Journal of psychiatric research最新文献

{"title":"Prevalence of depressive symptoms in the general population with a fully structured interview with skips vs. unconditional sequential assessment: implications for clinical and psychiatric epidemiology studies","authors":"Ana Vilar ,&nbsp;Ivet Bayes-Marin ,&nbsp;Samantha Álvarez-Salazar ,&nbsp;Jorge Piqueras-Marques ,&nbsp;Santiago Batlle Vila ,&nbsp;Carlos G. Forero","doi":"10.1016/j.jpsychires.2025.06.010","DOIUrl":"10.1016/j.jpsychires.2025.06.010","url":null,"abstract":"<div><div>Diagnostic methods in psychiatry often rely on categorical approaches, such as the skip-out procedure, which conditionally assesses symptoms based on prior responses. This study evaluates how assessment methods influence the prevalence of depressive symptoms and Major Depressive Episode (MDE), comparing the skip-out approach with a sequential assessment that evaluates all symptoms independently. It also examines how assessment method affects symptom associations and explores the relationship between self-perceived mental health and symptom count. We conducted a cross-sectional analysis of 2005 Spanish adults using a self-administered online version of the WHO Composite International Diagnostic Interview (CIDI) 3.0. MDE prevalence, symptom frequencies, and associations were compared between skip-out and sequential assessments. Odds ratios with 95 % confidence intervals analyzed symptom associations with MDE, while intercorrelations and self-perceived mental health ratings were evaluated by symptom count. The skip-out method identified only 25 % of the cases detected by the sequential assessment (102 vs. 407), indicating a 75 % reduction in the detected MDE cases. Core symptoms like sadness and anhedonia were more strongly associated with MDE under skip-out, whereas non-core symptoms were better captured by sequential assessment. Sadness and concentration difficulties showed the strongest links to impairment. Over half of individuals reporting five or more symptoms rated their mental health as good or excellent. These results suggest that clinical and epidemiological assessments should consider the use of skip-out logic, as it may substantially underestimate depression prevalence and diversity. Improving assessment strategies may enhance early detection, reduce underdiagnosis, and support more tailored public health interventions.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"189 ","pages":"Pages 424-434"},"PeriodicalIF":3.7,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513980","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 gray matter microstructure and psychological resilience in patients with depression: A preliminary study using DSI/NODDI imaging","authors":"Liaoming Gao ,&nbsp;Zhiming Chen ,&nbsp;Ziqi Wu ,&nbsp;Junyan Wen ,&nbsp;Zhujia Li ,&nbsp;Ying Guo ,&nbsp;Jingwen Luo ,&nbsp;Liya Gong ,&nbsp;Zhiting Chen ,&nbsp;Lin Wang ,&nbsp;Linlin Jing ,&nbsp;Honglei Yin ,&nbsp;Gen Wen","doi":"10.1016/j.jpsychires.2025.06.032","DOIUrl":"10.1016/j.jpsychires.2025.06.032","url":null,"abstract":"<div><h3>Background</h3><div>Psychological resilience serves as a crucial protective factor against depression, yet its microstructural neuroimaging correlates remain poorly understood. This study aimed to investigate gray matter microstructural features associated with psychological resilience levels in patients with depression.</div></div><div><h3>Methods</h3><div>Sixty-four patients with depression underwent diffusion spectrum imaging (DSI) and neurite orientation dispersion and density imaging (NODDI). Derived metrics included fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), axial diffusivity (AD), isotropic volume fraction (FISO), intracellular volume fraction (FICVF), and orientation dispersion index (ODI). Voxel-based analysis was performed to assess correlations between imaging metrics and resilience scores, followed by partial correlation analysis of significant regional metrics.</div></div><div><h3>Results</h3><div>Positive correlations with resilience were observed for: AD in the posterior cingulate gyrus (CCG; r = 0.48, p &lt; 0.001), AD in the right dorsal caudate (RDC; r = 0.45, p &lt; 0.001), FA in the right inferior midfrontal gyrus junction (fMFG; r = 0.33, p = 0.009), and FICVF in the left anterior superior parietal lobule (SPL; r = 0.27, p = 0.030). Negative correlation was found for ODI in the right dorsal midfrontal gyrus (dMFG; r = −0.27, p = 0.030). Neurosynth meta-analysis revealed significant functional associations between these brain regions and the following cognitive domains.</div></div><div><h3>Conclusion</h3><div>Altered psychological resilience in depression shows close associations with gray matter microstructural changes, potentially explaining neuroanatomical mechanisms underlying resilience. These findings provide novel insights for clinical interventions targeting resilience enhancement.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"189 ","pages":"Pages 335-342"},"PeriodicalIF":3.7,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366442","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 prevalence of moral distress and moral injury among U.S. veterans","authors":"Brett T. Litz ,&nbsp;Hannah E. Walker ,&nbsp;Robert H. Pietrzak ,&nbsp;Luke Rusowicz-Orazem","doi":"10.1016/j.jpsychires.2025.06.031","DOIUrl":"10.1016/j.jpsychires.2025.06.031","url":null,"abstract":"<div><div>Moral injury is a syndrome that involves adverse outcomes stemming from experiences violating deeply held moral beliefs. Moral injury has emerged as a distinct mental health concern, yet its prevalence among U.S. veterans remains uncertain. The aim of this study was to determine the prevalence of potentially morally injurious events (PMIEs), moral distress, and moral injury among U.S. veterans. This cross-sectional study surveyed a nationally representative sample of 3002 U.S. veterans using KnowledgePanel. The Moral Injury Outcome Scale assessed PMIE exposure, moral distress (subclinical), moral injury (clinical syndrome), and their functional impact. Among respondents, 44.7 % (95 % CI, 42.1–47.2) endorsed PMIEs; 45.2 % reported witnessing inhumanity, 40.2 % were directly affected by others' transgressions, and 14.0 % reported perpetrating transgressive acts. The weighted prevalence of moral distress and moral injury among PMIE endorsers was 9.1 % (95 % CI, 7.1–11.2) and 13.1 % (95 % CI, 9.9–16.3), respectively. In the full sample, prevalence was 4.1 % (95 % CI, 3.1–5.0) for moral distress and 5.9 % (95 % CI, 4.4–7.4) for moral injury. Moral injury was associated with significant functional impairment, with most cases characterized by shame-related (47.8 %) or blended subvariant symptoms (33.3 %). Approximately 664,000 and 955,000 U.S. veterans report functionally impairing moral distress and moral injury, respectively. These findings highlight the need for surveillance, mitigation, and treatment for these unique mental health challenges.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"189 ","pages":"Pages 435-444"},"PeriodicalIF":3.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518252","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":"Adult individual resilience interventions: A PRISMA-compliant meta-analysis","authors":"Ru-Wen Liao ,&nbsp;Wan-Chung Hu ,&nbsp;Chan-Yen Kuo ,&nbsp;Wan-Ling Hsu ,&nbsp;I-Shiang Tzeng","doi":"10.1016/j.jpsychires.2025.06.021","DOIUrl":"10.1016/j.jpsychires.2025.06.021","url":null,"abstract":"<div><h3>Background</h3><div>Psychological resilience interventions have garnered growing attention because of their potential to enhance mental health outcomes by facilitating adaptive responses to stress, adversity, and trauma. These approaches are especially pertinent during large-scale crises, such as the COVID-19 pandemic.</div></div><div><h3>Aim</h3><div>This study aimed to evaluate the effectiveness of psychological interventions designed to enhance individual resilience. Additionally, it aimed to explore differences in intervention outcomes across key subgroups, including intervention modality and implementation timing relative to the COVID-19 pandemic.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted across six electronic databases, including EMBASE, EBSCO, APA PsycINFO, PubMed, SpringerLink, and Web of Science, to identify controlled trials or randomized controlled trials (RCTs) that assessed the effectiveness of therapies proposed to increase psychological resilience. Trials that met the inclusion criteria were synthesized using a random-effects meta-analysis to calculate pooled standardized mean differences (SMDs) with 95 % confidence intervals.</div></div><div><h3>Results</h3><div>After excluding four studies owing to potential publication bias, 16 RCTs were included in the final meta-analysis. The interventions assessed were categorized as: (1) cognitive behavioral therapy (CBT), (2) mindfulness-based interventions, and (3) combined CBT and mindfulness approaches. Overall, resilience-focused interventions showed a statistically significant positive effect (SMD = 1.54, P &lt; 0.001), with subgroup analyses indicating that CBT was more effective (SMD = 1.92, P &lt; 0.001) than the other interventions. Additionally, interventions administered during the COVID-19 pandemic demonstrated a greater effect (SMD = 2.13, P &lt; 0.001) compared to those implemented before the pandemic.</div></div><div><h3>Conclusions</h3><div>The findings suggest that CBT, mindfulness-based, and combined interventions are efficacious in enhancing psychological resilience, with CBT appearing particularly beneficial. Resilience interventions may be especially impactful during periods of heightened stress, such as during pandemics.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"189 ","pages":"Pages 352-364"},"PeriodicalIF":3.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481785","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":"Predictors of p factor scores in children with chronic physical illness","authors":"Mark A. Ferro,&nbsp;Christy K.Y. Chan","doi":"10.1016/j.jpsychires.2025.06.023","DOIUrl":"10.1016/j.jpsychires.2025.06.023","url":null,"abstract":"<div><h3>Background</h3><div>The <em>p</em> factor represents the overall liability for the development of mental illness within individuals and we have previously validated a bi-factor model of the <em>p</em> factor in children with chronic physical illness.</div></div><div><h3>Objective</h3><div>In this next phase, we modelled predictors of the <em>p</em> factor in this sample of children.</div></div><div><h3>Methods</h3><div>Data come from the ongoing Multimorbidity in Children and Youth Across the Life-course study. Data from 263 children with a chronic physical illness aged 2–16 years and their parents were collected over 24 months. The parent-reported Emotional Behavioural Scales was used to develop a bi-factor model of the <em>p</em> factor. Subsequently, <em>p</em> factor scores were extracted from the model and standardized (Mean = 100, SD = 15). Analysis of variance compared <em>p</em> factor scores across different physical illnesses. Multiple regression was used to identify multilevel baseline predictors of <em>p</em> scores.</div></div><div><h3>Results</h3><div>There was no significant difference in <em>p</em> scores across categories of physical illness (F = 0.44, p = 0.849). Factors predictive of elevated <em>p</em> scores were older child age (B = 0.44), higher level of disability (B = 1.03), elevated parent psychopathology (B = 0.22) and stress (B = 0.21), and living in communities with older age and lower labor force participation (B = 1.66) and higher concentrations of racialized/newcomer populations (B = 2.05). Lower <em>p</em> scores were associated with being female (B = −3.85) and having immigrant parents (B = −5.43).</div></div><div><h3>Conclusion</h3><div>Factors predicting psychopathology, measured using <em>p</em> scores, in children with physical illness are multilevel. Fixed characteristics can inform targeted screening efforts, whereas modifiable characteristics are opportunities for upstream intervention in the context of family-centered integrated physical-mental health services.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"189 ","pages":"Pages 291-294"},"PeriodicalIF":3.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322588","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":"Exploring the association between beta-blockers use and sleep complaints in U.S. Adults: An analysis of NHANES data (2011–2018)","authors":"Kepeng Liu,&nbsp;Binfei Li,&nbsp;Xiaozu Liao,&nbsp;Yunjian Qin,&nbsp;Yong Chen","doi":"10.1016/j.jpsychires.2025.06.029","DOIUrl":"10.1016/j.jpsychires.2025.06.029","url":null,"abstract":"<div><h3>Purpose</h3><div>The primary objective of this investigation was to examine the potential association between the use of beta-blockers among the adult population in the United States from 2011 to 2018 and the occurrence of sleep complaints in adults.</div></div><div><h3>Methods</h3><div>This study utilized a nationally representative sample from the 2011–2018 National Health and Nutrition Examination Survey (NHANES). Using weighted multivariable logistic regression adjusted for demographics, comorbidities (hypertension, diabetes), and lifestyle factors (smoking, exercise), we assessed associations while controlling for confounders through propensity score matching. Formal interaction tests evaluated effect modification by age, race, diabetes status, and physical activity levels. NHANES sampling weights ensured nationally representative estimates.</div></div><div><h3>Results</h3><div>This study of NHANES 2011–2018 data (n = 17,391) revealed significantly higher prevalence of sleep disturbances among beta-blocker users versus non-users (46 % vs 29 %, <em>P</em> &lt; 0.001), an association that remained significant after adjustment (43 % vs 37 %, <em>P</em> &lt; 0.01). Notably, while users demonstrated longer median sleep duration (8 h vs 7 h) and higher proportion of ≥9 h sleepers (19.7 % vs 14.5 %), their sleep quality was significantly impaired, presenting a characteristic “sleep duration-quality paradox”. Subgroup analyses further identified particularly elevated risk among adults &lt;40 years (OR = 3.61, 95 %CI:2.05–6.34), physically active individuals, and non-diabetic patients.</div></div><div><h3>Conclusions</h3><div>This study establishes beta-blockers as an independent risk factor for sleep disturbances (29 % increased risk) while paradoxically prolonging sleep duration at the expense of sleep quality. The high-risk triad (adults &lt;40 years, physically active individuals, and non-diabetic patients) warrants prioritized sleep monitoring in clinical practice.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"189 ","pages":"Pages 316-324"},"PeriodicalIF":3.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366440","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":"Maladaptive beliefs, dissociation, and suicidal ideation in people with PTSD: Results from a national survey in Japan","authors":"Hong Wang Fung ,&nbsp;Chak Hei Ocean Huang ,&nbsp;Po-Han Chou ,&nbsp;Grace Wing Ka Ho ,&nbsp;Miyuki Makino ,&nbsp;Hironori Kuga ,&nbsp;Masaru Horikoshi ,&nbsp;Masaya Ito","doi":"10.1016/j.jpsychires.2025.06.030","DOIUrl":"10.1016/j.jpsychires.2025.06.030","url":null,"abstract":"<div><div>Suicide is a major public health concern and people with post-traumatic stress disorder (PTSD) are at a higher risk of engaging in suicidal behaviors. Less is known about the factors that predict suicidal ideation in people with PTSD, especially in non-Western contexts. To test the hypothesis that post-traumatic maladaptive beliefs and dissociative symptoms would predict suicidal ideation, we analyzed data from the National Survey for Stress and Health in Japan. A total of 712 participants with probable PTSD who provided data at two time points, four months apart, were included for analysis. After controlling for age, gender, depressive symptoms, and baseline suicidal ideation, post-traumatic maladaptive beliefs (β = .090, <em>p</em> = .016) and dissociative symptoms (β = .080, <em>p</em> = .025), but not PTSD symptoms (β = .038, <em>p</em> = .323), predicted suicidal ideation at follow-up. The findings point to the potential importance of early interventions for maladaptive beliefs and dissociative symptoms in people with PTSD in order to reduce suicide risks.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"189 ","pages":"Pages 280-284"},"PeriodicalIF":3.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322586","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":"Characteristics of and treatment outcome in inpatients with emetophobia and other specific phobias","authors":"Adrian Meule ,&nbsp;Eva M. Zisler ,&nbsp;Michael S. Metzner ,&nbsp;Ulrich Voderholzer ,&nbsp;David R. Kolar","doi":"10.1016/j.jpsychires.2025.06.028","DOIUrl":"10.1016/j.jpsychires.2025.06.028","url":null,"abstract":"<div><div>Emetophobia refers to a fear that oneself or others might vomit and is classified as a specific phobia in current diagnostic manuals. However, it is a relatively unknown and understudied mental disorder. Although it has been speculated that emetophobia might differ from other specific phobias (e.g., in terms of severity), studies on this are virtually non-existent. Thus, this retrospective study analyzed data at admission and discharge from 70 persons with emetophobia and 40 persons with other specific phobias who received a cognitive behavioral therapy-oriented, multimodal inpatient treatment (76.4 % female; mean age 22.7 years, <em>SD</em> = 12.4). Nearly 80 % of persons with emetophobia were female, more than half were adolescents and underweight, and the most common comorbid mental disorders were other anxiety disorders and depression. Compared to inpatients with other specific phobias, persons with emetophobia were younger, had a lower body weight, had higher phobic anxiety, and reported lower life satisfaction at admission. Across both groups, body weight increased with a small effect size and anxiety-related, depressive, and general psychopathology decreased and life satisfaction increased with medium-to-large effect sizes. In conclusion, the current study replicates findings about certain features of persons with emetophobia and is the first study that documents differences between persons with emetophobia and persons with other specific phobias, indicating that emetophobia partially represents a more severe type of specific phobia. Despite these differences, persons with emetophobia and persons with other specific phobias achieve similar and substantial symptom reductions during a multimodal inpatient treatment.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"189 ","pages":"Pages 285-290"},"PeriodicalIF":3.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322587","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":"A cross-lagged panel analysis of giving and receiving social support and anxiety among healthcare workers during the COVID-19 pandemic","authors":"Mary O. Smirnova,&nbsp;Anna C. Cole,&nbsp;Cynthia L. Lancaster","doi":"10.1016/j.jpsychires.2025.06.020","DOIUrl":"10.1016/j.jpsychires.2025.06.020","url":null,"abstract":"<div><div>During the pandemic, rates of anxiety among healthcare workers increased dramatically. Social support may be a promising strategy for buffering against anxiety under stress. For example, receiving support has been bidirectionally associated with lower stress reactivity. In contrast to receiving support, little is known about the impact of giving support. Therefore, we tested the bidirectional associations of giving and receiving support with anxiety among healthcare workers during the pandemic. We recruited 190 U.S. healthcare workers who completed measures of giving social support, receiving social support, and state anxiety at baseline (April–May 2020), one-month, and six-month follow-up. We used a three-wave, cross-lagged panel design to test for bidirectional and unidirectional relationships. Both giving and receiving support were associated with lower anxiety, but the direction of the relationship differed. Giving support at baseline predicted lower anxiety one month later. In contrast, lower anxiety at baseline predicted higher received support one month later. Notably, these relationships were present from baseline to 1-month follow-up, but not 1-month to 6-month follow-up, suggesting that the effects were most pronounced during the acute, rather than prolonged adjustment period. In sum, findings suggest that giving support may be a promising strategy for reducing anxiety. Reducing anxiety, in turn, may increase access to social support resources. Therefore, support-giving interventions, such as acts of kindness interventions, may be a promising pathway for buffering against anxiety under stress.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"189 ","pages":"Pages 311-315"},"PeriodicalIF":3.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144329784","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":"Empirically informed symptom severity cutoffs for body dysmorphic disorder","authors":"David Mataix-Cols ,&nbsp;Philip Andersson ,&nbsp;Daniel Rautio ,&nbsp;Oskar Flygare ,&nbsp;Jennifer L. Greenberg ,&nbsp;Susanne S. Hoeppner ,&nbsp;Hilary Weingarden ,&nbsp;Amita Jassi ,&nbsp;Benedetta Monzani ,&nbsp;Eric Hollander ,&nbsp;David Castle ,&nbsp;Georgina Krebs ,&nbsp;Susan L. Rossell ,&nbsp;Sabine Wilhelm ,&nbsp;Christian Rück ,&nbsp;Katharine A. Phillips ,&nbsp;Lorena Fernández de la Cruz ,&nbsp;Matti Cervin","doi":"10.1016/j.jpsychires.2025.06.019","DOIUrl":"10.1016/j.jpsychires.2025.06.019","url":null,"abstract":"<div><h3>Background</h3><div>Symptom severity cutoffs for body dysmorphic disorder (BDD) are lacking, hindering communication between professionals and with the patient community.</div></div><div><h3>Method</h3><div>We pooled data from 11 clinical trials or high-quality cohort studies from specialist clinics, totaling 804 individuals with BDD (80 % girls/women, 67 % adults). All participants had baseline scores on the adult or adolescent versions of the Yale-Brown Obsessive-Compulsive Scale Modified for BDD (BDD-YBOCS) and the Clinical Global Impressions–Severity scale (CGI-S). Receiver-operating characteristic analyses were used to identify BDD-YBOCS severity cutoffs, using the CGI-S as the benchmark measure. The classification performance of the cutoffs was evaluated in a holdout sample, consisting of 20 % of randomly selected participants.</div></div><div><h3>Results</h3><div>No participants had subclinical symptoms and the cutoff for clinical versus subclinical cases was not computed. A BDD-YBOCS score ≥24 distinguished moderate from mild cases (area under the curve [AUC] = 0.72 [0.64–0.81]; accuracy: 77 %), a score ≥30 distinguished severe from moderate cases (AUC = 0.83 [0.90–0.87]; accuracy: 77 %), and a score ≥37 distinguished extreme from severe cases (AUC = 0.82 [0.77–0.87]; accuracy: 80 %). The classification performance of the cutoffs was modest in the holdout sample (62 %), but consistent cutoffs were found across sexes/genders, age groups (children and adults), and participants from Europe and the United States.</div></div><div><h3>Conclusion</h3><div>These BDD-YBOCS severity cutoffs can be used for clinical and research purposes across different populations but should not be used as the sole basis for important clinical decisions affecting individual patients. The boundary between subclinical and clinical BDD will require further study.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"189 ","pages":"Pages 382-387"},"PeriodicalIF":3.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144491964","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}