BMC Psychiatry最新文献

{"title":"Guilt and shame and its relation to oxytocin in patients with depression and alcohol addiction.","authors":"Paraskevi Mavrogiorgou, Patric Dalhoff, Georg Juckel","doi":"10.1186/s12888-025-06762-y","DOIUrl":"10.1186/s12888-025-06762-y","url":null,"abstract":"<p><strong>Backround: </strong>Guilt and shame are important and universal social emotions that fundamentally shape the way people interact with each other. Mental illness such as depressive disorder (DD) or alcohol addiction (AA) is therefore often related to pronounced dysfunctional feelings of shame and guilt. Oxytocin has been suggested to play an important role in socially and morally associated emotions such as shame and guilt.</p><p><strong>Methods: </strong>A total of 85 participants (41 women and 44 men) were clinically investigated, including shame and guilty proneness. To assess the proneness for guilt and shame, the IGQ, the SCV scale, TOSCA, and SHAME were used.</p><p><strong>Results: </strong>Patients with DD showed a maladaptive guilt and shame profile, characterized by increased interpersonal feelings of guilt and increased proneness of shame. Patients with AA were characterized by the lowest reserve and antidelophilic attitude. Oxytocin values were lowest in the patients with AA compared to the two other groups, but not related to guilt and shame.</p><p><strong>Conclusion: </strong>The proneness to maladaptive guilt and shame of mental disorders appears to be less dependent on specific disease aspects than on individual characteristics. Dimensions such as guilt and shame should be more implemented in psychotherapy.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"315"},"PeriodicalIF":3.4,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762517","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":"Prevalence of significant anxiety symptoms and associated factors among adult people with HIV/AIDS in care and treatment clinic centers in Kilimanjaro region, Tanzania: a cross-sectional study.","authors":"Frank Kiwango, Eric Mboya, Florian Emanuel Ghaimo, Neema Ng'unda, Carl Mhina, Editruda Gamassa, Kim Madundo, Ester Steven Mzilangwe, Lyidia Vedasto Masika, Iddi Haruna, Saidi Bakari Kuganda, Blandina Mmbaga, Sylvia Kaaya","doi":"10.1186/s12888-025-06769-5","DOIUrl":"10.1186/s12888-025-06769-5","url":null,"abstract":"<p><strong>Background: </strong>People with human immunodeficiency virus (PWH) are more prone to generalized anxiety disorder. There is a limited understanding of the prevalence of significant anxiety symptoms and its associated risk factors among adult PWH in the Tanzanian context. This study aims to determine the prevalence of significant anxiety symptoms and related risk factors among adult PWH attending care and treatment clinics in Moshi Municipality, Kilimanjaro Region.</p><p><strong>Methods: </strong>We used a multistage random cluster sampling approach to select participants at four Care and treatment centers (CTCs) of Kilimanjaro Christian Medical Centre, Mawenzi Regional Referral Hospital, Majengo, and Pasua Health Centre, by location at tertiary, secondary, and primary health care levels. The seven-item Generalized Anxiety Disorder (GAD-7) screening tool assessed levels of generalized anxiety symptoms with significance set at scores ≥ 10. Sociodemographic, clinical, and psychosocial characteristics were collected using a semi-structured questionnaire. Bivariate analyses determined factors associated with significant anxiety symptoms (GAD-7 ≥ 10) at p-values [Formula: see text]0.20 for inclusion in the multivariate model. Adjusted prevalence ratios with confidence intervals are reported with significance set at a p-value of < 0.05.</p><p><strong>Results: </strong>Out of 593 PWH participants, 12.48% screened positive for significant anxiety symptoms. Participants treated at the tertiary health facility level (aPR = 2.91, 95% CI: 2.48-3.41, P-value = 0.001), early adulthood 25-44 years (aPR = 1.75, 95% CI: 1.27-2.42, P-value = 0.001), with higher anxiety sensitivity (aPR = 3.28, 95% CI: 2.08-5.19, P-value = 0.001), and higher levels of perceived social support (aPR = 2.09; 95% CI: 1.34-3.27, P-value = 0.001) showed a higher likelihood of significant generalized anxiety symptoms.</p><p><strong>Conclusions: </strong>Significant anxiety symptoms were common among adult PWH. Integrating routine generalized anxiety screening and raising PWH's and primary caregivers' awareness of GAD is recommended.</p><p><strong>Trial registration: </strong>Clinical trial number not applicable.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"320"},"PeriodicalIF":3.4,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771312","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":"Determinants of violent behaviors in individuals with severe mental illnesses: a cross-sectional study from 23 community health centers in Nanjing, China.","authors":"Yang Wang, Jiajia Dong, Jianwen Zhu, Jie Fu, Xia Zhang, Sizhe Wang, Lu Wen, Hong Fan","doi":"10.1186/s12888-025-06714-6","DOIUrl":"10.1186/s12888-025-06714-6","url":null,"abstract":"<p><strong>Background: </strong>Individuals with severe mental illnesses (SMIs) are at an increased risk of exhibiting violent behaviors, which may result in significant negative consequences, including damaged relationships, property destruction, and harm to themselves or others. The purpose is to investigate the current status of violent behaviors among individuals with SMIs and identify factors within the demographic information, psychological status, and treatment status of individuals with SMIs that may influence the occurrence of violent behaviors.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey of 1108 individuals with SMIs. The Logistic regression and Chi-squared Automatic Interaction Detection (CHAID) tree model were employed to analyze the influencing factors of violent behaviors in individuals with SMIs and compare their predictive performance.</p><p><strong>Results: </strong>49.6% of the participants engaged in violent behaviors in the past 12 months. The study identified that factors influencing violent behavior in individuals with SMIs include medication adherence, self-reported health status, employment, household income, experience of discrimination, disease concealment, access to medical assistance, and comorbidities. Medication adherence was identified as the most critical factor affecting violent behavior in individuals with SMIs. Logistic regression model and CHAID tree model had comparable predictive accuracy with AUC values of 0.734 and 0.730, respectively. No statistically significant difference was observed in the predictive performance of the two models (Z = -0.745, P = 0.456).</p><p><strong>Conclusions: </strong>Individuals with SMIs are at a higher risk of violent behavior, which is influenced by multiple factors, particularly medication adherence. This adherence may be a key determinant in the occurrence of violent behavior among individuals with SMIs. Healthcare professionals should implement targeted interventions addressing these influencing factors to prevent the manifestation of violent behavior in individuals with SMIs.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"316"},"PeriodicalIF":3.4,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771301","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":"Unravelling the link between alexithymia and psychological distress in nurses: a multi-hospital cross-sectional study exploring the mediating roles of workplace conflict and emotional exhaustion.","authors":"Yuan Li, Jie Li, Chunfen Zhou, Hanmei Peng, Biru Luo, Yanling Hu, Jinbo Fang","doi":"10.1186/s12888-025-06742-2","DOIUrl":"10.1186/s12888-025-06742-2","url":null,"abstract":"<p><strong>Background: </strong>Nurses are particularly susceptible to the adverse psychological effects of alexithymia, a personality trait characterized by difficulties in identifying and describing emotions. However, the mechanisms linking alexithymia to psychological distress among nurses remain unclear. The present study aimed to unravel the link between alexithymia and psychological distress in nurses, and to explore the potential mediating roles of workplace conflict and emotional exhaustion.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among 4088 nurses from 43 public hospitals in China. The participants completed a web-based questionnaire that comprised the Toronto Alexithymia Scale (TAS-20), the Interpersonal Conflict at Work Scale (ICAWS), the Emotional Exhaustion Scale (EES), and the Kessler Psychological Distress Scale (K6). The chain mediation model was evaluated using Mplus, with the bias-corrected bootstrap method. Moreover, a sensitivity analysis utilizing a structural equation modeling approach was performed to corroborate the findings.</p><p><strong>Results: </strong>Among the 3977 nurses who returned valid questionnaires, participants reported mean scores of 53.95 ± 10.78 for alexithymia and 7.26 ± 5.75 for psychological distress, with 22.0% meeting the threshold for alexithymia and 16.9% exhibiting clinically significant psychological distress. The study revealed that alexithymia had a direct positive effect on psychological distress (β = 0.164, 95% CI [0.148-0.181]). Furthermore, workplace conflict (β = 0.036, 95% CI [0.031-0.042]) and emotional exhaustion (β = 0.118, 95% CI [0.108-0.128]) independently mediated the pathway linking alexithymia to psychological distress, and also operated sequentially in a chain mediation pathway (β = 0.010, 95% CI [0.008-0.012]). Sensitivity analyses confirmed the robustness of these findings.</p><p><strong>Conclusions: </strong>This study suggests that alexithymia not only directly affects psychological distress but also exerts chain mediation effects through workplace conflict and emotional exhaustion. The findings unravel the complex mechanisms underlying the alexithymia-psychological distress link, providing valuable insights to guide efforts in safeguarding nurses' mental health. By addressing alexithymia and cultivating a supportive organizational environment, managers can facilitate the build-up of emotional resources, ultimately enhancing the psychological well-being of nurses.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"319"},"PeriodicalIF":3.4,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771320","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":"Comparative effectiveness and acceptability of internet-based psychological interventions on depression in young people: a systematic review and network meta-analysis.","authors":"Baijun Chen, Jialong Li, Yuxin Qi, Honghui Mao, Yihui Liu, Wenting Wang","doi":"10.1186/s12888-025-06757-9","DOIUrl":"10.1186/s12888-025-06757-9","url":null,"abstract":"<p><strong>Background: </strong>Depression represents a major global public health challenge, particularly among young individuals aged between 10 and 25. This age bracket is notably critical, as the onset of depression during these years tends to be more severe and consequential. In response to the growing demand for mental health services, internet-based psychological interventions have gained traction as a flexible and convenient alternative to traditional face-to-face treatment. This systematic review and network meta-analysis aims to rigorously assess the comparative efficacy and acceptability of internet-based psychological interventions in addressing depression within the young population over the past three decades.</p><p><strong>Methods: </strong>We conducted a comprehensive search of seven electronic databases for eligible randomized controlled trials published from January 1995 to July 2024. The literature screening process adhered to the principles of population, intervention, comparator, outcome, and study design. The quality of the included studies was assessed using the Cochrane Risk of Bias Assessment Tool. To evaluate the ranking probability of each intervention, we calculated the surface under the cumulative ranking curve values. Network meta-analysis (NMA) was conducted using RStudio and Stata software.</p><p><strong>Results: </strong>The NMA incorporated a total of 27 studies involving 3,451 participants. Among these studies, 18 assessed internet-based cognitive behavioral therapy (iCBT) interventions, whereas 12 employed a waitlist as a control group. At the end of the interventions, internet-based acceptance and commitment therapy (iACT), iCBT, internet-based dialectical behavior therapy (iDBT), and internet-based psychodynamic therapy (iPDT) all demonstrated statistically significant reductions in depression scores. Notably, no intervention measure was found to be statistically more acceptable than the others.</p><p><strong>Conclusions: </strong>Our NMA indicated that iDBT appeared to be more effective, whereas internet-based mindfulness-based therapy (iMBT) may be more acceptable. These findings offered preliminary evidence regarding the comparative effectiveness and acceptability of internet-based psychological interventions in treating depression among young people. However, the limited number of eligible studies underscored the importance and necessity of further research to evaluate novel intervention measures.</p><p><strong>Trial registration: </strong>The study was registered with the International Prospective Register of Systematic Reviews (PROSPERO), with the registration number CRD42024580958.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"321"},"PeriodicalIF":3.4,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771297","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 mediating effects of coping strategies between symptom clusters and quality of life in lung cancer patients undergoing immunotherapy.","authors":"Xuying Yang, Jingcui Bai, Xiaohong Zhang","doi":"10.1186/s12888-025-06635-4","DOIUrl":"10.1186/s12888-025-06635-4","url":null,"abstract":"<p><strong>Objective: </strong>Immunotherapy has significantly improved the survival rates of lung cancer patients. However, prevalent adverse immune reactions associated with this treatment can detrimentally affect their quality of life. Coping strategies play a crucial role throughout the cancer treatment process. Consequently, this study hypothesised that coping strategies act as a mediating factor between symptom clusters and quality of life. This study intended to provide a theoretical foundation and empirical data to support the optimisation of coping strategies for lung cancer patients, thereby enhancing their overall quality of life.</p><p><strong>Method: </strong>This study consisted of a cross-sectional survey. Data were collected using the Memorial Symptom Assessment Scale, the Medical Coping Modes Questionnaire, the Quality of Life Questionnaire-Lung Cancer 43, and a self-designed General Information Evaluation Form. The data were fitted, and the model was refined using the maximum likelihood estimation method. Additionally, the Bootstrap method was employed to assess mediating effects.</p><p><strong>Results: </strong>In total, 240 participants completed the survey. During immunotherapy, lung cancer patients predominantly adopted the acceptance-resignation coping strategy, which served as a mediating factor between symptom clusters and quality of life. In contrast, the mediating effects of confrontation and avoidance coping strategies between symptom clusters and quality of life were not significant.</p><p><strong>Conclusion: </strong>Both symptom clusters and the acceptance-resignation coping strategy negatively impacted quality of life, with acceptance-resignation serving as a mediating factor between symptom clusters and quality of life. Future research should focus on developing interventions for cognitive behaviour to improve coping strategies and quality of life throughout the disease trajectory.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"322"},"PeriodicalIF":3.4,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771316","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":"Sense of coherence in bipolar disorder- a longitudinal study.","authors":"Erik Pålsson, Mikael Landén","doi":"10.1186/s12888-025-06779-3","DOIUrl":"10.1186/s12888-025-06779-3","url":null,"abstract":"<p><strong>Background: </strong>The Sense of Coherence (SOC) scale was designed to measure an individual's ability to perceive life as comprehensible, manageable, and meaningful. While low SOC is associated with various psychiatric disorders, its association with bipolar disorder remains unclear. This study explores SOC in individuals with bipolar disorder, its associations with clinical characteristics, and its stability and predictive value over 14 years.</p><p><strong>Methods: </strong>We included 248 individuals with bipolar disorder and 113 healthy controls from the St. Göran Bipolar Project. SOC was assessed using Antonovsky's 29-item scale at baseline and after 14 years. Clinical measures included the Montgomery-Åsberg Depression Rating Scale (MADRS), Sheehan Disability Scale, and comorbid psychiatric diagnoses. SOC's predictive value for relapse, suicide attempts, and self-harm was evaluated using data from a 7-year follow-up visit.</p><p><strong>Results: </strong>SOC scores were lower in individuals with bipolar disorder than in healthy controls (p < 0.001). Lower SOC correlated with greater functional impairment, residual depressive symptoms, and comorbid anxiety disorders. SOC was stable over 14 years, with modest increases in both groups. In the bipolar disorder group, baseline SOC predicted self-harm during the initial 7-year follow-up (p = 0.012) but was not associated with mood episode relapse or suicide attempts.</p><p><strong>Conclusion: </strong>Although individuals with bipolar disorder exhibit lower SOC than healthy controls, the difference probably reflects broader psychopathology rather than core bipolar symptoms. SOC predicted self-harm during the 7-year follow-up period, but not mood episode relapse or suicide attempts. Targeting SOC in interventions may benefit comorbid conditions, but is unlikely to impact bipolar-specific outcomes.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"324"},"PeriodicalIF":3.4,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771315","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":"Association between internet addiction and insomnia among college freshmen: the chain mediation effect of emotion regulation and anxiety and the moderating role of gender.","authors":"Ye Yu, Li Zhang, Xuejian Su, Xinfeng Zhang, Xiaopeng Deng","doi":"10.1186/s12888-025-06778-4","DOIUrl":"10.1186/s12888-025-06778-4","url":null,"abstract":"<p><strong>Background: </strong>The advancement of the information age has led to the widespread use of the internet, accompanied by numerous internet-related issues that often correlate with various physical and mental health conditions, particularly among college freshmen. We examined the relationship between internet addiction (IA) and insomnia among these students, using emotion regulation (ER) and anxiety as mediators and gender as a moderating variable.</p><p><strong>Methods: </strong>This cross-sectional study included 7,353 freshmen from a university in Jingzhou City, Hubei Province, China. Data were collected through an online self-administered questionnaire, including the Internet Addiction Test (IAT), the Emotion Regulation subscale (ER), the Generalized Anxiety Disorder 7-item scale (GAD-7), and the Insomnia Severity Index (ISI). Data analysis was conducted using SPSS 21.0 and PROCESS version 4.1 to test the hypothesized relationships among variables.</p><p><strong>Results: </strong>In our survey, correlation analysis showed that ER was significantly negatively correlated with IA, anxiety, and insomnia; IA was significantly positively correlated with anxiety and insomnia (all p < 0.01). The mediating effect analysis indicated that IA was a significant positive predictor of insomnia. ER and anxiety played a chain - mediating role in the development of insomnia (β = 0.039, 95% confidence interval = 0.035-0.043). The moderating effect analysis showed that the interaction term of IA and gender had a significant negative predictive effect on ER (β = -0.014, 95% confidence interval [-0.027, -0.001]) and insomnia (β = -0.022, 95% confidence interval [-0.036, -0.007]). Males (direct effect: β = 0.048, 95% confidence interval = [0.037, 0.059]) had a stronger predictive ability for the level of insomnia than females (direct effect: β = 0.026, 95% confidence interval = [0.014, 0.037]). Females (indirect effect 1: β = 0.015, 95% confidence interval = [0.010, 0.020]; indirect effect 2: β = 0.041, 95% confidence interval = [0.037, 0.045]) had a stronger predictive ability for the level of insomnia through the level of IA than males (indirect effect 1: β = 0.014, 95% confidence interval = [0.009, 0.018]; indirect effect 2: β = 0.037, 95% confidence interval = [0.033, 0.041]).</p><p><strong>Conclusion: </strong>IA can exacerbate insomnia in college freshmen by compromising their ER, subsequently triggering anxiety symptoms. The process differs by gender, suggesting tailored strategies for each. These findings may play crucial roles in promoting the physical and mental well-being of college freshmen.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"326"},"PeriodicalIF":3.4,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771296","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":"Is muscarinic receptor agonist effective and tolerant for schizophrenia?","authors":"Xiaonan Guo, Rongshan Deng, Jianbo Lai, Shaohua Hu","doi":"10.1186/s12888-025-06662-1","DOIUrl":"10.1186/s12888-025-06662-1","url":null,"abstract":"<p><strong>Background: </strong>Several randomized clinical trials (RCTs) have recently examined the efficacy and tolerability of muscarinic receptor agonists in schizophrenia. However, whether therapeutics targeting muscarinic receptors improve symptom management and reduce side effects remains systemically unexplored.</p><p><strong>Methods: </strong>Embase, PubMed, and Web of Science were searched from inception until Jan 9, 2025. Altogether, the efficacy and safety outcomes of four RCTs (397 individuals in the muscarinic receptor agonists group, and 374 in the placebo control group) were meta-analyzed. To compare scores of positive and negative syndrome scale (PANSS), response rate, discontinuation rate, and adverse events with muscarinic receptor agonists vs. placebo in patients with schizophrenia, scale changes were pooled as mean difference (MD) for continuous outcomes and risk ratio (RR) for categorical outcomes.</p><p><strong>Results: </strong>It revealed that muscarinic receptor agonists were superior to placebo in terms of decrease in the total PANSS score (MD, - 9.92; 95% CI, -12.46 to -7.37; I² = 0%), PANSS positive symptom subscore (MD, - 3.21; 95% CI, -4.02 to -2.40; I² = 0%), and PANSS negative symptom subscore (MD, -1.79; 95% CI, -2.47 to -1.11; I² = 48%). According to the study-defined response rate, the pooled muscarinic receptor agonists vs. placebo RR was 2.08 (95% CI, 1.59 to 2.72; I² = 0%). No significance was found in the discontinuation rate. Muscarinic receptor agonists were associated with a higher risk of nausea (RR = 4.61, 95% CI, 2.65 to 8.02; I² = 3%), and in particular, xanomeline-trospium was associated with risks of dyspepsia, vomiting, and constipation.</p><p><strong>Conclusions: </strong>The findings highlighted an efficacy advantage with tolerated adverse event profiles for muscarinic receptor agonists in schizophrenia.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"323"},"PeriodicalIF":3.4,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771303","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 effect of core nodes of geographical identity on psychological stress in network analysis.","authors":"Lei Zhang, Yang Wang, Haibo Yang","doi":"10.1186/s12888-025-06563-3","DOIUrl":"10.1186/s12888-025-06563-3","url":null,"abstract":"<p><strong>Background: </strong>Previous research indicates that geographical identity influences psychological stress. However, there is a paucity of explanations for this relationship that considers a diverse range of influencing factors. As a critical component of higher education, university students are exposed to increasing competition and various pressures, which contribute to the widespread issue of psychological stress. Psychological stress is shaped by multiple factors, including geographical identity, interpersonal relationships, and adaptability. Examining the relationship between geographical identity and psychological stress, as well as identifying the core nodes of both, may provide valuable insights into the development of targeted strategies for mitigating psychological stress among university students.</p><p><strong>Methods: </strong>This cross-sectional study utilized online surveys to collect data from 1,145 volunteer university students in China. Structural equation modeling and network analysis techniques were employed to analyze the data.</p><p><strong>Results: </strong>Geographical identity was found to significantly predict psychological stress (p < 0.05), with adaptability acting as a mediating factor (p < 0.05), and interpersonal relationships serving as a moderating factor (p < 0.05). Interpersonal relationships moderated the relationship between geographical identity and adaptability, weakening the impact of geographical identity on adaptability. Conversely, interpersonal relationships enhanced the effect of adaptability on psychological stress. Additionally, the study found that the core nodes of psychological stress were associated with geographical characteristics (item 17). Notably, there were significant differences in core nodes across academic years and gender groups.</p><p><strong>Conclusions: </strong>Strengthening geographical identity and adaptability at the individual level can help alleviate psychological stress, while reducing interpersonal issues in the environmental context may further mitigate stress. Furthermore, university students of different genders and academic years may require tailored approaches for managing psychological stress.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"313"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762598","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}