BMC Psychiatry最新文献

{"title":"Suicidal ideation, attempted suicide and determinants among prisoners in Ethiopia 2024: a systematic review and meta-analysis.","authors":"Bereket Aberham Lajore, Sisay Moges, Dinku Daniel Kabiye, Abera Feyisa, Mengistu Lodebo, Betelhem Asmerom Debesay, Likawunt Samuel, Erdaro Wodebo, Zerihun Demessie, Kassahun Mekuria, Abrham Samuel, Anebo Getachew, Merkineh Mekebo, Belay Bancha, Tadesse Hamdalla, Degefa Tadele, Elias Terago, Bereket Birege","doi":"10.1186/s12888-025-06869-2","DOIUrl":"https://doi.org/10.1186/s12888-025-06869-2","url":null,"abstract":"<p><strong>Introduction: </strong>Prisoners face severe restrictions on freedom and social connections, negatively impacting their mental health and increasing suicidal thoughts and attempts. Suicide is a significant public health concern, with rates among inmates much higher than in the general population. Research indicates that suicidal ideation is common among convicts. Despite the alarming prevalence of suicidal ideation and attempts among inmates, many countries lack comprehensive data on prison suicides, highlighting the need for targeted preventive strategies. This systematic review and meta-analysis aims to synthesize findings of different studies and pool them to provide a comprehensive figure of suicidal ideation and attempts among prisoners and to inform policymakers on improving health services for vulnerable inmates.</p><p><strong>Objective: </strong>This study comprehensively assessed and pooled the prevalence of suicidal ideation and attempts and the effect size of determinants among prisoners in Ethiopia.</p><p><strong>Methods: </strong>Systematic searches for observational studies were conducted in various databases, including PubMed (MEDLINE), CINAHL (EBSCO), Embase, Web of Science, HINARI, Science Direct, Google Scholar, Mednar, and the Cochrane Library. Observational studies involving inmates from 2015 to 2024 were included, except those who fulfill exclusion criteria. Four research groups independently selected studies, extracted data, and assessed quality. Nine studies involving 4435 prisoners were included. A meta-analysis using random-effects models was performed.</p><p><strong>Results: </strong>A total of nine studies involving 4435 study participants were included in the review. This study of studies revealed that the pooled prevalence of suicidal ideation and attempted suicide among prisoners in Ethiopia was 23.28% (95% confidence intervals (CI): 12.26%, 34.29%) and 10.20% (95% CI: 8.63%, 11.78%), respectively. Depression, poor social support, suicidal history, and previous mental illness were significantly associated. Statistically significant heterogeneity across included studies was found both for suicidal ideation (I<sup>2</sup> = 98.74%, p ≤ 0.001) and suicidal attempts (I<sup>2</sup> = 73.05%, p ≤ 0.001). Egger's test revealed publication bias in studies on suicidal ideation (p = 0.001) but not in studies on suicidal attempts (p = 0.271).</p><p><strong>Conclusion: </strong>This study revealed a high prevalence of suicidal ideation and attempts among prisoners. These public health problems are significantly determined by depression, poor social support, mental illness, and family history of suicide. The review advocates for integrating mental health services in prisons, including routine screenings, while emphasizing the need to combat the marginalization of prisoners for meaningful change.</p><p><strong>Trial registration: </strong>The protocol for this study was submitted and registered in PROSPERO on 03 May 202","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"426"},"PeriodicalIF":3.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952986","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 and factors influencing low social support from family, friends, and significant others among people with mental illness attending psychiatric outpatient clinics in Gondar, Ethiopia.","authors":"Wondale Getinet Alemu, Lillian Mwanri, Clemence Due, Telake Azale, Anna Ziersch","doi":"10.1186/s12888-025-06889-y","DOIUrl":"https://doi.org/10.1186/s12888-025-06889-y","url":null,"abstract":"<p><strong>Background: </strong>Evidence demonstrates a correlation between high social support and better health outcomes. However, people with mental illness are less likely to receive adequate social support to overcome mental health challenges when compared with the general population. The main objective of this study is to determine the prevalence and associated factors of low perceived social support from family, friends and significant others among people with mental illness attending a psychiatry outpatient clinic in Gondar, Ethiopia.</p><p><strong>Methods: </strong>Data were collected from 636 participants attending a psychiatry outpatient clinic at the University of Gondar Comprehensive Specialized Hospital. Two individuals consented but did not complete the questionnaires from October 2022 to March 2023. A systematic random sampling technique was used to recruit participants. Perceived social support was measured with the Multidimensional Perceived Social Support scale (MPSS-12). Other questions assessed self-esteem, drug adherence, substance use and severity of illness, alongside sociodemographic factors. Variables were coded and entered into SPSS-28 software for further analysis. Bivariate and multivariate logistic regression analysis was conducted. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p-value less than 0.05 were considered significant.</p><p><strong>Results: </strong>Prevalence of low perceived social support was 12.1% (N = 77). In the final regression analysis, several factors were associated with a greater likelihood of overall low perceived social support. These include living alone (OR = 2.40, CI = 1.24,4.63), having a relapse (OR = 2.13; CI = 1.13,4.02), family not participating in patient care (OR = 4.67; CI = 2.49,8.76), having moderate and severe objective severity (OR = 2.51; CI = 1.41,4.45), having low self-esteem (OR = 2.36; CI = 1.34,4.15) and having poor drug adherence (OR = 1.99; CI = 1.02,3.89).</p><p><strong>Conclusions: </strong>Over 10% of people with a mental illness attending the outpatient psychiatry clinic reported low perceived social support. The study indicates that efforts to address low social support should focus specifically on patients, including those: living alone, having relapses, having families that do not participate in patient care, having moderate and severe objective severity of illness, having low self-esteem, and having poor drug adherence.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"429"},"PeriodicalIF":3.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966972","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":"Lifetime prevalence of psychotic experience, and its associated factors among Senegalese women: a cross-sectional study.","authors":"Joshua Okyere, Samuel Salu, Castro Ayebeng, Qorinah Estiningtyas Sakilah Adnani, Kwamena Sekyi Dickson","doi":"10.1186/s12888-025-06879-0","DOIUrl":"https://doi.org/10.1186/s12888-025-06879-0","url":null,"abstract":"<p><strong>Background: </strong>Psychotic experiences, which include a range of symptoms such as delusions and hallucinations, is an indication of elevated risk for mental disorders and poor quality of life. These experiences are often underreported and undertreated in low- and middle-income countries, including Senegal. This study aimed to investigate the lifetime prevalence of psychotic experience, its associated factors and adverse outcomes among Senegalese women.</p><p><strong>Methods: </strong>This study analyzed the 2023 demographic and health survey data of 16,521 Senegalese women. Descriptive analysis, cross-tabulations, chi-square test, and binary logistic regression models were computed in STATA 18. The multivariable logistic regression analysis followed a backward stepwise approach.</p><p><strong>Results: </strong>Overall, 6,819 women (41.3% [95%CI: 38.4-44.2]) had a lifetime prevalence of psychotic experience. Referential delusions were the most prevalent (24.5%), followed by paranoid ideation (17.1%), auditory hallucinations (14.1%), bizarre delusions (13.3%), possession (12.4%), visual hallucinations (11.5%), and thought insertion/broadcasting (11.4%). The odds of psychotic experience increased consistently with age. Higher educational attainment (AOR = 0.73, 95%CI: 0.61-0.88) and being currently in union were associated with lower odds of psychotic experiences (AOR = 0.90, 95%CI: 0.81-0.99). A higher risk of psychotic experience was found among women who were exposed to media (AOR = 1.08, 95%CI: 1.00-1.17), those in the richest wealth index (AOR = 2.33, 95%CI: 2.06-2.63), and currently employed women (AOR = 1.21, 95%CI: 1.12-1.30). Dietary habits were relevant, as consuming fried and processed food (AOR = 1.25, 95%CI: 1.15-1.37) and soda and energy drinks (AOR = 1.14, 95%CI: 1.03-1.27) were both associated with increased odds of psychotic experiences. Women who reported a lifetime prevalence of psychotic experience were significantly more likely to attempt suicide (AOR = 10.89; 95%CI: 7.10-16.72), anxiety (AOR = 4.64; 95%CI: 3.89-5.52), and depression (AOR = 7.39; 95%CI: 5.14-10.62).</p><p><strong>Conclusion: </strong>In conclusion, four out of ten women in Senegal had a lifetime prevalence of psychotic experience. These experiences increase the likelihood of anxiety, depression and suicidal attempts. We also conclude that psychotic experiences are associated with sociodemographic and lifestyle factors including age, educational level, employment status, media exposure and dietary habits. Interventions to reduce psychotic experiences should focus on education, media exposure, employment, and dietary habits.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"425"},"PeriodicalIF":3.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967409","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":"Evaluating the Chinese versions of delirium assessment scales: a diagnostic systematic review.","authors":"Chen Tang, Jun Zhong, Xiaojiao Wang, Fangfang Zhu, Bei Wang, Yanting Zhang, Deying Hu","doi":"10.1186/s12888-025-06745-z","DOIUrl":"https://doi.org/10.1186/s12888-025-06745-z","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The purpose of this study is to examine the validity, reliability and methodological quality of delirium scales that have been translated and adapted in China using quality assessment tools.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A comprehensive search was conducted in PubMed, Embase, Web of Science, China Knowledge Network (CNKI), VIP database, Wanfang database, and China Biomedical Literature Database. The search covered the period from the establishment of the database until September 1, 2023. Two researchers independently screened the literature and extracted data. Studies were included if they focused on the translation of a delirium scale from English into simplified or traditional Chinese, with a study population aged ≥ 18 years and full text available. The risk of bias was assessed through the QUADAS-2 instrument. Level of evidence recommendation is completed with the GRADE and performed with GRADE GPT. Due to high heterogeneity across studies, a random-effects model was applied to calculate diagnostic accuracy indicators (sensitivity, specificity, and area under the curve index). This study has registered in the prospero.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Thirteen studies were included, of which 2 were case-control studies and 11 were cross-sectional studies. These studies involved 13 adult delirium assessment tools, and were all translated following the Brislin or ISPOR principle. The results of the methodological quality assessment showed that 3D-CAM, 4AT, CAM-ICU, CAM-ICU-7, and S-PTD had higher quality ratings, with 4AT being the highest quality. 4AT, CAM, 3D-CAM, CAM-CR, CAM-ICU, CAM-ICU-7, and Nu-DESC were recommended at a level B. The Cronbach's coefficient of most studies is over 0.8, and the inter-rater reliability of most studies is near or over 0.9, indicating good internal consistency and stability. Besides, a significant inverse correlation was found between these 13 Chinese-adapted delirium scales and their reference tests, with most studies were over 0.7, and especially 3 studies offered S-CVI and I-CVI value that were all larger than 0.9, indicating a good discriminate validity and content validity, though different cut-off points were recommended by different scales. Moreover, the sensitivity and specificity of these studies were mainly larger than 0.9, which proved the good diagnostic accuracy of these included scales. The pooled sensitivity of 7 Chinese delirium adaption scales that provided statistical data is 0.93 (95% CI: 0.89-0.96), and the pooled specificity is 0.94 (95% CI: 0.94-0.96), and the AUC is 0.98 (95% CI: 0.96-0.99).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The research on the Chinese adaptation of the delirium scale in China is relatively abundant and of acceptable quality. Taking into account factors of methodological quality and diagnostic accuracy, Chinese-adapted delirium assessment scales such as 3D-CAM, 4AT, CAM, CAM-ICU, CAM-ICU-7, and NuDESC appear to be suitable alternatives t","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"431"},"PeriodicalIF":3.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956664","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":"Empowerment among treatment-engaged individuals living with schizophrenia in Tanzania.","authors":"Madeline Jin Van Husen, Sylvia Kaaya, Praxeda Swai, Paul Sarea Lawala, Beatrice Thadei, Anna Minja, Jennifer Headley, Joseph R Egger, Joy Noel Baumgartner","doi":"10.1186/s12888-025-06700-y","DOIUrl":"https://doi.org/10.1186/s12888-025-06700-y","url":null,"abstract":"<p><strong>Purpose: </strong>As low-resource settings move to address the treatment and social service gap for people living with schizophrenia (PLWS), person-centered and recovery-oriented interventions should monitor impacts on empowerment. This study explores empowerment and associated factors among PLWS in Tanzania.</p><p><strong>Methods: </strong>This study uses endline data from the Culturally Adapted Family Psychoeducation for Adults with Psychotic Disorders in Tanzania (KUPAA) pilot trial. Participants included 66 dyads of PLWS and caregivers recruited from two tertiary-level hospitals. The main outcome variable of interest was empowerment (Rogers 28-item Empowerment Scale), and the main exposure variable was Participation in Society (Domain 6 of the WHO Disability Assessment Schedule, WHODAS 2.0). Key psychosocial correlates of interest included hopefulness, general self-efficacy, internalized stigma, and family functioning. Bivariate and multivariable analyses were used to explore variable relationships.</p><p><strong>Results: </strong>There were 21 women and 40 men with a mean age of 32 years. Bivariate analyses revealed greater participation in society (p < 0.0003) was correlated with greater empowerment, higher hopefulness (p < 0.0001) and higher self-efficacy (p < 0.0001). Lower empowerment was correlated with higher self-stigma (p < 0.0001) and worse family functioning (p < .001). Multivariable models indicated more participation in society was associated with higher empowerment, but when hope, self-efficacy, internalized stigma, and/or family functioning were added to the models, those factors were more strongly correlated with empowerment than participation in society.</p><p><strong>Conclusion: </strong>Empowerment is increasingly being recognized as an important outcome of psychosocial interventions. Understanding empowerment and its possible effects on recovery-centered outcomes is important when thinking of future interventions for PLWS in low-resource settings. Future recovery-oriented interventions and research should both consider including empowerment measurement among PLWS and incorporate their lived experiences in psychosocial treatment programming.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"422"},"PeriodicalIF":3.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956846","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 who committed violent offences: an exploratory study on the role of circumstances during the index offence and victim characteristics.","authors":"Mark Mohan Kaggwa, Arianna Davids, Heather Moulden, Gary Andrew Chaimowitz, Parwiz Mohibi, Bailea Erb, Andrew Toyin Olagunju","doi":"10.1186/s12888-025-06877-2","DOIUrl":"https://doi.org/10.1186/s12888-025-06877-2","url":null,"abstract":"<p><strong>Background: </strong>Self-harming behaviors are common among forensic patients with violent index offenses. While various factors, including feelings of shame and guilt, may influence self-harming behaviors, little is known about how the circumstances surrounding the index offense and the victims' characteristics affect self-harming tendencies among forensic patients. In this study, we examined the association of the circumstances surrounding the index offence and victim characteristics with self-harming behaviors among forensic patients who have committed violent offences.</p><p><strong>Methods: </strong>The present study consisted of 845 forensic psychiatric patients under the Ontario Review Board who had violent offences (Mean age = 42.13 ± 13.29; 85.68% male) in the reporting year 2014/15. The study examined the association between self-harming incidents with the circumstances during the index offense and victims' characteristics while controlling for clinical and demographic factors based on multiple hierarchical negative binominal regression.</p><p><strong>Results: </strong>The prevalence of self-harm was 4.14%, and more than half (61.29%) of the patients with self-harming behaviors had multiple incidents. The total number of self-harming incidences recorded in the reporting year was 113. The results showed that of the overall 24.05% explained by the models, the victim's characteristics contributed approximately 5% points, and circumstances during the index offence contributed an additional 2% points in explaining self-harming behaviors among forensic psychiatric patients during the reporting year. In the final model, the risk of self-harm increased with having a victim who was a healthcare/support staff or a co-patient/cohabitant.</p><p><strong>Conclusion: </strong>Self-harm among forensic patients who committed violent offences is associated with various factors, including previous history of self-harm and the victim's characteristics, especially when the victim was a healthcare/support worker or co-patient. These findings suggest that self-harm might be a maladaptive way of coping with negative emotions, such as feelings of guilt and shame triggered by harming others. Mitigating measures for self-harm among patients with violent offences need to be robust and individualized, taking into consideration vulnerability issues and the best available evidence.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"427"},"PeriodicalIF":3.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957142","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":"\"Why shouldn't I expect a lot from life?\" - a qualitative study of what facilitates long-term recovery in first-episode psychosis.","authors":"Gina Åsbø, Hanne Haavind, Sindre Hembre Kruse, Kristin Fjelnseth Wold, Wenche Ten Velden Hegelstad, Kristin Lie Romm, Mike Slade, Torill Ueland, Ingrid Melle, Carmen Simonsen","doi":"10.1186/s12888-025-06681-y","DOIUrl":"https://doi.org/10.1186/s12888-025-06681-y","url":null,"abstract":"<p><strong>Background: </strong>Qualitative research frequently characterises recovery, but more knowledge on subjective experiences of facilitators of long-term recovery in psychosis is needed. This interview study aimed to explore what people with first-episode psychosis (FEP) highlight as important for their long-term recovery.</p><p><strong>Methods: </strong>Interviews with 20 individuals in recovery (personal and/or clinical) participating in two follow-up studies, 10 and 20-years after treatment start for a first episode schizophrenia or bipolar spectrum disorder. Interviews were thematically analysed by a research team that included a peer researcher.</p><p><strong>Results: </strong>The analysis generated that personal resources and agency were experienced as the overarching facilitators of recovery, with five themes: (1) Doing recovery in everyday life, involving agency in daily life; (2) Re-evaluating risk, involving re-evaluating limitations and stress reduction; (3) Becoming a caregiver, involving development from being cared for to taking care of others; (4) Negotiating normality, involving identity and social inclusion; (5) Owning and sharing your story, involving accepting lived experience and overcoming stigma.</p><p><strong>Discussion: </strong>All participants described themselves as the main facilitators of their own recovery, and treatment as secondary to their efforts. Gradually testing limitations and taking risks, providing social support to others, as well as owning and sharing your story were crucial for promoting long-term recovery in FEP. Clinical implications include supporting service users' agency with strength- based interventions and shared-decision making, as well as refining psychoeducation on stress reduction in a long-term perspective.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"423"},"PeriodicalIF":3.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979287","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":"Building and sustaining therapeutic relationships across treatment settings: a qualitative study of how patients navigate the group dynamics of mental healthcare.","authors":"Henrik Wang Iversen, Henriette Riley, Marit Råbu, Geir Fagerjord Lorem","doi":"10.1186/s12888-025-06874-5","DOIUrl":"https://doi.org/10.1186/s12888-025-06874-5","url":null,"abstract":"<p><strong>Background: </strong>Therapeutic relationships are vital for patients with complex and long-term psychosocial needs, yet such patients often face fragmented and unstable relationships within mental healthcare. These patients are more often than others moved between treatment settings and caregiving teams. Statutory obligations strain the relationships with frequent hospitalizations adding to the burden This study explores how these patients perceive and navigate therapeutic relationships, highlighting both positive and negative experiences across various treatment settings.</p><p><strong>Methods: </strong>This is a qualitative study with a narrative approach utilizing in-depth interviews focusing on participants personal experiences and perceptions. We utilized purposive sampling to recruit patients with extensive hospitalization experience, operationalized as more than four admissions within one year or more than four successive weeks of hospitalization. Our sample consisted of 16 participants, twelve women and four men. The interviews were analyzed using a holistic-content approach.</p><p><strong>Results: </strong>We found that therapeutic relationships were built on healthcare professionals recognizing and addressing patients' needs and advocating for their interests within the service system. Participants described therapeutic relationships as sources of collaboration, stability, and support but found them challenging to sustain due to fear of rejection and institutional barriers. Successful relationships worked as a vital buffer, offering protection against malpractices and depersonalized care.</p><p><strong>Conclusion: </strong>Therapeutic relationships play a crucial role in supporting patients with complex needs, but relational dilemmas and malignant group dynamics often impede their development. Mental healthcare services have an ethical responsibility to foster and maintain therapeutic environments and professional cultures that enable personalized care, while maintaining boundaries through reflective practices.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"424"},"PeriodicalIF":3.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977054","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":"Impact of childhood psychological abuse on the trajectory of adolescent depressive symptoms: a latent growth modeling approach.","authors":"Fang Yuan, Yongna Feng, Jingtao Wu, Jingxia Wang, Yanhong Shao","doi":"10.1186/s12888-025-06884-3","DOIUrl":"https://doi.org/10.1186/s12888-025-06884-3","url":null,"abstract":"<p><strong>Background: </strong>Although researchers have examined the impact of childhood psychological abuse on adolescent depressive symptoms, further investigation is needed to understand the mechanisms by which childhood psychological abuse influences these symptoms.</p><p><strong>Methods: </strong>Utilizing a latent variable growth model, this study analyzed the dynamic trajectories of depressive symptoms among 1,300 adolescents from four middle schools in Jiangsu Province and Sichuan Province, as well as the factors influencing these trajectories. A longitudinal survey was conducted with three rounds of questionnaires over the course of a semester. Data analysis was performed using SPSS 24.0 and Mplus 7.0.</p><p><strong>Results: </strong>The findings revealed several key points: (1) Depressive symptoms among adolescents generally showed a linear decline; however, there were significant individual differences in initial symptom levels and rates of change; (2) Childhood psychological abuse was found to significantly predict both initial levels and the pace of change in depressive symptoms; (3) All three dimensions of childhood psychological abuse-verbal aggression, threats, and intrusiveness-significantly influenced both initial symptom levels and the trajectory of change; (4) The dynamics of psychological abuse were significantly correlated with the rate of change in depressive symptoms.</p><p><strong>Conclusion: </strong>The results highlight the detrimental effects of childhood psychological abuse and suggest the feasibility of interventions targeting early secondary school students, providing insights into strategies to mitigate the impact of depressive symptoms among adolescents.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"421"},"PeriodicalIF":3.4,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974046","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 review on exploration-exploitation trade-off in psychiatric disorders.","authors":"Ali Jami, Sajjad Abbaszade, Abdol-Hossein Vahabie","doi":"10.1186/s12888-025-06837-w","DOIUrl":"https://doi.org/10.1186/s12888-025-06837-w","url":null,"abstract":"<p><p>Balancing exploration and exploitation is a crucial aspect of adaptive decision-making, but psychiatric disorders can disrupt this balance in various ways, shedding light on their neurocognitive roots and guiding targeted interventions. In this systematic review, we aimed to delineate potential exploration-exploitation impairments across psychiatric disorders. Through a thorough search on PubMed, we identified forty-six relevant studies employing tasks probing exploration-exploitation balances, which we synthesized to reveal distinct patterns. These disorders are clustered into three categories: addictive patterns, emotional/cognitive disturbances, and neurological (neurodevelopmental and neurodegenerative) disorders. Our findings show that anxiety and mood disorders often enhance exploratory behaviors, while depression impact decision stability and reward sensitivity. In contrast, schizophrenia, OCD (Obsessive-Compulsive Disorder), and ADHD (Attention-Deficit/Hyperactivity Disorder) are characterized by excessive switching and difficulties in balancing exploration and exploitation, leading to impaired learning and adaptability. Additionally, disorders with addictive-like features disrupt optimal decision-making strategies by either heightening exploration or causing maladaptive persistence, thus skewing the balance away from effective decision-making. Individuals exhibiting addiction-like or compulsive behaviors often demonstrate imbalances in the explore-exploit trade-off, resulting in suboptimal decision-making characterized by reduced exploration, flawed foraging strategies, and impulsive or perseverative choices despite adverse outcomes. This suggests that such disorders may originate from dysfunctional foraging processes applied to decision-making. In sum, different patterns of exploration-exploitation balance in different disorders are crucial in understanding the difficulties in learning and decision making of neuropsychiatric disorders. This suggests that such disorders may stem from dysregulated decision-making processes, where uncertainty plays a central role. Dysfunctions in dopaminergic and noradrenergic pathways appear to disrupt the brain's representation of uncertainty, thereby altering exploratory behavior. In sum, the varying patterns of exploration-exploitation balance across different disorders are critical for understanding the challenges in learning and decision-making associated with neuropsychiatric conditions.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"420"},"PeriodicalIF":3.4,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956554","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}