Annals of General Psychiatry最新文献

{"title":"Associational pathway analyses of depression and impulsivity in the relationship between internet addiction and non-suicidal self-injury among adolescents: a cross-sectional case-control study.","authors":"Alaa A Abdalla, Magda Fahmy, Khaled Anwar, Ahmed Elarabi Hendi, Kathryn R Cullen, Omneya Ibrahim","doi":"10.1186/s12991-026-00646-5","DOIUrl":"10.1186/s12991-026-00646-5","url":null,"abstract":"<p><strong>Background: </strong>Adolescents undergo important developmental changes, characterized by profound biological and psychosocial changes. This period is also associated with increased vulnerability to mental health challenges and engagement in risky/problematic behaviors. Non-suicidal self-injury (NSSI) and internet addiction (IA) are increasingly recognized as prevalent and interconnected behavioral concerns among adolescents, particularly those with depressive disorders. Impulsivity has also been identified as a key psychological factor in both IA and NSSI. This study aimed to investigate the cross-sectional interrelationships among depression, impulsivity, IA, and NSSI in adolescents.</p><p><strong>Methods: </strong>A total of 110 adolescents (55 diagnosed with major depressive disorder [MDD] and 55 healthy controls) were recruited from the Child and Adolescent Psychiatry Outpatient Clinic at Suez Canal University Hospital. The severity of depression was assessed using the Children's Depression Inventory (CDI). All participants completed the Internet Addiction Test (IAT), Deliberate Self-Harm Inventory (DSHI), and Barratt Impulsiveness Scale (BIS-11). Statistical analyses included group comparisons, correlation analyses, logistic regression. Cross-sectional pathway analyses using structural equation modeling (SEM) was conducted to examine indirect associations between IA and NSSI through depression and impulsivity.</p><p><strong>Results: </strong>Adolescents with MDD reported significantly higher levels of NSSI, IA, and impulsivity compared to controls. Significantly positive correlations between IAT, BIS-11, and CDI scores and lifetime NSSI frequency were demonstrated among the depression group. IA and NSSI were significantly associated by indirect pathways through both depression and impulsivity. In serial associational models, the cross-sectional indirect pathway from impulsivity to depression (B = 0.370) was stronger than the reverse direction (B = 0.310).</p><p><strong>Conclusion: </strong>Our findings highlighted the interrelated roles of IA, impulsivity, and NSSI among adolescents with MDD. Impulsivity may be a critical factor linking IA to emotional dysregulation and self-injurious behavior. These results highlight the need for integrated screening and prevention strategies targeting impulsivity and these risk behaviors.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":"25 1","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13255388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148222611","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":"Analysis of gut microbiota and intestinal mucosal neurotransmitter changes and their correlation in adolescent depression mice.","authors":"Jinrui Xing, Ziwei Jiang, Xushu Jing, Ying Li, Fengtao Guo, Penghong Liu, Zhifen Liu, Ning Sun","doi":"10.1186/s12991-026-00686-x","DOIUrl":"10.1186/s12991-026-00686-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Adolescent depression is a major mental health disorder with increasing prevalence and substantial long-term consequences. Although growing evidence suggests that the gut-brain axis is involved in depression, the relationships among gut microbiota, intestinal mucosal neurotransmitters, and adolescent depression remain insufficiently understood. This knowledge gap limits a better understanding of the pathophysiological mechanisms underlying adolescent depression and the identification of potential microbiota-related targets. Therefore, this study aimed to investigate alterations in gut microbiota and intestinal mucosal neurotransmitters, as well as their correlations, in an adolescent mouse model of depression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We established an adolescent depression mouse model using chronic unpredictable mild stress (CUMS), and collected data with the Smart video tracking system. We collected intestinal contents and mucosal tissues from mice. We analyzed gut microbial composition using metagenomic sequencing and quantified mucosal neurotransmitters with liquid chromatography-tandem mass spectrometry (LC-MS/MS). We analyzed correlations among gut microbiota, intestinal mucosal neurotransmitters, and behavioral indicators.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Mice in the CUMS group exhibited a significantly reduced sucrose preference rate in the sucrose preference test (P &lt; 0.001); a significantly prolonged immobility time in the forced swim test (P &lt; 0.01); and a significantly decreased total movement distance in the open field test (P &lt; 0.01). No significant intergroup difference was observed in the tail suspension test. Regarding the gut microbiome, the CUMS group showed significantly lower Simpson index (P = 0.018) and Pielou's evenness index (P = 0.022). Beta diversity analysis indicated a statistically significant but modest between-group difference in community structure (ANOSIM R = 0.145, P = 0.03); this finding was supported by PERMANOVA (Bray-Curtis; pseudo-F = 1.675, R² = 0.0897, P = 0.033). LEfSe (Linear discriminant analysis Effect Size) analysis suggested 27 candidate taxa with discriminatory signals between groups (nominal P &lt; 0.05; exploratory). Neurotransmitter analysis demonstrated that levels of 5-HIAA (5-hydroxyindoleacetic acid), 5-HT (serotonin), 5-HTP (5-hydroxytryptophan), and Kyn (kynurenine) in the colon were significantly decreased in the CUMS group, whereas levels of PA (phenylethylamine) and NE (norepinephrine) were significantly elevated (P &lt; 0.05). Spearman correlation analysis found that Lactobacillus and Lactobacillus acidophilus correlated positively with sucrose preference and negatively with immobility in the forced swim test. Lactobacillus acidophilus also showed a positive correlation with 5-HT pathway metabolites: 5-HIAA, 5-HT, 5-HTP, and Kyn.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Adolescent mice exposed to CUMS showed depression-relevant behavioral alterations, shifts i","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216080","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 generalized anxiety disorder and health-related quality of life.","authors":"Jiseon Kim, Yeonjin Lee, Sangshin Park","doi":"10.1186/s12991-026-00682-1","DOIUrl":"10.1186/s12991-026-00682-1","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to examine the association between generalized anxiety disorder (GAD) and health-related quality of life (HRQOL) in the general Korean population, and whether this relationship differed by multimorbidity profiles and household income.</p><p><strong>Methods: </strong>We included 5,542 participants aged 19 years or older from the data of the 2021 Korean National Health and Nutrition Examination Survey. The GAD was assessed using the Generalized Anxiety Disorder 7-item scale (GAD-7). Participants with a GAD-7 score ≥ 10 were classified as having GAD. HRQOL was measured using the Health-related Quality of Life Instrument with 8 Items (HINT-8). Multimorbidity profiles were derived using latent class analysis. Survey-weighted regression models were used to evaluate associations and interaction effects.</p><p><strong>Results: </strong>The weighted prevalence of GAD was 4.23%, with a mean GAD-7 score of 1.99. The mean HINT-8 index was 0.80. Higher GAD-7 scores and the presence of GAD were consistently associated with lower HINT-8 index values. GAD was associated with increased odds of problems across all HINT-8 domains, with particularly strong associations for depression (odds ratio [OR] = 34.43) and moderate associations for memory (OR = 4.88) and sleep (OR = 4.68). Three multimorbidity profiles (Healthy, Geriatric Disease, and Cardiometabolic Disease groups) were identified, and the association between GAD-7 scores and HRQOL differed by multimorbidity profile and household income, with similar patterns observed for GAD status.</p><p><strong>Conclusions: </strong>Higher GAD-7 scores and GAD were associated with substantially poorer HRQOL across both physical and psychological domains. The strength of this relationship varied according to multimorbidity profile and socioeconomic context.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148194302","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 combined discriminative value of LHR, NLR, and platelet count in distinguishing first-episode schizophrenia.","authors":"Chunyang Shi, Gang Zhang, Zhoubing Wang, Xianlu Chang, Zhiyun Yang, Huiying Xue, Yunxia Guo","doi":"10.1186/s12991-026-00677-y","DOIUrl":"10.1186/s12991-026-00677-y","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the discriminative value of the combination of lymphocyte-to-high-density lipoprotein ratio (LHR), neutrophil-to-lymphocyte ratio (NLR), and platelet count for patients with first-episode schizophrenia (FES).</p><p><strong>Methods: </strong>A retrospective analysis was performed on 181 antipsychotic-naïve inpatients with FES admitted to Zhenjiang Mental Health Center between January 2015 and February 2025.189 participants, including staff members who underwent health check-ups at the same center from July 2024 to November 2025, were prospectively recruited as the healthy control group. Both groups underwent fasting blood cell analysis. Univariate analysis, binary Logistic regression analysis, and receiver operating characteristic (ROC) curve analysis were employed to assess the diagnostic performance of the combined use of LHR, NLR, and platelet count for FES.</p><p><strong>Results: </strong>Univariate analysis revealed that white blood cell count, neutrophil count, monocyte count, platelet count, high-density lipoprotein (HDL), neutrophil-to-high-density lipoprotein ratio (NHR), LHR, platelet-to-lymphocyte ratio (PLR), NLR, and systemic immune-inflammation index (SIRI) were statistically significant influencing factors associated with FES (all P < 0.05) when comparing the FES group with the healthy control group. Binary Logistic regression analysis further identified platelet count, LHR, and NLR as independent predictors of FES relative to healthy controls (all P < 0.05). The ROC curve analysis demonstrated that the combination of platelet count, LHR, and NLR yielded an area under the curve (AUC) of 0.863 for distinguishing FES.</p><p><strong>Conclusion: </strong>The combination of LHR, NLR, and platelet count is significantly elevated in antipsychotic-naïve FES patients compared with healthy controls. These findings highlight immune-metabolic dysregulation in acute-phase FES, but do not establish diagnostic specificity. Comparative studies with other acute psychiatric disorders are needed.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155159","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":"Correction: A narrative review on trazodone as a multimodal and multifunctional antidepressant: clinical relevance of formulations, dosing, and pharmacokinetic/pharmacodynamic targets.","authors":"Alessandro Cuomo, Maurizio Pompili, Antonio Vita, Edoardo Spina, Filippo Caraci, Andrea Fagiolini","doi":"10.1186/s12991-026-00678-x","DOIUrl":"10.1186/s12991-026-00678-x","url":null,"abstract":"","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":"25 1","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13235162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155118","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":"Loneliness despite social integration: subjective loneliness without social isolation as a risk factor for psychotic-like experiences.","authors":"Norio Sugawara, Takahiro Tabuchi, Keita Tokumitsu, Norio Yasui-Furukori","doi":"10.1186/s12991-026-00685-y","DOIUrl":"10.1186/s12991-026-00685-y","url":null,"abstract":"<p><strong>Background: </strong>Psychotic-like experiences (PLEs) are associated with subjective loneliness, as well as social isolation. However, few studies have examined how different combinations of loneliness and social isolation relate to overall PLEs and specific psychotic symptom domains. The aim of this study was to examine the associations between combinations of loneliness and social isolation and PLEs in a population-based sample in Japan.</p><p><strong>Methods: </strong>Data were derived from the 2025 wave of the Japan Society and New Tobacco Internet Survey (JASTIS), including 25,424 adults aged 15-84 years. PLEs were assessed using the Japanese version of the PRIME Screen-Revised (PS-R). Loneliness was measured using the University of California, Los Angeles Loneliness Scale version 3, Short Form 3-item (UCLA-LS3-SF3), and social isolation was assessed using the Lubben Social Network Scale (LSNS-6). Logistic regression analyses with inverse probability weighting were conducted to examine associations between four categories of loneliness/social isolation and overall PLEs as well as six psychotic symptom domains.</p><p><strong>Results: </strong>The weighted prevalence of PLEs was 4.3%. Compared with participants with both loneliness and social isolation, those with neither loneliness nor social isolation showed lower odds of overall PLEs (OR = 0.51, 95% CI 0.42-0.63), as did those with social isolation without loneliness (OR = 0.62, 95% CI 0.51-0.74). In contrast, participants with loneliness without social isolation had higher odds of overall PLEs (OR = 1.46, 95% CI 1.24-1.71). Symptom-domain analyses indicated heterogeneous patterns across domains.</p><p><strong>Conclusions: </strong>These findings demonstrate that loneliness without social isolation is particularly associated with PLEs, highlighting the importance of subjective loneliness as a correlate of PLEs. This suggests that reliance on objective indicators of social isolation alone may overlook individuals at elevated risk, emphasizing the importance of attending to subjective loneliness in population-based mental health research.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13449475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148148046","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 and safety of repetitive transcranial magnetic stimulation in anorexia and bulimia nervosa: a systematic review and meta-analysis.","authors":"Dalia Kamal Ewis, Haneen Sabet, Yousef Hawas, Wajeeh Hassan, Moaz Elsayed Abouelmagd, Arwa Jader, Dina Essam Abo-Elnour, Abdallah Abbas, Mohamed E G Elsayed, Carlos Schönfeldt-Lecuona, Ahmed M Raslan","doi":"10.1186/s12991-026-00673-2","DOIUrl":"10.1186/s12991-026-00673-2","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review and meta-analysis aimed to evaluate the efficacy and safety of repetitive transcranial magnetic stimulation (rTMS) in patients with anorexia nervosa (AN) and bulimia nervosa (BN), focusing on its impact on psychological, psychopathological, neurocognitive, and behavioral outcomes.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, and Cochrane CENTRAL from inception to May 2025. Eligible studies included clinical trials involving adult patients with AN or BN treated with rTMS. Data were pooled using fixed or random-effects models depending on heterogeneity. Mean differences (MD) or standardized mean differences (SMD) with 95% confidence intervals (CI) were calculated. Risk of bias was assessed using Cochrane RoB 2.0 and NIH tools.</p><p><strong>Results: </strong>Thirteen studies were included, yielding a total of n = 195 active rTMS treatments and n = 132 sham treatments. Compared to sham, rTMS did not significantly improve BMI in AN patients (MD: 0.19; 95% CI: -0.50, 0.88; P = 0.59). A significant moderate reduction in eating disorder severity was found in single-arm analysis (31 patients, SMD: -0.50, 95% CI [-0.90, -0.10], p = 0.01). Depression improved with rTMS over sham (105 patients, SMD: -0.41, 95% CI [-0.81, -0.02], p = 0.04), while anxiety, binge frequency, and vomiting frequency did not. Urge to eat increased in AN (30 patients, MD: 1.20, 95% CI [0.20, 2.21], p = 0.02) and decreased in BN (25 patients, MD: -10.25, 95% CI [-15.88, -4.62], p = 0.0004). No serious adverse events were reported.</p><p><strong>Conclusions: </strong>rTMS shows potential in improving eating disorder severity and depressive symptoms in AN, with disorder-specific modulation of food-related urges. Its effects on BMI and behavioral symptoms remain inconclusive. rTMS was well tolerated.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":"25 1","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13224673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148142495","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":"Long-term trends in age at psychiatric admission (2006-2022): influence of sex, diagnosis, and admission type in a single Italian catchment.","authors":"Tommaso Barlattani, Federico Salfi, Valentina Socci, Giulio Renzi, Antony Bologna, Silvia Tamanti, Edoardo Trebbi, Alessandro Rossi, Ferdinando Romano, Francesca Pacitti","doi":"10.1186/s12991-026-00681-2","DOIUrl":"10.1186/s12991-026-00681-2","url":null,"abstract":"<p><strong>Aims: </strong>Following Italy's psychiatric reform, national inpatient numbers declined, but how the age at admission has changed across sex, diagnostic, and admission-type subgroups remains unclear. This study examined 17 consecutive years (2006-2022) of psychiatric admissions to the sole ward serving L'Aquila, assessing temporal trends in age at admission by diagnosis, sex, and admission status (voluntary vs. compulsory).</p><p><strong>Methods: </strong>All adult admissions (≥ 18 years) were extracted from hospital discharge records (Schede di Dimissione Ospedaliera, SDO). Analyses were conducted at the admission-episode level. Primary diagnoses were grouped into four ICD-9 categories: schizophrenia spectrum, major depressive disorder, bipolar disorder, and alcohol/substance use disorder. Multiple linear models tested time-related changes in mean age at admission, including interactions for time × diagnosis × sex × admission type.</p><p><strong>Results: </strong>Across 5,207 admission episodes, the Trimester × Diagnosis interaction showed a marked decline in age at admission for major depression (B = - 0.20 per trimester, p < 0.001) and bipolar disorder (B = - 0.09, p = 0.03), equivalent to approximately - 0.80 and - 0.36 years per year, yielding total reductions of ~ 13.6 and ~ 6.1 years over 2006-2022. The Trimester × Diagnosis × Sex interaction indicated that the decline in depression was driven by men (B = - 0.32, p < 0.001; ≈ -1.28 years/year; -21.76 over 17 years), while in bipolar disorder it was driven by women (B = - 0.14, p = 0.03; ≈ -0.56 years/year; -9.52 over 17 years). The Trimester × Admission type interaction showed the reduction was specific to voluntary admissions (B = - 0.10, p < 0.001; ≈ -0.40 years/year), while compulsory admissions were stable (B = - 0.01, p = 0.87). No significant age change occurred in schizophrenia spectrum disorders or in alcohol/substance use disorders.</p><p><strong>Conclusions: </strong>Between 2006 and 2022, we observed a progressive rejuvenation of voluntary and affective-disorder inpatient admissions, with the clearest subgroup-specific reductions detected in men with major depression and women with bipolar disorder, while remaining stable in schizophrenia spectrum, alcohol/substance use disorder, and compulsory admissions. These findings underscore the need to balance youth-focused outreach with adequate capacity for chronic psychosis and substance use disorder.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136546","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":"Initiation of aripiprazole once-monthly via a two‑injection start in adult patients diagnosed with schizophrenia: real-world experiences of healthcare professionals from five European countries.","authors":"Clodagh Beckham, Murat Yildirim, Andrea Fagiolini, Karolina Leopold, William J Cottam, Joe Hickey, Olivia Rogerson, Sofia Pappa","doi":"10.1186/s12991-026-00684-z","DOIUrl":"10.1186/s12991-026-00684-z","url":null,"abstract":"<p><strong>Background: </strong>The aripiprazole once-monthly 400 mg two-injection start (AOM 400-TIS) enables treatment initiation at a single clinic visit, without the need for 14 days of concurrent oral aripiprazole supplementation. Previously, results from a survey outlined the views and experiences of healthcare professionals (HCPs) with the AOM 400-TIS in a real-world setting in Europe. The current work extends these findings to include a broader pool of participants from more European countries.</p><p><strong>Methods: </strong>This was a non-interventional, cross-sectional survey of HCPs from Germany, Italy, the United Kingdom, Denmark, and Sweden. Participants were licensed nurses/physicians with experience prescribing and/or administering the AOM 400-TIS to patients diagnosed with schizophrenia. Two waves of survey data were pooled and analysed using descriptive methods.</p><p><strong>Results: </strong>Data from 229 HCPs were evaluated. Poor treatment adherence (88.6%), relapse (51.1%), and patient preference (47.6%) were common reasons for using the AOM 400-TIS, while patients not wanting two injections at the same time (52.4%) and concerns about safety (34.1%) and tolerability (33.6%) were common barriers. Among HCPs, 86.0% agreed/strongly agreed they were satisfied with outcomes of patients treated with the AOM 400-TIS, with most agreeing/strongly agreeing that patients appeared satisfied in general (73.4%) and with sustained quality of life and functioning (66.4%).</p><p><strong>Conclusions: </strong>This survey provides a pan-European account of HCPs' views and experiences with the AOM 400-TIS in adults diagnosed with schizophrenia. Initiatives to overcome barriers to AOM 400-TIS use include providing clearer evidence and education on its efficacy and safety and consideration of how the regimen is presented in patient-provider discussions.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148142538","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":"Risperidone long-acting in-situ microimplant following a brief oral risperidone lead-in in the acute inpatient management of manic episodes with psychotic symptoms in non-adherent patients with schizoaffective disorder: a retrospective, uncontrolled real-world study.","authors":"Giovanni Barillà, Andrea Fagiolini, Debora Bussolotti, Cristina Venco, Alessandro Cuomo","doi":"10.1186/s12991-026-00674-1","DOIUrl":"10.1186/s12991-026-00674-1","url":null,"abstract":"<p><strong>Background: </strong>Nonadherence is a major cause of relapse in patients with schizophrenia, schizoaffective disorder, or bipolar disorder who have achieved remission. However, it is also a significant challenge during manic episodes. Risperidone in-situ microimplant (ISM) releases the drug early and in a sustained manner once a month, eliminating the need for daily administration, which can be difficult during a manic episode. In this study, we described symptom trajectories and tolerability of a brief oral risperidone lead-in followed off-label initiation of risperidone ISM within multimodal inpatient care in nonadherent inpatients with schizoaffective disorder experiencing a manic episode with psychotic symptoms.</p><p><strong>Methods: </strong>This retrospective, observational, single-centre study included 50 consecutive adults admitted after discontinuation/marked non-adherence and with prior response to risperidone who received ≥ 6 days of oral risperidone to confirm tolerability, then risperidone ISM (75 or 100 mg) and were followed for 6 weeks. Mania severity was assessed with the Young Mania Rating Scale (YMRS).</p><p><strong>Results: </strong>Fifty patients were included; most received concomitant mood stabilisers and benzodiazepines. Median YMRS decreased from 32 at admission (Tx) to 26 at the first injection (T0, after the oral lead-in), 8 by day 8, and remained low at day 28 (5) and day 42 (6). Activation/behavioural items improved earlier, whereas psychotic thought content improved more gradually, predominantly between days 8 and 28. Side-effect burden at weeks 4 and 6 was minimal, and no discontinuations due to adverse events occurred.</p><p><strong>Conclusions: </strong>In this exploratory uncontrolled cohort, an oral risperidone lead-in plus monthly risperidone ISM within multimodal inpatient care was associated with with rapid and sustained improvement in symptom trajectories and favourable short-term tolerability. Findings reflect multimodal inpatient care and cannot be attributed to ISM alone. Prospective, controlled studies are warranted.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148051964","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}