BMC Psychiatry最新文献

{"title":"Exploring the mechanistic link between the oxytocinergic system and mindfulness training in adults with heightened stress: study protocol for a double-blind, randomized, placebo-controlled trial (MOX-MIND).","authors":"E van Weert, H J De Vuyst, K Van der Gucht, E Debbaut, J Steyaert, K Alaerts","doi":"10.1186/s12888-025-07077-8","DOIUrl":"https://doi.org/10.1186/s12888-025-07077-8","url":null,"abstract":"<p><strong>Background: </strong>Oxytocin administration is increasingly considered a novel therapeutic support option for alleviating psychological distress in stress-related neuropsychiatric conditions, including anxiety disorders and depression. However, oxytocin as a stand-alone treatment may fail to consistently target the relevant central autonomic circuitry without a complementary supportive therapeutic context that similarly stimulates stress-regulatory states and behaviors. Recent findings suggest that the neurophysiological mechanisms underlying stress regulation induced by mindfulness may rely on an activation of the endogenous oxytocinergic system. Accordingly, combining oxytocin with a mindfulness-based training program may enhance efficacy compared to each intervention alone.</p><p><strong>Methods: </strong>A randomized, double-blind, placebo-controlled clinical trial will be conducted in 120 adults with heightened stress complaints, randomly assigned to one of the following four treatment arms (n = 30 per group): (1) oxytocin + mindfulness, (2) mindfulness + placebo, (3) oxytocin, and (4) placebo (control). The oxytocin or placebo nasal spray will be administered four times a week in the morning before each mindfulness session for six weeks, followed by a six-week post-treatment follow-up session. Primary endpoints include self-reported behavioral measures of stress, depression, and anxiety. Secondary endpoints include self-reported behavioral measures of mood, mindfulness skills, quality of life, sleep quality, and negative thinking. Exploratory measures include (i) electroencephalography (EEG), electrocardiography (ECG), skin conductance, and respiration, measured during rest, meditation, stress induction, and stress recovery; (ii) intervention-induced changes in biological samples, including hormonal levels of oxytocin and cortisol and DNA methylation of the oxytocin receptor gene (OXTR); and (iii) stress reactivity in daily life, assessed through experience sampling and heart rate/sleep monitoring. All outcome measures will be assessed at baseline (T0), immediately post-intervention (T1), and at six-week follow-up (T2).</p><p><strong>Discussion: </strong>These findings could provide valuable insights into how combining oxytocin and mindfulness-based interventions might enhance stress regulation, particularly in populations with impaired oxytocinergic function.</p><p><strong>Trial registration: </strong>This trial was registered in the EU Clinical Trials Register (EU CT 2024-513482-39-00) on 18 March 2025.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"622"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the psychometric properties of the Premenstrual Symptoms Screening Tool (PSST) among Bangladeshi adolescent girls.","authors":"Md Saiful Islam, Maliha Khan Majlish, Md Saif Mahabub, Mahmudur Rahman, Md Shefatul Islam, Md Salim Uddin, Marc N Potenza, Kamrun Nahar Koly","doi":"10.1186/s12888-025-06678-7","DOIUrl":"https://doi.org/10.1186/s12888-025-06678-7","url":null,"abstract":"<p><strong>Background: </strong>Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) affect many reproductive-aged women and can significantly impact their quality of life, including academic performance, relationships, and mental health, perhaps even leading to suicidal behavior. However, there was no validated, robust, and psychometrically sound instrument to screen for symptoms in the Bangladeshi context. This study aimed to translate and adapt a widely used instrument, the Premenstrual Symptoms Screening Tool (PSST) in the Bangladeshi context, and to assess the prevalence of PMS and PMDD among adolescent girls in Bangladesh.</p><p><strong>Methodology: </strong>A cross-sectional study was conducted among 939 adolescent girls in Bangladesh aged 11-19 years using the \"Konnect\" platform of a2i between April to October 2022. Data were collected through a pre-tested semi-structured questionnaire that included informed consent, socio-demographic information, menstrual history, the Depression Anxiety and Stress Scale 21 (DASS-21), and the PSST scale. Statistical analysis, including descriptive statistics and confirmatory factor analysis, was performed using IBM SPSS Statistics (version 25.0) and IBM SPSS Amos (version 26.0). Convergent validity was assessed by correlating the Bangla version of the PSST with depression, anxiety, and stress subscales of the DASS-21.</p><p><strong>Results: </strong>The prevalence estimates of moderate to severe PMS and PMDD were 33.16%, and 19.05%, respectively. Item-level analysis showed that the measurement items were normally distributed which suggested measurement of the same construct. The Bangla version of the PSST demonstrated excellent internal consistency (Cronbach alpha = 0.96) and convergent validity. The total PSST score was positively and significantly correlated with depression (r = 0.54), anxiety (r = 0.50), and stress (r = 0.50), suggesting convergent validity. The scale-level psychometric properties were satisfactory, indicating an excellent fit to the data and supporting convergent validity.</p><p><strong>Conclusions: </strong>The Bangla version of the PSST was found to be a valid screening tool for assessing PMS in women in Bangladesh. It will help to identify and address their healthcare needs, promote well-being, and advance further research in the Bangladeshi context.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"606"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Being in a different world: a phenomenological study of life with gender dysphoria.","authors":"Nasrin Rezaee, Mahnaz Ghaljeh, Sally Pezaro, Zahra Ghiasi, Marjan Mardani-Hamooleh","doi":"10.1186/s12888-025-07110-w","DOIUrl":"10.1186/s12888-025-07110-w","url":null,"abstract":"<p><strong>Background: </strong>Individuals with gender dysphoria are exposed to greater health risks and are increasingly seeking medical care. In pursuit of gender equity and improved healthcare outcomes, this study aimed to explore the lived experiences of individuals with gender dysphoria in Iran, where the 'traditional' gender binary constitutes an integral aspect of Islamic social ethics.</p><p><strong>Methods: </strong>We employed a qualitative approach using a phenomenological hermeneutic framework. Fourteen individuals with gender dysphoria were recruited to participate using purposive sampling. Face-to-face and semi-structured interviews were used to collect data, which was subsequently analysed using the seven-stages of Critical Hermeneutic Analysis.</p><p><strong>Results: </strong>Our findings revealed how people living with gender dysphoria experienced a lack of social and cultural support and distressing psychological experiences. Theme (1) lacking social and cultural support included the following sub-themes; rejection by family and society; lack of legal support and being victims of cultural taboos. Theme (2) distressing psychological experiences included the following sub-themes; disgust in relation to sexual characteristics and gender conformity, fear, and anxiety about disclosing one's authentic gender. In this study, a constitutive pattern emerged of \"being in a different world\". Participants experienced being beaten, abused, suicidal ideation and death threats.</p><p><strong>Conclusions: </strong>This research was carried out in a unique cultural and religious context in which government jurisprudence is implemented. In Iran, individuals with gender dysphoria require social, familial support along with legal and medical frameworks which enable access to gender affirming care. The experience of gender dysphoria is deeply influenced by cultural factors. Thus, cultural and educational interventions are required in Iran to change both attitudes and perceptions. These may include endorsement of change by law and policy makers through public and television appearances.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"646"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High testosterone levels associated with elevated suicidal risk in male adolescents with depression.","authors":"Han Wang, Nan Lyu, Juan Huang, Bingbing Fu, Lili Shang, Fan Yang, Ling Zhang, Qian Zhao","doi":"10.1186/s12888-025-07098-3","DOIUrl":"10.1186/s12888-025-07098-3","url":null,"abstract":"<p><strong>Background: </strong>Adolescent suicide, as a public health issue, is becoming increasingly urgent, yet there remains a lack of effective objective biomarkers for identifying high-risk adolescents. While testosterone has been linked to suicide, no definitive conclusions have been reached. Studies in specific populations defined by significant changes in age or hormone levels and by gender have shown greater reproducibility. This study aims to investigate the association between testosterone levels and suicidal ideation or behavior in male and female adolescents with major depressive disorder (MDD).</p><p><strong>Methods: </strong>This retrospective, cross-sectional study included 1227 adolescents with MDD, aged 10-19 years, hospitalized at the Beijing Anding Hospital, Capital Medical University, from January 2013 to December 2020. Patients were categorized into two groups: those with suicidal ideation or behavior (MDS) and those without (MDNS). Demographic data, clinical characteristics, and serum testosterone levels at admission were extracted and compared. An additional 579 adolescents meeting the same inclusion criteria were included for validation, with data collected from January 2022 to December 2023.</p><p><strong>Results: </strong>In male adolescents, testosterone levels were significantly higher in the MDS group compared to the MDNS group(Z = -4.340, P < 0.001). After adjusting for confounding factors, testosterone levels remained significantly associated with suicidal ideation or behavior (OR = 1.220, 95% CI: 1.098-1.356). This finding was confirmed in the validation data set (OR = 1.444, 95% CI: 1.139-1.832). No significant difference in testosterone levels was observed in females (Z = 1.643, P = 0.100).</p><p><strong>Conclusions: </strong>Elevated serum testosterone levels were independently associated with increased risk of suicidal ideation or behavior in male adolescents with MDD, but not in females. These findings highlight the necessity for sex-specific biomarkers, however, due to the intrinsic limitations of the current study, they necessitate further validation.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"643"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Involving young people with lived experience in advancing mental health science: an exploratory qualitative study from Pakistan and India.","authors":"Syed Usman Hamdani, Zill-E- Huma, Bhismadev Chakrabarti, Syeda Wajeeha Zafar, Ayella Gillani, Vaishali Bagrodia, Amy Finlay Jones","doi":"10.1186/s12888-025-07062-1","DOIUrl":"10.1186/s12888-025-07062-1","url":null,"abstract":"<p><strong>Background: </strong>Meaningful involvement of young People with Lived Experience (PWLE) in co-designing youth mental health interventions has been much emphasized globally. However, there is a scarcity of evidence on involving PWLE of mental health problems in designing, implementing and evaluating mental health interventions, especially in Low- and Middle-Income Countries (LMICs). The aim of the current study was to understand the perspectives of young PWLE from two South Asian countries, Pakistan and India, regarding \"Active Ingredients\" (AIs) for youth mental health (i.e., components or processes of mental health intervention(s) that make a difference to mental health outcomes), as part of the Wellcome Trust AI Commission.</p><p><strong>Methods: </strong>For this exploratory qualitative study, we conducted 30 qualitative interviews via Zoom with young PWLE from Pakistan (n = 19, 14 females and 5 males) and India (n = 11, 8 females and 3 males) to explore their views about different AIs for youth anxiety and depression in South Asia. The qualitative data was analysed using a thematic analysis approach that moved through the phases of familiarization, generation of codes, searching, identification and review of themes and selection of illustrative quotes.</p><p><strong>Results: </strong>The results show that family and religion are integral to promoting positive youth mental health in the South Asian context. The AIs perceived to be most relevant for Pakistani and Indian young people were (i) improving social relationships; (ii) managing emotions; and (iii) relaxation techniques. Participants highlighted the need to explore the role of family support, personal space, spirituality/religion, schools, mental health literacy and stigma as potential AIs of mental health for young people in South Asia. The need for ease of access to mental health support and minimizing barriers to engagement with mental health services were highlighted as important contextual factors. Our findings highlight the need for culturally responsive youth mental health strategies that incorporate their preferred intervention components and address key challenges including stigma faced by South Asian youth.</p><p><strong>Conclusions: </strong>The current study highlights specific intervention components and contextual considerations that are important to Indian and Pakistani young PWLE when designing and delivering mental health interventions. Our findings underscore the need to work with young PWLE and consider their context, culture, and resources when developing or evaluating mental health interventions. Given our sample likely represents a relatively advantaged group, future studies can use targeted sampling strategies to capture perspectives of young people from lower socio-economic strata.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"647"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric evaluation of the Persian version of the Beliefs About Voices Questionnaire: revised in patients with schizophrenia spectrum disorders.","authors":"Vida Yousefi Asl, Abbas Pourshahbaz, Ali Nazeri Astaneh, Farhad Taremian","doi":"10.1186/s12888-025-07080-z","DOIUrl":"10.1186/s12888-025-07080-z","url":null,"abstract":"","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"667"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long COVID in people with mental health disorders: a scoping review.","authors":"Catharina Münte, Manuela Glattacker, Saskia Müller, Andrea E Zülke, Martin Heinze, Steffi G Riedel-Heller, Dawid Pieper, Christian Jacke, Stefanie Deckert, Anne Neumann","doi":"10.1186/s12888-025-06935-9","DOIUrl":"10.1186/s12888-025-06935-9","url":null,"abstract":"<p><strong>Background: </strong>Long COVID, Post COVID Syndrome or PASC (post-acute sequelae of COVID-19), according to the World Health Organization (WHO), is defined as the continuation or development of new symptoms 3 months after the initial SARS-CoV-2 infection, with these symptoms lasting for at least 2 months with no other explanation. The term Long COVID will be used throughout this review. Little is known about individuals with pre-existing mental health conditions experiencing Long COVID. This scoping review aims to provide an overview of these individuals, focusing on: 1) the course of mental disorders, 2) care needs, 3) utilization of healthcare services, and 4) psychosocial aspects, as outlined by the International Classification of Functioning (ICF).</p><p><strong>Methods: </strong>This review followed the JBI (Joanna Briggs Institute) methodology for scoping reviews and the PRISMA extension for scoping reviews. We included reports focusing on individuals with at least one pre-existing mental health diagnosis and Long COVID. Full-text reports in English or German were included, with no geographical limitations. Literature searches were conducted in PubMed, Embase, and PsycINFO on November 1, 2023, for records published between January 2020 and October 2023. Six reviewers participated in the screening process in pairs, independently conducting study selection and data extraction. Conflicts were resolved by consensus. Citation tracking was performed, and data were summarized narratively in tables.</p><p><strong>Results: </strong>From 4256 initial hits and citation tracking, 8 reports were included. The studies were heterogeneous, including chart reviews, case reports, cross-sectional, and longitudinal studies. Evidence on the impact of Long COVID on pre-existing mental health conditions was inconsistent. Most findings focused on the course of mental health disorders, ranging from symptom worsening to new symptoms of anxiety, depression, or insomnia. Evidence on mental health care needs, service utilization, and psychosocial aspects was limited.</p><p><strong>Conclusion: </strong>Limited evidence suggests that individuals with pre-existing mental health disorders who experience Long COVID may be at an increased risk of worsening mental health. However, critical aspects such as care needs, service utilization, and psychosocial factors remain under-researched, highlighting the need for further studies on mental health care for Long COVID.</p><p><strong>Review registration: </strong>Open Science Framework https://osf.io/tqexa .</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"669"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A network analysis of the depression and anxiety comorbidity: a nationwide survey among Chinese adolescents during the normalization phase of COVID-19 pandemic prevention and control.","authors":"Tingting Li, Dan Zhang, Tangjun Jiang, Wanyu Che, Yi Zhang, Yuhui Wan, Fangbiao Tao, Shuman Tao, Xiaoyan Wu","doi":"10.1186/s12888-025-07036-3","DOIUrl":"10.1186/s12888-025-07036-3","url":null,"abstract":"<p><strong>Objectives: </strong>This study employed network analysis to investigate the comorbidity model between depression and anxiety among Chinese adolescents during the normalization phase of COVID-19 pandemic prevention and control.</p><p><strong>Methods: </strong>From October to December 2021, a total of 22 868 adolescents were selected from 27 schools in 8 cities of China by multistage cluster sampling. Depressive symptoms and anxiety symptoms of adolescents were evaluated by the Patient Health Questionnaire 9 (PHQ-9) and the Generalized Anxiety Disorder scale 7 (GAD-7), respectively. The network structure between depression and anxiety was explored using the Extended Bayesian Information Criterion (EBIC) and the graphical Least Absolute Shrinkage and Selection Operator (LASSO) method. The centrality of nodes, stability, accuracy, central symptoms, bridging symptoms, and network comparison were analyzed.</p><p><strong>Results: </strong>In the present study, 7 236 (31.6%) participants reported with depression-anxiety comorbidity. The obtained network model was highly stable. The edges between 'Control worry' and 'Too much worry', between 'Restless' and 'Irritable', and between 'Anhedonia' and 'Sad mood' were the three strongest positive edges in the anxiety and depression community. The edges between 'Motor' and 'Restless', between 'Guilt' and 'Nervous', and between 'Suicide' and 'Afraid' were the three strongest positive edges in the comorbidity community. 'Sad mood' and 'Too much worry' were the core symptoms within the 'depression' network and 'anxiety' network. 'Nervous', 'Guilt', and 'Restless' were three crucial bridge symptoms linking the comorbidity of depression and anxiety networks. Furthermore, 'Too much worry' (strength index = 1.087) has the highest strength value. 'Nervous' (bridge strength index = 0.51, expected influence (1-step) = 0.51, expected influence (2-step) = 0.93) not only demonstrated the highest bridge strength but also exhibited the highest bridge expected influence. At last, we found that there were no significant differences between genders.</p><p><strong>Conclusions: </strong>In this study, 'Nervous', 'Guilt', and 'Restless' were identified as three crucial bridge symptoms linking the comorbidity of depression and anxiety networks. Timely and multilevel interventions targeting these bridge symptoms may help alleviate the comorbidity of depression and anxiety in Chinese adolescents.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"598"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute suicidal ideation in context: highlighting sentiment-based markers through the diary entries of a clinically depressed sample.","authors":"Damien Lekkas, Amanda C Collins, Michael V Heinz, Tess Z Griffin, Arvind Pillai, Subigya K Nepal, Daniel M Mackin, Andrew T Campbell, Nicholas C Jacobson","doi":"10.1186/s12888-025-07108-4","DOIUrl":"10.1186/s12888-025-07108-4","url":null,"abstract":"<p><strong>Background: </strong>Despite major strides in conceptualizing and modeling the multifaceted nature of suicidal thought and behavior (STB) over the past few decades, the overall predictability of STB has not improved. This may be partly due to the dynamic nature of suicidal ideation (SI), which often fluctuates over hours, yet is largely overlooked in studies. Bolstered by the application and promise of natural language processing (NLP) across the mental health field, efforts toward richer operationalization of acute SI may include analyses on written data that occur alongside changes in SI, thus offering a better understanding of STB as it unfolds.</p><p><strong>Methods: </strong>Ecological momentary assessment (EMA) data from 268 participants with major depressive disorder (MDD) were utilized to investigate acute changes in SI. Data consisted of thrice-daily SI severity scores measured through self-report responses to item 9 of the Patient Health Questionnaire mobile version (MPHQ-9) as well as free-form diary text. Using difference scores and probability of acute change thresholds, eleven acute SI phase trajectory types were defined to label change in SI over three consecutive EMAs. In total, 5,938 acute SI trajectories were paired with the temporally centered diary entries. The Sentiment Analysis and Cognition Engine (SEANCE) tool was applied to quantify the written content of each diary entry across eight established lexica. Entry results were grouped based on phase trajectory type, and the Kruskal-Wallis test was employed with post-hoc multiple hypothesis correction to statistically compare SEANCE features between all group pairs.</p><p><strong>Results: </strong>There were 131 statistically significant (adjusted p-value < 0.05) pairwise differences between acute SI phase trajectory groups, implicating 31 NLP features. Consistent with the literature, results highlighted qualities of writing that are generally associated with heightened SI, including personal pronoun usage, passivity, and negative valence. Patterns of significance also uncovered novel contextual nuance in terms of how characteristics such as verbosity, hostility, anger, and pleasantness present in relation to SI over short change trajectories.</p><p><strong>Conclusions: </strong>This work provides an accessible exploratory framework that capitalizes on the benefits of dense EMA sampling and NLP to profile and quantify acute SI trajectories. The use of the MPHQ's item 9 to quantify SI is an important limitation as it is designed to also capture precursory SI, passive SI, and SI-adjacent behaviors, potentially overestimating the SI expressed by participants. Nonetheless, future research should continue to focus on short timeframes as there are likely important signals and interpretative nuances to SI expression that have yet to be fully detailed.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"650"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in ECT services in India since the implementation of its mental health care act 2017: a clinician's perspective.","authors":"Preeti Sinha, Vanteemar S Sreeraj, Shyam Sundar Arumugham, Jagadisha Thirthalli","doi":"10.1186/s12888-025-07109-3","DOIUrl":"10.1186/s12888-025-07109-3","url":null,"abstract":"<p><strong>Background: </strong>The large treatment gap in mental disorders in India also includes a lack of access to electroconvulsive therapy (ECT), a potentially lifesaving treatment. With the introduction of the Mental Health Care Act (MHCA) 2017 in India, an impact was speculated on the utilisation of ECT due to the ban on unmodified ECT and the regularisation of ECTs in children.</p><p><strong>Methods: </strong>We planned this survey to identify the current status of ECT services in India as perceived by psychiatrists and to explore the barriers to providing ECT, particularly those influenced by the enactment of the MHCA 2017 in India. The psychiatrists practising in India were invited to complete an online questionnaire distributed through social media and professional group forums. A total of 225 consenting participants completed the survey.</p><p><strong>Results: </strong>A majority of the participating psychiatrists (n = 160; 71.11%) were from urban areas, and 102 (45.33%) worked in private hospitals. Approximately half of the respondents (n = 118; 52.44%) could provide ECT to less than a quarter of patients for whom ECT was recommended. Furthermore, 52.4% of psychiatrists (n = 118) reported a decrease in the number of patients receiving ECT following post MHCA 2017 in India, while 44.9% (n = 101) observed no change. Additionally, 114 psychiatrists (50.67%) noted a reduction in the use of ECT for children since MHCA 2017. A substantial proportion (78.22%; n = 176) regarded patient refusal of consent as a significant factor. Access to anaesthesia services and associated costs was identified as a major barrier by 59.1% of psychiatrists (n = 133), significantly influencing their opinion on the reduction of ECT services post-MHCA 2017 (Odds ratio = 2.024, p = 0.018).</p><p><strong>Conclusions: </strong>The limited availability of anaesthesia services and associated expenses are significant barriers to using ECT in developing countries such as India. This issue became more pronounced after the implementation of the MHCA 2017 and should be addressed promptly. Training psychiatrists in ECT anaesthetic skills via task-sharing and telementoring can help resolve this issue.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"670"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}