BMC Psychiatry最新文献

{"title":"Quantitative susceptibility mapping shows alterations of brain iron content in children with autism spectrum disorder: a whole-brain analysis.","authors":"Xiaowen Xu, Yang Li, Haifei Lan, Ning Ding, Weikai Li, Guifen Zheng, Xiufeng Song","doi":"10.1186/s12888-025-07235-y","DOIUrl":"https://doi.org/10.1186/s12888-025-07235-y","url":null,"abstract":"<p><strong>Background: </strong>Iron deficiency in subcortical structures has been reported in previous studies using manually drawn regions of interest (ROIs). However, no whole-brain iron content studies in individuals with autism spectrum disorder (ASD) have been published. This study aimed to explore whole-brain iron content in ASD children using quantitative susceptibility mapping (QSM) and to examine relationships between clinical features of ASD and regional susceptibility values.</p><p><strong>Methods: </strong>A total of 30 ASD children and 28 typically developing (TD) individuals who were matched for age and sex were prospectively recruited. Brain MRI scans were performed on each participant. Each brain region's susceptibility value was compared between groups, and correlations with clinical manifestations were examined.</p><p><strong>Results: </strong>The ASD patients showed significantly higher susceptibility values than TD children in the bilateral middle temporal gyrus, left inferior temporal gyrus, left inferior parietal gyrus, right lateral occipital gyrus, right insula, and bilateral rostral anterior cingulate gyrus. Conversely, significantly lower susceptibility was observed in the right cerebral white matter of ASD children. According to correlation analysis, susceptibility values in the left middle temporal gyrus, left inferior parietal gyrus, and right lateral occipital gyrus were negatively correlated with the Gesell Developmental Schedules (GDS) gross motor scores in the ASD group.</p><p><strong>Conclusions: </strong>ASD children had aberrant susceptibility values in cortical areas, and these abnormalities might be associated with their clinical features, which may provide new insights into understanding the pathophysiology of ASD.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"826"},"PeriodicalIF":3.4,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12392503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941872","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":"Adherence to evidence-based treatment guidelines for depression: a systematic review.","authors":"Sophie Dizet, Emmanuel Haffen, Hervé Javelot","doi":"10.1186/s12888-025-07192-6","DOIUrl":"https://doi.org/10.1186/s12888-025-07192-6","url":null,"abstract":"<p><strong>Background: </strong>Depression is a common mental disorder that has a profound impact on daily life and increases the risk of chronic diseases and mortality. Adherence to treatment guidelines would produce better patient outcomes but is often suboptimal. The objective of this systematic review was to examine adherence to evidence-based treatment guidelines for depression, identify factors that influence adherence and understand how to improve it.</p><p><strong>Methods: </strong>We searched the PubMed, Web of Science and Cochrane databases. We included original trials, studies dealing with treatment-related guidelines and patients suffering from depressive disorders. We excluded reviews, study protocols and studies that dealt exclusively with mental disorders other than depression.</p><p><strong>Results: </strong>85 studies met the inclusion criteria. Six studies focused on young subjects, three on the perinatal population and three on the elderly. A few studies concerned a population with somatic (n = 11) or psychiatric (n = 25) comorbidities. Eight articles focused on ethnic minorities.</p><p><strong>Discussion: </strong>The lack of standard measurement on adherence and the variability in adherence rates highlight the complexity of assessing and implementing guideline-concordant care, and the associated challenges. Factors that influence adherence, such as those related to patients and their comorbidities, physicians, and guideline-related factors, play a significant role in determining whether appropriate treatment is received. Despite the complexity and cost of these strategies, multifaceted approach to guideline implementation, including the active involvement of clinicians, ongoing monitoring, and organisational support, improves guideline adherence.</p><p><strong>Conclusion: </strong>This review provides a comprehensive overview of the current state of guideline adherence in treatment of depression and identifies areas for quality improvement initiatives.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"825"},"PeriodicalIF":3.4,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12392555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941595","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":"Implementation of a recovery-oriented assertive community treatment (Re-ACT) program for people with heavy use of psychiatric treatment in Switzerland: results from a three-year pilot study.","authors":"Mariela E Jaffé, Julian Moeller, Franziska Rabenschlag, Christine Althaus Aebersold, Jörg Eysell, Constantin Bruttel, Lukas Imfeld, André Nienaber, Undine E Lang, Christian G Huber","doi":"10.1186/s12888-025-07287-0","DOIUrl":"https://doi.org/10.1186/s12888-025-07287-0","url":null,"abstract":"<p><strong>Background: </strong>International guidelines recommend the provision of community based treatment as an alternative to predominant inpatient stays in psychiatric hospitals for people with severe mental illnesses. Assertive community treatments have been introduced across the globe; however, the development and implementation of such treatment options are still limited in Switzerland in general and were, until recently, not available in Basel-Stadt.</p><p><strong>Methods: </strong>We here describe the development and implementation of an assertive community treatment program created specifically for people with previous heavy use of psychiatric inpatient services in the canton of Basel-Stadt. The program offers this patient group a need-centered and recovery-oriented treatment option following an inpatient stay. Primary objectives are a reduction in the likelihood of further inpatient stays and the potential experience of involuntary admissions as well as high participant satisfaction.</p><p><strong>Results: </strong>Results from the three-year pilot study (2019-2022) are reported here on a case-level. We compare objective outcome measures for people participating in the program after an inpatient stay and receiving minimal treatment (n_cases = 110) versus people not participating (n_cases = 292). Overall, we show that program participation is associated with a lower number of inpatient treatment days, inpatient stays and number of involuntary admissions. Feedback on subjective outcome measures indicates high treatment satisfaction.</p><p><strong>Conclusion: </strong>These findings speak to the feasibility of the program's implementation and provide a first outlook for a new recovery-oriented treatment option for people with a history of frequent hospitalizations.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"828"},"PeriodicalIF":3.4,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12392508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941801","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 risk factors of obsessive-compulsive disorder: a cross-sectional study in Southwestern China.","authors":"Haibing Chen, Jie Feng, Mengling Wang, Huifang Han, Yue Deng, Kesu Qin, Jiangyu Liao, Chengzhi Chen, Jingfu Qiu, Hongyang Zhang","doi":"10.1186/s12888-025-07281-6","DOIUrl":"https://doi.org/10.1186/s12888-025-07281-6","url":null,"abstract":"<p><strong>Background: </strong>In recent years, obsessive-compulsive disorder (OCD) has emerged as the fourth most prevalent mental disorder. However, the relationship between OCD and various factors, including demographic characteristics, lifestyles, and dietary habits remains uncertain. This study aims to explore the connection between various factors and OCD.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted from January 14 to February 15, 2023, targeting the general population through an online platform. Demographic characteristics, lifestyles, dietary habits, and OCD symptoms were assessed using a validated classification scale. To identify potential risk factors for OCD, Lasso and logistic regression analyses were performed. Subsequently, the relative importance of these factors was evaluated through machine learning models, including Support Vector Machine, Random Forest, and Back Propagation Neural Network.</p><p><strong>Results: </strong>Among the 1572 participants, 30.40% were categorized as high-risk for OCD. Logistic regression analysis revealed that having a medical history (OR = 1.709, 95% CI: 1.064-2.738), sleep disorders (OR = 1.460, 95% CI: 1.005-2.137), gastrointestinal (GI) symptoms (OR = 1.562, 95% CI: 1.057-2.311), and abnormal defecation (OR = 1.431, 95% CI: 1.013-2.018) significantly increased the risk of OCD (all P < 0.05). These findings were consistent with the results from machine learning models, further supporting the critical role of these factors in OCD risk.</p><p><strong>Conclusion: </strong>This study identified medical history, GI symptoms, sleep disorders and picky eating as significant risk factors for OCD. These findings offer valuable insights into the etiology of OCD and suggest potential avenues for targeted interventions and preventive strategies aimed at reducing OCD risk.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"829"},"PeriodicalIF":3.4,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12392577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941862","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":"Effects of different interventions on anxiety disorders in children and adolescents: a systematic review and bayesian network meta-analysis.","authors":"Longhui Li, Qiner Li, Jingyi Wang, Quan Fu, Meng Chi","doi":"10.1186/s12888-025-07227-y","DOIUrl":"10.1186/s12888-025-07227-y","url":null,"abstract":"<p><strong>Background: </strong>Anxiety disorders are among the most prevalent psychiatric conditions, particularly affecting children and adolescents. Since the COVID-19 pandemic, the incidence of anxiety in this population has increased, making it a significant public health concern. This study aimed to evaluate the effectiveness of various interventions for anxiety disorders in children and adolescents and identify the most effective approach to mitigate the impact of these disorders.</p><p><strong>Methods: </strong>We conducted a thorough search of eligible randomized controlled trials across five databases: Cochrane, Embase, PubMed, Scopus, and Web of Science. A Bayesian network meta-analysis was performed using R Studio, and the quality of evidence was evaluated using the GRADE method.</p><p><strong>Results: </strong>From 19,442 publications retrieved, 30 RCTs involving 1,711 participants were included. The results showed that Acceptance and Commitment Therapy was the most effective intervention for treating anxiety disorders in children and adolescents (MD = -3.83 [95% CrI: -9.33, 1.51]). Cognitive Behavioral Therapy was the second most effective (MD = -3.64 [95% CrI: -7.36, -0.48]), followed by Virtual Reality Exposure Therapy (MD = -2.53 [95% CrI: -8.23, 3.32]) and Physical Exercise (MD = -2.16 [95% CrI: -9.99, 5.52]).</p><p><strong>Conclusions: </strong>Acceptance and Commitment Therapy (ACT) appears to be the most effective intervention for anxiety disorders in children and adolescents. However, this finding should be interpreted with caution due to the overall low quality of evidence, high heterogeneity, and imprecision in the results. Future research should investigate the potential benefits of combining physical exercise or virtual reality-assisted therapies. Moreover, large-scale, high-quality randomized controlled trials are essential to further validate and refine these findings.</p><p><strong>Trial registration: </strong>PROSPERO, CRD42024587910.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"809"},"PeriodicalIF":3.4,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941769","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-compassion in the prospective associations with the coexisting patterns of posttraumatic stress symptoms and posttraumatic growth during the pandemic: a regression mixture analysis.","authors":"Zimi Li, Xiangkui Zhang, Yizhen Ren","doi":"10.1186/s12888-025-07274-5","DOIUrl":"https://doi.org/10.1186/s12888-025-07274-5","url":null,"abstract":"<p><strong>Background: </strong>Previous research has highlighted the diverse range of posttraumatic psychological responses observed during the COVID-19 pandemic.</p><p><strong>Objective: </strong>This study aims to investigate the prospective associations between different dimensions of self-compassion and the concurrent patterns of posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG) among college students during the pandemic.</p><p><strong>Methods: </strong>A prospective study was conducted using an online survey administered to college students in mainland China. In May 2020, a total of 1099 college students provided assessments of their self-compassion, PTSS, and PTG in Wave 1. Six months later, 701 students reported their PTSS and PTG levels in Wave 2 once again.</p><p><strong>Results: </strong>After adjusting for PTSS and PTG in Wave 1, the study identified five distinct classes characterizing the coexisting PTSS and PTG patterns in college students during Wave 2: the coexistence group (11.6%), unaffected group (37.1%), growth group (30.7%), trauma group (10.6%), and vulnerable group (10.1%). In comparison to the growth group, a higher degree of self-kindness demonstrated a prospective association with a reduced likelihood of students belonging to the unaffected group, trauma group, and vulnerable group. Similarly, a higher level of common humanity was prospectively associated with a decreased probability of students being classified in the unaffected group. Furthermore, higher levels of mindfulness were linked to decreased likelihoods of students being placed in the trauma and vulnerable groups. Additionally, higher levels of overidentification demonstrated a prospective association with an increased likelihood of students being categorized into the other four groups when compared to the growth group.</p><p><strong>Conclusions: </strong>The study underscores the heterogeneous nature of pandemic-related posttraumatic psychological responses among college students. To effectively address PTSS and PTG in this population, intervention programs should focus on enhancing mindfulness, self-kindness, and common humanity while reducing overidentification.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"815"},"PeriodicalIF":3.4,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Bayesian network-based predictive model for postoperative delirium following coronary artery bypass grafting.","authors":"Lei Xu, Yang Zhang, Jin Zhang, Wenyan Xiao, Yu Liu, Qi Li, Min Yang","doi":"10.1186/s12888-025-07299-w","DOIUrl":"https://doi.org/10.1186/s12888-025-07299-w","url":null,"abstract":"<p><strong>Background: </strong>Delirium is a common complication following coronary artery bypass grafting (CABG). This study aims to develop and validate a predictive model for postoperative delirium in CABG patients using a Bayesian Network (BN).</p><p><strong>Methods: </strong>Data from the MIMIC-IV and eICU-CRD databases were analyzed, with the MIMIC-IV dataset used for model training and internal validation, and the eICU-CRD dataset for external validation. A directed acyclic graph was constructed using BN based on the Max-Min Hill-Climbing algorithm, followed by model inference. Model performance was assessed using the area under the receiver operating characteristic curve (AUROC) and compared with logistic regression, LightGBM, and a BN model based on the Hill-Climbing algorithm.</p><p><strong>Results: </strong>A total of 3,708 CABG patients from the MIMIC-IV database and 630 from the eICU-CRD database were included, with postoperative delirium incidence rates of 17% and 14.9%, respectively. The developed BN predictive model comprises 14 nodes and 22 directed edges, with Richmond Agitation-Sedation Scale and Sequential Organ Failure Assessment score appearing as parent nodes of delirium, indicating a probabilistic dependency within the network. The model achieved an AUROC of 0.79 in the internal validation cohort and 0.72 in the external validation cohort. Additionally, a Shiny platform application based on the BN model was developed.</p><p><strong>Conclusions: </strong>This study successfully constructed a BN predictive model for postoperative delirium following CABG, demonstrating robust predictive performance and high interpretability.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"822"},"PeriodicalIF":3.4,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941968","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":"Cognitive impairment and its influencing factors in patients with stable schizophrenia on regular medication: a real-world clinical study.","authors":"Ziyang Ji, Fengju Yao, Hanxiao Liu, Yixuan Zhang, Qinlin Lei, Haoxue Li, Jiao Dong, Jingyang Gu, Changhong Wang","doi":"10.1186/s12888-025-07297-y","DOIUrl":"https://doi.org/10.1186/s12888-025-07297-y","url":null,"abstract":"","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"819"},"PeriodicalIF":3.4,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomised controlled clinical and cost effectiveness trial of an online integrated bipolar parenting intervention (IBPI) compared to treatment as usual in improving child emotional and behavioural outcomes: a study protocol.","authors":"Steven H Jones, Sarah Byford, Elizabeth Coleman, Cathy Creswell, Lucy Cryle, Anne Duffy, Stephanie Fortier, Catherine E Hewitt, Fiona Lobban, Christopher Lodge, Richard Morriss, Jasper Palmier-Claus, Lesley Sinclair, Christopher J Sutton, Judith Watson, Nahel Yaziji, Eirian Kerry","doi":"10.1186/s12888-025-07214-3","DOIUrl":"10.1186/s12888-025-07214-3","url":null,"abstract":"<p><strong>Background: </strong>Bipolar disorder (BD) is a severe mental health problem linked to substantial personal and social costs. Many individuals living with bipolar disorder are parents. Due to the nature of the condition, parents with BD often experience challenges in delivering consistent parenting. In addition, up to 60% of their children experience at least one mental health problem in childhood and are at increased risk of future severe mental health problems including bipolar disorder. This paper describes the rationale and protocol for a definitive randomised controlled trial of a new digital intervention (Integrated Bipolar Parenting Intervention; IBPI) to support effective parenting in the context of BD.</p><p><strong>Methods and design: </strong>The randomised controlled clinical and cost-effectiveness trial compares IBPI plus treatment as usual (TAU) with TAU alone. Parents with BD with a child aged 4-11 years old and living in the UK will be recruited through the NHS, mental health charities, and social media. Participants will be screened to confirm a clinical diagnosis of BD. They will then complete baseline assessments and be randomised to receive either IBPI + TAU or TAU with follow up assessments after 24- and 48- weeks. The primary clinical outcome is child emotional and behaviour problems measured by the Strengths and Difficulties Questionnaire at 24 weeks. The primary economic evaluation will be a cost-utility analysis at 24-weeks with quality-adjusted life years (QALYs) measured using the Child Health Utility 9 Dimensions measure of health-related quality of life. Secondary outcomes include parental mood and confidence and family functioning at 24- and 48- weeks, and child emotional and behavioural problems and health economic outcomes at 48 weeks.</p><p><strong>Discussion: </strong>Despite the challenges faced by children of parents with BD and the parents themselves, research on how to improve their lives is lacking. This will be the first definitive trial of a tailored intervention that aims to improve child and parent outcomes. Results will be reported in line with CONSORT guidance for clinical and health economic findings.</p><p><strong>Trial registration: </strong>ISRCTN Registry (ISRCTN15962574) registered on 03/05/2023.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"816"},"PeriodicalIF":3.4,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941249","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 diagnostic role of exploratory eye movement in schizophrenia: a systematic review and meta-analysis.","authors":"Zelin Dong, Huan Chen, Ri-Sheng Zhu, Guoliang Jia, Ying Liang","doi":"10.1186/s12888-025-07233-0","DOIUrl":"10.1186/s12888-025-07233-0","url":null,"abstract":"<p><strong>Purpose: </strong>Exploratory eye movement (EEM) parameters, such as the number of eye fixations (NEF), the responsive search score (RSS), and the discriminant index (D score), serve as reliable biomarkers unaffected by medication or disease progression. However, the diagnostic accuracy of these parameters remains uncertain due to inconsistent thresholds and limited validation in small-sample studies. This study aimed to explore reliable diagnostic thresholds for NEF, RSS and D score values for clinical use.</p><p><strong>Methods: </strong>Eight databases were used to identify relevant studies with tailored search strategies. Two independent reviewers screened all retrieved literatures according to pre-defined inclusion and exclusion criteria. Key information of included studies was extracted in standardized tables. Diagnostic Accuracy-2 instrument (QUADAS-2) was used to assess quality of included studies. Two-by-two tables were created and were used to recompute the sensitivity and specificity. The cut-off for the D score was pre-specified based on prior studies, sensitivity and specificity were calculated for all indicators, with heterogeneity assessed by Cochrane Q test. For the RSS and NEF, logistic regression was used to model the diagnostic prediction probability of schizophrenia. ROC curves were constructed by evaluating all possible thresholds, and Youden's Index was employed to determine optimal cut-offs.</p><p><strong>Results: </strong>The D score was analysed on the basis of 1895 samples from 9 articles and achieved an overall accuracy of 90%, with a sensitivity of 79% and a specificity of 87%. On the basis of the 3158 predictive values from 21 articles, the NEF was shown to achieve the highest diagnostic rate of 70.1% when the threshold was set at 28.7, with a sensitivity of 63.38% and a specificity of 66.88%. On the basis of 3408 predictive values from 23 articles, the RSS was shown to achieve the highest diagnostic rate of 75.36% when the threshold was set at 8.05, with a sensitivity of 63.7% and a specificity of 73.2%.</p><p><strong>Conclusion: </strong>The study revealed that the D score had relatively high diagnostic power, while, the NEF and RSS had moderate overall diagnostic capacities at optimal cut-off points. However, reliability and generalizability of these result were comprised by using aggregated data for analysis in this study, and adoption of these result in clinical decision-making process should be cautious.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"813"},"PeriodicalIF":3.4,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941807","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}