Search Results (201)

Background/Objectives: Cannabis use has a particularly high prevalence in individuals with psychotic disorders. Although cannabis use is generally associated with cognitive impairments in the general population, its impact on cognition in psychosis remains controversial. This study aimed to investigate the association between cannabis use and cognitive performance in a cohort of individuals affected by psychotic disorders. Methods: A total of 105 inpatients with psychotic disorders (mean age: 40.3 years; 34 females) were recruited from the University Hospital Center “Mother Teresa” in Tirana. Data collection included socio-demographic and clinical variables. Cognitive functioning was evaluated using the Montreal Cognitive Assessment (MoCA), while psychopathology was assessed with the Brief Negative Symptom Scale (BNSS), the Calgary Depression Scale for Schizophrenia (CDSS), the Psychotic Symptom Rating Scales (PSYRATS), and the Scale for the Assessment of Thought, Language, and Communication (TLC). Results: Cannabis users (CU) were more frequently male, younger, and exhibited an earlier onset of psychosis compared to non-users (No-CU). Importantly, CU demonstrated higher MoCA scores, with the most favorable outcomes observed among daily users. Conclusions: Contrary to the prevailing assumption that cannabis use exacerbates cognitive decline, our findings indicate an unexpected association between cannabis use and preserved cognitive functioning in psychosis. These results underscore the need to consider dosage, frequency, and cannabinoid composition (THC/CBD ratio) when interpreting cannabis-related cognitive outcomes in psychotic disorders. Full article

Background/Objectives: Sensory deprivation, defined as a reduction or absence of external sensory input across one or more modalities, has long been investigated in extreme and experimental settings. More recently, its relevance has expanded to clinical contexts and environmental conditions. The present narrative review aims to synthesize current evidence on the neurobiological mechanisms, psychological effects, and clinical implications of sensory deprivation, with particular attention to its dual role as both a risk factor and, under controlled conditions, a potential therapeutic tool. Methods: A narrative literature search was conducted using PubMed, Scopus, and PsycINFO, covering studies published up to August 2025. Search terms included sensory deprivation, neuroplasticity, neurotransmitters, HPA axis, neuro-inflammation, circadian rhythms, psychopathology, extreme environments, and spaceflight. Preclinical and clinical studies examining biological, cognitive, and psychological consequences of reduced sensory stimulation were included. Data were synthesized thematically without quantitative meta-analysis. Results: Evidence indicates that sensory deprivation induces widespread neurobiological adaptations involving neurotransmitter systems (particularly dopaminergic pathways), dysregulation of the hypothalamic–pituitary–adrenal axis, neuroimmune activation, circadian rhythm disruption, and structural and functional brain changes, notably affecting the hippocampus. These alterations are associated with increased vulnerability to depression, anxiety, hallucinations, dissociative symptoms, and cognitive impairment. Duration, voluntariness, and individual differences (e.g., baseline vulnerability/resilience, trait anxiety, and prior psychiatric history) critically modulate outcomes. However, short-term and voluntary sensory restriction, such as Floatation-REST, may promote relaxation and emotional regulation under specific conditions. Conclusions: Sensory deprivation exerts complex, context-dependent effects on brain function and mental health. Duration, individual vulnerability, and voluntariness critically modulate outcomes. Understanding these mechanisms is increasingly relevant for clinical practice and for developing preventive strategies in extreme environments, including future long-duration space missions. Full article

Objective: Pain is among the most common and debilitating symptoms experienced by oncology patients and has been associated with adverse mental health outcomes, including depression and suicide. Nevertheless, the relationship between pain and suicide in oncology populations remains insufficiently characterized. A clearer understanding of this interplay is essential to guide personalized approaches aimed at reducing cancer-related burden and improving quality of life. Methods: We searched PubMed and PsycInfo without imposing limits regarding publication date using pain* AND (suicid* OR “self-harm” OR “self-injurious behavior” OR “self-inflicted injury” or “self-killing”) AND (cancer* OR oncolog* OR tumor* OR neoplasm* OR metasta*). A total of 832 articles were identified, and 15 of them were included in our review. Results: Inadequately managed pain in cancer patients is associated with a significantly elevated risk of suicidal ideation. This association is further exacerbated in individuals presenting with depressive symptoms, advanced-stage disease, or limited access to timely psychological support. These factors may interact synergistically, intensifying the emotional and cognitive burden of pain, thereby increasing vulnerability in cancer patients. Conclusions: Cancer-related pain should be conceptualized as a highly variable indicator of psychological vulnerability. Factors influencing this variability include cancer type and severity, as well as the presence of past psychopathology. These findings support the need for a personalized medicine approach, whereby pain management and psychosocial interventions are tailored to patient-specific factors such as disease stage, psychological comorbidity, and access to supportive care. Full article

Background/Objectives: Adults with intellectual disability (ID) experience high rates of psychiatric comorbidity but often face diagnostic challenges and treatment barriers, leading to inappropriate psychotropic medication use. This study examined the extent to which specialized psychiatric assessment and improved diagnostic accuracy had an impact on medication management and clinical outcomes in adults with ID and co-occurring psychiatric disorders. Methods: This observational retrospective study analyzed medical records from 25 adults with ID who underwent specialized psychiatric assessment at a community-based service in Italy between January 2023 and January 2024. Psychopathological diagnoses were established according to Diagnostic Manual—Intellectual Disability, Second Edition (DM-ID2) criteria, based on clinical observation and a comprehensive assessment using validated instruments. Clinical outcomes were assessed using a psychometric tool encompassing multiple psychopathological and behavioral dimensions. Data on psychotropic prescriptions and side effects were also collected. Non-parametric analyses were performed, with significance set at α = 0.05. Results: The proportion of patients with a psychiatric diagnosis increased from 32% to 96% after specialized assessment (p < 0.001), with notable rises in depressive (0% to 32%), bipolar (8% to 36%), anxiety (4% to 24%), and impulse control (0% to 16%) disorders. First-generation antipsychotic prescriptions decreased (from 36% to 8%, p = 0.023), while antidepressant use increased (from 12% to 52%, p = 0.004). The mean number of side effects per patient declined from 1.6 to 0.5 (p < 0.001), particularly the elevated prolactin level and psychomotor retardation. Significant improvements were observed in symptom intensity and frequency across multiple domains, including aggression, mood disturbances, and compulsions (p < 0.001). Conclusions: In this single-center retrospective study, specialized psychiatric assessment was associated with improved diagnostic accuracy, medication management, and clinical outcomes in adults with ID. The increase in psychiatric diagnoses likely reflects improved identification, addressing key challenges in precision diagnosis for people with neurodevelopmental disorders. Although the overall number of prescribed medications remained stable, optimization of treatment regimens reduced first-generation antipsychotic use and related adverse effects. These findings indicates that access to specialized assessment and precision diagnosis could improve psychopharmacological interventions and outcomes for this vulnerable population, but larger, multi-center and longer-term studies are needed to confirm these results. Full article

Background: Foster children exhibit higher rates of psychiatric and physical disorders than children living with their biological families. This places a high burden on the parenting skills of foster parents and potentially increases the risk of placement failure. One possibility to increase foster carers’ parenting skills and to reduce child problems is through parent training. In this study, the feasibility and effectiveness of the German-translated version of Fostering Changes, a parent training programme for foster parents, was investigated. The aims of Fostering Changes are the reduction in child behavioural problems, supporting children’s affect regulation, and improving the quality of the foster parent–child relationship through the promotion of foster parents’ sensitivity and parenting skills. Methods: We conducted six Fostering Changes courses in 2022 and 2023, with a total of 33 foster carers (i.e., foster parents) participating. Child behavioural problems (Carer-Defined Problems Scale; primary outcome), child psychopathology (Strengths and Difficulties Questionnaire), carer–child relationship quality (Child Relationship Behavior Inventory, Quality of Attachment Relationship Questionnaire), foster carers’ stress (Parental Stress Scale), and foster carers’ parenting strategies (Parenting Scale) were assessed at the start (t0) and end of each course (t1) and three months after course completion (t2). To examine the effect of training participation, mixed linear models and generalised estimating equations were applied. Additionally, effect sizes (Cohen’s d) were calculated. Results: When comparing t0 with t1 scores, there was a significant reduction in child behavioural problems (d = 1.87) and child psychopathology (d = 0.70), and improvement in foster carers’ parenting skills (d = 0.76) and the quality of the foster parent–child relationship (CRBI: d = 0.77, QUARQ: d = 0.72). Effect sizes for changes in the abovementioned variables between t0 and t2 were also moderate to large, with the exception of child psychopathology (d = 0.44). Conclusions: The results of this feasibility study, which is the first trial of Fostering Changes outside the UK, suggest that the German version of Fostering Changes could be an effective intervention for foster families. The largely comparable results for the periods t0–t1 and t0–t2 suggest constancy of the observed changes three months after course completion. Trial registration: DRKS-ID: DRKS00029014; date of registration: 23 May 2022. Full article

Background/Objectives: Caring for a child with Autism Spectrum Disorder (ASD) is often associated with elevated psychological distress and reduced life satisfaction. Mindfulness-based interventions may offer substantial benefits by enhancing emotion regulation, reducing maladaptive cognitive patterns, and strengthening mindful parenting. This randomized controlled trial (RCT) examined the effectiveness of an eight-week Mindfulness-Based Cognitive Therapy (MBCT) program, enriched with mindful parenting practices, delivered to parents of children with ASD. The primary aim was to improve parental mental health, while secondary analyses explored potential indirect, parent-perceived changes in child behavior outcomes. Methods: Fifty-six parents of children with ASD were randomly assigned to an MBCT intervention group (n = 30) or a waitlist control group (n = 26). Parents completed assessments at baseline (T0), post-intervention (T1), and at one-month follow-up (T2), including the Depression Anxiety Stress Scales–21 (DASS-21), the Positive and Negative Affect Schedule (PANAS), and the Satisfaction With Life Scale (SWLS). They also rated the overall severity of their child’s behavior problems to explore indirect treatment effects. Results: All parents receiving MBCT (100%) completed the program successfully and reported high acceptability. At baseline, no significant differences were observed between groups. At T1, the MBCT group demonstrated significant reductions in depression, anxiety, and stress, alongside increases in positive affect and life satisfaction. These improvements were maintained or strengthened at T2. However, the control group showed no significant changes over time. Additionally, parents in the MBCT group reported indirect improvements in their children’s behavioral adjustment at T1 and T2. Conclusions: Findings demonstrate that MBCT constitutes an effective intervention for reducing parental psychopathology and indirectly supporting parent-perceived improvements in child behavior, emphasizing the importance of incorporating mindfulness and mindful parenting components into family-centered interventions for parents of children with ASD. Full article

The present manuscript proposes an integrative clinical-theoretical framework that explores neurodivergence through the lens of attachment theory, aiming to enrich our understanding of atypical developmental trajectories. Drawing from both classical Bowlby–Ainsworth models and contemporary contributions from developmental psychopathology and affective neuroscience, I examine how early relational experiences shape the regulation of affect, intersubjectivity, and sensory processing in neurodivergent populations. Particular focus is given to autism spectrum conditions, attention-deficit/hyperactivity disorder (ADHD), and sensory integration challenges, highlighting the interdependence between attachment patterns and core neurodevelopmental features. By reframing neurodivergence not merely as a deficit or disorder but as an expression of individual variation in neuro-affective development, the manuscript offers implications for diagnostic refinement, therapeutic alliance building, and psychoeducational planning. This interdisciplinary approach aims to foster a more inclusive and relationally attuned clinical paradigm that addresses both the strengths and vulnerabilities of neurodivergent children and adolescents. Full article

Background/Objectives: The establishment of strong prenatal bonding is a key determinant of perinatal well-being, influencing maternal psychological adaptation and infant development. Numerous studies have examined risk factors and psychopathology during pregnancy, but limited research has explored the role of positive psychological constructs, such as positive mental health (PMH). This study aimed to assess whether anxiety mediates the relationship between PMH and the quality of prenatal bonding. Methods: A total of 90 pregnant women participated. PMH was assessed using the Abbreviated Positive Mental Health Questionnaire; anxiety using the Hospital Anxiety and Depression Scale; and prenatal bonding using the Prenatal Assessment Scale for Pregnant Women (EVAP). A simple mediation model was tested, with anxiety as a mediator between PMH (predictor) and prenatal bonding (outcome), controlling the analysis for previous miscarriages, relationship stability, high-risk pregnancy, and employment. Results: The model revealed partial mediation (F = 16.617, p < 0.001). Higher PMH was associated with lower anxiety (B = −0.297, SE = 0.062, p < 0.001) and stronger prenatal bonding (B = 0.777, SE = 0.091, p < 0.001). Interestingly, anxiety emerged as an adaptive response, which could improve maternal sensitivity and communication with the unborn child (B = 0.316, SE = 0.145, p = 0.032). The model explained 56% of the variance in prenatal bonding, even after accounting for relevant covariates. Conclusions: These findings underscore the importance of considering contextual and psychosocial factors when assessing the role of emotions such as anxiety during pregnancy. Rather than being inherently maladaptive, anxiety may play a functional role in facilitating maternal engagement with the baby, especially when grounded in PMH. Given the limited research, our findings support the integration of positive psychology frameworks into perinatal health interventions. Full article

Background: Electroconvulsive therapy (ECT) is a well-established intervention for severe and treatment-resistant psychiatric disorders, yet its use in adolescents remains limited, particularly in Europe. Data on its safety and effectiveness in this population are scarce. This study aimed to evaluate the clinical outcomes and tolerability of ECT in adolescents diagnosed with schizophrenia and schizoaffective disorder. Methods: We conducted a retrospective observational case series of 22 adolescents (mean age 16.7 ± 1.3 years) treated with ECT between 2017 and 2024 at a university psychiatric department. Diagnoses included paranoid schizophrenia (n = 15), catatonic schizophrenia (n = 2), and schizoaffective disorder (n = 5). Symptom severity was assessed with the Positive and Negative Syndrome Scale (PANSS) before and after the ECT course. Adverse events were evaluated based on daily clinical monitoring and medical records. Results: The overall response rate, defined as ≥50% reduction in total PANSS score, was 82% (schizophrenia: 82%; schizoaffective disorder: 80%). Mean PANSS total score decreased from 158.0 ± 22.6 to 72.1 ± 20.7 (p < 0.0001). Improvements were most pronounced in the general psychopathology and positive symptom domains. No serious adverse events were observed. The most common transient side effects were headache (41%), memory complaints (27%), and somnolence (22%). Conclusions: ECT appears to be an effective and safe treatment option for adolescents with treatment-resistant schizophrenia and schizoaffective disorder. These findings add to the limited European evidence base and support considering ECT earlier in the treatment course of severe adolescent psychosis. Larger, prospective studies with long-term follow-up are warranted to confirm these results. Full article

Background: Recent research has focused on psychological constructs that maintain psychopathology, along with the constraints of single-diagnosis protocols that have contributed to the expansion of process-based psychotherapy. Therefore, the Process-Based Assessment Tool (PBAT) was developed for identifying relevant psychological processes and facilitating personalized approaches. The aim of the present study was the adaptation of the PBAT for the Romanian population. Methods: Participants (n = 637) encompassed a non-clinical and a clinical sample who filled in the PBAT. In addition, within the non-clinical group, the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 were used for measuring the level of depression and anxiety, respectively. Results: The correlations between different PBAT processes were found in the expected direction, according to the valence of individual items. The outcomes of the network analyses revealed the centrality of several items within both samples. Also, the results of the Boruta analysis showed the predictive role of some processes in relation to anxiety and depression. Conclusions: By resembling the findings of other PBAT validation studies, the present investigation demonstrated that the instrument can be reliably applied for exploring psychological processes correlated with adaptation and maladaptation within the Romanian population. Full article

Background/Objectives: Childhood trauma is a well-established risk factor for adult psychopathology, yet the underlying neuropsychiatric mechanisms remain unclear. Therefore, this study examined whether resilience mediates the relationship between childhood trauma and depressive and anxiety symptoms, and whether this pathway is moderated by harm avoidance (HA). Methods: A total of 218 Korean adults (aged 19–50 years; 79 men and 139 women) completed validated measures of childhood trauma (Childhood Trauma Questionnaire (CTQ)-Short Form), harm avoidance (Temperament and Character Inventory–Harm Avoidance subscale), resilience (Brief Resilience Scale), depression (Patient Health Questionnaire-9), and anxiety (Generalized Anxiety Disorder-7). Mediation and moderated mediation models were tested using structural equation modeling, and indirect effects were estimated via bootstrapping with 5000 resamples. Results: Childhood trauma was associated with lower resilience, an effect moderated by HA. Resilience was strongly inversely associated with depression and anxiety. Indirect effects of trauma through resilience were significant for both outcomes, with stronger effects at higher HA. Conclusions: The associations between childhood trauma and both depression and anxiety were mediated by resilience, and this indirect pathway was amplified by HA. These findings suggest a neuropsychiatric mechanism whereby early-life stress and temperament jointly shape effective neural vulnerability, leading to depression- and anxiety-associated outcomes. Full article

Background: Human trafficking affects millions of people worldwide with multiple adverse outcomes including psychopathology. Although research on human trafficking has become abundant in other academic disciplines (e.g., public health, criminology, social work), healthcare research specific to the mental health treatment of survivors remains limited. Objective: The purpose of this study was to gather recommendations from professionals about mental health treatment of trafficking survivors. Method: Semi-structured interviews were conducted with 21 multidisciplinary professionals working with trafficking survivors. Data were analyzed using qualitative content analysis methodology. Results: An overarching theme derived from the data concerned the recommendation to implement trafficking survivor-informed care, specifically addressing complex trauma and individual client contexts, such as culture and history prior to trafficking. A second theme emphasized the recommendation for comprehensive care, achieved through outreach efforts, interdisciplinary services, case management, and ongoing training for mental health professionals. Conclusions: Professionals working with trafficking survivors perceived conventional service formats as insufficient, and they recommended personalized and comprehensive healthcare to address multiple needs and extensive trauma history. Full article

Background/Objectives: Major depressive disorder (MDD) and metabolic syndrome (MetS) are highly prevalent, bidirectionally linked conditions. Individuals with MetS are at increased risk of developing depression, while depression predisposes to metabolic dysfunction. Evidence suggests that comorbid MDD and MetS present a distinct psychopathological profile, with neurovegetative symptoms such as fatigue, sleep disturbances, and appetite dysregulation being more prominent. This study aimed to determine whether depressive symptom structures differ between MDD patients with and without MetS, applying Bayesian network methods to uncover probabilistic dependencies that may inform precision psychiatry. Methods: Data were drawn from 1779 adults with ICD-10-diagnosed MDD in the 2013–2020 National Health and Nutrition Examination Survey (NHANES). Using standard metabolic criteria, participants were categorized as MetS (n = 315) or non-MetS (n = 1464). Depressive symptoms were assessed with the Patient Health Questionnaire (PHQ-9). Directed Acyclic Graphs (DAGs) were estimated via a hill-climbing algorithm with 5000 bootstrap replications to ensure network stability. Results: MetS patients displayed a denser and more interconnected symptom network. Fatigue (PHQ4) emerged as a central hub linking sleep, appetite, cognition, and functional impairment. In contrast, non-MetS patients showed a more fragmented network dominated by affective symptoms (low mood, anhedonia) and negative self-cognitions. Conclusions: Depressive symptoms propagate differently depending on metabolic status. These results highlight the value of personalized medicine approaches, advocating for treatment strategies that address neurovegetative dysfunctions in MDD with MetS and affective-cognitive symptoms in non-MetS. Aligning interventions with individual symptom architectures and metabolic profiles may enhance therapeutic precision and improve clinical outcomes. Full article

Background: Previous longitudinal evidence suggested that screen exposure at age 4 was associated with dysregulation symptoms and lower academic achievement up to age 8. Yet, it remains unclear whether these effects persist in preadolescence and extend to higher-order developmental outcomes such as the capacity to be alone, a marker of self-regulation and autonomy within the developmental psychopathology framework. Aim: This follow-up study re-contacted the original cohort at age 12 (T3) to examine whether early screen time predicted dysregulation, academic achievement, and capacity to be alone, testing the mediating role of dysregulation at ages 6 (T1) and 8 (T2), and the moderating role of maternal scaffolding at age 4. Methods: A community sample of N = 323 children and their mothers, previously assessed at T0–T2, was re-evaluated at T3 (mean age = 12.2 years, SD = 0.7). At T0, screen exposure and maternal scaffolding were measured using the StimQ (PIDA subscale). Dysregulation at T1–T3 was assessed with the Teacher Report Form (TRF). Academic achievement in mathematics and literacy was rated by teachers using the Teacher Academic Ratings. At T3, children also completed the Capacity to Be Alone Scale for Children (CBASC). Structural Equation Modeling (SEM) tested longitudinal direct, indirect, and moderated pathways, adjusting for sex, maternal education, and socioeconomic status. Results: Screen time at age 4 was associated with elevated dysregulation at T1 and T2, which in turn mediated poorer mathematics and literacy outcomes and reduced capacity to be alone at age 12 (all p < 0.01). Maternal scaffolding buffered early dysregulation but did not prevent long-term academic or self-regulatory impairments. Conclusions: Findings indicate that early excessive screen use contributes to a cumulative cascade of dysregulation, undermining both academic achievement and the developmental capacity to be alone by preadolescence. Preventive strategies should integrate screen-time guidelines with parental scaffolding interventions. Full article

Anorexia nervosa (AN) is a severe psychiatric disorder with the highest mortality rate among mental illnesses, characterized by an intense fear of weight gain, persistent restriction of energy intake, and a distorted perception of body image. Despite decades of investigation, the pathogenesis of AN is only partially understood and is recognized as multifactorial, involving genetic, sociocultural, and neurobiological determinants. Beyond its core psychopathological features, AN leads to a wide spectrum of systemic complications, including cardiovascular, renal, skeletal, and endocrine dysfunctions. Increasing evidence implicates autophagy and oxidative stress as key molecular mechanisms underpinning its pathophysiology, while growing attention has been directed toward immune dysregulation and alterations in the gut–brain axis as potential mediators of disease onset and progression. Therapeutic advances, however, remain limited. Current management relies primarily on nutritional rehabilitation and psychotherapeutic interventions, while treatment outcomes are constrained by high relapse rates and the lack of pharmacological agents with proven efficacy. In this context, a more comprehensive understanding of the clinical spectrum and molecular substrates of AN is essential to improving prognosis and guiding the development of novel therapeutic strategies. This narrative review synthesizes current evidence on the non-psychopathological dimensions of AN, encompassing its clinical manifestations, systemic complications, and implicated molecular pathways. It also appraises existing treatment modalities and examines emerging interventions with translational potential. Overall, this review aims to provide clinicians and researchers with an updated and integrative overview of AN, shedding light on novel directions in ongoing research. Full article