screening and evaluating seasonal affective disorder: a systematic review of available assessment tools","authors":"Marine Ambar Akkaoui ,&nbsp;Pierre Alexis Geoffroy","doi":"10.1016/j.jpsychires.2025.05.008","DOIUrl":"10.1016/j.jpsychires.2025.05.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Seasonal Affective Disorder (SAD) is a frequent and severe disorder. The prevalence of SAD varies from 1 % to 10 %, influenced by latitude and assessment methods, and is higher in women and younger populations. SAD is also overrepresented in patients with bipolar disorders. In this context, screening for SAD appears crucial, particularly because specific treatments are available. We aimed to examine comprehensively and critically the existing scales and questionnaires for assessing and screening SAD.</div></div><div><h3>Methods</h3><div>A systematic literature review was performed using PRISMA guidelines and searching on PubMed, Cochrane Library, and PsycINFO databases up to April 2024.</div></div><div><h3>Results</h3><div>Out of 791 articles screened, 28 met the inclusion criteria. Seven scales were identified, divided into those for screening and those for severity measurement. The Seasonal Pattern Assessment Questionnaire (SPAQ) is widely used and validated in multiple languages and disorders. Of note, the SPAQ tends to overestimate SAD prevalence. It has good internal validity but limited reliability for diagnosing seasonal depression alone. The SIGH-SAD allows detailed symptom evaluation, with good psychometric properties, although the score interpretation can be complex. The SHQ is more specific and sensitive than SPAQ but longer and more complex. The ISV offers a detailed assessment of seasonal variations and a good reliability but is more complex and less studied than SPAQ. The SBQ provides specific cognitive assessment related to SAD, with good sensitivity and specificity, though more validation is needed. The BDI-add includes atypical symptoms for SAD assessment but lacks comprehensive psychometric data. Finally, the HIGH-SAD is useful for distinguishing unipolar from bipolar disorder in SAD patients, with good reliability but requiring more validation.</div></div><div><h3>Conclusion</h3><div>The SPAQ remains the reference scale despite some limitations. The review highlights the need for ongoing validation and potentially new scales integrating seasonal and mood dimensions for more accurate SAD diagnosis.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"187 ","pages":"Pages 223-232"},"PeriodicalIF":3.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071840","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":"Differences in baseline and dynamic plasma/saliva endocrine and linear/non-linear heart measures between patients with major depression and closely-matched healthy subjects: A 3-day combined overnight dexamethasone/metyrapone challenge study","authors":"Agorastos Agorastos ,&nbsp;Oliver Stiedl ,&nbsp;Alexandra Heinig ,&nbsp;Anne Sommer ,&nbsp;Torben Hager ,&nbsp;Klaus Wiedemann ,&nbsp;Cüneyt Demiralay","doi":"10.1016/j.jpsychires.2025.05.020","DOIUrl":"10.1016/j.jpsychires.2025.05.020","url":null,"abstract":"<div><h3>Background</h3><div>Major depressive disorder (MDD) has been consistently associated with hypothalamic-pituitary-adrenal (HPA)-axis and autonomic nervous system (ANS) (re-)activity abnormalities, however, often with conflicting results.</div></div><div><h3>Methods</h3><div>This study offers a concurrent multi-measure assessment of both HPA-axis and ANS activity and reactivity over 3 days to better characterize baseline and dynamic neuroendocrine alterations in MDD accounting for multiple individual factors. We therefore investigated group differences between 20 unmedicated MDD patients and 20 carefully-matched healthy controls (HC) by simultaneously assessing morning plasma (CORT, ACTH, copeptin) and awakening response saliva (CORT, DHEA, DHEA-s) endocrine measures, as well as multiple linear and non-linear measures of resting heart rate (HR) and its variability (HRV), before (baseline, day 1) and after a successive overnight metyrapone (HPA-axis stimulation, day 2) and dexamethasone (HPA-axis suppression, day 3) pharmaco-endocrine challenge, controlling for childhood trauma (CT) history.</div></div><div><h3>Results</h3><div>Statistically significant group differences emerged only for baseline plasma CORT and ACTH levels (MDD &gt; HC) and resting HR in all 3 days. No differences were found in dynamic plasma levels and all saliva endocrine measures, as well as all HRV measures. Baseline HR was the only significant predictor for MDD diagnosis.</div></div><div><h3>Conclusions</h3><div>Our detailed baseline and dynamic neuroendocrine comparison using closely matched HC indicates fewer neuroendocrine alterations in MDD than expected. These results challenge prior findings and support the importance of exact matching when investigating neuroendocrine biomarkers, as previously reported findings may rely on unaccounted individual but not group differences.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"187 ","pages":"Pages 192-199"},"PeriodicalIF":3.7,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143947188","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":"From lockdown to Liberation: How inflexible thinking, obsessive-compulsive and affective symptoms shape pandemic adjustment","authors":"Aaron T. Clarke ,&nbsp;Naomi A. Fineberg ,&nbsp;Luca Pellegrini ,&nbsp;Rodolfo Leuzzi ,&nbsp;Keith R. Laws","doi":"10.1016/j.jpsychires.2025.05.003","DOIUrl":"10.1016/j.jpsychires.2025.05.003","url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 pandemic significantly disrupted daily life, and the transition to post-pandemic living presented additional psychological challenges. Previous research shows that individuals with obsessive-compulsive traits and pre-existing mental health histories were vulnerable to adjustment difficulties, which appear to be mediated by depression, anxiety, and stress.</div></div><div><h3>Aims</h3><div>This study examined the relationship between post-pandemic adjustment and mental health variables in a population-based cohort during the final lifting of COVID-19 restrictions, tracking outcomes over six months to assess causality. The study was pre-registered on the Open Science Framework (<span><span>https://osf.io/v4c28</span><svg><path></path></svg></span>).</div></div><div><h3>Method</h3><div>A cohort of 343 UK adults was assessed online at baseline, three, and six months. Self-report measures included the Obsessive-Compulsive Inventory-Revised (OCI-R), Compulsive Personality Assessment Scale (CPAS), Depression, Anxiety, and Stress Scale-21 (DASS-21), Post-Pandemic Adjustment Scale (PPAS) and COVID-19 Safety Behaviour Scale. Cognitive flexibility was assessed using the Wisconsin Card Sorting Test (CST: at baseline) and the Intradimensional-Extradimensional Set-Shifting Task (IDED: at 3 months).</div></div><div><h3>Results</h3><div>Approximately 28 % of participants were identified as poor adjusters. Mediation analysis revealed that obsessive-compulsive symptoms, compulsive personality traits, and a history of mental health disorders predicted post-pandemic adjustment difficulties indirectly via depression, anxiety, and COVID-19 safety behaviours. While we found no evidence that adjustment was linked to cognitive flexibility on the WCST, exploratory analyses showed that poorer adjustment was linked to reversal learning issues on the IDED task.</div></div><div><h3>Conclusion</h3><div>This study replicated our prior findings, identifying obsessive-compulsive symptoms and traits, mental health histories, and cognitive inflexibility as key risk factors for poor post-pandemic adjustment. Moreover, depression, anxiety, and stress mediated these difficulties, suggesting potential markers for identifying at-risk individuals and guiding interventions for future public health crises.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"187 ","pages":"Pages 238-247"},"PeriodicalIF":3.7,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072440","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 role of alexithymia and maladaptive coping in long-term Trauma: Insights from the aftermath of the October 7th attacks","authors":"Stav Naim,&nbsp;Ariela Gigi","doi":"10.1016/j.jpsychires.2025.05.005","DOIUrl":"10.1016/j.jpsychires.2025.05.005","url":null,"abstract":"<div><div>The study investigates the psychological effects of alexithymia and maladaptive coping strategies on individuals exposed indirectly to trauma through media coverage. Focusing the October 7th, 2023, terrorist attacks in Israel, we explore how alexithymia characterized by difficulty in processing emotions, exacerbates trauma-related symptoms. The research examines 213 participants using the Toronto Alexithymia Scale (TAS-20) as well as trauma, somatization and coping questionnaires. Results indicate that individuals with alexithymia experience more severe and prolonged trauma symptoms, including physical manifestations. A significant correlation was observed between alexithymia, maladaptive coping, and the persistence of trauma. Participants with alexithymia reported more significant reliance on avoidance and denial, contributing to their psychological and somatic distress. Our findings reveal that even with indirect exposure through the media, alexithymic individuals experience heightened traumatic and somatic symptoms, likely due to their difficulty processing trauma, which finally manifests physically. The findings underscore the need for tailored interventions, including emotion-focused therapies and psychoeducation, to support those struggling with alexithymia in the aftermath of indirect trauma. These underscores the role of alexithymia in amplifying somatization and highlights the need for interventions that promote emotional processing and regulate media consumption to mitigate its effects. This study highlights the enduring impact of secondary trauma by media-exposure, particularly for emotionally vulnerable individuals<strong>.</strong></div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"187 ","pages":"Pages 254-260"},"PeriodicalIF":3.7,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072442","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":"Edge-centric network reveals altered functional integration and dispersion in major depressive disorder","authors":"Jiayong Pu ,&nbsp;Jinghua Wang ,&nbsp;Chi Yao ,&nbsp;Changxiao Kuai ,&nbsp;Minlie Pan ,&nbsp;Shao-Wei Xue","doi":"10.1016/j.jpsychires.2025.05.021","DOIUrl":"10.1016/j.jpsychires.2025.05.021","url":null,"abstract":"<div><div>Brain networks are composed of nodes representing neural elements, such as brain regions, and edges indicating functional or anatomical connections between these nodes. By shifting our focus from traditional node-centric perspectives to examining second-order similarity patterns between pairs of network edges, we captured and illuminated the co-fluctuation profiles between brain regions, revealing overlapping communities and the intensity of interactions within brain networks. Specifically, we mapped edge-centric networks and then computed edge-community normalized entropy and edge functional connectivity (eFC) to assess perturbations in normal brain network organization associated with major depressive disorder (MDD). Sample data were sourced from a cohort of 400 MDD patients and 441 healthy controls. Edge-community entropy was measured by clustering edge time series derived from resting-state functional magnetic resonance imaging data, while eFC was quantified using the Pearson correlation coefficient between edge time series. Our results showed that MDD patients exhibited increased entropy in the subcortical and frontoparietal networks and decreased eFC within the visual and sensory-motor networks compared to controls. These differences were less evident in first-episode drug-naive patients. However, in recurrent patients, the same abnormalities were observed and the entropy of subcortical network was positively correlated with depression severity, while the eFC of visual network was negatively correlated with depression and anxiety scores. This study provides new insights into the abnormal changes in MDD from a spatiotemporal flexibility and diversity perspective based on high-order edge-centric networks and offering potential novel biomarkers for MDD.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"187 ","pages":"Pages 200-210"},"PeriodicalIF":3.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144067566","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":"Betrayal experiences among individuals living in war zones: A longitudinal study","authors":"Doron Amsalem ,&nbsp;Shilat Haim-Nachum ,&nbsp;Chana T. Fisch ,&nbsp;Amit Lazarov ,&nbsp;Yossi Levi-Belz ,&nbsp;John C. Markowitz ,&nbsp;Nitsa Nacasch ,&nbsp;Milton L. Wainberg ,&nbsp;Ido Lurie ,&nbsp;Shlomo Mendlovic ,&nbsp;Yuval Neria","doi":"10.1016/j.jpsychires.2025.05.023","DOIUrl":"10.1016/j.jpsychires.2025.05.023","url":null,"abstract":"<div><h3>Objective</h3><div>Betrayal, a component of moral injury, refers to the harm caused by the deliberate actions or inaction of someone trusted, violating one's values and beliefs. This study examines the impact of betrayal experiences—specifically perceptions of failure by political and military leadership—on mental health outcomes among civilians in Israeli conflict zones, focusing on anxiety, depression, and posttraumatic stress disorder (PTSD). It also explores the relationship between betrayal and war-related factors such as traumatic loss, forced displacement, and income loss, along with the roles of gender and ethnicity. We hypothesized that higher betrayal levels would be associated with more severe mental health symptoms, and war-related experiences, female gender, and ethnic minority status would exacerbate these effects.</div></div><div><h3>Methods</h3><div>A longitudinal study was conducted with 1052 individuals (ages 18–40) living in northern and southern Israel, areas that were exposed to war and mass forced displacement of civilians. Participants were assessed at three time-points: February 2024, March 2024, and May 2024. Measures included the Moral Injury Events Scale focusing on betrayal, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and Primary Care PTSD Screen for DSM-5. We measured changes over time using Linear Mixed Models.</div></div><div><h3>Results</h3><div>High levels of betrayal experiences were significantly associated with greater symptoms of anxiety, depression, and PTSD across all timepoints. Traumatic loss, forced displacement, and income loss were strong predictors of increased betrayal experiences, with women and ethnic minorities reporting higher levels of betrayal experiences over time.</div></div><div><h3>Conclusions</h3><div>Our findings underscore the impact of war-related stressors on the sense of betrayal. The study highlights the urgent need for targeted mental health interventions to address the psychological effects of betrayal, particularly among vulnerable groups. Future research should explore these dynamics in more diverse populations to better understand the broader implications of betrayal experiences.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"187 ","pages":"Pages 95-100"},"PeriodicalIF":3.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143931577","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":"PANS and PANDAS – symptoms beyond OCD and tics – a systematic review","authors":"Paula Łojek,&nbsp;Marcin Rzeszutek","doi":"10.1016/j.jpsychires.2025.05.001","DOIUrl":"10.1016/j.jpsychires.2025.05.001","url":null,"abstract":"<div><div>This article aims to describe the symptomatology of Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS) and Pediatric Acute-onset Neuropsychiatric Syndrome (PANS), and to highlight some of their potential distinctive features, by juxtaposing available data with existing literature on pediatric obsessive - compulsive disorder (OCD).</div><div>Given the scarcity of high-quality studies, we decided to review a wide range of publications on the clinical presentation of PANS and PANDAS, including case series and case reports, regardless of their methodological heterogeneity.</div><div>Although PANS and PANDAS share many characteristics with non-PANS/PANDAS OCD, the acute onset of obsessive-compulsive symptoms in conjunction with concomitant features, especially separation anxiety, irritability, emotional lability, or dysgraphia should prompt consideration of a possible post-infectious etiology. Further research aimed at creating more precise diagnostic tools is needed to facilitate differential diagnosis.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"187 ","pages":"Pages 144-153"},"PeriodicalIF":3.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936893","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":"Psychiatric outcomes after mild concussion by treatment timing and age","authors":"Austin A. Kennemer ,&nbsp;Zhenxiang Gao ,&nbsp;Lindsey Wang ,&nbsp;Pamela B. Davis ,&nbsp;David C. Kaelber ,&nbsp;Rong Xu","doi":"10.1016/j.jpsychires.2025.05.017","DOIUrl":"10.1016/j.jpsychires.2025.05.017","url":null,"abstract":"<div><div>Previous guidance for mild concussion treatment has recommended physical and cognitive rest. However, it remains unknown if patients who received treatment at different times had differential neuropsychiatric outcomes. We examined if patients who received immediate treatment less than one week after a mild concussion had a different risk for subsequent depression or anxiety compared with those who received delayed treatment greater than one week after the event, stratified by age groups. This multicenter retrospective cohort study used the TriNetX Analytics platform to access de-identified electronic health records of over 100 million patients, including both inpatient and outpatient visits, from 60 healthcare organizations across the United States. A total of 9881 patients with a diagnosis of mild concussion either received either immediate treatment, defined as within 1 week (n = 4053), or delayed treatment, defined as 1 week to 6 months (n = 5828) following the diagnosis of mild concussion.</div><div>Each group was stratified by age:≤25, 26–64, and 65+ years. Patients who received early treatment had significantly lower risk of depression and anxiety compared with propensity-score matched patients who received delayed treatment during a 5-year follow-up after mild TBI diagnosis, with hazard ratios (HRs) of 0.74 (95 % CI, 0.65–0.84) and 0.75 (95 % CI, 0.68–0.84), respectively. These results are consistent across age groups, with strongest reduction in older adults aged 65 years and older. These findings suggest that timely treatment for concussion may mitigate subsequent adverse psychiatric outcomes.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"187 ","pages":"Pages 233-237"},"PeriodicalIF":3.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071799","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}