Psychological Medicine最新文献

{"title":"Protective role of school climate for impacts of COVID-19 on depressive symptoms and psychotic experiences among adolescents: a population-based cohort study.","authors":"Satoshi Yamaguchi, Jordan DeVylder, Syudo Yamasaki, Shuntaro Ando, Mitsuhiro Miyashita, Mariko Hosozawa, Kaori Baba, Junko Niimura, Naomi Nakajima, Satoshi Usami, Kiyoto Kasai, Mariko Hiraiwa-Hasegawa, Atsushi Nishida","doi":"10.1017/S0033291724003192","DOIUrl":"https://doi.org/10.1017/S0033291724003192","url":null,"abstract":"<p><strong>Background: </strong>Schools are central places for adolescent social lives, which is a major factor greatly affecting adolescent mental health; school climate (i.e. quality of the school social environments) can be a proximal social determinant for adolescent mental health. Supportive school environments may serve as a protective factor during crises like COVID-19, which disrupt social lives and worsen adolescent mental health. This is the first study examining whether the pandemic effects differed based on the levels of school climate on depressive symptoms (DS) and psychotic experiences (PEs) among adolescents.</p><p><strong>Methods: </strong>School climate (score range: 0-28), DS (0-26), and PEs (0-5) were self-reported in a population-based cohort (Tokyo Teen Cohort; <i>N</i> = 3171) at four timepoints (10y, 12y, 14y, and 16y) before and during COVID-19. COVID-19 occurred midway through the 16y survey, allowing us to examine its impact and interaction effect with school climate while accounting for within-person changes over time using mixed-effects models.</p><p><strong>Results: </strong>Significant interaction effects were found on DS (unstandardized coefficient [<i>B</i>] = -0.166, 95% confidence interval [CI] -0.225 to -0.107) and PEs (<i>B</i> = -0.020, 95% CI -0.028 to -0.012). The pandemic effects were not significant for adolescents with high school climate scores (around the 80th percentile or higher), although the pandemic significantly worsened these outcomes among the overall sample.</p><p><strong>Conclusions: </strong>The negative mental health effects of the pandemic were significantly mitigated among adolescents experiencing a supportive school climate. A positive school climate can protect adolescent mental health during challenging social conditions, such as pandemics.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":" ","pages":"1-8"},"PeriodicalIF":5.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865338","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":"Networks of care for the modern adolescent.","authors":"Simon R White, Emma Soneson, Mina Fazel","doi":"10.1017/S003329172400237X","DOIUrl":"https://doi.org/10.1017/S003329172400237X","url":null,"abstract":"<p><strong>Background: </strong>At a time of increased demand for specialist mental health services, a more nuanced understanding of how adolescents navigate systems of care and support is essential. We mapped 'networks of care' to explore patterns of mental health help-seeking alongside the perceived helpfulness of support accessed.</p><p><strong>Methods: </strong>We examined data from 23 927 adolescents aged 11-18 years who participated in the 2023 OxWell Student Survey, an English school-based, repeated cross-sectional survey of mental health and wellbeing. Students self-reported past-year access to 18 types of support across informal (e.g. friends and family), semi-formal (e.g. school and charities), and formal (e.g. health and social care) domains, alongside how helpful they found the support. We used a network approach to explore interconnections between sources of support accessed and perceived helpfulness.</p><p><strong>Results: </strong>One in four (27.0%, 6449/23927) adolescents reported past-year access to mental health support, of which 56.7% (3658/6449) reported accessing multiple types. Informal networks were the most commonly accessed (23.1%, 5523/23927), followed by semi-formal (9.7%, 2317/23927) and formal (6.8%, 1623/23927) supports. Informal sources had high acceptability, with around 80-90% reporting them as helpful, whereas child and adolescent mental health services (CAMHS), helplines, and online supports were perceived to be the least helpful. The networks also identified groups who might not be optimally served by current systems, including gender diverse adolescents and adolescents who found mental health support from their parents unhelpful.</p><p><strong>Conclusions: </strong>Adolescents are accessing mental health support across informal, semi-formal, and formal sources of care. Services can no longer be developed, delivered, or evaluated in isolation from these networks.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":" ","pages":"1-14"},"PeriodicalIF":5.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854971","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":"Predicting remission following CBT for childhood anxiety disorders: a machine learning approach.","authors":"Lizel-Antoinette Bertie, Juan C Quiroz, Shlomo Berkovsky, Kristian Arendt, Susan Bögels, Jonathan R I Coleman, Peter Cooper, Cathy Creswell, Thalia C Eley, Catharina Hartman, Krister Fjermestadt, Tina In-Albon, Kristen Lavallee, Kathryn J Lester, Heidi J Lyneham, Carla E Marin, Anna McKinnon, Lauren F McLellan, Richard Meiser-Stedman, Maaike Nauta, Ronald M Rapee, Silvia Schneider, Carolyn Schniering, Wendy K Silverman, Mikael Thastum, Kerstin Thirlwall, Polly Waite, Gro Janne Wergeland, Viviana Wuthrich, Jennifer L Hudson","doi":"10.1017/S0033291724002654","DOIUrl":"https://doi.org/10.1017/S0033291724002654","url":null,"abstract":"<p><strong>Background: </strong>The identification of predictors of treatment response is crucial for improving treatment outcome for children with anxiety disorders. Machine learning methods provide opportunities to identify combinations of factors that contribute to risk prediction models.</p><p><strong>Methods: </strong>A machine learning approach was applied to predict anxiety disorder remission in a large sample of 2114 anxious youth (5-18 years). Potential predictors included demographic, clinical, parental, and treatment variables with data obtained pre-treatment, post-treatment, and at least one follow-up.</p><p><strong>Results: </strong>All machine learning models performed similarly for remission outcomes, with AUC between 0.67 and 0.69. There was significant alignment between the factors that contributed to the models predicting two target outcomes: remission of all anxiety disorders and the primary anxiety disorder. Children who were older, had multiple anxiety disorders, comorbid depression, comorbid externalising disorders, received group treatment and therapy delivered by a more experienced therapist, and who had a parent with higher anxiety and depression symptoms, were more likely than other children to still meet criteria for anxiety disorders at the completion of therapy. In both models, the absence of a social anxiety disorder and being treated by a therapist with less experience contributed to the model predicting a higher likelihood of remission.</p><p><strong>Conclusions: </strong>These findings underscore the utility of prediction models that may indicate which children are more likely to remit or are more at risk of non-remission following CBT for childhood anxiety.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":" ","pages":"1-11"},"PeriodicalIF":5.9,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839069","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":"Familial co-aggregation and shared familiality among neurodevelopmental problems and with aggressive behavior, depression, anxiety, and substance use.","authors":"Melissa Vos, Rujia Wang, Nanda N J Rommelse, Harold Snieder, Henrik Larsson, Catharina A Hartman","doi":"10.1017/S003329172400309X","DOIUrl":"https://doi.org/10.1017/S003329172400309X","url":null,"abstract":"<p><strong>Objective: </strong>To refine the knowledge on familial transmission, we examined the (shared) familial components among neurodevelopmental problems (i.e. two attention-deficit/hyperactivity-impulsivity disorder [ADHD] and six autism spectrum disorder [ASD] subdomains) and with aggressive behavior, depression, anxiety, and substance use.</p><p><strong>Methods: </strong>Data were obtained from a cross-sectional study encompassing 37 688 participants across three generations from the general population. ADHD subdomains, ASD subdomains, aggressive behavior, depression, anxiety, and substance use were assessed. To evaluate familial (co-)aggregation, recurrence risk ratios (<i>λ</i>_R) were estimated using Cox proportional hazards models. The (shared) familiality (<i>f</i>²), which is closely related to (shared) heritability, was assessed using residual maximum likelihood-based variance decomposition methods. All analyses were adjusted for sex, age, and age².</p><p><strong>Results: </strong>The familial aggregation and familiality of neurodevelopmental problems were moderate (<i>λ</i>_R = 2.40-4.04; <i>f</i>² = 0.22-0.39). The familial co-aggregation and shared familiality among neurodevelopmental problems (<i>λ</i>_R = 1.39-2.56; <i>r_F</i> = 0.52-0.94), and with aggressive behavior (<i>λ</i>_R = 1.79-2.56; <i>r_F</i> = 0.60-0.78), depression (<i>λ</i>_R = 1.45-2.29; <i>r_F</i> = 0.43-0.76), and anxiety (<i>λ</i>_R = 1.44-2.31; <i>r_F</i> = 0.62-0.84) were substantial. The familial co-aggregation and shared familiality between all neurodevelopmental problems and all types of substance use were weak (<i>λ</i>_R = 0.53-1.57; <i>r_F</i> = -0.06-0.35).</p><p><strong>Conclusions: </strong>Neurodevelopmental problems belonging to the same disorder were more akin than cross-disorder problems. That said, there is a clear (shared) familial component to neurodevelopmental problems, in part shared with other psychiatric problems (except for substance use). This suggests that neurodevelopmental disorders, disruptive behavior disorders, and internalizing disorders share genetic and environmental risk factors.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":" ","pages":"1-13"},"PeriodicalIF":5.9,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829742","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":"Suicidal behavior in patients with severe mental disorders prior to and during the COVID-19 pandemic.","authors":"Ellenor Mittendorfer-Rutz, Jakob Bergström, Pontus Josefsson, Heidi Taipale, Marit Sijbrandij, Anke Witteveen, Matteo Monzio Compagnoni, Antonio Lora, Mireia Felez-Nobrega, Josep Maria Haro, Maria Melchior, Judith van der Waerden, Katalin Gemes, Ridwanul Amin","doi":"10.1017/S003329172400299X","DOIUrl":"https://doi.org/10.1017/S003329172400299X","url":null,"abstract":"<p><strong>Background: </strong>Determining whether the incidence of suicidal behavior during the COVID-19 pandemic changed for those with severe mental disorders is essential to ensure the provision of suicide preventive initiatives in the case of future health crises.</p><p><strong>Methods: </strong>Using population-based registers, quarterly cohorts from the first quarter of 2018 (2018Q1) to 2021Q4 were formed including all Swedish-residents >10 years old. Interrupted time series and generalized estimating equations analyses were used to evaluate changes in Incidence Rates (IR) of specialised healthcare use for suicide attempt and death by suicide per 10 000 person-years for individuals with or without specific severe mental disorders (SMDs) during, compared to before the pandemic.</p><p><strong>Results: </strong>The IR (95% Confidence interval, CI) of suicide in individuals with SMDs decreased from 16.0 (15.0-17.1) in 2018Q1 to 11.6 (10.8-12.5) in 2020Q1 (i.e. the quarter before the start of the pandemic), after which it dropped further to 6.7 (6.3-7.2) in 2021Q2. In contrast, IRs of suicide attempt in SMDs showed more stable trends, as did the trends regarding suicide and suicide attempt for individuals without SMD. These discrepancies were most evident for individuals with substance use disorder and ASD/ADHD. Changes in IRs of suicide <i>v.</i> suicide attempt for one quarter during the pandemic for substance misuse were 11.2% <i>v.</i> 3.6% respectively. These changes for ASD/ADHD were 10.7% <i>v.</i> 3.6%.</p><p><strong>Conclusions: </strong>The study shows pronounced decreases in suicide rates in individuals with SMDs during the pandemic. Further studies aiming to understand mechanisms behind these trends are warranted to consult future suicide prevention strategies.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":" ","pages":"1-9"},"PeriodicalIF":5.9,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829790","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":"Neurodevelopment as an alternative to neuroprogression to explain cognitive functioning in bipolar disorder.","authors":"Diego J Martino","doi":"10.1017/S0033291724003210","DOIUrl":"https://doi.org/10.1017/S0033291724003210","url":null,"abstract":"","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":" ","pages":"1-6"},"PeriodicalIF":5.9,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829788","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":"Implementing interpersonal psychotherapy globally: a content analysis from 31 countries.","authors":"Jennifer J Mootz, Myrna M Weissman","doi":"10.1017/S0033291724003003","DOIUrl":"https://doi.org/10.1017/S0033291724003003","url":null,"abstract":"<p><p>While there is ample evidence for the efficacy of IPT, confirmed through the results of the efficacy review, on the ground implementation factors are less well understood. We compiled a book on the global reach of IPT by requesting contributions from local authors through word-of-mouth methods. This approach resulted in reports from 31 countries across six continents and 15 diverse populations within the US that spanned the age range and types of usage. In this paper, our aim was to collate and summarize book contributors' descriptions of barriers and facilitators as related to their experiences of implementing IPT across the 31 countries. We conducted a conceptual content analysis and then applied the updated Consolidated Framework of Implementation Research (CFIR) to deductively organize the barriers and facilitators into its five domains. Most found IPT to be relevant and acceptable and described minor variations needed for tailoring to context. National level policies and mental health stigma were highlighted in the outer setting. Availability of specialists and general and mental health infrastructure were considerations relevant to the inner setting. Many sites had successfully implemented IPT through delivery by nonspecialized providers, although provider workload and burnout were common. Clients faced numerous practical challenges in accessing weekly care. Primary strategies to mitigate these challenges were use of telehealth delivery and shortening of the intervention duration. Most programs ensured competency through a combination of didactic training and case supervision. The latter was identified as time-intensive and costly.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":" ","pages":"1-10"},"PeriodicalIF":5.9,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829757","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":"Across the multiverse: exploring a diverse set of specifications related to cross-sectional and prospective associations between adolescent alcohol use and emotional problems.","authors":"J Halladay, R Visontay, T Slade, E K Devine, S Smout, J L Andrews, K E Champion, M Teesson, M Sunderland","doi":"10.1017/S0033291724002502","DOIUrl":"https://doi.org/10.1017/S0033291724002502","url":null,"abstract":"<p><strong>Background: </strong>The relationship between adolescent alcohol use and emotional problems remains unclear and contradictory. These inconsistencies may in part be due to differences in the measurement and operationalization of alcohol use and emotional problems across studies, as well as confounder selection and missing data decisions. This study explores the associations between common specifications of adolescent alcohol use and emotional problems in a large sample of adolescents.</p><p><strong>Methods: </strong>A multiverse analysis (also known as specification curve analysis or vibration of effects) was done with 7680 unique model specifications in a large longitudinal sample of 6639 Australian adolescents (aged ~14.7-15.7, 2021-2022).</p><p><strong>Results: </strong>While alcohol use and emotional problems nearly universally co-occurred in minimally adjusted cross-sectional models (98-99%), the operationalization of emotional problems, temporality of prospective relationships, and choice of confounders substantially impacted findings. Emotional problems appeared to predict later alcohol use more-so than the reverse, depression-focused measures yielded more consistent associations with alcohol use than anxiety-focused measures, and certain confounders (i.e. conduct, ADHD, smoking) explained most of the associations between adolescent alcohol use and emotional problems. Missing data decisions and whether outcomes were modelled continuously <i>v.</i> dichotomously had minimal impact on findings.</p><p><strong>Conclusions: </strong>While adolescent alcohol use and emotional problems commonly co-occur, inconsistencies in the magnitude, direction, and significance of effects are closely tied to researcher decisions that are often made arbitrarily.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":" ","pages":"1-15"},"PeriodicalIF":5.9,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829619","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":"Neural activity during working memory predicts clinical response to computerized executive function training prior to cognitive processing therapy.","authors":"Delaney Davey, Morgan M Caudle, Samantha N Hoffman, Amy J Jak, Jessica Bomyea, Laura D Crocker","doi":"10.1017/S0033291724003106","DOIUrl":"https://doi.org/10.1017/S0033291724003106","url":null,"abstract":"<p><strong>Background: </strong>Executive dysfunction, including working memory deficits, is prominent in posttraumatic stress disorder (PTSD) and can impede treatment effectiveness. Intervention approaches that target executive dysfunction alongside standard PTSD treatments could boost clinical response. The current study reports secondary analyses from a randomized controlled trial testing combined PTSD treatment with a computerized training program to improve executive dysfunction. We assessed if pre-treatment neurocognitive substrates of executive functioning predicted clinical response to this novel intervention.</p><p><strong>Methods: </strong>Treatment-seeking veterans with PTSD (<i>N</i> = 60) completed a working memory task during functional magnetic resonance imaging prior to being randomized to six weeks of computerized executive function training (five 30-minute sessions each week) plus twelve 50-minute sessions of cognitive processing therapy (CEFT + CPT) or placebo training plus CPT (PT + CPT). Using linear mixed effects models, we examined the extent to which the neurocognitive substrates of executive functioning predicted PTSD treatment response.</p><p><strong>Results: </strong>Results indicated that veterans with greater activation of working memory regions (e.g. lateral prefrontal and cingulate cortex) had better PTSD symptom improvement trajectories in CEFT + CPT <i>v.</i> PT + CPT. Those with less neural activation during working memory showed similar trajectories of PTSD symptom change regardless of treatment condition.</p><p><strong>Conclusions: </strong>Greater activity of frontal regions implicated in working memory may serve as a biomarker of response to a novel treatment in veterans with PTSD. Individuals with greater regional responsiveness benefited more from treatment that targeted cognitive dysfunction than treatment that did not include active cognitive training. Clinically, findings could inform our understanding of treatment mechanisms and may contribute to better personalization of treatment.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":" ","pages":"1-10"},"PeriodicalIF":5.9,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829762","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":"Predictors of outcome following psychological therapy for depression and anxiety in an urban primary care service: a naturalistic Bayesian prediction modeling approach.","authors":"John Hodsoll, Rebecca Strawbridge, Sinead King, Rachael W Taylor, Gerome Breen, Nina Grant, Nick Grey, Nilay Hepgul, Matthew Hotopf, Viryanaga Kitsune, Paul Moran, André Tylee, Janet Wingrove, Allan H Young, Anthony J Cleare","doi":"10.1017/S0033291724001582","DOIUrl":"https://doi.org/10.1017/S0033291724001582","url":null,"abstract":"<p><strong>Background: </strong>England's primary care service for psychological therapy (Improving Access to Psychological Therapies [IAPT]) treats anxiety and depression, with a target recovery rate of 50%. Identifying the characteristics of patients who achieve recovery may assist in optimizing future treatment. This naturalistic cohort study investigated pre-therapy characteristics as predictors of recovery and improvement after IAPT therapy.</p><p><strong>Methods: </strong>In a cohort of patients attending an IAPT service in South London, we recruited 263 participants and conducted a baseline interview to gather extensive pre-therapy characteristics. Bayesian prediction models and variable selection were used to identify baseline variables prognostic of good clinical outcomes. Recovery (primary outcome) was defined using (IAPT) service-defined score thresholds for both depression (Patient Health Questionnaire [PHQ-9]) and anxiety (Generalized Anxiety Disorder [GAD-7]). Depression and anxiety outcomes were also evaluated as standalone (PHQ-9/GAD-7) scores after therapy. Prediction model performance metrics were estimated using cross-validation.</p><p><strong>Results: </strong>Predictor variables explained 26% (recovery), 37% (depression), and 31% (anxiety) of the variance in outcomes, respectively. Variables prognostic of recovery were lower pre-treatment depression severity and not meeting criteria for obsessive compulsive disorder. Post-therapy depression and anxiety severity scores were predicted by lower symptom severity and higher ratings of health-related quality of life (EuroQol questionnaire [EQ5D]) at baseline.</p><p><strong>Conclusion: </strong>Almost a third of the variance in clinical outcomes was explained by pre-treatment symptom severity scores. These constructs benefit from being rapidly accessible in healthcare services. If replicated in external samples, the early identification of patients who are less likely to recover may facilitate earlier triage to alternative interventions.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":" ","pages":"1-15"},"PeriodicalIF":5.9,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829789","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}