BMC PsychiatryPub Date : 2025-09-29DOI: 10.1186/s12888-025-07322-0
Zhongyi Jiang, Ke Xu, Xing Gao, Yin Cao, Yihan Zhang, Guanzhong Dong, Yun Chen, Xuanyan Zhu, Qiaoyang Zhang, Ran Bi, Ke Wang
{"title":"DNet: a depression recognition network combining residual network and vision transformer.","authors":"Zhongyi Jiang, Ke Xu, Xing Gao, Yin Cao, Yihan Zhang, Guanzhong Dong, Yun Chen, Xuanyan Zhu, Qiaoyang Zhang, Ran Bi, Ke Wang","doi":"10.1186/s12888-025-07322-0","DOIUrl":"10.1186/s12888-025-07322-0","url":null,"abstract":"<p><p>Depression is a prevalent and severe global mental disorder, yet its diagnosis and treatment encounter numerous challenges. This study introduces an efficient depression identification network, termed DNet. Our approach utilizes facial images and local facial images as crucial sources of data. Although people with depression may exhibit similar general facial expressions, subtle changes in specific facial areas (e.g., eyes, mouth) can be observed as the severity of depression increases. These changes are reflected in the models' attention mechanisms, highlighting the differences between severity levels. To achieve higher recognition accuracy, a method is required to fuse advanced semantic features between local and global features. Therefore, we propose DNet, comprising two key components: the Feature Extraction Module (FEM) and the Vision Transformer (ViT) Block. Specifically, FEM introduces an attention mechanism that considers both channel and positional information of the feature Map. Two FEMs are employed to separately process facial and local facial images, extracting critical features to generate highly semantic information-rich feature Maps. Subsequently, the feature maps of both images are concatenated along the channel dimension, Using FPN feature fusion, and the ViT Block is utilized to comprehensively learn advanced semantic features of local and global information related to different facial expression regions. Finally, a 1× 1 convolution layer and a fully connected layer are applied to adjust feature channels, yielding more robust predictive results and ultimately outputting depression prediction scores.We experimentally validate the DNet network on the AVEC2014 dataset and our self-constructed CZ2023 dataset, obtaining results of MAE = 6.09, RMSE = 7.85, and MAE = 6.73, RMSE = 8.47, respectively. These results affirm the effectiveness of the proposed method.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"880"},"PeriodicalIF":3.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The provision of cognitive behavioral therapy in Japan: an analysis using insurance claims data.","authors":"Keiichiro Mukai, Yukihiko Hosoi, Kyosuke Yamanishi, Masahiko Sakurai, Shun Ogino, Kazuhisa Hayashida, Hisato Matsunaga","doi":"10.1186/s12888-025-07316-y","DOIUrl":"10.1186/s12888-025-07316-y","url":null,"abstract":"<p><strong>Background: </strong>Cognitive behavioral therapy (CBT) is a first-line treatment for many mental health conditions. In Japan, patients can receive health insurance coverage for CBT treatment of major depressive disorder (MDD), social anxiety disorder (SAD), panic disorder (PD), obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and bulimia nervosa; however, utilization of CBT remains insufficient. This study aimed to examine the status of CBT provision for these disorders using Japanese health insurance claims data.</p><p><strong>Methods: </strong>Data for April 2015-March 2022 from the Detroit Employment Solutions Corporation (DeSC) database were analyzed. The dataset included \"Kempo\" (salaried workers' insurance; large companies) and \"Kokuho\" (national health insurance; self-employed and their dependents) insurance, representing 2.8% and 12% of each insured population, respectively. Patients diagnosed with the above mental health conditions were identified, and their demographic characteristics, CBT session frequencies, session intervals, and psychotropic prescription status were evaluated.</p><p><strong>Results: </strong>Overall, 0.50% of Kempo and 0.24% of Kokuho clients diagnosed with the relevant mental health conditions claimed insurance for CBT. Among Kempo clients, CBT was claimed by 322 (89.2%) with MDD, 8 (2.2%) with SAD, 13 (3.6%) with PD, 11 (3.1%) with OCD, 5 (1.4%) with PTSD, and 2 (0.5%) with unspecified conditions. Among Kokuho clients, CBT was claimed by 1037 (92.0%) with MDD, 11 (1.0%) with SAD, 23 (2.0%) with PD, 25 (2.2%) with OCD, 13 (1.2%) with PTSD, and 18 (1.6%) with unspecified conditions. Average intervals between MDD sessions were 34.2 days under Kempo and 71.9 days under Kokuho.</p><p><strong>Conclusions: </strong>Few patients claimed insurance for CBT, and most session intervals exceeded 1 month. The findings highlight substantial unmet medical needs in CBT provision in Japan. Medical environments that support and integrate regular CBT must be established.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"878"},"PeriodicalIF":3.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BMC PsychiatryPub Date : 2025-09-29DOI: 10.1186/s12888-025-07357-3
John Todd-Kvam, Berit Johnsen, Catherine Appleton, Marianne Riksheim Stavseth, Hilde Dahl, Anne Bukten
{"title":"Prevalence and patterns of mental health disorders in long-term preventive detention: a 13-year national cohort study.","authors":"John Todd-Kvam, Berit Johnsen, Catherine Appleton, Marianne Riksheim Stavseth, Hilde Dahl, Anne Bukten","doi":"10.1186/s12888-025-07357-3","DOIUrl":"10.1186/s12888-025-07357-3","url":null,"abstract":"<p><strong>Background: </strong>Research consistently demonstrates significantly higher rates of mental health disorders among incarcerated individuals compared to the general population. This paper examines the prevalence of mental health disorders among all individuals serving preventive detention in Norway between 2009 and 2022, and compares the prevalence of mental health disorders in this group with a comparison group of individuals convicted of serious violent and sexual offences, and with the total prison population.</p><p><strong>Methods: </strong>We conducted a registry-based study to investigate the prevalence of psychiatric morbidity within this population in Norwegian prisons, using a subset of the data from the nPRIS-cohort including all people imprisoned in Norway between January 1st, 2000, and December 31st, 2022 (n = 112,877). The cohort, including 202 individuals serving preventive detention in the period 2009-2022, were linked to the Norwegian Patient Registry (NPR) and socio-economic data from Statistics Norway.</p><p><strong>Results: </strong>The prevalence of mental health disorders was high across all three comparison groups. However, of the preventive detention population (n = 202) almost all (95.0%) had at least one mental health diagnosis during the study period. In addition, 73.8% of the preventive detention population had received a severe mental health disorder diagnosis during the observation period (compared to 23.7% for the comparison group and 28.3% for the total prison population). Approximately one third of the preventive detention population had a combination of three or more of the five most common diagnoses.</p><p><strong>Conclusion: </strong>The preventive detention population in Norway is clearly a group with significant mental health treatment needs - even when compared to a prison population that is itself showing increasing prevalence of mental health disorders, indicating that they represent a particularly vulnerable population within the prison system.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"879"},"PeriodicalIF":3.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BMC PsychiatryPub Date : 2025-09-26DOI: 10.1186/s12888-025-07359-1
Xiaojie Wei, Wenqian Jian, Mengting Wang, Hong Pan, Jiayi Tang, Liujun Wu, Xudong Yang, Lutong Wen, Li Chen, Yanlong Liu
{"title":"Prevalence, associated factors, and nomogram model of suicidality among incarcerated individuals: a developmental adaptation perspective for targeted prevention strategies.","authors":"Xiaojie Wei, Wenqian Jian, Mengting Wang, Hong Pan, Jiayi Tang, Liujun Wu, Xudong Yang, Lutong Wen, Li Chen, Yanlong Liu","doi":"10.1186/s12888-025-07359-1","DOIUrl":"10.1186/s12888-025-07359-1","url":null,"abstract":"<p><strong>Background: </strong>Suicide remains one of the primary causes of death in people in prison, highlighting the urgent need for effective prevention strategies. This study investigated the prevalence and characteristics of suicidality (suicidal ideation, suicidal planning and suicidal attempts) among incarcerated individuals and examined both distal and proximal associated factors using the developmental adaptation framework. Additionally, three predictive models were constructed to assess suicide risk within this population.</p><p><strong>Methods: </strong>A total of 1,700 incarcerated individuals participated in the study, providing data through self-report questionnaires covering demographic variables, distal influences (e.g., childhood adversity, family history), and proximal indicators (e.g., mental health status, alexithymia, hopelessness). Logistic regressions were used to identify significant factors, which informed the construction and validation of nomograms for suicide risk assessment. The models' performance were evaluated in terms of discrimination, accuracy, practical application, and generalizability.</p><p><strong>Results: </strong>The findings revealed that 13.4% reported suicidal ideation, 7.8% reported suicide planning, and 6.1% reported suicide attempts. Proximal factors such as hopelessness, anxiety, and depression were strongly associated with suicidality, while childhood trauma emerged as important distal contributors. Three nomograms were developed to predict the risk of suicidal ideation, planning, and attempts, each demonstrating good discrimination and calibration. The AUCs ranged from 0.774 to 0.787 in training cohorts and from 0.764 to 0.829 in validation cohorts. Further validation confirmed their reliability, clinical relevance, and applicability across different gender groups.</p><p><strong>Conclusion: </strong>The predictive models developed in this study offer an effective tool for early detection of suicide risk among incarcerated individuals, supporting correctional staff in timely identification and intervention for high-risk individuals.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"874"},"PeriodicalIF":3.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Post-traumatic stress disorder symptoms among youths in war-affected areas of Northeast Ethiopia.","authors":"Degie Simie, Telake Azale, Fanuel Gashaw, Mesele Wondie, Daniel Ayelegne Gebeyehu, Biazin Yenealem Mekuriaw","doi":"10.1186/s12888-025-07356-4","DOIUrl":"10.1186/s12888-025-07356-4","url":null,"abstract":"<p><strong>Background: </strong>Globally, youth in violent conflict and war-affected areas are experiencing an increase in the rates of post-traumatic stress disorder (PTSD). War leads to severe social crises worldwide, with youths being the most vulnerable group. They often endure severe traumatic events and are at high risk of falling victim to violent crime, which further increases their susceptibility to developing symptoms of PTSD. PTSD is a prevalent in Ethiopian regions affected by war, although empirical data on its prevalence and associated factors among youth in these areas are scarce.</p><p><strong>Objective: </strong>To assess the prevalence and associated factors of post-traumatic stress disorder symptoms among youth in Kobo Town, Northeast Ethiopia.</p><p><strong>Methods: </strong>A community-based cross-sectional study was conducted with 595 participants. Outcome variables were assessed using the Post-traumatic Stress Disorder Checklist (PCL-5). Data were analysed using SPSS version 25. Bivariable and multivariable logistic regression analyses were performed to identify factors associated with PTSD symptoms. The presence of an association was indicated by an adjusted odds ratio with a 95% confidence interval, and a p-value less than 0.05 was considered statistically significant.</p><p><strong>Results: </strong>The prevalence of post-traumatic stress disorder symptoms among youths was 62.2% with 95% CI: 58.2, 66.1). Being female [AOR = 2.62 (95% CI = 1.27, 3.66)], experiencing childhood trauma [AOR = 1.71(95% CI = 1.033, 2.76)], having depression symptoms [AOR = 1.69 (95% CI = 1.12, 2.95)], having anxiety symptoms [AOR = 1.68 (95% CI = 1.09, 2.59)], having physical injury [AOR = 3.38(95% CI: 2.17, 5.28] and having poor social support [AOR = 3.52(95% CI = 2.08, 5.99)] were factors associated with PTSD symptoms.</p><p><strong>Conclusion: </strong>PTSD symptoms is highly prevalent among youth in the war-affected areas of Northeast Ethiopia. Being female, depressive and anxiety symptoms, childhood abuse and neglect, physical injury during war, and poor social support were factors associated with PTSD symptoms among youth. To combat this, early screening and treatment should be provided for youth with PTSD symptoms.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"871"},"PeriodicalIF":3.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BMC PsychiatryPub Date : 2025-09-26DOI: 10.1186/s12888-025-07286-1
Haiyan Liu, Yi Xia, Xiaoqin Wang, Shuangyu Cai, Lingling Hua, Zhijian Yao, Qing Lu
{"title":"Large-scale neural network correlates of response inhibition associated with antidepressant response in major depressive disorder.","authors":"Haiyan Liu, Yi Xia, Xiaoqin Wang, Shuangyu Cai, Lingling Hua, Zhijian Yao, Qing Lu","doi":"10.1186/s12888-025-07286-1","DOIUrl":"10.1186/s12888-025-07286-1","url":null,"abstract":"<p><strong>Background: </strong>A fundamental impairment of major depressive disorder (MDD) is response inhibition, which may serve as a predictor for inadequate responses to antidepressants. Nevertheless, the neurophysiological connections between treatment outcomes and response inhibition are not yet fully understood.</p><p><strong>Methods: </strong>This study involved 149 participants, consisting of 77 healthy controls (HCs) and 72 patients with MDD. All individuals undertook a Go/No-go task while undergoing magnetoencephalography (MEG) recording. Those patients with MDD showing at least a 50% decrease in symptom severity (the short 6-item version of Hamilton Depression Rating Scale) after four weeks were classified as responders. We assessed whole-brain connectivity within the beta-band.</p><p><strong>Results: </strong>Individuals with MDD demonstrated decreased connectivity in a right-lateralized network centred on inferior frontal gyrus. Additionally, non-responders displayed reduced functional connectivity in a left-dominant frontoparietal network centred on superior parietal gyrus and orbitofrontal cortex during response inhibition when compared to both responders and HCs. This identified dysregulation also has potential predictive value regarding the response to antidepressant treatment.</p><p><strong>Conclusions: </strong>Hypoconnectivity in the left-lateralized frontoparietal network centred on superior parietal gyrus and orbitofrontal cortex indicate a decompensatory mechanism that may contribute to an insensitivity toward antidepressant interventions.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"866"},"PeriodicalIF":3.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BMC PsychiatryPub Date : 2025-09-26DOI: 10.1186/s12888-025-07347-5
Yang Wang, Wenjun Jia, Zhuo Zhang, Tingyue Bai, Qi Xu, Jian Jiang, Zhen Wang
{"title":"Model-driven individualized transcranial direct current stimulation for the treatment of insomnia disorder: protocol for a randomized, sham-controlled, double-blind study.","authors":"Yang Wang, Wenjun Jia, Zhuo Zhang, Tingyue Bai, Qi Xu, Jian Jiang, Zhen Wang","doi":"10.1186/s12888-025-07347-5","DOIUrl":"10.1186/s12888-025-07347-5","url":null,"abstract":"","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"869"},"PeriodicalIF":3.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Psychological distress and sleep in papillary thyroid carcinoma: a case-control study.","authors":"Mi Zou, Wenji Liu, Chen Feng, Jiantao Gong, Shanshan Xing, Zhihong Zhou, Haiqiang Huang, Yunxia Lv","doi":"10.1186/s12888-025-07340-y","DOIUrl":"10.1186/s12888-025-07340-y","url":null,"abstract":"<p><strong>Background: </strong>The most prevalent form of thyroid cancer is papillary thyroid carcinoma (PTC), and its prevalence has been steadily increasing globally, especially in women. Although the exact aetiology of PTC remains unclear, existing evidence indicates that psychological factors may exert a substantial influence on its pathogenesis. The primary objective of this research was to investigate the prevalence of psychological distress (including anxiety and depressive symptoms) and sleep disorders among patients with PTC, and to examine their interrelationships.</p><p><strong>Methods: </strong>In this propensity score-matched (PSM) case-control study, we compared 446 PTC patients with demographically matched controls. Psychological distress was assessed using the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS), and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), via validated scales. Multivariable logistic regression analyzed associations, controlling for demographic confounders.</p><p><strong>Results: </strong>The analysis revealed significantly higher prevalence rates of anxiety disorders (9.6% vs 7.0%), clinically significant depressive symptoms (39.9% vs 30.0%), and sleep disturbances (52.2% vs 39.0%) among PTC patients. Notably, logistic regression analysis demonstrated that mild sleep disturbances (specifically) were associated with PTC status (OR = 1.694, 95%CI 1.276-2.248, p < 0.001). Our study also found a correlation between depression and multifocal tumors (p < 0.05). Furthermore, by further comparing specific dimensions of sleep quality, we found that PTC patients had significantly lower scores in daytime dysfunction, sleep efficiency, sleep latency, and subjective sleep quality compared to the normal population.</p><p><strong>Conclusion: </strong>These results reveal significant associations between psychological comorbidities, sleep dysfunction (particularly mild sleep disturbances), and PTC diagnosis, although the observational design precludes causal inference. Additionally, the results highlight the critical role of mental health in the clinical management of thyroid cancer. The incorporation of regular evaluations of depressive symptoms and sleep disturbances into clinical protocols is advised to improve the prognostic outcomes and quality of life of patients.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"872"},"PeriodicalIF":3.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BMC PsychiatryPub Date : 2025-09-26DOI: 10.1186/s12888-025-07373-3
Yuting Zhu, Jianjuan Ren, Zhengchuang Fu
{"title":"Sex-specific associations between Neutrophil-Percentage-to-Albumin Ratio(NPAR) and Neutrophil-to-Lymphocyte Ratio (NLR) with positive and negative symptoms in schizophrenia.","authors":"Yuting Zhu, Jianjuan Ren, Zhengchuang Fu","doi":"10.1186/s12888-025-07373-3","DOIUrl":"10.1186/s12888-025-07373-3","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory markers such as the Neutrophil-Percentage-to-Albumin Ratio (NPAR) and Neutrophil-to-Lymphocyte Ratio (NLR) have been associated with psychiatric disorders. However, the role of sex differences in the association between these markers and symptoms severity in schizophrenia remains largely unexplored. Given that sex differences in immune response may influence the relationship between systemic inflammation and clinical symptoms, understanding these differences is crucial. This study aims to evaluate sex differences in the associations of NPAR and NLR with the severity of positive and negative symptoms in patients with schizophrenia.</p><p><strong>Methods: </strong>This study retrospectively included 108 male and 109 female patients with schizophrenia of Han Chinese ethnicity who were admitted to our hospital between January 2023 and March 2025. Clinical data were collected and analyzed retrospectively. Venous blood samples were obtained to determine the neutrophil percentage, absolute neutrophil count, absolute lymphocyte count and albumin level. Based on these parameters, NPAR and NLR were calculated. We further examined the relationships between these inflammatory markers and symptom severity, assessed via the Scale for the Assessment of Positive Symptoms (SAPS) and the Scale for the Assessment of Negative Symptoms (SANS).</p><p><strong>Results: </strong>Male and female patients with schizophrenia exhibited differences in the severity of positive and negative symptoms. In male patients, NLR was positively associated with positive symptoms (B = 2.53; p < 0.001), while in female patients, NPAR was positively associated with negative symptoms (B = 2.58; p < 0.001). Furthermore, significant interaction effects were observed between sex and inflammatory markers (NPAR and NLR), which influenced the severity of both positive and negative symptoms.</p><p><strong>Conclusions: </strong>Our study suggests that NPAR and NLR are associated with the severity of schizophrenia symptoms and vary by sex, highlighting the importance of considering sex differences in clinical practice.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"873"},"PeriodicalIF":3.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}