Psychological Medicine最新文献

{"title":"Uncovering the genetic underpinnings for different psychiatric disorder combinations.","authors":"Liangying Yin, Menghui Liu, Yujia Shi, Ruoyu Zhang, Simom Lui, Hon-Cheong So","doi":"10.1017/S0033291725101396","DOIUrl":"10.1017/S0033291725101396","url":null,"abstract":"<p><strong>Background: </strong>Psychiatric disorders are highly heterogeneous. It is clinically valuable to distinguish psychiatric disorders by the presence or absence of a specific comorbid condition.</p><p><strong>Methods: </strong>We employed a novel algorithm (CombGWAS) to decipher the genetic basis of psychiatric disorder combinations using genome-wide association studies summary statistics. We focused on comorbidities and combinations of diseases, such as schizophrenia (SCZ) with and without depression, which can be considered as two 'subtypes' of SCZ. We also studied psychiatric disorders comorbid with obesity as disease subtypes.</p><p><strong>Results: </strong>We compared the genetic architectures of psychiatric disorders with and without specific comorbidities, identifying both shared and unique susceptibility genes/variants across 8 subtype pairs (16 entities). Despite high genetic correlations between subtypes, most subtype pairs exhibited distinct genetic correlations with the same cardiovascular disease (CVD). Some pairs even displayed opposite genetic correlations, especially those involving obesity. For instance, the genetic correlation (rg) between SCZ with obesity and type 2 diabetes (T2DM) was 0.248 (<i>p</i> = 4.42E-28), while the rg between SCZ without obesity and T2DM was -0.154 (<i>p</i> = 6.79E-12). Mendelian randomization analyses revealed that comorbid psychiatric disorders often have stronger causal effects on cardiovascular risks compared to single disorders, but the effects vary across psychiatric subtypes. Notably, obese and nonobese major depressive disorder/SCZ showed opposite causal effects on the risks of T2DM.</p><p><strong>Conclusions: </strong>Our study provides novel insights into the genetic basis of psychiatric disorder heterogeneity, revealing unique genetic signatures across various disorder combinations. Notably, comorbid psychiatric disorders often showed different causal relationships with CVD compared to single disorders.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e270"},"PeriodicalIF":5.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041206","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":"Effects of the histone deacetylase inhibitor valproic acid in combination with fear-memory retrieval before exposure therapy for spider phobia: A randomized controlled trial.","authors":"Nathalie Schicktanz, Frieder Dechent, Carlo Andreas Huber, Anja Zimmer, Galya Clara Iseli, Jeanne Howald, Maya Thalia Schenker, Johannes Gräff, Undine Lang, Dominique J F de Quervain, Dorothée Bentz","doi":"10.1017/S0033291725101475","DOIUrl":"10.1017/S0033291725101475","url":null,"abstract":"<p><strong>Background: </strong>Return of fear after successful exposure therapy for a phobia is a common clinical challenge. A previous study on mice demonstrated that the persistent attenuation of remote fear memories can be achieved by combining histone deacetylase inhibitors (HDACis) with fear-memory retrieval prior to extinction training.</p><p><strong>Methods: </strong>To evaluate the translational potential of this approach, we conducted a randomized, double-blind, placebo-controlled trial. Forty-eight individuals with DSM-IV spider phobia received either HDACi valproic acid (VPA, 500 mg) or a placebo prior to the retrieval of fear memory, followed by exposure therapy in virtual reality.</p><p><strong>Results: </strong>No significant group difference was found in terms of behavioral change on the behavioral approach test at 3 months follow-up and baseline (primary outcome). However, the VPA group displayed significantly reduced fear in two self-report questionnaires related to spider phobia (Fear of Spiders Questionnaire; Spider Phobia Beliefs Questionnaire) as compared to the placebo group. No group differences were observed for psychophysiological indicators of fear.</p><p><strong>Conclusions: </strong>The favorable impact of a single administration of VPA in combination with fear-memory retrieval prior to exposure therapy suggests that it might be an effective way to enhance symptom improvement at the subjective level in the treatment of phobias. Further studies need to investigate the conditions under which an improvement on the psychophysiological and behavioral levels can be achieved as well.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e266"},"PeriodicalIF":5.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041148","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":"Increased insular functional connectivity during repetitive negative thinking in major depression and healthy volunteers.","authors":"Landon S Edwards, Saampras Ganesan, Jolene Tay, Eli S Elliott, Masaya Misaki, Evan J White, Martin P Paulus, Salvador M Guinjoan, Aki Tsuchiyagaito","doi":"10.1017/S0033291725100925","DOIUrl":"10.1017/S0033291725100925","url":null,"abstract":"<p><strong>Background: </strong>Repetitive negative thinking (RNT) in major depressive disorder (MDD) involves a persistent focus on negative self-related experiences. Resting-state fMRI shows that the functional connectivity (FC) between the anterior insula and the superior temporal sulcus is associated with RNT intensity. This study examines how insular FC patterns differ between resting state and RNT induction in MDD and healthy control (HC) participants.</p><p><strong>Methods: </strong>Forty-one individuals with MDD and 28 HCs (total <i>n</i> = 69) underwent resting-state and RNT-induction fMRI scans. Seed-to-whole brain analysis using insular subregions as seeds was performed.</p><p><strong>Results: </strong>No diagnosis-by-run interaction effects were observed across insular subregions. MDD participants showed greater FC between the bilateral anterior, middle, and posterior insular regions and the cerebellum (<i>z</i> = 4.31-6.15). During RNT induction, both MDD and HC participants demonstrated increased FC between bilateral anterior/middle insula and prefrontal cortices, parietal lobes, posterior cingulate cortex (PCC), and medial temporal gyrus, encompassing the STS (<i>z</i> = 4.47-8.31). In exploratory correlation analyses, higher trait RNT was associated with increased FC between the right dorsal anterior/middle insula and the PCC, middle temporal gyrus, and orbital frontal gyrus in MDD participants (<i>z</i> = 4.31-6.15). Greater state RNT was linked to increased FC in similar insular regions, as well as the bilateral angular gyrus and right middle temporal gyrus (<i>z</i> = 4.47-8.31).</p><p><strong>Conclusions: </strong>Hyperconnectivity in insula subregions during active rumination, especially involving the default mode network and salience network, supports theories of heightened self-focused and negative emotional processing in depression. These findings emphasize the neural basis of RNT when actively elicited in MDD.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e268"},"PeriodicalIF":5.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041213","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":"Interpersonal and targeted rejection life stressors are proximal risk factors for suicidal ideation and behavior.","authors":"Lori N Scott, Iulia Banica Malcolm, Sarah L Brown, Evelyn M Hernandez Valencia, Robert T Krafty, George M Slavich","doi":"10.1017/S0033291725101414","DOIUrl":"10.1017/S0033291725101414","url":null,"abstract":"<p><strong>Background: </strong>Although life stressors are known risk factors for suicide, the specific stressor types that most strongly precipitate suicidal outcomes, and on what timescale, remain poorly understood. Based on existing theory, we investigated whether objectively rated interpersonal stressors, especially social and targeted rejection stressors, are proximally associated with increased likelihood of suicidal ideation and behavior.</p><p><strong>Method: </strong>Using an objectively rated contextual threat interview to assess stressful life events, and a timeline followback procedure for assessing suicide-related outcomes, we examined how the severity of four types of acute life events (i.e. non-interpersonal, interpersonal without social rejection, social rejection without targeted rejection, and targeted rejection) were temporally associated with the likelihood of same-day and next-day suicidal ideation and behavior over 16 months in 143 young adults (<i>M_age</i> = 25.27, <i>SD</i> = 4.65) with recent suicidal ideation or behavior.</p><p><strong>Results: </strong>After controlling for prior-day suicidal ideation and non-interpersonal stressors, daily within-person increases in interpersonal stressor severity were related to higher odds of same-day (but not next-day) suicidal ideation. Additionally, greater increases in targeted rejection severity were uniquely related to increased likelihood of both same-day and next-day suicidal behavior after controlling for prior-day suicidal behavior and other types of stressors.</p><p><strong>Conclusions: </strong>Interpersonal stressors are strong, proximal risk factors for suicidal ideation and behavior, and these effects are particularly strong for targeted rejection life events. Clinicians should thus assess recent interpersonal and, especially, targeted rejection stressors when evaluating acute suicide risk, and may reduce such risk by helping patients stabilize and strengthen their social relationships.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e271"},"PeriodicalIF":5.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041163","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-method evaluation of emotional processing in prospectively predicting suicidal ideation trajectories in adolescents post-psychiatric hospitalization.","authors":"Lauren A Haliczer, Yeonsoo Park, Margarid R Turnamian, Doga Cetinkaya, Sydney A DeCaro, Evan M Kleiman, Taylor A Burke, Richard T Liu","doi":"10.1017/S0033291725101426","DOIUrl":"10.1017/S0033291725101426","url":null,"abstract":"<p><strong>Background: </strong>The months following psychiatric hospitalization are associated with heightened suicide risk among adolescents. Better characterizing predictors of trajectories of suicidal ideation (SI) post-discharge is critical.</p><p><strong>Method: </strong>We examined trajectories of SI over 18 months post-discharge and emotional processing variables (recognition, reactivity, and regulation) as predictors using a multi-method approach. Participants were 180 adolescents recruited from a pediatric psychiatric inpatient unit, assessed during hospitalization and 3, 6, 12, and 18-months post-discharge. At each time-point, participants reported on SI; at baseline, they completed measures of emotion dysregulation, reactivity, and a behavioral task measuring facial emotion recognition.</p><p><strong>Results: </strong>A three-group model best fits the data (Chronic SI, Declining SI, and Subthreshold SI groups). The Chronic SI group, compared to the Declining SI group, had greater difficulty identifying children's sad facial expressions. The Declining SI group compared to the Subthreshold SI group reported greater overall emotion dysregulation and difficulties engaging in goal-directed behavior. No other emotional processing variable was significantly associated with specific SI trajectories.</p><p><strong>Conclusions: </strong>The findings suggest that difficulties in properly identifying peer emotions may be predictive of resolution of severe SI post-discharge. Furthermore, the results suggest that emotion regulation may be an important target for discharge planning.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e269"},"PeriodicalIF":5.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041178","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":"Causal structural covariance network identifies progressive gray matter atrophy in adolescents with major depressive disorder - CORRIGENDUM.","authors":"Jiahui Chen, Xinjuan Jin, Junqi Gao, Yihao Zhang, Yixin Zhang, Changlin Bai, Feiyu Xu, Yuan Yao, Wenxin Zhang, Ying Yang, Xingxing Zhu, Kangcheng Wang","doi":"10.1017/S0033291725101682","DOIUrl":"https://doi.org/10.1017/S0033291725101682","url":null,"abstract":"","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e267"},"PeriodicalIF":5.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041173","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":"Smaller hippocampal tail volume is associated with plasma CCL11 levels in patients with major depressive disorder.","authors":"Longhai Wu, Yilin Liu, Lingtao Kong, Xintong Yan, Yihui Lu, Xiaowei Jiang, Yifang Zhou, Qikun Sun, Feng Wu","doi":"10.1017/S0033291725101402","DOIUrl":"https://doi.org/10.1017/S0033291725101402","url":null,"abstract":"<p><strong>Background: </strong>This study investigates structural abnormalities in hippocampal subfield volumes and shapes, and their association with plasma CC chemokines in individuals with major depressive disorder (MDD).</p><p><strong>Methods: </strong>A total of 61 patients with MDD and 65 healthy controls (HC) were recruited. All participants underwent high-resolution T1-weighted imaging and provided blood samples for the detection of CC chemokines (CCL2, CCL7, and CCL11). Comparisons of hippocampal subregion volumes, surface shapes, and plasma CC chemokine concentrations were conducted between the MDD and HC groups. Furthermore, partial correlation analysis was performed to assess the relationship between structural abnormalities (hippocampal subfield volume and shape) and plasma CC chemokine levels.</p><p><strong>Results: </strong>The MDD group exhibited a significant reduction in the volume of the left hippocampal tail compared to the HC group (<i>F</i> = 9.750, Bonferroni-corrected <i>p</i> = 0.026). No significant outward or inward deformation of the hippocampus was detected in MDD patients relative to the HC group (all FWE-corrected <i>p</i> > 0.05). Additionally, plasma CCL11 levels were elevated in the MDD group compared to the HC group (<i>F</i> = 9.982, <i>p</i> = 0.002), with these levels showing a positive correlation with the duration of the illness (<i>r</i> = 0.279, <i>p</i> = 0.029). Partial correlation analysis further revealed a negative correlation between the smaller left hippocampal tail volume and plasma CCL11 levels in MDD patients (<i>r</i> = -0.416, <i>p</i> = 0.001).</p><p><strong>Conclusion: </strong>Abnormally elevated plasma CCL11 in MDD patients may mediate damage to specific hippocampal substructures.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e265"},"PeriodicalIF":5.5,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030468","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":"Dopamine D_2/3R availability after discontinuation of antipsychotic treatment: a [¹¹C]raclopride PET study in remitted first-episode psychosis patients.","authors":"Franciska de Beer, Erik de Vries, Ben Wijnen, Marieke J H Begemann, Nico van Beveren, Nynke Boonstra, Shiral S Gangadin, Lieuwe de Haan, Iris M H Hamers, Wim Veling, Sanne Koops, Iris E C Sommer","doi":"10.1017/S003329172510161X","DOIUrl":"https://doi.org/10.1017/S003329172510161X","url":null,"abstract":"<p><strong>Background: </strong>After remission of a first-episode psychosis (FEP), antipsychotic discontinuation is associated with an increased risk of relapse compared to maintenance treatment. We studied short and longer-term effects of discontinuation of D₂ receptor (D₂R) antagonist and partial agonist antipsychotics on striatal dopamine D_2/3R availability in FEP patients.</p><p><strong>Methods: </strong>Remitted FEP patients underwent two [¹¹C]raclopride PET scans to measure striatal D_2/3R availability: 1 week after antipsychotic discontinuation (n = 16 antagonist users, n = 6 partial agonist users) and after being medication free for 6-8 weeks (n = 8 antagonist users, n = 5 partial agonist users). Fifteen matched healthy controls were scanned once. Psychotic relapse was monitored up to 12 months after discontinuation.</p><p><strong>Results: </strong>One week after discontinuation, D₂R antagonist discontinuers showed higher striatal binding potential (BP_ND) than partial D₂R agonist discontinuers (<i>p</i> < 0.001, CI = 0.749 to 1.681) and controls (<i>p</i> = 0.045, CI = 0.008 to 0.708), while partial agonist discontinuers had significantly lower BP_ND than controls (<i>p</i> = 0.001, CI = -1.326 to -0.386). 6-8 weeks after discontinuation, former antagonist users showed similar BP_ND to controls (<i>p</i> > 0.25), whereas former partial agonist users had higher BP_ND than controls (<i>p</i> = 0.027, CI = 0.069 to 1.085). Participants who discontinued antagonists relapsed more often (81%) than those who discontinued partial agonists (17%)(χ² = 5.32, <i>p</i> = 0.021).</p><p><strong>Conclusions: </strong>Discontinuation of partial D₂R agonists may affect D_2/3R availability differently than discontinuation of antagonists, which might explain the greater relapse risk after tapering antagonists than partial agonist antipsychotics.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e264"},"PeriodicalIF":5.5,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016117","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":"Intergenerational continuity of depressive symptoms: genetic and environmental pathways.","authors":"Marie C Navarro, Marthe de Roo, Albertine J Oldehinkel, Catharina A Hartman, Tina Kretschmer","doi":"10.1017/S0033291725101633","DOIUrl":"https://doi.org/10.1017/S0033291725101633","url":null,"abstract":"<p><strong>Background: </strong>Depression runs in families, with both genetic and environmental mechanisms contributing to intergenerational continuity, though these mechanisms have often been studied separately. This study examined the interplay between genetic and environmental influences in the intergenerational continuity of depressive symptoms from parents to offspring.</p><p><strong>Methods: </strong>Using data from the Dutch TRAILS cohort (<i>n</i> = 2201), a prospective, genetically informed, multiple-generation study, we examined the association between parents' self-reported depressive symptoms (reported at mean age of 41 years) and offspring depressive symptoms, self-reported nearly two decades later, in adulthood (mean age: 29 years). We assessed the role of genetic (polygenic scores for depressive symptoms in parents and offspring) and environmental mechanisms (parental warmth during adolescence) in explaining intergenerational continuity of depressive symptoms in separate and combined models.</p><p><strong>Results: </strong>Parents' depressive symptoms, offspring genetic predisposition, and parental warmth were associated with an increased risk of depressive symptoms in offspring. In the combined model, parents' genetic predisposition was linked to their own depressive symptoms, which were linked to lower parental warmth, which, in turn, was linked to higher depressive symptoms in offspring, after accounting for offspring genetic predisposition, sex, age, and socioeconomic status.</p><p><strong>Discussion: </strong>Both genetic and environmental mechanisms contribute to the intergenerational continuity of depressive symptoms independently and in interplay. Despite a significant effect, the influence of parental warmth was modest, suggesting limited covariation between this particular parenting measure and depressive symptoms, at least when assessed with large temporal distance.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e263"},"PeriodicalIF":5.5,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016181","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":"Ethnic disparities, clinical and pathways to care characteristics associated with the offer, uptake, and type of psychological therapy during first-episode psychosis: examining the role of early intervention for psychosis.","authors":"Sherifat Oduola, Samir Pathan, Jo Hodgekins, Bonnie Teague, Thomas K J Craig, Robbin Murray, Craig Morgan","doi":"10.1017/S0033291725101529","DOIUrl":"10.1017/S0033291725101529","url":null,"abstract":"<p><strong>Background: </strong>Psychological therapy (PT) along with antipsychotic medication is the recommended first line of treatment for first-episode psychosis (FEP). We investigated whether ethnicity, clinical, pathways to care (PtC) characteristics, and access to early intervention service (EIS) influenced the offer, uptake, and type of PT in an FEP sample.</p><p><strong>Methods: </strong>We used data from the Clinical Record Interactive Search-First Episode Psychosis study. Inferential statistics determined associations between ethnicity, clinical, PtC, and PT offer/uptake. Multivariable logistic regression estimated the odds of being offered a PT and type of PT by ethnicity, clinical and PtC characteristics adjusting for confounders.</p><p><strong>Results: </strong>Of the 558 patients included, 195 (34.6%) were offered a PT, and 193 accepted. Cognitive behavioral therapy (CBT) (<i>n</i> = 165 of 195; 84.1%) was commonly offered than group therapy (<i>n</i> = 30 of 195; 13.3%). Patients who presented via an EIS (adj. OR = 2.24; 95%CI 1.39-3.59) were more likely to be offered a PT compared with those in non-EIS. Among the patients eligible for an EIS, Black African (adj. OR = 0.49; 95%CI = 0.25-0.94), Black Caribbean (adj. OR = 0.45; 95%CI = 0.21-0.97) patients were less likely to be offered CBT compared with their White British counterparts. Patients with a moderate onset of psychosis (adj. OR = 0.34; 95%CI = 0.15-0.73) had a reduced likelihood of receiving CBT compared with an acute onset.</p><p><strong>Conclusions: </strong>Accessing EIS during FEP increased the likelihood of being offered a PT. However, treatment inequalities remain by ethnicity and clinical characteristics.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e262"},"PeriodicalIF":5.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001357","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}