Nordic Journal of Psychiatry最新文献

{"title":"Prevalence and relevance of neurocognitive challenges in patients admitted to a secondary mental health outpatient clinic.","authors":"Camilla Angelsen Kvestad, Solveig Klæbo Reitan, Ingvild Rønneberg Holte, Turid Follestad, Katrine Høyer Holgersen","doi":"10.1080/08039488.2025.2489638","DOIUrl":"https://doi.org/10.1080/08039488.2025.2489638","url":null,"abstract":"<p><strong>Background: </strong>Knowledge on factors affecting mental health is pivotal to offer the appropriate help for patients referred to mental health services. Neurocognitive challenges affect a person's capacity to cope in life. If underlying issues with cognitive functioning rather than psychiatric pathology cause suffering and failure to function, other measures than merely psychiatric treatment may be needed. However, there is a lack of knowledge on occurrence of neurocognitive challenges in the general psychiatric outpatient population.</p><p><strong>Material and method: </strong>This study included 283 outpatients in a Community Mental Health Center. Information of previous neurocognitive testing as a proxy for cognitive challenges was registered by patient file exploration. Psychiatric symptoms as well as demographics were reported by patients and clinicians.</p><p><strong>Results: </strong>Of 283 participants, 45 (15.9%) had previously been tested for neurocognitive function, 217 (76.7%) had not been tested and for 21 (7.4%) information was lacking. Patients in the group tested were younger and had a lower level of education. They had higher use of psychotropic drugs, i.e. especially stimulants, and had a history of more psychiatric treatment and more school challenges. Clinicians reported higher cognitive challenges and lower social competence among this group.</p><p><strong>Discussion: </strong>A group of patients referred to specialized psychiatric treatment suffer from neurocognitive challenges that may affect their daily life function and symptoms more than merely psychiatric disorders. This indicates that neurocognitive difficulties should be assessed and adjusted for before further psychiatric treatment is initiated. Findings should be further explored.</p>","PeriodicalId":19201,"journal":{"name":"Nordic Journal of Psychiatry","volume":" ","pages":"1-8"},"PeriodicalIF":1.5,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive disengagement syndrome symptoms in obsessive-compulsive disorder with and without attention deficit hyperactivity disorder.","authors":"Yigit Ozaydin, Doga Sevincok, Ufuk Uyar, Borte Gurbuz Ozgur, Hatice Aksu, Levent Sevincok","doi":"10.1080/08039488.2025.2488386","DOIUrl":"https://doi.org/10.1080/08039488.2025.2488386","url":null,"abstract":"<p><strong>Objective: </strong>Comorbidity between Obsessive-Compulsive Disorder (OCD) and Attention Deficit/Hyperactivity Disorder (ADHD) appears complex in terms of etiology, phenomenology, and treatment. There is a need to identify possible factors which are related to the co-occurrence of OCD and ADHD in adults. Cognitive Disengagement Syndrome (CDS) may contribute to this comorbidity through its associations with ADHD, emotional dysregulation, cognitive processes, and neuropsychological deficits.</p><p><strong>Methods: </strong>In this study, we compared CDS and various sociodemographic and clinical characteristics in OCD patients with (<i>n</i> = 44) and without ADHD (<i>n</i> = 72), and healthy controls (<i>n</i> = 43), using the Yale Brown Obsessive-Compulsive Scale, Wender Utah Rating Scale, Adult ADD/ADHD DSM-IV Based Diagnostic Screening and Rating Scale, Barkley's Adult Sluggish Cognitive Tempo Rating Scale, Beck Depression Inventory, and Beck Anxiety Inventory.</p><p><strong>Results: </strong>In addition to contamination obsessions (OR = 7.733, <i>p</i> = 0.002), male gender (OR = 3.732, <i>p</i> = 0.031), high anxiety (OR = 1.053, <i>p</i> = 0.02), and high CDS symptoms (OR = 1.145, <i>p</i> = 0.037) were associated with comorbidity between OCD and ADHD.</p><p><strong>Conclusion: </strong>We suggest that CDS may serve as a valuable construct for understanding the nature of comorbidity between OCD and ADHD.</p>","PeriodicalId":19201,"journal":{"name":"Nordic Journal of Psychiatry","volume":" ","pages":"1-8"},"PeriodicalIF":1.5,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Positive predictive value of an ICD-10-based operationalization of bipolar II disorder for register-based research.","authors":"Søren Dinesen Østergaard, Christian Jon Reinecke-Tellefsen, Anne Hostrup Brunø, Torben Albert Devantier, Pernille Kølbæk","doi":"10.1080/08039488.2025.2483749","DOIUrl":"https://doi.org/10.1080/08039488.2025.2483749","url":null,"abstract":"<p><strong>Objective: </strong>Bipolar II disorder (BD-II) is a subtype of bipolar disorder characterized by recurrent episodes of depression and hypomania, without full manic episodes. Unfortunately, BD-II is not included as a diagnostic code in the ICD-10, which means that the Danish Psychiatric Central Research Register (DPCRR), where diagnoses are recorded according to the ICD-10, cannot be used to study BD-II without further ado. The aim of this study was to investigate whether BD-II can be operationalized retrospectively based on ICD-10 diagnoses with sufficient positive predictive value to allow for studies of BD-II using data from the DPCRR.</p><p><strong>Materials and methods: </strong>We operationalized BD-II a priori based on a set of criteria (e.g. a minimum of two mood episodes labelled with ICD-10 diagnostic codes of hypomania or bipolar depression - at least one being bipolar depression - and no manic/mixed episodes). The positive predictive value of this operationalization was then examined by reviewing (two independent reviewers) the electronic health records (EHRs) of 147 patients from the Psychiatric Services of the Central Denmark Region matching the ICD-10-based operationalization of BD-II.</p><p><strong>Results: </strong>For 107 of the 147 patients, the EHR review confirmed that BD-II was the most likely diagnosis, resulting in a positive predictive value of 73% for the ICD-10-based operationalization of BD-II.</p><p><strong>Conclusions: </strong>This study suggests that, while not perfect in terms of positive predictive value, the proposed ICD-10-based operationalization will allow for studies of 'predominantly BD-II' using data from the DPCRR with sufficient validity.</p>","PeriodicalId":19201,"journal":{"name":"Nordic Journal of Psychiatry","volume":" ","pages":"1-5"},"PeriodicalIF":1.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes on health, recovery and activity level for mental health service users attending a novel nature-based intervention: a prospective study.","authors":"Marie Gudmundsson, Anna María Pálsdóttir, Ulrika Bejerholm, Elisabeth Argentzell","doi":"10.1080/08039488.2025.2483736","DOIUrl":"https://doi.org/10.1080/08039488.2025.2483736","url":null,"abstract":"<p><strong>Purpose: </strong>Mental illness due to longstanding stress is increasing. It has been shown that service users with mental illness may benefit from nature-based interventions (NBI), including equine-assisted therapy, to support their health, recovery, and activity level of daily life. However, the evidence base to support this is still weak. The aim was thus to evaluate and provide knowledge of the possible effects on health, recovery and activity level from participating in a novel nature-based intervention among mental health service users with mental illness due to longstanding stress.</p><p><strong>Materials and methods: </strong>Forty participants took part in the study, which had a single group pretest-post-test design. The program was delivered in groups at a farm-based rehabilitation centre in a southern part of Sweden. It consisted of 24 weeks in two 12-week phases. Data were collected using well-tested questionnaires reflecting health, clinical and personal recovery, and activity level.</p><p><strong>Results: </strong>The analysis showed an improvement with medium to large effect sizes over time according to outcomes on aspects of health, recovery and activity level with exception for self-mastery. All outcomes were statistically significant with p-values ≤.005.</p><p><strong>Conclusions: </strong>This novel nature-based program has the potential to be a recovery-oriented intervention that could enhance health, both clinical and personal recovery, as well as activity level for mental health service users. The intervention could thus also be a beneficial complement to current psychiatric care services.</p>","PeriodicalId":19201,"journal":{"name":"Nordic Journal of Psychiatry","volume":" ","pages":"1-9"},"PeriodicalIF":1.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical consultation to identify somatic disorders and abnormal paraclinical findings in hospitalized psychiatric patients is feasible and worthwhile.","authors":"Louise Nissen, Anders Løkke, Jannie Christina Frølund, Ole Hilberg, Mikkel Højlund, Ejler Ejlersen, Peter Hjorth","doi":"10.1080/08039488.2025.2484387","DOIUrl":"https://doi.org/10.1080/08039488.2025.2484387","url":null,"abstract":"<p><strong>Purpose: </strong>While psychiatric treatment mostly focuses on mental health, comorbid somatic conditions are frequent and often undertreated. This study aimed to bridge the gap by assessing the feasibility of medical consultations for psychiatric inpatients and to identify somatic and lifestyle-related conditions, as well as abnormal paraclinical findings. Secondly, we aimed to identify psychiatric treatments and diagnoses associated with metabolic outcomes.</p><p><strong>Materials and methods: </strong>Patients admitted to Department of Psychiatry Vejle, Denmark, between October 2022 and December 2023 were invited to participate in a medical consultation. The consultations gathered data on comorbidities and lifestyle, including smoking habits, alcohol and drug use, and body metrics. Additionally, information on medical treatment and biochemical markers was collected.</p><p><strong>Results: </strong>A total of 238 patients were enrolled [mean age 48.2 ± 18.6 years; 50.8% were men]. Health assessment revealed that 111 (46.6%) were active smokers and 129 (54.2%) had a body mass index (BMI) of ≥ 25 kg/m². Biochemical analysis showed that 78 (32.8%) had vitamin D levels below 50 nmol/L and 89 (38%) had a low-density lipoprotein level >3 mmol/L. Patients treated with two or more antipsychotic drugs had a significantly higher BMI (4.6 kg/m², 95% CI: 0.8-8.3) compared with individuals not taking antipsychotic medication.</p><p><strong>Conclusion: </strong>The study demonstrates that medical consultations for hospitalized psychiatric patients are feasible and important, revealing abnormal biochemical markers and significant somatic comorbidities and lifestyle-related conditions. These findings suggest that routine medical assessments could enhance patient treatment and care and guide targeted interventions for metabolic and somatic health issues in psychiatric settings.</p>","PeriodicalId":19201,"journal":{"name":"Nordic Journal of Psychiatry","volume":" ","pages":"1-10"},"PeriodicalIF":1.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Data resource profile: treatment effect - data from the mental health services of the capital region of Denmark.","authors":"Frederikke Hørdam Gronemann, Sebastian Simonsen, Martin Balslev Jørgensen, Merete Osler","doi":"10.1080/08039488.2025.2480172","DOIUrl":"https://doi.org/10.1080/08039488.2025.2480172","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with a high probability of remission in response to low-cost therapies may be identified using a battery of inexpensive clinical predictors in large observational samples. Treatment Effect Data from the Mental Health Services of the Capital Region of Denmark contributes with valuable data on individuals with a non-psychotic psychiatric disorder referred to psychotherapeutic treatment. The aim of this paper is to introduce the content of Treatment Effect Data for patients with non-psychotic major depression (MD) or anxiety disorders (AD) in Denmark.</p><p><strong>Data collected: </strong>In Denmark the provision of psychiatric treatment is nationwide and in August 2007, the Mental Health Services of the Capital Region of Denmark launched a regional patient-reported system, Treatment Effect. All individuals residing within the Capital region of Denmark referred to psychotherapeutic treatment with a non-psychotic psychiatric disorder (e.g. AD, MD, eating disorders) electronically report symptoms, quality of life, and social functioning prior to and by the end of the treatment course.</p><p><strong>Data resource use: </strong>Between 2007 and 2021, a total of 18,700 unique patient courses, in which individuals were diagnosed with either non-psychotic MD or AD, received standardized psychotherapeutic treatment. The patients mean age at the initial interview was 34.7 years and 71.7% were women. Half of the patients (51.6%) had severe (29.8%) or moderate (21.7%) depression according to the Major Depression Inventory.</p><p><strong>Conclusion: </strong>Treatment Effect data provides a unique opportunity to examine treatment effects among a large cohort of unselected patients with AD and MD, but this data resource has been scarcely used for research.</p>","PeriodicalId":19201,"journal":{"name":"Nordic Journal of Psychiatry","volume":" ","pages":"1-7"},"PeriodicalIF":1.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PTSD screening using a ten-item checklist of psychological symptoms: a large-scale military veteran sample and a civilian comparison group.","authors":"Gerry Larsson, Sofia Nilsson, Alicia Ohlsson, Sofia Svensén, Marianne Stensvehagen","doi":"10.1080/08039488.2025.2479684","DOIUrl":"https://doi.org/10.1080/08039488.2025.2479684","url":null,"abstract":"<p><strong>Purpose: </strong>The aim was to explore if self-rated psychological symptoms in military veterans covary strong enough with established PTSD scales to make a symptom checklist a useful screening tool.</p><p><strong>Methodology: </strong>A Swedish sample of military veterans (<i>n</i> = 1,859) responded to a questionnaire which contained a checklist of ten psychological symptoms and a test of PTSD indication. The items measured the situation during the last month. All symptoms had the following response choices: 1 (<i>Never</i>), 2 (<i>Seldom</i>), 3 (<i>Sometimes</i>), 4 (<i>Often</i>) and 5 (<i>Very often</i>). The choices Often and Very often were combined and form the basis of the analysis.</p><p><strong>Findings: </strong>The majority of individuals in the military sample reported that they had not experienced any of the ten psychological symptoms often or very often during the last month. Approximately 5% of the men and 9% of the women scored five symptoms or more. Among the men who reported five symptoms or more, about one third scored above a higher established PTSD cut-off value (PCL-4 > 44).</p><p><strong>Originality: </strong>The psychological symptom checklist represents a new approach to PTSD indication screening and identification of individuals who may need further support.</p><p><strong>Research limitations and strengths: </strong>Clinical assessment of PTSD would be a necessary complement for those that indicate further need. Study strengths include a large sample, use of established scales and a straightforward and simple statistical analysis.</p><p><strong>Practical implications: </strong>The checklist is easy to administer and score. After a brief introduction, it takes about two minutes to complete.</p>","PeriodicalId":19201,"journal":{"name":"Nordic Journal of Psychiatry","volume":" ","pages":"1-6"},"PeriodicalIF":1.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-reported depressive and anxiety symptoms associated with fitness for military service and social-communicative skills in young Finnish men.","authors":"Jan Silvala, Raija Korpelainen, Heli Koivumaa-Honkanen, Carlos Sirkiä, Kai Parkkola, Anneli Yliherva, Anja Taanila, Tuula Hurtig","doi":"10.1080/08039488.2025.2475932","DOIUrl":"https://doi.org/10.1080/08039488.2025.2475932","url":null,"abstract":"<p><strong>Purpose: </strong>Studies on the association of self-reported depressive and anxiety symptoms with release from compulsory military service at the military call-up and with social-communicative difficulties are scarce.</p><p><strong>Materials and methods: </strong>This study is a part of population-based cross-sectional 'Young Men in the North' project (<i>N</i> = 2614 men, mean age 18.1). The Finnish Defence Forces arranges compulsory military call-ups for all Finnish 18-year-old male citizens, where our study subjects and filled out questionnaire including Raitasalo's modification of the Short Form of Beck Depression Inventory (R-BDI) and Generalized Anxiety Disorder 7-item scale (GAD-7), and three questions on social-communicative difficulties based on the DSM-5 diagnostic criteria. Young men's fitness for military service (fit, permanent or temporary release) was obtained from the call-up board.</p><p><strong>Results: </strong>Self-reported depressive symptoms were associated with permanent (OR = 6.6; 95% CI 3.88-11.20) and temporary (OR = 9.2; 95% CI 5.59-15.04) release from military service. These odds ratios for anxiety symptoms were 3.1 (95% CI 2.11-4.64) and 4.1 (95% CI 2.80-5.94). Depressive (OR = 5.7; 95% CI 3.88-11.20) and anxiety symptoms (OR = 3.2; 95% CI 2.47-4.17) were associated with self-reported social-communicative difficulties.</p><p><strong>Conclusions: </strong>Self-reported depressive and anxiety symptoms were associated with release from service as well as with social-communicative difficulties in young men. The early-onset mental health problems in young men seem to manifest at call-up as being unfit for the military service. Screening symptoms of depression and anxiety with self-reported scales defined those with mild, moderate or severe symptoms at risk for release from service.</p>","PeriodicalId":19201,"journal":{"name":"Nordic Journal of Psychiatry","volume":" ","pages":"1-9"},"PeriodicalIF":1.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a new measure for forced migrants/refugees: the Screening of Refugees Self-Report (ScoRE-SR).","authors":"Etzel Cardeña, Charlotte Sonne, Erik Vindbjerg, Jessica Carlsson Lohmann, Matti Cervin, Derrick Silove, Joshua Hall, Mariano Coello, Shakeh Momartin, Sabina Gušić, Jorge Aroche","doi":"10.1080/08039488.2025.2475940","DOIUrl":"https://doi.org/10.1080/08039488.2025.2475940","url":null,"abstract":"<p><strong>Purpose: </strong>To remedy the lack of a measure that jointly assesses the psychological status and impact of migration stressors among forced migrants, we developed and tested the Screening of Refugees Self-Report (ScoRE-SR) Questionnaire.</p><p><strong>Method: </strong>Four institutions with expertise on posttraumatic symptomatology and/or migration stressors developed the ScoRE-SR through an iterative process also involving consultation with migrants and experts. The measure consists of 54 items on functioning, migration stressors, and posttraumatic symptomatology. It was administered in English, Danish, Arabic, Farsi, Dari, and Tamil to migrants (<i>N</i> = 149) from different countries and residency types (citizen, permanent resident, holder of temporary protection visa, and Asylum Seeker) at refugee assistance institutions in Australia and Denmark.</p><p><strong>Analyses: </strong>The measure's internal psychometric properties were evaluated through confirmatory factor analyses and test-retest (at 2-3 months) intraclass correlations. Its convergent validity was evaluated through correlating the measure with questionnaires expected to relate to it.</p><p><strong>Results: </strong>The original 13 theoretical factors of the Score-SR showed adequate model-data fit, but CFAs indicated that a factor structure with 6 broader factors was more appropriate. These factors (emotional distress, anger, concerns about family/friends in other countries, concerns about family/friends in country of resettlement, adjustment/resettlement/practical difficulties, and impairment) were internally consistent, showed adequate temporal stability, and correlated as expected with measures of posttraumatic symptomatology and well-being.</p><p><strong>Conclusions: </strong>The ScoRE-SR is a valid measure of different types of migrants' distress and/or adjustment, filling a current gap and providing essential information for migrants' guidance and treatment.</p>","PeriodicalId":19201,"journal":{"name":"Nordic Journal of Psychiatry","volume":" ","pages":"1-7"},"PeriodicalIF":1.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment as involuntary, incompatible, and intimidating: exploring dropout processes in a randomized controlled trial for eating disorders.","authors":"Malin E Olofsson, Eline Fahret Born, Mari Sandnes Vehus, KariAnne Vrabel","doi":"10.1080/08039488.2025.2473614","DOIUrl":"https://doi.org/10.1080/08039488.2025.2473614","url":null,"abstract":"<p><strong>Background: </strong>Ambivalence to treatment and dropout are particularly common in Eating Disorder (ED) treatment, hindering recovery and posing a serious threat to the external validity of outcome research. Attrition may bias findings of randomized controlled trials (RCTs), and exacerbates the risk that complex cases are underestimated, which is serious since RCTs inform the development of evidence-based practices. An increased understanding of dropout processes may contribute to increased patient retention, still, patients' perspectives on voluntary dropout are rare.</p><p><strong>Aim: </strong>We explore the treatment responses involved in voluntary dropout processes in an RCT. Six female, cis-gendered non-completers were interviewed after dropout; rich descriptions from few informants rendered Interpretative Phenomenological Analysis suitable.</p><p><strong>Results: </strong>We developed three Master Themes with two subthemes each: «I had no choice» (fear of disappointing, other-orientation), «I did not fit in» (alienation, poor fit of treatment), «I left to survive» (Existing through the illness, Need to regain control of self) under the overarching Core Master Theme «Treatment as involuntary, incompatible, and intimidating».</p><p><strong>Discussion: </strong>Our findings underscored the centrality of perceived coercion, feeling pressured to choose recovery, alienation, misalignment with treatment goals, and the seemingly existential and critical urge to regain control of self during overwhelming emotions evoked when confronted with mandatory treatment components. RCT non-completers' accounts corroborate previous patient-as-expert research on dropout experiences in naturalistic settings. Refined methods are called for to bridge the research-practice gap.</p>","PeriodicalId":19201,"journal":{"name":"Nordic Journal of Psychiatry","volume":" ","pages":"1-8"},"PeriodicalIF":1.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}