Psychiatry Int., Volume 7, Issue 1 (February 2026) – 3 articles

This pilot exploratory qualitative study used the Modified Grounded Theory Approach (M-GTA) and the Realist Evaluation (RE) framework to clarify the interrelationships between nursing support and Peer Support (PS) in the creation and utilization of Crisis Plans (CPs) in Japan. Findings revealed that nursing support, constrained by psychiatric ward institutions, struggled with internal conflict while seeking to bridge risk and recovery. In contrast, PS support, rooted in lived experience, reframes crisis and risk, actively fostering patient self-determination and growth, and transforming. We propose an exploratory Context–Mechanism–Outcome (CMO) model that maps the distinctive contributions and interactions of nursing and PS support. This model provides provisional insights to inform the development of more robust, recovery-oriented CP support systems. Full article

Fluoxetine and carbamazepine are widely prescribed psychotropic drugs, yet few studies have quantified metal(loid) impurities in these medicines, which may pose health risks to patients. This study aimed to determine concentrations of As, Cd, Cr, Cu, Fe, K, Mg, Mn, P, Pb, Se, and Zn in brand, similar, and generic samples of fluoxetine and carbamazepine marketed in Campo Grande, Brazil. Drug samples were purchased from local pharmacies, digested with acid, and analyzed by Inductively Coupled Plasma Optical Emission Spectrometry (ICP OES). Results showed that arsenic was detected only in fluoxetine samples, with concentrations ranging from 0.068 to 0.217 mg/kg, all below national and international limits. Phosphorus presented the highest levels, especially in fluoxetine, reaching up to 14,000 mg/kg, and up to 93 mg/kg in carbamazepine. Other elements such as Fe (0.07–3.03 mg/kg), Mg (0.21–259 mg/kg), K (up to 45 mg/kg), Se (up to 1.5 mg/kg), and Zn (up to 4.2 mg/kg) were also quantified, while Cd, Cr, Cu, and Pb were below detection limits. The hazard index (HI) exceeded 1 for all carbamazepine samples and for one brand, two similar, and three generic fluoxetine samples, indicating that the intake of these medications may pose potential health concerns. These findings underscore the need for stricter monitoring of metal(loid) impurities in psychotropic drugs to protect patient safety and ensure regulatory compliance. Full article

Background: Clinical practice suggests that objective assessment tools are needed to assess adults with inattention or hyperactivity, informed by the underlying pathophysiology of attention-deficit and hyperactivity disorder (ADHD). This systematic review comprehensively evaluates the current objective assessment methods as an adjunct diagnostic tool for these adults. Methods: We conducted a systematic review of studies investigating various objective diagnostic methods to assess adults with ADHD and healthy controls. The database search occurred from its inception to 23 December 2024. Results: Our search yielded 46 studies that reported on various objective methods to assess adults with ADHD. The MOXO-distracted Continuous Performance Test (MOXO-d-CPT), eye-tracker with MOXO-d CPT, Conners’ Continuous Performance Test—3rd edition (CCPT-3), and oculomotricity can differentiate between true and feigned ADHD or other diagnostic possibilities. The Quantified Behavior Test (Qb Test+) can detect hyperactivity and differentiate it from other psychiatric disorders. Mono-d, CCPT-3, Qb Test+, Test of Variables and Attention (TOVA), Integrated Visual and Auditory Continuous Performance Test (IVA-CPT), and oculomotricity can monitor pharmacotherapy response. Functional near-infrared spectroscopy (fNIRS) offers more promise than structural imaging and demonstrates a moderate level of sensitivity and specificity to differentiate adults with and without ADHD by performing the verbal fluency test. Notwithstanding, electroencephalography (EEG)/event-related potential (ERP) shows potential in diagnosis and treatment monitoring (e.g., neurofeedback training). In addition, transcriptome-based biomarkers have also been explored as diagnostic tools. Conclusion: The diagnosis and monitoring of ADHD in adults come with a unique set of challenges due to psychiatric comorbidity, including depression and anxiety; fluctuation of symptoms over time; and lack of consensus among clinicians and professional organizations to adopt objective tests in the diagnostic process. Our findings support the notion that a combination of clinical assessment and objective biomarkers targeting distinct pathophysiological aspects may enhance the accuracy of ADHD diagnosis. Full article