Psychopathology最新文献

{"title":"Exploring Dual Diagnoses: Psychopathological Characteristics in the Co-Occurrence of Schizophrenia and Addiction - A Scoping Review.","authors":"Stefania Chiappini, Alessio Mosca, Andrea Miuli, Giacomo D Apos Andrea, Clara Cavallotto, Francesco Semeraro, Tommaso Piro, Maria Chiara Vicinelli, Rolando Tucci, Concetta Conidi, Alessia Santeusanio, Mauro Pettorruso, Giovanni Martinotti","doi":"10.1159/000547322","DOIUrl":"10.1159/000547322","url":null,"abstract":"<p><strong>Background: </strong>The co-occurrence of schizophrenia and substance use disorders (SUDs), referred to as dual diagnosis, represents a significant challenge in psychiatric research and clinical practice. The interplay between these conditions complicates symptomatology, diagnosis, and treatment, necessitating an integrated approach to care.</p><p><strong>Summary: </strong>This scoping review systematically examines the available literature on the psychopathological characteristics of individuals with dual diagnosis, emphasizing symptomatologic clusters associated with different substances. A systematic search was conducted in Medline and Scopus databases to identify original research articles published in the last 20 years. Studies examining psychosis-related symptoms in individuals with SUDs were included, excluding non-original research, non-English articles, and studies not focusing on dual diagnosis. A total of 129 studies were included, with cannabis being the most frequently studied substance, followed by alcohol, stimulants, and opioids. The most commonly reported symptoms were positive symptoms (hallucinations, delusions, paranoia, disorganized thinking), cognitive impairments, and negative symptoms (social withdrawal, anhedonia). Emotional dysregulation, impulsivity, and aggression were also frequently documented. Substance-induced psychosis was found to differ from primary psychotic disorders in symptom severity, age of onset, and associated comorbidities.</p><p><strong>Key messages: </strong>The psychopathology of dual diagnosis is multifaceted, with overlapping and complex symptom presentations. Substance use can exacerbate or trigger psychotic symptoms, making differential diagnosis challenging. These findings highlight the need for integrative treatment strategies that address both psychotic and substance-related symptoms. Further research is needed to develop standardized diagnostic criteria and targeted interventions for dual diagnosis patients.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"79-133"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Cortical Gyrification and Major Depression: Clinical Correlates.","authors":"Andreas Buchmann, Adrian Hase, Christopher Johannes Ritter, Sabrina Theresia Müller, Melanie Haynes, Carmen Ghisleni, Ruth O Apos Gorman Tuura, Charlotte Sophie Kohler, Gregor Hasler","doi":"10.1159/000550951","DOIUrl":"10.1159/000550951","url":null,"abstract":"<p><p><p>Introduction: Major depressive disorder (MDD) is one of the most frequent psychiatric diseases worldwide. Growing evidence suggests that cortical gyrification measures may present an early risk marker for depression. Medial views of cortical surface reconstructions provide the basis for a simple, expert-rated measure of cortical gyrification. In this study, we examined left anterior cingulate cortex (ACC) gyrification as a potential marker of MDD. We selected this region of interest based on the limbic-cortical dysregulation model of depression and prior research results.</p><p><strong>Methods: </strong>In a sample of 386 healthy and depressed young adults (147 with MDD), experts rated ACC gyrification using structural MRI reconstructions. Gyrification patterns were compared on clinical (e.g., MDD status), MRI (e.g., automatically derived region-wise curvature and volumetric variables), and psychological outcomes (e.g., personality questionnaire scores).</p><p><strong>Results: </strong>One-third of subjects exhibited two anteroposterior gyri in the left hemisphere, whereas the other subjects exhibited one longitudinal gyrus or longitudinal gyrification was interrupted. Subjects with the fewer-gyri left ACC variant more often experienced MDD at some point in their lifetime (p = 0.048). Moreover, among all subjects with MDD, disorder onset happened earlier in subjects with the fewer gyri variant (d = -0.30), hinting at early developmental contributions to the phenotypic marker. In addition, subjects with fewer longitudinal gyri scored higher on neuroticism (η2 = 0.02), but not on extraversion. Automatically derived measures of gyrification and cortical surface area were largely consistent with the differences observed using the expert rater-based gyrification measure.</p><p><strong>Conclusion: </strong>Future studies should investigate left ACC gyrification and, to what extent, it exists in at-risk subjects, further elucidating it with ACC structural and functional connectivity measures. </p>.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"254-264"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who Are People with Psychosis Delusional about? A Study of Social Agents in the Phenomenology of Delusions.","authors":"Elisavet Pappa, Nichola Raihani, Vaughan Bell","doi":"10.1159/000548611","DOIUrl":"10.1159/000548611","url":null,"abstract":"<p><strong>Introduction: </strong>Delusions frequently involve strong beliefs about, or interactions with, illusory social agents. Although such agents have been systematically described in hallucinations, few studies have investigated their nature and identity in delusions.</p><p><strong>Methods: </strong>We identified 205 electronic mental health records describing the content of delusions from the Clinical Record Interactive Search platform at South London and Maudsley NHS Foundation Trust. Delusional content was classified as non-social, implicitly social, or explicitly social. Descriptions of illusory social agents from explicitly social delusions were extracted and categorized using an upward coding analysis. A hierarchical cluster analysis identified distinct groupings of illusory social agents.</p><p><strong>Results: </strong>Most delusions (83.4%) contained explicit references to illusory social agents. Across 238 instances, we identified 220 distinct agent identities, with a mean of 1.17 agents per record. The majority were humans (85.1%), most often identified as family members (31.0%), followed by acquaintances (17.2%), religious figures (13.2%), unnamed persons (12.8%), professionals (11.8%), and cultural figures (10.9%). Hierarchical clustering revealed two distinct groups: one including socially proximate agents and the other more socially distant agents. These findings indicate a social gradient in delusions.</p><p><strong>Conclusion: </strong>Social content predominates in delusions, with patients experiencing delusions about socially closer individuals more frequently. We discuss the extent to which social gradient may not be unique to delusional misidentification syndromes but may instead represent a general feature of delusions. Better characterization of social agents in delusions could inform mechanistic accounts of these symptoms and, in clinical practice, guide family support and risk assessment.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-11"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12867498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodal Hallucinations in Muslim Patients with Severe Psychotic Disorders: The Entity Experience Revisited.","authors":"Anastasia Lim, Hans W Hoek, Jan Dirk Blom","doi":"10.1159/000548607","DOIUrl":"10.1159/000548607","url":null,"abstract":"<p><strong>Introduction: </strong>In biomedicine, entity experiences are conceptualised as compound hallucinations featuring living beings. The term \"experience\" suggests that these have an objective basis in reality, as those perceiving them may maintain. So-called jinn encounters, typically described by Muslims with and without a psychiatric diagnosis, involve the multimodal perception of a spirit that, as described in the Qur'an, was created by Allah.</p><p><strong>Methods: </strong>We conducted a phenomenological investigation among Muslim patients residing at Parnassia Psychiatric Institute, The Hague, mostly diagnosed with a schizophrenia spectrum disorder. To enquire specifically into multimodal hallucinations featuring jinn or related entities, we used the Hallucination Attribution List, a tailor-made, semi-structured questionnaire.</p><p><strong>Results: </strong>Of the 42 interviewees, 35 described multimodal hallucinations, of which 22 fulfilled the criteria of entity experiences involving 2 to 6 sensory modalities simultaneously. Twelve participants (54.5%) were fully convinced they were dealing with jinn; the others left some room for doubt. Although we did not quantitatively assess the levels of jinn-associated distress, all participants characterised their experiences as impressive and impactful.</p><p><strong>Conclusion: </strong>Multimodal hallucinations may involve full-blown entity experiences, which in Muslim patients typically take the form of jinn encounters. The way in which these entity experiences are mediated is as yet uncertain. However, since visual, auditory, and tactile hallucinations in our sample were described substantially more frequently than somatic, olfactory, and gustatory ones, we hypothesise that the processes underlying the hallucinations may be driven by a stochastic mechanism in that the first three sensory modalities need to have been engaged before the latter three can be recruited. We highlight several biological models of potential underlying mechanisms as well as two overarching models that may help place the mechanisms in the wider context of personal, social, cultural, religious, philosophical, and evolutionary factors that, conceivably, all play a role in their mediation.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"12-22"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12867496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Importance of Existential Questions in Patients with a Depressive Disorder: A Pilot Study.","authors":"Paraskevi Mavrogiorgou, Valerie Pauline Paffrath, Georg Juckel","doi":"10.1159/000548702","DOIUrl":"10.1159/000548702","url":null,"abstract":"<p><strong>Background: </strong>Depressive disorders are among the most common mental illnesses. Many approaches to treatment using psychotherapy or psychotropic drugs exist, but the proportion of non-responders should not be ignored. The consideration of existential, so-called \"meaningful questions\" of life, although their significance is well known, has so far been used little or not at all in the diagnosis and treatment of mental illnesses like depressive disorders. The aim of this study was, therefore, to examine the significance of existential questions in the context of depressive disorders and to shed light on the attitudes of affected patients.</p><p><strong>Method: </strong>This exploratory cross-sectional study used semi-structured interviews and questionnaires to examine 30 inpatients with a diagnosed depression and 30 mentally healthy individuals as a comparison group. Clinical parameters were collected from all study participants. The psychometrics included the recording of depression (BDI-II), anxiety (STAI-I/II), loneliness (UCLA Loneliness Scale), and life meaning (LeBe/SoMe). The BOFRETTA scale was also used to assess the subjects' fear of death and attitudes toward death. The Bochum Questionnaire on the Importance of Existential Questions (BOFBEX), newly designed for this study, was used to assess attitudes to existential issues.</p><p><strong>Results: </strong>For the depressed patients, there were unfavourable and significantly different values compared to the mentally healthy subjects with regard to meaningfulness and crisis of meaning. Most depressives (66.7%) stated they suffered subjectively from experience of meaninglessness at most, whereas this did not occur in any of the healthy subjects. However, the level of depressiveness correlated significantly positively with loneliness in both groups and with the perception of a crisis in meaning.</p><p><strong>Conclusions: </strong>Depressed patients had a need and desire to be able to address existential questions, which mainly concerned their loneliness, the feeling of autonomy, and having meaning in life, more strongly and more frequently with reference therapists as part of psychiatric-psychotherapeutic treatment.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"134-146"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145409856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decreased Sound Tolerance in Autism: A Clinical-Phenomenological Study.","authors":"Nicolás Vega, Constanza Vega","doi":"10.1159/000552498","DOIUrl":"10.1159/000552498","url":null,"abstract":"<p><strong>Introduction: </strong>Decreased sound tolerance (DST) is a common, yet understudied, sensory experience among individuals with autism. Beyond neurobiological or behavioral explanations, DST can be understood phenomenologically as a distinct mode of auditory being-in-the-world. This study examined how adults with autism experience, interpret, and inhabit their auditory world in situations where sound becomes overwhelming or invasive.</p><p><strong>Methods: </strong>Eight adults with autism were recruited through social media and participated in in-depth semi-structured interviews focused on their experiences with DST. Participants had a prior clinical diagnosis of autism established by a neurologist or psychiatrist (in some cases supported by ADOS-2), which was subsequently verified by the research team according to DSM-5 criteria. The interview guide was designed to collect information about perception, informed by Karl Jaspers' clinical phenomenology and Maurice Merleau-Ponty's philosophy of perception as sensitizing frameworks. Data were analyzed using Amedeo Giorgi's method, which includes holistic reading, delineation of meaning units, transformation into phenomenological-psychological language, and eidetic synthesis.</p><p><strong>Results: </strong>Participants described DST as an embodied and relational shift in how sound was encountered. Certain sounds are experienced as intense, intrusive, or difficult to accommodate, affecting bodily attunement and ongoing activities. The phenomenon fluctuated with emotional state, fatigue, and contextual predictability and was often accompanied by physical exhaustion and a need to recalibrate through rest or withdrawal. Alongside these challenges, participants also reported moments of heightened clarity and attunement, revealing a distinctive way of perceiving and engaging with the auditory world.</p><p><strong>Conclusion: </strong>DST in individuals with autism might be understood as a modification in the structure of embodied perception and auditory attunement, beyond a mere sensory alteration. From a phenomenological perspective, DST reflects a particular relational configuration with the auditory world that shapes embodiment, affectivity, and intersubjectivity. These findings contribute to the emerging phenomenological psychopathology of autism by describing how auditory experience can participate in the formation of lived presence and being with others.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"243-253"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147988597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Activity and Psychopathological Knowledge Are Related to Real-World Performance of Leading International Psychiatrists in Diagnosing Schizophrenia Spectrum Disorders.","authors":"Bar Urkin, Josef Parnas, Andrea Raballo, Danny Koren","doi":"10.1159/000549313","DOIUrl":"10.1159/000549313","url":null,"abstract":"<p><p><p>Introduction: A recent empirical benchmark study designed to assess real-world diagnostic accuracy and reliability among 30 internationally renowned psychiatrists specializing in the schizophrenia spectrum found that only 33.3% of the psychiatrists correctly diagnosed two vignettes that included typical descriptions of disorders in the schizophrenia spectrum. The present study aimed to identify clinician-related factors that might account for this poor diagnostic performance, such as clinical versus research focus, years of clinical experience, and perceived usefulness of psychopathological concepts.</p><p><strong>Methods: </strong>The study employed secondary analyses of data collected in in-depth online interviews with a group of 30 top-tier international psychiatrists specializing in schizophrenia spectrum disorders (SSDs). Participants were asked to make their best clinical diagnostic estimate for two written clinical vignettes developed on the basis of real-world SSD cases.</p><p><strong>Results: </strong>We found that diagnostic accuracy was nearly significantly related to length of clinical experience, greater emphasis on practice versus research (estimated by low H-index), a proclivity to engage in psychotherapy, a nuanced view of psychosis as a spectrum concept, and acknowledgment of the relevance of self-disorders (i.e., subtle, enduring, nonpsychotic phenomenological anomalies of subjective experience) for SSD diagnosis.</p><p><strong>Conclusion: </strong>Taken together, these findings suggest that continuous clinical activity and nuanced knowledge of psychopathology that goes beyond the guidelines of DSM and ICD are crucial for accurate diagnostic performance in real-world diagnostic encounters. </p>.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"147-153"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12707909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145409889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phenomenology of Hallucinations in Endogenous and Substance-Related Exogenous Psychoses.","authors":"Valerio Ricci, Massimiliano Aragona, Giuseppe Maina, Giovanni Martinotti","doi":"10.1159/000547087","DOIUrl":"10.1159/000547087","url":null,"abstract":"<p><strong>Background: </strong>Healthcare professionals encounter challenges in discerning endogenous and exogenous, drug-related, psychopathological phenomena. This study aimed to explore qualitative differences between hallucinations in schizophrenia and two forms of substance-related psychosis. These are substance-induced psychosis (SIP), which has an acute onset and is usually transient, and substance-related persistent psychosis (PP).</p><p><strong>Summary: </strong>To explore phenomenological differences, we use an ideal-typical method (which Jaspers borrowed in psychopathology from Weber), together with classic and contemporary phenomenological reflections. After a historical overview of the main issues concerning this topic, we consider the qualitative differences between the different types of hallucinations at the following levels: formal features of the phenomenon, contents, state of consciousness, temporal experience, and position-taking.</p><p><strong>Key messages: </strong>Our results indicate that while schizophrenic hallucinations typically occur in clear consciousness with variable sensory vividness, SIP hallucinations manifest in an oneiroid state with increased vividness and multisensory integration. In contrast, PP hallucinations occur in a twilight state of consciousness, often presenting as simpler but intrusive phenomena. Furthermore, the discussion includes a brief phenomenological analysis starting from Husserlian conceptions of perception to clarify the basic structural difference underlying the qualitative distinctions previously analysed. By identifying distinctive phenomenological characteristics of hallucinations across these conditions, this study provides clinicians with a conceptual framework for developing more effective diagnostic approaches and therapeutic strategies, particularly in the complex context of substance-induced psychopathologies.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"174-188"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145409851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender Differences in Rumination among Chinese Adolescents with Subthreshold Depression.","authors":"Ziqi Yan, Yu Tian, Yuheng Huang, Jing Xiao, Fangfang Shangguan, Qi Li","doi":"10.1159/000552390","DOIUrl":"10.1159/000552390","url":null,"abstract":"<p><strong>Introduction: </strong>Distraction response style, neuroticism, and parental conflict have been linked to rumination in adolescents with subthreshold depression. However, whether these associations differ by gender remains unclear.</p><p><strong>Methods: </strong>This study examined gender-stratified associations of distraction response style, neuroticism, and parental conflict with rumination among Chinese adolescents with subthreshold depression. Data were collected from 370 adolescents with subthreshold depression using the Center for Epidemiological Studies Depression Scale (CES-D), the Response Style Questionnaire (RSQ), the Children's Perception of Interparental Conflict Scale (CPICS), and the NEO Five-Factor Inventory (NEO-FFI).</p><p><strong>Results: </strong>Overall, 28.11% (n = 104) of adolescents with subthreshold depression were classified into the rumination group, with a higher proportion of females than males (33.83% vs. 21.08%). Gender-stratified logistic regression analyses showed that distraction response style and neuroticism were associated with rumination in both males and females. Parental conflict was associated with rumination among males but not females in the stratified analyses; however, the pooled gender × parental conflict interaction was not statistically significant (p = 0.347).</p><p><strong>Conclusion: </strong>Distraction response style and neuroticism were associated with rumination across both gender groups. Parental conflict may be relevant to rumination among males, but the present data did not support a statistically significant moderating effect of gender. These findings highlight the potential relevance of coping tendencies, trait neuroticism, and family context in understanding rumination among adolescents with subthreshold depression.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"296-302"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147875735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Paradox of Loving without Expectation: Between Existential Assurance and the Missed Encounter with the Other.","authors":"Giovanni Stanghellini","doi":"10.1159/000548794","DOIUrl":"10.1159/000548794","url":null,"abstract":"<p><strong>Background: </strong>The phenomenon of love is an important task for the psychopathologist since love experience is the site in which the Self is formed and potentially dismantled. This paper explores \"one-way love\" - an autotelic form of love that persists independently of return. It may serve as a way for the person to sustain a sense of autonomy finding fulfilment in the act of loving itself - a paradoxical affirmation of identity, existence, and autonomy.</p><p><strong>Summary: </strong>The analysis unfolds three central functions of one-way love: (1) it frees the person from dependency on the Other's love; (2) it preserves the integrity of the lover's own desire protecting it from the confrontation with the Other's desire; (3) it offers the lover a heroic and noble self-image rooted in fidelity to feeling. One-way lovers may appear as dependent on a beloved who does not reciprocate, but they are firmly convinced that they are performing a radical act of freedom: loving not to be loved in return, but to assert their own existence as a person fully capable of loving.</p><p><strong>Key message: </strong>One-way love is a strategy in which desire and fear intersect, sustaining the beloved at a distance and affirming the lover's capacity to love without dependence. Yet, this autonomy carries a cost: it prevents genuine intimacy with the Other. By avoiding the vulnerability required to share private aspects of the Self, one-way lovers evade the very encounter with otherness that is essential to the ongoing development and transformation of the Self.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"67-78"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}