Actas espanolas de psiquiatria最新文献

{"title":"Suicidal Ideation and Non-suicidal Self-injury in Early Adolescence: The Role of ADHD Symptoms, Affect, and Emotion Regulation.","authors":"Jon García-Ormaza, Karmele Salaberria, Amador Priede, César González-Blanch, Paloma Canduela, Ennio Ammendola, Jeffrey V Tabares, Alexander Muela","doi":"10.62641/aep.v54i3.2131","DOIUrl":"10.62641/aep.v54i3.2131","url":null,"abstract":"<p><strong>Background: </strong>Suicidal ideation and non-suicidal selfinjury (NSSI) are highly prevalent during early adolescence and represent serious public health concerns. Emotional dysregulation has been identified as a transdiagnostic factor underlying various risk behaviors, particularly in youth with externalizing difficulties such as attentiondeficit/hyperactivity disorder (ADHD). While prior research has examined these factors independently, few studies have explored their joint and differential contribution to suicide-related outcomes in early adolescence. This study aimed to examine the association of ADHD-related symptoms, positive and negative affect, and emotional dysregulation with suicidal ideation and NSSI, as well as to explore whether emotional dysregulation moderates the relationship between ADHD-related symptoms and these risk behaviors.</p><p><strong>Methods: </strong>A total of 1079 Spanish adolescents (M_age = 12.6 years, SD = 0.6) enrolled in the first year of compulsory secondary education participated in a cross-sectional study. Standardized self-report measures were used to assess ADHD-related symptoms (Strengths and Difficulties Questionnaire [SDQ]), affect (Positive and Negative Affect Schedule for Children and Adolescents [PANAS-N]), and difficulties in emotion regulation (Difficulties in Emotion Regulation Scale [DERS-18]), alongside indicators of suicidal ideation and NSSI. Data analysis included group comparisons and hierarchical logistic regression models.</p><p><strong>Results: </strong>Suicidal ideation was reported by 10.1% of participants, and NSSI by 16.4%. Adolescents with either behavior exhibited significantly more hyperactivityinattention symptoms, greater negative affect, lower positive affect, and substantially elevated emotional dysregulation. In regression analyses, ADHD-related symptoms remained significant predictors after accounting for affect, although emotional dysregulation emerged as the strongest predictor, reducing the effects of other variables. Specific dimensions such as lack of emotional clarity and nonacceptance of emotional responses were associated with suicidal ideation, while impulse control difficulties and lack of adaptive strategies predicted NSSI. No moderation effects were found.</p><p><strong>Conclusions: </strong>ADHD-related symptoms and emotional dysregulation both contribute independently to adolescent suicidal ideation and NSSI, with emotional dysregulation showing the most robust predictive value. Schoolbased prevention efforts should incorporate emotion regulation skill-building to reduce suicide risk and NSSI in early adolescence.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 3","pages":"726-740"},"PeriodicalIF":2.1,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics and Influencing Factors of Depressive Symptoms in Patients With Vascular Cognitive Impairment.","authors":"Hui Sun, Jingjing Ye, Yuyu Li, Li Xu","doi":"10.62641/aep.v54i3.2194","DOIUrl":"10.62641/aep.v54i3.2194","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to characterize depressive symptoms in patients with vascular cognitive impairment (VCI) after ischemic stroke and to identify independent predictors of treatment response to antidepressant therapy, with a focus on lesion-location heterogeneity.</p><p><strong>Methods: </strong>This retrospective observational cohort study enrolled 224 patients with VCI and concomitant depressive symptoms from June 2022 to June 2024. Depression severity was assessed using the 17-item Hamilton Depression Rating Scale (HAMD-17). All patients completed 8 weeks of standardized treatment including antidepressant medication and cognitive rehabilitation. Treatment response was defined as ≥50% reduction in HAMD-17 from baseline to week 8. Lesion locations were categorized into eight mutually exclusive anatomical groups (frontal, temporal, parietal, occipital, basal ganglia/internal capsule, thalamus, pons and cerebellum). Univariate and multivariable logistic regression identified predictors of treatment response, and Receiver Operating Characteristic (ROC) analysis evaluated model performance.</p><p><strong>Results: </strong>Mean baseline HAMD-17 was 27.4 ± 3.1, and 65.2% (146/224) achieved treatment response. Baseline depressive symptom severity differed significantly across lesion locations (one-way analysis of variance (ANOVA): F (7,216) = 3.48, p = 0.001), whereas baseline anxiety severity did not (F (7,216) = 0.72, p = 0.652). In multivariable analysis, lower baseline Hamilton Anxiety Rating Scale (HAMA) score (odds ratio (OR) = 0.93, 95% confidence interval (CI): 0.88-0.98, p = 0.006), shorter time since stroke (OR = 0.86 per month, 95% CI: 0.75 to 0.99, p = 0.034), and higher education-adjusted Montreal Cognitive Assessment (MoCA) score (OR = 1.12 per point, 95% CI: 1.01-1.24, p = 0.031) were independently associated with treatment response. The prediction model demonstrated moderate discriminative ability (area under the curve (AUC) = 0.795, 95% CI: 0.738-0.851), with sensitivity of 0.890 and specificity of 0.608 at the optimal cutoff.</p><p><strong>Conclusions: </strong>Depressive symptom burden in poststroke VCI exhibits significant anatomical heterogeneity across lesion locations. Baseline anxiety severity, disease duration, and baseline cognitive performance moderately predict treatment response, supporting early risk stratification and individualized management.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 3","pages":"774-785"},"PeriodicalIF":2.1,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Effects of Lactate on Improving Cognitive Function and Survival Rate in a Mouse Model of Post-Sepsis Cognitive Impairment.","authors":"Jinyong Huang, Haiyong Liu, Yongwei Wu, Xiaochun Yuan, Yongtao Gao","doi":"10.62641/aep.v54i3.2303","DOIUrl":"10.62641/aep.v54i3.2303","url":null,"abstract":"<p><p></p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 3","pages":"962"},"PeriodicalIF":2.1,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescribing Under Uncertainty: The Hidden Psychology of Psychiatric Decision-Making.","authors":"Carlos De Las Cuevas","doi":"10.62641/aep.v54i3.2271","DOIUrl":"10.62641/aep.v54i3.2271","url":null,"abstract":"<p><p></p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 3","pages":"956-961"},"PeriodicalIF":2.1,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148314885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential Effects of Morning Versus Afternoon Accelerated High-Frequency Repetitive Transcranial Magnetic Stimulation on Sleep Outcomes in Hospitalised Patients With Schizophrenia: Retrospective Cohort Study.","authors":"Yufeng Xiong, Yan Zhang, Haoshui Hua, Jixin Lin, Mengting Li, Qicheng Zhang, Linlin Jiang","doi":"10.62641/aep.v54i3.2227","DOIUrl":"10.62641/aep.v54i3.2227","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the differential effects of accelerated high-frequency repetitive transcranial magnetic stimulation (aHF-rTMS) administered in the morning and afternoon on sleep outcomes in hospitalised patients with schizophrenia.</p><p><strong>Methods: </strong>This single-centre retrospective cohort study was based on existing inpatient records from the Department of Psychiatry at The Third People's Hospital of Fuyang between November 2023 and May 2025. Eligible cases were identified from electronic medical records, nursing documentation and aHF-rTMS treatment logs. Patients were divided into a morning aHF-rTMS group and an afternoon aHF-rTMS group according to the predominant treatment-time category documented during hospitalisation. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and nighttime sleep duration was obtained from nursing records. Psychiatric symptoms and cognitive function were assessed using the Positive and Negative Syndrome Scale (PANSS) and Montreal Cognitive Assessment (MoCA), respectively. The influencing factors of sleep outcomes at discharge were explored by multivariate linear regression analysis, and sensitivity analysis was performed using propensity score matching.</p><p><strong>Results: </strong>The two groups were comparable in baseline demographics, sleep parameters and psychiatric symptoms. During hospitalisation, both groups showed substantial improvement in sleep quality and psychiatric symptoms compared with those upon admission. The morning aHF-rTMS group had significantly lower total PSQI scores at discharge (p < 0.001) and longer nighttime sleep duration (β = 0.58, p < 0.001) than the afternoon aHF-rTMS group. Sensitivity analysis showed that morning aHF-rTMS remained associated with low total PSQI scores at discharge (β = -1.83, p < 0.001). No statistically significant differences in PANSS total scores and MoCA scores at discharge were found between the two groups (both p > 0.05). The overall incidence of adverse reactions was 44.44%, slightly higher in the morning group than in the afternoon group (54.02% vs. 35.48%, p = 0.012).</p><p><strong>Conclusions: </strong>The timing of aHF-rTMS treatment may be associated with sleep-related treatment outcomes in hospitalised patients with schizophrenia. Compared with afternoon treatment, morning aHF-rTMS was associated with better subjective sleep quality and longer nighttime sleep duration.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 3","pages":"612-625"},"PeriodicalIF":2.1,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychiatrists' Knowledge, Attitudes, and Practices Regarding the Use of Modified Electroconvulsive Therapy in Adolescents With Major Depressive Disorder: A Cross-Sectional Survey in Chongqing, China.","authors":"Jingran Li, Xiwen Tan, Ruishen Li, Ning Du, Yang Zhou, Wo Wang","doi":"10.62641/aep.v54i3.2197","DOIUrl":"10.62641/aep.v54i3.2197","url":null,"abstract":"<p><strong>Background: </strong>Adolescent major depressive disorder (MDD) is a serious condition often resistant to treatment. Despite established efficacy in adults, modified electroconvulsive therapy (MECT) remains limited and controversial in youth. This study examined psychiatrists' knowledge, attitudes and practices (KAPs) regarding MECT for adolescent MDD, along with their interrelationships and associated factors.</p><p><strong>Methods: </strong>A cross-sectional online survey was conducted (May-July 2025) amongst psychiatrists in Chongqing, China. Using a validated KAP questionnaire, data were collected via WeChat and examined via descriptive, correlation and regression analyses.</p><p><strong>Results: </strong>Amongst the 125 questionnaires distributed, 113 valid responses were analysed (90.4%). Psychiatrists showed moderate knowledge (3.31 ± 0.88), positive attitude (3.68 ± 0.51) and moderate practice (3.09 ± 0.98) levels regarding MECT. KAPs were positively correlated. Higher professional level (attending physician: β = 0.374, p = 0.007; associate senior or above: β = 0.470, p = 0.004) significantly predicted greater knowledge. Better knowledge (β = 0.225, p = 0.028) predicted more positive attitude. Higher knowledge (β = 0.496, p < 0.001) and attitude (β = 0.226, p = 0.006) significantly predicted greater MECT-related practice. Working in a specialized psychiatric hospital (β = -0.525, p < 0.001) and clinical experience greater than 20 years (β = 0.324, p = 0.030) were significantly associated with practice.</p><p><strong>Conclusions: </strong>Psychiatrists in Chongqing showed positive attitude but only moderate knowledge and practice regarding MECT for adolescent MDD. Enhancing clinician education and addressing patient- and system-level barriers may help promote appropriate MECT use.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 3","pages":"680-691"},"PeriodicalIF":2.1,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148314903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric Properties of the MOLDES Questionnaire in a Clinical Sample of Patients With Psychotic Spectrum Disorders.","authors":"Juan Jesús Muñoz García, Ricardo M Hodann-Caudevilla, Alfonso García Castaño, Sergio Aguilera Garrido, Rafael Durán Tischhauser, Álvaro Pico Rada, Rafael Salom","doi":"10.62641/aep.v54i3.2176","DOIUrl":"10.62641/aep.v54i3.2176","url":null,"abstract":"<p><strong>Background: </strong>Psychotic spectrum disorders are associated with persistent impairments in psychosocial functioning that are not fully explained by symptom severity, particularly in individuals with chronic courses and prolonged hospitalization. Beyond psychopathological symptoms, relatively stable cognitive-emotional styles may influence long-term adaptation, subjective recovery, and quality of life in severe mental disorders. To examine the psychometric properties of the MOLDES questionnaire in a clinical sample of patients with psychotic spectrum disorders receiving long-term psychiatric care.</p><p><strong>Methods: </strong>A cross-sectional observational study was conducted in a sample of 83 clinically stable male patients with psychotic spectrum disorders hospitalized in a long-term psychiatric care unit. Internal consistency of the global MOLDES score and its three dimensions (Vital Spontaneity, Adjustment, and Optimization) was assessed using Cronbach's alpha. Convergent and discriminant validity were explored through Spearman's correlations with psychotic symptom severity, depressive symptoms, internalized stigma, and quality of life.</p><p><strong>Results: </strong>The global MOLDES score and its dimensions showed acceptable internal consistency, with Cronbach's alpha values ranging from 0.70 to 0.77. No significant associations were observed between MOLDES dimensions and psychotic or depressive symptom severity, supporting discriminant validity. In contrast, Vital Spontaneity and Adjustment were negatively correlated with internalized stigma, while the Optimization dimension showed a positive association with quality of life.</p><p><strong>Conclusions: </strong>These findings provide preliminary evidence supporting the reliability and validity of the MOLDES questionnaire in patients with chronic psychotic disorders. The instrument appears to capture adaptive cognitive-emotional styles that are largely independent of symptom severity and meaningfully related to relevant psychosocial outcomes, suggesting its potential usefulness as a complementary assessment tool in long-term psychiatric care and rehabilitation-oriented settings.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 3","pages":"602-611"},"PeriodicalIF":2.1,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for First-Attempt Suicide Fatalities: Evidence From the MCOSUL Cohort.","authors":"Eugènia Nicolau-Subires, María Irigoyen-Otiñano, Teresa Jové-Miró, Laura Arenas-Pijoan, Rubèn Gavilà-Esquerdo, Samuel Pámpols-Pérez, Anna Gallart-López, Ana Marina Lao-García, Núria Domènech-Martínez, Andrea Jiménez-Mayoral, Vicent Llorca-Bofí","doi":"10.62641/aep.v54i3.2220","DOIUrl":"10.62641/aep.v54i3.2220","url":null,"abstract":"<p><strong>Background: </strong>Individuals who die by suicide may differ depending on whether the fatal act is their first attempt or follows previous non-fatal attempts. Understanding these differences may help refine prevention strategies.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis within the MCOSUL Cohort, a clinical registry of all patients treated for a suicide attempt in two general hospitals in Lleida, Spain. We included all cohort members who died by suicide between January 2009 and December 2022. Sociodemographic, clinical, and method-related variables were compared between first-attempt and repeat-attempt fatalities. Variables with p < 0.20 in bivariate analyses were entered into a multivariable logistic regression model to identify independent predictors of first-attempt fatalities.</p><p><strong>Results: </strong>Among 117 suicide deaths, 38 (32.5%) occurred at the first attempt and 79 (67.5%) after one or more prior non-fatal attempts. Repeat-attempt fatalities had a mean of 1.89 (SD = 1.73) attempts from cohort entry to death. In multivariable analysis, unemployment (OR = 0.17, 95% CI: 0.04-0.66, p = 0.011) and recognized disability (OR = 0.20, 95% CI: 0.04-0.80, p = 0.035) were less frequent among first-attempt fatalities, indicating they were more common in those who died after repeated attempts. No significant differences were found for age, sex, alcohol use, psychiatric diagnosis, or fatal attempt method.</p><p><strong>Conclusions: </strong>Unemployment and recognized disability (formal legal/administrative disability certification issued by relevant regional authorities, which may encompass physical and/or psychiatric disabilities) appear to characterize individuals who die by suicide after a series of non-fatal attempts, suggesting a subgroup with a more prolonged suicidal course that may benefit from sustained engagement and prevention strategies.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 3","pages":"657-662"},"PeriodicalIF":2.1,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal Relationship Between Vitamin D and Anxiety and Depression: A Bidirectional Mendelian Randomization Study.","authors":"Ting Wang, Ran Chen, Jiacheng Kong, Qiu Zhang, Shouhong Shu","doi":"10.62641/aep.v54i3.2046","DOIUrl":"10.62641/aep.v54i3.2046","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the causal relationship between serum 25-hydroxyvitamin D (25(OH)D) levels and the risk of depression and anxiety, using Mendelian Randomization (MR) analysis from a genetic variation perspective.</p><p><strong>Methods: </strong>Genome-wide association study (GWAS) summary statistics for 25(OH)D levels, depression and anxiety were retrieved from the IEU Open GWAS Project, specifically from datasets \"ebi-a-GCST90000617\", \"ebia-GCST90013878\", and \"ukb-a-82\". A two-sample MR analysis was conducted with 25(OH)D levels as the exposure and depression and anxiety as outcome variables. Cochran's Q test was used to assess heterogeneity among the instrumental variables, and horizontal pleiotropy was tested using the MR-Egger intercept method. Sensitivity analyses were conducted via the leave-one-out approach.</p><p><strong>Results: </strong>The MR analysis, utilizing 32 single nucleotide polymorphisms (SNPs) as instrumental variables, revealed a significant causal association between 25(OH)D levels and depression, with all MR methods (excluding Simple Mode) yielding p-values < 0.05. The odds ratios (ORs) and 95% confidence intervals (CIs) for the significant methods were: OR = 0.82 [95% CI: 0.68-0.98], OR = 0.85 [95% CI: 0.77-0.95], OR = 0.80 [95% CI: 0.68-0.93] and OR = 0.90 [95% CI: 0.82-0.98]. However, no significant causal relationship was found between 25(OH)D levels and anxiety. In the reverse direction, genetically predicted depression showed a potential causal association with lower 25(OH)D levels (inverse variance weighting (IVW) OR = 0.98, 95% CI: 0.96-1.00, p = 0.02), while no such association was observed for anxiety.</p><p><strong>Conclusions: </strong>This study suggests that higher serum 25(OH)D levels may be associated with a lower risk of depression, highlighting the potential of serum 25(OH)D as an early biomarker for depression prevention and clinical management. However, no causal association was found between 25(OH)D levels and anxiety, warranting further investigation. This study provides a potential vitamin D-related intervention direction for the prevention and clinical management of depression.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 3","pages":"878-890"},"PeriodicalIF":2.1,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emotional and Behavioural Problems Including Anxiety and Depressive Symptoms Across Tanner Stages in Girls With Central Precocious Puberty: A Retrospective Clinical Study.","authors":"Peili Jin, Duomei Wang","doi":"10.62641/aep.v54i3.2205","DOIUrl":"10.62641/aep.v54i3.2205","url":null,"abstract":"<p><strong>Background: </strong>To examine the Tanner stage-specific patterns of psychological and behavioural problems in girls with central precocious puberty (CPP) and to identify clinical predictors of clinically significant psychological impairment.</p><p><strong>Methods: </strong>This retrospective cross-sectional study included 116 girls with CPP treated between January 2020 and December 2024. Clinical data were extracted from electronic medical records. Pubertal development was classified by breast Tanner staging into stage II (n = 32), stage III (n = 42) and stages IV-V (n = 42). Psychological outcomes were evaluated using the age-standardised Child Behavior Checklist (CBCL) T-scores. For participants aged ≥7 years, depressive and anxiety symptoms were assessed using the Children's Depression Inventory and the Screen for Child Anxiety Related Emotional Disorders. The independent predictors of clinically significant psychological problems were identified through logistic regression analysis, defined as CBCL Total Problems T-score of ≥64, and model performance was assessed using receiver operating characteristic curve analysis.</p><p><strong>Results: </strong>The mean CBCL Total Problems T-score was 58.6 ± 12.4, and 50 girls (43.1%) had clinically significant psychological problems. Psychological burden increased across Tanner stages. The CBCL Total T-scores were 52.4 ± 10.8 in stage II, 58.6 ± 11.6 in stage III and 65.8 ± 13.2 in stages IV-V (p < 0.001). The prevalence of clinically significant problems increased from 21.9% to 40.5% and 61.9% (p = 0.002). Internalising symptoms showed a stronger stage-related pattern than externalising symptoms. Early age at onset was associated with increased symptom severity (r = -0.385, p < 0.001). Multivariable analysis identified Tanner stages IV-V versus stage II (odds ratio [OR] = 2.94, 95% confidence interval [CI]: 1.44-5.99, p = 0.003), younger age at onset (OR = 0.72, 95% CI: 0.55-0.94, p = 0.016), higher peak luteinising hormone (LH) (OR = 1.45, 95% CI: 1.08-1.95, p = 0.014) and family history of early puberty (OR = 2.18, 95% CI: 1.26-3.77, p = 0.005) as independent predictors. The prediction model showed good discrimination (area under the curve = 0.812, 95% CI: 0.738-0.886).</p><p><strong>Conclusions: </strong>Girls with CPP experience substantial psychological burden, and risk increases with pubertal stage. Advanced Tanner stage, earlier pubertal onset, increase in peak LH and family history are indicators for enhanced psychological monitoring and support.</p>","PeriodicalId":7251,"journal":{"name":"Actas espanolas de psiquiatria","volume":"54 3","pages":"714-725"},"PeriodicalIF":2.1,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148314868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}