Asian journal of psychiatry最新文献

{"title":"Treatment gap and care characteristics for mental disorders among older adults in India: Evidence from National Mental Health Survey 2015–16","authors":"Tazkia Zainab ,&nbsp;Nikhil Kumar Mishra ,&nbsp;Divya Bharti ,&nbsp;Girish Nagaraja Rao","doi":"10.1016/j.ajp.2025.104723","DOIUrl":"10.1016/j.ajp.2025.104723","url":null,"abstract":"<div><h3>Background</h3><div>Mental health issues among older adults in India remain under-recognized. This study assessed the treatment gap and care characteristics for mental disorders and determined the association between psychiatric morbidity and select socio-demographic factors among older adults (≥ 60 years) in India, using the National Mental Health Survey (2015–2016) dataset.</div></div><div><h3>Methods</h3><div>Secondary data analysis was conducted on 5590 older adults from the NMHS dataset to assess the treatment gap and care characteristics. Descriptive statistics summarized treatment patterns mental disorders. Multivariate regression identified factors associated with current and lifetime psychiatric morbidity (Adjusted odds ratio [AOR], 95 % Confidence interval [CI]).</div></div><div><h3>Results</h3><div>Among older adults with any mental disorder, the overall treatment gap was 84 %, ranging from 76.9 % for neurotic and stress-related disorders to 90.9 % for severe mental disorders. The median duration of illness was 24 months, with delays of 1.5–8 months between symptom onset and first consultation. The treatment gap for any mental disorder is higher among males (85.5 %) compared to females (83.6 %). Multivariate analysis showed that urban metro residence (AOR: 1.510, 95 % CI: 1.223–1.863), male gender (AOR: 1.512, 95 % CI: 1.116–1.569), age 70 years and above (AOR: 1.148, 95 % CI: 0.949–1.389), and lower household income (AOR: 1.739, 95 % CI: 1.384–2.185) were significantly associated with psychiatric morbidity, while higher education was protective.</div></div><div><h3>Conclusion</h3><div>Substantial treatment gaps and sociodemographic disparities highlight the need for tailored, accessible, and age-friendly mental health interventions for older adults in India.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"113 ","pages":"Article 104723"},"PeriodicalIF":4.5,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus statements on perinatal depression and anxiety in the Asia-Pacific region","authors":"Phaik Ling Quah ,&nbsp;Anne Buist ,&nbsp;Prabha S Chandra ,&nbsp;Helen Chen ,&nbsp;Tze-Ern Chua ,&nbsp;Pui-wah Hui ,&nbsp;Milind Shah ,&nbsp;Endang Retno Surjaningrum ,&nbsp;Ganeshan Muniswaran ,&nbsp;Sachith Mettananda ,&nbsp;Dittakarn Boriboonhirunsarn ,&nbsp;Kok Hian Tan ,&nbsp;Asia–Pacific Perinatal Mental Health Guidelines on Depression and Anxiety Committee","doi":"10.1016/j.ajp.2025.104720","DOIUrl":"10.1016/j.ajp.2025.104720","url":null,"abstract":"<div><h3>Background</h3><div>The perinatal period, from conception to one year postpartum, is a time of major physical and emotional change, with heightened risk for mental health disorders such as anxiety and depression—particularly in the Asia-Pacific region. Poor maternal mental health during this phase can lead to obstetric complications and adversely affect child development and neurodevelopment.</div></div><div><h3>Method</h3><div>Representatives from 11 Asia–Pacific nations and/or jurisdictions developed a consensus statement on the perinatal mental health guidelines on depression and anxiety using the GRADE-ADOLOPMENT framework.</div></div><div><h3>Findings</h3><div>These guidelines support all women of childbearing age, including those with special circumstances—such as severe obstetric complications, adolescent pregnancies, or special needs—and their infants. Recommendations included special considerations for women who experienced severe maternal complications, personalized care for adolescents and women with unique needs, and attention to the mental health needs of infants. They focus on promoting optimal mental health for women experiencing depression and anxiety during the preconception, antenatal, and postnatal periods.</div></div><div><h3>Interpretation</h3><div>These guidelines, developed for maternal and child health practitioners in the Asia-Pacific, promote a holistic approach—combining lifestyle changes, early screening, and tailored interventions—to improve perinatal mental health and enhance outcomes for mothers and children.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"113 ","pages":"Article 104720"},"PeriodicalIF":4.5,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding hwa-byung across cultures: A survey of foreign residents' perspectives on culture-bound syndrome in Korea","authors":"Chan-Young Kwon","doi":"10.1016/j.ajp.2025.104719","DOIUrl":"10.1016/j.ajp.2025.104719","url":null,"abstract":"","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"113 ","pages":"Article 104719"},"PeriodicalIF":4.5,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145262981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What triggers suicidal ideation in daily life? A real-time study among young people with mood disorders at risk of suicide","authors":"Jiaxin Zhu ,&nbsp;Xiaofei Hou ,&nbsp;Haojuan Tao ,&nbsp;Kangguang Lin ,&nbsp;Liang Zhou ,&nbsp;Lu Niu","doi":"10.1016/j.ajp.2025.104718","DOIUrl":"10.1016/j.ajp.2025.104718","url":null,"abstract":"<div><div>Suicidal ideation (SI) is a dynamic phenomenon influenced by environmental, interpersonal, and emotional factors. However, its short-term predictors in daily life remain poorly understood. This study aimed to identify factors associated with SI in daily life among young people with mood disorders at risk of suicide, using ecological momentary assessment (EMA) to capture contextual data in real time. Over 14 days, 112 young people (75 % female, aged 12–24) who were diagnosed with mood disorders completed EMA surveys three times daily. Multilevel logistic regression models assessed concurrent, time-lagged, and adjusted associations between SI and environmental, interpersonal, and emotional factors. SI was most reported when participants were at home (61.0 %) or not alone (56.3 %). Key factors associated with increased SI risk included being with family (vs. alone) (OR = 1.54, 95 %CI: 1.01–2.34), experiencing family-related life events, such as conflicts (OR = 3.13, 95 %CI: 1.10–8.90). Other emotional factors linked to SI included perceived burdensomeness (OR = 1.37, 95 %CI: 1.14–1.64), thwarted belongingness (OR = 1.29, 95 %CI: 1.10–1.53), and sadness (OR = 1.93, 95 %CI: 1.56–2.40). In contrast, happiness was associated with a lower risk of SI (OR = 0.71, 95 %CI: 0.57–0.89). Sadness also predicted subsequent SI (OR = 1.54, 95 %CI: 1.26–1.90) and was a significant predictor of changes in SI, even after accounting for prior SI (OR = 1.32, 95 %CI: 1.06–1.65). These findings underscore the importance of real-time emotional and interpersonal contexts, particularly family conflict and negative affect, in the emergence and persistence of SI in daily life.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"113 ","pages":"Article 104718"},"PeriodicalIF":4.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postgraduate psychiatry training in the Middle East: Challenges and regional solutions","authors":"Salim AL-Huseini ,&nbsp;S.M. Yasir Arafat ,&nbsp;Nagina Khan","doi":"10.1016/j.ajp.2025.104717","DOIUrl":"10.1016/j.ajp.2025.104717","url":null,"abstract":"<div><div>This paper presents a comparative overview of postgraduate psychiatry training programs across the Middle East. Drawing on national training frameworks and peer-reviewed literature, it highlights the diversity in educational models, including curricula, training methods, assessment methods, accreditation processes, training durations, and subspecialty pathways in the region. Common challenges such as workforce shortages, curriculum variability and disruptions caused by conflict are examined alongside regional efforts toward harmonization and quality improvement. By identifying both innovative practices and persistent gaps, this review contributes to global mental health education and offers targeted, evidence-based recommendations to enhance psychiatry training in the region.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"113 ","pages":"Article 104717"},"PeriodicalIF":4.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145262983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wellbeing ambassadors: A peer-led initiative to support students in higher education","authors":"Nurul Hidayati Rofiah ,&nbsp;Goji Toshiro,&nbsp;Norimune Kawai","doi":"10.1016/j.ajp.2025.104708","DOIUrl":"10.1016/j.ajp.2025.104708","url":null,"abstract":"","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"113 ","pages":"Article 104708"},"PeriodicalIF":4.5,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145249431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aberrant voxel-mirrored homotopic connectivity in subcortical regions and associated transcriptional signatures in major depressive disorder with suicidal ideation","authors":"Miao Zhang ,&nbsp;Maoxing Zhong ,&nbsp;Zhening Liu ,&nbsp;Yiju Wang ,&nbsp;Feiwen Wang ,&nbsp;Jun Yang ,&nbsp;Lifu Tan ,&nbsp;the DIRECT Consortium ,&nbsp;Jie Yang","doi":"10.1016/j.ajp.2025.104709","DOIUrl":"10.1016/j.ajp.2025.104709","url":null,"abstract":"<div><h3>Background</h3><div>Suicidal ideation (SI) is one of the most high-risk clinical symptoms in patients with major depressive disorder (MDD). Despite extensive research efforts, a reliable biomarker for assessing SI remains lacking, limiting early detection and intervention efforts.</div></div><div><h3>Method</h3><div>This study included 62 MDD patients with SI (MDD-SI), 66 MDD patients without SI (MDD-NSI), and 134 healthy controls. We aimed to investigate group differences in voxel-mirrored homotopic connectivity (VMHC) and further explore its associations with the severity of SI. We further utilized the REST-meta-MDD consortium dataset (N = 2380; 24 sites) to validate our main findings. Imaging transcriptomic and enrichment analysis was conducted to explore gene expression characteristics associated with the brain regions exhibiting VMHC differences between MDD-SI and MDD-NSI.</div></div><div><h3>Results</h3><div>Compared to MDD-NSI, MDD-SI exhibited increased VMHC in the bilateral thalamus and parahippocampal gyrus (PHG), with VMHC values in these regions positively correlated with HAMD-suicidality item scores. These differences and associations were further validated in the REST-meta-MDD consortium dataset. Imaging transcriptomic and enrichment analyses revealed that genes associated with these regions were primarily enriched in immune- and inflammation-related terms.</div></div><div><h3>Conclusion</h3><div>Abnormal subcortical VMHC patterns in MDD-SI, closely associated with SI severity and validated across two independent datasets, may be associated with genes enriched for immune and inflammatory processes. These findings provide novel insights into the neurobiology of MDD-SI and underscore VMHC alterations as a reliable biomarker for early detection and intervention.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"113 ","pages":"Article 104709"},"PeriodicalIF":4.5,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145217946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can AI replace clinician-rated depression scales? The psychometric properties of HAMLET – Hamilton Large-Language-Model Evaluation Tool","authors":"Wen Xin ,&nbsp;Huailiang Yi ,&nbsp;Jiaqi Song ,&nbsp;Zhanxiao Tian ,&nbsp;Haitao Chen ,&nbsp;Shuping Tan","doi":"10.1016/j.ajp.2025.104707","DOIUrl":"10.1016/j.ajp.2025.104707","url":null,"abstract":"<div><h3>Background</h3><div>The Hamilton Depression Rating Scale (HAMD) is the gold standard for assessing depression but requires clinician administration, limiting its accessibility. Large language models (LLMs) offer potential for automated, valid assessments. We developed HAMLET (Hamilton Large-language-model Evaluation Tool), an interactive LLM-based tool designed to replicate the HAMD-17, and compared its results with those obtained by a psychiatrist.</div></div><div><h3>Methods</h3><div>HAMLET utilizes Qwen-Max in the temperature of 0.7 and a top-p value of 0.6, guided by structured prompts engineered via clinician-supervised tuning. 60 patients with Major Depressive Disorder completed: (1) HAMLET, (2) clinician-rated HAMD-17, and (3) PHQ-9. Agreement was assessed using Intraclass Correlation Coefficient (ICC), Bland-Altman plots, and Gwet’s AC2. Correlations with HAMD and incremental validity beyond the PHQ-9 were evaluated.</div></div><div><h3>Results</h3><div>HAMLET demonstrated strong overall agreement with clinician-rated HAMD scores (ICC=0.911; 95 % CI: 0.855–0.946). It outperformed the PHQ-9 in correlating with HAMD scores (r = 0.92 vs 0.79; Steiger’s Z = 3.798, p &lt; 0.001) and demonstrated incremental validity (ΔR²=0.252). Item-level agreement (Gwet’s AC2) was &gt; 0.60 for all items, though was lower for sensitive questions.</div></div><div><h3>Conclusion</h3><div>HAMLET is the first LLM framework to autonomously conduct HAMD-17 assessments demonstrating substantial agreement with clinician ratings. It combines the rigor of clinician-rated scales with the accessibility of self-report tools. This demonstrates the feasibility of LLMs for scalable, low-cost psychiatric assessment. Future work should address contextual limitations and explore multimodal integration.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"113 ","pages":"Article 104707"},"PeriodicalIF":4.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145262982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rapid bedside inventory for post-electroconvulsive therapy cognition: Derivation and validation of the electroconvulsive therapy–cognition inventory (ECT-CI)","authors":"Qinghua Guo ,&nbsp;Yong Wang ,&nbsp;Libo Guo ,&nbsp;Xiaoxiao He ,&nbsp;Chengcheng Pu ,&nbsp;Xiao Zhang ,&nbsp;Haifeng Zhang ,&nbsp;Baoyu Chen ,&nbsp;Chuan Shi ,&nbsp;Shaomei Shang","doi":"10.1016/j.ajp.2025.104706","DOIUrl":"10.1016/j.ajp.2025.104706","url":null,"abstract":"<div><h3>Background</h3><div>Electroconvulsive therapy (ECT) is effective for treatment-resistant major depressive disorder (MDD), but peri-treatment cognitive effects require rapid, accurate bedside assessment. We developed and prospectively validated the Electroconvulsive Therapy–Cognition Inventory (ECT-CI).</div></div><div><h3>Methods</h3><div>Single-centre, prospective, assessor-masked diagnostic-accuracy/psychometric study including adults with MDD initiating first-course ECT (n = 54; assessed ≤48 h pre-ECT and 7–10 days post-ECT) and age-matched healthy controls (n = 54, single assessment). The reference standard was a DSM-5-TR–anchored, blinded clinical determination of clinically significant cognitive impairment (yes/no) rendered independently by two psychiatrists, who were masked to index-test results.Index tests were ECT-CI (primary) and MoCA (comparator). The primary endpoint was post-ECT ROC AUC; secondary endpoints included pre–post responsiveness, administration time, and inter-rater agreement (Lin’s CCC). Prospectively registered (ChiCTR2400094414).</div></div><div><h3>Findings</h3><div>Among 108 participants, ECT-CI declined from 24.99 to 20.07 after ECT (mean change 4.92; 95 % CI 4.17–5.67), whereas MoCA showed no change. Post-ECT discrimination favoured ECT-CI over MoCA (AUC 0.972 [95 % CI 0.928–1.000] vs 0.852 [0.751–0.953]). The operational ECT-CI cut-off (≤21) yielded sensitivity 0.970 and specificity 0.905; MoCA’s optimal cut-off (25.5) yielded sensitivity 0.909 and specificity 0.667. ECT-CI required 5.9 ± 2.1 min versus 10.7 ± 3.9 min for MoCA. Inter-rater reliability for ECT-CI was high (Lin’s CCC 0.922; 95 % CI 0.810–0.969).</div></div><div><h3>Interpretation</h3><div>ECT-CI outperformed MoCA for detecting clinically defined post-ECT cognitive impairment, was more responsive to short-term change, and was briefer to administer. An operational threshold of ≤ 21 supports pragmatic bedside use; external multicentre validation is warranted.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"113 ","pages":"Article 104706"},"PeriodicalIF":4.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role-play-based hug-robot-mediated communication in promoting friendship among individuals with autism spectrum disorders","authors":"Hirokazu Kumazaki ,&nbsp;Yuya Ohnishi ,&nbsp;Hidenobu Sumioka ,&nbsp;Masahiro Shiomi","doi":"10.1016/j.ajp.2025.104704","DOIUrl":"10.1016/j.ajp.2025.104704","url":null,"abstract":"<div><div>Individuals with autism spectrum disorder (ASD) often experience challenges in building friendships across the lifespan. To address the limitations of existing hug-based interventions, we developed Moffuly-MS, a tele-operated interactive hugging robot. In this study, participants were paired and alternated roles using Moffuly-MS; one person operated the robot to deliver a hug, while the other received it, and they took turns playing both roles. This study aimed to evaluate whether bidirectional haptic interaction via Moffuly-MS could improve mutual understanding and promote a sense of oneness. Twenty-four individuals (20 males and four females) participated over 6 consecutive days. In the with-hug condition, post-intervention scores significantly improved from baseline in both knowledge of partner (<em>t</em> (22) = 3.873, <em>p</em> = .005, <em>r</em> = .64) and sense of oneness (<em>t</em> (22) = 3.182, <em>p</em> = .013, <em>r</em> = .57). A Wilcoxon signed-rank test revealed that perceived relaxation in the hug condition was significantly higher than that in the without-hug condition (<em>z</em> = 2.377, <em>p</em> = 0.017, <em>r</em> = 0.49). The results indicated that participants demonstrated enhanced knowledge of their partner and a greater sense of oneness following the intervention. These findings suggest that our approach may promote social connectedness in individuals with ASD. Future research with larger, more diverse samples and longitudinal designs is needed to confirm and expand upon these results.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"112 ","pages":"Article 104704"},"PeriodicalIF":4.5,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}