European psychiatry : the journal of the Association of European Psychiatrists最新文献

{"title":"Assessment of decisional capacity. A systematic review and analysis of instruments regarding their applicability to requests for assisted suicide.","authors":"Leonie Kupsch, Jakov Gather, Jochen Vollmann, Stephan Nadolny, Jan Schildmann","doi":"10.1192/j.eurpsy.2025.10041","DOIUrl":"10.1192/j.eurpsy.2025.10041","url":null,"abstract":"<p><strong>Background: </strong>Decisional capacity is an important requirement for assisted suicide, which has been legalized in an increasing number of countries. While several instruments have been developed over the past few decades to assess the capacity to consent to treatment, little is known about their applicability to assessing capacity in the context of requests for assisted suicide.</p><p><strong>Methods: </strong>Systematic review of instruments assessing decisional capacity published up to March 2024. Data concerning criteria for determining decisional capacity, psychometric properties, and other aspects were extracted from all instruments included. Selected instruments were analyzed regarding their applicability to requests for assisted suicide.</p><p><strong>Results: </strong>We identified 23 instruments assessing the capacity to consent to treatment. There is considerable heterogeneity regarding the criteria utilized for assessing decisional capacity and their operationalization. Next to more cognitive abilities, some instruments directly incorporated emotions and values. Five instruments were assessed for applicability to requests for assisted suicide. The framing of decisional capacity within the context of disease and treatment options frequently limits the application of instruments to assess decisional capacity in the context of requests for assisted suicide.</p><p><strong>Conclusions: </strong>No instrument could be identified that could be applied to assessing decisional capacity in the context of requests for assisted suicide without any limitations or without necessitating adjustments. Further normative and empirical work is required for developing an instrument that could be applicable in this context.</p>","PeriodicalId":520621,"journal":{"name":"European psychiatry : the journal of the Association of European Psychiatrists","volume":"68 1","pages":"e91"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12260724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586103","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":"Experimental Pasta as an Innovative Approach to Cholesterol Reduction in Patients with Metabolic Syndrome, with and without Major Psychiatric Disorders: A Randomized Controlled Trial Supported by In Vitro Validation.","authors":"Enrico D'Ambrosio, Maria Favia, Marcello Greco Miani, Francesco Pappagallo, Laura De Mastro, Antonia Ianniello, Silvia Saltarelli, Maria Fiore, Giulia Napoletano, Rita Masellis, Agostino Di Ciaula, Mohamad Khalil, Elisa Lanza, Antonino Noto, Felice Ungaro, Gianluca Kikidis, Giulio Pergola, Piero Portincasa, Alessandro Bertolino, Antonio Rampino","doi":"10.1192/j.eurpsy.2025.10057","DOIUrl":"https://doi.org/10.1192/j.eurpsy.2025.10057","url":null,"abstract":"","PeriodicalId":520621,"journal":{"name":"European psychiatry : the journal of the Association of European Psychiatrists","volume":" ","pages":"1-42"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577581","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":"AI in Scientific Writing and Publishing: A Call for Critical Engagement.","authors":"Sophia Frangou, Umberto Volpe, Andrea Fiorillo","doi":"10.1192/j.eurpsy.2025.10061","DOIUrl":"https://doi.org/10.1192/j.eurpsy.2025.10061","url":null,"abstract":"","PeriodicalId":520621,"journal":{"name":"European psychiatry : the journal of the Association of European Psychiatrists","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562609","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":"Evaluation of the feasibility and effectiveness of trauma-focused cognitive behavioural therapy for children and youth in Ukraine during the war.","authors":"Elisa Pfeiffer, Maike Garbade, Renée Beer, Anette Birgersson, Natalie Cabrera, Judith A Cohen, Esther Deblinger, Rafaela Gjini, Veronica Kirsch, Zlatina Kostova, Michael Larsson, Anthony Mannarino, Gavin Moffitt, Marja Onsjö, Tale Ostensjo, Anna Vikgren, Hanna Weyler, Vitalii Klymchuk, Cedric Sachser","doi":"10.1192/j.eurpsy.2025.10032","DOIUrl":"10.1192/j.eurpsy.2025.10032","url":null,"abstract":"<p><strong>Background: </strong>The large-scale Russian invasion of Ukraine in early 2022 resulted in a humanitarian crisis with hundreds of thousands of children exposed to traumatic events. To date, trauma-focused evidence-based treatments (EBTs) for children and youth have not been systematically evaluated and implemented in Ukraine. This study aims at evaluating 1) the feasibility of a training program for Ukrainian therapists on Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) and 2) the feasibility and effectiveness of the treatment for children, youth, and their families in and from Ukraine during the ongoing war.</p><p><strong>Methods: </strong>The project \"TF-CBT Ukraine\" was implemented between March 2022 and May 2024, in close collaboration with local and international partners. Therapists completed questionnaires before/after the training, and patients were asked to complete a measure on PTSD before and after treatment.</p><p><strong>Results: </strong>Altogether 138 therapists started the training program and 44.9% were certified as TF-CBT therapists. The program completers reported overall high satisfaction with the training program, a positive change in their attitude towards EBTs and trauma-related knowledge gain. The patients (age 3-21, 37% male) reported significant improvement in symptoms of PTSD at the end of treatment with large pre-post effect sizes for DSM-5 PTSD (<i>d</i>_selfreport = 2.36; <i>d</i>_{caregiverreport} = 2.27), ICD-11 PTSD (<i>d</i>_selfreport = 1.97; <i>d</i>_{caregiverreport} = 1.77), ICD-11 CPTSD (<i>d</i>_selfreport = 2.04; <i>d</i>_{caregiverreport} = 1.99), and DSM-5 pre-school PTSD (<i>d_{caregiverreport}</i> = 3.14).</p><p><strong>Conclusions: </strong>The results of this study are promising in regard to the general implementation of trauma-focused EBTs in active conflict areas. Future studies need to replicate these findings in a randomized controlled study design.</p>","PeriodicalId":520621,"journal":{"name":"European psychiatry : the journal of the Association of European Psychiatrists","volume":" ","pages":"e96"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532799","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":"Cognitive Behavioural Therapy for psychosis: a cost-effectiveness study using the EPiSODe model.","authors":"Stefan R A Konings, Maureen Berkhof, Wim Veling, Ellen Visser, Jochen Mierau, Talitha Feenstra, Richard Bruggeman","doi":"10.1192/j.eurpsy.2025.10028","DOIUrl":"https://doi.org/10.1192/j.eurpsy.2025.10028","url":null,"abstract":"","PeriodicalId":520621,"journal":{"name":"European psychiatry : the journal of the Association of European Psychiatrists","volume":" ","pages":"1-24"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532798","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":"Mad or bad: Psychiatry's foundational divide and the illusion of binary thinking.","authors":"Giovanni Stanghellini","doi":"10.1192/j.eurpsy.2025.10054","DOIUrl":"10.1192/j.eurpsy.2025.10054","url":null,"abstract":"<p><p>This paper revisits Philippe Pinel's (1745-1826) psychiatric legacy, on the occasion of the 200th anniversary of his death, to challenge the enduring dichotomy between madness and criminality. While Pinel is celebrated for separating the insane from the criminal, his deeper insight - that madness is always partial and never fully negates agency - has been largely overlooked. Drawing on this dialectical view, the paper critiques the persistence of rigid classifications in psychiatry and forensic contexts. It argues for a model of mental illness as a dynamic interplay between vulnerability and self-awareness, with profound implications for clinical practice, legal judgment, and public perception. By highlighting psychiatry's double bind - caught between therapeutic nuance and legal absolutism - the paper calls for a renewed ethical stance that embraces complexity and reclaims psychiatry's role as a bridge-builder rather than a boundary enforcer.</p>","PeriodicalId":520621,"journal":{"name":"European psychiatry : the journal of the Association of European Psychiatrists","volume":" ","pages":"e89"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12260714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532800","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":"Temporal patterns of loneliness and their associations with mental health outcomes: Observations from a longitudinal study.","authors":"Błażej Misiak, Paweł Liśkiewicz, Jerzy Samochowiec","doi":"10.1192/j.eurpsy.2025.10055","DOIUrl":"10.1192/j.eurpsy.2025.10055","url":null,"abstract":"<p><strong>Background: </strong>Loneliness is a global public health concern. Investigating loneliness in the general population offers a greater generalizability across various levels of health-related impairments, the identification of at-risk individuals, the detection of different loneliness severity levels, and broader insights into social determinants. Previous studies have shown that loneliness might be a transient or chronic experience, depending on how consistently it is reported across at least two timepoints. This study aimed to assess differential associations of chronic and transient with various domains of psychopathology.</p><p><strong>Methods: </strong>Participants were enrolled from the general population and assessed at two timepoints spanning 6-7 months. Depressive symptoms, generalized anxiety, social anxiety, and paranoid thoughts were measured using self-reports. The data were analyzed using binary logistic regressions.</p><p><strong>Results: </strong>Altogether, 3,275 participants completed both assessments with a retention rate of 64.2%. Chronic loneliness was associated with higher baseline and follow-up scores across all symptom domains. The strongest association was observed for social anxiety. Transient loneliness was not robustly associated with symptom scores. It was not significantly associated with depressive symptoms (at either of timepoints) and paranoid ideation (at baseline). The strongest association was observed for generalized anxiety. Chronic loneliness, compared to transient loneliness, was associated with significantly higher odds of social anxiety, depressive symptoms, and paranoid ideation, but not generalized anxiety.</p><p><strong>Conclusions: </strong>Both transient and chronic loneliness are associated with mental health outcomes, with the latter one showing generally stronger associations. Risk stratification and early intervention among individuals experiencing loneliness might be needed to prevent the development of more severe psychopathology.</p>","PeriodicalId":520621,"journal":{"name":"European psychiatry : the journal of the Association of European Psychiatrists","volume":" ","pages":"e94"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532801","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":"Beyond capacity limits: can social cohesion offset the impact of service constraints on youth mental health?","authors":"Jo-An Occhipinti, Nicholas Ho, Paul Crosland, Sam Huntley, Wendy Hawkins, Adam Connell, Judith Piccone, Sarah Piper, Seyed Hossein Hosseini, Catherine Vacher, Jordan van Rosmalen, Sophie Morson, Courtney Milham, Wendy Burton, Kayla Andrade, Chloe Gosling, Kristen Tran, Yun Ju Christine Song, Victoria Loblay, Jo Robinson, Adam Skinner, Ian B Hickie","doi":"10.1192/j.eurpsy.2025.10053","DOIUrl":"10.1192/j.eurpsy.2025.10053","url":null,"abstract":"<p><strong>Background: </strong>Rates of youth anxiety, depression, and self-harm have increased substantially in recent years. Expansion of clinical service capacity is constrained by workforce shortages and system fragmentation, and even substantial investment may not achieve the scale of growth required to address unmet need. Preventive strategies - such as strengthening social cohesion - are therefore essential to alleviate mounting pressures on the mental health system, yet their potential to compensate for these constraints remains unquantified.</p><p><strong>Methods: </strong>This study employed a system dynamics model to explore the interplay between service capacity and social cohesion on youth mental health outcomes. The model was developed for a population catchment characterized by a mix of urban, suburban, and rural communities. Primary outcomes were prevalence of psychological distress and mental disorders, and incidence of mental health-related emergency department (ED) presentations among young people aged 15-24 years, projected over a 10-year time horizon. Two-way sensitivity analyses of services capacity and social cohesion were conducted.</p><p><strong>Results: </strong>Changes to specialized mental health services capacity growth had the greatest projected impact on youth mental health outcomes. Heatmaps revealed thresholds where improvements in social cohesion could offset negative impacts of constrained service capacity. For example, if services capacity growth was sustained at only 80% of baseline, improving social cohesion could still reduce years lived with symptomatic disorder by 6.3%. To achieve a similar scale of improvement without improvements in social cohesion, the current growth rate in services capacity would need to be more than double. Combining a doubling of service capacity growth with reversing the decline in social cohesion could reduce ED presentations by 25.6% and years with symptomatic mental disorder by 19.2%. A doubling of specialized, headspace, and GP services capacity growth could prevent 24,060 years lived with symptomatic mental disorder among youth aged 15-24.</p><p><strong>Conclusions: </strong>This study provides a quantitative framework for understanding how social cohesion improvements can help mitigate workforce constraints in mental health systems, demonstrating the value of integrating service expansion with social cohesion enhancement strategies.</p>","PeriodicalId":520621,"journal":{"name":"European psychiatry : the journal of the Association of European Psychiatrists","volume":" ","pages":"e93"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12260717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510330","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":"Clinical effects and correlates of standard rTMS and theta burst stimulation (TBS) on suicidal ideation in late-life depression.","authors":"Hyewon H Lee, Katharina Göke, Rafae A Wathra, Benoit Mulsant, Alisson P Trevizol, Jonathan Downar, Shawn M McClintock, Sean M Nestor, Yoshihiro Noda, Tarek K Rajji, Zafiris J Daskalakis, Daniel M Blumberger","doi":"10.1192/j.eurpsy.2025.10049","DOIUrl":"10.1192/j.eurpsy.2025.10049","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have shown that repetitive transcranial magnetic stimulation (rTMS) can treat suicidal symptoms; however, the effects of rTMS on suicidal ideation (SI) in late-life depression (LLD) have not been well-characterized, particularly with theta burst stimulation (TBS).</p><p><strong>Methods: </strong>Data were analyzed from 84 older adults with depression from the FOUR-D trial (ClinicalTrials.gov identifier: NCT02998580), who received either bilateral standard rTMS or bilateral TBS targeting the dorsolateral prefrontal cortex. The primary outcome was change in the Beck Scale for Suicide Ideation (SSI). The secondary outcome was remission of SI. Demographic, cognitive, and clinical characteristics that may moderate the effects of rTMS or TBS on SI were explored.</p><p><strong>Results: </strong>There was a statistically significant change in the total SSI score over time [<i>χ</i>²(7) = 136.018, <i>p</i> < 0.001], with no difference between the two treatment groups. Remission of SI was 55.8% in the standard rTMS group and 53.7% in the TBS group. In the standard rTMS group, there was no difference in remission of SI between males and females, whereas remission was higher in females in the TBS group (χ²(1) =6.87, <i>p</i> = 0.009). There was a significant correlation between time to remission of SI and RCI <i>z</i>-score for D-KEFS inhibition<i>/</i>switching [<i>r_s</i> = -0.389, <i>p =</i> 0.012].</p><p><strong>Conclusions: </strong>Both bilateral rTMS and bilateral TBS were effective in reducing SI in LLD. There may be sex differences in response to TBS, with females having more favorable response in reducing SI. There may be an association between improvement in cognitive flexibility and inhibition and reduction of SI.</p>","PeriodicalId":520621,"journal":{"name":"European psychiatry : the journal of the Association of European Psychiatrists","volume":" ","pages":"e92"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12260718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510331","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":"Does treatment of adolescent depression reduce risk of later psychosis: A quasi-experimental study of selective serotonin reuptake inhibitor treatment in a total population cohort.","authors":"Colm Healy, Kirsite O'Hare, Ulla Lång, Martta Kerkelä, Jonah Byrne, Juha Veijola, Anna Pulakka, Johanna Metsälä, Eero Kajantie, Ian Kelleher","doi":"10.1192/j.eurpsy.2025.10050","DOIUrl":"10.1192/j.eurpsy.2025.10050","url":null,"abstract":"<p><strong>Background: </strong>Psychotic disorders are frequently preceded by depressive disorders, and it has been hypothesized that treatment of depression in youth may reduce risk for later psychosis. Using quasi-experimental methods, we estimated the causal relationship between the treatment of adolescent depression with selective serotonin reuptake inhibitors (SSRIs) and the risk of later psychosis.</p><p><strong>Methods: </strong>We used data linkage from multiple national Finnish registries for all individuals (<i>n</i> = 697,289) born between 1987 and 1997 to identify depression diagnosed before age 18, cumulative SSRI treatment within three years of diagnosis, and diagnoses of non-affective psychotic disorders by end of follow-up (age 20-29). We used instrumental variable analyses, exploiting variability in prescribing across hospital districts to estimate causal effects. Analyses were conducted using two-stage least squares modelling. Sensitivity analyses examined effects stratified by confounders and effects of specific SSRIs.</p><p><strong>Results: </strong>Our final sample included 22,666 individuals diagnosed with depression in adolescence, of whom 60.2% (<i>n</i> = 13,650) had used SSRIs. 10.7% of adolescents with depression went on to be diagnosed with a non-affective psychotic disorder. SSRI treatment for adolescent depression was not associated with a reduced risk of developing a psychotic disorder (one-year <i>β =</i> 0.04,CI:-0.01 to 0.09; two-years <i>β =</i> 0.02,CI:-0.06 to 0.09; three-years <i>β =</i> -0.02,CI:-0.08 to 0.05).</p><p><strong>Conclusions: </strong>Our quasi-experimental investigation does not support the hypothesis that treatment of adolescent depression reduces the subsequent risk of psychosis. Our findings question the assumption that treatment of common mental health disorders in youth may impact the risk of developing severe mental illnesses in adulthood.</p>","PeriodicalId":520621,"journal":{"name":"European psychiatry : the journal of the Association of European Psychiatrists","volume":"68 1","pages":"e82"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487686","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}