Journal of psychiatric research最新文献

{"title":"Are sleep disturbances a risk factor for suicidal behavior in the first episode of psychosis? Evidence from a systematic review","authors":"Valentina Baldini ,&nbsp;Martina Gnazzo ,&nbsp;Giulia Santangelo ,&nbsp;Armando D'Agostino ,&nbsp;Giorgia Varallo ,&nbsp;Maristella Scorza ,&nbsp;Giovanni Ostuzzi ,&nbsp;Gian Maria Galeazzi ,&nbsp;Diana De Ronchi ,&nbsp;Giuseppe Plazzi","doi":"10.1016/j.jpsychires.2025.03.053","DOIUrl":"10.1016/j.jpsychires.2025.03.053","url":null,"abstract":"<div><div>Sleep disturbances are common in individuals with first-episode psychosis (FEP) and have been identified as potential contributors to an increased risk of suicidal behavior. This systematic review aims to synthesize the existing evidence on the association between sleep disturbances and suicidal behavior in individuals experiencing FEP, a critical period for early intervention.</div><div>In accordance with the guidelines established by PRISMA, this systematic review was duly registered in PROSPERO (CRD42024598203) prior to its initiation. A comprehensive search was conducted across databases including PubMed, Web of Science, EMBASE, and PsycINFO, encompassing studies from their inception through February 2025. The review specifically included observational studies that investigated the association between sleep disturbances and suicidal behaviors, which include suicidal ideation, attempts, or completed suicides, among individuals with FEP. The inclusion criteria required that all studies featured adult participants aged 18 years and older, employed validated measures for both sleep disturbances and suicidality, and concentrated on populations with FEP. Reviews, case reports, and studies not published in English were systematically excluded. The selection of studies, extraction of data, and assessment of quality were conducted independently by two reviewers.</div><div>Seven studies met the inclusion criteria, with sample sizes ranging from 118 to 688 participants. The findings indicate that sleep disturbances, especially insomnia, are significantly linked to an increased risk of suicidal ideation and behavior in individuals with FEP. The strength of these associations varied among the studies, with some reporting moderate to strong effect sizes. However, there was noted methodological heterogeneity, including variations in sleep assessment tools.</div><div>This systematic review highlights sleep disturbances as a key modifiable risk factor for suicidal behavior in individuals with FEP. Future research should prioritize longitudinal designs and standardized sleep assessments to better characterize this relationship and guide targeted interventions.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"185 ","pages":"Pages 186-193"},"PeriodicalIF":3.7,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143799851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severity of autism-related symptoms in treatment-resistant schizophrenia: associations with cognitive performance, psychosocial functioning, and neurological soft signs — Clinical evidence and ROC analysis","authors":"Licia Vellucci ,&nbsp;Annarita Barone ,&nbsp;Elisabetta Filomena Buonaguro ,&nbsp;Mariateresa Ciccarelli ,&nbsp;Giuseppe De Simone ,&nbsp;Federica Iannotta ,&nbsp;Marta Matrone ,&nbsp;Benedetta Mazza ,&nbsp;Roberto Vitelli ,&nbsp;Andrea de Bartolomeis ,&nbsp;Felice Iasevoli","doi":"10.1016/j.jpsychires.2025.03.040","DOIUrl":"10.1016/j.jpsychires.2025.03.040","url":null,"abstract":"<div><div>Treatment-resistant schizophrenia (TRS) occurs when symptoms persist despite adequate antipsychotic treatment in terms of both timing and dosage. This severe condition is often overlooked, despite the existence of guidelines, with an average delay of 4–9 years before the introduction of clozapine, the gold standard treatment. We hypothesized that schizophrenia patients with severe autistic symptoms are more prone to develop TRS. To test this, we administered the Positive and Negative Syndrome Scale for Schizophrenia Autism Severity Scale (PAUSS) to 117 patients diagnosed with schizophrenia. Our results revealed that both TRS and clozapine non-responder (CLZ-nR) groups had higher rates of autistic symptoms than non-TRS patients. A machine learning model was developed to examine the relationship between PAUSS scores and TRS, obtaining an accuracy of 0.65 and an AUC of 0.67. Specifically, PAUSS items N6 (“lack of spontaneity and flow of conversation”) and N7 (“stereotypical thinking”) emerged as the most significant factors in the model. In addition, PAUSS was correlated with cognitive and social functions, as well as soft neurological signs, in TRS patients. Autism-related symptoms were found to predict significant variance in motor coordination, verbal fluency, functional ability and soft neurological signs. These results suggest that autism-related symptoms in schizophrenia may define a distinct subgroup with unique neurobiological characteristics.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"185 ","pages":"Pages 119-129"},"PeriodicalIF":3.7,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment-related changes during and after inpatient treatment for refractory somatic symptom disorder or functional neurological symptom disorder: Testing the applicability of a new approach for analyzing routine outcome monitoring data","authors":"Jan Houtveen ,&nbsp;Jonna van Eck van der Sluijs ,&nbsp;Pieter Jan Herremans ,&nbsp;Rinie Geenen","doi":"10.1016/j.jpsychires.2025.03.046","DOIUrl":"10.1016/j.jpsychires.2025.03.046","url":null,"abstract":"<div><div>The aim of the current observational study was to examine changes and the moments of change during and after intensive integrated multidisciplinary inpatient treatment for patients with refractory Somatic Symptom Disorder (SSD) or Functional Neurological symptom Disorder (FND). Observational Routine Outcome Monitoring (ROM) data were analyzed to examine changes during and after tertiary care inpatient treatment. Treatment was a combination of acceptance and commitment therapy, body-oriented mentalization therapy, psychophysiology therapy, and systemic therapy. Fifty-five inpatients were included. Eight domains of health status (RAND-36) and symptoms of psychopathology (BSI) were analyzed with multiple-lag two-phase mixed model regression analysis. In this new approach, a series of regression analyses evaluated changes and the moments of change (i.e., the improvement lag). Graphs were created for each outcome measure to visualize estimates and significances as a function of all lags explored. A Monte Carlo validation study with simulated data demonstrated the applicability of this approach. Regarding the RAND-36, the most pronounced and significant (p &lt; .001) improvements were found for perceived change in health (improvement lag = 25 days), energy/fatigue (lag = 58), and social functioning (lag = 169). For the BSI, improvements were found on the positive symptom distress index (lag = 43), the global severity index (lag = 71), obsession-compulsion (lag = 73), and psychoticism (lag = 133). This study observed increases in mental and physical health and decreases in symptoms of psychopathology during and after inpatient treatment for refractory SSD or FND, with delayed improvements for some outcomes.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"185 ","pages":"Pages 138-145"},"PeriodicalIF":3.7,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747478","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":"Local connections enhancement as a neuroprotective strategy against depression recurrence: Insights from structural brain network analysis","authors":"Yang Li ,&nbsp;Hu Xu ,&nbsp;Bo Chen ,&nbsp;Yi Ding ,&nbsp;Yunqian Zhu ,&nbsp;Yang Wang ,&nbsp;Xingbing Chen ,&nbsp;Hui Su","doi":"10.1016/j.jpsychires.2025.03.052","DOIUrl":"10.1016/j.jpsychires.2025.03.052","url":null,"abstract":"<div><h3>Background</h3><div>Depression recurrence significantly impacts patients' well-being and presents a major clinical challenge. Identifying the risk of recurrence during remission could enable early intervention and prevent disease progression.</div></div><div><h3>Methods</h3><div>This study included 115 patients in remission from their first depressive episode and 47 healthy controls (HCs). Participants underwent diffusion tensor imaging (DTI), neuropsychological assessments, and follow-up evaluations every three months over a two-year period. Structural brain networks were constructed using deterministic fiber tracking and graph theory analysis.</div></div><div><h3>Results</h3><div>Non-recurrence patients exhibited significantly higher baseline local connections compared to the recurrence group (t = 8.148; <em>P</em> &lt; 0.001), which emerged as a robust negative predictor of recurrence (AUC = 0.853 [95 % CI: 0.774–0.912]; OR = 0.594 [95 % CI: 0.489–0.722]; <em>P</em> &lt; 0.001). Rich-club connections were inversely correlated with depression severity (r = −0.510; <em>P</em> &lt; 0.001) and duration (r = −0.221; <em>P</em> = 0.018). Additionally, increases in local connections during remission correlated positively with subsequent rich-club connections (r = 0.540; <em>P</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Elevated local connections during remission after the first depressive episode significantly reduce the risk of recurrence. This suggests a compensatory neuroprotective mechanism, where enhanced local connections stabilize rich-club connections, thereby maintaining the integrity of the whole-brain network. These findings highlight local connections as a critical factor in preventing depression recurrence and as a potential target for early clinical intervention.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"185 ","pages":"Pages 74-83"},"PeriodicalIF":3.7,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143740119","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":"Electrophysiological effects of deep brain stimulation in anorexia nervosa","authors":"M.S. Oudijn ,&nbsp;K. Sargent ,&nbsp;A. Lok ,&nbsp;P.R. Schuurman ,&nbsp;P. van den Munckhof ,&nbsp;A.A. van Elburg ,&nbsp;R.J.T. Mocking ,&nbsp;D.J.A. Smit ,&nbsp;D. Denys","doi":"10.1016/j.jpsychires.2025.03.043","DOIUrl":"10.1016/j.jpsychires.2025.03.043","url":null,"abstract":"<div><h3>Objective</h3><div>To study deep brain stimulation (DBS)-induced electrophysiological changes over time in patients with anorexia nervosa (AN).</div></div><div><h3>Methods</h3><div>We performed EEG recordings on 4 AN patients treated with DBS at 3 time points, and on 8 age-matched controls. We extracted oscillatory power in the alpha and beta bands, connectivity and global network organization parameters based on graph theory.</div></div><div><h3>Results</h3><div>We found strong significant within-subject changes in alpha and beta power over time. Nominally significant effects were observed for posterior left (L) alpha (p = 0.034) and anterior/posterior L scalp areas (p = 0.034 and p = 0.013, respectively), however, multiple testing indicated that the effects are heterogeneous across subjects. We found V-shaped curves over time for average functional connectivity. This was largely re-established at the final time-point. The graph-theoretical measures showed similar V-shaped effects consistent with an initially disordered network state.</div></div><div><h3>Conclusion</h3><div>Within-subject effects of stimulation were large, widespread over frequencies, and visible across wide brain areas and networks. Prolonged stimulation seemed to reinstate organization in the functional brain networks. Our results support the observations that effects of DBS are not merely local, but influence widespread pathological network activity and that, after an initial period of disorganisation, the brain adapts to the stimulation.</div></div><div><h3>Significance</h3><div>A better understanding of the electrophysiological effects of DBS may allow us to personalize and optimize the intervention and thereby further improve effectiveness in AN.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"185 ","pages":"Pages 57-66"},"PeriodicalIF":3.7,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home-based transcranial direct current stimulation for major depressive disorder: 6-month follow-up from randomised sham-controlled trial and open-label treatment phases","authors":"Rachel D. Woodham ,&nbsp;Sudhakar Selvaraj ,&nbsp;Nahed Lajmi ,&nbsp;Harriet Hobday ,&nbsp;Gabrielle Sheehan ,&nbsp;Ali-Reza Ghazi-Noori ,&nbsp;Peter J. Lagerberg ,&nbsp;Rodrigo Machado-Vieira ,&nbsp;Jair C. Soares ,&nbsp;Allan H. Young ,&nbsp;Cynthia H.Y. Fu","doi":"10.1016/j.jpsychires.2025.03.047","DOIUrl":"10.1016/j.jpsychires.2025.03.047","url":null,"abstract":"<div><div>Transcranial direct current stimulation (tDCS) is a potential home-based treatment for major depressive disorder (MDD). In our double-blind randomised controlled trial (RCT) (n = 174; UK and USA), a 10-week course of home-based tDCS demonstrated clinical efficacy (clinical response: 58.3 % active treatment arm and 37.8 % sham (<em>p</em> = 0.017). tDCS was delivered in a bifrontal montage, with anode over left dorsolateral prefrontal cortex (DLPFC) and cathode over right DLPFC. Each session was 30 min, with active stimulation at 2 mA and sham at 0 mA, incorporating brief ramp-up and ramp-down phased. Following the 10-week RCT, all participants were offered active tDCS in a 10-week open-label treatment phase, with 111 participants completing this phase. UK cohort (n = 77 MDD) were invited for additional 3-month and 6-month follow-ups, extending the total study period to 11 months post-randomisation. Participants were able to continue using the tDCS device during follow-up. At least one follow-up visit was attended by 42 MDD participants (27 women). Device usage rates were 59 % at 3-month follow-up and 55 % at 6-month follow-up. Clinical response rate was 64 % at 3-month follow-up and 76 % at 6-month follow-up. Among participants who had shown a clinical response after the open-label phase, 90 % maintained their response at the 6-month follow-up. In summary, long-term follow-up showed high and sustained clinical response rates regardless of continued tDCS device use.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"186 ","pages":"Pages 23-32"},"PeriodicalIF":3.7,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143808616","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":"Breast cancer risk of hormone replacement therapy in Japanese women with schizophrenia on antipsychotic treatment: A retrospective cohort study","authors":"Ryosuke Ota ,&nbsp;Atsushi Hirata ,&nbsp;Takeo Hata ,&nbsp;Masami Nishihara ,&nbsp;Akira Ashida ,&nbsp;Tetsufumi Kanazawa ,&nbsp;Takahiro Katsumata","doi":"10.1016/j.jpsychires.2025.03.048","DOIUrl":"10.1016/j.jpsychires.2025.03.048","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to identify the risk factors for breast cancer onset in patients with schizophrenia who are receiving antipsychotic treatment. The focus was on understanding how baseline patient characteristics and treatment factors influence breast cancer risk in this population.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using a nationwide claims database in Japan, including 12,479 patients with schizophrenia who were receiving antipsychotic medications. The primary outcome was the development of breast cancer. Multivariate Cox regression analysis was employed to identify independent risk factors, with sensitivity analyses conducted using the jackknife and elastic net methods.</div></div><div><h3>Results</h3><div>Among the 12,479 patients, 22 developed breast cancer during the follow-up period. Baseline age of 38 years or older (hazard ratio (HR) = 4.87, 95 % confidence interval (CI) = 1.41–16.87, <em>p</em> = 0.013) and the use of progestogens (HR = 4.47, 95 % CI = 1.04–19.18, <em>p</em> = 0.044) were identified as independent risk factors for breast cancer onset. Sensitivity analyses confirmed the robustness of these findings, although the study's limited number of events highlighted potential variability in the HRs.</div></div><div><h3>Conclusion</h3><div>The results suggest that certain treatment factors, particularly the use of progestogens, may increase the risk of breast cancer in patients with schizophrenia who are receiving antipsychotic treatment. Given these findings, careful consideration of treatment plans, including the dosage and duration of hormone replacement therapy and adjustments in antipsychotic treatment, may be warranted. Further research is needed to clarify the interactions between mental disorders, treatment factors, and breast cancer risk.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"185 ","pages":"Pages 67-73"},"PeriodicalIF":3.7,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734612","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":"Anti-suicidal effectiveness of clozapine, lithium, and valproate in patients with schizophrenia and bipolar disorder: A real-world nationwide study","authors":"Junhee Lee ,&nbsp;Jiseun Lim ,&nbsp;Se Hyun Kim ,&nbsp;Jaewon Kim ,&nbsp;Kwang Ho Mun ,&nbsp;Jiwon Kang","doi":"10.1016/j.jpsychires.2025.03.045","DOIUrl":"10.1016/j.jpsychires.2025.03.045","url":null,"abstract":"<div><div>Despite advances in psychiatric treatment, individuals with schizophrenia (SZ) and bipolar disorder (BD) continue to experience alarmingly high suicide rates. Clozapine, lithium, and valproate are medications that may potentially reduce suicide in these populations, but evidence is limited and often inconsistent. This study aimed to evaluate the anti-suicidal effectiveness of these medications using a nationwide health insurance database in South Korea.</div><div>A retrospective cohort study was conducted using data from the National Health Information Database. This study included 102,540 patients with SZ and 96,336 patients with BD diagnosed between 2007 and 2010. We assessed the association between suicide mortality and recent prescriptions of clozapine, lithium, and valproate, as well as other psychotropic drugs. Suicide hazard ratios (HR) were calculated using a time-dependent Cox regression analysis.</div><div>Suicide rates per 100,000 person-years were 308.0 for SZ and 285.1 for BD. After adjustment for confounders, lithium and valproate prescriptions were associated with significantly lower suicide hazard ratios in both SZ (HR of lithium: 0.58, 95 % CI: 0.46–0.72; HR of valproate: 0.61, 95 % CI: 0.52–0.71) and BD (HR of lithium: 0.54, 95 % CI: 0.44–0.65; HR of valproate: 0.66, 95 % CI: 0.57–0.76). Clozapine was associated with a lower suicide hazard in patients with SZ but remained statistically non-significant.</div><div>Lithium and valproate have significant anti-suicidal effects in patients with SZ and BD, underscoring the potential role of mood stabilizers in suicide prevention among them.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"185 ","pages":"Pages 105-111"},"PeriodicalIF":3.7,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747444","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":"Network structure of psychotic symptoms and childhood trauma in first-episode versus treatment-resistant schizophrenia","authors":"Zhaofan Liu ,&nbsp;Xiaoying Wang ,&nbsp;Hu Deng ,&nbsp;Junchao Huang ,&nbsp;Jue Wang ,&nbsp;Wenjin Chen ,&nbsp;Kebing Yang ,&nbsp;Wei Li ,&nbsp;Song Chen ,&nbsp;Ting Xie ,&nbsp;Ran Liu ,&nbsp;Li Tian ,&nbsp;Fude Yang ,&nbsp;Baopeng Tian ,&nbsp;Yanli Li ,&nbsp;Chiang-Shan R. Li ,&nbsp;Yunlong Tan","doi":"10.1016/j.jpsychires.2025.03.037","DOIUrl":"10.1016/j.jpsychires.2025.03.037","url":null,"abstract":"<div><h3>Objective</h3><div>The study aims to examine the network structures of childhood trauma (CT) and psychotic symptoms in patients with first-episode schizophrenia (FES) and treatment-resistant schizophrenia (TRS). Specifically, it seeks to elucidate how different dimensions of CT influence symptoms across FES and TRS.</div></div><div><h3>Methods</h3><div>289 patients with FES and 50 patients with TRS were assessed using Positive and Negative Syndrome Scale (PANSS) and Childhood Trauma Questionnaire. Partial correlation was used to elucidate the network connections between CT and symptoms in FES and TRS patients. Betweenness, closeness coefficient, and community detection were further calculated to investigate the interactions between CT and psychotic symptoms.</div></div><div><h3>Results</h3><div>The analysis revealed three key findings: (1) Symptom-trauma networks differ between FES and TRS patients; (2) Based on network analysis, CT in TRS forms tight interlinks, as evidenced by a larger value of closeness coefficient, which influences psychotic symptoms in TRS compared to FES. Sexual abuse plays a vital role in the TRS network while emotional neglect is more important in FES; and (3) The divergent community structures suggest distinct pathways through which CT and symptoms in FES and TRS patients. Specifically, in the FES symptom-CT network, CT influences the symptoms through traditional symptom patterns, while in TRS the pathway cannot be divided by traditional divisions and it involves a complex manner.</div></div><div><h3>Conclusion</h3><div>The findings suggest that the pathways linking childhood trauma experiences and clinical symptoms differ between FES and TRS patients, providing valuable insights into how early traumatic stress may contribute to symptom evolution in schizophrenia.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"185 ","pages":"Pages 31-39"},"PeriodicalIF":3.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705932","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":"Impact of the concept of “Open Doors” on coercive measures - A pre-/post- comparison","authors":"Bianca Ueberberg,&nbsp;Niklas Lübbeling,&nbsp;Hans-Jörg Assion","doi":"10.1016/j.jpsychires.2025.03.039","DOIUrl":"10.1016/j.jpsychires.2025.03.039","url":null,"abstract":"<div><h3>Intro</h3><div>With the intention of reducing restraints and increasing patient autonomy, the “Open Doors” policy (ODP) is an intensely discussed alternative to the tradition of closed wards. The aim of this study was to investigate the impact of the ODP on coercive measures, the need for staff presence and critical incidences among involuntarily admitted patients after implementation in a general psychiatric hospital.</div></div><div><h3>Methods</h3><div>Retrospectively, data were collected from involuntarily admitted patients before and after the implementation of the concept of “Open Doors” based on the electronic patient's medical records. Data comprised socio-demographic and clinical information with focus on coercive measures, staff presence and critical incidences.</div></div><div><h3>Results</h3><div>There was a moderate reduction in coercive measures after the introduction of the ODP. More specifically, recurrent mechanical restraints, combinations of different kinds of coercive measures as well as one-to-one supervision were applied less often. Regarding critical incidences, there were more abscondings, yet their duration was shorter and there were less suicide attempts recorded.</div></div><div><h3>Conclusion</h3><div>The results suggest that the ODP can be effective in reducing coercive measures applied among involuntarily admitted patients. However, it should be noted that this may not only be due to the opening of the ward doors, but may also be related, for example, to a change in the therapeutic relationship or a change in the ward climate. Thus, prospective and qualitative studies could give a more differentiated insight into the effect of the ODP.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"185 ","pages":"Pages 93-97"},"PeriodicalIF":3.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143740121","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}