Journal of Psychiatric Research

BackgroundNeuropsychological deficits are common in obsessive-compulsive disorder (OCD) and may influence functional and treatment outcomes. Only a few studies have effectively targeted these deficits, with most failing to show broad transfer of training. This study aimed to evaluate the efficacy of an integrated cognitive control training (ICCT) program on neuropsychological functioning in OCD patients and assess related changes in clinical and socio-occupational functions. MethodA single-grou...

AimSurgical interventions such as deep brain stimulation (DBS) have demonstrated efficacy for severe treatment-resistant obsessive-compulsive disorder (TR-OCD) internationally, but surgical treatment has yet to be implemented in Japan. One factor hindering progress is uncertainty regarding domestic clinical demand, so a nationwide survey of psychiatrists was conducted to clarify their perceptions of OCD surgery. We analysed the data with the aim of identifying factors associated with the accepta...

BackgroundTo clarify the working mechanisms of psychotherapy for obsessive-compulsive disorder (OCD), we studied the neural effects of two psychotherapies: cognitive behavioral therapy with exposure and response prevention (CBT-ERP) and inference-based cognitive behavioral therapy (I-CBT). MethodsFifty-five individuals with OCD completed an emotional processing task during fMRI before and after 20 weekly psychotherapy sessions, using general fear and OCD-related visual stimuli. Forty-two health...

Evidence-based psychotherapies are first-line treatments for psychiatric disorders, yet response rates remain suboptimal. Noninvasive brain stimulation (NIBS) may augment psychotherapy by modulating treatment-engaged circuits. We conducted a systematic review and meta-analysis of randomized controlled trials comparing active NIBS plus evidence-based psychotherapy versus sham NIBS plus psychotherapy. Following Cochrane methods, we searched six databases through February 2025, screening 1,017 reco...

BackgroundForensic psychiatric services are expanding in many countries, and discharging patients from secure hospitals relies on accurate estimates of risk of adverse outcomes. Novel evidence-based tools for estimating one key risk, violent reoffending, have been developed in recent years. We aimed to externally validate one new tool, FoVOx, in forensic psychiatric patients sentenced to treatment, and to develop an updated model (FoVOx2), incorporating additional clinical predictors. MethodsUs...

Major depressive disorder (MDD) involves dysregulated neuroimmune, metabolic, and oxidative stress (NIMETOX) pathways. Recently, it was shown that NIMETOX pathways should be evaluated in MDD patients stratified for metabolic syndrome (MetS). The current study aims to characterize the metabolic hormone and adipokine profiles of Chinese MDD patients stratified for MetS and to delineate their associations with overall severity of depression (OSOD), suicidal ideation (SI), recurrence of illness (ROI...

BackgroundIn 2020, Oregon became the first U.S. state to establish a regulated framework for adults to access psilocybin services using naturally-derived mushroom products. No studies have examined mental health outcomes among individuals receiving psilocybin in this context. AimsTo evaluate changes in self-reported symptoms of depression, anxiety, and well-being 30-days post-psilocybin session under the Oregon state-regulated model , and document session-related adverse events and doses consum...

BackgroundAn accelerated schedule of intermittent theta burst stimulation (aiTBS) has been shown to improve clinical efficacy of transcranial magnetic stimulation for bipolar disorder (BD) and major depressive disorder (MDD). We investigated the functional connectivity changes underpinning clinical effects of aiTBS on transdiagnostic treatment-resistant depression (TRD). MethodsData were collected from two studies: an open-label active aiTBS study for MDD and a double-blind, randomized control ...

BackgroundPersonalized connectivity-guided accelerated intermittent theta burst stimulation (iTBS), like the Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT), shows high efficacy for treatment-resistant depression (TRD) in Western cohorts. However, generalizability to other demographics with substantial comorbidity remains unclear. Here, we evaluate connectivity-guided iTBS in a naturalistic Asian TRD population with high comorbidity burden. MethodsTwenty TRD participants receiv...

BackgroundPoor patient retention and family engagement compromise the effectiveness of coordinated specialty care (CSC) for first-episode psychosis (FEP). This mixed methods study aimed to identify program-level characteristics (CSC fidelity and engagement strategies) associated with patient retention and family engagement in Massachusetts CSC programs. MethodsPrimary outcomes were rates of patient retention and family engagement ([≥]1 evidence-based family intervention session), based on CS...

ObjectivesElectroconvulsive Therapy (ECT) is an effective treatment for bipolar disorder, particularly in severe acute cases or for illness resistant to pharmacotherapy. However, the risk of relapse following ECT is high, necessitating intervention to reduce this risk. Based on findings from ECT studies in unipolar depression and its well-known mood-stabilizing properties, it is likely that lithium treatment may reduce the risk of relapse of bipolar disorder following ECT. Therefore, we conduct...

Structured AbstractO_ST_ABSObjectiveC_ST_ABSThis mixed-methods study investigated the lived-experience perspectives of receiving a novel, brief digital mental health intervention after psychological trauma. The online gamified imagery-competing task intervention (ICTI) involves one researcher-guided session followed by self-use. Tested in two randomised controlled trials (GAINS-01; GAINS-02), ICTI led to fewer intrusive memories at week-4, with the reduction sustained over 24 weeks, alongside re...

ObjectivesTrauma-focused cognitive behavioural therapy (TF-CBT) is the established first-line treatment for paediatric posttraumatic stress disorder (PTSD), but access to evidence-based care remains limited. This study aimed to evaluate the feasibility and acceptability of a therapist-guided, 12-week, internet-delivered TF-CBT (iTF-CBT) programme for adolescents with PTSD, and to explore preliminary changes in PTSD symptoms. DesignSingle-group feasibility trial. SettingSave the Children, Swede...

ImportanceLarge language models (LLMs) have demonstrated diagnostic potential in several medical specialties, but their application to psychiatry - where diagnosis relies heavily on clinical judgment, narrative interpretation, and reasoning under uncertainty - remains insufficiently evaluated. ObjectiveTo evaluate diagnostic accuracy and clinician-judged reasoning quality of multiple large language models using psychiatric case vignettes. DesignMixed-methods evaluation study of diagnostic accu...

ObjectiveDespite recommendations that young people at clinical high risk (CHR) for psychosis receive stepped treatment, few programs have published details of their clinical models or outcomes. This study describes the preliminary effectiveness of a risk calculator-informed stepped care model used at the Yale PRIME Clinic, a specialized outpatient clinic for young people at CHR. MethodsSeventy-one individuals (ages 12-25) at CHR enrolled in Yales PRIME Clinic during the first four years of the ...

ObjectiveCharacterization of psychosis typically relies on cognitive and behavioral assessments. This study suggests the use of feature-specific sensory experiments to detect subtle perceptual alterations in early psychosis. MethodsPatients (N=120) diagnosed with schizophrenia (SCHZ, N=45), bipolar disorder (BIP, N=36), or first-episode psychosis (FEP, N=39), recruited from public mental health facilities in Brazil, were compared with age-matched healthy controls (HCSCHZ, HCBIP, and HCFEP; pool...

BackgroundWorldwide, common mental disorders such as anxiety and depression are major contributors to disability. However, the role of diet as a risk factor for anxiety and depression remains underexplored. Therefore, we investigated the associations between food groups and major depressive disorder (MDD) and anxiety disorders, following a harmonized protocol to enable integration of studies. MethodsWe analysed data from 1,634 participants in the Netherlands Study of Depression and Anxiety to e...

ImportanceAI-enabled features may improve the effectiveness of routine mental health care, yet large-scale real-world evidence remains limited. ObjectiveTo evaluate whether access to AI-enabled continuous care features embedded within routine psychotherapy delivery is associated with improved treatment engagement and clinical outcomes under real-world conditions. DesignPreregistered cluster-level, matched, quasi-experimental study using a real-world rollout of AI-enabled continuous care featur...

BackgroundThe Michigan Freshman Study on Stress and Resilience aims to identify factors that predict the emergence of depression and/or anxiety symptoms in college freshmen. We previously showed that a combination of psychiatric instruments (Affect Score) strongly predicts who will develop such symptoms during the freshman year. Here, we ask: a) Can we replicate the predictive power of the Affect Score in an independent cohort? and b) Can the neuroendocrine profile during the Trier Social Stress...

BackgroundAttention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by attentional deficits, hyperactivity and impulsivity that often persists into adulthood. While dysfunction of dopaminergic neurotransmitter systems has been observed, underlying mechanisms remain incompletely understood. Current treatments with methylphenidate and amphetamines show limited long-term effectiveness and do not address broader clinical needs. The endocannabinoid system represen...