Psychiatry Research最新文献

{"title":"Diagnostic Accuracy of “System for the Assessment of Children and Adolescents” (SENA) for Emotional Disorders in Youth: Insights from the EmoChild Study in Spain","authors":"Jose A. Piqueras ,&nbsp;Raul Castaño ,&nbsp;Laura Ballester ,&nbsp;Gemma Vilagut ,&nbsp;Jordi Alonso ,&nbsp;Alexandra Morales ,&nbsp;Jose P. Espada ,&nbsp;Mireia Orgiles","doi":"10.1016/j.psychres.2026.116994","DOIUrl":"10.1016/j.psychres.2026.116994","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the diagnostic accuracy of the System for the Assessment of Children and Adolescents (SENA) in identifying emotional disorders and suicidal thoughts and behaviors. SENA is a widely used Spanish screening tool for assessing emotional and behavioral symptoms in youth.</div></div><div><h3>Method</h3><div>526 primary and secondary pupils aged 8-16 in several Spanish regions (a subset of the EmoChild Project, n=5,652 completed SENA), completed the SENA and underwent with clinical interviews using KSADS-COMP within 3 months. We screened potential participants by identifying possible positive and negative cases based on a T-score equivalent to the 75th percentile and served as a cut-off point for accessing a diagnostic interview.</div></div><div><h3>Results</h3><div>SENA’s Emotional subscale showed a sensitivity (SN) of 78.5% in children and 80.4% in adolescents for detecting any emotional disorder, with specificities (SP) of 65.9% and 66.1%, and Area Under the ROC curve (AUC) of .74 in children and .73 in adolescents. AUCs were adequate for all subscales (0.72-0.93) other than obsessive compulsive disorder (AUC=.67). Specific subscales performed best: Generalized Anxiety Disorder (SN=100%, SP=88.4%) and Social Anxiety Disorder-SAD (SN = 91.4%, SP = 80.3%) in children, and SAD (SN=88.1%, SP=72.5%), Post-Traumatic Stress Disorder (SN=81.2%, SP=68.2%) and suicidal thoughts in adolescents (SN=84.5%, SP=73.8%).</div></div><div><h3>Conclusions</h3><div>SENA is a valuable screening tool for educational and clinical settings, facilitating early intervention through a standardized and user-friendly assessment. Nevertheless, there is need for refined thresholds to enhance specificity and clinical alignment.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"358 ","pages":"Article 116994"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137659","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":"A comparative study of medication adherence in schizophrenia patients receiving clozapine and other antipsychotics","authors":"Shweta Chanalia,&nbsp;Sandeep Grover,&nbsp;Subho Chakrabarti","doi":"10.1016/j.psychres.2025.116879","DOIUrl":"10.1016/j.psychres.2025.116879","url":null,"abstract":"<div><h3>Background</h3><div>There is a lack of data on medication adherence among patients receiving clozapine from Asian countries. Few studies across the globe have longitudinally assessed medication adherence among clozapine patients.</div></div><div><h3>Aim</h3><div>This study aimed to longitudinally evaluate medication adherence and its correlates in schizophrenia patients receiving clozapine and compare the same with patients receiving other oral second-generation antipsychotics (SGAs).</div></div><div><h3>Methods</h3><div>100 patients receiving clozapine and 100 patients with another SGA were evaluated at two-time points six months apart for medication adherence using the Medication Adherence Questionnaire (MAQ) and Compliance Rating Scale (CRS).</div></div><div><h3>Results</h3><div>At the baseline assessment a higher percentage of patients in the clozapine group were fully adherent to their medication as per the MAQ. On CRS, a significantly higher proportion of patients on clozapine reported passive acceptance of medication and resultantly had better medication adherence. At the follow-up assessment, compared to patients on clozapine, a higher proportion of patients on other SGAs reported forgetting to take medication, being careless of taking medication, and stopping medication when they felt better. Overall, the medication adherence of patients on clozapine was higher than that for patients on other SGAs as assessed on MAQ and CRS.</div></div><div><h3>Conclusion</h3><div>To conclude, the present study suggests that about one-third of patients using clozapine and other SGAs are poorly adherent to their medications, and medication adherence among patients receiving clozapine is better than those receiving other SGAs.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"358 ","pages":"Article 116879"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080191","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":"Clinical remission, functional recovery, and employment in early-phase schizophrenia treated with paliperidone palmitate: An 18-month longitudinal Asia-Pacific study","authors":"Chien-Heng Lin ,&nbsp;Chih-Lin Chiang ,&nbsp;Dae Young Yu ,&nbsp;Hiroshi Horio ,&nbsp;Natsuko Tokushige ,&nbsp;David Bin-Chia Wu","doi":"10.1016/j.psychres.2026.116955","DOIUrl":"10.1016/j.psychres.2026.116955","url":null,"abstract":"<div><h3>Objective</h3><div>The study aimed to evaluate the impact of monthly paliperidone palmitate (PP1M) on competitive employment and clinical/function remission in patients with early-phase schizophrenia during an 18-month observational period of a multicenter, open-label, single-arm clinical trial.</div></div><div><h3>Methods</h3><div>Patients with schizophrenia diagnosed within 5 years were enrolled across the Asia-Pacific region and received PP1M treatment. Employment status (full-time or part-time), symptom severity, and psychosocial functioning were assessed using standardized instruments. Predictors of employment improvement were identified through logistic regressions.</div></div><div><h3>Results</h3><div>A total of 474 patients were enrolled, with competitive employment rates rising from 28.1 % at baseline to 45.4 % at month 18. For patients unemployed at baseline, the employment rate improved to 33.8 % at month 18. Significant remission improvements were observed in PANSS (40.0 % to 80.4 %), CGI-SCH (55.6 % to 89.3 %), and PSP (25.2 % to 65.4 %) over the same period. Employment and remissions followed distinct improvement trajectories. Baseline employment status (adjusted OR 5.544, 95 % CI: 2.902-10.592) and male sex (adjusted OR 1.927, 95 % CI 1.066–3.483) were significantly associated with employment improvement in multivariate analyses.</div></div><div><h3>Conclusion</h3><div>PP1M treatment resulted in significant improvements in clinical symptoms, functional recovery, and competitive employment over 18 months. The findings emphasize the need to address systemic barriers to employment while supporting sustained clinical and functional recovery to facilitate workforce reintegration for schizophrenia patients.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"358 ","pages":"Article 116955"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146025907","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":"Correspondence regarding “Efficacy of esketamine after cesarean section for women with symptoms of prenatal depression: A randomized controlled trial by Xue-Song et al.","authors":"Fu-Shan Xue ,&nbsp;Dan-Feng Wang ,&nbsp;Yan-Hua Guo","doi":"10.1016/j.psychres.2026.116982","DOIUrl":"10.1016/j.psychres.2026.116982","url":null,"abstract":"","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"358 ","pages":"Article 116982"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146126211","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":"Genetic studies of psychosocial disability establish correlations and causal relationships with neuropsychiatric disorders","authors":"Evie Doherty ,&nbsp;Aodán Laighneach ,&nbsp;Mia Casburn ,&nbsp;Fergus Quilligan ,&nbsp;Gary Donohoe ,&nbsp;Dara M. Cannon ,&nbsp;Derek W. Morris","doi":"10.1016/j.psychres.2026.116963","DOIUrl":"10.1016/j.psychres.2026.116963","url":null,"abstract":"<div><div>Psychosis is a clinically heterogenous disorder associated with significant difficulties with social and occupational function (psychosocial disability; PD). While environmental and cognitive factors are identified predictors of PD, the genetic contribution remains unclear. Here, we investigated the hypothesis that objective social participation (SP) and occupational engagement are genetically influenced.</div><div>We performed mixed-linear-model genome-wide association studies of these phenotypes in the UK Biobank (<em>N</em>∼404,500) and a series of post-hoc analyses including Mendelian randomization (MR) to interpret findings. SP was defined as the frequency of social visits and leisure activities based on response to questionnaires. Occupational engagement was represented by two variables: occupational function (OF) and the established Not in Education, Employment, and Training (NEET) measure, both derived from employment status responses. We identified 17 independent loci for SP, with a SNP-based heritability of 4.1%. A list of contributory genes included <em>TNRC6B, STAU1, CDH7, GBE1, DDX27</em>, and several known schizophrenia risk genes including <em>CSE1L, ZNF536 and TCF4</em>. The regulation of synaptic signalling was implicated in the biology of SP by gene-set analysis. SNP-based heritabilities for OF and NEET were 1.8% and 1.3% respectively and <em>DRD2</em> was associated with both phenotypes by gene-based analysis. Reduced SP and occupational engagement demonstrated genetic correlations with an increased risk for neuropsychiatric disorders, socioeconomic deprivation, lower cognitive ability, loneliness, neuroticism and chronic pain. MR indicated that attention-deficit hyperactivity disorder and schizophrenia were likely causal for reduced occupational engagement.</div><div>PD has a genetic component with shared genetic links and relationships with neuropsychiatric disorders and related traits.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"358 ","pages":"Article 116963"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197937","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":"A multi-cohort assessment of the polygenic prediction in ADHD treatment response","authors":"Diego L. Rovaris ,&nbsp;Eugenio H. Grevet ,&nbsp;André Høberg ,&nbsp;Pâmela F. da Cunha ,&nbsp;Natalia Llonga ,&nbsp;Pau Carabí-Gassol ,&nbsp;Eduarda P. Oliveira ,&nbsp;Cibele E. Bandeira ,&nbsp;Maria Eduarda A. Tavares ,&nbsp;María Soler Artigas ,&nbsp;Josep Antoni Ramos-Quiroga ,&nbsp;Christian Fadeuilhe ,&nbsp;Montse Corrales ,&nbsp;Vanesa Richarte ,&nbsp;Astri J. Lundervold ,&nbsp;Anne Halmøy ,&nbsp;Eduardo S. Vitola ,&nbsp;Luis A. Rohde ,&nbsp;Marta Ribasés ,&nbsp;Jan Haavik ,&nbsp;Bruna S. da Silva","doi":"10.1016/j.psychres.2026.116988","DOIUrl":"10.1016/j.psychres.2026.116988","url":null,"abstract":"<div><div>Pharmacological treatments for attention-deficit/hyperactivity disorder (ADHD) are efficacious and safe; however, substantial interindividual variability in treatment response persists, with many patients experiencing suboptimal outcomes or early discontinuation. Although genetic factors have been proposed as contributors to this variability, clinically actionable predictors remain elusive. Here, we present the first meta-analysis evaluating whether polygenic liability for ADHD and related psychiatric and behavioral-cognitive phenotypes is associated with clinically meaningful response to methylphenidate in 1000 ADHD cases from Norway, Brazil, and Spain assessed in real-world settings. Polygenic scores (PGS) for ADHD, autism, bipolar disorder, educational attainment, major depressive disorder, neuroticism, and schizophrenia were calculated separately for each cohort. Treatment response was assessed using evaluations of global clinical improvement and harmonized by categorizing individuals as responders or non-responders. Cohort-specific associations were combined using fixed-effects meta-analysis. No PGS showed a significant association with treatment response. Effect sizes were small, consistent across cohorts, and characterized by minimal between-study heterogeneity. Sensitivity analyses incorporating clinical and treatment-related covariates yielded convergent results. As the first meta-analytic evaluation of polygenic predictors evaluating clinically meaningful ADHD stimulant response, these findings delineate the current limits of PGS in pharmacogenomic applications. Rather than supporting immediate clinical utility, our results highlight key methodological and conceptual constraints, including limited sample sizes, heterogeneous outcome definitions, and the indirect nature of susceptibility-based PGS for predicting treatment response. By mapping these boundaries, this study provides a framework to recalibrate research priorities and guide the next generation of ADHD pharmacogenomic studies toward larger, harmonized, and more informative definitions of treatment response.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"358 ","pages":"Article 116988"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143504","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":"Transdiagnostic investigation of white matter integrity and cortical thickness in cognitive subgroups within the schizophrenia-bipolar spectrum","authors":"Burcu Verim ,&nbsp;Cemal Demirlek ,&nbsp;Nabi Zorlu ,&nbsp;Burak Erdeniz ,&nbsp;Ozge Akgul ,&nbsp;Deniz Ceylan ,&nbsp;Koksal Alptekin ,&nbsp;Aysegul Ozerdem ,&nbsp;Berna Binnur Akdede ,&nbsp;Emre Bora","doi":"10.1016/j.psychres.2026.116964","DOIUrl":"10.1016/j.psychres.2026.116964","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive deficits are cardinal features of schizophrenia-spectrum disorders (SSD) and bipolar disorder (BD). However, their heterogeneous and overlapping characteristics require a dimensional approach to better understand the neurobiological basis of cognition in the psychosis spectrum. To date, only a few studies have examined the neuroanatomical features of cognitive subgroups in transdiagnostic samples, and white matter microstructural characteristics of these subgroups have not been elucidated. This study aimed to investigate white matter and cortical thickness alterations in cognitive subgroups in the schizophrenia-bipolar spectrum.</div></div><div><h3>Methods</h3><div>Globally Impaired (<em>n</em> = 31) and Near-Normal (<em>n</em> = 28) cognitive subgroups, comprising individuals diagnosed with schizophrenia (SZ), schizoaffective disorder (SAD) or BD, and healthy controls (HCs, <em>n</em> = 29), underwent 3T T1-weighted structural magnetic resonance imaging and diffusion tensor imaging scanning. Fractional anisotropy and cortical thickness measures were compared between the cognitive subgroups and healthy controls.</div></div><div><h3>Results</h3><div>Abnormalities in white matter microstructure were only observed in patients with global cognitive impairment compared to HCs. The Near-Normal subgroup did not differ from HCs in white matter integrity. A bilateral reduction in cortical thickness was observed in both the Globally Impaired and Near-Normal subgroups when compared to HCs. Cortical thickness measures did not differentiate between the cognitive subgroups.</div></div><div><h3>Conclusions</h3><div>While reductions in cortical thickness in frontal and temporal regions appear to be a common feature of SZ and BD, abnormalities in white matter microstructure are associated with global cognitive impairment in the schizophrenia-bipolar spectrum. These original findings may be important in identifying more biologically valid clinical syndromes within the schizophrenia-bipolar spectrum.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"358 ","pages":"Article 116964"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080186","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":"Social networks and symptomatology in recently hospitalized individuals with schizophrenia-spectrum disorders: A six-month longitudinal study","authors":"Gabriella V. Schock ,&nbsp;Andrew R. Kittleson ,&nbsp;Annalise S. Halverson ,&nbsp;Jinyuan Liu ,&nbsp;Julia M. Sheffield","doi":"10.1016/j.psychres.2026.116960","DOIUrl":"10.1016/j.psychres.2026.116960","url":null,"abstract":"<div><div>Individuals with psychosis have reduced social networks; however, little is known about whether social networks change over time, particularly after an acute episode requiring hospitalization. Furthermore, longitudinal associations between social network engagement, symptom severity, and the impact of illness duration remains unclear. Using linear mixed models controlling for age and sex, we analyzed self-reported social network engagement, positive and negative symptom severity, and self-reported paranoia in individuals with a schizophrenia-spectrum disorder (SSD; <em>N</em> = 68) during six months following psychiatric hospitalization and compared them with non-clinical participants (NC; <em>N</em> = 70). SSD participants reported significantly lower social network scores than NC participants at every time point (<em>b</em> = –5.77), and significantly greater disruption in friendship than family ties (<em>b</em> = – 2.00). Social networks remained stable over time in both groups (<em>b</em> = –0.01), regardless of illness stage in the SSD group (<em>b</em> = 8.08). Notably, lower social engagement with family at baseline predicted greater increases in paranoia over time (<em>b</em> = –1.01). Conversely, more severe paranoia at baseline predicted greater reductions in friend networks over time (<em>b</em> = –0.03). Finally, social network related to negative symptom severity at baseline (<em>b</em> = –0.42) and longitudinally (<em>b</em> = –0.18). These findings suggest that clinical severity may influence the social network disruptions commonly found in psychotic disorders, especially during vulnerable periods of recovery following a psychotic exacerbation. Ultimately, this highlights the need for tailored post-discharge interventions that address social network deficits, particularly within families and in the context of severe paranoia.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"358 ","pages":"Article 116960"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146025897","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":"From noise to signal: Interpreting heterogeneity in ADHD-related non-suicidal self-injury","authors":"Herul Wahyudin ,&nbsp;Maria Oktasari ,&nbsp;Ida Dwi Lestari","doi":"10.1016/j.psychres.2026.117001","DOIUrl":"10.1016/j.psychres.2026.117001","url":null,"abstract":"<div><div>Meta-analytic evidence indicates that non-suicidal self-injury (NSSI) is substantially more prevalent among individuals with attention-deficit/hyperactivity disorder (ADHD), yet estimates are accompanied by extreme between-study heterogeneity and preliminary sex-stratified differences. In this Letter to the Editor, we argue that such heterogeneity should be interpreted not only as a methodological limitation but also as a clinically meaningful signal of multiple, context-dependent pathway configurations linking ADHD and NSSI. We propose a pathway-oriented framing in which ADHD related NSSI vulnerability may cluster around impulsivity/emotion dysregulation, internalizing burden, and context-sensitive factors that shape detection and help seeking. We further caution that sex-related estimates may be influenced by gender differences in symptom expression, diagnostic timing, and measurement practices, and therefore require explicitly gender-sensitive designs. Finally, we outline how this interpretation can strengthen translation by supporting person-centered, context sensitive screening—pairing routine NSSI assessment with brief internalizing probes—without extending the scope of the original meta-analysis.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"358 ","pages":"Article 117001"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158090","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":"Prolonged grief and psychological distress among the public amidst the ongoing hostage crisis following the october 7 attack","authors":"Yoav Groweiss ,&nbsp;Carmel Blank ,&nbsp;Hili Kohavi ,&nbsp;Doron Amsalem ,&nbsp;Yuval Neria ,&nbsp;Yossi Levi-Belz","doi":"10.1016/j.psychres.2026.116978","DOIUrl":"10.1016/j.psychres.2026.116978","url":null,"abstract":"<div><h3>Background</h3><div>The October 7, 2023, terrorist attack in Israel led to over 1,200 civilian deaths and the abduction of 251 individuals to Gaza. While prior studies have documented the psychological toll on directly affected populations, the broader emotional impact of the ongoing hostage crisis on the general public remains unclear. This study explored how public concern for the hostages relates to psychological distress and functional impairment, focusing on prolonged grief–like responses in the context of unresolved national uncertainty.</div></div><div><h3>Methods</h3><div>A nationally representative sample of 515 Israeli adults completed self-report questionnaires at two time points: August 2023 (pre-attack) and May 2025. Measures included anxiety, depression, PTSD symptoms, cumulative stress, emotional burnout, and daily functioning. Concern for the hostages was rated on a 4-point scale. Symptoms associated with Prolonged Grief Disorder (PGD) were measured using an adapted PG-13 scale. Multivariate analyses controlled for baseline distress and trauma exposure.</div></div><div><h3>Results</h3><div>Higher concern levels were significantly associated with elevated distress across all symptom domains. Approximately half of the participants (48.7%) reported elevated levels of PGD-like symptoms in relation to the hostage situation, exhibiting significantly higher psychological symptoms and lower functional well-being, including poorer sleep, reduced concentration, and diminished optimism and hope.</div></div><div><h3>Conclusions</h3><div>Findings indicate that the prolonged hostage crisis constitutes a collective psychological burden marked by ambiguous loss and unresolved national trauma. This form of distress affects even those without direct exposure. Mental health efforts may therefore benefit from addressing distress related not only to direct trauma and bereavement, but also to prolonged uncertainty and symbolic loss.</div></div>","PeriodicalId":20819,"journal":{"name":"Psychiatry Research","volume":"358 ","pages":"Article 116978"},"PeriodicalIF":3.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119995","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}