{"title":"Perceived stigma, social support and depression among prison inmates in Northwest Ethiopia: Using structural equation modeling","authors":"Setegn Fentahun , Shegaye Shumet , Mamaru Melkam , Gidey Rtbey , Fantahun Andualem , Gebremariam Wulie Geremew , Tekletsadik Teklesilassie Alemayehu , Samuel Teferi Chanie , Melese Gobezie , Getasew Kibralew , Girum Nakie , Girmaw Medfu Takelle , Techilo Tinsae , Gebresilassie Tadesse , Mulualem Kelebie","doi":"10.1016/j.jadr.2025.100927","DOIUrl":"10.1016/j.jadr.2025.100927","url":null,"abstract":"<div><h3>Background</h3><div>There is a well-established empirical association between mental health problems and imprisonment. Depression is a widespread mental health condition that affects a variety of demographic groups, particularly individuals who are in prison. Among inmates, depression occurs much more frequently than in the general community, which puts them at a higher risk of suicide. Hence, the current study was conducted to estimate the prevalence of depression and its correlated factors among incarcerated individuals in Northwest Ethiopia.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted on 410 prisoners who were recruited using a simple random sampling technique. The Patient Health Questionnaire-9 was used to evaluate depression through an interviewer-administered questionnaire. The direct, indirect, and total effects of predictors on depression have been examined using a Structural Equation Model. The standardized regression coefficient, 95 % confidence interval, and <em>p</em>-value <0.05 were used to determine the significance of the correlation.</div></div><div><h3>Results</h3><div>This study revealed that depression affected 54.6 % of incarcerated individuals (95 % CI: 49.76, 59.41). Social support had a positive direct effect (β= 0.184, 95 % CI: 0.052, 0.309) and a negative indirect effect on depression (β= −0.025, 95 % CI:0.066, −0.002). Perceived stigma mediated the association between social support and depression and significantly correlated with depression (β=−0.158, 95 % CI:0.290, −0.027). Chronic medical illness (β=−0.127, 95 % CI: 0.028, 0.237) had a direct association with depression.</div></div><div><h3>Conclusions</h3><div>In the current study, depression was reported in more than half of imprisoned people. Accordingly, incarcerated individuals need more attention, early screening, and intervention for depression by enhancing the provision of mental health services in correctional institutions.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"21 ","pages":"Article 100927"},"PeriodicalIF":0.0,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143877308","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}
Amy Coët, F. Meredith Blampied, Julia J. Rucklidge
{"title":"1-year naturalistic follow-up of a Randomised Double-Blind, Placebo-Controlled Trial (“NoMAD”) Exploring the Effectiveness of Micronutrients in Improving Symptoms of Anxiety and Depression","authors":"Amy Coët, F. Meredith Blampied, Julia J. Rucklidge","doi":"10.1016/j.jadr.2025.100913","DOIUrl":"10.1016/j.jadr.2025.100913","url":null,"abstract":"<div><h3>Background</h3><div>A randomised controlled trial (NoMAD trial) showed micronutrients led to faster recovery from depression and anxiety compared with placebo. The RCT was followed by a 10 week open-label component and then a one year naturalistic review.</div></div><div><h3>Aims</h3><div>This 1-year follow-up of NoMAD explored the association between dominant treatment at 1-year follow-up with psychiatric outcomes.</div></div><div><h3>Study design/Methods</h3><div>Ninety-four (63 %) of the original 150 NoMAD participants completed 1-year follow-up. Primary outcomes included Generalised Anxiety Disorder-7 questionnaire (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Modified-Clinical Global Impression-Improvements (MCGI-I). Outcomes were explored based on dominant therapy at 1-year follow-up: Micronutrients (<em>n</em> = 20), Psychiatric Medications (<em>n</em> = 9), and No Treatment (<em>n</em> = 56). Nine participants could not be grouped due to mixed treatments at follow-up.</div></div><div><h3>Results</h3><div>Regardless of dominant therapy, participants were functioning significantly better at 1-year compared to baseline. There was little change from end of 10 weeks of open-label micronutrient treatment, with the exception of depression scores, which were significantly lower (<em>d</em> = 0.4; <em>p</em><.001). Most participants had either no or mild depression (78 %) and anxiety (85 %) scores at 1-year follow-up. Those who stayed on micronutrients were those who experienced better response at end of open-label compared with those who stopped or switched to medications. They also showed a greater reduction in health anxiety from end of open-label to 1-year follow-up compared with others. The main reason cited for stopping micronutrients was the cost. Limitations include a third of original sample lost to follow-up and uneven group sizes limit generalisability of results.</div></div><div><h3>Conclusion</h3><div>Participants, regardless of long-term supplementation, were functioning well at one year.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"20 ","pages":"Article 100913"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143807666","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":"Effects of acute stress on executive functions in depression, generalised anxiety and borderline personality disorder","authors":"T.M. Scott , Joanne M. Dickson","doi":"10.1016/j.jadr.2025.100917","DOIUrl":"10.1016/j.jadr.2025.100917","url":null,"abstract":"<div><h3>Background</h3><div>Acute stress adaptively alters executive functions (EFs) essential for emotion regulation. Emerging systems of psychiatric classification, such as the Hierarchical Taxonomy of Psychopathology (HiTOP) and the Research Domain Criteria, emphasise the underlying mechanisms and dimensional nature of psychopathology. Distress disorders—a subfactor within the HiTOP model including major depressive disorder, generalised anxiety disorder and borderline personality disorder—are characterised by altered stress reactivity, impaired emotion regulation, and modest responsiveness to first-line psychotherapies. This systematic review sought to examine whether distress disorders and their related symptoms confer heightened vulnerability to transient EF impairment under conditions of acute stress.</div></div><div><h3>Methods</h3><div>A comprehensive search of articles published in ProQuest, PsycINFO, PubMed, Scopus and Web of Science prior to December 31st, 2022 identified 17 suitable studies examining stress-induced alterations to working memory, inhibition and cognitive flexibility in the context of distress disorders and associated symptoms.</div></div><div><h3>Results</h3><div>This review found a heightened susceptibility to stress-induced impairment of working memory in depression, and of response inhibition in borderline personality disorder—even for sub-clinical presentations of depressive symptoms wherein diagnostic criteria for a depressive disorder were not met. Findings for cognitive flexibility were inconclusive.</div></div><div><h3>Limitations</h3><div>While a thorough systematic review was conducted, heterogeneity in study design and methodologies precluded inclusion of a meta-analysis<em>.</em></div></div><div><h3>Conclusions</h3><div>The findings indicate that altered stress reactivity leads to maladaptation of EF under acute stress, and subsequent disruption of adaptive emotion regulation strategies. The present finding may help account for non-responsiveness among therapeutic interventions predicated upon cognitively-demanding emotion regulation strategies.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"20 ","pages":"Article 100917"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820817","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":"Virtual Reality in the treatment of depression; what therapeutic strategies does VR target?","authors":"Nancy Kramer Freher , Martine van Bennekom , Anika Bexkens , Wim Veling , Claudi L.H. Bockting","doi":"10.1016/j.jadr.2025.100912","DOIUrl":"10.1016/j.jadr.2025.100912","url":null,"abstract":"<div><h3>Background</h3><div>Major Depressive Disorder (MDD) is one of the most prevalent mental health conditions and has a tremendous impact on those affected. Immersive Virtual Reality (VR) technology has high potential to improve psychotherapy for MDD, as VR can personalize the treatment process and directly influence affect. Research on VR interventions for MDD is emerging, but current applications for treatment are heterogeneous and lack strong theoretical support. This scoping review aims to identify the therapeutic strategies that should and can be targeted in VR interventions for depression.</div></div><div><h3>Methods</h3><div>A systematic search of the literature was conducted in PubMed, PsycINFO, Ovid Medline, Embase, Web of Science, Google Scholar, Clinical Trials Register, and the ‘Dutch Trial Register’ from inception through November 2023 to identify the most relevant research.</div></div><div><h3>Results</h3><div>Findings from 43 studies included in this review resulted in the following potential therapeutic strategies: 1) psychoeducation (n=5), 2) behavioral activation (n=16), 3) cognitive restructuring (n=4), 4) enhancing positive affect (n=5), 5) mental imagery (n=4), 6) skills training (n=3), 7) enhancing cognitive functioning (n=3), and 8) other (n=3).</div></div><div><h3>Limitations</h3><div>We did not conduct a systematic assessment of the methodological quality of the studies nor perform a statistical analysis of the results.</div></div><div><h3>Conclusions</h3><div>VR shows potential to facilitate the treatment process for patients with depression in different ways, providing excellent prospects for personalizing and potentially improving the treatment of MDD. Future studies should focus on evaluating presumed mechanisms of change to fully understand the added value of VR in the treatment of depression.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"20 ","pages":"Article 100912"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768523","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}
Hendrik-Jan De Vuyst , James W. Griffith , Eline Belmans , Filip Raes
{"title":"Validity and Reliability of the Dutch version of the Affective Control Scale","authors":"Hendrik-Jan De Vuyst , James W. Griffith , Eline Belmans , Filip Raes","doi":"10.1016/j.jadr.2025.100910","DOIUrl":"10.1016/j.jadr.2025.100910","url":null,"abstract":"<div><h3>Background</h3><div>The Affective Control Scale (ACS) is a widely-used instrument for evaluating the fear of losing control over emotions, a key factor implicated in anxiety and depressive disorders. However, despite its widespread use, substantial inconsistencies have raised questions about the scale's reliability and validity.</div></div><div><h3>Methods</h3><div>This study aimed to assess the factor structure of the Affective Control Scale (ACS) using confirmatory factor analysis (CFA) in two Dutch-speaking samples (n<sub>1</sub> = 250, n<sub>2</sub> = 325). Various factor structures, as previously proposed in the literature, were examined. Convergent validity was assessed by correlating the resulting factors with concurrent measures of anxiety and depression.</div></div><div><h3>Results</h3><div>In both samples, a bifactor model excluding reverse-scored items demonstrated the best overall fit. However, despite showing high reliabilities, the specific factors exhibited low attributable score variance. Furthermore, the convergent validity assessment revealed poor associations between these specific factors and measures of anxiety and depression.</div></div><div><h3>Limitations</h3><div>The study's generalizability is limited due to the predominantly female samples. Additionally, the complexities of bifactor models may lead to overfitting of the data.</div></div><div><h3>Conclusions</h3><div>We conclude that a bifactor model excluding all reverse-scored items offers the most robust fit. Nevertheless, while the ACS is effective in measuring general fear of emotions, its ability to assess specific emotional fears is limited. Clinically, these findings underscore the importance of focusing on the overall fear of emotions rather than its specific components. Therefore, we recommend the use of a simplified, 30-item version of the ACS that assesses general fear of emotions.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"20 ","pages":"Article 100910"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833347","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":"Retraction notice to: “Default mode intranetwork resting-state functional connectivity is correlated with increased symptom severity in common anxiety disorders: A systematic review and meta-analysis” [Journal of Affective Disorders Report 14 (2023), 100674]","authors":"Zachary P. Pierce , Jessica M. Black","doi":"10.1016/j.jadr.2024.100853","DOIUrl":"10.1016/j.jadr.2024.100853","url":null,"abstract":"","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"20 ","pages":"Article 100853"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876497","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}
Sara B. Marjanovic , Madelene Christin Holm Bukhari , Rikka Kjelkenes , Irene Voldsbekk , Claudia Barth , Lars T. Westlye
{"title":"Assessing brain morphological correlates of premenstrual symptoms in young healthy females","authors":"Sara B. Marjanovic , Madelene Christin Holm Bukhari , Rikka Kjelkenes , Irene Voldsbekk , Claudia Barth , Lars T. Westlye","doi":"10.1016/j.jadr.2025.100916","DOIUrl":"10.1016/j.jadr.2025.100916","url":null,"abstract":"<div><div>While 90 % of females with a menstrual cycle will experience premenstrual symptoms in their reproductive years, it is estimated that 20 % experience treatment-warranted emotional, behavioral, or somatic symptoms in the premenstrual phase of their menstrual cycle. Premenstrual symptoms have been partly attributed to the brain's sensitivity to menstrual cycle-related hormonal fluctuations, which may be modulated by individual differences in the structural characteristics of the brain. In a population-based sample of 292 non-pregnant females aged 23–43 years, we tested for associations between self-reported premenstrual symptom load and T1-weighted MRI based brain measures of cortical thickness, volume, and surface area as well as subcortical volumes, not controlling for menstrual cycle phase. After corrections for multiple comparison, linear models including age revealed significant positive associations between premenstrual symptom load and the volume of the left posterior cingulate cortex. Item-level analyses confirmed that the association with overall symptom load were not driven by specific symptom domains. These findings partly overlap with previous brain morphological findings in individuals with PMS and could possibly represent a non-phase dependent correlate of premenstrual symptoms.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"20 ","pages":"Article 100916"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143799286","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}
Benedikt Römer , Stian Maroni , Espen Fevang , Henrik Bjørgaas Helle , Lowan H. Stewart , Dag Aarsland , Audun Osland Vik-Mo
{"title":"Ketamine treatment for depression in elderly inpatients: an observational case series","authors":"Benedikt Römer , Stian Maroni , Espen Fevang , Henrik Bjørgaas Helle , Lowan H. Stewart , Dag Aarsland , Audun Osland Vik-Mo","doi":"10.1016/j.jadr.2025.100904","DOIUrl":"10.1016/j.jadr.2025.100904","url":null,"abstract":"<div><h3>Introduction</h3><div>Treatment-resistant depression (TRD) in elderly patients is a challenging issue, with limited options beyond electroconvulsive therapy (ECT). Intravenous ketamine has emerged as a potential alternative, but its efficacy in older patients is not well-studied. This study evaluates the tolerability and efficacy of intravenous ketamine in 10 consecutively treated elderly patients mostly with TRD in an inpatient geriatric psychiatry setting.</div></div><div><h3>Methods</h3><div>Ten elderly patients (aged 61–77) mostly with TRD were treated with six bi-weekly intravenous ketamine infusions (0.5–1.0 mg/kg) as an add-on treatment in an open-label trial. Depression severity was assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS) at baseline, after two treatments, and after six treatments. Clinically significant improvement (≥25 % improvement), response (≥50 % improvement), and remission (MADRS < 10) rates were calculated. Tolerability was monitored throughout.</div></div><div><h3>Results</h3><div>After six treatments, 7 out of 10 patients showed clinically significant improvement, with 5 meeting response criteria, and 2 achieving remission. The mean MADRS score reduction was 14.2 (SD = 9.62) for the entire sample. Those with ≥25 % improvement exhibited a rapid decrease in symptoms, with a mean MADRS score reduction of 14.14 (SD = 6.74) already after the second infusion. Only 2 of the 7 patients showed sustained benefit four weeks after treatment. The treatment was well-tolerated with no serious adverse events.</div></div><div><h3>Conclusion</h3><div>Intravenous ketamine rapidly reduced depressive symptoms in most patients, but the majority did not maintain the response at four-week follow-up. Further research is needed to develop strategies for maintaining the effects and to study larger samples.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"20 ","pages":"Article 100904"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143825581","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":"Home-use transcranial direct current stimulation (tDCS) as a safe, effective, and feasible application in depression: A randomized, single-blind, placebo-controlled trial","authors":"Tuba Aktürk , Mehmet Yücel Ağargün , Sümeyye Özdemir , Esra Dalmızrak , Bahar Güntekin","doi":"10.1016/j.jadr.2025.100902","DOIUrl":"10.1016/j.jadr.2025.100902","url":null,"abstract":"<div><h3>Introduction</h3><div>Anodal transcranial direct current stimulation (tDCS) targeting the left dorsolateral prefrontal cortex (DLPFC) alleviates depression symptoms and enhances cognitive functions in major depressive disorder (MDD) patients. Previously, these outcomes were demonstrated primarily in clinical or laboratory settings through randomized placebo-controlled trials. Our objective was to assess the feasibility and effectiveness of asynchronously supervised, home-use tDCS on both mood and cognition in MDD patients, within a randomized, single-blind, placebo-controlled trial.</div></div><div><h3>Method</h3><div>Twenty MDD patients were randomized into active (<em>N</em> = 11) and sham (<em>N</em> = 9) tDCS groups. The protocol entailed daily 30-minute sessions at 2 mA with the anode over the left-DLPFC and the cathode over the right-DLPFC, conducted five days a week for three weeks. Sham stimulation consisted of a brief 30-second interval between 10-second ramp-up and down periods. After initial training, patients were administered tDCS at home and were evaluated using depression-related questionnaires and cognitive tests at baseline and post-intervention. Adherence and tolerance were asynchronously monitored via a remote supervision platform.</div></div><div><h3>Results</h3><div>High tolerability (adverse-event incidence rate of 0.63 %) and strong adherence (an average of 14.45 out of 15 sessions completed) were observed for home-use tDCS. The active group demonstrated significantly greater improvements in depression scores (BDI-II) and in cognitive performance (Digit Span tests), compared to the sham group, which received placebo treatment with the same protocol.</div></div><div><h3>Conclusion</h3><div>The results of our study demonstrate that home-use tDCS is feasible, safe and might be effective for patients with depression, offering a more accessible and cost-effective approach to neuromodulation treatments in mental health.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"20 ","pages":"Article 100902"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143760596","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}
Joannes W. Renes , Ralph W. Kupka , Willem A. Nolen , Adriaan W. Hoogendoorn , Eline J. Regeer
{"title":"Caregivers’ burden and psychological distress in bipolar disorder in everyday clinical practice","authors":"Joannes W. Renes , Ralph W. Kupka , Willem A. Nolen , Adriaan W. Hoogendoorn , Eline J. Regeer","doi":"10.1016/j.jadr.2025.100903","DOIUrl":"10.1016/j.jadr.2025.100903","url":null,"abstract":"<div><h3>Introduction</h3><div>The effect of interventions involving caregivers of patients with bipolar disorder (BD) in everyday clinical practice has been understudied.</div></div><div><h3>Aim</h3><div>To investigate associations between the use of an emergency plan on emerging symptoms and participation in group psychoeducation versus burden and psychological distress experienced by caregivers, while controlling for patients’ severity of illness.</div></div><div><h3>Methods</h3><div>A nationwide naturalistic study on long-term outpatient treatment of BD, using self-report questionnaires about patients’ treatment and illness outcome, caregivers’ burden as measured with the core module of the Involvement Evaluation Questionnaire (IEQ), and caregivers’ psychological distress as measured with the General Health Questionnaire (GHQ-12).</div></div><div><h3>Results</h3><div>In total 777 dyads of patients and caregivers participated. Caregivers reported low levels of burden and psychological distress. Use of an emergency plan was associated with decreased level of caregivers’ burden (<em>p</em>=.014) and remained so (<em>p</em>=.003) when testing the independent association given the effect of group psychoeducation and controlling for patients’ severity of illness. No evidence was found for an effect on psychological distress. Participation in group psychoeducation was not associated with either outcome measure.</div></div><div><h3>Limitations</h3><div>The study used self-report questionnaires, and possibly included better functioning patients with a Dutch cultural background, and more resilient caregivers being mostly spouse or partner.</div></div><div><h3>Conclusions</h3><div>Use of an emergency plan was associated with less burden in caregivers of patients with BD. Longitudinal studies are needed to gain better insight in the effects of interventions on caregiver outcomes in BD.</div></div>","PeriodicalId":52768,"journal":{"name":"Journal of Affective Disorders Reports","volume":"21 ","pages":"Article 100903"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868210","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}