BMC Psychiatry最新文献

{"title":"How robust is the association between school-related stress and internalizing mental health problems? A specification curve analysis.","authors":"Björn Högberg","doi":"10.1186/s12888-025-06829-w","DOIUrl":"https://doi.org/10.1186/s12888-025-06829-w","url":null,"abstract":"<p><strong>Background: </strong>A recent review of research on the association between school-related stress and internalizing problems found growing scholarly interest in the topic, but also raised questions concerning the quality and reliability of the existing knowledge base. The aim of this study was to investigate how robust the association between school-related stress and internalizing problems is to differences in model specifications.</p><p><strong>Methods: </strong>Longitudinal survey data from between 2,991 and 4,845 Swedish adolescent students aged 13-16 years were used. A total of 57,322 different models were estimated, varying the choice of sample, measure of internalizing problems, functional form, statistical method, and combinations of included control variables. The results were summarized using specification curve analysis.</p><p><strong>Results: </strong>Most estimates of the association between school-related stress and internalizing problems were statistically significant at the 5% level. The choice of sample, outcome, functional form, and control variables had a limited influence on the size and significance of the estimates, but the estimates were markedly smaller and mostly non-significant in models investigating lagged effects.</p><p><strong>Conclusions: </strong>This study showed that school-related stress is a robust predictor of internalizing problems as long as the association is assumed to be contemporaneous, while evidence for lagged effects was weaker. A key conclusion is that the choice of whether to estimate lagged or contemporaneous effects may be the most consequential in studies on school-related stress and internalizing problems or similar topics.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"413"},"PeriodicalIF":3.4,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956686","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":"Thinning of the temporal and insular cortex is associated with negative symptoms and impaired attention in Chinese chronic schizophrenia patients with deficit syndrome.","authors":"Jin Li, Xiaobin Zhang, Junjie Wang, Haidong Yang, Man Yang, Ju Gao, Xiangdong Du","doi":"10.1186/s12888-025-06835-y","DOIUrl":"https://doi.org/10.1186/s12888-025-06835-y","url":null,"abstract":"<p><strong>Background: </strong>The considerable clinical heterogeneity of schizophrenia poses significant challenges for elucidating its neurobiology. The concept of deficit schizophrenia (DS) is a valuable framework for addressing the heterogeneity of schizophrenia. Growing evidence suggests notable differences between deficit (DS) and nondeficit (NDS) schizophrenia, indicating that DS could represent a separate disease entity.</p><p><strong>Methods: </strong>We aimed to use FreeSurfer to identify specific changes in cortical thickness among NDS patients and healthy controls (HCs) in a Chinese sample. Furthermore, we examined the potential relationships between changes in cerebral cortical thickness and negative symptoms and attention deficits in DS patients. A total of 142 subjects (48 HCs, 50 NDSs, and 44 DSs) underwent MRI scans and completed the assessment of psychopathological severity and cognitive performance.</p><p><strong>Results: </strong>Compared with HCs, DS and NDS patients presented common cortical thinning in the right insula, whereas cortical thinning in the left supramarginal cortex was more prominent in DS patients. We also found that thinning of the temporal and insular cortex was correlated with negative symptoms and impaired attention in DS patients.</p><p><strong>Conclusions: </strong>Cortical thinning in specific brain regions in DS patients was found to be correlated with specific clinical and cognitive symptoms.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"411"},"PeriodicalIF":3.4,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953503","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":"Understanding cognitive control in depression: the interactive role of emotion, expected efficacy and reward.","authors":"Mostafa Toobaei, Mohammadreza Taghavi, Laura Jobson","doi":"10.1186/s12888-025-06847-8","DOIUrl":"https://doi.org/10.1186/s12888-025-06847-8","url":null,"abstract":"<p><strong>Background: </strong>Difficulties in cognitive control over negative emotional stimuli are a key characteristic of depression. The Expected Value of Control (EVC) provides a framework for understanding how cognitive control is allocated, focusing on the motivational factors of efficacy and reward. Efficacy is the likelihood that an effort will result in a specific result, while reward is the value assigned to that outcome. However, the impact of emotion on the estimation of EVC has not been explored. We investigated the interplay between emotion and motivation, using the EVC theoretical framework, in depression.</p><p><strong>Methods: </strong>We utilized a within-between-subject design. The subjects were healthy controls (n = 31) and those with depression (n = 36), who underwent a clinical diagnostic interview, completed the General Health Questionnaire-12, the Beck Depression Inventory-II, and participated in an incentivized Emotional Stroop Paradigm, whereby participants received cues indicating different levels of efficacy (low vs. high) and reward (low vs. high) prior to the targeted stimuli.</p><p><strong>Results: </strong>Significant interactions were detected between a) group × emotional valence × efficacy, and b) group × reward regarding accuracy rates on the Emotional Stroop Task. Follow-up analyses revealed that during high-efficacy trials, the Control group demonstrated significantly greater accuracy than the Depressed group for both positive and neutral stimuli. In low-efficacy trials, the Controls were also significantly more accurate than the Depressed group when responding to negative stimuli. Additionally, the Depressed group performed significantly worse than Controls on high-reward trials, no significant difference was detected between the two groups on low-reward trials.</p><p><strong>Conclusion: </strong>The emotional valence of stimuli can influence the assessment of reward efficacy, and individuals with depression may have difficulties focusing on reward cues. Further research is necessary to incorporate emotion into the EVC framework.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"406"},"PeriodicalIF":3.4,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967835","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":"Identifying the diagnostic gap of tardive dyskinesia: an analysis of semi-structured electronic health record data.","authors":"Kira Griffiths, Yida Won, Zachery Lee, Lu Wang, Christoph U Correll, Rashmi Patel","doi":"10.1186/s12888-025-06780-w","DOIUrl":"https://doi.org/10.1186/s12888-025-06780-w","url":null,"abstract":"<p><strong>Background: </strong>Tardive dyskinesia (TD) is a severe and persistent involuntary movement disorder associated with long-term antipsychotic treatment. TD is likely underreported and misdiagnosed in routine practice, and there is a need to understand the proportion of patients who may experience TD but receive no formal diagnosis. This information could support the characterisation of patient populations that may benefit from novel therapeutic interventions. This study aimed to identify and describe patients with diagnosed or undiagnosed TD. Demographic and clinical features associated with an ICD-9/10 diagnosis of TD were explored.</p><p><strong>Methods: </strong>A retrospective study was conducted using de-identified electronic health record (EHR) data captured between 1999 and 2021 in the US. A cohort of 32,558 adults with schizophrenia-spectrum disorders, major depressive disorder with psychosis or bipolar disorder with psychosis who were prescribed antipsychotics was selected. Abnormal movements associated with TD and presence of TD documented in semi-structured EHR data were extracted through manual review of text recorded as part of the mental state examination. Patients with a recorded diagnosis of TD were identified based on the presence ICD-9/10 codes within structured portions of medical records: ICD-9: 333.85; ICD-10: G24.01. Logistic regression was used to assess the association between patient characteristics and an ICD diagnosis.</p><p><strong>Results: </strong>Altogether, 1,301 (4.0%) patients had either description of abnormal movements associated with TD (n=691) or documented TD (n=610) within semi-structured EHR data. Of those patients, only 64 (4.9%) had an ICD-TD diagnosis in structured EHR data. When the cohort was limited to those with documented TD in semi-structured EHR data, 56 (9.2%) had an ICD-TD diagnosis. Black/African-American race was associated with lower odds of ICD diagnosis compared with white race (OR=0.46, 95%CI=0.20-0.95, p=0.04). Treatment in community mental health centres was associated with increased odds of an ICD diagnosis compared to an academic medical centre (OR=adjusted OR=2.02, 95%CI=1.09-3.74, p=0.03).</p><p><strong>Conclusions: </strong>This study highlights a pressing need for clinicians to better recognise and diagnose TD, which in turn may contribute to increased access to treatments for patients. A recorded ICD diagnosis of TD may be driven by factors related to both the patient and clinical setting.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"407"},"PeriodicalIF":3.4,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962866","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":"Catatonia in ICD-11.","authors":"Jonathan P Rogers, Jo Ellen Wilson, Mark A Oldham","doi":"10.1186/s12888-025-06857-6","DOIUrl":"https://doi.org/10.1186/s12888-025-06857-6","url":null,"abstract":"<p><p>In the International Statistical Classification of Diseases and Related Health Problems Version 11 (ICD-11), the diagnostic criteria for catatonia have been extensively revised. We provide context for these changes beginning with a brief history of how catatonia has been conceptualized and a description of how the criteria for catatonia have changed across ICD versions. We also compare ICD-11 with the criteria in the latest Diagnostic and Statistical Manual of Mental Disorders (i.e., DSM-5-TR), consider clinical implications of the changes in ICD-11, and highlight conceptual areas in need of further development.Described in 1874 by Karl Kahlbaum, catatonia was subsequently subsumed into the Kraepelinian concept of dementia praecox. This was reflected in versions of ICD up to ICD-9, which considered catatonia exclusively as a form of schizophrenia. ICD-10 introduced the diagnosis of organic catatonic disorder but did not incorporate the growing evidence that catatonia can occur in psychiatric conditions such as mood and autism-spectrum disorders.ICD-11 conceptualizes catatonia as an independent disorder with a common clinical phenotype regardless of associated condition, if present. In ICD-11, catatonia diagnosis requires at least three clinical features from the following categories: decreased, increased or abnormal psychomotor activity. These features may come from any combination of the categories, but only one from the increased psychomotor activity category should be counted. The four catatonia diagnoses in ICD-11 are catatonia associated with another mental disorder, catatonia induced by substances or medications, secondary catatonia syndrome and catatonia, unspecified. This expanded view of catatonia more closely resembles DSM-5-TR, which also recognizes catatonia associated with several psychiatric and general medical conditions. ICD-11 also offers guidance on distinguishing catatonia from similar behavioural features of other conditions, such as psychomotor retardation in depression, delirium, and factitious disorder.This new classification stands to improve recognition of catatonia and our hope is that it may lead to a growing awareness of the wide range of conditions associated with it. Ultimately, a better understanding of catatonia should contribute to improved outcomes as clinicians offer treatments both for catatonia itself as well as tailored treatments for its broad range of associated conditions.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"405"},"PeriodicalIF":3.4,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12008857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975136","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":"Sleep disturbances, mental health symptoms, and chronotype in Chinese elite athletes: insights from the Beijing 2022 winter olympics preparatory period.","authors":"Sifan Hu, Li Wang, Yun Chen, Na Li, Sijia Lou, Yan Shao, Yupeng Guo, Qiqing Sun, Zhaojun Ni, Li Dong, Peng Li, Ying Qian, Lin Lu, Ping Hong, Hongqiang Sun","doi":"10.1186/s12888-025-06839-8","DOIUrl":"https://doi.org/10.1186/s12888-025-06839-8","url":null,"abstract":"<p><strong>Objectives: </strong>The present study aimed to investigate sleep disturbance and mental health symptoms in elite athletes during the Beijing 2022 Winter Olympics preparatory period and whether they were associated with chronotype.</p><p><strong>Method: </strong>This study included 428 elite Chinese winter sports athletes from the National Training Team (the response proportion was 94.1%) in August 2021. All participants completed self-reported scales, including Insomnia Severity Index (ISI) to assess sleep disturbance, the Generalized Anxiety Disorder Seven-Item (GAD-7) and the Patient Health Questionnaire Nine-Item (PHQ-9) to assess mental health symptoms (including anxiety and depression symptoms). Multivariable logistic regression models were applied to identify factors associated with sleep and mental health symptoms.</p><p><strong>Results: </strong>In this study, we found that the point prevalence was 13.1% (95% confidence interval [CI] 11.5-14.7%) of insomnia, 20.1% (95% CI 18.2-22.0%) of depression, and 15.0% (95% CI 13.3-16.7%) of anxiety symptoms. Female sex (odds ratio 2.4 [95% CI 1.3-4.6], p = 0.008) and age of 20-24 years (4.1 [1.5-10.9], p = 0.005) were associated factors for insomnia symptoms. Evening chronotype was a significant contributing factor for insomnia (6.7 [2.0-22.6], p = 0.002), depression (5.7 [2.2-15.1], p < 0.001), and anxiety (7.4 [2.3-23.2], p < 0.001) symptoms.</p><p><strong>Conclusions: </strong>Disruptions were reported in the sleep and mental health of elite athletes during the preparation phase of the Beijing 2022 Winter Olympics. Evening chronotype may be a potential independent predictor of sleep and mental health changes for Chinese winter sport elite athletes in preparatory period, and further research is needed to generalize the results. These findings suggest that strategies to manage sleep and mental health better are critical.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"400"},"PeriodicalIF":3.4,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12008967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978271","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":"VIRTUS: virtual reality exposure training for adolescents with social anxiety - a randomized controlled trial.","authors":"Elizabeth S Uduwa Vidanalage, Jella De Lee, Dirk Hermans, Iris M Engelhard, Sara Scheveneels, Katharina Meyerbröker","doi":"10.1186/s12888-025-06756-w","DOIUrl":"https://doi.org/10.1186/s12888-025-06756-w","url":null,"abstract":"<p><p>While virtual reality exposure (VRE) has shown effectiveness in treating social anxiety in adults, research on its efficacy for adolescents remains limited. Given that adolescence is a critical period for early intervention, this study aims to address this gap by evaluating the efficacy and acceptability of VRE compared to in vivo exposure (IVE) in a non-referred sample of socially anxious adolescents. Additionally, we seek to identify mechanisms of change-such as expectancy violation, habituation, and self-efficacy-as well as predictors of treatment response, including clinical, personality, and VR-related factors. Using a randomized controlled trial (RCT), 120 adolescents (ages 12-16) with subclinical to moderate social anxiety will be assigned to one of three conditions: VRE, IVE, or a waitlist control (WL). Participants in the active conditions will undergo a seven-session exposure-based intervention (either in VR or in vivo). Primary (SPAI-18, LSAS-avoidance) and secondary (SPWSS) measures of social anxiety, along with general well-being indicators (e.g., resilience, depression, psychosocial functioning), will be assessed at baseline, post-treatment, and 3- and 6-month follow-ups. A series of linear mixed model (LMM) analyses will be used to examine and compare the effects of the interventions. We hypothesize that both VRE and IVE will significantly reduce social anxiety symptoms compared to WL at post-assessment, with comparable long-term efficacy between the two exposure methods. Additionally, thematic analyses will be conducted to explore participants' experiences and acceptance of VRE and IVE through qualitative interviews. The findings of this study aim to advance digital mental health research by evaluating the potential of VRE as an early intervention and identifying mechanisms and predictors to inform personalized treatments for socially anxious youth.Trial registrationClinicaltrials.gov: NCT06379633, registered on April, 23, 2024.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"401"},"PeriodicalIF":3.4,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12008921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963291","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":"Effect of a web-based intervention on the mental health of informal caregivers of the elderly: a randomized controlled trial.","authors":"Fatemeh Rahimi, Elham Shakibazadeh, Mahnaz Ashoorkhani, Hamed Hosseini, Mahshid Foroughan, Zahra Aghayani, Hadiseh Farhandi","doi":"10.1186/s12888-025-06819-y","DOIUrl":"https://doi.org/10.1186/s12888-025-06819-y","url":null,"abstract":"<p><strong>Background: </strong>Iran's demographic trends indicate significant aging, with intensive caregiving linked to mental health issues among caregivers, especially during the Covid-19 pandemic. This study aimed to evaluate the impact of Mehrpishegan's web-based intervention on depression, anxiety, and stress levels among informal primary caregivers of older adults in Iran.</p><p><strong>Methods: </strong>This study was a parallel-group, superiority, single-blinded randomized controlled trial conducted in Tehran. Eligible participants were informal caregivers with primary caregiving responsibility, access to the internet and a smart device, at least one month of caregiving experience, and the ability to use a web-based intervention. The primary outcomes were measured at baseline, 3 months, and 6 months using DASS-21. Participants with mild and moderate levels at baseline were randomized into intervention (n = 83) and control (n = 80) groups. The intervention group accessed the website, which provided structured educational content and chatrooms(psychologist-led for three months, then peer-led). Engagement was measured via session attendance, forum participation, and educational material usage. Data were analyzed using repeated measures ANOVA based on the intention-to-treat (ITT) and per-protocol approaches.</p><p><strong>Results: </strong>Of the participants, 128 completed the final assessment at six months, resulting in an attrition rate of 20%. The intervention group showed a small decrease in depression (10.23 ± 0.80 vs. 10.48 ± 0.75, diff = 0.253; 95% CI = -0.24, 1.94), anxiety (6.70 ± 0.64 vs. 7.86 ± 0.60, diff = 1.17; 95% CI = -2.93, 0.59), and stress (13.94 ± 0.78 vs. 15.16 ± 0.74, diff = 1.22; 95% CI = -3.37, 0.92), but none of these differences were statistically significant (p > 0.05). Effect size calculations indicated small reductions in anxiety (d = -0.30) and depression (d = -0.28) at three months, though these remained below the threshold for clinical significance (|d| < 0.5).</p><p><strong>Conclusions: </strong>Although the web-based intervention showed some improvements in caregivers' mental health outcomes, the changes were not significantly different from those in the control group. Several challenges, including internet disruptions, voluntary participation, and the impact of the COVID-19 pandemic, may have influenced these outcomes. To enhance the effectiveness of web-based support programs, future interventions must overcome technological barriers, strengthen caregivers' digital competencies, tailor content to individual needs, and address key mental health risk factors. A more personalized and accessible approach could improve engagement and long-term benefits for caregivers.</p><p><strong>Trial registration: </strong>The protocol of this research was registered in the Iran Randomized Clinical Trial Center with registration number IRCT2 02010 12,048 999N1 on 25 December 2020.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"404"},"PeriodicalIF":3.4,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12008969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953443","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":"Evaluating the efficacy of radically open dialectical behavior therapy (RO-DBT) in patients with anorexia nervosa: study protocol for a randomized controlled clinical trial.","authors":"Aina Avila-Parcet, Ana Martín-Blanco, Leonor Gawron, Marta Cano, Víctor De la Peña-Arteaga, Mar Carceller-Sindreu, Joaquim Soler, Maria J Portella, Gloria Faustino, Narcís Cardoner, Cristina Carmona I Farrés","doi":"10.1186/s12888-025-06854-9","DOIUrl":"https://doi.org/10.1186/s12888-025-06854-9","url":null,"abstract":"<p><strong>Background: </strong>Anorexia nervosa (AN) is a severe and disabling disorder, with relapse rates as high as 50% after the first episode, posing a significant challenge for clinicians. Most therapies excessively focus on nourishment, resulting in temporary weight restoration but with no improvements in general well-being and quality of life. Radically Open Dialectical Behavior Therapy (RO-DBT) is a transdiagnostic treatment designed to address overcontrol, a key aspect in the functioning of patients with AN. To date, no clinical trial (CT) has shown its efficacy in these patients or evaluated its neurobiological mechanism of action.</p><p><strong>Methods: </strong>A randomized CT in weight restored adult AN patients will be conducted, with one group receiving treatment as usual (TAU) and the other TAU plus RO-DBT, with the main outcome being quality of life. Secondary variables will include eating disorders (EDs) symptoms, overcontrol characteristics, autistic traits, and neuroimaging changes.</p><p><strong>Discussion: </strong>The results will address a gap in knowledge regarding AN treatment, with the expectation that patients receiving TAU with RO-DBT will exhibit improved quality of life and experience fewer relapses at the one-year follow-up. This is the first study examining neuroimaging changes in RO-DBT to better understand its underlying mechanisms.</p><p><strong>Trial registration: </strong>The study has been registered in ClinicalTrials.gov in September 22, 2023. It can be found in https://classic.</p><p><strong>Clinicaltrials: </strong>gov/ct2/show/NCT06050421 .</p><p><strong>Trial registration number: </strong>NCT06050421.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"403"},"PeriodicalIF":3.4,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12008890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961446","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":"Work re-entry and functioning in people with major depression: a longitudinal study of supported employment participants.","authors":"Juliane Bergdolt, Stella Hubert, Julia Schreiter, Sarah Jenderny, Thomas Beblo, Martin Driessen, Ingmar Steinhart, Lorenz B Dehn","doi":"10.1186/s12888-025-06826-z","DOIUrl":"https://doi.org/10.1186/s12888-025-06826-z","url":null,"abstract":"<p><strong>Background: </strong>People with major depression are affected by impaired daily functioning and non-participation in the workforce. At the same time, employment has been associated with improved mental health outcomes. The aim of this study was to examine the relationship between work re-entry and subsequent functioning and depressive symptoms.</p><p><strong>Methods: </strong>The present observational study included a sample of 129 participants of a supported employment intervention project in Germany diagnosed with depressive disorders. Participants were assessed before the start of the intervention (baseline) and after two years (follow-up). Functioning and depressive symptom severity were measured using the World Health Organization Disability Assessment Schedule 2 (WHODAS 2.0) and the Beck's Depression Inventory II (BDI-II). After multiple imputation, linear regression analyses were conducted to analyze the relationship between work re-entry and follow-up functioning and symptom severity, controlling for baseline scores and age.</p><p><strong>Results: </strong>Work re-entry was significantly associated with better overall functioning (p =.002), cognitive functioning (p =.001) and community participation (p =.002), adjusted for baseline scores and age. A significant interaction effect (p =.001) suggested that the association between work re-entry and overall functioning at follow-up was stronger in older participants. After adjustment for baseline functioning and age, work re-entry was not significantly associated with self-care, social interaction and household responsibilities, while associations with mobility (p =.072) and symptom severity (p =.054) were marginally nonsignificant.</p><p><strong>Conclusions: </strong>The results support the association between work re-entry and lower disability in people with depression who participated in supported employment. Certain functional domains, especially cognition and participation, may be more closely associated with becoming re-employed. The association between work-re-entry and overall functioning may be stronger in older individuals.</p><p><strong>Trial registration: </strong>The data used for this study were collected as part of a clinical trial called \"IPS-ZIB\" which was prospectively registered with the German register for clinical trials on 12/14/2020 (DRKS; ID: DRKS00023521).</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"402"},"PeriodicalIF":3.4,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12008965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953147","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}