روانپزشکی
مقالهها، منابع و پژوهشهای تازه حوزه روانپزشکی
ورود به زیرشاخهنقشه موضوعی
جستوجوی دقیقسلامت روان
روانپزشکی، روانشناسی، اعتیاد و سلامت روان جامعه
زیرشاخهها
برای رسیدن به فهرست متمرکزتر، یک مسیر تخصصی را انتخاب کنید.
روانشناسی بالینی
مقالهها، منابع و پژوهشهای تازه حوزه روانشناسی بالینی
ورود به زیرشاخهروانپزشکی کودک و نوجوان
مقالهها، منابع و پژوهشهای تازه حوزه روانپزشکی کودک و نوجوان
ورود به زیرشاخهاعتیاد و سوءمصرف مواد
مقالهها، منابع و پژوهشهای تازه حوزه اعتیاد و سوءمصرف مواد
ورود به زیرشاخهرواندرمانی
مقالهها، منابع و پژوهشهای تازه حوزه رواندرمانی
ورود به زیرشاخهپیشگیری از خودکشی
مقالهها، منابع و پژوهشهای تازه حوزه پیشگیری از خودکشی
ورود به زیرشاخهسلامت روان جامعه
مقالهها، منابع و پژوهشهای تازه حوزه سلامت روان جامعه
ورود به زیرشاخهتازهترین رکوردها
شواهد سلامت روان
PubMed2026
[THE EPISTEMOLOGY OF PSYCHIATRY: DISPOSITIF OF KNOWLEDGE AND PROFESSIONAL WORK].
The article offers systematic consideration of epistemology of psychiatry as section of medicine which examination permits to analyze dispositif of science successfully implementing conceptual theoretical constructs in everyday practice. The various versions and trends in this area are considered, from traditional history of medicine with its positive or negative models of development of psychiatry to historical epistemology and history of ideas striving to create conceptualized picture of permanent scientific revolution or explosive evolution of psychiatry. The number of key moments are marked representing crystallization points of epistemology of psychiatry as systematic form of research: 1) the question about area of knowledge that is provide space for research in this direction; 2) creation of space of reflexive thinking where internal problematization of psychiatric theory and practice will be possible, excluding development of general theory of psychiatry that is externally imposed on it as general guidelines; 3) problematization of modus of openness of psychiatry to related areas of knowledge and public practice, minimizing interference of non-professionals in professional activities of psychiatrists.
PubMed2026
An Alternative Approach for Detecting Problematic Alcohol Use: Developing the Student Alcohol Risk Assessment Scale-15 Using AI-Assisted Machine Learning.
BACKGROUND/AIM: Risky alcohol use is common among university students and negatively impacts physical and psychosocial health. Current screening instruments focus only on behavioral indicators, neglecting psychosocial factors. This study aimed to develop an AI-supported, brief student-focused tool for assessing alcohol-related risk and to evaluate its preliminary reliability and validity among university students. MATERIALS AND METHODS: A total of 599 university students participated in this cross-sectional study. From a pool of 59 items covering behavioral, psychological, social, and academic questions related to alcohol use, a new risk model was created using 15 items selected with ChatGPT-supported AI algorithms (SARAS-15). Risk scores ranged from 0 to 27, categorizing participants into low, medium, and high-risk groups. The model's performance was evaluated using machine learning methods such as Random Forest, Logistic Regression, SVM, and KNN, along with cross-validation and ROC analysis. We also analyzed its internal consistency and its correlations with screening instruments (AUDIT, RAPS4-QF, CAGE). RESULTS: In machine learning analyses, the logistic regression model achieved the highest performance (93.5% accuracy, F1-score = 0.864, sensitivity = 0.826, specificity = 0.959). ROC analysis demonstrated excellent discrimination between low-risk (AUC = 0.96) and high-risk (AUC = 0.93) groups, with strong discrimination for the intermediate-risk group (AUC = 0.88). The Random Forest model achieved an overall accuracy of 87%, successfully differentiating between the low-risk group (F1 score = 0.91) and the high-risk group (F1 score = 1.00). The new model's Cronbach's alpha was 0.811, with strong convergent validity correlations with screening instruments (AUDIT, r = 0.861; RAPS4-QF, r = 0.793; CAGE, r = 0.631). CONCLUSION: The developed artificial intelligence-supported 15-item new risk score model is valid and reliable in assessing risky alcohol use among university students. This scale demonstrates a high level of agreement with traditional tests and can accurately detect three risk levels. Due to its multi-domain content structure, which addresses both behavioral and psychosocial effects, it serves as a complementary screening tool for early risk identification and intervention planning.
PubMed2026
Association Between Participant Satisfaction and Self-Reported Clinical Practice Behaviors in a Nationwide Guideline Education Program.
BACKGROUND: Educational interventions are widely used to promote guideline-concordant psychiatric practice. However, it remains unclear whether participants' subjective satisfaction translates into actual changes in clinical behavior (CB). This study examined the association between subjective assessment (SA) scores of the EGUIDE training programs for schizophrenia and major depressive disorder (MDD) and CB. METHODS: In this multicenter observational study, we analyzed data from psychiatrists who participated in the EGUIDE training program. SA scores were obtained immediately after training using standardized questionnaires assessing satisfaction with program content, knowledge, skills, and future clinical intentions. CB was evaluated using self-report measures of guideline-concordant practice in general, schizophrenia-specific, and MDD-specific domains. Associations between SA and CB scores were examined using Spearman's rank correlation coefficients. RESULTS: A total of 1399 psychiatrists were included in the analysis. The comprehensive SA score showed a significant positive correlation with the comprehensive CB score (r = 0.19, p < 0.001). Likewise, schizophrenia- and MDD-specific SA scores were positively correlated with all CB domains, including general guideline use and disorder-specific practices (ρ = 0.14-0.19, all p < 0.001). Although effect sizes were small, the associations were consistent across disorders and clinical domains. CONCLUSIONS: Higher satisfaction with guideline-based educational programs was associated with greater self-reported guideline-concordant CBs, suggesting that positive educational experiences may support improvements in psychiatric practice at the national level.
PubMed2026
Caring for Chosen Family: A Scoping Review of Clinical Work With Chosen Family.
This scoping review provides an overview of empirical research and practice-based literature that addresses direct clinical practice with chosen families-familial relationships that are not based on biology or law. Given the prevalence of chosen family among sexual and gender minorities as well as the amount of research that underlines chosen family as an important social support, this paper aims to synthesize recommendations for clinical work with chosen families and to highlight gaps in the literature. Using the five-step Arksey and O'Malley (2005) scoping review process, four electronic databases were systematically searched to identify papers that address working with chosen family in care-related fields, including social work, couple and family therapy, and nursing. Twenty-seven articles were included in this review and seven themes were identified by these authors that culminated in recommendations for clinical practice: (a) educate oneself about diverse family forms and address biases; (b) invite self-definition of "family"; (c) proactively include chosen family; (d) consider legal and policy barriers; (e) refer chosen family members to sources of support; (f) encourage people to create or maintain chosen family; and (g) engage in sexual and gender minority affirmative practices generally. The existing literature focuses primarily on individual services that involve chosen family as needed, but do not explicitly focus on dynamic and systemic needs. Further research into systemic work with chosen family is needed.
PubMed2026
Economic Costs and Benefits of the Digital OurRelationship Program for Distressed Couples.
Relationship distress is a prevalent issue with significant economic and societal consequences, including increased mental and physical health problems, decreased workplace productivity, and increased absences. Although couple therapy has been shown to improve relationship and individual well-being, its high costs limit accessibility. Digital relationship interventions provide a cost-effective alternative. However, limited research has assessed the cost-benefit of such programs using experimental designs. This study conducted a cost-benefit analysis of the OurRelationship program using data from two randomized controlled trials (RCTs). The Washington State Institute for Public Policy (WSIPP) cost-benefit model was applied to quantify economic benefits across four domains-depression, anxiety, alcohol misuse, and insomnia-relative to a waitlist control. Program costs were estimated at $280 per individual, and benefits were assessed in terms of healthcare savings, productivity gains, and labor market outcomes. The primary analysis found that, for every dollar spent on the OurRelationship program, $6.60 was saved in societal costs. Sensitivity analyses suggested benefit-cost ratios ranging from $1.88 to $22.06 depending on assumptions regarding the number of participants, duration of effects, and magnitude of program impact. Findings suggest that the OurRelationship program yields substantial economic benefits, making it a viable investment for policymakers, employers, and healthcare systems. The study supports broader implementation of efficacious digital relationship interventions and highlights the importance of economic evaluations in guiding funding decisions for relationship support programs. Further research should explore the long-term benefits and applicability across diverse populations.
PubMed2026
Evaluating the impact of antioxidant enzymes on cardiometabolic health markers among methamphetamine users compared with healthy participants.
BACKGROUND: Methamphetamine (MA) use induces oxidative stress and metabolic dysregulation. OBJECTIVES: This study is to compare and explore the association between oxidative stress markers and cardio metabolic risk factors in order to elucidate potential mechanisms linking MA use with metabolic and cardiovascular complications. METHODS: A comparative cross-sectional study was conducted and a total of 70 males aged 18 years and above were enrolled from Mamajee Welfare Trust: 35 healthy controls (Group A) and 35 MA users (Group B) confirmed via drug panel testing. Sociodemographic characteristics, substance use patterns, lifestyle behaviors and anthropometric indices were recorded through structured questionnaires. Fasting blood samples were analyzed for lipid profile, fasting plasma glucose, Troponin-I and antioxidant enzyme activities using standardized assays. Data analysis was performed using statistical packages for social sciences (SPSS) software (version 20). RESULTS: MA users reported significantly higher smoking, alcohol intake and physical inactivity. Body mass index (BMI) and systolic blood pressure were also significantly elevated (p<0.01). MA users exhibited pronounced dyslipidemia with increased lipid variables. Antioxidant enzyme activity was significantly lower in MA users, with higher catalase (5.31 ± 0.15 vs. 4.89 ± 0.32 ng/mL; p=0.047) and superoxide dismutase (SOD) levels (127 ± 43.1 vs. 109 ± 23.4 pg/mL; p=0.003) in healthy controls vs. MA users, respectively. In methamphetamine users, catalase correlated positively with BMI, cholesterol, triglycerides and low-density lipoprotein (LDL). While SOD in this group showed a significant positive association with blood pressure, lipid markers and very low density lipoprotein (VLDL), with a near-significant trend for Troponin-I. A significant interrelationship between catalase and SOD (r=0.381, p=0.003) in MA users was also observed. In multivariable analysis, MA use and antioxidant enzyme levels (catalase, SOD) were independently associated with BMI, blood pressure and lipid abnormalities. CONCLUSION: MA use is associated with considerable cardiometabolic disturbances and compromised antioxidant defenses, highlighting the need for early screening and preventive interventions.
PubMed2026
First Psychological Aid for Families During War: Integrating the Narrative Approach With Emotionally Focused Therapy (EFT).
The article describes a first psychological support project for families living in the seam zone between Israel and areas controlled by the Palestinian Authority. Since October 7th, the proximity to the border and potential of terrorist infiltration into communities have generated heightened anxiety among residents, alongside concern for family members enlisted to reserve duty or on mandatory service. Therefore, the Family Therapy Unit of Menashe Regional Council initiated a psychological support program designed to strengthen families' resources and enhance their ability to cope with the ongoing stress and anxiety. The intervention was based on an integration of the narrative approach and emotionally focused therapy (EFT). These approaches were chosen for their grounding in positive and humanistic psychology, which highlights family resilience and can be applied in a focused, short-term intervention. The intervention protocol and a case example are described in detail. Additionally, an attempt to evaluate the project under wartime conditions is described, including its limitations. The evaluation method included a quantitative component and a content analysis of one open-ended question focused on the family's experiences with the intervention. The results indicated a significant reduction in parents' stress and in their perceptions of children's stress, but no significant difference in family resilience. Consistent with previous studies, participants experienced the therapeutic relationship as the most meaningful factor rather than the techniques employed. The article concludes with a call for further evaluation of such interventions in war zones and disaster-affected regions across diverse sociocultural and political contexts.
PubMed2026
The Global Mode of Experience in Psychodynamic Movement and Dance Therapy - Bodily Awareness as a Therapeutic Factor: Effects and Clinical Considerations.
Bodily awareness has become a central therapeutic factor in psychodynamic and body-oriented psychotherapies, yet its clinical effects and theoretical status remain insufficiently integrated. This paper offers a clinically grounded account of bodily awareness work in Psychodynamic Movement and Dance Therapy (PMT), conceptualising the body as the primary medium of lived experience rather than as an object of intervention. Drawing on phenomenology, developmental psychoanalysis, and clinical theory, the paper argues that therapeutic change in PMT unfolds through prereflective, embodied processes that precede verbal reflection and symbolic articulation. To integrate these perspectives, it introduces the concept of the global mode of experience, defined as an amodal, prereflective organisation of experience in which bodily sensation and affective vitality are lived as an integrated whole. Rooted in Daniel Stern's work, this mode is understood as a stable, activatable capacity rather than a regressive state, with orientation to the reality of the here-and-now fundamentally preserved. The paper positions the global mode of experience as a clinically orienting framework for understanding both the therapeutic effects and the limitations of bodily awareness work, highlighting the importance of timing, containment, and indication in psychodynamic movement and dance therapy. (Neuropsychopharmacol Hung 2026; 28(3): 141-154)
PubMed2026
A scoping review of opioid agonist treatment in Australian general practice.
In Australia, opioid use disorder is a major public health concern, and opioid agonist treatment (OAT) is an effective and evidence-based approach for treating opioid use disorder, reducing morbidity, mortality and societal cost. In Australia, 60% of OAT prescribing occurs in general practice, but significant barriers exist. This scoping review aimed to find research describing the characteristics and evaluation of different models of primary care-based OAT in Australia. Following the PRISMA guidelines for scoping reviews, a systematic search was conducted of PubMed, Embase, Scopus and CINAHL, and several grey literature databases. We conducted a narrative synthesis, and derived study themes inductively from included studies. We identified 24 relevant articles over 34 years that reported primary research on general practice-based OAT. Seven studies evaluated general practice OAT; eight examined prescriber attitudes, behaviour and workforce; two described single-models of care; four investigated primary care OAT policy; and two studies examined consumer experiences. The studies showed primary care OAT was as effective as specialist care for retention in OAT; however, prescriber deficits exist, with lack of remuneration and stigma identified as common barriers. The multidisciplinary models of care all received external funding, with GPs well placed, but underfunded, to coordinate care. The limited research demonstrates research gaps in service delivery, models of care, funding and views of people who use drugs. Future research scope needs to be broadened to encompass improved national monitoring datasets, patient views, models of care, holistic support and coordination, and structural supports to recruit and retain active prescribers.
PubMed2026
'Traumatic to Say the Least; It Still Affects Me': Consumer Perspectives on Community Treatment Orders in Australia.
BACKGROUND: Community Treatment Orders (CTOs) are contested practices in mental healthcare due to unresolved evidence of effectiveness and persistent human rights concerns. Despite this, Australia has high rates of CTO use internationally. Research from a lived and living experience (LLE) perspective remains limited. METHODS: This mixed methods research explored experiences of people with LLE of mental ill-health and being on a CTO ('consumers'). An online survey including Likert-rated, categorical and open-ended questions was disseminated across Australia in 2024 to consumers aged 18 years or over. Quantitative data were reported descriptively, and qualitative data were analysed using Latent Content Analysis. RESULTS: Forty-three people completed the survey; most identified as female (86%); 51.2% were aged 30-49 years; 7.2% were currently on a CTO; 40.5% had been on a CTO in the past 1-5 years; and 45.2% had been on a CTO more than once. Automated data contamination ('bot') infiltration hampered inclusion of further data. Participant responses included: (1) experiences prior to being on a CTO; (2) experiences whilst on a CTO; (3) attitudes towards CTOs; (4) family involvement; and (5) views on mental health services. While some consumers reported experiencing positive care, many rejected use of CTOs, reporting coercion, exclusion from decision-making and information, lack of alternative support options, and lack of compassion. CONCLUSIONS: Policy and practice reforms, including focus on recovery and human rights, appear to have failed to improve experiences of CTOs. Further work to close the policy-practice gap and translate policy into more inclusive, human rights-based care is indicated. LIVED EXPERIENCE OR PUBLIC CONTRIBUTIONS: This project has included considerable involvement and community engagement with people with lived and living experience ('LLE') of CTOs and/or mental health service use in all phases of the project. The project includes two Chief Investigators who identify as LLE leaders and researchers (VE and SL), and who have direct lived experience of CTOs, or as a family/caregiver of individuals who have direct lived experience of CTOs. The project manager (TZ) and some project staff (TS, TK, and PS) are LLE researchers, and the project is guided by a Lived Experience Advisory Panel (LEAP) with LLE experience of CTOs, including both service users and family/caregivers. We also have LLE experts on our project's international advisory panel. Together, their contributions have been vital in the project team's open and transparent reflections on their diverse perspectives and positioning which have grounded the project's focus on LLE perspectives.
PubMed2026
A Randomized Controlled Trial With an Internal Pilot of a Co-Designed App Targeting Upstream Suicide-Related Risk and Protective Factors Among International Students.
BACKGROUND: International students frequently report suicidal thoughts, yet often do not access support. Bud is a co-designed, self-guided mobile app developed as an upstream suicide-prevention intervention targeting transdiagnostic mechanisms related to suicide risk. AIM: To evaluate the effectiveness, acceptability, engagement, and safety of Bud compared with an active and structured psychoeducational comparator. MATERIALS AND METHODS: A two-arm, parallel-group randomized controlled trial was conducted with international students in Australia. Participants were randomized 1:1 to Bud (n = 156) or psychoeducational fact sheets (n = 156), completing assessments at baseline, 2 weeks and 4 weeks. The primary outcome was psychological distress (K10). Secondary outcomes included help-seeking intentions, interpersonal risk processes, emotion regulation, suicidal ideation, and mental health literacy. Analyses used intention-to-treat mixed-effects models. RESULTS: Contrary to the hypotheses, psychological distress decreased from baseline to 4 weeks (Bud: -2.23; Comparator: -2.15), with no group × time interaction (F(2,342.45) = 0.43, p = 0.652); emotion regulation and suicidal ideation showed similar patterns across groups, and other secondary outcomes remained stable across groups. As expected, Bud was rated as enjoyable, worthwhile, and usable. Engagement was moderate (median 10 activities), and no iatrogenic effects occurred. CONCLUSION: Bud was feasible, acceptable, and safe but did not outperform an active psychoeducational comparator over 4 weeks. TRIAL REGISTRATION: ClinicalTrials.gov identifier: ACTRN12625000584437.
PubMed2026
An Evaluation of AI-Generated Clinical Notes in the OpenNotes Era: A Thematic Analysis of Clinician Discourse.
BACKGROUND: The integration of ambient artificial intelligence (AI) scribes into the OpenNotes environment presents a profound governance crisis in healthcare. While patient access to medical records was designed as a transparency reform, the introduction of machine-generated text introduces novel vulnerabilities regarding record integrity, liability, and patients' trust. OBJECTIVE: This study investigates how clinicians discursively negotiate the systemic risks and accountability challenges of patient-facing, AI-assisted documentation. METHODS: Employing a netnographically informed qualitative design, the research conducted a reflexive thematic analysis of 484 relevant comments across 120 threads from eight clinician-oriented subreddits spanning October 2020 to February 2026. RESULTS: The analysis revealed five distinct governance challenges. First, an accountability vacuum exists where the mandatory clinician signature functions merely as a legal shock absorber for institutional AI liability. Second, clinicians frame AI hallucinations as a mathematically inevitable epistemic risk rather than a correctable technical bug. Third, a "dual-audience" problem emerges, as algorithmic optimization compromises both the individual clinical voice needed for peer communication and the empathetic clarity required for patient readers. Fourth, existing privacy frameworks are structurally inadequate to manage commercial data extraction during patient encounters. Finally, institutional productivity demands and AI-driven over-documentation severely threaten the fiscal credibility of the medical record through inadvertent upcoding. CONCLUSIONS: The prevailing regulatory assumption-that a physician's digital signature combined with passive patient visibility guarantees documentation accountability-is a fragile fiction. To protect clinical truth, health systems must transition from models of passive disclosure toward contingent transparency. This requires establishing authoritative, enforceable mechanisms for provenance tracking, error contestation, and vendor accountability.
PubMed2026
Association of GLP-1 receptor agonists with alcohol use disorder-related and substance use disorder-related hospital admissions during treatment and after discontinuation: a Swedish register-based within-individual observational study.
BACKGROUND: Evidence suggests that GLP-1 receptor agonists might reduce substance use across different substance use disorders. However, data on substance use-related outcomes after GLP-1 discontinuation are absent. This study aimed to investigate the risk of alcohol and substance use-related hospitalisations during and after exposure to GLP-1 receptor agonists. METHODS: This within-individual observational study used Swedish registers to identify residents of Stockholm County with a first registered diagnosis of type 2 diabetes between Jan 1, 2005, and Dec 31, 2024 who had received GLP-1 receptor agonists and, for comparison, DPP-4 inhibitors. Active follow‑up started on Jan 1, 2015, or on the date of the first registered diabetes diagnosis, whichever occurred later. Patients were followed up until the end of the observation period (Dec 31, 2024). The main outcomes were hospitalisations related to alcohol use disorder and substance use disorder (which included the alcohol use disorder-related events). Fixed-effects Poisson regression models were used to estimate rate ratios (RRs) of hospitalisations, comparing periods of GLP-1 receptor agonist or DPP-4 inhibitor exposure and two post-exposure windows (days 1-182 and 183-364) with unexposed periods in the same individuals. People with lived experience were not involved in the study. FINDINGS: 167 026 individuals with type 2 diabetes (mean age 63·98 years [SD 13·77]; median age 65·00 years [IQR 55·00-74·00]; 96 133 [57·6%] males and 70 893 [42·4%] females) were included in the study. Ethnicity data were unavailable. 1559 (0·9%) individuals had at least one alcohol use disorder-related hospitalisation and 2008 (1·2%) had at least one substance use disorder-related hospitalisation. 41 109 (24·6%) individuals received GLP-1 receptor agonists during the study period, and 23 666 (14·2%) received DPP-4 inhibitors. 308 (0·7%) of those receiving GLP-1 receptor agonists had at least one alcohol-related hospitalisation during the observational period, and 444 (1·1%) had at least one substance use-related hospitalisation; 957 (66·1%) of the 1447 substance use disorder-related hospitalisations recorded in these 444 individuals were attributed to alcohol use disorder. GLP-1 exposure was associated with lower rates of hospitalisations related to alcohol use disorder (RR 0·55, 95% CI 0·43-0·70) and substance use disorder (0·61, 0·50-0·74) compared with unexposed periods for the same individuals. For individuals with alcohol use disorder, the association with hospitalisation rate reduction persisted during days 1-182 after discontinuation of GLP-1 receptor agonists (0·70, 0·50-0·98) but was no longer evident during days 183-364 after discontinuation (1·07, 0·71-1·63); for substance use disorder, there were no statistically significant associations with reduction after discontinuation of GLP-1 receptor agonists (days 1-182: 0·79, 0·61-1·02; days 183-364: 0·89, 0·63-1·26). DPP-4 inhibitors were not associated with consistent rate reductions. INTERPRETATION: GLP-1 receptor agonist treatment was associated with lower rates of hospitalisation in individuals with alcohol use disorder and substance use disorder. This association extended into the first 182 days after discontinuation for alcohol use disorder but not for substance use disorder. Findings support clinical monitoring of substance use when GLP-1 receptor agonist treatment is stopped. FUNDING: Forte, Karolinska Institutet, and Region Stockholm.
PubMed2026
Characteristics of higher-education students in England who died by suspected suicide in a single academic year: a national retrospective case series study.
BACKGROUND: Suicide in young people is a global priority and strengthening mental health support in education is central to England's suicide prevention strategy. Few studies have examined in detail the individual characteristics of higher-education students nationally who died by suicide. We aimed to describe individual and institutional characteristics of suspected student suicide, contact with support services, and adherence to sector guidance on serious incident investigations. METHODS: We used a national case-series design to identify suspected suicide deaths in higher-education students in the 2023-24 academic year (from Aug 1, 2023, to July 31, 2024). Anonymised serious incident reports were obtained from higher-education providers in England. Data were systematically extracted using a structured pro forma developed with bereaved families and sector organisations and charities. Serious incident reports were also assessed for adherence to national guidance. FINDINGS: Higher-education providers in England informed us of 107 suspected suicide deaths during the 2023-24 academic year. A serious incident report was completed for 86 of these deaths, of which 79 were obtained from 50 providers. Most students who died were men (50 [71%] of 70 with available data were men and 18 [26%] were women). Where known (n=24), mean age was 23·9 years (SD 7·0; range 19-47). Ethnicity was unknown for most students (70 [89%] of 79). Most students were undergraduates (45 [71%] of 63) who lived away from home (44 [72%] of 61). 11 (22%) of 50 deaths with available data occurred in university-managed or privately managed student accommodation. Six reports indicated potential suicide clusters. Mental health difficulties (45 [62%] of 73), academic problems (38 [52%] of 73), and neurodivergence (30 [41%] of 73) were the most common features reported before death, often alongside relationship problems (24 [33%] of 73), self-harm (16 [22%] of 73), social isolation (11 [15%] of 73), housing or financial problems (15 [21%] of 73), and violence (nine [12%] of 73). 52 (69%) of 75 students had previous contact with university support services, although reports highlighted recurring issues with access to support, information sharing, monitoring engagement, and joint working between academic and pastoral supports. Despite national guidance, family involvement in serious incident investigations was only reported for 19 (24%) of 79. INTERPRETATION: A range of actions, including prioritising mental health on campus and offering targeted support to those at risk (eg, neurodivergent or financially insecure students) could contribute to suicide prevention. Universities should ensure the safety of accommodation and routinely involve families in an independent investigation process, promoting openness and transparency from the earliest point. FUNDING: UK Department for Education.
PubMed2026
Evaluating the Efficacy of an Online Community Helper Training Program Living Works Start.
BACKGROUND: Community Helper Training (CHT) equips people to identify and support individuals thinking about suicide. Most CHT occurs in person, but interest in online delivery is growing. Living Works Start is a 90 min online CHT designed to improve recognition of warning signs, confidence, and willingness to help. AIMS: Evaluate learning outcomes from Start using quality assurance (QA) data, examine the efficacy of online CHT, and determine if prior suicide prevention training influences gains. METHODS: Pre- and post-training surveys from 44,003 learners assessed willingness to talk, ability to recognize signs, confidence to help, and knowledge of how to get help. Paired t-tests and effect sizes examined changes. Subgroup analyses explored differences by quantity and recency of prior training. RESULTS: Significant improvements were observed across all outcomes (p < 0.001). Learners with no prior training showed the greatest gains, though all improved. LIMITATIONS: QA data lacked randomization, comprehensive demographics, and follow-up, limiting generalizability, understanding of skill use, or long-term retention. CONCLUSIONS: Start was associated with self-reported learning gains. Benefits were observed across learners and were strongest among those with no or more distant prior training. Future research should test efficacy under controlled conditions and examine long-term outcomes and real-world use of skills.
PubMed2026
Exploring the Mechanisms of the Yueju Pill for ALD by Integrating UPLC-QE Orbitrap-MS/MS, Network Pharmacology, and Experimental Verification.
This study integrated UPLC-QE Orbitrap-MS/MS, network pharmacology, and experimental validation to investigate the chemical profile and therapeutic mechanisms of the Yueju pill (YJP) in the treatment of alcoholic liver disease (ALD). Chemical analysis identified 91 compounds in the YJP. After SwissADME screening, 45 active ingredients were predicted as potential bioactive compounds. By overlapping the targets of these compounds with ALD-related targets, a "component-target-disease" network was constructed, revealing 183 common targets. Enrichment analysis indicated that YJP exerts its therapeutic effects through multiple pathways, including the HIF-1 signaling pathway. In animal experiments, an ALD mouse model was established using the Lieber-DeCarli ethanol liquid diet. YJP intervention significantly reduced serum TG, AST, and ALT levels, alleviated hepatic lipid deposition and collagen deposition, improved liver mitochondrial homeostasis, and decreased hepatic HIF-1α expression. Moreover, the YJP improved intestinal barrier integrity and upregulated intestinal HIF-1α and occludin expression, reflecting a therapeutic mechanism involving coordinated regulation of the gut-liver axis.
PubMed2026
Iatrogenic Harm, Psychotherapy, and Eating Disorders: An Urgent Call to Action.
Iatrogenic harm in psychotherapy remains under-recognised, despite longstanding evidence that psychological treatments can produce adverse effects. This omission is consequential in eating disorder care, where treatment is often intensive, prolonged and characterised by significant power asymmetries alongside poor long-term outcomes. This article examines iatrogenic harm in the context of eating disorders through an epistemic justice and intersectional framework. Drawing on qualitative and lived-experience-led scholarship, it argues that iatrogenesis is produced through structural features of mental health systems, including rigid diagnostic practices and manualised treatment models, limited professional accountability and the marginalisation of experiential knowledge. Treatment dropout and the attribution of treatment failure to patients are examined as mechanisms that obscure harm and inflate perceptions of treatment safety and effectiveness. Rather than rejecting evidence-based psychotherapy, the article calls for epistemic pluralism, routine monitoring and reporting of iatrogenesis and meaningful co-production as prerequisites for ethical, accountable and humane eating disorder care.
PubMed2026
Instrumental Reminiscence and Coping Strategies in Older Adults Exposed to Armed Conflict in Colombia.
Older adults exposed to prolonged sociopolitical violence often experience chronic stress that may undermine adaptive coping processes. Instrumental reminiscence, which focuses on recalling past experiences of successfully managing adversity, has been proposed as a strategy potentially associated with greater coping flexibility in later life. This study examined whether participation in an instrumental reminiscence programme was associated with changes in coping strategies among older adults registered as victims of armed conflict in Catatumbo, Colombia. A quasi-experimental controlled design with repeated measures (pre-intervention, post-intervention, 2-month follow-up) was conducted with 64 community-dwelling adults aged 60 years and older (intervention n = 37; control n = 27). The intervention consisted of 8 weekly 90-min instrumental reminiscence sessions, while the comparison group received psychoeducational sessions. Coping strategies were assessed using the Coping with Stress Questionnaire. Linear mixed-effects models were used to examine Group × Time interactions. Significant interactions were observed for problem-solving focus, positive reappraisal, social support seeking, overt emotional expression, negative self-focus, and avoidance (all p < 0.001). Compared with controls, the intervention group was characterised by higher post-intervention scores on problem-solving focus, positive reappraisal, social support seeking, and avoidance, and lower scores on overt emotional expression and negative self-focus; these differences were maintained at follow-up. No significant effects were found for religious coping. Participation in the instrumental reminiscence programme was associated with changes in multiple self-reported coping strategies among older adults exposed to chronic conflict-related stress.
PubMed2026
Integrated Studies of Infectious Disease Elimination (InSIDE): Hepatitis C Antibody and RNA Status of Persons Who Inject Drugs in New York State, 2021-2023.
Hepatitis C virus (HCV) infection disproportionately impacts people who inject drugs (PWID). Understanding the prevalence and correlates of current and lifetime HCV infection is necessary to inform prevention, testing and treatment efforts among PWID to reduce HCV burden and achieve HCV elimination targets in this population From June 2021-December 2023, 751 PWID were recruited from syringe service harm reduction programs (SSP) and by referral from communities around New York State (NYS). Participants completed web-based surveys on risk factors and social determinants of health and were tested for HCV antibody and RNA to assess their current and lifetime HCV status (never infected, previously infected, or currently infected). Controlling for recruitment site as a fixed effect, a multivariate mixed logistic regression model was built to assess factors significantly associated with HCV status. Among PWID, 58% had a lifetime history of infection, and 29% were currently infected (50% among those with a lifetime history of infection). Daily/almost-daily injection, opioid injection, homelessness, and experience of abscess (all past-year) were significantly associated with current infection, as was younger age. Past-year SSP utilization was associated with a lifetime history of infection. PWID are a priority population to achieve HCV elimination in NYS. Our findings show that HCV burden is high among PWID utilizing SSPs. Expanding access to HCV care and treatment in harm reduction service settings while also providing services to address social determinants of health may be an effective strategy to progress towards reducing the burden of HCV among PWID.
PubMed2026
Navigating Professional Growth and Constraint Through Clinical Supervision: A Qualitative Study of Community Mental Health Nurse Specialists in South Korea.
As community mental health services expand in scope and responsibility, mental health nurses are playing a central role in delivering integrated, recovery-oriented care. However, they face substantial challenges in adapting to community practice and sustaining professional development. Clinical supervision can mitigate these demands through its formative, normative, restorative functions. This study explored the supervision experiences of community mental health nurse specialists in South Korea to provide evidence for specifying the effective functions and operational systems of supervision using an exploratory qualitative design. Twelve community mental health nurse specialists participated in three focus group interviews conducted between June 2024 and July 2025. Data were analysed using reflexive thematic analysis. Four themes and 10 subthemes were generated: translating community mental health ideals into professional practice; serving as an anchor in unfamiliar terrain; supervision undermined by superficiality and disrespect; and competency development constrained by structural barriers. Supervision was perceived as a critical space for clarifying clinical direction, regulating emotional involvement and supporting professional adaptation. However, formalistic delivery and structural constraints limited its impact. These findings highlight the need for integrated and systematic supervision approaches aligned with the community mental health paradigm, supported by organisational and policy commitments to protected time, staffing, education and financial resources. Strengthening supervision under such conditions may enhance practitioner development and service user outcomes.
PubMed2026
On the prowl for disciplinary vassals: Neurologists, psychiatrists, and clinical psychologists discuss science, technology, and profession at the National Research Council's Conference on Relations of Psychiatry to Psychology (1921).
The 1910s were a complex and rapidly changing decade in mental hygiene, marked by institutional innovation, professional development, and the expanding reconceptualization of mental disease and maladjustment. This growth frequently generated friction between practical clinical sciences, particularly psychiatry and consulting clinical psychology. After years of mounting tension, the National Research Council convened a joint conference in 1921 on the "Relations of Psychiatry to Psychology," bringing together 12 representatives to debate and draft resolutions intended to harmonize collaboration. Despite being the first coordinated effort of its kind in the United States, the meeting has been largely overlooked by historians. Yet the conference, especially its unpublished 43-page stenographic transcript and related correspondence, offers a rare window into the conflicts of the 1920s, capturing the tone, immediacy, and strategic maneuvering that more polished publications sideline or obscure. Drawing on these proceedings alongside contemporary publications and archival materials, this article reconstructs the meeting, its background, and its immediate repercussions. I argue that the conference revolved around four intertwined points of contention: (a) the definition and scope of core concepts such as "disease," "diagnosis," and "medical"; (b) psychologists' freedom to conduct clinical research without psychiatric supervision; (c) the hierarchical relationship and division of labor between the professions; and (d) the organization, administration, and authority of psychological clinics. Ultimately, the 1921 meeting saw psychologists pressing for clearer definitions, research autonomy, and practical authority, whereas psychiatrists defended broad conceptual frameworks and professional precedence that confined psychologists to experimental work and narrowly defined psychometric consultation. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
PubMed2026
Phenomenology in Psychiatry as an Ethical Obligation.
RATIONALE: Contemporary psychiatry increasingly recognises the importance of person-centred, recovery-oriented, and biopsychosocial approaches to care. Yet these frameworks do not fully resolve the methodological question of how clinicians should investigate patients' lived experience in ways that inform ethical psychiatric practice. AIMS AND OBJECTIVES: This paper argues that phenomenology should be understood not merely as a humanistic supplement to psychiatry, but as a methodological foundation for ethically responsible clinical practice. METHODS: A conceptual analysis drawing on phenomenological psychopathology, philosophy of medicine, and clinical ethics is used to examine how attention to lived experience informs psychiatric understanding, therapeutic engagement, and ethical decision-making. RESULTS: Phenomenology contributes a disciplined method of inquiry into subjective experience. It complements diagnostic classification and neurobiological explanation by clarifying how illness reorganises the patient's lived world. A comparative clinical illustration demonstrates how phenomenological inquiry can deepen psychiatric assessment without replacing conventional diagnosis. This enriched understanding strengthens autonomy, informed consent, shared decision-making, diagnostic humility, and psychiatric education. CONCLUSION: Phenomenology does not require psychiatry to abandon diagnostic reliability, neuroscience, or evidence-based treatment. Rather, it provides a method through which psychiatry can more fully realise ethical commitments it already recognises. Attending to lived experience should therefore be regarded as a professional obligation within psychiatric practice.
PubMed2026
Predicting Next-Day Passive Suicidal Ideation in At-Risk Youth.
INTRODUCTION: Passive suicidal ideation (SI) is a well-established risk factor for suicidal behavior but has received less attention than active SI. Although recent work has leveraged intensive longitudinal data and machine learning (ML) to forecast short-term risk for active SI, passive SI remains understudied as a prediction target. METHODS: Seventy-eight psychiatrically hospitalized youth (ages 13-17 years) completed baseline assessments and daily ratings of risk and protective factors for 28 days post-discharge. Multiple ML models were trained to predict the presence of next-day passive SI. Models with and without baseline variables were compared to assess the relative predictive value of time-varying versus baseline features. RESULTS: ML models predicted next-day passive SI with high accuracy (AUC = 0.90). The strongest predictors were within-person 7-day moving averages of passive SI duration and frequency. Including baseline variables had negligible performance impact, even during initial days post-discharge. CONCLUSIONS: Short-term passive SI remains an underutilized but important target for suicide prevention. Forecasting next-day passive SI using ML is feasible and highly accurate. Within-person, time-varying features outperformed baseline factors, even in early days post-discharge. Additional research on SI facets, such as duration, is needed. Integrating passive SI into personalized intervention frameworks may enhance the precision of suicide prevention efforts.
PubMed2026
Prospective Volumetric Changes in the Thalamus in Adolescent First Episode of Mania and Cannabis Use: A Preliminary Study.
BACKGROUND: Aberrant thalamic structure has been documented in youth with bipolar disorder (BD) and linked with cannabis use, which commonly co-occurs with BD. However, the timeline of when these associations evolve remains unclear. This study aimed to longitudinally compare thalamic volume among youth with and without first episode mania who do or do not use cannabis and other substances. METHODS: Demographic and magnetic resonance imaging (MRI) data from youth (13-18 years old) with BD (n = 22) were compared to similarly aged healthy youth (n = 23) at baseline and 12-month follow-up. Clinical group status, including BD and substance misuse and dependence, was evaluated using semistructured interviews. Multivariate analyses accounting for total brain volume and baseline age were conducted to evaluate baseline and longitudinal group differences in thalamic volume. RESULTS: At 12 months, BD youth had significantly smaller left thalamus volumes compared to healthy youth (p = 0.009). Lifetime cannabis use was associated with smaller left thalamus volumes for all youth (p < 0.001) and for youth with BD compared to healthy controls (p < 0.001) across time. Among BD youth, co-occurring lifetime substance use was associated with significant volumetric reductions in the left thalamus from baseline to follow-up (p = 0.004), but not among healthy youth (p = 0.517). No significant group differences or changes were observed in the right thalamus. CONCLUSIONS: BD is associated with smaller left thalamic volume after the first manic episode. Cannabis use may compound thalamic volume reductions in youth with BD. Investigations with larger sample sizes are needed to replicate these findings and examine clinical correlates of cannabis use alongside long-term thalamic trajectories.
PubMed2026
Smoking Initiation, Age at Onset of Symptoms and Suicide Attempts Among Patients With Bipolar Disorder: Comparisons With Non-Psychiatric Adults.
INTRODUCTION: The prevalence of tobacco smoking and high nicotine dependence (ND) in bipolar disorder (BD) is higher than in the general population but lower than in schizophrenia. This study aims to analyse the relationship of smoking behaviours, including age at onset of daily smoking (AODS), with age at onset of BD and course-of-illness variables -particularly recurrent suicide attempt- in a community sample of BD patients, also compared in their smoking behaviour variables with a sample of non-psychiatric adults. METHODS: Samples of 108 patients with BD and 290 non-psychiatric adults were compared in their smoking habit. High ND was defined by a score of ≥ 6 on the Fagerström Test for Nicotine Dependence. Logistic regression analyses were employed to identify factors associated with daily smoking and high ND. Hazard curves were used to compare AODS between patients and controls and, among patients, age of BD onset between smokers and non-smokers. Within-subject survival times -AODS and the age at onset of BD symptoms- were compared with a multi-state illness-death model. RESULTS: Compared with controls, BD patients showed higher prevalences of current daily smoking (44% vs. 34%) and high ND (25% vs. 9%); and lower smoking cessation rates (23% vs. 38%). Among BD patients, recurrent suicide attempt showed a strong independent association with both daily smoking and high ND. AODS was later in BD patients than the control group. Among patients, illness onset was earlier in smokers and AODS was earlier than illness onset. CONCLUSION: Addressing tobacco consumption should be an integral component of BD prevention and treatment strategies.
PubMed2026
The Association Between Mindfulness and Perceived Stress: A Meta-Analysis.
This study consolidated the association of mindfulness with perceived stress found across studies. A meta-analysis examined the relationship between mindfulness and perceived stress in 56 samples, which included a total of 24,494 participants. The weighted effect size of r(55) = -0.40, 95% CI [-0.36, 0-44], p = 0.0001, showed that greater mindfulness was associated with less perceived stress. Studies assessing mindfulness using the Mindful Attention Awareness Scale or the Five Facet Mindfulness Questionnaire showed substantial effect sizes, as did studies assessing stress using the Perceived Stress Scale. Even though the present meta-analysis does not show causality, the results suggest a possible bidirectional relationship between mindfulness and perceived stress. The nonjudgmental awareness comprising mindfulness may facilitate an appraisal of life events and challenges that results in events and challenges as being perceived as less stressful. Lower perceived stress may free cognitive resources that promote mindfulness.
PubMed2026
The Impact of Mimicry on Tobacco Addiction.
Tobacco addiction, a major cause of preventable death, requires an understanding of how it develops and is maintained. This paper examines mimicry as a 'social glue' in smokers' social interactions and its influence on the development and maintenance of smoking behaviour. A first laboratory experiment showed that nonverbal mimicry (physical actions, hand and arm movements and body posture) increases cigarette consumption due to increased liking for the mimicker, proving that mimicry not only binds (smokers) but first and foremost reduces chances for quitting smoking. The second experiment, conducted in a natural setting, showed that mimicry of smoking behaviour reduced the desire to quit smoking. This suggests that whilst mimicry acts as a strong 'social glue' amongst smokers, it also impedes efforts to quit. Thus, it seems that mimicry maintains smoking addiction and overcoming tobacco addiction might require severing the social bonds created by mimicry (e.g., smoking in solitary).
PubMed2026
[How can the profession of psychiatry become attractive again?].
The issue of psychiatric workforce renewal is no longer merely a human resource problem; it lies at the intersection of professional identity, training structure, and the organizational logic of the healthcare system. International medical education literature describes professional identity formation as a gradual process of socialization in which the novice physician progresses from performing professional tasks to internalizing the vocation itself. This process is strongly influenced by the clinical learning environment, the presence of role models, structured reflection, the gradual transfer of responsibility, psychological safety, and whether the resident is truly able to practice the chosen specialty. A specific challenge in Hungarian psychiatry is that the process of becoming a psychiatrist is often constrained by systemic pressures that lead to blurred professional boundaries, distortion of training, increased risks to patient safety, and erosion of professional self-identity. The aim of this paper is to examine the educational and organizational conditions necessary for psychiatry to become an attractive and sustainable career choice again. The article is based on a synthesis of the international literature on professional identity formation, Hungarian research on psychiatric professional identity, and a qualitative case-based analysis. Orv Hetil. 2026; 167(29): 1142-1151.
PubMed2026
Dynamic flexibility of the murine gut microbiota during morphine disturbance enables escape from the stable dysbiosis that is associated with addiction-like behavior.
Although opioids are effective analgesics, they can lead to problematic drug use behaviors that underlie opioid use disorder (OUD). Opioids also cause gut microbiota dysbiosis, which is linked to altered opioid responses. We used a longitudinal paradigm of voluntary oral morphine self-administration to capture multiple facets of drug seeking and preserve both individual behavioral responses and individual gut microbiota variation to investigate the role of the gut microbiota in a mouse model of OUD. Although all the mice consumed morphine, only a subset of the mice that transitioned to a state we defined statistically as compulsive. In compulsive mice, morphine constricted natural variability and fragmented the microbiota community networks, which convergently reorganized to form robust novel connections post-morphine. In contrast, the more variable communities of non-compulsive mice were highly interconnected during morphine disturbance and displayed more continuity post-morphine, suggesting greater flexibility and adaptability. Compulsive mice displayed a greater loss of functional diversity and a shift in favor of potential pathobionts, whereas non-compulsive mice better preserved genera associated with gut health and broader functional diversity. These findings highlight the potential role of persistent and stable opioid-induced microbiota dysbiosis in long-term behavioral changes underlying OUD and contributing to vulnerability to relapse.
PubMed2026
Integrated treatment of posttraumatic stress disorder and substance use disorders for adolescents and youth: current evidence and future directions.
Background: Posttraumatic stress disorder (PTSD) and substance use disorders (SUD) frequently co-occur during adolescence and are associated with substantial functional impairment and elevated risk for chronic comorbidity. Despite strong evidence supporting integrated, trauma-focused treatments for adults with PTSD + SUD, the adolescent treatment literature remains limited.Objective: This review synthesizes current evidence on the integrated treatments for co-occurring PTSD + SUD problems among adolescents and youth, with emphasis on evaluating the strength of the evidence and identifying key directions for future research.Method: Targeted searches identified randomized controlled trials, open trials, pilot studies, and feasibility studies evaluating treatments for adolescents with PTSD + SUD problems. Studies were included if they reported PTSD and/or substance use outcomes. Findings from the adult PTSD + SUD literature were reviewed to inform developmentally appropriate adaptation for youth.Results: The adolescent evidence base is sparse. Risk Reduction Through Family Therapy (RRFT) is the only integrated treatment supported by multiple randomized controlled trials, demonstrating durable improvements in PTSD symptoms and substance use. Preliminary evidence also supports Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure for Adolescents (COPE-A). Across studies, trauma-focused treatment was not associated with increased substance use and was generally acceptable to adolescents. However, conclusions are constrained by small samples, heterogeneous interventions, and limited long-term and implementation data.Conclusions: Integrated, trauma-focused psychotherapies appear safe and promising for adolescents with co-occurring PTSD + SUD problems. Larger trials, mechanistic research, and implementation-focused studies are needed to inform best practices and expand access to effective care.