BMC Psychiatry最新文献

{"title":"Cost-utility analysis of a collaborative and stepped care model in patients with mental disorders in German primary care (the COMET study).","authors":"Thomas Grochtdreis, Daniela Heddaeus, Tharanya Seeralan, Kerstin Maehder, Sarah Porzelt, Anne Daubmann, Amra Pepic, Bernd Löwe, Moritz Rosenkranz, Ingo Schäfer, Martin Scherer, Bernd Schulte, Olaf von dem Knesebeck, Angelika Weigel, Karl Wegscheider, Silke Werner, Antonia Zapf, Thomas Zimmermann, Jörg Dirmaier, Martin Härter, Hans-Helmut König, Judith Dams","doi":"10.1186/s12888-025-07428-5","DOIUrl":"10.1186/s12888-025-07428-5","url":null,"abstract":"<p><strong>Background: </strong>In order to reduce the health burden and the health care costs caused by the most common mental disorders, health care systems throughout Europe have tried to improve services and treatment choices. Recently, a collaborative and stepped care (CSC) model for patients with depressive, anxiety, somatoform or alcohol-related disorders and their comorbidities was developed and implemented under routine care conditions in Germany. The aim of this study was to determine the cost-effectiveness of this CSC model from a societal perspective with a 12-month follow-up.</p><p><strong>Methods: </strong>This study was part of a cluster-randomized controlled trial to compare a CSC model with treatment as usual (TAU) in patients with depressive, anxiety, somatoform or alcohol-related disorders and their comorbidities in German routine care. The cost-effectiveness of the CSC model compared with TAU was analyzed based on the incremental cost-utility ratio (ICUR) with quality-adjusted life years (QALYs) based on the EQ-5D-5L index as measure of health effect. The uncertainty of the ICUR was assessed using cost-effectiveness acceptability curves based on net-benefit regressions.</p><p><strong>Results: </strong>In total, n = 307 patients in the CSC and n = 308 patients in the TAU group were included, with a mean age of 38 and 43 years, respectively. There were no differences in mean QALYs and total costs between the CSC (0.86 QALY, 27,174€) and the TAU group (0.86 QALY, 26,441€). Only the adjusted mean costs for outpatient mental health services were higher in the CSC group (+685€; 95% CI 398€ to 972€; p < 0.001). The probability of cost-effectiveness of the CSC model was 35% at a willingness-to-pay (WTP) of 0€ and 34% at a WTP of 50,000€ per additional QALY.</p><p><strong>Conclusion: </strong>The evaluated CSC model was unlikely to be cost-effective compared with TAU from a societal perspective for patients with depressive, anxiety, somatoform or alcohol-related disorders and their comorbidities during the 12-month follow-up period. The higher mean costs for outpatient mental health services might indicate that general practitioners in the CSC group were able to refer patients to psychotherapists and psychiatrists more frequently through the network of health care providers.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov: NCT03226743. Registration date: 24/7/2017.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"973"},"PeriodicalIF":3.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285584","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":"How demoralization is related to trait resilience factors: a network analysis in a representative sample of the general population.","authors":"Markus Ramm, Kathrin Schnabel, Johanna Jedamzik, Lara Jürgens, Jelena Gerke, Miriam Rassenhofer, Elmar Brähler, Gereon Heuft, Rupert Conrad","doi":"10.1186/s12888-025-07487-8","DOIUrl":"10.1186/s12888-025-07487-8","url":null,"abstract":"<p><strong>Background: </strong>Demoralization refers to a mental state of poor coping characterized by a loss of purpose and meaning, feelings of hopelessness and worthlessness, and suicidal ideation. The revised demoralization scale (DS-II) is among the most frequently used self-report measures. Recently, the psychometric properties and normative values of the DS-II-Ms (Münster version of the DS-II) were published, alongside a validation study linking it to depression and anxiety in the general population. This study investigates the relationship between DS-II-Ms scores and resilience, as well as well-validated trait resilience factors, specifically locus of control and general self-efficacy, using a network psychometrics approach.</p><p><strong>Methods: </strong>DS-II-Ms, Patient Health Questionnaire 2 (PHQ-2), Generalized Anxiety Disorder Scale 2 (GAD-2), Internal-External Locus of Control Short Scale-4 (IE4), General Self-Efficacy Short Scale-3 (GSE-3) and Brief Resilience Scale (BRS) were applied to a representative sample (N = 2401) of the German general population. A gaussian graphical model was estimated using a non-regularized algorithm to depict the unique connections between the measures.</p><p><strong>Results: </strong>DS-II-Ms was moderately associated with lower internal (and higher external) locus of control while being conditionally independent from BRS and GSE-3. Conversely, depression symptoms lack of interest/low mood were connected to resilience and general self-efficacy but conditionally independent from locus of control.</p><p><strong>Conclusions: </strong>Although the cross-sectional study design limits directional interpretation, our findings indicate that trait resilience measures have unique associations with demoralization and depression/anxiety symptoms, supporting the discriminant validity of the demoralization construct. Depressed and demoralized individuals might benefit from different therapeutical approaches, targeting specific resilience factors.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"975"},"PeriodicalIF":3.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285586","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":"Assessment of psychometric properties of autism spectrum diagnostic profile (ASDP) among Egyptian children aged 2-12 years.","authors":"Mona Mohamed Asar, Reham Abdel Rahman Amer, Ibrahim Ali Kabbash, Mohamed Ahmed Abdelhay","doi":"10.1186/s12888-025-07456-1","DOIUrl":"10.1186/s12888-025-07456-1","url":null,"abstract":"","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"974"},"PeriodicalIF":3.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285582","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":"Brain structural and functional aberrant of hippocampal subregions was associated with somatic depression.","authors":"Qiao Juan, Zhang Liuyi, Hu Yuxuan, Shi Jiabo, Chen Yu, Tian Shui, Yao Zhijian, Lu Qing","doi":"10.1186/s12888-025-07386-y","DOIUrl":"10.1186/s12888-025-07386-y","url":null,"abstract":"<p><strong>Background: </strong>Somatic depression (SD) was a different subtype compared to non- somatic depression (NSD) in presentation of the resting-state MRI study. Among these studies, hippocampus was believed to be significantly associated with somatization symptoms. However, the hippocampus was a heterogeneous structure which contains five main subfields. Until now, the disruption pattern of the hippocampus subfields in SD patients were not clearly. Therefore, it is necessary to study the different function of each hippocampus subfield in SD group.</p><p><strong>Methods: </strong>261 subjects were recruited including 190 major depressive disorder (MDD) patients and 71 health controls (HC). All subjects underwent 3.0T resting state magnetic resonance image scanning. The disruption of grey matter volume (GMV) and the functional connectivity (FC) of the hippocampal subregion were compared between each pairs, respectively. In addition, the correlation between the abnormal functional connectivity of the hippocampal subregions and the symptom of the SD patients were estimated.</p><p><strong>Results: </strong>Compared to the NSD group, SD group showed decreased grey matter volume (GMV) in the left hippocampus amygdala transition area (HATA) and right HATA. Relative to the NSD group, the SD group showed decreased FC between the left HATA and the left superior occipital gyrus, between the right HATA and left middle temporal gyrus. In SD group, the FC between the left HATA and left superior occipital gyrus were positively correlated with the HAMD-17 and cognitive disturbance.</p><p><strong>Conclusion: </strong>The structural and functional aberrant of HATA was a neurobiology indicator of the SD and the left superior occipital gyrus may be a potential neuroregulatory targets for SD.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"978"},"PeriodicalIF":3.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12519868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285583","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 impact of fluoxetine on obesity and diabetes-related biomarkers in overweight and obese individuals: a systematic review and meta-analysis of randomized controlled trials.","authors":"Guixia Tong, Chen Zhang, Hainan Li, Xin Gao, Periyannan Velu, Mohammad Safargar, Kousalya Prabahar, Hua Xie, Xiaoyan Wang","doi":"10.1186/s12888-025-07441-8","DOIUrl":"10.1186/s12888-025-07441-8","url":null,"abstract":"","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"977"},"PeriodicalIF":3.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12519731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285588","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":"Distribution of mental health diagnoses in relation to sexual orientation and gender discontent in a late adolescent community population.","authors":"Arne Gerdner, Therése Skoog, Sabina Kapetanovic, Emma Claesdotter-Knutsson, Susanna Askelöf, Anders Håkansson","doi":"10.1186/s12888-025-07411-0","DOIUrl":"10.1186/s12888-025-07411-0","url":null,"abstract":"<p><strong>Background: </strong>Few population studies have assessed the prevalence of various psychiatric disorders separately for sexual and gender minority groups, and none in an adolescent population. Given the increased mental health problems in sexual and gender minority groups combined, the present study aimed to estimate prevalence of mental disorders in separate sexual minority groups as well as gender discontent persons in community-recruited adolescents in Sweden.</p><p><strong>Methods: </strong>The present study is based on two waves (at 17 and 18 years of age) of a longitudinal cohort study (N = 949; 56% with female and 44% male legal gender, of which 1.7% reported gender discontent). Diagnostic data of 20 mental health disorders (psychiatric, substance use, and addictive behavior disorders) for each group of sexual orientation (asexual, homosexual, bisexual, and heterosexual) and gender discontent are reported, based on structured screening and subsequent diagnostic procedures.</p><p><strong>Results: </strong>The largest prevalence of mental health disorders was detected in homosexual girls and in bisexuals of both genders. Among asexual individuals, and among homosexual boys, none of the participants fulfilled the mental health disorders assessed. Gender discontent was associated with a moderately higher number of mental health disorders.</p><p><strong>Conclusion: </strong>Mental health services, both in specialized psychiatry and in community-based services targeting the mental health of adolescents may need to take into consideration the increased vulnerability for mental health disorders in bisexual individuals and in female homosexual individuals. Further research with larger samples is essential to better understand mental health in asexual individuals, young male homosexuals, and transgender or gender discontent populations.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"972"},"PeriodicalIF":3.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285585","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":"Self-harming behaviors among forensic psychiatric patients living with intellectual disability.","authors":"Mark Mohan Kaggwa, Joan Abaatyo, Arianna Davids, Luke Brenton, Madeline Komar, John M W Bradford, Gary Andrew Chaimowitz, Andrew Toyin Olagunju","doi":"10.1186/s12888-025-07431-w","DOIUrl":"10.1186/s12888-025-07431-w","url":null,"abstract":"<p><strong>Background: </strong>Individuals with intellectual disabilities (ID) are frequently involved in the criminal justice system, and many subsequently enter the forensic psychiatric system. While individuals with ID in forensic psychiatric settings are known to have a high burden of engaging in self-harming behaviors, limited studies have explored self-harming behaviors among them.</p><p><strong>Aim: </strong>To determine the prevalence of ID and explore the burden of self-harming behaviors and the associated factors among forensic psychiatric patients with ID.</p><p><strong>Methods: </strong>This retrospective study utilized data on 155 patients diagnosed with ID under the Ontario Review Board during the reporting year 2014 to 2015. The primary outcome variable was engagement in physical self-harming behaviors. Factors associated with self-harm were identified using logistic regression analysis, performed with STATA-17.</p><p><strong>Results: </strong>The prevalence of ID among forensic psychiatric patients in Ontario was found to be 13.1%. Of these patients, 43.2% had their Full-Scale Intelligence Quotient (FSIQ) score included in the report used for the database. The prevalence of self-harming behaviors among patients with ID was 9.7%. The likelihood of self-harm was significantly lower in males (adjusted odds ratio [aOR] = 0.02, 95% confidence interval [CI] = 0.002-0.47, p-value = 0.013) and significantly higher in those with a previous history of self-harm (aOR = 28.21, 95% CI = 1.61-494.66, p-value = 0.022).</p><p><strong>Conclusion: </strong>This study found a high burden of both ID and self-harm, especially among females and those with prior history of self-harming. These findings highlight the need for relevant resources, targeted interventions, and specialized programs to mitigate self-harm in this vulnerable population.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"976"},"PeriodicalIF":3.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12519855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285587","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":"Assessing decision-making capacity in clinical practice in Norway: a qualitative exploration of stakeholder perspectives.","authors":"Jacob Jorem, Reidun Førde, Tonje Lossius Husum, Jørgen Dahlberg, Reidar Pedersen","doi":"10.1186/s12888-025-07161-z","DOIUrl":"10.1186/s12888-025-07161-z","url":null,"abstract":"<p><strong>Background: </strong>Decision-making capacity (DMC) is a widely used criterion in health law, but assessments pose challenges in practice. In Norway, lacking DMC became an additional criterion for involuntary care and treatment following comprehensive amendments to the Mental Health Care Act in 2017. Contrary to the amendments' objectives, involuntary care rates have continued to increase after an initial reduction in 2017. Assessing DMC typically involves four abilities: understanding, reasoning, appreciating relevant information, and communicating a choice. This four abilities model was introduced to aid in DMC assessments. With limited assessment experience pre-2017, the Norwegian context offers valuable insights into how stakeholders integrate DMC into clinical practice over time. This study aimed to explore how DMC was assessed in clinical practice following the introduction of a capacity-based mental health law governing involuntary care and treatment in Norway.</p><p><strong>Methods: </strong>In 2018, semi-structured interviews and focus groups were conducted with 44 key stakeholders, including psychiatrists, specialists in clinical psychology, general practitioners, and lawyers in supervisory bodies (the Control Commission and County Governor). In 2022-23, 21 of these participants took part in individual follow-up interviews. The interviews were transcribed and thematically analysed.</p><p><strong>Results: </strong>Data analysis generated three themes with subthemes: (1) DMC assessments primarily relied on the four abilities model in specialist care, experiencing gradual clinical adaptation with decreased importance, and exhibited variations in quality, particularly in primary care; (2) several challenges in DMC assessments, including lack of training in applying the four abilities model, ownership, continuity of care, information, and patient cooperation, with certain patient groups posing particular challenges, such as those with manic symptoms, substance misuse, and severe eating disorders; and (3) quality assurance measures needed, including systematic training and tools to improve assessment quality.</p><p><strong>Conclusions: </strong>Assessing DMC involves variations and several challenges across the healthcare system. While the four abilities model served as a primary basis of DMC assessments in specialist care, systematic training, validated tools, and further research seem needed to improve assessment quality and better understand factors influencing assessments. Recognising the complex interplay between legal, health service, and societal factors when implementing health law reforms seems crucial for achieving their objectives.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"965"},"PeriodicalIF":3.4,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273633","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":"Investigating the role of depression in obstructive sleep apnea and predicting risk factors for OSA in depressed patients: machine learning-assisted evidence from NHANES.","authors":"Xiangyang Cheng, Fang Liu, Xiao Zhang, Ye Liu, Jiaxi Guo, Xuelai Zhong, Dongdong Tian, Aijie Pei, Xuwu Xiang, Yongxing Yao, Diansan Su","doi":"10.1186/s12888-025-07414-x","DOIUrl":"10.1186/s12888-025-07414-x","url":null,"abstract":"<p><strong>Objective: </strong>The relationship between depression and obstructive sleep apnea (OSA) remains controversial. Therefore, this study aims to explore their association and utilize machine learning models to predict OSA among individuals with depression within the United States population.</p><p><strong>Methods: </strong>Cross-sectional data from the American National Health and Nutrition Examination Survey were analyzed. The sample included 14,492 participants. Weighted logistic regression analysis was performed to examine the association between OSA and depression.Additionally, interaction effect analyses were conducted to assess potential interactions between each subgroup and the depressed population.Multiple machine learning models were constructed within the depressed population to predict the risk of OSA among individuals with depression, employing the Shapley Additive Explanations(SHAP) interpretability method for analysis.</p><p><strong>Results: </strong>A total of 14,492 participants were collected. The full-adjusted model OR for Depression and OSA was (OR,1.31;95%CI(1.08, 1.60); P < 0.005).The positive association between depression and OSA was revealed in all models.The interaction analysis revealed no subgroups exhibited statistical significance. The Neural Network was identified as the best-performing model, achieving the highest Youden's Index, AUC, and Kappa scores. SHAP analysis highlighted the most significant predictors of OSA: BMI, Age, Marital status, Hypertension, Caffeine intake, Sex, Alcohol status, and Fat intake.</p><p><strong>Conclusion: </strong>In conclusion, our research indicates that depression is associated with OSA, highlighting the importance of early detection and management of depressive symptoms in individuals at risk of OSA.ML models were developed to predict OSA and were interpreted using SHAP. This method identified key factors associated with OSA, encompassing demographic, dietary, and health-related dimensions.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"964"},"PeriodicalIF":3.4,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273658","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":"Psychotropic-associated delusional pseudo-gender dysphoria: a case report.","authors":"Karim Abdel Aziz, Abeer Saleh Al Ammari, Mouza Sultan Alzaabi, Farah Jamal Al Naqbi, Mariam MohamedObadah Adi, Fatima Saleh Aljaberi, Zakaria Husam Ouda, Emmanuel Stip","doi":"10.1186/s12888-025-07450-7","DOIUrl":"10.1186/s12888-025-07450-7","url":null,"abstract":"<p><strong>Background: </strong>Gender dysphoric delusions are reported in about 20-25% of patients with schizophrenia. There have been no previous cases of psychotropics contributing to the occurrence of gender dysphoric delusions or cases where two different types of gender dysphoric delusions occur in the same patient at different times.</p><p><strong>Case presentation: </strong>We report on a 30-year-old female with bipolar disorder who after being maintained on sodium valproate and once-monthly paliperidone, experienced side effects in the form of hirsutism (facial hair) and amenorrhea. After discontinuing them, she started reporting that her lower half was female and her upper half was male, then began to identify as \"a man trapped in a woman's body\" and expressed a desire to undergo gender affirming surgery. Treatment with a clozapine resulted in her identifying once again as 100% female.</p><p><strong>Conclusions: </strong>This is the first case to report on the contribution of psychotropics in the development of gender dysphoric delusions and is also the first to report on two different types of gender dysphoric delusions occurring in the same patient at different times, with initial delusions of simultaneously belonging to both genders and then delusions of belonging to the opposite gender only.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"969"},"PeriodicalIF":3.4,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273620","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}