Journal of psychiatric research最新文献

{"title":"Plausible therapeutic effects of melatonin and analogs in the dopamine-associated pathophysiology of bipolar disorder","authors":"Laurence S. Pe ,&nbsp;Kristine Cate S. Pe ,&nbsp;Jiraporn Panmanee ,&nbsp;Piyarat Govitrapong ,&nbsp;Jenq-Lin Yang ,&nbsp;Sujira Mukda","doi":"10.1016/j.jpsychires.2024.12.046","DOIUrl":"10.1016/j.jpsychires.2024.12.046","url":null,"abstract":"<div><div>Bipolar disorder (BD) is a significant neuropsychiatric condition characterized by marked psychological mood disturbances. Despite extensive research on the symptomatology of BD, the mechanisms underlying its development and presentation remain unknown. Consequently, potential treatments are limited, and existing medications often cause significant side effects, leading to treatment discontinuation. Dopamine (DA) has been implicated in behavioral regulation, reward systems, and mood, highlighting the importance of the dopaminergic system in BD. Elevated levels of DA and tyrosine hydroxylase are associated with the onset of manic episodes, whereas reduced levels are linked to the depressive phase. Additionally, endogenous melatonin (MEL) levels are considerably lower in patients with BD. When administered as a treatment, exogenous MEL and MEL agonists improve behavioral characteristics and significantly modulate DA-related pathophysiological pathways in BD, with minimal adverse effects achieved through MEL receptor activation. Moreover, MEL and MEL agonists offer neuroprotection by promoting physiological homeostasis during disruption. The aim of this review is to investigate and propose MEL receptors as potential novel therapeutic targets for BD. This review seeks to analyze the role of MEL and its agonists in modulating dopamine-related pathophysiological pathways, improving behavioral outcomes, and providing neuroprotection with minimal side effects.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"182 ","pages":"Pages 13-20"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965411","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":"Imagery rehearsal therapy for the treatment of nightmares in individuals with borderline personality disorder – A pilot study","authors":"Clara Sayk ,&nbsp;Nicole Koch ,&nbsp;Janine Stierand ,&nbsp;Felix Timpe ,&nbsp;Hong-Viet V. Ngo ,&nbsp;Ines Wilhelm ,&nbsp;Klaus Junghanns","doi":"10.1016/j.jpsychires.2024.12.044","DOIUrl":"10.1016/j.jpsychires.2024.12.044","url":null,"abstract":"<div><div>Insomnia and nightmares are present in up to 45 % of individuals with borderline personality disorder (BPD) and can contribute to challenges with emotion regulation, low sleep quality, dream anxiety, increased arousal and self-control. Despite their prevalence, nightmares are usually not addressed in classical BPD treatment. Imagery rehearsal therapy (IRT) is considered first in line treatment for nightmares, however, there are no studies to date that investigate its effects in individuals with BPD. Here we investigated a) whether IRT can be used to treat nightmares in individuals with BPD and b) whether there is an additional benefit of the intervention on symptoms associated with BPD. In a between-subjects design, 22 individuals with BPD completed eight sessions of group-IRT as an add-on to their inpatient treatment and were compared to 22 gender and age matched control participants regarding nightmares, trauma, depression and anxiety symptoms. Nightmare symptoms improved significantly during the intervention as indicated by subjective ratings. Moreover, participants in the IRT group showed a more pronounced decrease in intrusions, hyperarousal and anxiety compared to the control group. This pilot study gives a first glimpse into the feasibility and benefits of imagery rehearsal therapy in individuals with BPD. Our findings suggest that IRT may not only help treat nightmare symptoms but also reduce anxiety and trauma symptoms in BPD. Future studies should include randomized controlled trials of IRT in individuals with BPD with larger sample sizes and polysomnography in both groups.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"182 ","pages":"Pages 34-41"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971400","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":"Marriage and postpartum major depressive disorder: A systematic review and meta-analysis of cohort studies","authors":"Meng Wei ,&nbsp;Yan Qin ,&nbsp;Xingmeng Niu ,&nbsp;Sifang Niu ,&nbsp;Fuqin Mu ,&nbsp;Lu Yang ,&nbsp;Ying Li ,&nbsp;Ying Zhang ,&nbsp;JianLi Wang ,&nbsp;Yan Liu","doi":"10.1016/j.jpsychires.2025.01.004","DOIUrl":"10.1016/j.jpsychires.2025.01.004","url":null,"abstract":"<div><div>Many studies have explored the relationships between demographic variables and postpartum major depressive disorder. However, there is no clear conclusion on the impact of different marital statuses and quality on postpartum major depressive disorder. This systematic review and meta-analysis examined the combined effects of different marital status and quality on postpartum major depressive disorder with cohort studies. Two authors independently searched 6 English databases (PubMed, Medline, Web of Science, PsycARTICLES, EBSCOhost and Scopus) and 3 Chinese databases (China Knowledge Resource Integrated Database (CNKI), Weipu database and Wanfang database) from the beginning of database construction to October 25, 2024. Studies that met the inclusion criteria included maternal diagnosis of postpartum major depressive disorder by clinical diagnostic criteria, inclusion of marital status, and reporting risk estimate. There were no language limitations in this study. The quality of the included studies was assessed using the Newcastle-Ottawa scale (NOS). Publication bias was assessed using a funnel plot and Egger's test. Finally, nineteen cohort studies were included in this meta-analysis. Low marital satisfaction was the most significant predictor of postpartum major depressive disorder (pooled RR = 3.47, 95% CI: 1.96, 6.12) followed by being single/divorced/separated/widowed/unmarried (pooled RR = 1.19, 95% CI: 1.02, 1.39). However, there was not a significant relationship between “worsening relationship/dissatisfaction with partner/problems in marital relationship” and postpartum major depressive disorder (pooled RR = 2.30, 95% CI:0.69, 7.62) yet. Marital status and marriage quality impacted heavily on maternal postpartum major depressive disorder. There is an urgent need to focus on family therapy and marital intervention for pregnant women and to enhance the sense of involvement of the husband or partner.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"182 ","pages":"Pages 83-91"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971402","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":"Enhancing prediction of major depressive disorder onset in adolescents: A machine learning approach","authors":"Devon LoParo ,&nbsp;Ana Paula Matos ,&nbsp;Eiríkur Örn Arnarson ,&nbsp;W. Edward Craighead","doi":"10.1016/j.jpsychires.2025.01.007","DOIUrl":"10.1016/j.jpsychires.2025.01.007","url":null,"abstract":"<div><div>Major Depressive Disorder (MDD) is a prevalent mental health condition that often begins in adolescence, with significant long-term implications. Indicated prevention programs targeting adolescents with mild symptoms have shown efficacy, yet the methods for identifying at-risk individuals need improvement. This study aims to evaluate the utility of Partial Least Squares Regression (PLSR) in predicting the onset of MDD among non-depressed adolescents, compared to traditional screening methods. The study recruited 1462 Portuguese adolescents aged 13–16, who were assessed using various self-report measures and followed for two years. Participants were randomly divided into training (70%, N = 1023) and testing (30%, N = 439) samples. PLSR models were developed to predict the occurrence of a major depressive episode (MDE) within two years, using 331 variables. The model's performance was compared to the Children's Depression Inventory (CDI) in predicting MDE onset. The best-fitting PLSR model with two components explained 19.1% and 16.9% of the variance in the training and testing samples, respectively, significantly outperforming the CDI, which explained 7.7% of the variance. The area under the ROC curve was 0.78 for PLSR, compared to 0.71 for CDI. An empirically derived cut-off point was used to create dichotomous risk categories, and it showed a significant difference in MDE rates between predicted high-risk and low-risk groups. The balanced accuracy of the PLSR model was 0.77, compared to 0.65 for the CDI method. The PLSR model effectively identified adolescents at risk for developing MDD, demonstrating superior predictive power over the CDI. This study supports the potential utility of ML techniques (e.g., PLSR) in enhancing early identification and prevention efforts for adolescent depression.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"182 ","pages":"Pages 235-242"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007289","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":"SNORD3C, a blood biomarker associated to suicide attempts in patients with anorexia nervosa","authors":"Camille Verebi ,&nbsp;Nicolas Lebrun ,&nbsp;Philibert Duriez ,&nbsp;Lucie Adoux ,&nbsp;Benjamin Saint-Pierre ,&nbsp;Philip Gorwood ,&nbsp;Nicolas Ramoz ,&nbsp;Thierry Bienvenu","doi":"10.1016/j.jpsychires.2025.01.026","DOIUrl":"10.1016/j.jpsychires.2025.01.026","url":null,"abstract":"<div><div>Anorexia nervosa (AN) is a psychiatric disorder with a high heritability (h²∼70%). Despite extensive meta-analysis of genome-wide association studies, the molecular mechanisms underlying genetics of AN and its complications, particularly suicidal behavior, remain unclear. We performed mRNA sequencing on peripheral blood mononuclear cells from 15 patients with AN (5 with a lifetime history of suicide attempts and 10 without). After correcting for multiple testing, we identified dysregulation of several genes, and confirmed our findings in an independent cohort of 34 patients with AN. Our analysis revealed significant dysregulation of several genes, including <em>SNORD3C</em>, which is implicated in vitamin D metabolism. These genes were enriched in RNA metabolism and innate immune pathways. The presence of these dysregulated genes was associated with suicidal behavior in patients with AN. Our findings suggest that <em>SNORD3C</em> and other differentially expressed genes may serve as potential biomarkers for suicidal risk in AN. This study enhances our understanding of the biological pathways involved in the pathogenesis of suicidal behavior in AN, paving the way for future research and potential clinical applications.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"182 ","pages":"Pages 358-367"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029011","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":"Eyes on the body: Assessing attentional bias toward body-related stimuli in Anorexia Nervosa","authors":"Valentina Meregalli ,&nbsp;Serena Giovannini ,&nbsp;Alessia Trevisan ,&nbsp;Marco Romanelli ,&nbsp;Sanberk Ugur ,&nbsp;Elena Tenconi ,&nbsp;Paolo Meneguzzo ,&nbsp;Valentina Cardi ,&nbsp;Enrico Collantoni","doi":"10.1016/j.jpsychires.2025.01.043","DOIUrl":"10.1016/j.jpsychires.2025.01.043","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of the present study was to assess whether patients with Anorexia Nervosa (AN) presented an attentional bias toward pictures of other women's bodies, as this bias could implicitly promote self-other comparisons thus increasing body/weight concerns.</div></div><div><h3>Methods</h3><div>The sample included 48 healthy controls (HC) and 54 patients with AN. All participants performed a dot-probe task with pictures of bodies or body parts of underweight (UWB), normal weight (NWB) and overweight (OWB) women, while their gaze was recorded with an eye-tracking system. Two indices of attentional bias, a gaze direction bias and a gaze duration bias were extracted.</div></div><div><h3>Results</h3><div>The models conducted on both direction bias and duration bias showed a significant main effect of group, revealing a stronger attentional bias toward bodies in patients as compared to controls. One sample t-tests conducted on the direction bias of patients with AN revealed that they presented a significant positive bias at 500 ms toward all the bodies. At 1500 ms, instead, they presented a positive bias toward UWB and an avoidance bias of OWB. HC instead presented an initial avoidance of all body stimuli, and an avoidance of NWB and OWB at 1500 ms.</div></div><div><h3>Discussion</h3><div>Our results revealed a stronger attentional bias toward other women's bodies in patients than in HC. Moreover, patients presented a tendency to focalize their attention on UWB while they avoided maintaining their attention on OWB. This pattern might promote upward social comparisons, which are usually associated with negative self-evaluation and increased levels of body dissatisfaction.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"182 ","pages":"Pages 506-512"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143138430","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":"Cerebral blood flow differences in cognitive disengagement syndrome and attention deficit hyperactivity disorder: Doppler ultrasonography findings","authors":"Ahmet Kursat Karaman ,&nbsp;Enes Sarıgedik ,&nbsp;Osman Kamer Eryılmaz ,&nbsp;Meltem Küçükdağ ,&nbsp;İbrahim Feyyaz Naldemir","doi":"10.1016/j.jpsychires.2025.01.024","DOIUrl":"10.1016/j.jpsychires.2025.01.024","url":null,"abstract":"<div><h3>Objective</h3><div>The present study aims to investigate potential differences in cerebral blood flow between children with Cognitive Disengagement Syndrome (CDS) and those with Attention Deficit Hyperactivity Disorder (ADHD) using Doppler ultrasound.</div></div><div><h3>Methods</h3><div>In this single-center prospective study, we included 24 cases in the ADHD group with CDS symptoms, 29 cases in the ADHD group without CDS symptoms and, 26 children in the healthy controls. The children ranged in age from 6 to 15. Participants were evaluated by diagnostic interviews and standardized measures. Doppler ultrasound was performed to measure peak systolic velocity and blood flow volume (BFV) in the internal carotid (ICA) and vertebral arteries for each participant.</div></div><div><h3>Results</h3><div>The right ICA and total ICA BFVs were significantly lower in the CDS group compared to the ADHD and control groups (p = 0.007 and p = 0.003, respectively). In addition, there was a weak negative correlation between right ICA BFV and CDS scores, suggesting a possible link between reduced cerebral blood flow and CDS symptom severity.</div></div><div><h3>Conclusion</h3><div>This study provides a noteworthy starting point for research on the neurovascular basis of CDS. Our findings indicated significant differences in cerebral blood flow between CDS and ADHD, supporting the idea that CDS is a unique attentional disorder with distinct neurobiological characteristics from ADHD.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"182 ","pages":"Pages 161-165"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007276","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":"Subjective trauma perception as a Distinctive predictor of somatization and disability during the 2022 Russian invasion of Ukraine","authors":"Shir Mor-Ben-Ishai,&nbsp;Menachem Ben-Ezra,&nbsp;Yaira Hamama-Raz,&nbsp;Elazar Leshem,&nbsp;Yafit Levin","doi":"10.1016/j.jpsychires.2025.01.027","DOIUrl":"10.1016/j.jpsychires.2025.01.027","url":null,"abstract":"<div><h3>Objectives</h3><div>This study examines the association between the Subjective Traumatic Outlook (STO), somatization, and physical and mental aspects of disability during wartime in Ukraine. It highlights the STO's role in emphasizing the perceptual component of trauma as a screening tool, distinguishing somatic symptoms alongside physical and psychological disability.</div></div><div><h3>Method</h3><div>A national sample of 1895 Ukrainians affected by the Russian invasion completed the International Trauma Questionnaire (ITQ), the Somatic Symptom Scale-8 (SSS-8), the World Health Organization Disability Assessment Schedule (WHODAS), and the STO. Hierarchical multiple regression analysis was performed with STO as the dependent variable, controlling for age, sex, marital status, and ICD-11 PTSD/CPTSD symptoms.</div></div><div><h3>Results</h3><div>Findings indicate that STO is significantly associated with somatization and all six disability domains. These associations remain robust when controlling for demographic variables and the effects of ICD-11 PTSD/CPTSD symptoms, suggesting that STO independently contributes to these outcomes.</div></div><div><h3>Conclusion</h3><div>The STO shows promise as a screening tool for somatization and physical and psychological impairments. This study underscores the importance of evaluating individuals' subjective trauma experiences to better understand the severity of somatic symptoms and impairment during wartime. The findings emphasize the STO's potential as a concise, effective measure for clinicians, particularly in wartime contexts.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"182 ","pages":"Pages 284-289"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007341","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":"Clinical studies of blood-borne Extracellular vesicles in psychiatry: A systematic review","authors":"Mette Elise Tunset ,&nbsp;Hanne Haslene-Hox ,&nbsp;Jeanette Brun Larsen ,&nbsp;Daniel Kondziella ,&nbsp;Mona Nygård ,&nbsp;Sindre Andre Pedersen ,&nbsp;Arne Vaaler ,&nbsp;Alicia Llorente","doi":"10.1016/j.jpsychires.2025.01.037","DOIUrl":"10.1016/j.jpsychires.2025.01.037","url":null,"abstract":"<div><div>Biomarkers for the diagnosis and clinical management of psychiatric disorders are currently lacking. Extracellular vesicles (EVs), lipid membrane-encapsulated vesicles released by cells, hold promise as a source of biomarkers due to their ability to carry molecules that reflect the status of their donor cells and their ubiquitous presence in biofluids. This review examines the literature on EVs in biofluids from psychiatric disorder patients, and discuss how the published studies contribute to our understanding of the pathophysiology of these conditions and to the discovery of potential biomarkers.</div><div>We analyzed 46 studies on blood-borne EVs; no investigations on cerebrospinal fluid-derived EVs were found. A significant number of studies lacked optimal description of the methodology and/or characterization of the isolated EVs. Moreover, many studies aimed to capture brain-derived EVs, but often capture-proteins with low brain specificity were used. Considering biomarkers, miRNAs were the most investigated molecular type, but based on the studies analyzed it was not possible to identify robust biomarker candidates for the investigated disorders. Additionally, we describe the contribution of EV studies in illuminating the pathophysiology of psychiatric disorders, including research on insulin resistance, inflammation, mitochondrial dysfunction, and the microbiota.</div><div>We conclude that there is a shortage of studies with detailed methodology description and EV sample characterization in psychiatric research. To exploit the potential of EVs to investigate psychiatric disorders and identify biomarkers more studies and validated protocols using capture proteins with high specificity to brain cells are needed.</div><div>The review protocol was pre-registered in the PROSPERO database under the registration number CRD42021277534.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"182 ","pages":"Pages 373-390"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143039134","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":"Associations between minimally adequate treatment and clinical outcomes among Medicaid-enrolled youth with bipolar disorder","authors":"Elyse N. Llamocca ,&nbsp;Mary A. Fristad ,&nbsp;Guy Brock ,&nbsp;Danielle L. Steelesmith ,&nbsp;Ashley S. Felix ,&nbsp;Cynthia A. Fontanella","doi":"10.1016/j.jpsychires.2025.01.023","DOIUrl":"10.1016/j.jpsychires.2025.01.023","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate associations between minimally adequate treatment and clinical outcomes among youth with bipolar disorder.</div></div><div><h3>Methods</h3><div>This study utilized a retrospective cohort of publicly-insured (Medicaid) youth aged 10–18 years with a new bipolar disorder episode between 2009 and 2013 from 15 geographically diverse states. Four minimally adequate treatment measures were evaluated during a 180-day treatment period: 1) <em>Minimally Adequate Pharmacotherapy</em>: medication (mood stabilizer and/or atypical antipsychotic) possession ratio ≥80%<em>;</em> 2) <em>Minimally Adequate Psychotherapy:</em> ≥8 psychotherapy visits; 3) <em>Minimally Adequate Pharmacotherapy and Psychotherapy</em>, and 4) <em>Recommended Pharmacotherapy with No Antidepressant Monotherapy:</em> no antidepressant prescription without a mood stabilizer and/or atypical antipsychotic. Cox proportional hazards models examined associations between minimally adequate care and time to four clinical outcomes: bipolar disorder-related psychiatric hospitalization or emergency room (ER) visits, deliberate self-harm, and all-cause mortality. We estimated average treatment effects (ATE) using propensity score weighting with stabilized ATE weights to control for confounding.</div></div><div><h3>Results</h3><div>Hazard of hospitalization was increased among youth receiving minimally adequate psychotherapy (HR = 1.23 [95% CI: 1.04–1.44]) and both minimally adequate pharmacotherapy and psychotherapy (HR = 1.48 [95% CI: 1.12–1.96]) and decreased among youth receiving no antidepressant monotherapy (HR = 0.74 [95% CI: 0.62–0.88]). Hazard of ER visits was increased among youth receiving minimally adequate pharmacotherapy (HR = 1.38 [95% CI: 1.14–1.68]), minimally adequate psychotherapy (HR = 1.35 [95% CI: 1.13–1.61]), and both minimally adequate pharmacotherapy and psychotherapy (HR = 1.66 [95% CI: 1.24–2.24]).</div></div><div><h3>Conclusions</h3><div>Further research is needed to understand why receipt of minimally adequate care is positively associated with increased mental healthcare utilization among youth with new bipolar disorder episodes.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"182 ","pages":"Pages 497-505"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123165","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}