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

{"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}

{"title":"In its very early phases, COVID-19 shifts the associations between alcohol consumption and psychological symptoms in young adults.","authors":"Karina Janson, Arun L W Bokde, Sylvane Desrivières, Hugh Garavan, Penny Gowland, Antoine Grigis, Andreas Heinz, Jean-Luc Martinot, Marie-Laure Paillère Martinot, Eric Artiges, Dimitri Papadopoulos Orfanos, Tomáš Paus, Luise Poustka, Michael N Smolka, Nathalie E Holz, Nilakshi Vaidya, Henrik Walter, Robert Whelan, Gunter Schumann, Herta Flor, Olaf Reis, Emanuel Schwarz, Tobias Banaschewski, Frauke Nees","doi":"10.1192/j.eurpsy.2025.2450","DOIUrl":"10.1192/j.eurpsy.2025.2450","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has impacted various aspects of daily life, leading to increased psychological symptoms and changes in alcohol use, yet little is known about their specific interactions, particularly early stages during the pandemic. We examined the relationship between psychological symptoms and alcohol-related behaviors associated with COVID-19, and determined whether associations shifted already early during the pandemic and whether changes in psychological symptoms from the pre- to during COVID-19 impacted changes in alcohol consumption.</p><p><strong>Methods: </strong>Participants were young adults from a longitudinal cohort (N=435, age: 22-25) from two time points. We applied paired samples t-tests, correlation analyses, SHapley Additive exPlanations, and classification models to examine the multiple associations between psychological symptoms and alcohol use directly pre- and early during COVID-19.</p><p><strong>Results: </strong>We found significant associations between psychological symptoms and alcohol use pre- compared to during COVID-19. Anxiety was the strongest factor influencing alcohol use pre-pandemic, depression had the greatest impact during COVID-19. Changes in anxiety from pre- to during COVID-19 were the main factor associated with an increase in alcohol use, while changes in depression appeared to be most predictive for a decrease/persistence in alcohol use.</p><p><strong>Conclusion: </strong>These findings suggest a shift in the association between psychological symptoms and alcohol use following COVID-19, as well as a differential impact of psychological symptoms, depending on their changes related to the pandemic. Changes in anxiety may contribute to riskier alcohol use behaviors following the pandemic, while depression appears to be one of the most critical factors influencing alcohol use during such crisis situations.</p>","PeriodicalId":520621,"journal":{"name":"European psychiatry : the journal of the Association of European Psychiatrists","volume":"68 1","pages":"e77"},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370061","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":"Low cholesterol and risk of violence in forensic inpatients with schizophrenia, personality disorder or dual diagnosis: same or different?","authors":"Piyal Sen, Mehr-Un-Nisa Waheed, Fern Taylor, Rebecca Mottram, Quazi Haque, Alex Blakemore, Veena Kumari","doi":"10.1192/j.eurpsy.2025.10051","DOIUrl":"10.1192/j.eurpsy.2025.10051","url":null,"abstract":"<p><strong>Background: </strong>Violence and suicidality are common in forensic inpatients, most commonly with schizophrenia (SZ), personality disorder (PD), or comorbid SZ and PD (dual diagnosis, DD). There are no biological markers used in risk assessment tools. Lipids may provide a useful biomarker to aid violence prediction, but the roles of diagnosis and sex remain unclear. We therefore investigated lipids in adult forensic inpatients in association with the risk of violence and suicidality by primary diagnosis and sex.</p><p><strong>Method: </strong>Anonymized data were obtained for all eligible inpatients [<i>n</i> = 230; 114 SZ (75 males), 77 PD (40 males), 39 DD (20 males)] who had been admitted (2002-2021) to Elysium Healthcare (UK-wide) medium/low-secure facilities on lipids, age, sex, diagnosis, medication, risk of violence and suicidality, as well as days in seclusion and on high observations due to violence.</p><p><strong>Results: </strong>Mean total cholesterol (TC) in the patient sample (4.57, s.d. = 1.09) was lower, relative to the age- and sex-corrected UK population norm (4.91 mmol/l). PD (4.46 ± 1.08 mmol/l) and DD (4.24 ± 0.82 mmol/l), compared to SZ patients (4.77 ± 1.14 mmol/l), had significantly lower TC (not explained by statin use; no effect or interaction involving sex). Lower TC had significant though small associations with more days in seclusion or high observation levels due to violence across all patients, and marginally with suicidality in females.</p><p><strong>Conclusions: </strong>A low TC-violence (towards others) link exists not only for SZ but also for PD and DD and for males and females, encouraging further enquiry into lipids as a biomarker to aid violence prediction in secure care.</p>","PeriodicalId":520621,"journal":{"name":"European psychiatry : the journal of the Association of European Psychiatrists","volume":" ","pages":"e87"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12260726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334800","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":"Long-term alteration of heart rate variability following childhood maltreatment: Results of a general population study.","authors":"Marian Stürmer, Johanna Klinger-König, Marcus Vollmer, Antoine Weihs, Stefan Frenzel, Marcus Dörr, Lars Kaderali, Stephan B Felix, Beate Stubbe, Ralf Ewert, Henry Völzke, Hans J Grabe, Elischa Krause","doi":"10.1192/j.eurpsy.2025.10040","DOIUrl":"10.1192/j.eurpsy.2025.10040","url":null,"abstract":"<p><strong>Background: </strong>Childhood maltreatment (CM) is a risk factor for mental and physical health problems in adulthood, potentially mediated by long-term autonomic nervous system (ANS) dysregulation. To explore this link, the association between CM and vagal-sensitive heart rate variability (HRV) metrics in adults was examined, accounting for biopsychosocial factors.</p><p><strong>Methods: </strong>Data from 4,420 participants in the Study of Health in Pomerania were analyzed, with CM assessed using the Childhood Trauma Questionnaire. HRV was derived from 10-second electrocardiograms and 5-minute pre-sleep polysomnographic recordings. Post hoc analyses examined abuse and neglect.</p><p><strong>Results: </strong>CM was associated with reduced HRV (logRMSSD: <i>β</i> = -0.20 [95%-CI: -0.28, -0.12], <i>p</i> = 1.2e-06), driven by neglect (<i>β</i> = -0.27 [-0.35, -0.18], <i>p</i> = 1.9e-09) rather than abuse (<i>β</i> = 0.01 [-0.12, 0.14], <i>p</i> = 1). Adjustments for age, sex, and medication attenuated these effects, which remained robust after additionally controlling for socioeconomic, lifestyle, body mass index, and depressive symptoms (fully adjusted model: CM <i>β</i> = -0.08 [-0.15, -0.001], <i>p</i> = .047; neglect <i>β</i> = -0.11 [-0.19, -0.03], <i>p</i> = .009; abuse <i>β</i> = -0.08 [-0.20, -0.04], <i>p</i> = .174). Age-related differences were found, with reduced HRV in both young and older participants but not in middle-aged participants (fully adjusted: <i>F</i>(2,743) = 6.75, <i>p</i> = .001).</p><p><strong>Conclusions: </strong>This study highlights long-term ANS dysregulation following CM, particularly neglect, indicated by altered vagal-sensitive HRV metrics. Although small in magnitude, the effect on the ANS was independent of adult biopsychosocial factors. This long-term dysregulation may contribute to an increased risk of adverse health outcomes in adulthood.</p>","PeriodicalId":520621,"journal":{"name":"European psychiatry : the journal of the Association of European Psychiatrists","volume":" ","pages":"e86"},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12260733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328397","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":"Psychotherapy training in psychiatry: a systematic review on the early career psychiatrists' interests and opportunities.","authors":"Selin Tanyeri Kayahan, Mustafa Dinçer, Jesper Nørgaard Kjær, Thomas Gargot","doi":"10.1192/j.eurpsy.2025.10044","DOIUrl":"10.1192/j.eurpsy.2025.10044","url":null,"abstract":"<p><strong>Background: </strong>Psychotherapy plays a crucial role in mental healthcare. Integrating evidence-based practices into treatment guidelines highlights the need for basic psychotherapy competence in psychiatry training. While programs set minimum requirements for psychotherapy training in line with the recommendations of the World Psychiatric Association or accreditation bodies like the European Union of Medical Specialists, implementation is often inconsistent, and resources are limited. This systematic review explores early career psychiatrists' (ECPs) views, interests, and available opportunities for psychotherapy training worldwide.</p><p><strong>Methods: </strong>We systematically searched MEDLINE, Scopus, and PubPsych for survey-based studies on ECPs' perspectives on psychotherapy training, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Of 31,281 studies screened, 48 articles were included. Quality assessment was conducted using the Quality Assessment Checklist for Survey Studies on Psychology, and the findings were summarized through narrative synthesis.</p><p><strong>Results: </strong>Included studies were from Europe (24, 50%), United States (12, 25%), Western Pacific (6, 12.5%), South-East Asia (4, 8.3%), Eastern Mediterranean (1, 2%), and Africa (1, 2%), with a total of 7,196 participants. Thirty-one studies on ECPs' interest in psychotherapy training found that 57-80% were interested in psychotherapy, 67-92% viewed being a psychotherapist as part of their psychiatrist identity, and 88-97.7% supported its inclusion in psychiatry training. Training opportunities varied by country and institution, with cognitive behavioral therapy and psychodynamic psychotherapy being primary modalities.</p><p><strong>Conclusion: </strong>Improving psychiatrists' access to evidence-based, culturally adapted psychotherapy training is essential. Educational activities offered by training institutions and professional organizations can play a key role in supporting ongoing professional development.</p>","PeriodicalId":520621,"journal":{"name":"European psychiatry : the journal of the Association of European Psychiatrists","volume":" ","pages":"e88"},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12260736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304383","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":"Electroconvulsive therapy modulates the interplay between depressive symptoms in difficult-to-treat depression: A longitudinal network analysis.","authors":"Marialaura Lussignoli, Marco Bortolomasi, Giulia Perusi, Giorgio Pigato, Alessandra Minelli, Fabio Sambataro","doi":"10.1192/j.eurpsy.2025.10052","DOIUrl":"10.1192/j.eurpsy.2025.10052","url":null,"abstract":"<p><strong>Background: </strong>Difficult-to-treat depression (DTD) is a common clinical challenge for major depressive disorder and bipolar disorders. Electro convulsive therapy (ECT) has proven to be one of the most effective treatments for this condition. Although several studies have investigated individually the clinical factors associated with the DTD response, the role of their interplay in the clinical response to ECT remains unknown. In the present study, we aimed to characterize the network of symptoms in DTD, evaluate the effects of ECT on the interrelationship of depressive symptoms, and identify the network characteristics that could predict the clinical response.</p><p><strong>Methods: </strong>A network analysis of clinical and demographic data from 154 patients with DTD was performed to compare longitudinally the patterns of relationships among depressive symptoms after ECT treatment. Furthermore, we estimated the network structure at baseline associated with a greater clinical improvement (≥80% reduction at Montgomery-Åsberg Depression Rating Scale total score).</p><p><strong>Results: </strong>ECT modulated the network of depressive symptoms, with increased strength of the global network (<i>p</i> = 0.03, Cohen's <i>d</i> = -0.98, 95% confidence interval = [-1.07, -0.88]). The strength of the edges between somatic symptoms (appetite and sleep) and cognitive-emotional symptoms (tension, lassitude, and pessimistic thoughts) was also increased. A stronger negative relationship between insomnia and pessimistic thoughts was associated with a greater improvement after ECT. Concentration difficulties and apparent sadness showed the greatest centrality.</p><p><strong>Conclusions: </strong>In conclusion, ECT treatment may affect not only the severity of the symptoms but also their relationship; this may contribute to the response in DTD.</p>","PeriodicalId":520621,"journal":{"name":"European psychiatry : the journal of the Association of European Psychiatrists","volume":" ","pages":"e84"},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12260723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304382","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":"Symptoms of the suicide crisis syndrome and associated risk factors in an acute psychiatric population, a cross-sectional study.","authors":"Linde Melby, Karina Høyen, Astrid Prestmo, Arne Vaaler, Tuva Kvithyld, Igor Galynker, Fredrik Walby, Mette Langaas, Terje Torgersen","doi":"10.1192/j.eurpsy.2025.10030","DOIUrl":"10.1192/j.eurpsy.2025.10030","url":null,"abstract":"<p><strong>Background: </strong>The focus of suicide research changes from traditional risk factors to acute warning signs. Patient self-reported suicidal ideation (SI) is not a reliable measure of acute suicide risk. Presuicidal syndromes such as suicide crisis syndrome (SCS) attempt to describe measurable syndromes based on warning signs other than SI.</p><p><strong>Methods: </strong>Seven hundred and ten acutely admitted patients were included in the study. Identification of symptoms describing the five components of SCS was done by performing a retrospective text analysis of the patient records (electronic medical records). Patients were grouped according to high or low level of SCS symptoms. We performed statistical tests for group differences in demographics, traditional risk factors, and clinical variables, including agitation assessed by the Positive and Negative Symptom Scale-Excited Component (PANSS-EC).</p><p><strong>Results: </strong>Seventy-two patients had high levels of SCS symptoms. They reported less SI the last month before admission; suicidality was less relevant for referral, the intake suicide assessment more often concluded with high suicide risk, they were more often referred and admitted involuntarily, and they had higher total scores on PANSS-EC.</p><p><strong>Conclusion: </strong>The individual SCS symptoms may provide useful information in the evaluation of acute suicide risk at intake. A high level of SCS symptoms suggests more severe conditions. The lower reports among high-level than low-level SCS patients of self-reported SI last month before admission, shows the limitation of using SI as a warning sign. The association between the level of SCS symptoms and PANSS-EC total score suggests that agitation could give valuable additional information for suicide risk assessments.</p>","PeriodicalId":520621,"journal":{"name":"European psychiatry : the journal of the Association of European Psychiatrists","volume":" ","pages":"e83"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12260716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288054","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":"Socioeconomic status, antidepressant use, and return to work after disability due to common mental disorders.","authors":"Helena Leppänen, Olli Kampman, Reija Autio, Antti Tanskanen, Heidi Taipale, Tino Karolaakso, Päivi Rissanen, Turkka Näppilä, Sami Pirkola","doi":"10.1192/j.eurpsy.2025.10046","DOIUrl":"10.1192/j.eurpsy.2025.10046","url":null,"abstract":"<p><strong>Background: </strong>Common mental disorders (CMDs) are significant causes of work disability. Low socioeconomic status (SES) is a known risk factor for CMDs and work disability, one possible reason being poorer treatment adherence. We aimed to study the realization of pharmacological treatment and antidepressant adherence in patients with CMDs 3 years before and 3 years after being granted a disability pension (DP) and the role of SES in this. We also studied whether antidepressant adherence is associated with return to work (RTW) after a temporary DP.</p><p><strong>Methods: </strong>Information on all persons granted a DP due to CMD between 2010 and 2012 in Finland (<i>n</i> = 12,388) was retrieved from national registers, which included medical, socioeconomic, and sociodemographic information of the subjects. We used the PRE2DUP method to estimate drug use periods and regression analyses to study associations between SES, taking medications, and RTW.</p><p><strong>Results: </strong>Prevalence of taking antidepressants increased towards the DP grant and decreased thereafter, but 14.6% of subjects did not take antidepressants or antipsychotics at all during the study period. Of SES factors, only income was positively associated with antidepressant adherence, lasting over a year. Antidepressant adherence was not associated with RTW.</p><p><strong>Conclusions: </strong>An alarming result was the absence of recommended medication in fewer than every seventh patient estimated to be disabled due to pharmacologically treatable psychiatric disorders. Contrary to expectations, SES had only a minor predictive role in antidepressant adherence in this patient group. Contrary to taking antidepressants, rehabilitation was associated with RTW. The results adduced the importance of CMD treatment optimization regardless of SES.</p>","PeriodicalId":520621,"journal":{"name":"European psychiatry : the journal of the Association of European Psychiatrists","volume":" ","pages":"e79"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288053","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}