Annals of General Psychiatry最新文献

{"title":"Reflections from individuals with schizophrenia on a life with delusions and hallucinations: a phenomenological study.","authors":"Sevda Uzun, Çiçek Ediz, Mehmed Burak Erdaş","doi":"10.1186/s12991-026-00635-8","DOIUrl":"10.1186/s12991-026-00635-8","url":null,"abstract":"<p><strong>Background: </strong>Despite their profound influence on the lives of individuals with schizophrenia, few studies explore delusions and hallucinations from the first-person perspective using a phenomenological approach. This study aimed to examine how individuals diagnosed with schizophrenia experience delusions and hallucinations from their own perspective.</p><p><strong>Methods: </strong>This descriptive phenomenological study was conducted between August and September 2023. Semi-structured, in-depth interviews were conducted with 14 individuals diagnosed with schizophrenia who regularly attended a state community mental health center in eastern Turkey. Interviews were audio-recorded, transcribed verbatim, and analyzed using Colaizzi's seven-step method. The study was reported in line with the COREQ checklist.</p><p><strong>Results: </strong>Four main themes were identified: (1) effects of schizophrenia, (2) triggers for delusions and hallucinations, (3) the impact of delusions and hallucinations on daily life, and (4) coping with delusions and hallucinations. Ten sub-themes captured psychological, physical, and social effects and triggers, as well as control mechanisms, challenges in life, perceived social support, and emotions.</p><p><strong>Conclusion: </strong>The findings highlight the pervasive psychological, physical, and social burden of living with delusions and hallucinations and the variability in coping resources and support. Developing and evaluating tailored psychosocial interventions may help individuals with schizophrenia manage these experiences more effectively. These findings suggest the need for developing psychoeducation programs focused on identifying personal symptom triggers, family-based support interventions that enhance communication and stigma reduction, and community mental health interventions aimed at strengthening coping skills, social participation, and emotional regulation.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13005560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146193966","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":"Prevalence and associated risk factors of psychotic experiences in the general population during the COVID-19 pandemic: a systematic review and meta-analysis.","authors":"Feten Fekih-Romdhane, Vanessa Azzi, Frederic Harb, Sahar Obeid, Souheil Hallit","doi":"10.1186/s12991-025-00590-w","DOIUrl":"10.1186/s12991-025-00590-w","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 is strongly associated with common mental disorders, but little is known about its association with psychotic experiences (PEs). Subclinical psychotic experiences, such as hallucinations and delusions, can precede psychotic disorders. This review sought to consolidate estimates and correlates of PEs in population-based samples during the COVID-19 pandemic.</p><p><strong>Methods: </strong>This systematic review and meta-analysis was conducted in accordance with PRISMA and was registered in PROSPERO (CRD42024499153). A systematic search in EMBASE, MEDLINE (PubMed), Web of Science, Google Scholar, Scopus, APA PsycINFO, and other databases was conducted for relevant papers published between January 2020 (when COVID-19 was declared a worldwide health emergency) and September 30, 2024. Papers were included if they investigated the prevalence of self-reported PEs among people from the general public during the COVID-19 pandemic. The Newcastle-Ottawa Scale was used to evaluate the risk of bias. Meta-analyses were performed based on the random-effects model, and the effect size was presented as odds ratios (ORs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Twenty-five studies involving 264,504 adults were eligible. The prevalence of non-clinician administered self-reported PEs (12 studies) was 15.2% (pool). Subgroup analyses demonstrated that prevalence was higher in non-students compared to students (defined in the reference studies as individuals enrolled in college or university), those assessed during lockdown or quarantine than those assessed outside of lockdown or quarantine, and participants in Western versus non-Western countries. There was no meaningful difference between adolescents (≤ 24 years) and adults (> 24 years). Substantial heterogeneity (I² = 100%) was found, probably owing to differences in measurement instruments, participants, and settings.</p><p><strong>Conclusion: </strong>The results indicated that more than one-in-seven non-help-seeking individuals from the general public were screened as having self-reported PEs and a high-risk profile for psychosis during the pandemic. Elevated prevalence rates observed during lockdowns and among specific subgroups support the need for psychosis risk screening in public health strategies. Further research is needed to directly compare pre- and post-pandemic rates and explore long-term outcomes.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":"25 1","pages":"7"},"PeriodicalIF":3.6,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12896117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146177374","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":"Understanding individual and structural factors behind extensive care needs in personality disorders: an interpretative phenomenological analysis.","authors":"Jennifer Strand, Flavio Di Leone, Evelina Dervisoski, Parinazz Iranmanesh, Peter Sand","doi":"10.1186/s12991-025-00623-4","DOIUrl":"10.1186/s12991-025-00623-4","url":null,"abstract":"<p><p>Extensive care needs, including frequent hospitalizations and compulsory care, are common among individuals with personality disorders (PD), yet the outcomes of such interventions remain uncertain. This study aimed to explore patient perspectives on the individual and structural factors contributing to the high demand for psychiatric interventions. Eleven high-care-consuming patients diagnosed with PD were interviewed, and data were analyzed using interpretative phenomenological analysis. The findings indicate that emergency department visits often stem from emotional turmoil and social isolation, reflecting acts of desperation. Participants described inpatient treatments as impersonal, lacking direction, and primarily focused on repeated pharmacological interventions that exacerbated feelings of hopelessness. Both inpatient and outpatient care were perceived as \"a state of waiting for something that never happens,\" reflecting an ongoing sense of invalidation and unmet needs. These results highlight the urgent need for healthcare systems to prioritize individualized care plans, improved communication, and explore alternative approaches for managing crises or reforming emergency department practices for this group of patients. Addressing these factors could enhance patient well-being, reduce self-destructive tendencies, and alleviate reliance on the mental health system.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12930921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146140590","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 the correlation between the expression levels of caspase-1/IL-1β in the peripheral blood and clinical efficacy in patients with first-episode MDD.","authors":"Jing-Yang Gu, Dong-Chuan Di, Meng-Yue Gu, Huan-Zhong Liu","doi":"10.1186/s12991-026-00632-x","DOIUrl":"10.1186/s12991-026-00632-x","url":null,"abstract":"<p><p>BACKGROUND: Major depressive disorder (MDD) pathogenesis is associated with immune-inflammatory dysregulation. This study investigated the mechanistic role of caspase-1-mediated inflammatory pathways in MDD, exploring their therapeutic targeting potential and clinical predictive utility. METHODS: Peripheral blood levels of caspase-1, IL-1β, and IL-10 were assessed in MDD patients, with longitudinal analysis of dynamic changes pre-/ post-antidepressant treatment. The predictive performance of the biomarker was validated using leave-one-out cross-validation (LOOCV) and receiver operating characteristic (ROC) analysis. A chronic unpredictable stress (CUS) rat model was established to evaluate the combined therapeutic effects of caspase-1 inhibitors with fluoxetine. RESULTS: Clinical data revealed that expression levels of caspase-1 and IL-1β exhibited an negative correlation with clinical treatment response in patients with MDD, with varying levels observed among patients with differing depression severity. In contrast, IL-10 expression demonstrated a positive correlation with therapeutic efficacy. Following treatment, significant reductions in caspase-1 and IL-1β levels were observed, concurrent with an elevation in IL-10. Caspase-1 demonstrated superior predictive accuracy for treatment response (0.8529 ± 0.3542), yielding an area under the ROC curve (AUC) of 0.72. In animal models, co-administration of a caspase-1 inhibitor with fluoxetine accelerated the onset of antidepressant effects, while simultaneously reducing peripheral blood caspase-1 and IL-1β levels. CONCLUSIONS: The caspase-1/IL-1β axis contributes to MDD pathogenesis by disrupting the pro-inflammatory/anti-inflammatory balance. Its mediated immune response pattern represents a potential therapeutic target for novel antidepressant development. Combined caspase-1 modeling provides a reliable tool for predicting clinical efficacy in MDD, while caspase-1-targeted intervention strategies may overcome the limitation of slow onset of action associated with conventional therapies. </p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12977920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137030","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 predictive potential and relationship of peripheral non-enzymatic antioxidants with clinical symptoms in first-episode male adolescent-onset schizophrenia patients.","authors":"Baolun Du, Jun Ma, Huafeng Chen, Kai Zhang, Zishu Wang, Zhao Zhao, Heguo Li, Xiaobo Meng, Zhihua Liu","doi":"10.1186/s12991-026-00628-7","DOIUrl":"10.1186/s12991-026-00628-7","url":null,"abstract":"<p><strong>Background: </strong>Oxidative stress is associated with the pathophysiology of schizophrenia. Peripheral non-enzymatic antioxidants can reflect the degree of oxidative stress and antioxidant levels, and can be used as markers of oxidative stress. However, the relationships between these markers and the clinical phenotypes of first -episode adolescent-onset schizophrenia (AOS) is unclear. This study aimed to elucidate the impact of peripheral non - enzymatic antioxidants on male AOS patients and their association with clinical symptoms.</p><p><strong>Methods: </strong>Serum albumin (ALB), total bilirubin (TBIL), and uric acid (UA) of 59 first-episode AOS patients and 55 healthy controls were measured respectively. Furthermore, schizophrenia-related clinical symptoms were evaluated using the five-factor model of the Positive and Negative Syndrome Scale (PANSS).</p><p><strong>Results: </strong>In Han Chinese first-episode male AOS patients, levels of TBIL and UA were significantly increased (p < 0.05), while ALB decreased (p < 0.01) compared with healthy controls. Furthermore, multivariate logistic regression showed that UA, ALB, and TBIL (all p < 0.01) were independently associated with AOS. Moreover, correlation analysis revealed that ALB was positively correlated with the PANSS total, cognitive and excited factor scores (all p < 0.05); TBIL was positively correlated with the excited factor score (p < 0.01); UA was positively correlated with the PANSS total, negative, cognitive and excited factor scores (all p < 0.05). In addition, Receiver operating characteristics assessment indicated that ALB and TBIL could effectively distinguish AOS patients from healthy controls.</p><p><strong>Conclusions: </strong>This study confirms the association of peripheral non-enzymatic antioxidants (ALB, TBIL, and UA) with clinical manifestations and pathophysiology in schizophrenia. ALB and TBIL may serve as potential biomarkers for oxidative stress and symptom severity in AOS, particularly in males, providing insights for diagnostic and therapeutic strategies.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12964649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117727","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":"Risk of suicidal acts in patients with dissociative disorder: a population-based cohort study.","authors":"Wai Kwong Tang, Kelvin K F Tsoi, Terry Cheuk Fung Yip, Vivien Wei Jun Liew, Selina Kit Yi Chan","doi":"10.1186/s12991-025-00622-5","DOIUrl":"10.1186/s12991-025-00622-5","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to examine if individuals diagnosed with dissociative disorder (DD) are at a higher risk of suicidal acts compared to individuals without DD.</p><p><strong>Methods: </strong>We conducted a matched cohort study by examining electronic health records of patients admitted to Hong Kong public hospitals between January 1, 1993, through December 31, 2022. The study included 716 patients with DD and a matched comparison cohort of 716 individuals. Participants were tracked until they either received a diagnosis of suicidal acts, died from other causes, or until the end of 2023, whichever happened first. Cox proportional hazards regression models were applied to determine the risk of suicidal acts following DD onset.</p><p><strong>Results: </strong>During the 30-year study period, 87 individuals (12.2%) in the DD cohort and 29 individuals (4.1%) in the comparison cohort exhibited suicidal acts, with the difference being statistically significant (χ² = 25.21, p = 0.0001). The incidence rates of suicidal acts were 86.7 and 27.3 per 10,000 person-years for the DD and comparison cohorts, respectively. After adjustment, the hazard ratio for suicidal acts in the DD cohort compared with the comparison cohort was 1.89 (95% confidence interval, 1.17-3.06).</p><p><strong>Conclusions: </strong>DD is linked to a heightened risk of suicidal acts. Future research is required to replicate these findings and to more comprehensively identify the specific risk factors contributing to suicidal acts in this patient population.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12955262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146111844","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":"Benzodiazepines at the crossroads: navigating therapeutic promise and perils of misuse.","authors":"John W Figg, Caitland A Love, Vasu Sorathia, Mia Engelbart, Ana Turner, Amanda Elton","doi":"10.1186/s12991-025-00627-0","DOIUrl":"10.1186/s12991-025-00627-0","url":null,"abstract":"<p><p>Benzodiazepines (BZDs) are a widely prescribed class of psychoactive drugs known for their rapid anxiolytic, anticonvulsant, and sedative effects. Introduced as safer alternatives to barbiturates, BZDs quickly gained popularity across clinical settings but have since become a subject of public health concern due to rising rates of misuse, dependence, and overdose, particularly when co-administered with opioids. This narrative review explores the historical development, pharmacologic mechanisms, clinical indications, and adverse outcomes associated with BZD use, while highlighting emerging areas of research such as pharmacogenetics (PGx) and genome-wide association studies (GWAS). BZDs act as positive allosteric modulators of the GABA_A receptor, enhancing inhibitory neurotransmission. This mechanism underlies both their therapeutic efficacy and their potential for physiological dependence and misuse. Clinical applications span acute anxiety, insomnia, seizure management, and alcohol withdrawal; however, long-term use carries significant risks including cognitive decline, fall-related injuries, paradoxical excitation, and withdrawal syndromes. Reinforcement and neuroadaptation processes within the mesolimbic dopamine system contribute to BZD addiction, especially with chronic exposure. Regulatory responses include Schedule IV classification under the Controlled Substances Act and FDA black box warnings. Despite declining prescription rates in recent years, misuse, including nonmedical use and use of illicit designer BZDs, remains prevalent, especially among older adults and those with comorbid psychiatric or substance use disorders. Pharmacogenomic studies have identified genetic polymorphisms in hepatic enzymes (e.g., Cyp2c19 and Cyp3a4) and GABA_A receptor subunits (e.g. Gabra2) that may influence BZD metabolism, efficacy, and addiction vulnerability, suggesting potential for personalized medicine approaches. In conclusion, the dual nature of BZDs, as essential tools in acute care and potential contributors to substance use disorders, demands a balanced, evidence-informed approach. Continued research, improved prescriber education, and integration of genetic insights into clinical care may help mitigate harm while preserving therapeutic benefit.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":"5"},"PeriodicalIF":3.6,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12879474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146099500","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":"Shared genetic architecture between schizophrenia and gastrointestinal diseases: insights from large-scale genome-wide cross-trait analysis.","authors":"Yifan Ding, Jiawen Wang, Qinghua Luo, Chenwei Deng, Pan Shen, Zhiqiang Xu, Leichang Zhang","doi":"10.1186/s12991-025-00625-2","DOIUrl":"10.1186/s12991-025-00625-2","url":null,"abstract":"<p><strong>Background: </strong>Patients with schizophrenia (SCZ) frequently present with comorbid gastrointestinal diseases. However, the cross-disorder genetic correlations and shared mechanisms remain largely unknown. This study aims to elucidate the shared genetic architecture between SCZ and five types of gastrointestinal diseases: inflammatory bowel disease, Crohn's disease, ulcerative colitis, constipation, and irritable bowel syndrome. Furthermore, we seek to identify shared genetic risk loci, pinpoint potentially implicated tissues, and conduct in-depth analyses of the genetic mechanisms.</p><p><strong>Methods: </strong>Using summary statistics from large-scale genome-wide association studies (GWAS), we conducted an in-depth analysis of the genetic correlations between schizophrenia (SCZ) and gastrointestinal diseases via linkage disequilibrium score regression (LDSC) and high-definition likelihood (HDL) methods. Significant genetic correlations were observed between SCZ and gastrointestinal diseases. To further investigate the shared genetic basis, we performed cross-trait pleiotropy analyses to identify common pleiotropic loci and genes. Additionally, to uncover potential links between these complex traits, we conducted comprehensive functional annotation and tissue-specific enrichment analyses. Heritability enrichment analysis was employed to assess the contributions of key tissues. Finally, immune colocalization approaches were utilized to explore immune-mediated relationships between SCZ and gastrointestinal diseases.</p><p><strong>Results: </strong>Our research highlighted shared genetic mechanisms between SCZ and five gastrointestinal diseases. A total of 2,367 novel SNPs were identified at a genome-wide significance level (P < 5 × 10⁻⁸), and annotation revealed 96 pleiotropic genome-wide risk loci, among which 32 passed causal colocalization analysis. Shared loci were identified at regions 1q32.1, 2q33.1, 3p21.31, 10q21.2, 16p11.2, and 18q21.2. Further gene-level analyses identified pleiotropic genes including C1orf106, SLC26A6, FES, BSN, C3orf62 and CELSR3. Pathway analyses revealed critical roles of FOXP3 target genes, lymphocyte activation, T cell activation, and PDZ domain-related pathways in these diseases. Finally, phenotype-level immune colocalization analysis uncovered immunological mediators including PD-L1, CD3, T cells, and CD28 that bridge SCZ and gastrointestinal diseases.</p><p><strong>Conclusion: </strong>Our findings support a shared genetic architecture between SCZ and gastrointestinal diseases and shed light on the potential mechanism that might involve in.These findings hold important implications for coordinated interventions targeting SCZ and its comorbid conditions.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":"25 1","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12954898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147347239","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":"Perceived social support in mental disorder: insights from the SSQ-6 and its associations with sociodemographic characteristics, clinical features, and admission patterns in a tertiary psychiatric care unit.","authors":"Maria T Dalliou, Christos Hadjichristodoulou, Ioannis Stefanidis, Konstantinos S Bonotis","doi":"10.1186/s12991-026-00633-w","DOIUrl":"10.1186/s12991-026-00633-w","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate perceived social support (SS) in inpatients with mental disorders, its association with sociodemographic and clinical characteristics, and its impact on hospitalization patterns, highlighting the importance of evaluating and enhancing SS.</p><p><strong>Methods: </strong>This hospital-based study, using a cross-sectional design, was conducted at the Psychiatric Clinic of University Hospital Larissa, Greece and included 280 consecutive admitted patients. SS was assessed with short form social support questionnaire SSQ-6, and sociodemographic and clinical characteristics were examined along with possibility of reentry during a 32-month period.</p><p><strong>Results: </strong>Most respondents reported low SS levels, with significant differences in SS quantity across diagnostic categories. Sociodemographic factors, including age, work status, housing conditions, medical insurance and the number of cohabitants, were significantly associated with both SS quantity and satisfaction. Clinical factors, including diagnosis, illness duration and prior admissions also showed significant associations with both dimensions of SS. Multivariate analysis identified increasing age, urbanicity, homelessness, retirement, and unemployment as independent risk factors for lower SS quantity, while cohabitation and affective disorder diagnoses were protective factors. Regarding SS satisfaction, homelessness, retirement, and prolonged illness duration, emerged as risk factors, while medical adherence was protective. Notably, SS quantity was marginally negatively associated with involuntary type of admission. Low SS significantly increased the likelihood of readmission during the 32- month follow-up period.</p><p><strong>Conclusions: </strong>The study highlights the critical role of assessing and enhancing SS in hospitalized patients with mental disorders. Sociodemographic and clinical factors significantly influence SS, with poor SS contributing to a higher risk of involuntary admission and increased readmission likelihood.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":"12"},"PeriodicalIF":5.8,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12911178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146043635","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 prefrontal-striatal signatures of reduced model-based learning in depressed patients.","authors":"Xiaoxia Wang, Xiaoyan Zhou, Dong Zhang, Zongzhang Zhang, YuShun Gong, Zhengzhi Feng, Jing Ming Hou","doi":"10.1186/s12991-026-00630-z","DOIUrl":"10.1186/s12991-026-00630-z","url":null,"abstract":"<p><p>BACKGROUND: Anhedonia is the core symptom of major depressive disorder (MDD). Accumulating evidence indicates that an imbalance between model-based (MB) and model-free (MF) reinforcement learning (RL) characterizes MDD, but the underlying neural substrates remain unclear. We examined whether alterations in MB and MF reward prediction error (RPE) neural signature underlie deficits in RL in depressed patients. METHODS: We used a two-stage Markov decision task (MDT) in combination with computational modeling to examine model-based and model-free learning. A total of 49 MDD and 41 matched HC individuals performed the MDT. 19 MDD and 21 HC individuals underwent functional neuroimaging during the MDT. The stress-RL deficits model was tested using a mediation model with MB and MF RL as mediators between stress and depressive/anhedonic symptoms. RESULTS: Depressed patients showed RL deficits, with less reliance on MB strategies and more reliance on MF strategies. MB and MF RL deficits mediated the relationship between stress and anhedonic symptoms, with specific striatal signatures (i.e., RPEMF signals in VTA and caudate) mediating stress and anhedonia symptoms across MDD and HC groups. CONCLUSIONS: This study showed deficits in model-based RL for depressed patients, with underlying neural deficits in prefrontal-striatal RPE signals, which would be promising for improving therapeutic practice in depression. </p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":"11"},"PeriodicalIF":5.8,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12908330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146028147","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}