Psychological Medicine最新文献

{"title":"A transdiagnostic examination of sex- and race and ethnicity-based mental health treatment disparities among publicly insured youth.","authors":"Erin C Accurso, Megan E Mikhail, Kate Duggento Cordell, Amanda E Downey, Lonnie R Snowden","doi":"10.1017/S003329172510069X","DOIUrl":"10.1017/S003329172510069X","url":null,"abstract":"<p><strong>Background: </strong>Low-income, publicly insured youth face numerous barriers to adequate mental health care, which may be compounded for those with multiple marginalized identities. However, no research has examined how identity and diagnosis may interact to shape the treatment experiences of under-resourced youth with psychiatric conditions. Applying an intersectional lens to treatment disparities is essential for developing targeted interventions to promote equitable care.</p><p><strong>Methods: </strong>Analyses included youth ages 7-18 with eating disorders (EDs; <i>n</i> = 3,311), mood/anxiety disorders (<i>n</i> = 3,219), or psychotic disorders (<i>n</i> = 3,035) enrolled in California Medicaid. Using state billing records, we examined sex- and race and ethnicity-based disparities in receipt of core services - outpatient therapy, outpatient medical care, and inpatient treatment - in the first year after diagnosis and potential differences across diagnostic groups.</p><p><strong>Results: </strong>Many youth (50.7% across diagnoses) received no outpatient therapy, and youth with EDs were least likely to receive these services. Youth of color received fewer days of outpatient therapy than White youth, and Latinx youth received fewer therapy and medical services across outpatient and inpatient contexts. Sex- and race and ethnicity-based disparities were especially pronounced for youth with EDs, with particularly low levels of service receipt among boys and Latinx youth with EDs.</p><p><strong>Conclusions: </strong>Results raise concerns for unmet treatment needs among publicly insured youth, which are exacerbated for youth with multiple marginalized identities and those who do not conform to historical stereotypes of affected individuals (e.g., low-income boys of color with EDs). Targeted efforts are needed to ensure equitable care.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e170"},"PeriodicalIF":5.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12201955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The causal effect of smoking on psychiatric disorders: an examination of brain volume as a potential pathway.","authors":"Margot P van de Weijer, Shu Liu, Anaïs B Thijssen, Robyn E Wootton, Adrià Túnez, Jentien M Vermeulen, Guido van Wingen, Dirk J A Smit, Marcus Munafò, Karin J H Verweij, Jorien L Treur","doi":"10.1017/S0033291725100561","DOIUrl":"10.1017/S0033291725100561","url":null,"abstract":"<p><strong>Background: </strong>There is growing evidence that smoking increases the risk of developing psychiatric disorders, but the underlying mechanisms are largely unknown. We examine brain structure as a potential pathway between smoking and psychiatric disease liability.</p><p><strong>Methods: </strong>We test associations between smoking (initiation, cigarettes per day, cessation, lifetime use) and depression, bipolar disorder, and schizophrenia, with and without correcting for volume of the amygdala, hippocampus, lateral and medial orbitofrontal cortex, superior frontal context, and cortical thickness and surface area. We use three methods that use summary statistics of genome-wide association studies to investigate genome-wide and local genetic overlap (genomic structural equation modeling, local analysis of (co)variant association), as well as causal associations (Mendelian randomization).</p><p><strong>Results: </strong>While we find causal effects of smoking on brain volume in different brain areas, and with psychiatric disorders, brain volume did not seem to mediate the effect of smoking on psychiatric disorders.</p><p><strong>Conclusions: </strong>While these findings are limited by characteristics of the included summary statistics (e.g. sample size), we conclude that brain volume of these areas is unlikely to explain a substantial part of any effect of smoking on psychiatric disorders. Nevertheless, genetic methods are valuable tools for exploring other potential mechanisms, such as brain functional connectivity, foregoing the need to collect all phenotypes in one dataset.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e171"},"PeriodicalIF":5.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12201961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progression of clinical diagnostic features and cognitive decline in mild cognitive impairment with Lewy bodies.","authors":"Calum Alexander Hamilton, Paul C Donaghy, John-Paul Taylor, Joanna Ciafone, Rory Durcan, Michael Firbank, Gemma Greenfinch, Louise Allan, John O'Brien, Alan Thomas","doi":"10.1017/S0033291725100895","DOIUrl":"10.1017/S0033291725100895","url":null,"abstract":"<p><strong>Background: </strong>Mild cognitive impairment with Lewy bodies (MCI-LB) may be identified prospectively based on the presence of cognitive impairment and several core clinical features (visual hallucinations, cognitive fluctuations, parkinsonism, and REM sleep behavior disorder). MCI-LB may vary in its presenting features, which may reflect differences in underlying pathological pattern, severity, or comorbidity.We aimed to assess how clinical features of MCI-LB accumulate over time, and whether this is associated with the rate of cognitive decline.</p><p><strong>Methods: </strong>In this cohort study, 74 individuals seen with MCI-LB prospectively underwent repeated annual cognitive and clinical assessment up to nine years. Relationships between clinical features (number of core features present and specific features present) and cognitive change on the Addenbrooke's Cognitive Examination-Revised (ACE-R) were examined with time-varying mixed models. The accumulation of core clinical features over time was examined with a multi-state Markov model.</p><p><strong>Results: </strong>When an individual with MCI-LB endorsed more clinical features, they typically experienced a faster cognitive decline (ACE-R Score Difference β = -1.1 [-1.7 to -0.5]), specifically when experiencing visual hallucinations (β = -2.1 [-3.5 to -0.8]) or cognitive fluctuations (β = -3.4 [-4.8 to -2.1]).Individuals with MCI-LB typically acquired more clinical features with the passage of time (25.5% [20.0-32.0%] one-year probability), limiting the prognostic utility of baseline-only features.</p><p><strong>Conclusions: </strong>The clinical presentation of MCI-LB may evolve over time. The accumulation of more clinical features of Lewy body disease, in particular visual hallucinations and cognitive fluctuations, may be associated with a worse prognosis in clinical settings.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e175"},"PeriodicalIF":5.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476462","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":"The use of problem-specific and strategic treatment add-ons in inpatient psychiatric care.","authors":"M David Rudd","doi":"10.1017/S003329172510086X","DOIUrl":"10.1017/S003329172510086X","url":null,"abstract":"","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e172"},"PeriodicalIF":5.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12201956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of interventions at frequently used suicide locations on occurrence of suicides at other sites: a systematic review and meta-analysis.","authors":"Lay San Too, Sangsoo Shin, Yamna Taouk, Jane Pirkis, Mark Sinyor, Paul Siu Fai Yip, Keith Hawton","doi":"10.1017/S0033291725100792","DOIUrl":"10.1017/S0033291725100792","url":null,"abstract":"<p><strong>Background: </strong>Interventions at frequently used suicide locations that restrict access to means, encourage help-seeking, and increase the likelihood of intervention by a third party are effective in preventing suicide at such sites. However, there have been concerns that such efforts may displace suicides to other sites. It is important to synthesize the evidence on suicide displacement effects.</p><p><strong>Methods: </strong>We conducted a systematic search of Medline, PsycINFO, Scopus, and Google for eligible studies from their inception to February 20, 2025. Meta-analyses were conducted to assess the pooled effects of interventions on suicides at frequently used locations and other sites, and on overall suicides involving the same method.</p><p><strong>Results: </strong>Our search identified 17 studies. Meta-analyses showed a reduction in suicides at the intervention sites (pooled incidence rate ratio [IRR] 0.09, 95% confidence interval [95% CI] 0.04-0.21) and no evidence of changes in suicides at other sites after restricting access to means was deployed alone. The pooled IRR for nearby sites (same type) was 0.99 (95% CI 0.72-1.38); for other sites (same type), it was 0.99 (95% CI 0.76-1.29); and for other sites (different/unspecified type), it was 1.19 (95% CI 0.90-1.58). There was an overall reduction in suicides involving the same method during the post-intervention period (IRR 0.77, 95% CI 0.65-0.92). Similar patterns were observed when restricting access to means was assessed alone or with other interventions.</p><p><strong>Conclusions: </strong>Suicide numbers at other sites did not change after interventions such as restricting access to means were deployed at frequently used locations.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e168"},"PeriodicalIF":5.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12201958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor.","authors":"Helerin Raikkerus","doi":"10.1017/S0033291725100524","DOIUrl":"10.1017/S0033291725100524","url":null,"abstract":"","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e173"},"PeriodicalIF":5.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12201957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reciprocal relations between prolonged grief and anger in homicidally bereaved people involved in a criminal trial: a four-wave cross-lagged panel model.","authors":"Lieke C J Nijborg, Maarten J J Kunst, Gerben J Westerhof, Jos de Keijser, Lonneke I M Lenferink","doi":"10.1017/S0033291725100809","DOIUrl":"https://doi.org/10.1017/S0033291725100809","url":null,"abstract":"<p><strong>Background: </strong>Anger may increase the risk for prolonged grief disorder (PGD) after violent loss. A source of anger for violently bereaved people can be the criminal proceedings that ensue following the loss. The present study explored the reciprocal associations between PGD and state anger and whether aspects of involvement in the criminal justice system (CJS) relate to PGD and state anger.</p><p><strong>Methods: </strong>We analyzed data of 237 MH17-bereaved people collected 67, 79, 88, and 103 months after the loss. Cross-lagged panel modeling was employed to examine the reciprocal associations between PGD and state anger. In the optimal model, we regressed PGD and state anger levels on different aspects of CJS involvement.</p><p><strong>Results: </strong>Higher PGD levels significantly predicted higher state anger levels at each wave (<i>β</i> = .112-.130) but not the other way around. This was found while constraining autoregressive and cross-lagged paths. When adding predictors and covariates to the model, PGD levels still consistently predicted state anger levels over time (<i>β</i> = .107-.121), with state anger levels predicting PGD levels to a lesser extent (<i>β</i> = .064-.070). None of the aspects of CJS involvement were related to either PGD or state anger levels.</p><p><strong>Conclusions: </strong>If replicated, a clinical implication could be that targeting PGD levels in treatment may reduce state anger levels and, to a lesser extent, vice versa. Also, CJS involvement does not seem to have an impact on PGD and state anger in people confronted with violent loss.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e169"},"PeriodicalIF":5.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317798","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":"Novel tools for comparing the architecture of psychopathology between neurogenetic disorders: An application to X- versus Y-chromosome aneuploidy effects in males.","authors":"Isabella G Larsen, Siyuan Liu, Lukas Schaffer, Srishti Rau, Tiffany Ajumobi, Bridget W Mahony, Allysa Warling, Ethan T Whitman, Ajay Nadig, Cassidy McDermott, Anastasia Xenophontos, Kathleen Wilson, Liv S Clasen, Erin N Torres, Jonathan D Blumenthal, Dani S Bassett, Armin Raznahan","doi":"10.1017/S0033291725000765","DOIUrl":"10.1017/S0033291725000765","url":null,"abstract":"<p><strong>Background: </strong>Psychiatric symptoms are typically highly inter-correlated at the group level. Collectively, these correlations define the architecture of psychopathology - informing taxonomic and mechanistic models in psychiatry. However, to date, it remains unclear if this architecture differs between etiologically distinct subgroups, despite the core relevance of this understanding for personalized medicine. Here, we introduce a new analytic pipeline to probe group differences in the psychopathology architecture - demonstrated through the comparison of two distinct neurogenetic disorders.</p><p><strong>Methods: </strong>We use a large questionnaire battery in 300 individuals aged 5-25 years (<i>n</i> = 102 XXY/KS, <i>n</i> = 64 XYY, <i>n</i> = 134 age-matched XY) to characterize the structure of correlations among 53 diverse measures of psychopathology in XXY/KS and XYY syndrome - enabling us to compare the effects of X- versus Y-chromosome dosage on the architecture of psychopathology at multiple, distinctly informative levels.</p><p><strong>Results: </strong>Behavior correlation matrices describe the architecture of psychopathology in each syndrome. A comparison of matrix rows reveals that social problems and externalizing symptoms are most differentially coupled to other aspects of psychopathology in XXY/KS versus XYY. Clustering the difference between matrices captures coordinated group differences in pairwise coupling between measures of psychopathology: XXY/KS shows greater coherence among externalizing, internalizing, and autism-related features, while XYY syndrome shows greater coherence in dissociality and early neurodevelopmental impairment.</p><p><strong>Conclusions: </strong>These methods offer new insights into X- and Y-chromosome dosage effects on behavior, and our shared code can now be applied to other clinical groups of interest - helping to hone mechanistic models and inform the tailoring of care.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e166"},"PeriodicalIF":5.9,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting involuntary admission following inpatient psychiatric treatment using machine learning trained on electronic health record data - CORRIGENDUM.","authors":"Erik Perfalk, Jakob Grøhn Damgaard, Martin Bernstorff, Lasse Hansen, Andreas Aalkjær Danielsen, Søren Dinesen Østergaard","doi":"10.1017/S0033291725100846","DOIUrl":"10.1017/S0033291725100846","url":null,"abstract":"","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e167"},"PeriodicalIF":5.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic abnormalities in catatonia: a systematic review.","authors":"Isabella Conti, Kanchana Ramachandran, James B Badenoch, Jack B Fanshawe, Emma Rengasamy, Ben Cross, Maria Rogdaki, Anthony S David, Paramala Santosh, Jonathan P Rogers, Cameron Watson","doi":"10.1017/S0033291725100536","DOIUrl":"10.1017/S0033291725100536","url":null,"abstract":"<p><strong>Background: </strong>Catatonia has many potential underlying causes, but in some patients, no clear etiology is identified, sparking growing interest in its genetic basis. We aimed to provide the first comprehensive synthesis of genetic abnormalities in catatonia.</p><p><strong>Methods: </strong>In this systematic review (PROSPERO CRD42023455118) we searched MEDLINE All, Embase Classic + Embase, PsycINFO, and AMED up to August 15, 2023, for studies on genetic testing and catatonia phenotyping in all age groups. Catatonia was diagnosed using specified diagnostic criteria or description of clinical features. Risk of bias was assessed using the Joanna Briggs Institute quality assessment tools. Results were summarized with a narrative synthesis.</p><p><strong>Results: </strong>We included 99 studies involving 8600 individuals. Sex was reported for 6080 individuals, of whom 3208 (52.8%) were male. Mean age at onset of catatonia was 28.8 years (SD 16.3). The median duration of the index catatonic episode was 180 days (IQR 38 to 668). Stupor and mutism were the most frequently reported symptoms. Forty-seven genetic conditions were reported in catatonia, including Phelan-McDermid syndrome (<i>n</i> = 80), 22q11.2 deletion syndrome (<i>n</i> = 23), and Down's syndrome (<i>n</i> = 19). Study quality was good in 29 studies, moderate in 53, and poor in 17. The major focus of association studies has centered on periodic catatonia; despite identifying candidate genes at both 22q13 and 15q15, none have been replicated.</p><p><strong>Conclusions: </strong>Catatonia can manifest in a wide range of genetic syndromes, suggesting a shared vulnerability across diverse genetic and developmental disorders. We did not identify a unique phenomenology or treatment response profile in genetic associations of catatonia.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e164"},"PeriodicalIF":5.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}