Annals of General Psychiatry最新文献

{"title":"Validating objective and scalable speech markers of depression across two independent psychiatric cohorts.","authors":"Felix Menne, Felix Dörr, Johannes Tröger, Alexandra König, Julia Schräder, Diana Immel, René Hurlemann, Simon Barton, Lisa Wagels","doi":"10.1186/s12991-026-00691-0","DOIUrl":"https://doi.org/10.1186/s12991-026-00691-0","url":null,"abstract":"<p><strong>Background: </strong>Using speech as objective markers for major depressive disorder (MDD) has shown promise, yet their generalizability across clinical settings remains largely unvalidated.</p><p><strong>Objective: </strong>This study aimed to validate previously identified speech markers of depressive symptoms in an independent clinical cohort, thereby assessing their reproducibility and robustness for cross-site application.</p><p><strong>Methods: </strong>Speech data from two independent psychiatric cohorts (RWTH Aachen and University of Oldenburg, Germany) were analyzed, comprising 135 participants (71 healthy controls, 64 MDD patients). Participants completed a positive and a negative storytelling task, over 80 temporal, lexical, and spectral speech features were extracted from the acoustic signal. Statistical analyses assessed group differences and correlations with Beck Depression Inventory (BDI-II) scores. Machine learning models trained on the Aachen data were tested on the Oldenburg cohort.</p><p><strong>Results: </strong>Several temporal and spectral speech features, including utterance duration, pause duration, and MFCCs, were consistently associated with MDD diagnosis and symptom severity across both cohorts. Machine learning models trained on Aachen data achieved a classification accuracy (ROC-AUC) of 0.63 on the Oldenburg sample, demonstrating above-chance but modest transfer performance. Voice quality features (shimmer, jitter) showed more variable associations: partial correlations indicated some significant effects (e.g., shimmer and jitter during positive storytelling), whereas moderation analyses revealed interaction effects, particularly for shimmer and jitter in negative storytelling, where MDD patients exhibited higher values in the Aachen cohort but lower values in the Oldenburg cohort compared to healthy controls.</p><p><strong>Conclusions: </strong>The study indicates that temporal and spectral markers of speech are relatively robust across independent clinical samples, whereas voice quality markers (shimmer, jitter) show site-dependent inconsistencies, acting as technical artifacts of varying recording conditions rather than robust biomarkers. While current speech-based classifiers remain less accurate than established self-report measures, their integration with clinical scores offers a more balanced trade-off between sensitivity and specificity. Future work should prioritize systematic evaluation across elicitation tasks, languages, and longitudinal settings to delineate which speech features are transferable and which are task-specific.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":"25 1","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13495444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The COVID-19 pandemic's impact on psychotropic medication prescriptions for children and adolescents: a scoping review of quantitative longitudinal studies.","authors":"Ida Aktner, Hilma Forsman, Viviane S Straatmann","doi":"10.1186/s12991-026-00692-z","DOIUrl":"https://doi.org/10.1186/s12991-026-00692-z","url":null,"abstract":"<p><p>Global evidence shows a deterioration in the mental health of children and adolescents during the COVID-19 pandemic, raising questions about how mental health care, including psychotropic medication prescriptions, has adapted. However, it remains unclear how this deterioration affected prescription trends. This scoping review examined quantitative longitudinal studies comparing psychotropic drug prescriptions before and during the pandemic. A search of five databases, PubMed, CINAHL, Web of Science, Scopus, and PsycINFO, yielded 14 studies from 11 OECD countries (Austria, Australia, Canada, Denmark, Israel, Italy, the United States, Portugal, Sweden, Norway, and New Zealand). Included studies were quantitative, longitudinal, in English, and focused on individuals aged 0-19. Most used national health registers or clinical data covering pre-pandemic (2013-2019) and pandemic years (2020-2022). Six studies focused exclusively on adolescents (10-19 or 12-18 years), while others included larger age ranges (0-17/18/19 years). Ten studies reported increases in antidepressant and antipsychotic prescriptions during the pandemic, with two showing initial declines followed by rises; four reported overall decreases. Notable gender and age differences emerged, with girls showing the largest rise in antidepressant use and adolescents exhibiting higher usage than younger children. Stimulant prescription trends varied across countries. Socioeconomic disparities and national policy responses, including school closures and healthcare access, also influenced prescribing patterns. Two studies found higher prescription rates among children from more advantaged backgrounds. Twelve studies focused on the early pandemic period, limiting time generalisability, while only two extended into 2022. This review highlights the need for enhanced monitoring and extended longitudinal research to assess the long-term impact of crises like COVID-19 on youth mental health care. It also emphasises the importance of health system preparedness for managing psychiatric treatment in future public health emergencies. Although an overall shift in psychotropic prescribing among children and adolescents is suggested, the limited number of studies and short follow-up periods restrict conclusions about long-term trends.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":"25 1","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of curcumin in depression: A grade-assessed systematic review and meta-analysis of randomized controlled trials.","authors":"Vali Musazadeh, Amir Hossein Faghfouri, Maryam Falahatzadeh, Mahsa Mahmoudinezhad, Mohammad Alizadeh, Farzad Shidfar","doi":"10.1186/s12991-026-00676-z","DOIUrl":"https://doi.org/10.1186/s12991-026-00676-z","url":null,"abstract":"<p><strong>Backgrounds: </strong>Curcumin is a natural polyphenolic compound that is believed to have the potential to treat various ailments, including depressive mood. However, studies on the anti-depressive properties of curcumin have yielded conflicting results. This meta-analysis seeks to assess the clinical benefits of curcumin for patients with depression or depressive symptoms.</p><p><strong>Methods: </strong>We systematically reviewed Scopus, PubMed, Web of Science, and Embase, inception February 15, 2025, to identify studies evaluating the impact of curcumin supplementation on depression in adults. The overall effects calculated using random effects model.</p><p><strong>Results: </strong>Nineteen RCTs were included in meta-analysis. A pooled analysis of eight studies showed a significant effect for curcumin supplementation in term of improving depression (SMD: -0.76; 95% CI: -1.22, -0.30, p = 0.001; I²= 94.5%, p-heterogeneity < 0.001). Similarly, combined effect of eleven studies investigating the effect of curcumin on depressive symptoms revealed an significant improvement (SMD: -0.53; 95% CI: -0.97, -0.09, p = 0.019; I²= 85.7%, p-heterogeneity < 0.001). No evidence of publication bias was observed for depression and depressive symptoms respectively (Begg's test = 0.428, and 0.533).</p><p><strong>Conclusions: </strong>This meta-analysis suggests that curcumin supplementation may improve depression and depressive symptoms significantly; however, due to sensitivity analysis the observed effect was fragile. Therefore, these findings should be interpreted with caution, and further high-quality trials are needed to determine its potential clinical efficacy.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148519776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"C-reactive protein-triglyceride-glucose index and risk of incident depressive symptoms in older adults: an eight-year follow-up study from ELSA.","authors":"Mixue Guo, Mengyuan Cai, Huqiang Dong, Zongren Zhao, Ke Zheng","doi":"10.1186/s12991-026-00690-1","DOIUrl":"https://doi.org/10.1186/s12991-026-00690-1","url":null,"abstract":"<p><strong>Background: </strong>Depression is a common mental health issue among older adults, yet few studies have explored whether metabolic biomarkers predicting its onset exist. The CRP-TyG index (CTI), combining C-reactive protein and the triglyceride-glucose index, may more effectively capture inflammatory-metabolic dysregulation than either marker alone. However, prospective evidence on the relationship between CTI and depression in aging populations is limited.</p><p><strong>Methods: </strong>We analyzed data from 2,813 depression-free participants aged ≥ 50 years in ELSA, with follow-up through Wave 8. Baseline CTI was assessed from fasting blood biomarkers, and depressive symptoms were evaluated using the CES-D-8 scale. Cox proportional hazards models were used to estimate hazard ratios (HRs). To assess the potential influence of missing data, multiple-imputation analyses were additionally performed as sensitivity analyses.</p><p><strong>Results: </strong>During follow-up, 136 participants developed incident depressive symptoms. After full adjustment including BMI, each 1-SD increase in CTI was associated with a higher risk of incident depressive symptoms (HR = 1.253; 95% CI: 1.002-1.479; p = 0.035). Multiple-imputation sensitivity analyses yielded directionally consistent results.</p><p><strong>Conclusion: </strong>In this nationally representative cohort of adults aged 50 years and older in England, higher baseline CTI was prospectively associated with an increased risk of incident depressive symptoms. CTI may serve as a scalable biomarker for identifying older adults at elevated risk of depressive symptoms.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148417965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Prevalence of suicidal thoughts and attempts in the transgender population of the world: a systematic review and meta‑analysis.","authors":"Parisa Kohnepoushi, Maziar Nikouei, Mojtaba Cheraghi, Parsa Hasanabadi, Hamza Rahmani, Maryam Moradi, Ghobad Moradi, Farhad Moradpour, Yousef Moradi","doi":"10.1186/s12991-026-00688-9","DOIUrl":"10.1186/s12991-026-00688-9","url":null,"abstract":"","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":"25 1","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13325568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148374339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular fitness of forensic psychiatric patients: a longitudinal clinical study.","authors":"Anja Fernqvist, Peter Andiné, Roland Thomeé, Alessio Degl'Innocenti, Thomas Nilsson, Annelie Gutke","doi":"10.1186/s12991-026-00680-3","DOIUrl":"10.1186/s12991-026-00680-3","url":null,"abstract":"<p><strong>Background: </strong>Forensic psychiatric patients have a reduced life expectancy, largely due to cardiovascular diseases. Low maximal oxygen uptake is a risk factor for cardiovascular diseases in the general population and may also be essential to the cardiovascular risk among forensic psychiatric patients. The purpose of this study was to verify previous results of very low estimated maximal oxygen uptake levels in a larger group of forensic psychiatric patients and investigate the impact of the length of inpatient forensic psychiatric care on estimated maximal oxygen uptake. Further, we examined the extent to which BMI, level of physical activity, and smoking status were associated with estimated maximal oxygen uptake.</p><p><strong>Methods: </strong>We evaluated estimated levels of maximal oxygen uptake based on clinical testing of 115 forensic psychiatric patients and the development of these levels during inpatient care for those who underwent retesting (two tests, n = 66, three tests, n = 30).</p><p><strong>Results: </strong>Mean estimated levels of maximal oxygen uptake were remarkably low, confirming previous findings. Levels correlated negatively with higher body mass index, lower physical activity, and older age; however, no change was observed during forensic psychiatric inpatient care. Estimated physical activity levels tended to increase between tests one and two, but decreased significantly between tests two and three.</p><p><strong>Conclusions: </strong>This Swedish forensic psychiatric cohort had very low cardiovascular fitness. The strongest associated factors were a high BMI and a low level of physical activity. These results make essential contributions to the planning of future studies on treatment strategies aimed at improving metabolic health in forensic psychiatric patients. The importance of aerobic exercise, as well as means to encourage patients to reach and maintain recommended levels of physical activity, needs to be further explored.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148366562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between changes in sleep quality and serum pro-inflammatory cytokine levels in patients with major depressive disorder following duloxetine treatment.","authors":"Yayun Xu, Wenfan Gao, Feng Shan, Qingrong Xia, Jun Liang","doi":"10.1186/s12991-026-00689-8","DOIUrl":"https://doi.org/10.1186/s12991-026-00689-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Major depressive disorder (MDD) is accompanied by prominent physiological abnormalities, notably sleep disturbances and immune-inflammatory dysregulation. As a serotonin-norepinephrine reuptake inhibitor, antidepressant duloxetine exhibits both anti-inflammatory effects and therapeutic benefits in improving sleep architecture. This study aimed to investigate the effects of duloxetine on objective sleep parameters and serum pro-inflammatory cytokine levels in patients with MDD, and further to explore the correlation between treatment-related improvements in sleep quality and dynamic changes in inflammatory cytokine profiles.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study included 74 patients with MDD who met the DSM-5 criteria, had a baseline 24-item Hamilton Depression Rating Scale score ≥ 20, and no prior use of antidepressants or anti-inflammatory drugs within 3 months. All patients were administered duloxetine at a daily dose of 40-60 mg for 4 consecutive weeks. Objective sleep parameters, including total sleep time (TST), sleep efficiency (SE), wake time after sleep onset (WASO), and rapid eye movement (REM) latency, were evaluated using polysomnography (PSG). Serum levels of 6 pro-inflammatory cytokines, including interleukin‑1β (IL‑1β), IL‑6, IL‑8, IL‑12, tumor necrosis factor‑α (TNF‑α), and interferon‑γ (IFN‑γ), were measured by enzyme-linked immunosorbent assay. Changes from baseline to post-treatment were analyzed using paired t-tests or Wilcoxon signed-rank tests based on data distribution. Correlation analyses were performed using Pearson or Spearman tests, followed by partial correlation analysis adjusting for potential confounders.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;After 4 weeks of duloxetine treatment, significant improvements in sleep parameters were observed, characterized by increased TST (t = -6.614, P &lt; 0.001) and SE (t = -6.631, P &lt; 0.001), as well as decreased WASO (t = 6.331, P &lt; 0.001). Moreover, serum concentrations of IL‑1β (t = 4.759, P &lt; 0.001), IL‑8 (t = 6.327, P &lt; 0.001), IL‑12 (t = 6.194, P &lt; 0.001), and IFN‑γ (t = 8.713, P &lt; 0.001) were significantly reduced following treatment. Furthermore, at baseline, TST was negatively correlated with serum IL-12 levels (r = -0.306, P = 0.016) in patients with MDD. Similarly, SE was negatively correlated with serum levels of IL‑1β (r = -0.343, P = 0.006), IL‑8 (r = -0.297, P = 0.019), and IL‑12 (r = -0.279, P = 0.028). Additionally, following treatment, the change in TST was negatively correlated with the change in IL-12 levels (r = -0.285, P = 0.025). Likewise, the change in SE was negatively correlated with changes in IL-8 levels (r = -0.263, P = 0.039) and IL-12 levels (r = -0.294, P = 0.020).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Four-week duloxetine treatment was associated with improved sleep disturbances and reduced peripheral pro-inflammatory cytokine levels in patients with MDD. The baseline correlations between sleep parameters and pro-inflammato","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148343726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timing of childhood adversity and cognitive profiles in adults with autism spectrum disorder.","authors":"Rio Ishida, Kazuhiko Yamamuro, Michihiro Toritsuka, Tsutomu Takeda, Hiroto Tamakoshi, Natsuko Kashida, Takashi Okada, Nakao Iwata, Manabu Makinodan","doi":"10.1186/s12991-026-00679-w","DOIUrl":"10.1186/s12991-026-00679-w","url":null,"abstract":"<p><strong>Background: </strong>This study examined whether the timing of adverse childhood experiences (ACEs) is associated with differences in intellectual ability in adults with autism spectrum disorder (ASD) without intellectual disability.</p><p><strong>Methods: </strong>A total of 161 adults with ASD were categorized into three groups based on ACE onset: no ACEs (Group 0), early childhood ACEs (≤ 10 years; Group 1), and adolescent ACEs (11-18 years; Group 2). Intellectual ability was assessed using the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV).</p><p><strong>Results: </strong>Findings revealed that Group 1 outperformed Group 2 on the picture completion and figure weights subtests, suggesting that early ACE exposure may be linked to distinct cognitive profiles in ASD. To account for the higher severity of post-traumatic stress disorder (PTSD) symptoms, including hypervigilance, in Group 1 compared to Group 2, we conducted multivariate analyses of covariance and logistic regression to control for potential confounders such as years of education and PTSD symptom severity, given that hypervigilance may influence cognitive task performance. However, the observed differences remained significant.</p><p><strong>Conclusion: </strong>These results suggest a potential association between the timing of ACE exposure and specific cognitive subdomains in adults with ASD. Furthermore, WAIS-IV subtests, particularly picture completion and figure weights, may serve as potential markers for identifying cognitive adaptations associated with early adversity in ASD individuals.</p><p><strong>Clinical trial registration: </strong>Since this study was not a clinical trial, this section does not apply.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148300594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining clinical relevance of interpretation inflexibility in social contexts.","authors":"Wisteria Deng, Reut Zabag, Saumya Narain, Tyrone D Cannon, Jutta Joormann","doi":"10.1186/s12991-026-00683-0","DOIUrl":"10.1186/s12991-026-00683-0","url":null,"abstract":"<p><p>Growing research highlights interpretation inflexibility as a key transdiagnostic mechanism across psychopathologies. Yet, few studies have examined its role in everyday socio-emotional processing. This review bridges that gap by exploring how interpretation inflexibility contributes to psychopathology-particularly depression and psychosis-in social contexts. Evidence suggests disrupted interpersonal processes, including rigid interpretations of social scenarios and impressions of others, are central to understanding depressive and psychotic symptoms. Depression is marked by valence-specific, context-dependent inflexibility, with difficulty disengaging from negative biases. In contrast, psychosis shows a broader inflexibility across emotional valences. The review also outlines evolving measures of interpretation inflexibility, emphasizing the need to account for social context in interpretation revision. Current findings highlight the value of examining inflexibility within social frameworks to better understand its role in adaptive functioning and psychopathology. Future research on interpretation inflexibility in social contexts could inform novel interventions and improve clinical outcomes.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148283070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demoralization in patients with obsessive-compulsive disorder: results from an exploratory cross-sectional report.","authors":"Annalisa Maraone, Matteo Panfili, Valentina Roselli, Daniele D'Agostini, Irene Pinucci, Tommaso Accinni, Lorenzo Tarsitani, Francesco Saverio Bersani, Massimo Pasquini","doi":"10.1186/s12991-026-00687-w","DOIUrl":"10.1186/s12991-026-00687-w","url":null,"abstract":"<p><strong>Background: </strong>Obsessive-compulsive disorder (OCD) is a chronic, early-onset condition often associated with high rates of treatment resistance, and affective disturbances are frequent comorbidities and linked to poorer therapeutic outcomes. Recently, the concept of \"demoralization syndrome\" has been proposed as not fully overlapping with major depressive episodes. Given the disabling nature of OCD, it is relevant to specifically evaluate the states of demoralization, considering that this condition may have treatment implications partially different from those related to other forms of affective disturbances. The aim of the present exploratory study was to evaluate demoralization in subjects with OCD and its relationship with the severity of OCD-related symptoms.</p><p><strong>Methods: </strong>Adults with a primary diagnosis of OCD were consecutively recruited from the OCD outpatient clinic of Azienda Ospedaliero-Universitaria Policlinico Umberto I (Rome, Italy). Participants were assessed with clinical interviews as well as with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) for OCD severity, the Demoralization Scale (DS) for demoralization, and the Patient Health Questionnaire (PHQ) and Hamilton Depression Rating Scale (HAM-D) for depressive symptoms. Descriptive and correlational analyses have been performed.</p><p><strong>Results: </strong>A total of 43 adults with OCD were included. Both depressive and demoralization symptoms were highly prevalent, with clinically-significant demoralization observed in 88% of patients. A subset of individuals exhibited clinically-significant demoralization without clinically-relevant depression. Demoralization severity showed significant associations with the severity of obsessions.</p><p><strong>Conclusion: </strong>Demoralization was highly prevalent in our sample, and it was significantly associated with the severity of obsessions. Recognizing demoralization states in OCD may improve diagnostic precision and guide tailored therapeutic interventions, complementing standard treatments for the diseases. Further research, including longitudinal studies, is needed to clarify its impact on the course of the disorder.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13495429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148248924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}