Clinical Neuropsychiatry最新文献

{"title":"Smartphone And Internet Addiction, Social Support, And Mental Health Among Health Science Students: A Structural Equation Modeling Approach.","authors":"Huynh Ngoc Linh, Ngo Thi Tam, Tran Quoc Thang, Nguyen Thi Lan Huong, Nguyen Bich Nguyet, Hoang Duc Hanh","doi":"10.36131/cnfioritieditore20260107","DOIUrl":"https://doi.org/10.36131/cnfioritieditore20260107","url":null,"abstract":"<p><strong>Objective: </strong>This study assessed smartphone addiction, internet addiction, eHealth literacy, social support, loneliness, depression, and sleep quality among health sciences students, and examined their structural relationships using structural equation modeling (SEM).</p><p><strong>Method: </strong>A cross-sectional survey was conducted among 447 Medicine, Nursing, and Pharmacy students at a university in Hanoi. Data were collected using a self-administered paper questionnaire incorporating validated instruments: SAS-SV, IAT-6, eHEALS, DUFSSQ-8, UCLA-3, PHQ-9, and B-PSQI. Descriptive statistics, correlation analyses, and SEM were performed using Stata 17 and SmartPLS 3.0.</p><p><strong>Results: </strong>Participants reported moderate levels of smartphone addiction (35.7 ± 8.9) and internet addiction (13.1 ± 4.8). Internet addiction demonstrated direct effects on higher depression (β = 0.36, p < 0.001), poorer sleep quality (β = 0.27, p < 0.001), and lower social support (β = -0.25, p < 0.001). Smartphone addiction was positively associated with eHealth literacy (β = 0.21, p < 0.001) and loneliness (β = 0.16, p = 0.003). Social support showed strong inverse associations with depression, loneliness, and poor sleep, and mediated the effects of internet addiction on all three outcomes. eHealth literacy did not attenuate adverse effects.</p><p><strong>Conclusions: </strong>Among Vietnamese health science students, problematic smartphone and internet use is associated with greater loneliness, depressive symptoms, and sleep disturbances. Enhancing social support ‒ rather than relying solely on eHealth literacy ‒ appears critical to reducing these harms. Universities should implement strategies that foster digital well-being, limit problematic technology use, and strengthen peer connectedness and supportive campus environments.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"23 1","pages":"69-76"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12937498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Narrative Identity Development In Adolescents And Young Adults: A Scoping Review.","authors":"Cecilia Maria Esposito, Giovanni Stanghellini","doi":"10.36131/cnfioritieditore20260102","DOIUrl":"https://doi.org/10.36131/cnfioritieditore20260102","url":null,"abstract":"<p><strong>Objective: </strong>Adolescence is a vulnerable phase of life, especially in relation to the development of personal identity. Researchers and clinicians must pay close attention to how the perception of time, the organization of events and information into a coherent narrative, and the development of self-representations unfold during this period of life. Aim of the present review is to summarize the research evidence about narrative identity development in healthy adolescents and discuss this in the framework of contemporary socio-cultural changes.</p><p><strong>Method: </strong>Conducted as a scoping review following the PRISMA-ScR guidelines, a literature search was performed in PubMed without predefined restrictions. Eligibility criteria included original human studies in English, involving non-clinical participants aged 11-22 years. Twenty-six studies met inclusion criteria and were analyzed regarding narrative coherence, narrative self-awareness, and developmental trajectories.</p><p><strong>Results: </strong>Among the included studies we identified two main areas of investigation, that are narrative coherence and narrative self-awareness. Studies about narrative coherence generally show an age-related increase. Narrative self-awareness development was found to be related to the influence of the environment and to psychological well-being from adolescents to adulthood.</p><p><strong>Conclusions: </strong>Anomalies of narrative identity have been studied in psychopathological contexts but are understudied in healthy adolescents. Given that narrative identity development is influenced by the environment, and in light of rapid socio-cultural changes (e.g., digitalization and episodic temporal modes), more research is needed to explore how contemporary conditions affect identity construction in adolescents. The findings highlight developmental patterns in narrative identity that reflect both maturational processes and socio-cultural influences. Refining our understanding of these dynamics can guide future longitudinal studies and inform identity-focused interventions in adolescent mental health.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"23 1","pages":"14-29"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12937495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Roles Of Adverse Childhood Experiences And Early Maladaptive Schemas In Antisocial Personality Disorder: A Systematic Review.","authors":"Marianna Aceto, Nicole Loren Angelo, Andrea Gragnani","doi":"10.36131/cnfioritieditore20260103","DOIUrl":"https://doi.org/10.36131/cnfioritieditore20260103","url":null,"abstract":"<p><strong>Objective: </strong>Antisocial personality disorder (ASPD) is characterized by a pattern of negligence towards social norms, illicit and aggressive conduct, and lack of remorse. Adverse Childhood Experiences (ACEs) and subsequent development of Early Maladaptive Schemas (EMS) play a significant role in psychopathology vulnerability, including personality disorders. However, the evidence on the link between cognitive and environmental vulnerability in ASPD specifically is still limited. The aim of the present review is to analyze and discuss the available literature exploring the role of specific ACEs and EMSs in the development of ASPD and investigate the possible mediating role of cognitive variables between environmental factors and ASPD.</p><p><strong>Method: </strong>A systematic analysis was conducted of records published from January 1st, 2002 to March 18th, 2025 on APAJournals, MEDLINE, Google Scholar, PubMed, using keywords pertaining to three concepts: \"antisocial personality disorder\", \"early maladaptive schema/schema mode\", \"adverse childhood experiences\".</p><p><strong>Results: </strong>A total of 7719 records were screened, while 229 records were analyzed against our eligibility criteria, resulting in the inclusion of 26 records. The studies emphasize the contribution of physical abuse, and Disconnection/Rejection and Impaired limits domains in the etiology of ASPD. Regarding the mediation between ACEs and ASPD, various studies focused on dysfunctional schema-modes, finding that Child, Over-compensatory, and Healthy Adult modes play a role in ASPD, highlighting the relevance of maladaptive coping and rapid emotional fluctuation in the disorder.</p><p><strong>Conclusions: </strong>The results enhance our understanding of the contribution of ACEs and EMS in the development of ASPD; however, evidence of a link between cognitive and environmental variables in the development of the disorder is scarce and heterogeneous. Going forward, studies should particularly investigate environmental and cognitive vulnerability to promote a greater understanding of ASPD functioning and tailor clinical interventions based on specific hyper-invested goals and the learned maladaptive coping strategies to pursue them.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"23 1","pages":"30-48"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12937500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Links Between Externalizing And Internalizing Symptoms And Peer Victimization: The Role Of Rumination And Self-Efficacy.","authors":"Julia El Kallassi, Raymond Bou Nader, Martine Bouvard","doi":"10.36131/cnfioritieditore20260108","DOIUrl":"https://doi.org/10.36131/cnfioritieditore20260108","url":null,"abstract":"<p><strong>Objective: </strong>Bullying is a serious problem among school-age children, contributing to both internalizing and externalizing difficulties. The existing literature does not place much emphasis on the factors explaining the link between victimization and psychological difficulties. This study looked into the roles of rumination and self-efficacy in this relationship.</p><p><strong>Method: </strong>Data was collected from 362 children (202 girls; <i>Mage</i> = 13.1, <i>SD</i> = 1.16) over two points in time, separated by 6 months.</p><p><strong>Results: </strong>Findings revealed a main effect of bullying status (being a victim of bullying vs. being non-involved) on rumination, self-efficacy, and internalizing/externalizing symptoms. Additional analyses explored different existing profiles (non-involved who stayed non-involved, new victims, escaped victims, and continuous victims) in terms of their psychological difficulties, ruminative responses, and self-efficacy. Mediation analyses show that victimization at Time 1 predicts internalizing difficulties at Time 2, but this effect is not mediated by rumination or self-efficacy. Conversely, victimization indirectly predicts externalizing symptoms at Time 2 via rumination. Moreover, internalizing symptoms at Time 1 predict victimization at Time 2 through both rumination and self-efficacy, while externalizing symptoms at Time 1 predict victimization at Time 2 via self-efficacy.</p><p><strong>Conclusions: </strong>The findings provide practical insights for those working with victims of bullying and also lay the foundation for future research.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"23 1","pages":"77-89"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12937494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants Of Cognitive Impairment Among Older Adults In Hanoi, Vietnam: Insights From The Montreal Cognitive Assessment.","authors":"Doan Thi Hue, Le Thi Thu Ha, Nguyen Van Tuan, Nguyen Van Phi, Le Cong Thien, Nguyen Hoang Yen, Nguyen Thi Hoa, Nguyen Thu Ha, Tran Thi Thu Ha, Tran Thi Thu Huong, Nguyen Hoang Thanh","doi":"10.36131/cnfioritieditore20260106","DOIUrl":"https://doi.org/10.36131/cnfioritieditore20260106","url":null,"abstract":"<p><strong>Objective: </strong>Cognitive impairment is a growing public health concern among aging populations, yet evidence from Vietnam remains limited. This study aimed to assess the prevalence of cognitive impairment among older adults in Hanoi and identify demographic, socioeconomic, lifestyle, and health-related determinants.</p><p><strong>Method: </strong>A cross-sectional study was conducted among 763 adults aged ≥60 years from one urban ward and one rural commune in Hanoi (June-December 2023). Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), with impairment classified into mild, moderate, and severe levels. Mental health, anxiety, and sleep quality were measured using the PHQ-9, GAD-7, and PSQI. Multivariate logistic regression with stepwise forward selection identified independent predictors of cognitive impairment.</p><p><strong>Results: </strong>Cognitive impairment was highly prevalent, affecting 70.4% of participants (46.1% mild, 19.3% moderate, 5.0% severe). Mean MoCA score was 21.3 (SD=6.3). Age was the strongest predictor (OR=1.11 per year, 95% CI: 1.08-1.15). Female gender (OR=1.63, 95% CI: 1.09-2.44), lower education (OR=0.58 for >high school vs <high school, 95% CI: 0.34-1.00), rural residence (OR=0.58, 95% CI: 0.34-0.99), and lack of pension income (OR=0.54, 95% CI: 0.32-0.93) were significant socioeconomic risk factors. Physical inactivity showed the largest effect size (OR=3.18, 95% CI: 1.34-7.55). Poor sleep quality (OR=1.62, 95% CI: 1.11-2.36) and mental health disorders (OR=1.91, 95% CI: 1.05-3.49) were also independently associated. No significant association was found with COVID-19 status.</p><p><strong>Conclusions: </strong>Cognitive impairment is widespread among older adults in Hanoi and is shaped by demographic, socioeconomic, and modifiable health factors. Interventions to promote physical activity, mental health, and economic security, alongside improved access to screening and elder care in rural areas, are essential for supporting healthy cognitive aging in Vietnam.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"23 1","pages":"63-68"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12937493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Internal States In Children With Neuromuscular Disorders Through An Oral Narrative Task.","authors":"Paola Cristofani, Costanza Ruffini, Bianca Buchignani, Guja Astrea, Bianca Noli, Benedetta Magozzi, Chiara Pecini, Roberta Battini","doi":"10.36131/cnfioritieditore20260101","DOIUrl":"https://doi.org/10.36131/cnfioritieditore20260101","url":null,"abstract":"<p><strong>Objective: </strong>Neuromuscular disorders (NMD) are rare, chronic diseases affecting muscle and nerve function, leading to motor, cognitive, and socio-emotional challenges. While physical and cognitive aspects have been widely studied, socio-emotional functioning remains underexplored. This study assessed the feasibility of using invented oral stories to examine internal state language in children with NMD compared to typically developing peers.</p><p><strong>Method: </strong>Forty 5-12 years old children (20 with NMD, 20 typically developing) spontaneously narrated fictional stories, analyzed for structure, cohesion, and psychological lexicon that refers to words expressing internal mental and emotional states.</p><p><strong>Results: </strong>Results showed no significant differences in narrative structure or cohesion, supporting the feasibility of oral storytelling. However, children with NMD used more physiological and socio-relational terms, emphasizing their attention to bodily experiences and social interactions as coping strategies.</p><p><strong>Conclusions: </strong>These findings highlight oral narratives as a valuable tool to access socio-emotional development in children with NMD through narrative-based interventions.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"23 1","pages":"3-13"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12937491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating Peer Inclusion And Exclusion: Pathological Narcissism, Reflective Functioning, And Rejection-Related Emotions In Adolescents.","authors":"Andrea Fontana, Lucia Sideli, Beatrice Cianfanelli, Antonella Somma, Andrea Fossati","doi":"10.36131/cnfioritieditore20260109","DOIUrl":"https://doi.org/10.36131/cnfioritieditore20260109","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to explore the interplay between pathological narcissism, reflective functioning (RF), and peer exclusion (vs. inclusion) among adolescents. The study hypothesizes that peer exclusion (vs. inclusion) is associated with greater post-task difficulties in reflective functioning and higher rejection-related emotions, and tests whether these associations vary as a function of pathological narcissism.</p><p><strong>Method: </strong>A sample of 204 adolescents (aged 14-18) participated in an experimental task simulating social media interactions using the Social Media Ostracism Paradigm (SMOP). Participants were assigned to one of three experimental conditions: Over-Inclusion (OI), Neutral (N), and Over-Exclusion (OE). Pathological narcissism was assessed using the Pathological Narcissism Inventory (PNI), and reflective functioning and rejection-related emotions were evaluated post-task.</p><p><strong>Results: </strong>High-risk narcissistic adolescents exhibited significantly lower RF scores than their low-risk peers (F(1, 198) = 13.72, p < .001), particularly in the OE condition (F(2, 198) = 6.76, p < .001). Low-risk adolescents in the OI condition demonstrated better RF. Social exclusion significantly impacted rejection-related emotions (F(2, 198) = 13.890, p < .001), with OE participants reporting higher distress than N and OI groups. However, narcissism did not significantly moderate emotional responses.</p><p><strong>Conclusions: </strong>Pathological narcissism was associated with greater RF difficulties, which were most evident under exclusion. However, rejection distress appears to be a broadly shared response in adolescence and may function as a normative signal of threatened belongingness, relatively independent of narcissism levels. These results emphasize the importance of targeted interventions focusing on mentalization and peer dynamics, particularly for adolescents with high-risk narcissism traits.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"23 1","pages":"90-99"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12937490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When A Critique Becomes Untenable: A Scholarly Response To Grossman Et Al.'S Evaluation Of Polyvagal Theory.","authors":"Stephen W Porges","doi":"10.36131/cnfioritieditore20260111","DOIUrl":"https://doi.org/10.36131/cnfioritieditore20260111","url":null,"abstract":"<p><p>A recent critique advanced by Grossman et al. (2026, this issue) argues that Polyvagal Theory is scientifically untenable, asserting that its core claims regarding autonomic organization, respiratory sinus arrhythmia (RSA), and evolutionary framing are inconsistent with established neurophysiology. The present paper evaluates these assertions not by disputing individual claims in isolation, but by examining whether the critique engages Polyvagal Theory as it is articulated in the peer-reviewed literature and whether it meets the epistemic standards required for scientific refutation. Rather than responding sequentially to individual objections, the analysis clarifies the theory's conceptual foundations, scope, and explicit conditions of falsifiability as a systems-level, pathway-specific framework of autonomic state regulation. It demonstrates that the critique repeatedly evaluates a reconstructed proxy of the theory shaped by persistent category errors, including conflation of neuroanatomy with neurophysiology, reduction of theory to measurement, and substitution of phylogenetic continuity for functional organization. These structural misrepresentations propagate across methodological, neurophysiological, evolutionary, and developmental domains, precluding meaningful empirical adjudication. Across these domains, the paper shows that disagreements concerning RSA metrics, comparative anatomy, or evolutionary framing do not engage the theory's specified mechanisms or demonstrate conditions under which its predictions would fail. Where disagreement exists, it reflects differences in measurement preference, level of analysis, or theoretical framing rather than evidence against the theory's organizing principles. An appendix presents a historical audit showing that several central claims reiterated in the critique were identified in the literature nearly two decades earlier as mischaracterizations of Polyvagal Theory. Their continued repetition without substantive modification reflects a persistent failure of representational uptake rather than unresolved empirical controversy. It is concluded that the charge of scientific untenability does not apply to Polyvagal Theory as formulated, but instead reflects a critique that fails to engage the theory on its own terms. Productive scientific discourse requires representational fidelity, appropriate alignment of levels of analysis, and responsiveness to theoretical and empirical clarification ‒ criteria essential to theory evaluation but not met in the critique under review.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"23 1","pages":"113-128"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12937496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glycemic Control, Quality Of Life, And Social Determinants Of Sleep Quality In Newly Diagnosed Type 2 Diabetes Mellitus.","authors":"Nguyen Quang Bay, Duong Thi Mai Phuong, Phan Hoang Hiep, Lam My Hanh, Pham Tran Anh Khoa, Nguyen Thi Thuy Hanh, Nguyen Dang Vung, Vu Minh Tuan, Tran Thi Thanh Thuy, Le Anh Tuan, Nguyen Hoang Thanh","doi":"10.36131/cnfioritieditore20260104","DOIUrl":"https://doi.org/10.36131/cnfioritieditore20260104","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prevalence of poor sleep quality and identify associated factors among patients newly diagnosed with T2DM.</p><p><strong>Method: </strong>A cross-sectional study was conducted at the National Hospital of Endocrinology, Vietnam, from August 2024 to July 2025. A total of 106 patients with newly diagnosed T2DM were recruited. Data on sociodemographics, lifestyle, clinical and biochemical measures, social support (MSPSS), and quality of life (WHOQOL-BREF) were collected. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Logistic regression was applied to identify predictors of sleep disorder (PSQI ≥5), and Tobit regression was used to examine determinants of the total PSQI score.</p><p><strong>Results: </strong>The mean PSQI global score was 6.86 ± 4.63, and 67.9% of participants experienced at least mild sleep disturbance. Logistic regression showed that elevated HbA1c (OR = 7.66, 95% CI: 2.81-20.86, p < 0.001) and female sex (OR = 0.13, 95% CI: 0.02-0.82, p = 0.029) were significant predictors of poor sleep. Tobit regression further identified HbA1c (Coef. = 1.45, p < 0.001), female sex (Coef. = -3.40, p < 0.001), economic stress (Coef. = -3.42, p < 0.001), WHOQOL physical (Coef. = -0.07, p = 0.027), and WHOQOL environment (Coef. = 0.11, p = 0.012) as significant determinants of PSQI score. Lifestyle factors and family support showed weaker or non-significant associations.</p><p><strong>Conclusions: </strong>These findings suggest that sleep should be routinely assessed at diagnosis, with integrated management strategies addressing biomedical, psychosocial, and environmental determinants to improve outcomes.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"23 1","pages":"49-55"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12937492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacological Interventions for Excoriation Behaviors in Alzheimer's Disease: An Empty Systematic Review of Clinical Trials.","authors":"Victor Linking Magalhães Campos, Antonio de Pádua Serafim","doi":"10.36131/cnfioritieditore20250607","DOIUrl":"10.36131/cnfioritieditore20250607","url":null,"abstract":"<p><strong>Objective: </strong>skin-picking behaviors are often maintained in association with mood changes, but can also manifest as separate manifestations particularly in Alzheimer's disease (AD). Verifying the effect of interventions on its remission may contribute to reducing stress in patients and caregivers. This systematic review sought to evaluate the eficacy of pharmacological interventions for skin-picking behaviors in elderly individuals with AD.</p><p><strong>Method: </strong>according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA 2020), searches were conducted in ClinicalTrials.gov,Embase, Lilacs, Open Science Framework, PsycNET, PubMed, Scopus, SciELO, SciELO Preprints and Web of Science, with no language or date restrictions. Inclusion criteria were clinical trials with participants aged ≥ 40 years with AD, evaluating pre/ post-test outcomes with standardized instruments.</p><p><strong>Results: </strong>of the 87 records found, none met the eligibility criteria, configuring an empty review. Two studies related to the topic were excluded because they were not clinical trials (a single case report and a case series), involving five patients treated with antipsychotics (risperidone, pimozide and thioridazine) and antidepressants (paroxetine). The absence of eligible studies suggests a gap in the literature and the lack of robust evidence on the pharmacological efficacy on these behavioral symptoms in this population.</p><p><strong>Conclusions: </strong>future clinical trials are needed to support specific therapeutic recommendations, since the evidence suggested by studies that are not clinical trials, evaluated in addition to the main objective of this review, is primary and limited.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"22 6","pages":"498-506"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12752926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145878762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}