Psychotherapy and Psychosomatics最新文献

{"title":"Effectiveness and Cost-effectiveness of a Digital Mindfulness-Based Intervention for Psychological Distress Delivered by Trainee Instructors: A Randomized Controlled Trial.","authors":"Dongyang Chen, Elena Gomzyakova, Yutian Gu, Yuzhuo Zhang, Stefan G Hofmann, Xinghua Liu","doi":"10.1159/000553463","DOIUrl":"https://doi.org/10.1159/000553463","url":null,"abstract":"<p><strong>Introduction: </strong>The high prevalence of psychological distress and shortage of mental health professionals create a service gap for highly symptomatic populations exceeding routine care capacity. We evaluated a hybrid digital mindfulness intervention (MIED) delivered via a train-the-trainer (TTT) model for reducing psychological distress and providing economic value.</p><p><strong>Methods: </strong>In this randomized controlled trial in China, adults with significant psychological distress (Kessler-10 score ≥ 22) were assigned (1:1) to 8-week MIED plus services as usual (SAU), or SAU alone. Primary outcomes were 8-week trajectory of psychological distress. Secondary outcomes included mental health indicators and short-term cost-utility. Intention-to-treat analyses used generalized estimating equations (GEE).</p><p><strong>Results: </strong>Between Nov 1 and 8, 2024, 1,281 participants were assigned (MIED: n = 641; SAU: n = 640). GEE revealed a significant Group × Time interaction for distress (χ² (4) = 143.611, p < 0.001), with the intervention group demonstrating greater reductions than SAU (Cohen's d = -0.526 at Week 8). Secondary indicators also improved (p < 0.001). From a societal perspective, MIED incurred lower mean costs (993 CNY [~$140] vs 1,326 CNY [~$186]; p < 0.001) with 95% probability of cost-effectiveness at 9,246 CNY [~$1,299] per quality-adjusted life-year. Adherence was high (mean, 6.04 of 8 sessions). No severe adverse events were identified, and self-reported meditation-related adverse experiences declined over time within the intervention group.</p><p><strong>Conclusions: </strong>Compared with SAU, TTT-delivered MIED is a safe, effective, and potentially cost-saving adjunct strategy for scaling mindfulness interventions in resource-constrained systems. Future research should evaluate long-term sustainability beyond 8 weeks.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"1-27"},"PeriodicalIF":9.0,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute affective symptoms during antidepressant tapering indicate withdrawal reactions rather than relapse: Results from a prospective longitudinal cohort study.","authors":"Michael P Hengartner, Andri Rennwald, Oliver Senn, Stefan Neuner-Jehle, Mark A Horowitz","doi":"10.1159/pps/aemag002","DOIUrl":"https://doi.org/10.1159/pps/aemag002","url":null,"abstract":"<p><strong>Introduction: </strong>It remains contested if rapid onset of affective symptoms during antidepressant tapering reflects pharmacological withdrawal effects or relapse of an underlying mental disorder.</p><p><strong>Methods: </strong>A prospective cohort (n=32) of adult primary care patients from Switzerland was assessed repeatedly over 26 weeks after initiation of antidepressant tapering. Dose reductions and within-person change in withdrawal symptoms (DESS affective and discriminatory physical symptom subscales), depressive (PHQ-9) and anxiety symptoms (GAD-7) were assessed over six intervals, resulting in 187 measurements for each variable.</p><p><strong>Results: </strong>Over the 26-week observation period, within-person change in PHQ-9 and GAD-7 scores were strongly associated with concurrent change in DESS affective scores (r≈0.6), and both were also moderately associated with DESS physical scores (r≈0.3). Dose reductions were accompanied by significant increases in DESS affective, PHQ-9 and GAD-7, while scores in both DESS affective and GAD-7 significantly declined during intervals without dose reductions. Within-person change in DESS physical score was independently associated with changes in DESS affective and both PHQ-9 and GAD-7 scores. Adjusting for DESS physical scores substantially attenuated the within-person increase in DESS affective, PHQ-9 and GAD-7 scores during periods with dose reductions.</p><p><strong>Conclusion: </strong>During antidepressant tapering, affective symptoms reflect a periodic course of increasing intensity after dose reductions and decreasing intensity after stabilizations of dosage that is accompanied by change in discriminatory physical withdrawal symptoms. Although causality cannot be inferred, this pattern indicates withdrawal reactions rather than relapse of mental disorders. These findings are relevant for researchers evaluating discontinuation trials and clinicians seeing patients during antidepressant tapering.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"1"},"PeriodicalIF":9.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ACT and CBT single-session interventions reduce procrastination among students compared to a control group - The CONCRAS study.","authors":"Daria Mousavi, Winfried Rief, Marcel Wilhelm","doi":"10.1159/pps/aemag001","DOIUrl":"https://doi.org/10.1159/pps/aemag001","url":null,"abstract":"<p><p>Procrastination is highly prevalent among university students and associated with substantial impairments in well-being and functioning. This randomized controlled trial examined the efficacy of two single-session interventions (SSIs) - one based on Cognitive Behavioural Therapy (CBT) and one on Acceptance and Commitment Therapy (ACT) - for reducing procrastination and tested the role of outcome expectations and experimentally induced expectation (in)congruence. A total of 151 students with recurrent procrastination and a currently postponed task were randomly assigned to a CBT-SSI, ACT-SSI, or a no-intervention control group. Interventions (approximately 60 minutes) were delivered face-to-face and preceded by a videotaped ACT- or CBT-based treatment rationale to manipulate expectation congruence. Assessments took place at baseline, post-intervention, and 2-week follow-up. The primary outcome was state procrastination (APSI-d); secondary outcomes included APSI-d Anxiety and Doubt and Task Aversion, depressive symptoms (PHQ-9), psychological flexibility (CompACT-8), perceived improvement and improvement expectations (G-EEE). Linear mixed models showed a substantial time x condition interaction for state procrastination, with both SSIs yielding significantly greater reductions than the control group and no significant difference between CBT and ACT. Similar patterns emerged for task-related anxiety and doubt, depressive symptoms, psychological flexibility (small-to-moderate gains), and perceived improvement. Higher baseline improvement expectations were associated with greater improvement, whereas expectation congruence and experimentally induced expectation violation did not differentially affect expectations or outcomes. Findings suggest that CBT- and ACT-based SSIs are effective, low-threshold options for reducing procrastination in students in the short term and highlight adherence and treatment expectations as important levers for optimizing brief interventions.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"1"},"PeriodicalIF":9.0,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benchmarking Language Models for Clinical Safety: A Primer for Mental Health Professionals.","authors":"Matthew Flathers, Phuong Anh Nguyen, Julian Herpertz, Mason Granof, Sean Ryan, Leah Wentworth, Christine Yu Moutier, John Torous","doi":"10.1159/000553576","DOIUrl":"https://doi.org/10.1159/000553576","url":null,"abstract":"<p><strong>Background: </strong>Millions of people use language models to discuss mental health concerns, including suicidal ideation, but limited frameworks exist for evaluating whether these systems respond safely. Benchmarking, the practice of administering standardized assessments to language models, offers direct parallels to clinical competency evaluation, yet few clinicians are involved in designing, validating, or interpreting these assessments.</p><p><strong>Aims: </strong>To introduce mental health professionals to benchmarking language models by administering a validated clinical instrument and demonstrating how configuration decisions, measurement limitations, and scoring context affect result interpretation.</p><p><strong>Method: </strong>We administered the Suicide Intervention Response Inventory (SIRI-2) programmatically to nine commercially available language models from three providers. Each item was presented 60 times per model (three prompt variants × two temperature settings x 10 repetitions), yielding 27,000 individually scored responses compared against point-in-time expert consensus.</p><p><strong>Results: </strong>Total scores ranged from 19.5 to 84.0 (expert panel baseline: 32.5). Prompt design alone shifted individual model scores by as much as the difference between trained and untrained human groups. The best performing model approached the instrument's measurement floor. All nine models consistently overrated clinically inappropriate responses that sounded supportive.</p><p><strong>Conclusions: </strong>A single benchmark score can support markedly different claims depending on the assumed standard of clinical behavior, the instrument's remaining measurement range, and the configuration that produced the result. The skills required to make these distinctions must become core competencies. Benchmark results are increasingly utilized to support claims about mental health safety that may not be accurate, making it necessary to close the gap between clinical measurement and AI.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"1-21"},"PeriodicalIF":9.0,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing access to CBT for psychosis patients: a randomized controlled trial evaluating a brief, targeted CBT-informed intervention for distressing voices delivered by Assistant Psychologists (the GiVE3 study).","authors":"Mark Hayward, Katherine Berry, Anna-Marie Bibby-Jones, Stephen Bremner, Kate Cavanagh, Marsha Cochrane, Guy Dodgson, David Fowler, Heather Gage, Kathryn Greenwood, Cassie M Hazell, Sam Robertson, Morro Touray, Peter Williams, Clara Strauss","doi":"10.1159/000553617","DOIUrl":"https://doi.org/10.1159/000553617","url":null,"abstract":"<p><p>Background Cognitive Behaviour Therapy for psychosis (CBTp) is recommended for treating psychosis. However, access to CBTp is extremely poor for patients internationally due to its intensive nature and delivery by highly trained therapists. This study evaluated the clinical and cost effectiveness of the GiVE intervention (Guided self-help CBT for distressing voices) delivered by briefly trained therapists (Assistant Psychologists). Methods This study was a pragmatic, two-arm, parallel group, superiority randomised controlled trial, comparing the GiVE intervention (delivered by Assistant Psychologists) in addition to treatment-as-usual (TAU) to TAU alone, recruiting patients with psychosis across three National Health Service sites in the UK, using 1:1 allocation and blinded post-treatment and follow-up assessments. Clinical and health economic outcomes were assessed at baseline, 16 weeks, and 28 weeks. The primary outcome was the Psychotic Symptom Rating Scale - Auditory Hallucinations Distress Scale (PSYRATS-AH Distress). Results In total, 135 participants were randomised: 68 to GiVE plus TAU, 67 to TAU alone. Participant's mean age was 43.8 years (SD=12.1; range 18-69), 44 (33%) were women, 88 (65%) men, and 2 (1%) non-binary. For the intention-to-treat analysis, adjusted between-group differences in mean PSYRATS-AH Distress were -0·73 (95% CI -2·34 to 0·88; p=0·376; Cohen's d=-0·35) at 16-weeks and -0·61 (95% CI -2·23 to 1·01; p=0·460; Cohen's d=-0·30) at 28-weeks in favour of GiVE plus TAU but were not statistically significant. Conclusion Our study found that the GiVE intervention was not clinically effective in treating distressing voice hearing experiences when delivered by briefly trained Assistant Psychologists to psychosis patients.</p>","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":" ","pages":"1-28"},"PeriodicalIF":9.0,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When memories keep grief alive: A dynamic model of memory characteristics and prolonged grief.","authors":"Franziska Lechner-Meichsner,Omid V Ebrahimi,Anke Ehlers,Kirsten V Smith","doi":"10.1159/000553394","DOIUrl":"https://doi.org/10.1159/000553394","url":null,"abstract":"INTRODUCTIONProlonged grief disorder (PGD) is a condition marked by sustained separation distress. Although cognitive models suggest that memory processes are critical in PGD, the specific characteristics of loss-related memories have received limited longitudinal attention. This study examined how loss-related memory characteristics and prolonged grief symptoms (PGS) influence each other over the first 18 months of bereavement.METHODA community sample of 275 bereaved adults (79% women, Mage = 46.4) completed assessments of PGS and the Oxford Grief-Memory Characteristics Scale at three timepoints (0-6, 6-12, and 12-18 months post-loss). Panel graphical vector autoregressive (GVAR) models decomposed contemporaneous and temporal with-in person associations over time.RESULTSMemory characteristics emerged as the most influential variables over time. Memories high in re-experiencing qualities predicted increasing difficulty accepting the death and a greater range of memory triggers over time, which predicted subsequent difficulty moving forward. Predominantly negative memories were associated with subsequent heightened yearning, while visceral consequences of memories predicted later loneliness, and disconnection from memories of the past self predicted role confusion. Re-experiencing qualities and the PGS emotional numbness had a bidirectional link. Contemporaneous networks showed dense connections among memory characteristics and symptoms within the same time point.CONCLUSIONOverall, the findings demonstrate that loss-related memory processes are predictors of later change in PGS during the first 18-month post-bereavement. This highlights maladaptive memory characteristics as promising mechanistic targets for intervention and supports therapeutic approaches that directly address how memories of loss are encoded, retrieved, and interpreted.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"9 1","pages":"1-25"},"PeriodicalIF":22.8,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148415839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WFP News Section","authors":"","doi":"10.1159/000553470","DOIUrl":"https://doi.org/10.1159/000553470","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"56 1","pages":""},"PeriodicalIF":22.8,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148401039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ICPM News Section","authors":"","doi":"10.1159/000553471","DOIUrl":"https://doi.org/10.1159/000553471","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"6 1","pages":""},"PeriodicalIF":22.8,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148401040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Before Diagnostic Closure: State-Forming Information in Psychiatric Assessment.","authors":"Takehiro Tamura,Hiroki Shiwaku,Hidehiko Takahashi","doi":"10.1159/000553341","DOIUrl":"https://doi.org/10.1159/000553341","url":null,"abstract":"","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"19 1","pages":"1-6"},"PeriodicalIF":22.8,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Schizophrenia Genetic Liability Drives Chronic Disease Risk in Unaffected Individuals Through Immune and Metabolic Pathways.","authors":"Wenming Wei,Bolun Cheng,Dan He,Xin Qi,Jingni Hui,Jin Feng,Shiqiang Cheng,Xuena Yang,Boyue Zhao,Chuyu Pan,Yifan Gou,Yan Wen,Huan Liu,Yumeng Jia,Li Liu,Feng Zhang","doi":"10.1159/000553256","DOIUrl":"https://doi.org/10.1159/000553256","url":null,"abstract":"Background Comorbidity between schizophrenia (SCZ) and chronic diseases is well documented. However, it remains unknown whether unaffected individuals with elevated SCZ genetic liability also face increased risk, and what biological pathways may underlie these associations. Methods We analyzed 426,237 UK Biobank participants without SCZ to test associations between SCZ polygenic risk score (SCZ-PRS) and 24 chronic diseases using logistic regression. Multi-omics mediation analysis incorporated seven inflammatory markers, 1,463 plasma proteins, and 250 circulating metabolites to delineate intermediate pathways linking genetic liability to disease outcomes. Genetic colocalization analyses were further conducted to determine whether SCZ genetic liability and chronic diseases share common association signals at the locus level. Results Higher SCZ-PRS was associated with increased risk of asthma (OR=1.018, 95% CI 1.008-1.029), COPD (1.033, 1.017-1.050), liver disease (1.033, 1.015-1.051), peptic ulcer (1.032, 1.013-1.051), and fluid/electrolyte disorders (1.027, 1.014-1.040), while conferring reduced risk of diabetes (0.979, 0.968-0.991) and renal disease (0.978, 0.964-0.992). Multi-omics mediation revealed that these bidirectional associations were linked to immune cell activity (notably eosinophils, neutrophils, and monocytes), lipid and energy metabolism (lipoprotein composition, fatty-acid unsaturation, creatinine, lactate), and immune-regulatory proteins (e.g., HLA-E, CD1C, SPINT1). Shared genetic signals, notably at HLA and SLC39A8, reinforced these immune-metabolic pathways. Conclusions SCZ-PRS is associated with multiple chronic diseases among unaffected individuals, and these associations suggest shared biological pathways. These findings support a psycho-neuro-immune-metabolic interpretation of SCZ-related chronic physical comorbidity and a more integrated psychosomatic understanding of the shared biology linking psychiatric vulnerability with chronic physical disease.","PeriodicalId":20744,"journal":{"name":"Psychotherapy and Psychosomatics","volume":"9 37 1","pages":"1-20"},"PeriodicalIF":22.8,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148349300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}