BMC Psychiatry最新文献

{"title":"Exploring the relationship between lifestyle factors and depressive symptoms in Korean adolescents amid the COVID-19 pandemic.","authors":"YoonJin Lee, Eunyeong Jang, Sejeong Park, Jinhee Lee","doi":"10.1186/s12888-025-06988-w","DOIUrl":"10.1186/s12888-025-06988-w","url":null,"abstract":"","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"844"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941721","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":"Factors associated with depression among people living with HIV in primary health care of Southern Ethiopia.","authors":"Tagese Yakob, Begidu Yakob, Awoke Abraham, Eskinder Israel","doi":"10.1186/s12888-025-07345-7","DOIUrl":"10.1186/s12888-025-07345-7","url":null,"abstract":"","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"845"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941704","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":"Integrating multiple feature assessment methods to identify key predictors of repeat suicide attempts in Taiwan.","authors":"Joh-Jong Huang, Shu-Jen Lu, Min-Wei Huang","doi":"10.1186/s12888-025-07252-x","DOIUrl":"https://doi.org/10.1186/s12888-025-07252-x","url":null,"abstract":"<p><strong>Background: </strong>The high rate of repeat attempts among individuals who have previously attempted suicide presents a critical challenge in public health and suicide prevention. While early and targeted intervention is crucial for this high-risk group, effectively identifying those most likely to re-attempt is a persistent difficulty, especially when public health resources are limited. This creates a pressing need for accurate and practical risk assessment tools. This study aims to address this gap by using machine learning to analyze a nationwide suicide surveillance database to identify key predictors of repeat suicide attempts and develop a robust predictive model to aid in resource allocation and early intervention.</p><p><strong>Methods: </strong>This study analyzed data from 32,701 individuals, encompassing 31 features, recorded in Taiwan's National Suicide Surveillance System for 2020. We employed binary decision tree regression with multiple feature selection techniques to identify significant predictors of recurrent suicide attempts. A prediction model was then developed without requiring biological samples.</p><p><strong>Results: </strong>History of mental illness, specific age groups, and supervision status of mentally ill patients emerged as primary influences on repeated suicide attempts. The prediction model achieved 66.3% accuracy in identifying potential repeat attempters, with a 57.9% success rate for predicting re-suicide events. These findings align with recent literature on suicide recurrence risk factors.</p><p><strong>Conclusions: </strong>This study provides a practical risk assessment tool that enables early intervention for high-risk individuals without invasive biological sampling. The insights offer valuable guidance for government suicide prevention policies, especially when prioritizing cases with limited resources. Future enhancements through broader data integration and interdisciplinary cooperation could establish a more comprehensive prevention system to reduce the societal impact of suicidal behavior.</p><p><strong>Trial registration: </strong>Not applicable as this was a retrospective database analysis rather than a randomized controlled trial.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"841"},"PeriodicalIF":3.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941817","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":"Intensive home treatment: an exploratory study on when patients in psychiatric crises benefit.","authors":"Leo Jan Klunder, Dorien Spanhaak, Oswald Jan Nicolaas Bloemen","doi":"10.1186/s12888-025-07238-9","DOIUrl":"https://doi.org/10.1186/s12888-025-07238-9","url":null,"abstract":"<p><strong>Background: </strong>Intensive Home Treatment (IHT) is an acute intensive outpatient treatment intended to replace or shorten clinical admission for patients in psychiatric crisis. Recent studies have demonstrated that IHT is noninferior to clinical admission in several patient groups. However, it remains unclear which patient characteristics, if any, predict the degree of reduction in crisis severity after IHT. Furthermore, the effectiveness of IHT in reducing crisis severity when used to shorten clinical admissions remains unclear.</p><p><strong>Aims: </strong>To elucidate what variables predict the course of crisis severity in IHT.</p><p><strong>Method: </strong>We conducted an exploratory prospective naturalistic study. We recruited 120 participants referred for IHT. A list of putative predicting variables was constructed on the basis of interviews with IHT staff and a patient and support system council. To measure crisis severity, symptom severity questionnaires (SQ-48; symptom questionnaire 48) were administered at the beginning and after 3 and 6 weeks of IHT.</p><p><strong>Results: </strong>None of the putative predicting variables predicted the course of crisis severity during IHT. Crisis severity decreased, the mean SQ-48 decreased from 84 to 46 (Cohen's d 1.25, 95% CI 0.66-1.81). Participants with bipolar or psychotic disorders reported less severe baseline symptoms but improved equally to other participants. In participants receiving IHT after admission, no clear improvement was observed.</p><p><strong>Conclusions: </strong>Crisis severity decreased during IHT, but baseline participant characteristics did not predict outcome of IHT. The lower baseline crisis severity in participants with bipolar or psychotic disorder suggests that clinicians have a different referral pattern to IHT for patients with these diagnoses. IHT did not further improve crisis severity if initiated after clinical admission. This suggests that both the need for IHT as aftercare and its timing should be critically evaluated by clinicians.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"834"},"PeriodicalIF":3.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941791","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":"Recurrent postpartum chest pain unmasking undiagnosed borderline personality disorder: a diagnostic case report.","authors":"Aditya Shrivastav, Suhas Tiwaskar, Priyansh Kumar Sahu, Anurag Luharia, Vibhawari Pal, Sarthak Das","doi":"10.1186/s12888-025-07307-z","DOIUrl":"https://doi.org/10.1186/s12888-025-07307-z","url":null,"abstract":"<p><strong>Background: </strong>Recurrent Emergency Department (ED) visits for non-cardiac chest pain are common among postpartum women. When cardiac workups are repeatedly normal, psychiatric etiologies, particularly trauma-related personality disorders, should be considered. Borderline Personality Disorder (BPD) may present with panic-like somatic symptoms during periods of interpersonal stress but is often underrecognized in acute care settings.</p><p><strong>Case-presentation: </strong>We report the case of a 29-year-old postpartum woman who presented to the ED five times over two months with episodic chest pain, palpitations, and a fear of dying. Cardiac and medical evaluations were consistently unremarkable. Each episode followed emotionally distressing interactions with her estranged spouse. The clinical pattern did not meet DSM-5 criteria for primary panic disorder. A structured psychiatric evaluation, corroborated by collateral history, resulted in a diagnosis of BPD based on five core DSM-5 criteria: abandonment fears, affective instability, identity disturbance, impulsivity, and unstable relationships. A sixth criterion, past self-injury, was present but excluded from the diagnostic threshold due to its isolated nature. Treatment included restarting sertraline, continuing propranolol for somatic symptoms, and referral for Dialectical Behaviour Therapy (DBT). The patient reported improved emotional regulation and no further ED visits at one-month followup. While longer-term outcomes remain unknown, her early response was promising.</p><p><strong>Conclusions: </strong>This case illustrates a diagnostically complex postpartum presentation in which panic-like somatic symptoms masked an underlying personality disorder. Although postpartum depression was initially suspected, psychiatric evaluation revealed previously undiagnosed BPD. Clinicians should consider trauma-informed psychiatric assessment in postpartum patients with medically unexplained symptoms, especially when symptoms are closely tied to interpersonal distress.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"838"},"PeriodicalIF":3.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941836","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":"Predictors of extrapyramidal side effects among patients taking antipsychotic medication at Mekelle psychiatry units, Northern Ethiopia, 2023: unmatched case-control study.","authors":"Welu Abadi Gebru, Gebregziabher Kidanemariam Asfaw, Kenfe Tesfay Berhe, Tesfaye Derbie Begashaw, Hiwot Gebrewahid Reta, Hagos Tsegabrhan Gebresilassie","doi":"10.1186/s12888-025-07202-7","DOIUrl":"10.1186/s12888-025-07202-7","url":null,"abstract":"<p><strong>Background: </strong>Schizophrenia is one of the most disruptive of neuropsychiatric disorders, affecting around 1% of the world's population. Antipsychotic medications have been the backbone of schizophrenia treatment for the past 50 years. Extrapyramidal side effects of antipsychotic medication are a major problem which is associated with various factors. However, there is a dearth of evidence about the predicting factors for extrapyramidal side effects.</p><p><strong>Objective: </strong>To determine the predictors of extrapyramidal side effects among all patients taking antipsychotic medication at Mekelle Psychiatry units, Northern Ethiopia, 2023.</p><p><strong>Methodology: </strong>A Case-control study design was employed with a total of 201 study subjects (67cases and 134 controls). A systematic random sampling technique was employed to select the required study subjects. Extrapyramidal Side Effects were measured by the Simpson-Angus Scale, Abnormal Involuntary Movement Scale (AIMS), and the Barnes Akathisia Rating Scale (BARS) scale. The data were analyzed using Statistical Package for Social Sciences (SPSS) version 22. Bivariate and multiple logistic regression analyses were performed to determine between the independent and dependent variables. The significant independent predictor was declared at a 95% confidence interval and P-value of less than 0.05.</p><p><strong>Result: </strong>Among the study subjects the modifiable factors significantly associated with EPS were; being female (AOR = 0.140, 95% CI: 0.042-0.465, p = 0.001),being single (AOR = 3.084, 95% CI: 0.569-16.727, p = 0.006), perceived stigma (AOR = 0.165, 95% CI: 0.038-0.708, p = 0.015), having mental illness history (AOR = 6.316, 95% CI: 2.026-19.692), p = 0.001), combination first generation antipsychotic drugs (AOR = 0.095,95% CI: 0.010-0.877, p = 0.038), Khat chewing practice/ behavior (AOR = 4.033, 95% CI: 1.120-14.531, p = 0.033) and history of alcohol use and currently drink alcohol (AOR = 6.213, 95% CI: 1.375-28.079, p = 0.018).</p><p><strong>Conclusion and recommendation: </strong>Our study revealed, being female, single, stigma, combination first-generation antipsychotic drug, having mental illness history, Khat chewing practice/ behavior and Alcohol intake in the last 3 months were significant factors of Extrapyramidal Side Effects. Psychiatric professionals should be assessing the predictors of Extrapyramidal Side Effects especially, combination of first-generation antipsychotic drugs, substance use with antipsychotic drugs and management comorbid diagnosis routinely is strongly recommended.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"837"},"PeriodicalIF":3.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941809","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 validity of diagnoses of non-affective psychotic disorder including schizophrenia in Swedish registers revisited - are the diagnoses valid for migrants and Swedish-born?","authors":"Jens Falk, Lidija Pavlovic, Susanne Wicks, Christina Dalman, Anna-Clara Hollander","doi":"10.1186/s12888-025-07282-5","DOIUrl":"https://doi.org/10.1186/s12888-025-07282-5","url":null,"abstract":"<p><strong>Background: </strong>The first aim of the study was to assess the validity of non-affective psychosis diagnoses, including schizophrenia, for migrants and Swedish-born to determine if the registered diagnoses were of sufficient quality for epidemiological research. If the validity was insufficient, the second aim was to find out what the non-valid cases have in common to see if there was a feasible way to handle these cases in future studies.</p><p><strong>Study design: </strong>We validated the register-diagnoses of 179 randomly selected patients aged 18-48 living in municipalities with a high proportion of migrants, diagnosed with non-affective psychotic disorder (F20-F29 according to ICD-10), drawn from the Region of Stockholm's medical records database by comparing them to their case notes to see if they fulfilled the DSM-5 criteria.</p><p><strong>Results: </strong>We found acceptable validity for non-affective psychotic disorder for migrant men (70.5%), low for Swedish-born men (60.0%), and even lower for women (50.0% for Swedish-born and 40.0% for migrants). There was no statistically significant difference between Swedish-born and migrants. The case notes revealed that by excluding cases with an additional diagnosis equivalent of psychotic disorder due to psychoactive substance (ICD10: F11X.5 and F11X.7) the validity was good for both Swedish-born and migrant men.</p><p><strong>Conclusions: </strong>This study supports continued use of the register-diagnoses but only after taking appropriate measures to avoid that patients with additional psychotic disorder due to psychoactive substance are not violating the validity. It also suggests caution when studying non-affective psychosis diagnoses among migrant women as the validity is low, possibly due to difficulties in separating non-affective psychosis from symptoms of other disorders with psychotic features.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"831"},"PeriodicalIF":3.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12392502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941870","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 associations between insomnia symptoms and clinical features, lipid metabolism parameters, as well as inflammatory cytokines in patients with chronic schizophrenia.","authors":"Lewei Liu, Zhenkuo Li, Jiawei Wang, Lili Zhao, Xi Zhang, Yinghan Tian, Xianhu Yao, Wenzheng Li, Lei Xia, Huanzhong Liu","doi":"10.1186/s12888-025-07293-2","DOIUrl":"https://doi.org/10.1186/s12888-025-07293-2","url":null,"abstract":"<p><strong>Background: </strong>Chronic schizophrenia is commonly associated with a high incidence of insomnia. Co-morbid insomnia not only exacerbates psychiatric symptoms but also significantly impairs cognitive functioning, and increases the risk of suicide. Therefore, this study sought to explore the relationships between insomnia symptoms and clinical features, lipid metabolism parameters, and inflammatory cytokines in patients with chronic schizophrenia, thereby providing a scientific basis for early identification and intervention of insomnia in this population.</p><p><strong>Methods: </strong>From May to December 2018, 317 patients with chronic schizophrenia were included. General demographic data were collected using a self-administered questionnaire. Insomnia, psychotic symptoms, and depression were assessed using a series of validated scales. Additionally, plasma levels of lipid metabolism parameters and inflammatory cytokines, including interleukin (IL)-1β, IL-6, IL-17 A, and tumor necrosis factor-α (TNF-α), were measured. Finally, logistic regression analysis was conducted to identify the independent predictors of insomnia symptoms.</p><p><strong>Results: </strong>Among patients with chronic schizophrenia, 42.3% exhibited insomnia symptoms. Univariate analyses revealed that, compared to the non-insomnia group, patients in insomnia group were older and had higher positive symptom scores, higher general psychopathology scores, higher total scores on the Calgary Depression Scale (CDSS), and elevated plasma levels of Log IL-6 (all p < 0.05). Furthermore, regression analyses identified age (OR = 1.027, 95% CI = 1.005-1.048, p = 0.013), CDSS total score (OR = 1.265, 95% CI = 1.163-1.375, p < 0.001), and Log IL-6 level (OR = 2.053, 95% CI = 1.251-3.371, p = 0.004) as independent correlates of insomnia.</p><p><strong>Conclusion: </strong>Patients with chronic schizophrenia are at a relatively high risk of developing insomnia. Insomnia symptoms may be associated with age, psychotic symptoms, depressive symptoms, and elevated levels of IL-6. Based on these findings, clinical staff should enhance the monitoring and assessment of sleep quality in patients with chronic schizophrenia and implement targeted early interventions for those at risk of insomnia.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"830"},"PeriodicalIF":3.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12392616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941811","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":"Amygdala volume abnormalities and cognitive impairment in major depressive disorder and bipolar disorder II.","authors":"Bin Li, Chunguo Zhang, Wensheng Chen, Guojun Xie, Jiaquan Liang","doi":"10.1186/s12888-025-07313-1","DOIUrl":"https://doi.org/10.1186/s12888-025-07313-1","url":null,"abstract":"<p><strong>Background: </strong>The amygdala, as a crucial brain region, plays a key role in processing emotions and cognitive information. Given that patients with major depressive disorder (MDD) and bipolar disorder II (BD II) experience cognitive impairments, accurate diagnosis becomes a vital research focus. Consequently, we conducted an in-depth investigation into the relationship between the static volume of the amygdala and cognitive functions, aiming to provide valuable insights for future research in this field.</p><p><strong>Methods: </strong>We collected a total of 42 treatment-naive MDD patients, 38 BD II patients, and 46 healthy controls (HC) from the Third People's Hospital of Foshan. Using magnetic resonance imaging (MRI) and an automated segmentation tool, we extracted the structural volumes of the amygdala. Pearson correlation analyses were performed with scores from the 17-item Hamilton Depression Rating Scale (HAMD), the Hamilton Anxiety Rating Scale (HAMA), and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Finally, we compared clinical data, as well as volume changes in the amygdala, among MDD patients, BD patients, and HC.</p><p><strong>Results: </strong>In terms of depression scores, MDD individuals experience more severe emotional distress than those with BD. Both MDD and BD II patients show significantly higher anxiety levels compared to the HC. BD II is linked to widespread cognitive deficits, indicating poorer cognitive performance compared to both MDD and HC. In MDD, there is an observed amygdala volume increase compared to the HC. Additionally, correlation analysis revealed that the left amygdala volume is significantly correlated with Delayed Memory (List Recall) (r = 0.234, p = 0.010) and Delayed Memory (Story Recall) (r = 0.215, p = 0.018) (after multiple Bonferroni correction).</p><p><strong>Conclusion: </strong>For medication-naïve individuals with MDD and BD II, we observed a correlation between amygdala volume and cognitive function. From this, changes in amygdala volume may help reflect cognitive impairment in patients during the acute phase.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"839"},"PeriodicalIF":3.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941634","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":"Emotion word repertoire in the adult attachment interview predicts a reduction of non-suicidal self-injury in the psychotherapy of borderline personality disorder.","authors":"S Schmitz-Riol, J Fuchshuber, J Herpertz, A Buchheim, S Hörz-Sagstetter, M Rentrop, M Fischer-Kern, P Buchheim, J Taylor, A Tmej, K L Weihs, R D Lane, S Doering","doi":"10.1186/s12888-025-07300-6","DOIUrl":"https://doi.org/10.1186/s12888-025-07300-6","url":null,"abstract":"<p><strong>Background: </strong>Borderline personality disorder (BPD) is characterized by mental representation deficits and emotion dysregulation, with non-suicidal self-injury (NSSI) often occurring as a maladaptive regulation strategy. The ability to verbally express emotions might be advantageous for coping with emotion dysregulation and benefiting from psychotherapy.</p><p><strong>Methods: </strong>In the present study, we used a novel text-based measure of emotional awareness to examine whether a greater emotion word repertoire (EWR) predicts improvement in psychotherapy for patients with BPD regarding NSSI, suicide attempts, attachment representations, mentalization, and personality organization. We conducted a secondary analysis of a randomized controlled trial comparing the efficacy of Transference-Focused Psychotherapy (TFP) vs. treatment as usual over one year in a sample of female BPD outpatients. The German electronic Levels of Emotional Awareness Scale (eLEAS) scoring system was applied to Adult Attachment Interviews (AAI) administered at baseline (n = 87; M_age = 27.4, SD_age = 7.4) and upon treatment termination (n = 52; M_age = 28.6, SD_age = 7.2).</p><p><strong>Results: </strong>In both treatment groups, EWR at baseline was positively correlated with a reduction of NSSI after one year of psychotherapy (r = .46, p < .001). No significant correlations were found between baseline EWR and changes in other outcome measures. Compared to baseline, mean EWR scores significantly decreased after one year of treatment.</p><p><strong>Discussion: </strong>Our findings indicate that a borderline patient's ability to verbalize emotions might be a resource facilitating a reduction of NSSI in psychotherapy. We discuss strengths and limitations of applying the eLEAS scoring system to open-ended texts in a psychotherapy context. Given the exploratory nature of this study, replication in future studies is warranted.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (identifier NCT00714311, registration date 07/09/2008).</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"832"},"PeriodicalIF":3.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941743","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}