Journal of psychiatric research最新文献

{"title":"Autism characteristics in young patients with first episode of schizophrenia spectrum disorder: findings from a 2-year longitudinal research","authors":"Lorenzo Pelizza ,&nbsp;Antonio Federico ,&nbsp;Emanuela Leuci ,&nbsp;Emanuela Quattrone ,&nbsp;Derna Palmisano ,&nbsp;Simona Pupo ,&nbsp;Giuseppina Paulillo ,&nbsp;Clara Pellegrini ,&nbsp;Pietro Pellegrini ,&nbsp;Marco Menchetti","doi":"10.1016/j.jpsychires.2025.04.041","DOIUrl":"10.1016/j.jpsychires.2025.04.041","url":null,"abstract":"<div><h3>Purpose</h3><div>The PANSS Autism Severity Score (PAUSS) is a recent popular measure of autistic characteristics in Schizophrenia Spectrum Disorders (SSD). Evidence on its factor structure, longitudinal course, and treatment response is poor. The main aims of this investigation were: to examine its internal consistency and factor configuration in young patients with first-episode SSD treated in an Early Intervention (EI) service, and to compare clinical outcomes between SSD individuals with or without “autistic features” across 2 years of follow-up, as well as their treatment response.</div></div><div><h3>Methods</h3><div>SSD participants completed the Positive And Negative Syndrome Scale (PANSS), the Global Assessment of Functioning (GAF), and the Health of the Nation Outcome Scale (HoNOS) across the follow-up. Statistical tests included the α statistic, Exploratory Factor Analysis, Kaplan-Meyer survival analysis, mixed-design ANOVA, and multiple linear regression analysis.</div></div><div><h3>Results</h3><div>170 SSD individuals were enrolled (58 [34.1 %] scoring above the PAUSS cut-off [PAUSS+]). Internal consistency of the PAUSS was acceptable (α = .792). EFA identified a 3-factor model. At baseline, PAUSS + individuals showed greater severity in psychopathology and social decline. Across the follow-up, PAUSS + individuals had lower incidence rates of symptomatic remission. No PAUSS long-term stability was found, but a significant reduction that was predicted by lower antipsychotic dosage and higher number of case management sessions offered along the follow-up.</div></div><div><h3>Conclusions</h3><div>The PAUSS seems to capture a SSD subgroup characterized by higher baseline severity levels in psychopathology and poorer outcomes.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"186 ","pages":"Pages 407-415"},"PeriodicalIF":3.7,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891097","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":"Reply to letter to the editor: It is not yet proven that xanomeline-trospium chloride is effective in the treatment of schizophrenia.","authors":"Artur Menegaz de Almeida, Fernanda Moraes Tamashiro, Maria Eduarda Cavalcanti Souza, Iasmin Isabelli Luiz Silvério, Celso de Almeida Souza Miranda, Ítalo Barros Andrade, Michele Kreuz, Francisco Cezar Aquino de Moraes, Francinny Alves Kelly","doi":"10.1016/j.jpsychires.2025.04.040","DOIUrl":"https://doi.org/10.1016/j.jpsychires.2025.04.040","url":null,"abstract":"","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004895","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":"Pretreatment anhedonia as a predictor of exposure-based anxiety treatment outcomes","authors":"Matthew Mattoni ,&nbsp;Iris Ka-Yi Chat ,&nbsp;Lily A. Brown ,&nbsp;Marin Kautz","doi":"10.1016/j.jpsychires.2025.04.036","DOIUrl":"10.1016/j.jpsychires.2025.04.036","url":null,"abstract":"<div><div>Reward processes can reinforce extinction learning and aide cognitive processes involved with inhibitory learning. Anhedonia, characterized by deficits in reward incentivization, hedonic response, and learning, may therefore predict worse treatment outcomes. The current study examined associations between pretreatment self-reported anhedonia and several measures of anxiety symptom severity and treatment outcomes in a naturalistic exposure-based treatment setting. We used multilevel models to examine the relationship between pretreatment anhedonia with change in general treatment response and disorder-specific symptoms for obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD), social anxiety disorder (SAD), and panic disorder (PD). Consistent with hypotheses, pretreatment anhedonia severity was associated with higher pretreatment anxiety symptom severity across all measures. However, inconsistent with hypotheses, higher anhedonia scores were associated with greater symptom improvement across treatment for OCD, GAD, and PD, and had no significant relationships with diagnosis-general outcome measures, PTSD symptoms, or SAD symptoms. In sensitivity analyses including number of sessions, higher anhedonia was associated with more sessions across treatment and anhedonia no longer significantly predicted OCD or GAD treatment outcomes when controlling for treatment dose. Together, findings suggest that individuals with higher pretreatment anhedonia still respond to exposure therapy for anxiety disorders, but may require more sessions. More broadly, results highlight challenges in translating laboratory research to naturalistic clinical settings and the need for intensive longitudinal studies that can assess the role of reward processes in exposure therapy.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"186 ","pages":"Pages 305-312"},"PeriodicalIF":3.7,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868691","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 change in insomnia on change in pandemic paranoia: a longitudinal moderated-mediation model in an international sample","authors":"Eric M.J. Morris ,&nbsp;Jessica Kingston ,&nbsp;Lyn Ellett ,&nbsp;Tania Lincoln ,&nbsp;Brandon A. Gaudiano ,&nbsp;Suzanne H. So","doi":"10.1016/j.jpsychires.2025.04.042","DOIUrl":"10.1016/j.jpsychires.2025.04.042","url":null,"abstract":"<div><div>The impact of mistrust of others during a pandemic is an important consideration for public health interventions. Pandemic paranoia is a particular form of persecutory thinking characterised by mistrust and suspicion towards other people specifically due to a pandemic. Pandemic paranoia is heightened among those with a persecutory thinking tendency. We examined the longitudinal relationship between insomnia and pandemic paranoia, with anxiety, depression, and worry as mediators and persecutory thinking as moderator. A longitudinal online survey design was utilized involving an international sample (N = 715) across two timepoints, 12 weeks apart. A moderated mediation model was tested, assessing the effect of change in insomnia on change in pandemic paranoia with changes in anxiety, depression and worry as mediators. The effect of persecutory thinking as a moderator was then tested on the above paths in relation to insomnia. Changes in insomnia predicted changes in pandemic paranoia. Change in anxiety was a significant mediator of insomnia's effects on pandemic paranoia: this indirect pathway was moderated by persecutory thinking. Changes in worry and depression were not significant mediators. Our findings indicate that insomnia influences pandemic paranoia, indirectly through anxiety; persecutory thinking plays a consequential role in these relationships. These findings suggest that special attention should be given to mitigation efforts during pandemics to promote sleep health in individuals with pre-existing vulnerabilities, such as persecutory thinking styles.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"186 ","pages":"Pages 341-347"},"PeriodicalIF":3.7,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874123","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":"Young people's social withdrawal intention during COVID-19 in Hong Kong: A three-wave longitudinal study","authors":"Tim M.H. Li ,&nbsp;Shimin Zhu ,&nbsp;Paul W.C. Wong","doi":"10.1016/j.jpsychires.2025.04.034","DOIUrl":"10.1016/j.jpsychires.2025.04.034","url":null,"abstract":"<div><div>Worldwide physical distancing measures and lockdowns might have triggered and normalised <em>hikikomori</em> or prolonged social withdrawal behaviour especially among young people. The study aimed to examine the potential contributing COVID-related, psychological, family and school factors that related to one's intention to social withdrawal among young people during semi-lockdowns in Hong Kong. A three-wave longitudinal survey was conducted between June 2020 and June 2021. Mixed-effects logistic regression analyses were performed to investigate the association of COVID-related, psychological, and family and school factors with social withdrawal intention. 632 young people aged 10–20 years from 11 schools completed baseline and follow-up measures. The response rate was 83.05 %. At follow-ups, 39.40 % of the respondents reported to have social withdrawal intention. 37.18 % of the respondents felt helpless about COVID-19. The regression models showed loneliness, mother working from home, and hopelessness about COVID-19 at baseline were positive associated with persistent social withdrawal intention at follow-ups. Father working from home at baseline, better school bonding, and better family environment at the second wave were negatively associated with social withdrawal intention. Early identification of young people with poor psychological well-being, especially loneliness, and intention for being socially withdrawn should become a prioritised research and service focus in the post-COVID-19 period.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"186 ","pages":"Pages 314-321"},"PeriodicalIF":3.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868692","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":"Mental disorders and sexual orientation in college students across 13 countries of differing levels of LGBTQ+ acceptance","authors":"Roberto Rentería ,&nbsp;Claes Andersson ,&nbsp;Marcus Bendtsen ,&nbsp;Philippe Mortier ,&nbsp;Randy P. Auerbach ,&nbsp;Jason Bantjes ,&nbsp;Harald Baumeister ,&nbsp;Anne H. Berman ,&nbsp;Erik Bootsma ,&nbsp;Ronny Bruffaerts ,&nbsp;Irina F. Cohut ,&nbsp;Marcelo A. Crockett ,&nbsp;Pim Cuijpers ,&nbsp;Oana A. David ,&nbsp;David D. Ebert ,&nbsp;Raúl A. Gutierrez-García ,&nbsp;Penelope A. Hasking ,&nbsp;Xanthe Hunt ,&nbsp;Petra Hurks ,&nbsp;Mathilde M. Husky ,&nbsp;Wouter Voorspoels","doi":"10.1016/j.jpsychires.2025.04.021","DOIUrl":"10.1016/j.jpsychires.2025.04.021","url":null,"abstract":"<div><div>Mental health disparities have been reported among sexual minority individuals; minority stress theory posits that such disparities are a result of stigma and discrimination. We estimated the prevalence of mental disorders across sexual orientation groups among first-year college students and whether differences across sexual orientation groups varied by gender and country-level LGBTQ+ (lesbian, gay, bisexual, transgender, queer) social acceptance. Using data (<em>N</em> = 53,175; 13 countries) from the World Mental Health Surveys International College Surveys, we performed multilevel logistic regressions to estimate the associations between sexual orientation (i.e., heterosexual, heterosexual with same-gender attraction [SGA], gay/lesbian, bisexual, asexual, questioning, and other) and five twelve-month DSM-5 disorders (major depressive disorder, generalized anxiety disorder, panic disorder, alcohol use disorder, drug use disorder). Heterosexual students with SGA (AORs 1.30–2.15), gay/lesbian (AORs 1.49–2.70), bisexual (AORs 2.26–3.49), questioning (AORs 1.38–2.04), and “other” (AORs 1.76–2.94) students had higher odds of all disorders compared to heterosexual students with no SGA; asexual students did not. Significant interactions with gender show that the gender difference in prevalence was greater among bisexual individuals for most disorders and among all sexual minorities (except “other”) for drug use disorder. Significant interactions with country level LGBT+ social acceptance showed some sexual minority groups had lower odds (AORs 0.83–0.95) of disorder as country-level acceptance increased. These findings provide further evidence of mental disorder disparities across a wide range of sexual orientations and how these disparities vary by gender and societal LGBTQ+ acceptance in students from diverse countries.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"186 ","pages":"Pages 331-340"},"PeriodicalIF":3.7,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874124","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":"Brain functional changes in juvenile delinquents: a preliminary meta-analysis","authors":"Yong-ming Wang ,&nbsp;Jia-sheng Yang ,&nbsp;Xin-qi Liu ,&nbsp;Qing-wen Bie ,&nbsp;Yu-shan Xie ,&nbsp;Meng Zhang ,&nbsp;Lu-yang Tao ,&nbsp;Xi-ping Chen","doi":"10.1016/j.jpsychires.2025.04.032","DOIUrl":"10.1016/j.jpsychires.2025.04.032","url":null,"abstract":"<div><h3>Background</h3><div>Juvenile delinquency is a serious social issue that poses significant challenges to public safety and mental health systems. However, the neurophysiological mechanisms underlying delinquent behaviour in juveniles remain unclear. In this meta-analysis, we aimed to investigate the functional brain characteristics during resting-state and task-based conditions in juvenile offenders.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted in PubMed, Web of Science and MEDLINE, focusing on whole-brain resting-state and task-based functional magnetic resonance imaging (fMRI) studies examining brain activation patterns in juvenile delinquents compared with controls.</div></div><div><h3>Results</h3><div>Six task-based fMRI studies were incorporated into the meta-analysis. Our findings revealed increased activation in juvenile delinquents in the left medial orbital part of the superior frontal gyrus (SFG), amygdala and cerebellum vermis VI region across these task-based fMRI studies, and increased activation in the left medial orbital part of the SFG and vermis VI region in studies using emotional tasks. The other five resting-state fMRI studies reported different indicators. Therefore, no meta-analysis was performed on the resting-state data.</div></div><div><h3>Conclusion</h3><div>These findings suggest that overactivation in the fronto-amygdala-cerebellar circuit may be a key neurophysiological basis for impaired emotional and behavioural regulation, as well as increased violent behaviour in juvenile offenders.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"186 ","pages":"Pages 297-304"},"PeriodicalIF":3.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864114","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":"Effects of early-life antibiotic use on emotional and behavioral development trajectories in preschool children","authors":"Lu Chen ,&nbsp;Penggui Wu ,&nbsp;Juan Tong ,&nbsp;Shuangqin Yan ,&nbsp;Guopeng Gao ,&nbsp;Fangbiao Tao ,&nbsp;Kun Huang","doi":"10.1016/j.jpsychires.2025.04.031","DOIUrl":"10.1016/j.jpsychires.2025.04.031","url":null,"abstract":"<div><h3>Background</h3><div>Limited research exists on the link between antibiotic use and emotion and behavior, particularly the lack of continuous emotional and behavioral assessment. Emotions and behaviors reflect key modifiable dimensions of brain function and evolve during childhood growth and development. This paper aimed to examine the antibiotic use (yes/no), categories and duration in association with preschool children's emotional and behavioral development trajectory.</div></div><div><h3>Methods</h3><div>Based on Ma'anshan-Anhui Birth Cohort, 1147 mother-child pairs were included in the study. Parents or guardians reported the children's antibiotic use before age 3, including whether antibiotics were used and the types and duration of antibiotics use. The trajectories of children's emotional and behavioral development were fitted using scores from the Strengths and Difficulties Questionnaire (SDQ) at 48, 60, and 72 months.</div></div><div><h3>Results</h3><div>A total of 23.3 % (268/1147) of children had used antibiotics in the past three months. Children's antibiotic use significantly related with high level of hyperactivity. The use of β-lactam antibiotics, especially non-penicillin, was associated with the risk of high level hyperactivity at a dose-response pattern in duration. Children's combined use of β-lactam and macrolides was related with increased risk of high level hyperactivity, total difficulties and emotional symptoms.</div></div><div><h3>Conclusions</h3><div>Children's antibiotic use before age 3 is observed to be associated with hyperactivity development, especially using β-lactam antibiotics with a relatively long duration. The combined use of β-lactam and macrolides may increase the development of hyperactivity, total difficulties and emotional symptoms.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"186 ","pages":"Pages 244-251"},"PeriodicalIF":3.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143850807","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":"Lack of social interaction advantage: A domain-general cognitive alteration in schizophrenia","authors":"Enze Tang ,&nbsp;Jian Li ,&nbsp;Huiying Liu ,&nbsp;Chihao Peng ,&nbsp;Dongsheng Zhou ,&nbsp;Shaohua Hu ,&nbsp;Hui Chen","doi":"10.1016/j.jpsychires.2025.04.030","DOIUrl":"10.1016/j.jpsychires.2025.04.030","url":null,"abstract":"<div><div>People with schizophrenia (PSZ) showed preserved ability to unconsciously process simple social information (e.g., face and gaze), but not in higher-order cognition (e.g., memory). It is yet unknown how PSZ process social interactions across different cognitive domains. This study systematically investigated the cognitive characteristics of PSZ during social interaction processing from bottom-up perception to top-down memory, and established correlations with schizophrenic symptoms. In two experiments, social interactions were consistently displayed by face-to-face or back-to-back dyads. Experiment 1 enrolled 30 PSZ and 30 healthy control subjects (HCS) with a breaking continuous flash suppression (b-CFS) paradigm. Experiment 2 recruited 36 PSZ and 36 HCS for two memory tasks, wherein participants restored the between-model distance (working memory task) and recalled the socially bound pairs (long-term memory task). Results indicated that HCS showed advantageous processing of socially interactive stimuli against non-interactive stimuli throughout two experiments, including faster access to visual consciousness, closer spatial distance held in working memory and higher recollection accuracy in long-term memory. However, PSZ did not show any of these advantages, with significant interaction effects for all three tasks (task one: <em>p</em> = .018, η_p² = .092; task two: <em>p</em> = .021, η_p² = .074; task three: <em>p</em> = .015, η_p² = .082). Moreover, correlation analyses indicated that PSZ with more severe negative symptoms (<em>r</em> = −.344, <em>p</em> = .040) or higher medication dosages (<em>r</em> = −.334, <em>p</em> = .046) showed fewer advantages in memorizing socially interactive information. Therefore, social interaction is not prioritized in schizophrenia from bottom-up perception to top-down memory, and the magnitude of such a domain-general cognitive alteration is clinically relevant to symptom severity and medication.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"186 ","pages":"Pages 434-444"},"PeriodicalIF":3.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143894903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening tool for predicting patient aggressive behavior and staff injury at a pediatric hospital","authors":"Aaron Vaughn ,&nbsp;Nancy M. Daraiseh ,&nbsp;Madeline Aeschbury ,&nbsp;Camryn Backman ,&nbsp;Chunyan Liu ,&nbsp;Michael Sorter ,&nbsp;Maurizio Macaluso","doi":"10.1016/j.jpsychires.2025.04.029","DOIUrl":"10.1016/j.jpsychires.2025.04.029","url":null,"abstract":"<div><h3>Introduction</h3><div>Few clinical tools predict patients at the highest risk for seclusion/restraint events (SREs) or staff injury due to aggressive patient interactions (APIs). We examined the utility of a \"high-risk notification\" (HRN) tool to proactively identify patients at admission at greatest risk of SREs and APIs. We also assessed how initial SRE events influence subsequent risk.</div></div><div><h3>Methods</h3><div>Using the HRN tool, 2166 patients (61.3% female; mean age 13.5 years) across 2969 admissions were classified as either HRN + or HRN−. We calculated SRE and API incidence rates per 100 patient-days and estimated the proportion of SREs and APIs attributable to HRN + status at admission. To examine the influence of SRE/API on subsequent events, we used logistic regression with random hospital-stay effects, modeling daily risk of SREs and APIs as a function of SREs or APIs on previous days.</div></div><div><h3>Results</h3><div>HRN + patients made up 5.6% of admissions but accounted for &gt;50% of APIs (9.55 per 100 days) and &gt;45% of SREs (28.7 per 100 days). HRN− patients (94.4% of admissions) experienced significantly lower rates (1.56 APIs and 5.69 SREs per 100 days). Both HRN+ and HRN− patients had significantly increased risk of SRE and API after their first event. HRN + patients with prior events were 19 and 26 times more likely to experience another SRE or API, respectively. Among HRN− patients, over 90% of subsequent events followed an initial SRE/API event, while 67% of subsequent events for HRN + patients were attributable to a first event.</div></div><div><h3>Discussion</h3><div>The HRN tool identified &lt;5% of patients as responsible for ∼50% of SREs and APIs and analyses strongly indicate that preventing initial SRE/API significantly reduces repeated events for both high- and low-risk patients. The HRN tool shows promise in predicting and preventing SREs and APIs, allowing for targeted safety interventions that could reduce recurring events and improve staff and patient safety.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"186 ","pages":"Pages 373-378"},"PeriodicalIF":3.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887308","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}