Asian journal of psychiatry最新文献

{"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}

{"title":"Validation of the Russian version of the Adult Rejection Sensitivity Questionnaire (A-RSQ): Factor structure and associations with psychological constructs","authors":"E. Iurina ,&nbsp;V. Kosonogov","doi":"10.1016/j.ajp.2025.104703","DOIUrl":"10.1016/j.ajp.2025.104703","url":null,"abstract":"<div><div>This study aimed to translate and validate the Russian version of the Adult Rejection Sensitivity Questionnaire (A-RSQ). A total of 407 Russian-speaking adults (53.3 % men; aged 18–74, M = 40.89, SD = 11.03) completed the A-RSQ and a battery of psychological scales, including the Depression Anxiety Stress Scales-21, Brief Fear of Negative Evaluation, Hikikomori Questionnaire-25, Existential Isolation Scale, and Emotional Dysregulation Scale. For factor-structure validation, the sample was randomly split into EFA (n = 213) and CFA (n = 194). Exploratory factor analysis supported a two-factor model (Rejection Concern and Rejection Expectancy), both subscales showing good internal consistency (α ≥.83). Confirmatory factor analysis (WLSMV; ordered-categorical items) showed acceptable incremental fit with elevated RMSEA (CFI =.960, TLI =.954, RMSEA =.095, SRMR =.073) and a negative latent correlation between factors (r = −.44). Test–retest reliability over a four-week interval was acceptable (r = .79). Correlations with external constructs supported convergent validity, revealing distinct associations between A-RSQ components and depression, anxiety, social withdrawal, and interpersonal sensitivity. Exploratory analyses by sex and age revealed that men scored higher on the total A-RSQ and the Rejection Expectancy subscale, while Rejection Expectancy also showed a small age-related decrease.</div><div>These findings support the use of the Russian A-RSQ as a psychometrically valid instrument for assessing rejection sensitivity and its associations with emotional and interpersonal maladjustment.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"112 ","pages":"Article 104703"},"PeriodicalIF":4.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091103","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":"Letter to editor: Advancing neuropsychiatric research via secure large-scale data sharing","authors":"Muhammad Liaquat Raza","doi":"10.1016/j.ajp.2025.104705","DOIUrl":"10.1016/j.ajp.2025.104705","url":null,"abstract":"","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"113 ","pages":"Article 104705"},"PeriodicalIF":4.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079600","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":"Development of a multicomponent lifestyle modification intervention package (LMIP) for persons with schizophrenia in India","authors":"Jothimani Gurusamy ,&nbsp;Sailaxmi Gandhi ,&nbsp;Dinakaran Damodharan ,&nbsp;Marimuthu Palaniappan ,&nbsp;Venkatasubramanian Ganesan","doi":"10.1016/j.ajp.2025.104701","DOIUrl":"10.1016/j.ajp.2025.104701","url":null,"abstract":"<div><h3>Background</h3><div>Providing patients with individualized lifestyle intervention is essential, especially for persons with schizophrenia (PwS), to reduce co-morbid physical health problems. The aim of the study is to develop a multicomponent, individually tailored lifestyle modification intervention package (LMIP) for PwS in a tertiary level mental health center, India.</div></div><div><h3>Methods</h3><div>The lifestyle intervention package was developed in 7 stages. The stages included: defining the purpose and reviewing the literature for identifying specific interventions for the Asian population, expert consultation, preparation of an intervention package draft, and validation by experts from various disciplines. Expansion of the intervention package was based on the existing theories from the chronic care model and pilot tested for the feasibility and practicability of the intervention. Revisions were made based on the pilot study and experts’ suggestions, and finalization of the intervention package.</div></div><div><h3>Results</h3><div>The final lifestyle intervention package consisted of psychoeducation, criteria for metabolic syndrome, WHO classification for obesity, dietary modification includes healthy eating behaviours, dietary choices for metabolic syndrome, exercise guidelines and appropriate physical exercises for metabolic syndrome. Further, the intervention package was refined and finalized based on pilot testing in 5 subjects with their caregivers.</div></div><div><h3>Conclusion</h3><div>The LMIP was designed to be delivered by a mental health professional through comprehensive 40–45 min sessions, integrated into both inpatient care and routine follow up visits. This package employed a robust strategy aimed at achieving possible widest impact on the physical well-being of persons with schizophrenia, particularly by addressing modifiable lifestyle risk factors contributing to metabolic syndrome.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"112 ","pages":"Article 104701"},"PeriodicalIF":4.5,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145084989","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":"U.S. funding cuts and the future of disaster mental health in the Asia Pacific","authors":"Zui C. Narita ,&nbsp;Revathi N. Krishna ,&nbsp;Michael Wright ,&nbsp;Jaya A.R. Dantas ,&nbsp;Elizabeth A. Newnham","doi":"10.1016/j.ajp.2025.104702","DOIUrl":"10.1016/j.ajp.2025.104702","url":null,"abstract":"","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"112 ","pages":"Article 104702"},"PeriodicalIF":4.5,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079580","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":"Increased plasma TRANK1 levels in first-episode drug-naïve schizophrenia: Association with delayed memory decline","authors":"Xu Yuan Yin ,&nbsp;Yi Ming Wu ,&nbsp;Qing Yang ,&nbsp;Zhen Hua Zhu,&nbsp;Wen Long Hou,&nbsp;Ming Wang,&nbsp;Jie Lv,&nbsp;Xin Yu,&nbsp;Huiping Zhang,&nbsp;Li Hui","doi":"10.1016/j.ajp.2025.104700","DOIUrl":"10.1016/j.ajp.2025.104700","url":null,"abstract":"","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"113 ","pages":"Article 104700"},"PeriodicalIF":4.5,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091192","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":"Mental hospitals in Pakistan: A historic perspective","authors":"Afzal Javed ,&nbsp;Maryam Afzal ,&nbsp;Nasar Sayeed Khan","doi":"10.1016/j.ajp.2025.104699","DOIUrl":"10.1016/j.ajp.2025.104699","url":null,"abstract":"<div><div>Although mental illnesses &amp; their treatment have been described from ancient times in the Indian subcontinent, establishment of proper &amp; formal institutions for the treatment of mentally ill has generally been attributed to the British rule. During their period, psychiatric services were started in the mental hospitals established by the East India Company. Post colonial period continued with expansion of such services both in India &amp; Pakistan. At the time of independence in 1947, there were three mental hospitals in Pakistan situated in Lahore, Hyderabad and Peshawar &amp; and a psychiatric unit at the Military Hospital in Rawalpindi. A fourth mental hospital was added to the list in the 1960s. A parallel movement was taking place with general hospital psychiatry and with an increased number of trained psychiatrists; at present almost all teaching hospitals in the country have psychiatric units This paper describes history of establishment of mental hospitals in Pakistan and their role in shaping mental health services in the country.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"112 ","pages":"Article 104699"},"PeriodicalIF":4.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079577","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":"Unmasking a reversible cause of childhood psychosis and catatonia: Cobalamin C deficiency","authors":"Ankita Garg,&nbsp;Deepak Gupta,&nbsp;Sunita Bijarnia-Mahay,&nbsp;Praveen Kumar,&nbsp;Nabanita Sengupta","doi":"10.1016/j.ajp.2025.104697","DOIUrl":"10.1016/j.ajp.2025.104697","url":null,"abstract":"","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"113 ","pages":"Article 104697"},"PeriodicalIF":4.5,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145061493","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}