Psychiatric research and clinical practice最新文献

{"title":"Fostering Social Connection: Progress and Opportunities in VA and Beyond.","authors":"Jay A Gorman, Susan Strickland, Alan R Teo","doi":"10.1176/appi.prcp.20250159","DOIUrl":"10.1176/appi.prcp.20250159","url":null,"abstract":"<p><p>Social isolation and loneliness threaten both mental and physical health. This commentary highlights innovative programs that prioritize treating social connection as a social need and driver of health, drawing from four major initiatives within the Department of Veterans Affairs: Veterans Socials, Caring Contacts, the Expiration Term of Service Sponsorship Program, and Department of Veterans Affairs S.A.V.E. Key features of these four programs and suggestions for how healthcare systems can act as meaningful catalysts of social connection are provided, including community engagement, volunteer involvement, commitment to research and evaluation, and scaling evidence-based models and education.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":" ","pages":"100-102"},"PeriodicalIF":0.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586152","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":"Pilot Study of Behavioral Activation Treatment for Negative Symptoms in Older Adults With Schizophrenia Spectrum Disorder.","authors":"Stephen F Smagula, Jessica M Gannon, Fabio Ferrarelli","doi":"10.1176/appi.prcp.20250178","DOIUrl":"10.1176/appi.prcp.20250178","url":null,"abstract":"<p><strong>Objective: </strong>Behavioral activation (BA) is an established treatment for depression in older adults, yet BA has been relatively less examined as a treatment for the negative symptoms (NS) of schizophrenia spectrum disorder (SSD). We here aimed to demonstrate the feasibility and proof-of-concept that BA can improve NS and function in older adults with SSD. We also evaluated if changes in putative targets correlate with health improvements.</p><p><strong>Methods: </strong>Older adults (<i>n</i> = 19; mean age = 58.6 years [standard deviation = 10]) with SSD were offered 12 weekly BA sessions. Primary outcomes were: feasibility of administration, measured as session attendance; and pre/post NS changes, assessed with the Clinical Assessment Interview for Negative Symptoms (CAINS) total scores. Secondary measures were expressive symptoms (CAINS-Expressive subscale), adaptive functioning (Role Functioning Scale), and disability (World Health Organization Disability Assessment Schedule 2.0 scores). Target measures were: avolition and anhedonia (CAINS items), BA (Behavioral Activation for Depression Scale-activation subscale), and actigraphy-measured inactivity (activity level during most active 10 h) and behavioral rigidity (inter-daily stability). Analyses evaluated post- to pre-BA changes using Cohen's <i>d</i> and 95% confidence intervals.</p><p><strong>Results: </strong>Participants attended 95% of the sessions. All health outcomes improved, including expressive symptoms (<i>d</i> = -0.69; 95% CI: -1.14, -0.23) and health-related disability (<i>d</i> = -0.45; 95% CI: -0.80, -0.11). Of target measure changes, notably, improved avolition (<i>d</i> = -0.46; 95% CI: -0.82, -0.10) correlated with clinical benefits, including reduced disability <i>r</i> = 0.48 (<i>p</i> = 0.04).</p><p><strong>Conclusions: </strong>High engagement and health improvements support the use of BA for NS in older patients with SSD.</p><p><strong>Relevance to clinical practice: </strong>In older adults, BA may reduce NS and improve function, but precision medicine trials are needed to determine how and for whom.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"8 2","pages":"88-95"},"PeriodicalIF":0.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228926","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":"Flashbacks Through Time: Historical Development and Current Use of the Term \"Flashback\" in Psychedelic and Post-Traumatic Stress Disorder Research.","authors":"Ricarda Evens","doi":"10.1176/appi.prcp.20250129","DOIUrl":"10.1176/appi.prcp.20250129","url":null,"abstract":"<p><p>In psychiatry, the term flashback is widely recognized in relation to post-traumatic stress disorder (PTSD) as well as in the characterization of post-psychedelic experiences. Although it is now most commonly associated with PTSD, the term was originally introduced in the context of psychedelics. While it broadly denotes specific forms of re-experiencing in both fields, its precise meaning differs significantly between them. In PTSD, flashbacks refer to intrusive, vivid memories with a pronounced \"here-and-now\" quality. In psychedelic research, however, the term flashback does not function as a clearly defined symptom but rather as an umbrella term encompassing multiple similar yet distinct forms of post-acute psychedelic experiences that potentially arise from different causal mechanisms. This terminological ambiguity complicates systematic investigation and precise clinical understanding of post-psychedelic symptoms, ultimately limiting effective care for affected individuals. As research into the classification and treatment of post-psychedelic difficulties advances, the development of a more differentiated and clearly defined vocabulary is needed. Greater conceptual clarity would facilitate improved scientific communication, more targeted research, and better clinical care for individuals navigating the often complex aftermath of psychedelic experiences.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"8 2","pages":"60-62"},"PeriodicalIF":0.0,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228940","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":"Correction to \"Minds and Brains, Sleep and Psychiatry\".","authors":"","doi":"10.1176/rcp2.70040","DOIUrl":"10.1176/rcp2.70040","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1176/appi.prcp.20200023.].</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"8 1","pages":"56"},"PeriodicalIF":0.0,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791559","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":"Developing a Natural Language Processing Strategy to Avoid Biased Data in Electronic Health Record Suicide Risk Modeling.","authors":"Maxwell Levis, Monica Dimambro, Joshua Levy, Brian Shiner","doi":"10.1176/appi.prcp.20250047","DOIUrl":"10.1176/appi.prcp.20250047","url":null,"abstract":"<p><strong>Objective: </strong>Unstructured electronic health record (EHR) data is increasingly used to enhance suicide risk modeling. Unfortunately, EHR reported death dates are frequently inaccurate. Including EHR data from after patients' deaths, or after suicidal actions which led to their deaths, potentially biases suicide prediction models. In contrast to prior methods which withheld all data from 5-day before reported death, this study investigates using natural language processing to improve the accuracy of detecting EHR reported death dates.</p><p><strong>Methods: </strong>We selected all Veterans Affairs patients who died by suicide with EHR data during 5-day before reported death date (<i>n</i> = 1620) during 2017-2018 and extracted all interval EHR texts (texts = 9127). We randomly sub-selected corpus to develop code to identify if texts were written before or after death or suicidal action and utilized this approach in our full corpus.</p><p><strong>Results: </strong>In the full corpus, we identified 1742 texts entered on reported death date, 274 texts after death date, and 1556 texts that did not reference death or suicidal action but were entered chronologically after other texts indicating death. In contrast to the prior method, which excluded all interval texts, our derived approach retained 60.9% of interval data.</p><p><strong>Conclusions: </strong>Our approach improved detection of valid EHR data in the interval before patient death. Relevance to clinical practice: This study operationalizes a method to detect immediate pre-mortem EHR data that could contribute to less bias in suicide risk modeling. This utilization can improve risk prediction and in turn bolster prevention services.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"8 2","pages":"82-87"},"PeriodicalIF":0.0,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148229736","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":"The Psychological Support Model in Psilocybin Research: Psychotherapy in Disguise?","authors":"Celia Faye Jacobsen, Dea Siggaard Stenbæk, Stig Poulsen, Sophia Armand","doi":"10.1176/appi.prcp.20250113","DOIUrl":"10.1176/appi.prcp.20250113","url":null,"abstract":"","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"8 1","pages":"4-6"},"PeriodicalIF":0.0,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791566","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":"Serious Mental Illness-Associated Socio-Medical Needs and Imprisonment Risk in Reentry Clients.","authors":"David L Rosen, Theodore R Zarzar, Anna Baker, Evan A Ashkin","doi":"10.1176/appi.prcp.20250046","DOIUrl":"10.1176/appi.prcp.20250046","url":null,"abstract":"<p><strong>Objective: </strong>To examine whether the socio-medical needs and imprisonment risk among transitional care clients with serious mental illness (SMI) differ from other transitional care clients.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted of adults who entered the Formerly Incarcerated Transition (FIT) Program from 2018 to 2023 following a period of incarceration. At program entry, FIT clients were screened for socio-medical needs and diagnoses, including those reflecting SMI. Imprisonment outcomes were assessed using administrative records. Cumulative imprisonment risk and relative risk of imprisonment were estimated comparing clients by SMI status.</p><p><strong>Results: </strong>Among 759 clients, 78.1% were men, 53.6% were aged 31-50 years, 59.8% reported Black race, and 32.9% had SMI. Clients with SMI were significantly more likely to be female, aged ≤40 years, White race, recently without food, to have healthcare coverage, to be unhoused, and to be in need of housing assistance, disability benefits, or legal assistance. Cumulative imprisonment risk at 360 and 720 days for clients with SMI (0.14 and 0.21) was higher than for those without (0.08 and 0.11), <i>p</i> < 0.001. In a multivariable proportional hazards model, SMI was associated with increased risk of imprisonment (1.75, 95% CI: 1.18, 2.60).</p><p><strong>Conclusions: </strong>Released persons with SMI have a particularly heavy burden of socio-medical needs and high imprisonment rates in North Carolina (NC).</p><p><strong>Relevance to clinical practice: </strong>Similar programs in other states should consider assessing outcomes among their clients with SMI. In NC, efforts are underway to facilitate greater care continuity upon re-entry for people with SMI, including direct linkage to co-located primary and psychiatric care.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"8 2","pages":"72-81"},"PeriodicalIF":0.0,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148229255","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":"Characteristics of Rural Veterans Using VA Video-to-Home Telehealth or Community Care Network for Mental Healthcare.","authors":"Luke Rozema, Sarah L Cornelius, Brian Shiner, Bradley V Watts","doi":"10.1176/appi.prcp.20250081","DOIUrl":"10.1176/appi.prcp.20250081","url":null,"abstract":"<p><strong>Objective: </strong>To compare characteristics of rural veterans using VA brick and mortar (B&M), VA video-to-home telehealth (VA VTH), or VA community care network (CCN) for mental healthcare.</p><p><strong>Methods: </strong>Rural VA patients that received at least 2 days of mental healthcare in fiscal year 2023 were classified as B&M, VA VTH, or CCN patients based on where they received the plurality of care. Bivariate differences in characteristics were determined via SMDs. Adjusted differences in characteristics were estimated using nested dichotomies logistic regression and reported as odds ratios (factor) or predicted probabilities (continuous).</p><p><strong>Results: </strong>The analyses demonstrate that rural VA patients (<i>N</i> = 177,514) using VA VTH or CCN were younger (OR = 0.77), more often female (OR = 1.64), Asian/Pacific Islander (OR = 1.27), had higher psychiatric comorbidity (OR = 1.20), had greater drive times (OR = 1.15), and lived in counties with higher county broadband coverage (OR = 1.06) compared to those using B&M VA care. Among those using VA VTH or CCN, rural black patients were less likely to use CCN (OR = 0.68).</p><p><strong>Conclusions: </strong>Off-site modes of care like CCN and VA VTH have the potential to address long wait- and drive-times for in-person VA care that are especially pertinent for rural patients. As such, it is important to ensure that these care alternatives are being utilized by all strata of rural VA patients, and to identify differences in their use.</p><p><strong>Relevance to clinical practice: </strong>This large retrospective cohort study provides clinicians insight into the characteristics of veterans using alternatives to on-site mental healthcare, allowing them to be better prepared to provide care to patients using those modalities.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"8 2","pages":"63-71"},"PeriodicalIF":0.0,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148229749","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":"Prevalence and Clinical Impact of Attention Deficit Hyperactivity Disorder in Patients With Severe Borderline Personality Disorder.","authors":"María Del Pilar Paz-Otero, Íñigo Alberdi-Páramo, José Luis Carrasco-Perera, Marina Díaz-Marsá","doi":"10.1176/appi.prcp.20250115","DOIUrl":"10.1176/appi.prcp.20250115","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to estimate the prevalence and assess the clinical impact of ADHD in patients with severe borderline personality disorder (BPD) treated in a specialized unit.</p><p><strong>Methods: </strong>Cross-sectional study of a sample of 145 patients diagnosed with BPD according to DSM-5 criteria, consecutively referred by outpatient psychiatrists to a Personality Disorders Unit. ADHD symptoms were assessed using the self-reported long version of the Conners Adult ADHD Rating Scale (CAARS-S:L). Groups were compared based on ADHD presence. Hypothesis testing was performed and variables with statistically significant differences were further analyzed using linear correlation and simple linear regression analyses.</p><p><strong>Results: </strong>Of the 145 BPD patients, 88 (60.7%) scored above 70 on the CAARS S:L. The BPD-ADHD group showed significantly greater anxiety, depression, impulsivity, poorer global functioning, and more severe BPD symptoms. Among ADHD domains, inattention is the one that best predicts the clinical severity of BPD.</p><p><strong>Conclusions: </strong>The coexistence of BPD and ADHD is associated with greater clinical severity and poorer overall functioning. Inattention, in particular, emerges as a key factor explaining BPD symptom variability.</p><p><strong>Relevance to clinical practice: </strong>These findings emphasize the importance of systematically screening for ADHD symptoms in patients with severe BPD. Recognizing and addressing this comorbidity may allow clinicians to design more comprehensive treatment strategies, reduce clinical severity, and improve functional outcomes.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"8 1","pages":"7-16"},"PeriodicalIF":0.0,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791619","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":"Mechanistic Underpinnings of Emotional Face Processing in Suicide Risk: Exploring the Moderating Effects of Cortisol on Neural Parameters Using Magnetoencephalography.","authors":"Steven J Lamontagne, Jessica R Gilbert, Yoojin Lee, Lucinda I Neely, Laura R Waldman, Carlos A Zarate, Elizabeth D Ballard","doi":"10.1176/appi.prcp.20250049","DOIUrl":"10.1176/appi.prcp.20250049","url":null,"abstract":"<p><strong>Objective: </strong>Suicide has been linked to distinct impairments in emotional face processing. This magnetoencephalography (MEG) study used a multimodal design to address how cortisol dysregulation, often reported in individuals with suicidal thoughts and behaviors, affects emotional face processing.</p><p><strong>Methods: </strong>The electrophysiological correlates of emotional face processing were investigated in 118 adults with varying suicide risk. Tonic cortisol levels and their moderating effects on face processing were analyzed. Participants performed an emotional evaluation task during MEG to categorize face stimuli. MEG data were source-localized in the gamma (30-58 Hz) frequency, and dynamic causal modeling (DCM) examined effective connectivity between regions implicated in face processing.</p><p><strong>Results: </strong>Individuals with a past suicide attempt (>1 year) showed blunted cortisol. Distinct gamma oscillation patterns emerged based on risk: at-risk groups showed higher gamma power in early visual cortex (EV) but lower power in superior frontal gyrus. Cortisol moderated EV gamma power in those with a recent suicide crisis, with higher EV gamma linked to lower cortisol levels. DCM revealed that at-risk groups exhibited increased effective connectivity from EV to amygdala (AMYG) during face processing.</p><p><strong>Conclusions: </strong>A recent suicide crisis was characterized by disengaged higher-order processing of emotional faces despite heightened early sensory processing, which was moderated by tonic cortisol levels. Enhanced feedforward prediction errors from EV to AMYG suggest impaired top-down control in at-risk individuals.</p><p><strong>Relevance to clinical practice: </strong>Altered neural and hormonal responses to emotional cues highlight the potential for cortisol dysregulation and impaired top-down processing to serve as biomarkers of suicide risk. Incorporating these methods could eventually complement existing clinical suicide risk assessments, pointing to stress regulation or attentional retraining as practical adjuncts to suicide prevention.</p>","PeriodicalId":74592,"journal":{"name":"Psychiatric research and clinical practice","volume":"8 1","pages":"38-48"},"PeriodicalIF":0.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791582","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}