BMC Psychiatry最新文献

{"title":"Prenatal exposure to maternal stress hormones and the risk of autism: a neuroendocrine-epigenetic scoping review.","authors":"Temba Munsaka, Mqemane Tshababa, Phumuzani Mpofu, Mokoena Patronella Maepa","doi":"10.1186/s12888-026-08399-x","DOIUrl":"10.1186/s12888-026-08399-x","url":null,"abstract":"<p><p>Maternal psychosocial stress during pregnancy is increasingly recognized as a factor capable of shaping fetal neurodevelopment through alterations in the hypothalamic-pituitary-adrenal (HPA) axis and placental regulatory systems. When maternal stress hormones, particularly cortisol, rise persistently during gestation, they may exceed the buffering capacity of the placenta, influencing fetal brain pathways implicated in social communication, sensory processing, and emotional regulation. Empirical evidence from prospective cohorts has shown that elevated maternal cortisol, altered diurnal HPA rhythms, and increased placental corticotropin-releasing hormone (CRH) trajectories are associated with neurodevelopmental outcomes relevant to autism spectrum disorder (ASD), although results remain heterogeneous across populations and methods [1-3]. This scoping review examines confirmed studies on prenatal stress hormones, placental enzymatic processes, epigenetic changes and their relation to stress, and the diagnosis of ASD and ASD-related traits on a continuum. Per the guidance of the Joanna Briggs Institute and the Scoping Reviews and Mapping Approaches (PRISMA-ScR) framework, we cataloged the eligible studies on their research design, biomarkers, gestational periods, and outcomes by neurobiological processes, and of the children in question. Across studies with multiple methodologies, there is a consensus that disruptions in maternal HPA axis functioning and placental signaling contribute to early changes in the trajectory of ASD development, with the moderating variables of fetal sex, maternal mental health and environmental adversity. While there is no compelling evidence of a causal relationship, the strength and consistency of the proposed mechanisms support the idea that prenatal HPA and epigenetic processes play an important role in shaping the development of ASD. The review highlights the importance of cross study harmonization of biomarkers, expanded longitudinal study designs with varied and several gestational samplings, and the need to pinpoint the timing, magnitude, and detail of the relationships between the stress biology of pregnancy and ASD with outcomes. Collectively, the findings present a framework and strengthened the linkage of the maternal stress physiology to the neurodevelopment of the fetus. This provides a pathway for future mechanistic research and further applied research [10].</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13693158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149242934","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":"Accelerated brain aging associated with executive deficits in adolescence and early adulthood among individuals with schizophrenia and genetic high risk.","authors":"Caijiu Deng, Peiyi Wu, Lingtao Kong, Yifang Zhou, Ziyi Wang, Yuning Zhou, Qikun Sun, Ting Sun, Zhengjiao Tuo, Lei Wang, Yuang Liu, Yuxin Shen, Yanqing Tang","doi":"10.1186/s12888-026-08455-6","DOIUrl":"10.1186/s12888-026-08455-6","url":null,"abstract":"<p><strong>Introduction: </strong>Abnormal brain development and cognitive function are present in adolescence and early adulthood of schizophrenia (SZ). However, it is still unclear whether these developmental abnormalities and cognitive deficits occur in adolescence and early adulthood in individuals at genetic high risk (GHR). This study aims to examine brain age gap differences during adolescence and early adulthood in individuals with SZ, GHR, and healthy control (HC), as well as their associations with cognitive function.</p><p><strong>Methods: </strong>This study recruited a total of 240 subjects aged between 12 and 25, comprising 83 SZ, 48 GHR, and 109 HC. We calculated all participants' brain age gap using their structural MRI. The subtests of Wisconsin Card Sorting Test were utilized to evaluate executive function.</p><p><strong>Results: </strong>Compared to HC group, both GHR group (P = .021) and SZ (P < .001) group showed greater brain age gap (brain age > chronological age). Notably, within GHR group, greater brain age gap was associated with higher non-perseverative errors in executive function (r=.39, P_FDR=0.035), whereas in SZ group, it was correlated with higher perseverative errors (r=.35, P_FDR=0.005).</p><p><strong>Conclusions: </strong>This study suggests that changes in brain age during adolescence and early adulthood in SZ and GHR individuals may reflect disease's genetic susceptibility. A greater brain age gap may be associated with the onset and progression of executive deficits in SZ.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13693000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149242931","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":"Predicting olanzapine induced BMI increase using machine learning on population-based electronic health records.","authors":"Foteini Aktypi, Michael E Benros, Simon Rasmussen","doi":"10.1186/s12888-026-08373-7","DOIUrl":"https://doi.org/10.1186/s12888-026-08373-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Weight gain is a common side effect in patients treated with olanzapine, contributing to increased risks of metabolic complications such as diabetes, cardiovascular disease, and reduced treatment adherence. However, identifying which patients are most likely to experience clinically significant BMI increase remains difficult in routine clinical practice. We investigated whether routinely collected electronic health record data could be used to predict BMI increase in individuals treated with olanzapine.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We developed explainable machine-learning models using population-based psychiatric electronic health record data from Denmark. The study included 11,984 adults treated with olanzapine between 2016 and 2025 who had BMI measurements available during a period relevant to olanzapine exposure. The model outcome was defined as BMI increase &gt; 5% from baseline. We evaluated three prediction settings: BMI increase after olanzapine initiation, BMI increase from the first BMI measurement during treatment to the next available follow-up, and BMI increase within a standardized 30-180-day follow-up window during treatment. Models were trained and internally evaluated using 2016-2024 data and then tested on held-out temporal 2025 data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Prediction of clinically significant BMI increase after olanzapine initiation showed moderate discrimination, with the best performance observed within the 30-180 days post-initiation prediction window. XGBoost achieved an AUROC of 0.72 in the 2016-2024 data and 0.79 in the held-out 2025 data for this prediction. For the prediction of on-treatment BMI increase to the next available follow-up, AUROC was 0.71 in the 2016-2024 data but decreased to 0.61 in the 2025 data. When the on-treatment follow-up window was standardized to 30-180 days, performance was lower, with AUROCs of 0.64 and 0.58 in the 2016-2024 and 2025 data, respectively. Models using a minimal feature set of variables performed close to the full-feature models, suggesting that most predictive signal was captured by basic clinical variables. SHAP analysis indicated that lower baseline BMI, younger age, increasing olanzapine dosage, historical BMI variability and past anxiolytic prescriptions were the features most associated with model predictions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Routinely collected electronic health record data predicted olanzapine-associated BMI increase with moderate discrimination, but performance was less stable in temporally held-out data. The model associations were consistent with known risk patterns for olanzapine-associated weight gain and highlighted less established predictors of BMI increase during olanzapine treatment. These findings may support future work on risk stratification and metabolic monitoring, but they should be interpreted as preliminary and underscore the need for continued research in this domain to establish effective preve","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149285093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of low-intensity secondary theory-based Chatbot intervention for adolescents with digital addictions: protocol for a randomized controlled trial.","authors":"Xue Yang, Xin Wang, Nick Ka-Wo Tse, Zixin Wang, Winnie W S Mak, Phoenix Kit-Han Mo, Samuel Yeung-Shan Wong, Qingpeng Zhang, Liping Zhang","doi":"10.1186/s12888-026-08375-5","DOIUrl":"10.1186/s12888-026-08375-5","url":null,"abstract":"<p><strong>Background: </strong>Adolescence is a unique and vulnerable stage, and mental health problems and digital addictions such as internet gaming disorder (IGD) and social media addiction (SMA) are arising among adolescents. The current study thus aims to develop and evaluate the effectiveness of a secondary low-intensity stage of change (SoC)- and motivation interviewing (MI)-based Chatbot-assisted intervention in reducing common digital addictions, sedentary lifestyles, and mental distress, compared to an active control group. We also examined whether the treatment effects are mediated by the perceived autonomy and competence.</p><p><strong>Methods: </strong>The proposed study is a two-arm randomized controlled trial (RCT) comparing a five-week low-intensity SoC and MI-based Chatbot-assisted group with a psycho-educational control group both via WhatsApp. The expected number of participants with clinical digital addiction symptoms is 330. The primary outcome is the composite score of IGD and SMA, while the secondary outcomes include sedentary lifestyle, quality of life, psychological distress, and eHealth literacy. Perceived autonomy and competence are set as mediators. The evaluation involves baseline evaluation (T0), post-program evaluation (T1), and a 3-month follow-up evaluation (T2). In addition to the psycho-educational materials received by the control group, the intervention group will receive the SoC- and MI-based chatbot intervention via WhatsApp.</p><p><strong>Discussion: </strong>This proposed RCT study may fill critical knowledge and service gaps by evaluating an evidence-based and Chatbot-assisted intervention program for at-risk adolescents. By applying an active control with psycho-educational materials, the current study may determine whether digital interventions offer a more cost-effective and scalable alternative to traditional information-based methods. The findings may provide a scalable and sustainable intervention for adolescents with common digital addictions and mental health problems, especially in resource-limited settings.</p><p><strong>Trial registration: </strong>The RCT protocol was pre-registered at the ClinicalTrials.gov registry (NCT06821373) on February 09, 2025.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13712097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149262354","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":"Associations between depressive symptoms and work productivity loss in patients with schizophrenia: an observational 48-week longitudinal study.","authors":"Takahiro Nemoto, Takashi Uchino, Ryu Ikeda, Tadashi Nosaka, Kenji Baba","doi":"10.1186/s12888-026-08397-z","DOIUrl":"10.1186/s12888-026-08397-z","url":null,"abstract":"<p><strong>Background: </strong>We evaluated the potential association between depressive symptoms and work productivity loss among employed individuals with schizophrenia.</p><p><strong>Methods: </strong>This was a 48-week, prospective, longitudinal, web-based, observational questionnaire study. Patients with schizophrenia, aged 20-59 years, who were employed or on sick leave were included. The Patient Health Questionnaire-9 (PHQ-9), Work Productivity and Activity Impairment Questionnaire: General Health (WPAI-GH), Health Utilities Index Mark 3 (HUI3), and Japanese version of the Pittsburgh Sleep Quality Index (PSQI) were used to assess depressive symptom severity, work productivity loss, quality of life, and sleep disturbance, respectively.</p><p><strong>Results: </strong>Of the 107 patients included, the mean age was 40.9 years, 57.0% were full-time workers, and 47.7% had depressive symptoms based on a PHQ-9 score ≥ 10. Regarding the primary endpoint, there was a weak but significant correlation between change from baseline to 48 weeks in depressive symptoms and presenteeism (WPAI-GH) (Pearson R = 0.308, P = 0.013). No significant correlation was observed between sleep disturbance (PSQI) and presenteeism or between cognitive impairment (HUI3 cognition) and presenteeism. Multiple regression analysis revealed that the change in depressive symptoms from baseline to 48 weeks significantly contributed to presenteeism (regression coefficient = 1.932 [95% confidence interval 0.182-3.682], P = 0.031). Cluster analysis identified two clusters and showed that patients with higher presenteeism throughout the study period had greater depression severity at baseline.</p><p><strong>Conclusions: </strong>Changes in depressive symptoms were modestly associated with changes in presenteeism among employed individuals with schizophrenia.</p><p><strong>Trial registration: </strong>UMIN Clinical Trials Registry (UMIN000050711): Registration date, 29 March 2023).</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757598","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":"Exposure to multiple metals and adolescent major depressive disorder: a case-control study in China.","authors":"Yuqian He, Xue Li, Dan Zhu, Xueer Liu, Xuemei Li, Teng Teng, Tingting Lei, Jie Li, Yajie Huang, Xieyu Gan, Hang Du, Yijue Wang, Jingye Zhou, Chengzhi Chen, Fen Huang, Xinyu Zhou","doi":"10.1186/s12888-026-08444-9","DOIUrl":"10.1186/s12888-026-08444-9","url":null,"abstract":"<p><strong>Background: </strong>Major depressive disorder (MDD) in adolescents is a common mental health problem with a complicated cause and increasing prevalence. Previous studies reported the impact of metals on adolescents with depressive symptoms, but limited evidence is available on the relationship between metals and adolescent MDD.</p><p><strong>Methods: </strong>A total of 203 adolescents with MDD and 203 healthy controls were recruited for this case-control study. Urinary levels of 21 metals were measured using inductively coupled plasma mass spectrometry. The Least Absolute Shrinkage and Selection Operator (LASSO) regression was applied to identify metals for key metals, and conditional logistic regression and Bayesian Kernel Machine Regression (BKMR) were applied to assess individual and joint effects.</p><p><strong>Results: </strong>In the multi-metal model, higher urinary copper (Cu) and iron (Fe) levels were associated with increased MDD risk, whereas nickel (Ni) and iodine (I) inversely associated. BKMR analysis confirmed positive associations for Cu and Fe and protective effects for Ni and I. The combined metal exposure showed an overall negative association with MDD risk. These associations were consistent across several subgroups.</p><p><strong>Conclusions: </strong>This research was the first case-control study to explore the relationship between urinary metal levels and adolescent MDD. Our study identified urinary Cu and Fe as risk factors for adolescent MDD, whereas urinary Ni and I were potential protective factors. These findings might provide new light on the future prevention of adolescent MDD.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13693137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149242895","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":"A novel perspective on biomarkers of neurodegeneration and neuroinflammation in first episode psychosis: a cross-sectional study.","authors":"Valeria Zakurazhnaya, Yana Zorkina, Olga Abramova, Daria Riabinina, Alexandra Ochneva, Valeriya Ushakova, Alexander Reznik, Georgy P Kostyuk, Anna Morozova","doi":"10.1186/s12888-026-08381-7","DOIUrl":"10.1186/s12888-026-08381-7","url":null,"abstract":"<p><strong>Background: </strong>The biological distinction between first-episode psychosis (FEP) and chronic schizophrenia remains unclear. This study investigated a panel of non-canonical serum biomarkers related to neurodegeneration, neuroinflammation, and neurotrophic signaling across these clinical stages.</p><p><strong>Methods: </strong>In a cross-sectional design, serum concentrations of 18 biomarkers were measured using multiplex immunoassay in 49 FEP patients, 80 patients with chronic schizophrenia (SCH), and 80 healthy controls (CON). Principal component analysis identified two major axes (neuroinflammatory-neurotrophic and synaptic), but the distributions of diagnostic groups overlapped substantially.</p><p><strong>Results: </strong>A distinct biomarker profile was identified in FEP, characterized by significantly lower levels of YKL-40 and BDNF, elevated NCAM-1, decreased TDP-43, and a higher frequency of detectable Aβ1‑42 compared to both SCH and CON groups. In contrast, the SCH group did not differ from CON on most of these markers. Correlation analysis revealed a dense, interconnected biomarker network in SCH, centered on MIF and BDNF, while FEP exhibited a single strong correlation between TDP-43 and YKL-40. Principal component analysis identified two major axes (neuroinflammatory-neurotrophic and synaptic) but showed substantial overlap between diagnostic groups.</p><p><strong>Conclusion: </strong>The findings reveal a unique, stage-dependent biological signature in early psychosis, differentiating FEP from both health and the chronic phase of illness. This supports the view of FEP as a distinct pathophysiological state involving dysregulated neuroinflammation, synaptic plasticity, and protein homeostasis, rather than merely a prodromal stage of chronic schizophrenia.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720754","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 association of anxiety, depression, developmental disabilities, and congenital heart disease in US children and adolescents.","authors":"Benli Yu, Bin Li, Xiaodan Deng, Ji Tang, Rong Chen, Tonglei Guo","doi":"10.1186/s12888-026-08454-7","DOIUrl":"10.1186/s12888-026-08454-7","url":null,"abstract":"<p><strong>Background: </strong>Congenital heart disease (CHD) has been linked to the risk of mental health or some developmental disabilities, but there is limited research on the effect of CHD on children and adolescents' mental health and developmental disabilities (varying severity) in the general children and adolescents' population.</p><p><strong>Methods: </strong>This nationally representative study included 52,846 children and adolescents aged 6-17 years who participated in the 2022-2023 National Survey of Children's Health (NSCH) in the US from July 2022 to January 2024. Weighted adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by multivariable logistic regression models to investigate the association of CHD with anxiety, depression, and multiple developmental disabilities.</p><p><strong>Results: </strong>Finally, 52,846 children and adolescents representing 38 million US youth aged 6-17 years (mean age 11.47 years, 95% CI: 11.41-11.52) were included. Children and adolescents with CHD was associated with a higher presence of of anxiety (OR, 1.80 [95% CI, 1.37-2.37]), depression (OR, 1.52 [95% CI, 1.02-2.27]), Down syndrome (OR, 25.59 [95% CI, 14.27-61.36]), behavior problems (OR, 2.39 [95% CI, 1.77-3.24]), developmental delay (OR, 3.16 [95% CI, 2.39-4.18]), intellectual disability (OR, 3.81 [95% CI, 2.29-6.33]), speech disorder (OR, 2.61 [95% CI, 1.99-3.43]), learning disability (OR, 2.39 [95% CI, 1.80-3.17]), autism spectrum disorder (ASD) (OR, 2.11 [95% CI, 1.35-3.28]) and attention deficit disorder/attention-deficit hyperactivity disorder (ADD/ADHD) (OR, 2.04 [95% CI, 1.52-2.72]), respectively. In stratified analyses, the ORs for depression, Tourette syndrome, behavior problems, developmental delay, speech disorder, learning disability, ASD, and ADD/ADHD were higher in moderate or severe status than in mild status. The results were similar in the sensitivity analyses.</p><p><strong>Conclusion: </strong>In conclusion, this is the first nationally representative, population-based study to demonstrate that children and adolescents with CHD are associated with increased presence of anxiety, depression, and developmental disabilities in US children and adolescents. The presence of depression and developmental disabilities was higher in moderate or severe status than in mild status. Our findings suggested that early prevention, risk assessment, and support of mental health conditions and developmental disorders in high-risk children and adolescents, such as those with CHD.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13692856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149242865","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":"Current situation and influencing factors of knowledge, attitudes, and behaviors related to depression among parents of adolescents with depression.","authors":"Yingfan Zhang, Lingfang Zhang, Yong Han","doi":"10.1186/s12888-026-08380-8","DOIUrl":"10.1186/s12888-026-08380-8","url":null,"abstract":"<p><strong>Objective: </strong>To assess depression-related knowledge, attitudes, and practices (KAP) among parents of adolescents hospitalized with depression and to identify associated factors.</p><p><strong>Methods: </strong>Using purposive sampling, we surveyed 138 parents of adolescents with depression hospitalized at our center (December 2023-September 2024). Participants completed a 25-item questionnaire covering knowledge (10 items), attitudes (9 items), and practices (6 items). Group differences were examined using independent-samples t tests or one-way ANOVA (with appropriate nonparametric tests when assumptions were not met). Multiple linear regression was performed to identify factors associated with KAP (overall and by subdomain).</p><p><strong>Results: </strong>Mean standardized scores (0-100) were 54.33 ± 13.59 for knowledge, 59.29 ± 10.93 for attitudes, 73.77 ± 12.20 for practices, and 60.78 ± 7.46 overall. Knowledge, attitudes, and overall scores differed by age, occupation, and education. Knowledge, practices, and overall scores differed by education, monthly income, and residence. In multivariable models, age, occupation, education, and income were independently associated with the overall KAP score (all p < 0.05).</p><p><strong>Conclusion: </strong>Parents of adolescents with depression demonstrated limited disease-related knowledge, comparatively negative attitudes, and moderate practices. These findings highlight the need for targeted psychoeducation and support to improve parental mental health literacy in the inpatient setting.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13693144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149242926","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":"Translation and validation of a German version of the \"Hopkins Competency Assessment Test,\" a brief method for evaluating patients' capacity to give consent.","authors":"Hannah C Keppeler, Mounira Jabat, Lena Machetanz, Mona Redlich Bossy, Achim Burrer, Stefan Vetter, Erich Seifritz, Johannes Kirchebner, Stephan T Egger","doi":"10.1186/s12888-026-08401-6","DOIUrl":"10.1186/s12888-026-08401-6","url":null,"abstract":"<p><strong>Background: </strong>The \"Hopkins Competency Assessment Test\" (HCAT) assesses a patient's ability to provide written informed consent or advance directives. It includes an essay for three reading difficulty levels (12th, 8th, and 6th school grade) and an understanding questionnaire. Currently, there is no equivalent test to the HCAT in German. Therefore, we translated, adapted, and evaluated a German version of the HCAT.</p><p><strong>Methods: </strong>We conducted a cross-sectional study to evaluate the psychometric properties of the HCAT in a clinical and a non-clinical sample. Statistical analysis included ANOVA and t-tests for group comparisons. Cronbach's alpha was used to assess internal consistency; an exploratory factor analysis (EFA) was conducted to examine the underlying factor structure; and network analysis with centrality indices to explore the relational structure among HCAT items and to identify particularly central components within the network. The data collection and analysis were approved (BASEC 2021-01123) by the ethics committee of the Canton of Zurich.</p><p><strong>Results: </strong>We enrolled two samples: one clinical, consisting of 110 psychiatric inpatients, and for comparison, one non-clinical, consisting of 32 participants recruited from hospital staff. We present the results from both samples, unless stated otherwise. The total number of participants, both clinical and non-clinical, was 142 individuals; the majority were male (n = 117, 82.4%), with a mean age of 37.5 years. Most had no education beyond regular school (n = 69, 48.6%). Among the psychiatric patients, schizophrenia (n = 87, 75.5%) was the primary diagnosis, followed by affective disorders (24.5%). Patients often had comorbid substance use disorders (n = 39, 35.5%). A considerable proportion completed the HCAT successfully in the first attempt (n = 100, 70.4%) or the second attempt (n = 20, 14.1%). All participants of the non-clinical sample completed the HCAT successfully on the first attempt. For those requiring more than one attempt, the Intraclass Correlation Coefficient between the different HCAT reading difficulty versions was 0.07 (F(19,6.81) = 1.75, p = .23). The essay took 2.0 (0.8) minutes to read and 5.3 (3.1) minutes to answer. Persons in psychiatric treatment required more time, more attempts, and had lower scores. The Cronbach's alpha was 0.88. The CFA suggested a two-factor model as the preferred solution. In our interpretation, the network analysis revealed the dynamics influencing consent capacity and highlighted the role of risk-benefit valuation for patients (or potential participants) in informed decision-making.</p><p><strong>Conclusion: </strong>The German version of the HCAT demonstrated promising psychometric properties and may be a useful tool for screening for decisional capacity in psychiatric patients.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13681955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223290","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}