BMC Psychiatry最新文献

{"title":"Mortality in national psychiatric hospitals in Sudan: a fifteen-year review of hospital deaths.","authors":"Abdelgadir Hussein M Osman, Mohga Mohamed, Ibtihal A Osman, Khalid A Abdalhai, Lubaba A Elawad","doi":"10.1186/s12888-025-06726-2","DOIUrl":"10.1186/s12888-025-06726-2","url":null,"abstract":"<p><strong>Background: </strong>Mortality rates in psychiatric hospitals reflect the intricate challenges faced within mental healthcare systems globally. Mortality auditing of in-patient psychiatric hospitals for a period extending 14 years is rare in low-income countries. We are reporting a 15-year mortality review of Sudan's National Psychiatric Hospitals. It is intended to enhance the standard of care in low-resource settings.</p><p><strong>Methods: </strong>A retrospective audit was conducted in primary psychiatric hospitals across Sudan's capital city over a 15-year period. Missing or incomplete data were addressed by cross-referencing available hospital records, consulting medical staff for clarifications when possible, and excluding cases where critical information was unavailable. Data on deceased patients were collected from hospital records, encompassing demographic details, medical histories, psychiatric diagnoses, pharmacological interventions, and causes of death.</p><p><strong>Results: </strong>The study identified 108 deaths out of 28,085 admissions, yielding a mortality rate of 0.38 per cent. The majority of deceased patients were male 71 (65.7%), aged below 40 years 65 (60.2%), and experienced shorter durations of hospital stay before death, with significant mortality occurring within the first week of admission. Common causes of death included infections 30 (27.7%), circulatory failure 27 (24.3%), and no clear cause 17 (15.7%). The main diagnoses of deceased patients were, major mood disorders and mania 42 (38.9%), schizophrenia /schizophrenia-like psychosis 27 (25.0%) and organic psychosis and drug-induced psychosis 16 (14.8%). Haloperidol emerged as the most frequently prescribed medication before death.</p><p><strong>Conclusion: </strong>Infection and circulatory failure are the leading causes of mortality in Sudanese mental hospitals, necessitating a thorough examination to find remedies for these avoidable problems. Additionally, enhanced monitoring and early intervention, particularly in the critical initial phase of hospitalization, are essential for mitigating mortality risks associated with psychotropic medications.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"279"},"PeriodicalIF":3.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708054","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":"Patient and public involvement in basic and clinical psychiatric research: a scoping review of reviews.","authors":"Anne Werner, Julia Lauberger, Anke Steckelberg, Gabriele Meyer","doi":"10.1186/s12888-025-06608-7","DOIUrl":"10.1186/s12888-025-06608-7","url":null,"abstract":"<p><strong>Background: </strong>Patient and public involvement (PPI) in health research has become established as an essential component of international health research. Particularly, patients and stakeholders' commitment to psychiatric research faces various challenges. This scoping review aimed to examine the existing literature to identify the aims, methods, barriers, and facilitators of PPI in clinical and basic psychiatric research.</p><p><strong>Methods: </strong>This scoping review's methods were guided by the framework proposed by Arksey and O'Malley. The literature search was conducted between October and November 2023 on six databases (MEDLINE, Web of Science, EMBASE, PsycInfo, PubPsych, and the Cochrane Library). We included reviews that summarized the results of primary studies describing methods for PPI in psychiatric scientific research, regardless of their subjects' underlying psychiatric conditions and the primary research context (clinical or preclinical). The inclusion criteria included a description of the methods, components, and characteristics of participation in psychiatric research. We included reviews published between 2008 and 2023 regardless of participants' language, country, or age.</p><p><strong>Findings: </strong>Twenty reviews comprising 429 studies were included. They revealed that PPI was used to pursue various objectives (e.g., prioritizing research questions). Common methods included focus groups, advisory boards, workshops and interviews. Only one review reported financial compensation for those involved. PPI ranged from tokenism to involvement in data analysis and the dissemination of findings. Facilitators and barriers were identified in relationship and communication factors, organizational and practical factors, and in (co-) researchers training. The most frequently mentioned facilitators of successful PPI were trust and strong relationships. The most frequently mentioned barrier was the power imbalance between the participants and researchers. We identified positive and potential negative effects of PPI.</p><p><strong>Conclusion: </strong>Golden rules for practice (clinical and basic research) derived from the results are as follows: (I) Foster a culture of collaboration and mutual respect between researchers and PPI participants. (II) Provide adequate resources and support for PPI activities, including funding and training programs. (III) Develop clear guidelines and standards for PPI to ensure consistency and quality. (IV) Develop a willingness to integrate PPI into all phases of research, from planning to the dissemination of results. SCOPING REVIEW REGISTRATION: https://doi.org/10.17605/OSF.IO/7YS5C .</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"283"},"PeriodicalIF":3.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708188","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":"Alcohol-induced psychosis and delirium tremens: a comparison with alcohol dependence on demographic characteristics, mortality, and morbidity.","authors":"Jørgen G Bramness, Eline Borger Rognli, Anne Høye, Ina H Heiberg","doi":"10.1186/s12888-025-06753-z","DOIUrl":"10.1186/s12888-025-06753-z","url":null,"abstract":"<p><strong>Objectives: </strong>The study aim was to compare patients with alcohol-induced psychosis (AIP) and delirium tremens (DT) with patients with alcohol dependency (AD) only. Using data from Norwegian Patient Registry (NPR) we investigated demographic characteristics, mortality, and physical and mental health comorbidities, among individuals with AIP or DT compared with AD patients.</p><p><strong>Methods: </strong>Data from NPR was used to create a cohort of patients aged 20-79 diagnosed with either AIP, DT or AD, from 2009 to 2015. If patients received more than one of these diagnoses, AIP and DT were prioritized. For patients with both AIP and DT, the earliest diagnosis took priority, except when the diagnoses were assigned simultaneously, when DT was prioritized. Data on comorbidities were taken from NPR, while cause of death was obtained from the Norwegian Cause of Death Registry. Estimates were compared using chi-square test and the Kruskal-Wallis test with Bonferroni adjustments for multiple testing. Mortality was analysed using Cox regression models and by calculating standardized mortality ratios, adjusting for age and gender.</p><p><strong>Results: </strong>The cohort included 33 107 patients diagnosed with AD, 1 784 with DT, and 700 with AIP. AIP patients were the youngest. DT patients displayed significantly higher mortality rates, with an annual rate of 8.0%, and generally increased comorbidity rates. AIP patients showed significantly higher rates of schizophrenia spectrum disorders compared to both AD and DT patients, highlighting a potential link between AIP and psychotic disorders.</p><p><strong>Conclusion: </strong>This study reveals that patients with DT experience higher morbidity and mortality rates compared to those with AIP and AD. AIP patients did not show increased all-cause or cause-specific mortality compared to AD patients across a variety of causes. Notably, AIP seemed to be more closely linked to comorbid schizophrenia spectrum disorders than AD and DT patients. The findings underscore the complexities of AIP in relation to schizophrenia and highlight significant differences in health outcomes among the three patient groups.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"285"},"PeriodicalIF":3.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708019","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 relationship between childhood trauma and social anxiety in college students: the mediating role of evaluation fear.","authors":"Huoyin Zhang, Xinyi Zhu, Hao Zhang, Xin Xie, Erzhan Wei, Wei Huang","doi":"10.1186/s12888-025-06668-9","DOIUrl":"10.1186/s12888-025-06668-9","url":null,"abstract":"<p><strong>Background: </strong>Social anxiety has become a common psychological problem that seriously affects the mental health of contemporary youth. Although numerous studies have shown that childhood trauma is closely related to social anxiety in adulthood, the mediating role of evaluation of fear in this relationship remains unclear. This study aims to explore the relationships among childhood trauma, evaluation fear, and social anxiety among college students and their internal pathways.</p><p><strong>Methods: </strong>In September 2023, a sample of 559 Chinese university students aged 18-22 years (mean age = 20.20, SD = 1.211; 229 males and 330 females) completed the Childhood Trauma Questionnaire, Liebowitz Social Anxiety Scale, Fear of Positive Evaluation Scale, and Brief Fear of Negative Evaluation Scale. Correlation analyses were conducted to explore the initial relationships among the main variables. Structural equation modeling was performed to examine the parallel mediating effects of fear of positive and negative evaluation on the relationship between childhood trauma and social anxiety.</p><p><strong>Results: </strong>Significant correlations were found among childhood trauma, social anxiety, fear of negative evaluation, and fear of positive evaluation. Childhood trauma significantly and positively predicted both fear of positive evaluation (β = 0.40, p < 0.001) and fear of negative evaluation (β = 0.31, p < 0.001). Fear of positive and negative evaluation also positively predicted social anxiety (β = 0.45, p < 0.001; β = 0.43, p < 0.001, respectively). The parallel mediation effects of fear of positive and negative evaluation on the relationship between childhood trauma and social anxiety were significant (effect size: 0.309, 95% CI = [0.240, 0.380]), with the mediation effects accounting for 60.78% of the total effect.</p><p><strong>Conclusion: </strong>Fear of positive and negative evaluation plays a mediating role in the impact of childhood trauma on social anxiety. This finding provides a new perspective for understanding the formation mechanism of social anxiety and offers a scientific basis for developing effective intervention strategies.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"280"},"PeriodicalIF":3.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708324","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":"Altered oral health and microbiota in drug-free patients with schizophrenia.","authors":"Huawei Huang, Naiyan Yang, Mian-Mian Chen, Xiaoting Chen, Wei Chen, Xiaoping Li, Yuchun Chen, Zhengang Deng, Wenbing Zhou, Shu-Xian Xu, Xin-Hui Xie","doi":"10.1186/s12888-025-06633-6","DOIUrl":"10.1186/s12888-025-06633-6","url":null,"abstract":"<p><strong>Background: </strong>The oral microbiota is associated with neuro-psychiatric disorders. However, there is presently inadequate comprehension regarding the correlation between schizophrenia and the oral microbiota. Moreover, patients with schizophrenia frequently exhibit poor oral health, potentially influencing research outcomes. Therefore, this study aims to investigate changes in the oral microbiota and oral health status in drug-free schizophrenia patients.</p><p><strong>Methods: </strong>Oral microbiota samples were collected from 50 drug-free patients with schizophrenia and 50 healthy controls (HCs). The downstream microbiota analysis was based on Illumina sequencing of the V3-V4 hypervariable region of the 16 S rRNA gene.</p><p><strong>Results: </strong>The alpha diversity of SCZ group is increased, such as the Shannon index (p < 0.001) and Simpson index (p = 0.004), while the community structure also displays variance compared to the HC group (p < 0.001). Key discriminative taxa were found in LEfSe analysis, including the phyla Fusobacteriota, Firmicutes, and Actinobacteriota. The differential taxa and microbial functions showed a strong correlation with clinical oral conditions. Further analysis demonstrated that models based on the entire oral microbiota effectively distinguished SCZ patients from HC (AUC = 0.97).</p><p><strong>Conclusions: </strong>The significant changes in the microbiota of Drug-free SCZ patients appear to be closely associated with the poor oral environment.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"274"},"PeriodicalIF":3.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707991","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":"Using personalised brain stimulation to modulate social cognition in adults with autism-spectrum-disorder: protocol for a randomised single-blind rTMS study.","authors":"Katia Ourania Brouzou, Daniel Kamp, Lukas Hensel, Jana Lüdtke, Juha M Lahnakoski, Juergen Dukart, Nace Mikus, Christoph Mathys, Simon B Eickhoff, Leonhard Schilbach","doi":"10.1186/s12888-025-06719-1","DOIUrl":"10.1186/s12888-025-06719-1","url":null,"abstract":"<p><strong>Background: </strong>Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairments of social interaction and communication as well as repetitive, stereotyped behaviour. Previous research indicates that ASD without intellectual impairment is associated with underactivity and reduced functional connectivity of the brain's mentalizing pathway, to which the right temporo-parietal junction (rTPJ) serves as an important entry point and hub. In this study, we aim to utilize functional magnetic resonance imaging (fMRI) to localize activation maxima in the rTPJ and other regions involved in social cognition to generate individualized targets for neuro-navigated, intermittent theta burst stimulation (iTBS) in order to modulate brain activity in a region centrally engaged in social information processing.</p><p><strong>Methods: </strong>In this single-blind, randomized, between-subject neuroimaging-guided brain stimulation study we plan to recruit 52 participants with prediagnosed ASD and 52 controls without ASD aged between 18 and 65 years. Participants will be classified into two groups and will randomly receive one session of either verum- or sham-iTBS. Effects will be assessed by using well-established experimental tasks that interrogate social behaviour, but also use computational modelling to investigate brain stimulation effects at this level.</p><p><strong>Discussion: </strong>This study aims to use personalized, non-invasive brain stimulation to alter social information processing in adults with and without high-functioning ASD, which has not been studied before with a similar protocol or a sample size of this magnitude. By doing so in combination with behavioural and computational tasks, this study has the potential to provide new mechanistic insights into the workings of the social brain.</p><p><strong>Trial registration: </strong>German Clinical Trial Register, DRKS-ID: DRKS00028819. Registered 14 June 2022.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"281"},"PeriodicalIF":3.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708328","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":"Risk factors for postpartum depression in pregnant women with allergic rhinitis: a retrospective study.","authors":"Fan Li, Yuan Liao, Cheng Lei, Jie Zhou, Yannan Li, Qiuling Shi","doi":"10.1186/s12888-025-06702-w","DOIUrl":"10.1186/s12888-025-06702-w","url":null,"abstract":"<p><strong>Objective: </strong>Allergic rhinitis can cause symptoms to worsen after pregnancy and may cause problems such as postpartum depression. The goal of this study was to investigate the factors that influence postpartum depression in pregnant women with allergic rhinitis (AR).</p><p><strong>Methods: </strong>We conducted a retrospective cohort study that included women with AR (based on self-reports) between June 2015 to June 2019 in Harvard University Partners Healthcare Systems (PARTNERS) in the USA. The study group was divided into postpartum depression and non-postpartum depression. Routine clinical and laboratory information was collected. Univariate and least absolute shrinkage and selection operator (LASSO, employed for predictor selection) regression analysis was used to study associations between AR during pollen seasons and adverse outcomes. Additionally, the receiver operating characteristic (ROC) curve evaluates discriminative ability by the area under the ROC curve (AUC). The calibration curve (DCA) was conducted to determine the clinical utility and benefit of the nomogram.</p><p><strong>Results: </strong>A total of 216 pregnant women with AR participated in this study. Univariate analysis showed that 7 indicators were significantly different (P < 0.05). LASSO and multivariable regression identified four predictors to construct a nomogram for PPD in pregnant women with AR, the four selected risk predictors are as follows: pollen season pregnancy (OR = 1.514, 95%CI: 0.771-2.973), history of preterm birth (OR = 2.723, 95%CI: 1.157-6.406), number of pregnancies (OR = 2.104, 95%CI: 1.356-3.267), anti-allergy medication during pregnancy (OR = 2.975, 95%CI: 1.521-5.819). The nomogram displayed good discrimination, with AUC of 0.732 (95% CI: 0.657-0.808). The risk of postpartum depression increased with the increasing risk score of predictive nomogram. The calibration curve and DCA present optimal predictive power.</p><p><strong>Conclusions: </strong>We highlighted the comorbidity of AR and postpartum depression, and suggested that a multidisciplinary consideration between allergists and obstetricians or midwives is needed to ensure that pregnant women consult experts to reduce AR symptoms.</p><p><strong>Trial registration number: </strong>2018P002646.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"276"},"PeriodicalIF":3.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708378","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":"Treatment expectancy and credibility as predictors of concentrated exposure treatment outcomes in patients with difficult-to-treat obsessive-compulsive disorder.","authors":"Håvard Berg, Kristian Tjelle, Bjarne Hansen, Stian Solem, Thröstur Björgvinsson, Gerd Kvale, Kristen Hagen","doi":"10.1186/s12888-025-06737-z","DOIUrl":"10.1186/s12888-025-06737-z","url":null,"abstract":"<p><strong>Background: </strong>Treatment readiness factors, such as treatment credibility and expectancy, are postulated to be predictors of outcomes within the context of cognitive behavioral therapy (CBT). Concentrated exposure therapy (cET) is a form of short-term, intensive, exposure-based CBT that has shown promising results. This study investigated whether treatment expectancy and credibility predict cET treatment outcomes in patients with difficult-to-treat (nonresponders and patients with relapse following CBT) obsessive-compulsive disorder (OCD).</p><p><strong>Methods: </strong>A total of 163 patients underwent 4 days of cET treatment. Treatment credibility and expectancy were measured using the Credibility/Expectancy Questionnaire (CEQ) prior to the start of treatment. OCD symptom severity was measured using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) at pretreatment, posttreatment, 3-month follow-up, and 1-year follow-up. Work- and social functioning were measured before treatment and at the 1-year follow-up.</p><p><strong>Results: </strong>Higher CEQ scores were significantly associated with lower Y-BOCS score at posttreatment and follow-up after controlling for age, sex, and pretreatment OCD, anxiety, and depression levels. The CEQ scores were also significantly associated with work- and social functioning at the 1-year follow-up. A receiver operating characteristic analysis suggested a mean item cutoff point of 92.5 (0-100 scale) for the CEQ, and 87% of the patients classified as having high expectancy had a positive treatment response.</p><p><strong>Conclusions: </strong>This study confirmed that treatment expectancy and credibility are predictors of cET outcomes in patients with OCD. Higher scores on the CEQ were linked to better treatment results, both immediately and up to one year later. These insights highlight the need to consider patients' attitudes toward treatment in the early treatment phase.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT02656342 (First registered: 2015-11-30).</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"275"},"PeriodicalIF":3.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708326","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 associations of negative and disorganization symptoms with verbal fluency in schizophrenia: the mediation effect of processing speed and cognitive flexibility.","authors":"Ernest Marek Tyburski, Ewa Zawadzka, Adrianna Bober, Ewa Karabanowicz, Piotr Podwalski, Jerzy Samochowiec, Anna Michalczyk, Leszek Sagan, Ashok Jansari, Shane T Mueller, Michał Harciarek, Błażej Misiak, Karolina Lutkiewicz, Krzysztof Wietrzyński, Jolanta Kucharska-Mazur, Artur Reginia, Monika Mak","doi":"10.1186/s12888-025-06597-7","DOIUrl":"10.1186/s12888-025-06597-7","url":null,"abstract":"<p><strong>Background: </strong>Psychopathological symptoms appear important for cognitive functions in schizophrenia. Nevertheless, the factors and their impact on relationships between negative or disorganization symptoms and verbal fluency are still debatable. The preliminary objective of the study was to compare verbal fluency, including clustering and switching as cognitive strategies, executive functions, and processing speed between individuals with schizophrenia (SZ) and healthy controls (HC). The main aim of the study was to investigate mediation models and identify whether relationships between negative and disorganization symptoms and verbal fluency in schizophrenia are mediated by cognitive flexibility and processing speed.</p><p><strong>Methods: </strong>Semantic (animal and fruit) and phonemic (letter k and letter f) fluency tasks, the Berg Card Sorting Test (BCST), and the Color Trails Test (CTT) were administered in the SZ group (n = 108) and a matched HC group (n = 108). The Positive and Negative Syndrome Scale (PANSS) was applied to measure psychopathological symptoms in schizophrenia patients.</p><p><strong>Results: </strong>SZ produced fewer words, had larger cluster size, and fewer switches in semantic fluency than HC. Moreover, the SZ group had longer completion time in CTT 1 and CTT 2 and higher percent of perseverative and non-perseverative errors in BCST than HC. Three mediation models demonstrated good fit indices, suggesting that processing speed and cognitive flexibility were significant mediators for relationships between: (1) psychopathological symptoms and productivity or semantic clustering in animal fluency; (2) negative symptoms and productivity in semantic or phonemic fluency; and (3) disorganization symptoms and productivity in semantic fluency.</p><p><strong>Conclusions: </strong>Individuals with schizophrenia are characterized by a specific performance profile on verbal fluency tasks. They manifest poor productivity and problems using cognitive strategies for semantic fluency. Referring to executive functioning, schizophrenia patients exhibit decreased cognitive flexibility, problem-solving, and formulating concepts, as well as slow processing speed. It was found that processing speed and cognitive flexibility may be understood as the neuropsychological mechanisms modifying the relationships between negative symptoms, disorganization symptoms, and semantic and phonemic fluency. Therefore, these results provide a foundation for including cognitive flexibility and processing speed in cognitive remediation for schizophrenia patients.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"282"},"PeriodicalIF":3.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the role of mega cisterna magna in criminal responsibility: implications for neurocognitive disorders in forensic evaluations.","authors":"Gamze Onar, Sena Inal Azizoglu, Ece Büyükakça, Fatih Oncu","doi":"10.1186/s12888-025-06723-5","DOIUrl":"10.1186/s12888-025-06723-5","url":null,"abstract":"<p><p>This article explores the intersection of neurocognitive disorders and criminal behavior, highlighting the significant role of conditions such as traumatic brain injury (TBI), substance misuse, and neurodegenerative diseases in cognitive decline and associated criminal activities. We present three case studies of patients with mega cisterna magna diagnosed through imaging, discussing their legal proceedings and the impact of their cognitive impairments on criminal responsibility. The study underscores the prevalence of neurocognitive disorders among incarcerated and psychiatrically assessed individuals, suggesting these conditions are often underdiagnosed in forensic settings. Our findings indicate a critical need for comprehensive neurocognitive assessments to better understand and manage the influence of neurological disorders on behavior and legal responsibility. The cases demonstrate how neurocognitive impairments, particularly mega cisterna magna, can influence behavior and complicate the assessment of criminal responsibility, advocating for enhanced diagnostic practices and tailored treatment approaches in forensic psychiatry. This study calls for more focused research on neurocognitive disorders within forensic populations to refine diagnostic and treatment strategies, ultimately aiming to improve legal adjudications and clinical outcomes for affected individuals.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"25 1","pages":"284"},"PeriodicalIF":3.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708103","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}