Trends in Psychiatry and Psychotherapy最新文献

{"title":"Association between clinical remission in schizophrenia and immunological biomarkers: a systematic review.","authors":"Edmundo Rinolino Magalhães Flores, Breno Fiuza Cruz, Lucas Machado Mantovani, Joao Vinicius Salgado","doi":"10.47626/2237-6089-2026-1389","DOIUrl":"https://doi.org/10.47626/2237-6089-2026-1389","url":null,"abstract":"<p><strong>Objective: </strong>Schizophrenia involves complex interactions between genetic, neurobiological, and environmental factors, with immuno-inflammatory processes and oxidative stress playing central roles in its pathophysiology. Despite evidence linking these pathways to disease course, the specific relationship between clinical remission and immunological biomarkers remains underexplored. This systematic review aimed to investigate the association between clinical remission in individuals with schizophrenia and immune system markers, including inflammatory and oxidative stress indicators.</p><p><strong>Methods: </strong>This systematic review followed PRISMA guidelines, searching Scopus, PubMed, BVS, Web of Science, and PsycINFO from 2005-2024 for observational studies (cross-sectional, case-control, cohort) in English. Inclusion criteria required evaluation of schizophrenia patients, comparison of remitted versus non-remitted groups using RSWG or equivalent criteria, and assessment of immunological biomarkers and oxidative stress markers.</p><p><strong>Results: </strong>Twenty-two studies met inclusion criteria. Fifteen studies found inflammatory biomarker alterations: neutrophil-to-lymphocyte ratio (NLR) reduction in remission versus relapse/stability periods; higher hsCRP, lower IL-33/sST2 in remission; baseline TNF-α reductions predicting remission; IL-6 decreases correlating with white matter improvements; higher baseline neutrophil gelatinase-associated lipocalin (NGAL) levels and complement pathway proteins such as C4A. Four studies on oxidative stress showed increased SOD/TAC activity and reduced biopirines/AOPP in remission versus acute phases, though some markers like erythrocyte SOD remained persistently altered.</p><p><strong>Conclusions: </strong>Clinical remission in schizophrenia appears to be associated with changes in selected peripheral inflammatory and oxidative stress biomarkers, although further prospective longitudinal studies are needed.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Vitamin D during Pregnancy towards Postpartum Depression: A Meta-Analysis of Dose-response Association and Intervention.","authors":"Samuel Partogi Nababan, Gresita Novelia Uirianto, Juan Fransiscus Wira, Whitney Joycelyn Tenaya, Deva Fitra Firdausa Anwar","doi":"10.47626/2237-6089-2025-1280","DOIUrl":"https://doi.org/10.47626/2237-6089-2025-1280","url":null,"abstract":"<p><strong>Introduction: </strong>Serum vitamin D (25(OH)D) concentration has been associated with PPD in previous studies. However, whether there is a dose-response relationship and if its supplementation during pregnancy can improve symptoms after delivery remains unclear.</p><p><strong>Methods: </strong>Five databases were searched on September 27, 2025. Cohort studies were included for dose-response meta-analysis (DRMA), while randomized controlled trials (RCTs) were included for meta-analysis (MA) of supplementation. The outcome for MA of supplementation was postpartum Edinburgh Postnatal Depression Scale (EPDS) score using the effect measure of mean difference (MD), while the outcome for DRMA was the odds ratio (OR) of PPD after delivery. Certainty was assessed using GRADE for MA of supplementation.</p><p><strong>Results: </strong>Only two prospective cohort studies were included for DRMA and two RCTs were included for MA of supplementation. There was a significant log linear dose-response relationship between 25(OH)D serum concentration and developing PPD with β = -0.0256 (95% CI = -0.0454 to -0.0057). Every 10 nmol/L increase was associated with OR = 0.77 (95% CI = 0.63 to 0.94). Meta-analysis found a significant reduction in EPDS scores at 4 weeks after delivery (MD = -2.70; 95% CI = -3.68 to -1.71; low certainty).</p><p><strong>Conclusion: </strong>Vitamin D serum concentration during pregnancy might be log linearly associated with developing PPD after delivery and its supplementation during pregnancy may improve PPD symptoms at 4 weeks postpartum. However, findings should be interpreted cautiously as evidence is limited to the small number of studies.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics of Autism Spectrum Disorder in older adults: a scoping review.","authors":"João P S Gontijo, Marcelo H S S Martins, Lucas M Alves","doi":"10.47626/2237-6089-2026-1369","DOIUrl":"https://doi.org/10.47626/2237-6089-2026-1369","url":null,"abstract":"<p><strong>Introduction: </strong>Autism Spectrum Disorder (ASD) is a lifelong condition; however, literature regarding its manifestation in old age remains scarce.</p><p><strong>Objective: </strong>To synthesize descriptive studies on the clinical characteristics of ASD in the elderly, aiming to improve diagnosis and quality of life.</p><p><strong>Methodology: </strong>This is a scoping review based on the Joanna Briggs Institute guidelines and reported according to PRISMA-ScR. Searches were conducted in MEDLINE/PUBMED and SCIELO databases, covering the period from 2011 to 2026, focusing on descriptive studies with participants aged over 50 years. Ultimately, 18 articles were selected and analyzed.</p><p><strong>Results: </strong>The evolution of autism symptoms proved to be complex and non-linear; while some behaviors and psychiatric symptoms tend to decline with age, social difficulties may persist or worsen. From a cognitive perspective, data suggest an aging pattern parallel to neurotypicals, although there are reports of specific deficits in working memory and attention. An alarming burden of psychiatric comorbidities was identified, highlighting depression and high rates of suicidality, as well as significant clinical comorbidities.</p><p><strong>Conclusion: </strong>Older adults with ASD constitute a vulnerable population. There is an urgent need for prospective longitudinal studies to adequately map the aging trajectories of this population.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychobiological Effects of Music Therapy and Structured Musical Interventions on Biomarkers in Mental Disorders: A Systematic Review and Meta-analysis.","authors":"Lìlian Cunha, Laiana Quagliato","doi":"10.47626/2237-6089-2026-1312","DOIUrl":"10.47626/2237-6089-2026-1312","url":null,"abstract":"<p><strong>Objective: </strong>To systematically synthesize evidence on the psychobiological effects of music therapy and structured musical interventions on biomarkers in individuals with mental disorders, within a psychoneuroimmunological framework.</p><p><strong>Methods: </strong>This systematic review and meta-analysis followed PRISMA 2020 guidelines. Searches were performed in PubMed, LILACS, PsycINFO, and Cochrane Library up to October 2025. Studies with individuals aged ≥16 years, psychiatric diagnoses, and both psychological and biomarker outcomes were eligible. Ten studies met inclusion criteria. Random-effects meta-analysis was conducted for sufficient, comparable data.</p><p><strong>Results: </strong>Cortisol was the only biomarker with sufficient data for meta-analysis (n=4). Results showed no significant effect on cortisol levels (SMD = -0.18; 95% CI = -0.96 to 0.59), with substantial heterogeneity (I² = 88.7%). Exploratory analyses indicated more consistent responses in autonomic and inflammatory biomarkers than endocrine markers. Psychological outcomes showed greater improvement consistency across studies, even without short-term physiological changes. Findings must be interpreted cautiously due to the limited number of studies and high heterogeneity.</p><p><strong>Conclusion: </strong>Psychobiological effects of music therapy and musical interventions vary by intervention, design, and population. Despite heterogeneity and limited quantitative data, findings support the clinical relevance of these interventions. More standardized, biomarker-informed research is needed to clarify underlying mechanisms.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Craving, cognition, and self-esteem in adults with crack cocaine use disorder participating in inpatient multicomponent exercise: a prospective naturalistic study.","authors":"Jader Calzavara, Daniele Regina Colosso, Renata Cruz Soares de Azevedo, Paula Teixeira Fernandes","doi":"10.47626/2237-6089-2026-1382","DOIUrl":"https://doi.org/10.47626/2237-6089-2026-1382","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether participation in a multicomponent physical exercise program is associated with longitudinal changes in craving, cognition, and self-esteem among inpatients with crack cocaine use disorder.</p><p><strong>Methods: </strong>This prospective, naturalistic, non-randomized longitudinal study included 37 inpatients with crack cocaine use disorder classified into an exercise group (EG, n = 21) or non-exercise group (NEG, n = 16) based on participation in the institutional exercise program. Assessments were conducted at baseline, week 5, and week 10. Outcomes included global cognition (MMSE), executive function (TMT-A/B), self-esteem (RSE), and craving (CCQ-Brief). Longitudinal data were analyzed using repeated-measures models.</p><p><strong>Results: </strong>No significant group-by-time interactions were observed for cognition or self-esteem, although both groups improved over time. In the primary analysis, a significant group-by-time interaction was observed for craving (p = 0.034), with greater reductions in the exercise group, particularly during the first five weeks. However, this interaction was attenuated after adjustment for age and duration of crack cocaine use.</p><p><strong>Conclusions: </strong>Participation in multicomponent exercise was associated with greater reductions in craving in the primary analysis, although this finding was attenuated after adjustment for baseline group differences. Improvements in cognition and self-esteem were observed in both groups, suggesting shared effects of structured care and abstinence. These findings support further investigation of exercise as a complementary strategy in substance use disorder treatment.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clustering of Aggressive Behaviors and Physical Activity Among Brazilian Adolescents.","authors":"Camilo L M Lourenço, Thiago M Fidalgo, Jorge Mota, Deborah C Malta","doi":"10.47626/2237-6089-2026-1341","DOIUrl":"https://doi.org/10.47626/2237-6089-2026-1341","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether bullying, physical aggression, and peer rejection cluster among Brazilian adolescent students and whether aggressive-behavior cluster pairs are associated with leisure-time physical activity according to sex.</p><p><strong>Methods: </strong>This cross-sectional study analyzed data from PeNSE 2019, including 157,921 adolescents aged 13 to 17 years. Bullying, physical aggression, and rejection in the previous 30 days were dichotomized as present or absent. Clustering was assessed using observed/expected ratios (O/E) and 99% confidence intervals. Logistic regression models estimated associations between aggressive-behavior cluster pairs and sufficient leisure-time physical activity, defined as ≥300 min/week.</p><p><strong>Results: </strong>Bullying, physical aggression, and rejection were reported by 39.41%, 14.60%, and 26.69% of adolescents, respectively. The simultaneous occurrence of all three behaviors exceeded expectation in the overall sample (O/E = 127.69), boys (O/E = 122.05), and girls (O/E = 170.23). In boys, physical aggression plus rejection was associated with lower odds of sufficient leisure-time physical activity (aOR = 0.99, 99%CI: 0.97-0.99). In girls, physical aggression plus rejection (aOR = 0.88, 99%CI: 0.86-0.89), bullying plus rejection (aOR = 0.97, 99%CI: 0.96-0.98), and bullying plus physical aggression (aOR = 0.98, 99%CI: 0.97-0.99) were associated with lower odds of sufficient leisure-time physical activity.</p><p><strong>Conclusion: </strong>Aggressive behaviors clustered among Brazilian adolescents and were associated with leisure-time physical activity, particularly among girls. Because this study was cross-sectional and several effect sizes were small, findings should be interpreted as associations rather than causal effects.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differentiating ASD from Personality Disorders: The Impact of Masking, Burnout, and Intersectionality.","authors":"Felipe Dalvi-Garcia, Laiana Azevedo Quagliato, Antonio Egidio Nardi","doi":"10.47626/2237-6089-2026-1355","DOIUrl":"https://doi.org/10.47626/2237-6089-2026-1355","url":null,"abstract":"","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Constructs and Historical Insights of the Autism Spectrum Disorder in adults.","authors":"Luísa Alencar Santos Lage, Mirela Paiva Vasconconcelos-Moreno, Renata de Sanson Lemann, Cintia Vasques Cruz Heidemann, Flávio Kapczinski, Antônio Egídio Nardi","doi":"10.47626/2237-6089-2026-1309","DOIUrl":"https://doi.org/10.47626/2237-6089-2026-1309","url":null,"abstract":"<p><strong>Objective: </strong>Autism spectrum disorder (ASD) is clinically heterogeneous, and adult presentations, especially among individuals requiring Level 1 support, may be subtle, shaped by adaptation, and obscured by comorbidity and diagnostic overshadowing. We review the historical evolution of autism-related constructs and their implications for recognising and interpreting ASD in adults.</p><p><strong>Methods: </strong>We conducted a narrative review in MEDLINE (PubMed). Searches combined \"autism\", \"autism spectrum disorder\", and \"ASD\" with predefined constructs (central coherence, theory of mind, social skills, sensory processing differences, repetitive behaviours, restricted and intense interests, executive functions, alexithymia, sleep disturbances, motor abnormalities, and camouflaging). A second search focused on adult autism (adulthood, autistic adults, late diagnosis, and compensatory mechanisms). Grey literature was also considered; publications available up to December 2025 were included.</p><p><strong>Results: </strong>The literature reflects a progressive refinement of the autism construct from descriptive behavioural syndromes to mechanism-oriented models that better accommodate phenotypic variability across development. In adults, these constructs help explain how pragmatic-communication difficulties, rigidity, intense interests, sensory reactivity, and executive-attentional differences can coexist with preserved language and intelligence. Recognition of compensatory strategies and social camouflaging helps explain delayed or missed diagnoses and associated distress. Shifts in diagnostic boundaries and awareness complicate inference from apparent prevalence increases.</p><p><strong>Conclusion: </strong>A historically grounded, construct-based framework can improve recognition of clinically meaningful adult ASD, sharpen differential diagnosis amid comorbidity, and support nuanced interpretation of changing diagnostic practices and epidemiological findings. It may inform individualized assessment and support planning as occupational, relational, and adaptive demands increase across adulthood substantially.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148007019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coping strategies and psychiatric symptoms among essential professionals during the COVID-19 pandemic: a cross-sectional analysis of a randomized controlled trial.","authors":"Mariane Bagatin Bermudez, Natan Pereira Gosmann, Malu Joyce de Amorim Macedo, Dayane Santos Martins, Gisele Gus Manfro, Marianna de Abreu Costa, Giovanni Abrahão Salum, Carolina Blaya Dreher","doi":"10.47626/2237-6089-2025-1134","DOIUrl":"https://doi.org/10.47626/2237-6089-2025-1134","url":null,"abstract":"<p><strong>Background: </strong>Coping strategies are essential for managing stress and emotional well-being, particularly in high-demand settings like healthcare. In high-demand contexts such as the COVID-19 pandemic, coping strategies may play a critical role in shaping mental health outcomes. Understanding how specific strategies relate to psychiatric symptoms is critical for effective interventions.</p><p><strong>Methods: </strong>This cross-sectional study analyzed baseline data from 3,075 essential workers enrolled in the TelePSI project, a nationwide randomized controlled trial of brief telepsychotherapy. Participants reported coping strategies from a list of 22 options (in a yes/no format). Psychiatric symptoms-depression, anxiety, and irritability-were measured using PROMIS scales. Exploratory factor analysis (EFA) was used to identify coping dimensions, followed by correlation analyses.</p><p><strong>Results: </strong>The most frequent strategies were watching YouTube (58.3%) and eating sweets (41.6%). EFA revealed two distinct factors: maladaptive (e.g., substance use, overeating) and adaptive strategies (e.g., physical activity, healthy eating). Maladaptive strategies showed weak positive correlations with psychiatric symptoms, while adaptive strategies showed weak negative correlations. Participants with higher symptom severity were more likely to report maladaptive behaviors.</p><p><strong>Discussion: </strong>The findings reveal associations between coping patterns and mental health outcomes. Adaptive strategies were associated with lower psychological distress, while maladaptive behaviors showed the opposite pattern, indicating the multifactorial nature of mental health in crisis situations.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148036403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translation, cultural adaptation, and validation of the Prolonged Grief 13 Revised (PG-13-R) for Brazilian Portuguese.","authors":"Laura Teixeira Bolaséll, Alice Martins Abadi, Natália Saldanha Silva, Clara Machado Pinto, Alice Einloft Brunnet, Giulia da Silva Maciel, Holly G Prigerson, Christian Haag Kristensen","doi":"10.47626/2237-6089-2025-1067","DOIUrl":"https://doi.org/10.47626/2237-6089-2025-1067","url":null,"abstract":"<p><strong>Objective: </strong>Prolonged Grief Disorder (PGD), characterized by persistent yearning, loss of meaning, and identity disruption, was recently recognized as a mental disorder in the DSM-5-TR. Despite its significant impact on functioning, no validated instruments exist to measure PGD in Brazilian Portuguese. This study aimed to translate, culturally adapt, and validate the Brazilian version of the Prolonged Grief 13 Revised (PG-13-R), an instrument aligned with DSM-5-TR criteria for assessing PGD symptoms.</p><p><strong>Methods: </strong>The study sample comprised 286 bereaved individuals with a mean age of 30.75 years (SD = 12.65), predominantly females (80%). Exploratory Factor Analysis and correlation analysis with depressive and prolonged grief symptoms were performed.</p><p><strong>Results: </strong>The results demonstrated an adequate content validation index for all items. EFA indicated a unidimensional construct, and the scale showed an excellent internal consistency (Cronbach's alpha = 0.90, McDonald's omega = 0.90) and concurrent validity.</p><p><strong>Conclusions: </strong>These findings indicate the reliability and validity of the Brazilian PG-13-R for assessing PGD symptoms.</p>","PeriodicalId":46305,"journal":{"name":"Trends in Psychiatry and Psychotherapy","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}