Journal of psychiatric research最新文献

{"title":"Escitalopram treatment for patients with major depressive disorder: decision trees for treatment algorithm","authors":"Xuequan Zhu ,&nbsp;Rou Zhong ,&nbsp;Xu Chen ,&nbsp;Lei Feng ,&nbsp;Yuan Feng ,&nbsp;Ling Zhang ,&nbsp;Gang Wang","doi":"10.1016/j.jpsychires.2026.02.001","DOIUrl":"10.1016/j.jpsychires.2026.02.001","url":null,"abstract":"<div><h3>Background</h3><div>Current treatment algorithms for major depressive disorder (MDD) lack dynamic prediction capabilities, leading to delayed therapeutic adjustments. This study sought to develop escitalopram-specific decision tree models to identify critical treatment adjustment time points and optimize personalized treatment strategies for MDD.</div></div><div><h3>Methods</h3><div>Using longitudinal data from two multicenter studies in China (2015–2020), we analyzed 800 patients with MDD receiving escitalopram monotherapy. Decision tree models incorporated baseline characteristics (age, BMI, disease duration, depressive symptoms) and dynamic treatment parameters (dose, 2-/4-week improvement) to predict full response (&gt;50% symptom reduction) or non-full response (≤50% reduction) at weeks 2 and 4, and remission status (QIDS-SR16≤5 vs. &gt;5) at week 8. Model performance was assessed by accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC).</div></div><div><h3>Results</h3><div>The week 2 model (n = 800) identified BMI, age, disease duration, course and baseline symptom severity as primary predictors (accuracy = 61.88%, NPV = 84.04%). By week 4 (n = 650), early response status (week 2) merged as a key predictor (accuracy = 69.23%, NPV = 71.62%). The week 8 model (n = 456) demonstrated enhanced predictive power, driven by life quality score, week 2/4 response status, and week 4 dosage (accuracy = 78.02%, PPV = 81.48%, NPV = 72.97%). Logistic regression confirmed week 4 response status as a significant predictor of week 8 outcome (p &lt; 0.005).</div></div><div><h3>Conclusions</h3><div>Week 4 emerges as a key decision point for escitalopram-treated MDD patients, where integration of baseline profiles, early response patterns, and dose parameters allows timely intervention. Our decision tree framework offers a methodological approach for dynamic decision points that warrant prospective validation and extension to other antidepressants.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"195 ","pages":"Pages 284-290"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132158","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":"Reality monitoring across disorders of reality: Systematic and narrative reviews of dissociation and psychosis","authors":"Gwynnevere Suter ,&nbsp;Ian Apperly ,&nbsp;Lei Zhang ,&nbsp;Emma Černis","doi":"10.1016/j.jpsychires.2026.01.021","DOIUrl":"10.1016/j.jpsychires.2026.01.021","url":null,"abstract":"<div><div>Reality monitoring is the ability to remember whether information was internally- or externally-generated and is often impaired in clinical populations. Though an altered sense of reality characterizes both dissociation and psychosis, no review has compared reality monitoring between them. This paper compares these fields to inform the relation between dissociation and psychosis and the role of reality monitoring in mental health.</div><div>First, a systematic review identified four eligible high-quality papers (according to Kmet and Lee's Quantitative Checklist; <em>n</em> = 482) which measured dissociation directly and tested reality monitoring experimentally. Meta-analysis indicated a small significant negative association between reality monitoring and dissociation (Correlation = −0.013, [-0.22, −0.04]), implying reality monitoring impairment in dissociation. Papers were identified from inception to May 15, 2025 through searching Web of Science, Scopus, PsycINFO, PsycARTICLES, EMBASE, and MEDLINE.</div><div>Next, a narrative review of psychosis and reality monitoring, covering pre-existing systematic reviews and original articles, indicated variation across the clinical spectrum. While clinical psychosis was robustly associated with impaired reality monitoring ability and externalising bias, results at non-clinical and sub-clinical levels were mixed.</div><div>Finally, the reviews were compared to understand how reality monitoring and research practices vary across dissociation and psychosis. This indicated that both dissociation and psychosis are associated with impaired reality monitoring. Though this suggests a shared cognitive basis, no papers on dissociation included clinical presentations or bias towards internalising/externalising the item's source, meaning any comparison is incomplete. Future research should consider clinical dissociation, reality monitoring bias in dissociation, and compare dissociation and psychosis directly.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"195 ","pages":"Pages 21-30"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030046","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":"Using contemporary psychometric methods to construct a concise version of the psychological strain scale","authors":"Xiaoyan Yuan ,&nbsp;Mengyun Hu ,&nbsp;Lianhui Wei ,&nbsp;Duojie Pengmao ,&nbsp;Xuekun Zhang ,&nbsp;Jie Zhang","doi":"10.1016/j.jpsychires.2026.01.044","DOIUrl":"10.1016/j.jpsychires.2026.01.044","url":null,"abstract":"<div><h3>Objective</h3><div>To develop a concise version of the Psychological Strain Scale (PSS-40) by integrating Classical Test Theory (CTT) and Item Response Theory (IRT).</div></div><div><h3>Methods</h3><div>PSS-40 was applied to measure the psychological strain in a total of 10478 college students. The demographic information was collected by a self-designed questionnaire. The analysis of PSS-40 items was conducted using classical measurements including variability, correlation coefficient, factor analysis, Cronbach coefficient, as well as the Samejima graded response model from IRT. IRT parameters include discrimination, difficulty, average information volume, etc.</div></div><div><h3>Results</h3><div>20 items with the highest comprehensive evaluation of PSS-40 were selected based on methods combined CTT and IRT. Exploratory factor analysis revealed that each item in PSS-20 had a standardized factor loading greater than 0.6, and the cumulative variance explained exceeded 66 %. Additionally, confirmatory factor analysis showed good fit of the model (RMESA = 0.057, RMR = 0.028). PSS-20 exhibited excellent reliability with a Cronbach's alpha coefficient of 0.939 and criterion validity of 0.558.</div></div><div><h3>Conclusions</h3><div>The PSS-20 scale has been validated to have good reliability and validity, and can be used as a tool to evaluate psychological strain.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"195 ","pages":"Pages 291-298"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132117","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":"Selective serotonin re-uptake inhibitor use and risk of gastrointestinal bleeding in aspirin users","authors":"Yihui He ,&nbsp;Xin Zhang ,&nbsp;Qixuan Luo ,&nbsp;Yitian Chen ,&nbsp;Ziting Gao ,&nbsp;Hongye Wei ,&nbsp;Yajing Wei ,&nbsp;Ziyi Qiu ,&nbsp;Wuqing Huang","doi":"10.1016/j.jpsychires.2025.12.038","DOIUrl":"10.1016/j.jpsychires.2025.12.038","url":null,"abstract":"<div><h3>Background and objective</h3><div>Both aspirin and selective serotonin reuptake inhibitors (SSRIs) have been linked to an increased risk of gastrointestinal (GI) bleeding, while the interaction between the combined use of these two drugs on GI bleeding remains unclear. We aimed to explore the association between SSRIs use and risk of GI bleeding among aspirin users.</div></div><div><h3>Methods</h3><div>This is a prospective cohort study of 12,712 new aspirin users with a history of ischemic cardiovascular disease from the UK Biobank. Information on aspirin or SSRIs prescriptions was retrieved from primary care records, and GI bleeding data from hospital inpatient admissions. A competing risk model was used to calculate hazard ratios (HRs) and 95 % confidence intervals (CIs).</div></div><div><h3>Results</h3><div>The incidence rate was 7.44 and 4.99 per 1000 person-years in the group of SSRIs and non-SSRIs use, respectively. A significant positive association was observed between SSRIs use and GI bleeding risk among aspirin users (Adjusted HR,1.27; 95 % CI, 1.01–1.58). The observed association was more pronounced in younger adults, females, individuals with a history of GI bleeding or those using PPIs. Besides, the association varied across different types of SSRIs, with paroxetine users showing the highest risk of GI bleeding (Adjusted HR, 1.73; 95 % CI, 1.06–2.83).</div></div><div><h3>Conclusion</h3><div>This study indicated an additional risk of GI bleeding associated with SSRIs use in aspirin users, especially when combining paroxetine with aspirin. This finding underscores the necessity for further investigation into the differential risks of specific SSRIs to guide personalized polypharmacy.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"194 ","pages":"Pages 51-57"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145819870","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":"Are factors associated with death by suicide in people with borderline personality disorder modified by co-occurring depression?","authors":"Jillian H. Broadbear ,&nbsp;Jeremy Dwyer ,&nbsp;Mostafa Qorbani ,&nbsp;Emily Schembri ,&nbsp;Lyndal Bugeja ,&nbsp;Jason Webb ,&nbsp;Sathya Rao","doi":"10.1016/j.jpsychires.2025.12.033","DOIUrl":"10.1016/j.jpsychires.2025.12.033","url":null,"abstract":"<div><div>The diagnosis of Borderline Personality Disorder (BPD), which frequently co-occurs with depression, is known to have a high risk of death by suicide. This study explored the contribution of co-occurring depression to factors thought to contribute to death by suicide in people with BPD. Coronial data (2009–2016) included 291 suicide cases where BPD was formally diagnosed (221 with co-occurring depression and 70 without depression). These were compared with depression cases, matched by age, sex, region of usual residence and year of death. The most notable differences were evident between BPD cases (regardless of co-occurring depression) and depression only comparators. These differences included greater prevalence of substance use disorder, psychotic disorders, and anxiety disorders among BPD cases in comparison with depression only (p &lt; 0.05), with psychotic disorders diagnosed most frequently in BPD without depression cases. Service contacts were greater for BPD cases regardless of co-occurring depression, with a wider range of accessed services compared to depression-only cases (p &lt; 0.05) The only exception was for general practitioner contacts, which were lowest for BPD without depression cases. Family, legal, and abuse-related stressors were higher among BPD cases regardless of co-occurring depression. Despite clinical wisdom to the contrary, this evidence suggests that for people with co-occurring BPD and depression, BPD is the dominant condition shaping clinical presentation, service utilisation, and stressor-related experiences prior to death by suicide. The current focus on prioritising depression treatment in people with co-occurring BPD may overlook the broad range of additional suicide-related features associated with BPD.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"194 ","pages":"Pages 271-280"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966347","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 and risk factors of complex post-traumatic stress disorder in victims of intimate partner violence","authors":"Jia-Hui Hu ,&nbsp;Yun Zhou ,&nbsp;Ye Ye ,&nbsp;Fu-Jun Jia ,&nbsp;Cai-Lan Hou","doi":"10.1016/j.jpsychires.2026.01.015","DOIUrl":"10.1016/j.jpsychires.2026.01.015","url":null,"abstract":"<div><h3>Introduction</h3><div>The purpose of this study was to explore risk factors of ICD-11 complex post-traumatic stress disorder (CPTSD) among intimate partner violence (IPV) victims in China.</div></div><div><h3>Methods</h3><div>We conducted a combination of online and offline surveys of trauma exposure, mental health problems, and psychological factors among IPV victims in hospitals and on social media. A total of 170 participants who had experienced IPV were collected.</div></div><div><h3>Results</h3><div>According to the International Trauma Questionnaire (ITQ) results, CPTSD prevalence was 31.2 % and PTSD prevalence was 17.1 %. In the one-way ANOVA analysis, the CPTSD group was significantly different from the PTSD and non-PTSD groups on almost all variables, such as anxiety, depression, attachment, personality, and social support. Multiple logistic regression showed that CPTSD was associated with more severe anxiety, higher levels of attachment anxiety, psychoticism (P), and neuroticism (N).</div></div><div><h3>Conclusion</h3><div>CPTSD was more common than PTSD among IPV victims, and the CPTSD group showed more severe and extensive mental health problems than the PTSD group and Non-CPTSD/PTSD group. In addition, attachment anxiety was considered to be the strongest factor of those mental and psychological factors. These findings may have intervention implications for IPV victims with CPTSD.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"194 ","pages":"Pages 242-251"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952116","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":"Discharge from mental health service admissions as a short-term causal risk factor for suicide: A case-crossover study","authors":"Kristoffer Bele Ødegård ,&nbsp;Martin Øverlien Myhre ,&nbsp;Ole Klungsøyr ,&nbsp;Lars Mehlum ,&nbsp;Anita Johanna Tørmoen ,&nbsp;Fredrik A. Walby","doi":"10.1016/j.jpsychires.2026.01.004","DOIUrl":"10.1016/j.jpsychires.2026.01.004","url":null,"abstract":"<div><h3>Background</h3><div>The month following discharge from inpatient mental health treatment is the period associated with the highest short-term risk of suicide. The nature of this risk is not well understood. We aim to assess a potential short term causal effect of discharge on suicide risk using a novel counterfactual framework for causal inference.</div></div><div><h3>Methods</h3><div>National registry linkage study with individuals 18 years or older who died by suicide from 1.1.2018 to 31.12.2022 and was discharged in the last year (N = 731). We used a Case-crossover design comparing risk at a case-time and five randomly selected control-times within subjects and employed the Mantel-Haenszel estimator.</div></div><div><h3>Results</h3><div>We found an effect of discharge on the Incidence Rate Ratio (IRR) for suicide within 14 days (IRR = 5.48 95 % CI:4.37–6.72). Comparing the first four weeks, the IRR was 6.32 (95 % CI 4.87–8.00) for the first week, with significantly reduced risk for subsequent weeks.</div></div><div><h3>Conclusion</h3><div>Our findings are consistent with a causal effect of discharge on short-term suicide risk, under the assumptions described and controlling for confounders not addressed in prior studies. Recognizing this risk as causal enhances our understanding of the suicides that happen shortly after discharge and emphasizes the importance of identifying realistic targets for intervention in the post discharge period, which can then be evaluated through clinical trials.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"194 ","pages":"Pages 174-180"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917841","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":"Latent profiles of affective temperaments can support differentiation of bipolar I disorder, bipolar II disorder, and major depressive disorder","authors":"Myeongkeun Cho ,&nbsp;Heejae Lee ,&nbsp;C. Hyung Keun Park","doi":"10.1016/j.jpsychires.2025.12.045","DOIUrl":"10.1016/j.jpsychires.2025.12.045","url":null,"abstract":"<div><h3>Background</h3><div>Differentiating bipolar I, bipolar II, and major depressive disorders is essential; therefore, the relationship between affective temperaments and mood disorder diagnoses has garnered considerable attention.</div></div><div><h3>Objectives</h3><div>This study aimed to explore the representative types of Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire (TEMPS-A) profiles and examine their associations with the proportions of bipolar I, bipolar II, and major depressive disorders.</div></div><div><h3>Methods</h3><div>Psychiatric outpatients diagnosed with bipolar I, bipolar II, or major depressive disorder and aged ≥18 years were analyzed. Latent profile analysis was conducted using TEMPS-A scores, and each patient was classified into a subgroup according to their TEMPS-A scores. After that, multinomial logistic regression was conducted to verify the relationship between TEMPS-A profiles and mood disorder diagnoses.</div></div><div><h3>Results</h3><div>The results indicated that the seven-profile model was the most appropriate. Furthermore, the <em>cyclothymic profile</em> and <em>anxious, cyclothymic and depressive profile</em> increased the likelihood of bipolar II disorder, while the <em>cyclothymic and hyperthymic profile</em>; <em>cyclothymic, depressive and irritable profile</em>; and <em>anxious, cyclothymic, hyperthymic and irritable profile</em> increased the likelihood of bipolar II and bipolar I disorders.</div></div><div><h3>Conclusion</h3><div>Cyclothymic temperament can be a risk factor for bipolarity. Moreover, hyperthymic or irritable temperaments might help differentiate between bipolar I and bipolar II disorders.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"194 ","pages":"Pages 79-84"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834244","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":"Clinicians’ perspectives on family-based therapy (FBT) and psychiatric medication for eating disorders","authors":"Brad A. MacNeil,&nbsp;Bailey Coon,&nbsp;Talia Gruber,&nbsp;Shainee Price,&nbsp;Magdalena Samela,&nbsp;Reece Sandercock,&nbsp;Emily Wilson","doi":"10.1016/j.jpsychires.2025.12.047","DOIUrl":"10.1016/j.jpsychires.2025.12.047","url":null,"abstract":"<div><div>This study examined clinicians’ perspectives of family-based therapy (FBT) and psychiatric medication, and whether they would recommend these for treating their own child or another family member if they had an eating disorder (ED). Participants were 80 clinicians (45 women, 35 men; <em>M</em>_<em>age</em> = 31.7 years) who completed an e-survey that included questions about their profession, whether they use FBT, training, and length of time providing it. Participants also reported their main theoretical orientation, whether they recommend FBT to their patients, and if they would recommend it to their own child or another family member. Approximately 42.5 % were physicians or psychiatrists, 30.1 % nurses or nurse practitioners, and 27.6 % therapists (e.g., psychologist, social worker etc.). The average amount of time they had been providing treatment for EDs was 4.38 years (<em>SD</em> = 1.09). Treatment settings included hospitals (45 %), community mental health (31.3 %), private practice (15 %), and residential treatment (8.8 %). Most participants were FBT trained (98.8 %) by in person workshop with supervision (46.8 %), in person workshop only (31.6 %), or other (21.6 %; online training, self-paced reading). Engagement in consultation or supervision for FBT was reported by 83.8 % of clinicians. All providers endorsed recommending FBT to their patients or another family member if they had an ED, whereas 88.8 % would recommend it for their own child. A considerable proportion of clinicians (96.3 %) would agree to start their own family member on psychiatric medication if they had an ED. These results have important implications for training and dissemination of the FBT.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"194 ","pages":"Pages 85-89"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145856597","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":"Alterations in white matter integrity and asymmetry in children with autism spectrum disorder: an automated fiber quantification tractography study","authors":"Dan Luo ,&nbsp;Chunfeng Zhao ,&nbsp;Lisha Nie ,&nbsp;Yu Yin ,&nbsp;Xiaoqing Liu ,&nbsp;Haoyue Yu ,&nbsp;Fuqin Wang ,&nbsp;Heng Chen ,&nbsp;Heng Liu","doi":"10.1016/j.jpsychires.2026.01.018","DOIUrl":"10.1016/j.jpsychires.2026.01.018","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate microstructural and lateralization abnormalities of white matter (WM) in children with autism spectrum disorder (ASD) using automated fiber quantification tractography, assess their relationship with behavioral symptoms, and analyze developmental trajectories of WM tracts with age.</div></div><div><h3>Materials and methods</h3><div>This study analyzed diffusion tensor imaging data of 36 children with ASD (mean age, 5.44 ± 0.95 years; male:female, 28:8) and 27 healthy controls (mean age, 5.06 ± 1.83 years; male:female, 17:10) using automated fiber quantification. A support vector machine (SVM) classifier was applied to distinguish ASD from healthy controls (HC) based on WM metrics.</div></div><div><h3>Results</h3><div>ASD children exhibited local WM abnormalities, atypical lateralization, and impaired age-related development of WM. The callosum forceps major (CF_major) and left inferior longitudinal fasciculus impairments correlated with social impairments, while CF_major and right thalamic radiation impairments correlated with repetitive behaviors. The cingulum cingulate was atypically lateralized and negatively correlated with the Childhood Autism Rating Scale. SVM classification based on WM metrics achieved 75 % accuracy (AUC = 0.81) in distinguishing ASD from HC.</div></div><div><h3>Conclusions</h3><div>Children with ASD show subtle microstructural abnormalities, atypical lateralization patterns, and delayed development of WM tracts, correlated with behavioral symptoms. SVM classification supports the discriminative utility of WM metrics as potential ASD biomarkers.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"194 ","pages":"Pages 312-320"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978075","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}