Psychiatry Research最新文献

{"title":"Predictors of non-fatal suicide attempts and alignment with clinician assessments of overall risk: Findings from veterans’ comprehensive suicide risk evaluations","authors":"Kevin G. Saulnier ,&nbsp;Courtney L. Bagge ,&nbsp;Dara Ganoczy ,&nbsp;Nazanin H. Bahraini ,&nbsp;Jennifer Jagusch ,&nbsp;Avinash Hosanagar ,&nbsp;Mark A. Ilgen ,&nbsp;Paul N. Pfeiffer","doi":"10.1016/j.psychres.2025.116660","DOIUrl":"10.1016/j.psychres.2025.116660","url":null,"abstract":"<div><div>This study examined the structured suicide risk assessment utilized by the Veterans Health Administration (VHA), the Comprehensive Suicide Risk Evaluation (CSRE), as related to non-fatal suicide attempts (NFSAs) and provider-determined risk level. The study included 269,374 CSREs, assessing 43 suicide warning signs, risk factors, and protective factors. CSREs were completed by 153,736 patients (67.3 % completed a single CSRE; <em>M</em>_age<em>=</em>50.5, 63.6 % White, 86.3 % male). CSREs were the unit of analysis. Multivariable Cox proportional hazards regression models examined NFSAs in the 30 and 365 days after CSRE administration. Multivariable logistic regression models examined provider-determined 1) high acute risk and 2) high chronic risk levels (vs. low or intermediate). Increased risk for 30-day NFSAs was associated with suicidal ideation (multivariable-adjusted hazard ratio [aHR]=2.23), non-firearm lethal means access (aHR=1.31), preparations for a suicide attempt (aHR=1.32), and history of suicidal behavior (aHR=1.52), as well as provider-determined intermediate acute risk (vs. low; aHR=1.39), and high and intermediate chronic risk (vs. low; aHRs=2.33 and 1.71, respectively). Increased risk for 365-day NFSAs was associated with suicidal ideation (aHR=1.84), history of suicidal behavior (aHR=1.61), and firearm access (aHR=0.77) as well as provider-determined high and intermediate chronic risk (vs. low; aHRs=2.07 and 1.56, respectively). In adjusted models, 26 CSRE responses were associated with provider-determined high <u>acute</u> risk (vs. low/intermediate) and 19 CSRE responses were associated with provider-determined high <u>chronic</u> risk. Findings highlight risk factors for subsequent NFSAs and areas of misalignment with factors associated with provider-determined risk, suggesting benefit to assisting providers synthesize information obtained from comprehensive risk evaluations.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"351 ","pages":"Article 116660"},"PeriodicalIF":3.9,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144763809","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":"Looking beyond depression: meta-analysis of digital interventions for depression on eleven secondary mental health and wellbeing outcomes","authors":"Jake Linardon,&nbsp;Cleo Anderson,&nbsp;Mariel Messer,&nbsp;Zoe McClure,&nbsp;Claudia Liu","doi":"10.1016/j.psychres.2025.116657","DOIUrl":"10.1016/j.psychres.2025.116657","url":null,"abstract":"<div><div>Prior meta-analyses show that digital interventions for depression can effectively reduce primary symptoms. However, it remains unclear whether these digital interventions provide broader benefits beyond symptom reduction. Randomized controlled trials (RCTs) of digital depression interventions typically assess a wide range of secondary outcomes, but no study has aggregated these using meta-analytic techniques to quantify the interventions’ broader impacts. This meta-analysis examined the broader effects of digital interventions for depression, analysing various outcomes covering mental health and wellbeing. We located trials from the most recent meta-analysis on digital interventions for depression and updated the search (Jan 2025) to capture new trials. Full inclusion criteria were met in 112 trials overall (97 from the previous meta-analysis and 15 from the updated search). Random effects meta-analyses were conducted on 11 outcomes. Significant pooled effects favouring digital interventions for depression over controls were observed across all outcomes, including anxiety (<em>N</em> = 83; <em>g</em> = 0.40), global (<em>N</em> = 47; <em>g</em> = 0.30), physical (<em>N</em> = 21; <em>g</em> = 0.14) and mental quality of life (<em>N</em> = 37; <em>g</em> = 0.32), distress (<em>N</em> = 23; <em>g</em> = 0.51), disability (<em>N</em> = 28; <em>g</em> = 0.25), stress (<em>N</em> = 13; <em>g</em> = 0.36), behavioral activation (<em>N</em> = 14; <em>g</em> = 0.39), insomnia (<em>N</em> = 10; <em>g</em> = 0.28), self-efficacy (<em>N</em> = 11; <em>g</em> = 0.41), and work functioning (<em>N</em> = 12; <em>g</em> = 0.10). Effects remained largely stable in various sensitivity analyses that adjusted for risk of bias, potential outliers, small-study bias, and differences in population groups. Meta-regressions revealed positive associations between the effect sizes for depression and the effect sizes for nine of the secondary outcomes. Digital interventions for depression may offer transdiagnostic benefits, improving comorbid mental health problems and enhancing several wellbeing indicators.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"351 ","pages":"Article 116657"},"PeriodicalIF":3.9,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722679","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":"Traumatic Brain Injury and Suicidal Thoughts and Behaviors among Post-9/11 Veterans: Investigating Longitudinal Change and Interactions with Mental Health","authors":"Alyssa Bernanke ,&nbsp;Nathan A. Kimbrel ,&nbsp;VA Mid-Atlantic MIRECC Workgroup ,&nbsp;Jean C. Beckham ,&nbsp;Kyle J. Bourassa","doi":"10.1016/j.psychres.2025.116654","DOIUrl":"10.1016/j.psychres.2025.116654","url":null,"abstract":"<div><div>Veterans die by suicide at almost twice the rate of non-veterans, and risks for suicide can be further increased after sustaining traumatic brain injury (TBI). This is notable, given that over 20 % of post-9/11 Veterans are estimated to have experienced TBI. Better understanding risk for suicidal thoughts and behaviors (STBs) would allow for improved screening processes and targeted treatment approaches. In this study, we use data from 823 veterans who served after September 11, 2001 and participated in the VISN 6 MIRECC’s Post-Deployment Mental Health Study. In total, 511 (62.1 %) veterans reported at least one TBI during their lifetime and 241 (29.3 %) reporting at least one TBI during military deployment. Veterans had more STBs at baseline if they also reported more lifetime TBIs (β = 0.45, CI [0.18, 0.72], <em>p</em> &lt; .001) or deployment TBI (β = 0.53, CI [0.16, 0.90], <em>p</em> = .005). When examining change over 12 years, veterans showed greater increases in STBs if they reported more lifetime TBIs (β = 0.34, CI [0.12, 0.55], <em>p</em> = .002) or deployment TBI (β = 0.62, CI [0.33, 0.91], <em>p</em> &lt; .001). These associations remained when accounting for baseline mental health conditions (depressive symptoms, posttraumatic stress disorder symptoms, and lifetime trauma burden). All reported results accounted for age, gender, self-reported race/ethnic group, and education. Findings suggest that TBI is associated with increases in STBs and emergence of STBs over time. To better differentiate risk, screening measures and treatment for STBs should consider whether brain injury occurred in combat.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"351 ","pages":"Article 116654"},"PeriodicalIF":3.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757148","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":"Soluble interleukin-6 receptor–associated functional connectivity as an indicator of bipolar disorder prognosis","authors":"Yen-Ling Chen ,&nbsp;Tzu-Hsuan Huang ,&nbsp;Pei-Chi Tu ,&nbsp;Tung-Ping Su ,&nbsp;Mu-Hong Chen ,&nbsp;Ya-Mei Bai ,&nbsp;Yu-Te Wu","doi":"10.1016/j.psychres.2025.116652","DOIUrl":"10.1016/j.psychres.2025.116652","url":null,"abstract":"<div><h3>Background</h3><div>Predictive neurobiological markers are essential for indicating the prognosis of patients with bipolar disorder (BD). Exploring the association between soluble interleukin-6 receptor (sIL-6R) and alterations in functional connectivity (FC) may contribute to an improved understanding of the pathophysiology of BD. Therefore, on the basis of the heterogeneous types of inflammation exhibited by patients with BD, sIL-6–associated FC was investigated as a predictor of various treatment responses.</div></div><div><h3>Methods</h3><div>A total of 165 patients with BD were recruited and assessed using the Young Mania Rating Scale, Montgomery–Åsberg Depression Rating Scale (MADRS), Personal and Social Performance (PSP) Scale, and Global Assessment of Functioning (GAF) Scale at baseline and 1-year follow-up. Agglomerative hierarchical clustering by using sIL-6R–associated FC was used to divide patients with BD into subgroups. Then, the changes in symptom and functioning scores among the clusters were compared.</div></div><div><h3>Results</h3><div>Regarding major FC, the subgroup that had a significantly decreased MADRS score and increased PSP and GAF scores exhibited lower connectivity between the medial frontal network (MFN) and motor network (MON) and within the MON and higher connectivity between the MFN and default mode network (DMN) and within the MFN than the other subgroup. Moreover, these altered FC findings may be remediated through a mildly increased sIL-6R level.</div></div><div><h3>Conclusion</h3><div>These altered connections displayed a counteractive direction on the most pronounced abnormal FC of patients with BD and are recommended to help patients offset the detrimental effects of neuroinflammation.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"351 ","pages":"Article 116652"},"PeriodicalIF":3.9,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724042","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":"Early-stage assessment of investigational digital technologies in mental health: a guide for innovators","authors":"Zoltán Kaló ,&nbsp;Attila Imre ,&nbsp;Manna Tatár ,&nbsp;Balázs Nagy","doi":"10.1016/j.psychres.2025.116634","DOIUrl":"10.1016/j.psychres.2025.116634","url":null,"abstract":"<div><div>Digital technologies, including artificial intelligence, hold great promise for transforming mental health care by enhancing diagnosis, personalizing treatments, and improving patient support. However, many innovations fail to reach clinical practice due to challenges in development and implementation. In this paper we address the implementation issue, whereby we introduce Early-stage Health Technology Assessment (eHTA) as a systematic approach to guide the development of digital technologies in mental health care. eHTA involves evaluating a technology's potential clinical benefits, economic value, and feasibility at an early stage. We present a five-step framework to assist developers of these inventions: (1) assessing the degree of innovation by determining how the new technology differs from existing solutions; (2) defining the target product profile by outlining its intended use, target population, and key features; (3) selecting an appropriate payment model by identifying who will pay for the technology and understanding their expectations; (4) translating clinical benefits into economically meaningful outcomes important to payers, such as improved clinical outcomes or cost savings; and (5) determining a pricing strategy that reflects the technology's value while remaining acceptable to payers and accessible to patients. By following these steps, innovators can align their technologies with clinical needs, generate necessary evidence, and create strategies for successful integration into mental health services. Incorporating early HTA in the development process is crucial for maximizing both the clinical impact and the successful adoption of digital technologies in mental health care.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"351 ","pages":"Article 116634"},"PeriodicalIF":3.9,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144723960","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":"Characterizing oligodendrocyte-lineage cells and myelination in the basolateral amygdala: Insights from a novel methodology in postmortem human brain","authors":"Kelly Perlman ,&nbsp;Emanuel Curto ,&nbsp;Sarah Barnett-Burns ,&nbsp;Maria-Antonietta Davoli ,&nbsp;Volodymyr Yerko ,&nbsp;Reem Merza ,&nbsp;Andreas I Papadakis ,&nbsp;Alan Spatz ,&nbsp;Christopher R Pryce ,&nbsp;Gustavo Turecki ,&nbsp;Naguib Mechawar","doi":"10.1016/j.psychres.2025.116653","DOIUrl":"10.1016/j.psychres.2025.116653","url":null,"abstract":"<div><div>The basolateral amygdala (BLA) plays a key role in the pathophysiology of depressive disorders and trauma, yet oligodendrocyte (OL)-lineage cells and myelin in this region remain understudied in humans. This may be due in part to the lack of a cost-effective, antibody-based method to isolate OL and OL precursor cells (OPC) from postmortem brain tissue. This study aimed to 1) create and validate a method for isolating OPC and OL nuclei from postmortem grey matter; 2) compare OPC and OL gene expression in the BLA between individuals with depression who died by suicide (with or without a history of childhood abuse) and matched controls; and 3) provide histological characterizations of OPCs, OLs, and myelin in the BLA. Frozen left-hemisphere BLA samples were obtained from brain donors with well-characterized phenotypic information. Immunolabeled nuclei were sorted into OPC (SOX10+/CRYAB−) and OL (SOX10+/CRYAB+) populations, and RNA was measured using a custom Nanostring codeset. OPC (PDGFRα+) and OL (MYRF+) densities were determined using RNAScope, and axons (NF-H) and myelin (MBP) were labeled by immunofluorescence to assess myelin area fraction. This method successfully isolated OPC and OL nuclei with correct transcriptomic profiles. In the OL fraction, MOBP expression was significantly decreased in depressed individuals with a history of childhood abuse compared to controls. No other genes showed group differences in either fraction, though significant age-related expression patterns were observed. Furthermore, no group differences were seen in cell densities or myelin coverage. This study validates a novel sorting method and provides a comprehensive characterization of OL-lineage gene expression, cell densities, and myelin in the human BLA.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"351 ","pages":"Article 116653"},"PeriodicalIF":3.9,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738699","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":"Prevalence and clinical correlates of dissociation symptoms in chinese patients with bipolar disorder: An exploratory cross-sectional study","authors":"Huixue Xu ,&nbsp;Qian Yang ,&nbsp;Zejun Li ,&nbsp;Min Wu ,&nbsp;Xin Wang ,&nbsp;Pu Peng ,&nbsp;Qiuxia Wu ,&nbsp;Tieqiao Liu","doi":"10.1016/j.psychres.2025.116650","DOIUrl":"10.1016/j.psychres.2025.116650","url":null,"abstract":"<div><h3>Background</h3><div>Increasing studies indicate that dissociation symptoms (DS) are common in bipolar disorder (BD) patients, but little is known about it in Chinese patients. This study aimed to assess the prevalence and clinical correlates of DS in this population.</div></div><div><h3>Methods</h3><div>Patients diagnosed with BD were recruited between December 2021 and February 2024. The study assessed DS alongside depressive and anxiety symptoms, manic episode frequency and severity, psychotic symptoms, childhood traumatic experiences, borderline personality traits, suicide risk, quality of life (QOL), and demographic data. Statistical analyses mainly included Spearman’s correlation and regression analyses.</div></div><div><h3>Results</h3><div>A total of 517 BD patients were recruited. The study found that 53.5% had a high-level DS (measured by Dissociative Experiences Scale-II total score ≥30). Those with DS showed earlier age of onset, more severe clinical symptoms, increased childhood trauma and borderline personality traits, and poorer QOL. Correlation analyses revealed significant positive associations between DS and depressive, anxiety, manic, psychotic symptoms, suicide risk, borderline personality traits, and childhood trauma, with a negative correlation to QOL. Regression analyses indicated that depressive (<em>β</em> = 0.243), manic (<em>β</em> = 0.167), childhood traumatic experience (<em>β</em> = 0.113), and borderline personality traits (<em>β</em> = 0.228) significantly predicted DS.</div></div><div><h3>Limitations</h3><div>Cross-sectional design with convenience sampling and small sample size, backward clinical assessment of psychotic symptoms.</div></div><div><h3>Conclusions</h3><div>As a preliminary exploratory study, the findings highlight a notable prevalence of DS among Chinese BD patients, emphasizing its association with various clinical characteristics. The findings support targeted screening and early intervention for DS in BD patients.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"351 ","pages":"Article 116650"},"PeriodicalIF":4.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144711346","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":"Suicidality among sexual minority individuals: A preregistered systematic umbrella review of 20 years of research","authors":"Annika A. Zwickl ,&nbsp;Ulrich S. Tran ,&nbsp;Sofie Schmied ,&nbsp;Valentina Hampejs ,&nbsp;Martin Voracek","doi":"10.1016/j.psychres.2025.116648","DOIUrl":"10.1016/j.psychres.2025.116648","url":null,"abstract":"<div><h3>Purpose</h3><div>This preregistered (PROSPERO CRD42022384378) inclusive systematic umbrella review (adhering to the PRISMA-Equity extension guidelines) aimed to exhaustively synthesize suicidality (encompassing suicidal ideations, suicidal behaviors, suicide attempts, and death by suicide) among sexual minority individuals.</div></div><div><h3>Methods</h3><div>A systematic umbrella review was conducted, with eligible studies identified through databases and cited-reference searches. Systematic reviews, meta-analyses, or scoping reviews addressing suicidality in sexual minority individuals (lesbian, gay, bisexual individuals) were included. Quality of reviews was assessed, using AMSTAR-2. Qualitative evidence synthesis and study overlap analysis across reviews were conducted.</div></div><div><h3>Results</h3><div>53 reviews, published 2006–24, were eligible, encompassing 570 primary studies. Most reviews strongly indicated increased risks of suicidality among sexual minority individuals. For suicidal ideation, reported odds ratios ranged from 1.56 to 5.04, and for suicide attempts from 1.13 to 8.36. There was broad evidence for increased suicide risk among various sexual minority subgroups, including men who have sex with men, bisexual individuals, and those from ethnic minority backgrounds. Quality among included reviews varied considerably (on average, 58%, range: 16.7–87.7%, expressed as POMP [percent of maximum possible] scores of applicable AMSTAR-2 quality features). Overlap of primary literature across all 53 reviews was low, indicating substantial diversity in the reviews’ inclusion criteria and research aims and a need for more comprehensive research syntheses.</div></div><div><h3>Conclusions</h3><div>Future research on this topic should adopt intersectional sampling, utilize longitudinal studies for deeper understanding, and improve reporting. Mental health professionals need specialized training, support organizations should provide safe spaces, and policymakers must prioritize mental health and anti-discrimination laws.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"351 ","pages":"Article 116648"},"PeriodicalIF":3.9,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757147","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":"Parental educational levels association with autism risk in offsprings and their autistic phenotypes","authors":"Xian Liu ,&nbsp;Cheng Guo ,&nbsp;Linzhuo Lyu ,&nbsp;Huan Liu ,&nbsp;Jing Yu ,&nbsp;Zhifang Huang ,&nbsp;Li Yang ,&nbsp;Wenqing Wei ,&nbsp;Jingyu Huang ,&nbsp;Cailing Liao ,&nbsp;Yunting Li ,&nbsp;Liyu Chen ,&nbsp;Wen-Xiong Chen","doi":"10.1016/j.psychres.2025.116649","DOIUrl":"10.1016/j.psychres.2025.116649","url":null,"abstract":"<div><div>This study aims to explore the association between parental education levels and the risk of autism in offspring, as well as to further investigate the relationship between parental education and the phenotypic characteristics of autistic symptoms. The study is based on an autism cohort of 835 autistic children, with a control group of 504 typically developing children randomly selected for comparison. Socioeconomic data from the parents of the study participants were collected, and the clinical phenotypes of the autistic children were assessed. Multivariate logistic regression and linear analyses were conducted. Our findings indicate that higher parental education levels significantly reduce the risk of autism in offspring. Furthermore, higher parental education is associated with milder autism severity and better cognitive, language, and adaptive behavior development. This study underscores the association between higher parental education levels and a lower risk of autism in offspring, as well as milder clinical phenotypes, highlighting the urgent need for targeted support for families with lower educational attainment.</div></div><div><h3>Lay Summary</h3><div>This study found that higher parental education levels are associated with a lower risk of autism in children, as well as milder autism symptoms. Additionally, higher parental education is linked to better cognitive, language, and adaptive behavior development in children. The study highlights the impact of parental education levels on autism risk and clinical phenotypes, and calls for more support for families with lower educational attainment.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"351 ","pages":"Article 116649"},"PeriodicalIF":4.2,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714191","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":"Outcomes of patients receiving interventional psychiatric procedures in a large integrated healthcare system","authors":"Kevin J. Li ,&nbsp;Natalie E. Slama ,&nbsp;Ingrid L. Chen ,&nbsp;Samuel Ridout ,&nbsp;Esti Iturralde","doi":"10.1016/j.psychres.2025.116647","DOIUrl":"10.1016/j.psychres.2025.116647","url":null,"abstract":"<div><div>Interventional psychiatric procedures (IPPs) such as electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), and ketamine intravenous treatments (KIT) are widely used for treatment resistant depression (TRD), but we lack studies of their real-world impact compared to standard outpatient medication management (MM). Longitudinal electronic health records of 22,481 patients in a large integrated healthcare system during 2018–2022 were examined to describe depression improvement via 9-item Patient Health Questionnaire (PHQ-9), changes in psychiatric admissions, and use of continuation/maintenance (C/M) treatments. Overall, each IPP group had significantly greater depression improvement at 6 weeks compared to MM: adjusted estimates TMS:1.64 (<em>p</em> &lt; 0.001), KIT:2.02 (<em>p</em> &lt; 0.001), and ECT:2.16 (<em>p</em> &lt; 0.001). Patient characteristics were associated with symptom worsening within treatment groups, for example: (1) non-white race for ECT (2.33, <em>p</em> &lt; 0.01) and MM (0.29, <em>p</em> &lt; 0.001); (2) anxiety disorder for TMS (1.73, <em>p</em> &lt; 0.001); and (3) personality disorder for all treatment groups, with significant coefficients found for KIT (3.27, <em>p</em> &lt; 0.05) and MM (1.27, <em>p</em> &lt; 0.001). Some examples of correlations with improved symptom response include: (1) psychotic disorder for ECT (-3.57, <em>p</em> &lt; 0.01); and (2) bipolar disorder for KIT (-2.19; <em>p</em> &lt; 0.05). For the KIT group, C/M treatment versus no C/M treatment was associated with lower risk for 12-month psychiatric hospitalization (adjusted relative risk: 0.25). This is the first study to show a protective association for maintenance ketamine on psychiatric hospitalization risk. Treatment-specific predictors of response should be confirmed in future comparative effectiveness studies.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"351 ","pages":"Article 116647"},"PeriodicalIF":4.2,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144713122","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}