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Psychiatry Int., Volume 6, Issue 1 (March 2025) – 23 articles

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16 pages, 253 KiB  
Article
Clinicians’ Perspectives on Managing Medical Emergencies in Eating Disorders (MEED) in Adolescence—A Reflexive Thematic Analysis
by Cliona Brennan, Sarah Illingworth, Erica Cini, Mima Simic, Julian Baudinet, Ellen McAdams and Dee Bhakta
Psychiatry Int. 2025, 6(1), 23; https://doi.org/10.3390/psychiatryint6010023 - 25 Feb 2025
Viewed by 131
Abstract
Objective: Despite the UK national guidance for Managing Emergencies in Eating Disorders (MEED) being widely used, little is known about how the guidance has been embedded into clinical practice or implemented across services. Methods: Clinicians (n = 13) working in community child [...] Read more.
Objective: Despite the UK national guidance for Managing Emergencies in Eating Disorders (MEED) being widely used, little is known about how the guidance has been embedded into clinical practice or implemented across services. Methods: Clinicians (n = 13) working in community child and adolescent eating disorder services and medical wards were interviewed about their experience of using the MEED guidance in their clinical practice. Open-ended questions were used. Reflexive thematic analysis was used to analyse interview data. Results: Reflexive thematic analysis of responses identified three main themes. These were the following: (1) a common language, (2) looking beneath the surface, and (3) refeeding syndrome—a rare event in youth. These themes evidenced the important role of the MEED guidance in child and adolescent eating disorders and highlighted both the benefits and limitations of the current guidance. Conclusions: This study demonstrated that MEED was most helpful as a tool to clearly communicate acuity of medical risks between services, aiding multi-agency working required to manage both physical and mental health risks of young people with AN. The absence of parameter risk stratification and the lack of consistency on refeeding guidance across adolescent and adult guidance were highlighted as areas that future research should focus on. Full article
15 pages, 601 KiB  
Review
Does Vitamin D Deficiency Increase the Risk of Autism Spectrum Disorder? Linking Evidence with Theory—A Narrative Review
by Sadia Sultan, Noor Alhejin, Raed Serafi, Manar Abu Alrahi, Gehad Afifi, Layan Al-Adawi, Mohammed Serafi and Nada El Madhoun
Psychiatry Int. 2025, 6(1), 22; https://doi.org/10.3390/psychiatryint6010022 - 24 Feb 2025
Viewed by 436
Abstract
Introduction: Vitamin D plays a crucial role in brain health by providing antioxidant, anti-inflammatory, and neuroprotective benefits. It regulates neurotransmitters and neurotrophins that are essential for the development, maintenance, and functioning of the nervous system. Deficiency in vitamin D during pregnancy and [...] Read more.
Introduction: Vitamin D plays a crucial role in brain health by providing antioxidant, anti-inflammatory, and neuroprotective benefits. It regulates neurotransmitters and neurotrophins that are essential for the development, maintenance, and functioning of the nervous system. Deficiency in vitamin D during pregnancy and early childhood can disrupt neurodevelopment, potentially contributing to autism spectrum disorder (ASD). The aim of this narrative review was to analyze the potential link between vitamin D deficiency and the development of ASD, as well as to explore the therapeutic benefits of vitamin D supplementation. Method: We performed a literature search across PubMed, EMBASE, Web of Science, and the Cochrane Library databases, reviewing observational studies, randomized controlled trials (RCTs), and meta-analyses for evidence of an association between vitamin D deficiency and ASD. Results: The results were mixed but promising, with most observational studies suggesting a positive link between vitamin D deficiency and ASD, though these findings were not consistently replicated in prospective studies or RCTs. In conclusion, the available data are insufficient to establish vitamin D deficiency as a definitive cause of ASD. Further RCTs, particularly during pregnancy and infancy, are needed to better understand the role of vitamin D in the etiology of ASD and its potential as a therapeutic intervention. Conclusions: The current available data are insufficient to support vitamin D deficiency as a definitive factor in the etiology of autism spectrum disorders. To translate this hypothesis into clinical practice, additional randomized controlled trials, particularly during pregnancy and early infancy, are needed. Full article
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<p>Summary of the various etiological factors implicated in ASD and the desirable effects of VD that can counter these factors.</p>
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15 pages, 563 KiB  
Article
Understanding Stigma in Mental Illness: A Novel Literature-Based Model of Development
by Jorge Magalhães Rodrigues, Ana Sofia Cruz and Cristina Queirós
Psychiatry Int. 2025, 6(1), 21; https://doi.org/10.3390/psychiatryint6010021 - 22 Feb 2025
Viewed by 236
Abstract
The concept of stigma has evolved, initially denoting a mark of shame and now encompassing a broader range of negative societal perceptions. Cognitive-social models describe stigma as containing stereotypes, discrimination, and prejudice, with each dimension significantly impacting individuals’ health, social interactions, and willingness [...] Read more.
The concept of stigma has evolved, initially denoting a mark of shame and now encompassing a broader range of negative societal perceptions. Cognitive-social models describe stigma as containing stereotypes, discrimination, and prejudice, with each dimension significantly impacting individuals’ health, social interactions, and willingness to seek help. This study has the objective of exploring the main theories about stigma to propose a novel model that integrates these dimensions, illustrating their interactions and cumulative impact on individuals and their families. The model aims for a comprehensive understanding of stigma development in mental illness and provides valuable insights for developing targeted anti-stigma interventions, ultimately improving the lives of individuals with mental illness and their families. Full article
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<p>Proposal for the development of stigma in its dimensions related to the individual with mental illness and their family members.</p>
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14 pages, 553 KiB  
Systematic Review
Maternal Attachment and Perinatal Health in Refugee Women: A Systematic Review
by Patricia Catalá, Lorena Gutiérrez, Carmen Écija and Cecilia Peñacoba
Psychiatry Int. 2025, 6(1), 20; https://doi.org/10.3390/psychiatryint6010020 - 19 Feb 2025
Viewed by 222
Abstract
Background: In the general population, a relationship between maternal mental health and maternal attachment has been identified, but it has not been studied in depth in vulnerable populations like refugee women. This review aims to analyze the relationship between maternal attachment and mental [...] Read more.
Background: In the general population, a relationship between maternal mental health and maternal attachment has been identified, but it has not been studied in depth in vulnerable populations like refugee women. This review aims to analyze the relationship between maternal attachment and mental health in postpartum refugee women and to propose a conceptual framework for understanding these interactions. Methods: A systematic review was conducted following PRISMA guidelines, using search terms such as “attachment”, “bonding”, “mental health”, “post-traumatic stress”, “depression”, “anxiety”, and “refugee women”. The search was conducted between September and October 2023 in Scopus, MEDLINE, PsycINFO, and PubMed. Nine studies met the inclusion criteria, and their results were systematically synthesized to identify patterns and limitations. Results: Of the 455 studies identified, only 9 met the inclusion criteria. The analysis reveals a complex relationship between maternal mental health and maternal attachment. Although four studies (n = 4) found no significant relationships between maternal mental health and attachment styles, others identified negative correlations between secure attachment and symptoms of post-traumatic stress (n = 2) or depression (n = 2), highlighting the influence of maternal psychological well-being on the bond with the infant. Conclusions: The findings suggest that post-traumatic symptoms play a key role in shaping the relationship between maternal attachment and mental health. Consequently, psychosocial interventions focusing on maternal attachment could help prevent difficulties in mother–infant interactions and improve gestational health, thus supporting the development of the maternal role in refugee populations. Full article
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<p>PRISMA flowchart of the search strategy.</p>
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14 pages, 397 KiB  
Article
Harm Perception and Result Awareness Study for Tertiary Prevention in Patients with Comorbidity of Substance Use Disorder and Bipolar Disorder
by Nevzat Tarhan, Çiğdem Demirsoy and Aylin Tutgun-Ünal
Psychiatry Int. 2025, 6(1), 19; https://doi.org/10.3390/psychiatryint6010019 - 19 Feb 2025
Viewed by 155
Abstract
The long-term protective effect of self-awareness in substance use disorders, described as a type of brain disease, is currently being discussed and is called tertiary prevention. The aim of this study was to demonstrate the contribution of a positive psychotherapy program implemented in [...] Read more.
The long-term protective effect of self-awareness in substance use disorders, described as a type of brain disease, is currently being discussed and is called tertiary prevention. The aim of this study was to demonstrate the contribution of a positive psychotherapy program implemented in tertiary prevention by repeatedly measuring patients’ levels of harm perception and result awareness. A one-group pre-test–post-test experimental model was used according to the quantitative method. The sample of the study consisted of 44 patients who applied to AMATEM and were diagnosed with substance use disorder and/or alcohol use disorder and comorbid bipolar disorder. Two groups were formed by taking into account comorbidities: The first group consisted of 30 individuals with substance use disorder and/or alcohol use disorder. The second group consisted of 14 patients diagnosed with bipolar disorder together with substance use disorder. The data were collected with the Uskudar Harm Perception Scale (USHPS) and the Uskudar Result Awareness Scale (USRAS), developed by Tarhan, Demirsoy, and Tutgun-Ünal. As a result of the study, the pre-test and post-test scores of the patients differed, and their awareness levels increased after the psychotherapy program. According to the pre-test and post-test Cohen’s d calculations, the effect size of the difference between the two groups was high (d > 0.8). It was understood that the program and measurement tools contributed to the tertiary prevention studies. Full article
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<p>USRAS and USHPS pre-test and post-test scores of the groups (a cut-off point of 2.5 was accepted as the median value).</p>
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15 pages, 732 KiB  
Article
Training Profiles, Efficacy Perceptions, and Outcomes of Non-Invasive Neuromodulation: An Exploratory Study Among Practitioners
by Laura Oliveira Campos, Bianca Rossi Botim, Mayra Evelise Cunha, Denys Batista Campos, Michelle Almeida Barbosa, Gabriela Lopes Gama and Alexandre Carvalho Barbosa
Psychiatry Int. 2025, 6(1), 18; https://doi.org/10.3390/psychiatryint6010018 - 17 Feb 2025
Viewed by 257
Abstract
Advances in non-invasive neuromodulation (NM) have enabled practitioners to modulate neural activity safely, offering a promising approach to treating neuropsychiatric and neurological conditions. This study aimed to analyze the training profiles of NM practitioners and assess their perceptions of NM’s clinical efficacy, safety, [...] Read more.
Advances in non-invasive neuromodulation (NM) have enabled practitioners to modulate neural activity safely, offering a promising approach to treating neuropsychiatric and neurological conditions. This study aimed to analyze the training profiles of NM practitioners and assess their perceptions of NM’s clinical efficacy, safety, and patient satisfaction. An online survey was conducted among 117 practitioners in various healthcare fields, using the Clinical Global Impression (CGI) scale to gauge outcomes. The findings indicate that 99.13% of practitioners perceive NM as effective, with high rates of patient improvement in quality of life and symptom management. The study underscores the importance of standardized NM training protocols to enhance therapeutic outcomes. Full article
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<p>Training characteristics.</p>
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<p>Adverse effects responses.</p>
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13 pages, 553 KiB  
Article
Differential Effects by Caring and Positive Empathy on Depression and Anxiety: Gender Differences in a Sample of Spanish University Students
by Diego Gomez-Baya, Denisse Manrique-Millones, Arlen J. Garcia and Esther Lopez-Bermudez
Psychiatry Int. 2025, 6(1), 17; https://doi.org/10.3390/psychiatryint6010017 - 13 Feb 2025
Viewed by 660
Abstract
(1) Background: The literature to date has shown some contradictory findings regarding the associations between empathy and mental health. Thus, the caring component of the Positive Youth Development model has been related to more mental health symptoms, while positive empathy seems to have [...] Read more.
(1) Background: The literature to date has shown some contradictory findings regarding the associations between empathy and mental health. Thus, the caring component of the Positive Youth Development model has been related to more mental health symptoms, while positive empathy seems to have a positive impact on psychological adjustment. The present study aimed to analyze the associations between caring and positive empathy with youth depression and anxiety, as well as examine gender differences. (2) Methods: A cross-sectional study was carried out by administering an online self-report to a sample composed of 370 university students (67.2% women), aged 18–29 (M = 21.29, SD = 3.61), enrolled across 10 universities in the Spanish region of Andalusia; (3) Results: Women reported higher levels of the caring dimension of PYD, more positive empathy, but more symptoms of depression and anxiety. Mediational analyses to explain the gender differences in mental health concluded that (a) women reported more depression and anxiety partly due to their higher scores in caring, and (b) despite women had more positive empathy than men, this mechanism was only protective against anxiety in the subsample of men; (4) Conclusions: The promotion of mental health in the university context should address gender differences and the role of caring and positive empathy. Full article
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<p>Multiple mediation model with standardized coefficients. Note. *** <span class="html-italic">p</span> &lt; 0.001, ** <span class="html-italic">p</span> &lt; 0.01, * <span class="html-italic">p</span> &lt; 0.05.</p>
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14 pages, 1191 KiB  
Article
When Eating Healthy Becomes Unhealthy: A Cross-Cultural Comparison of the Indirect Effect of Perfectionism on Orthorexia Nervosa Through Obsessive–Compulsive Symptoms
by Alexandra Cobzeanu, Ioana-Cătălina Roman and Iulia Cristina Roca
Psychiatry Int. 2025, 6(1), 16; https://doi.org/10.3390/psychiatryint6010016 - 12 Feb 2025
Viewed by 412
Abstract
Orthorexia nervosa (ON) is a pathological obsession with eating only healthy and biologically pure food. The primary aim of this study was to explore the relationships between ON, perfectionism, and obsessive–compulsive symptoms in two cultural contexts, i.e., Romania and Germany. Our sample included [...] Read more.
Orthorexia nervosa (ON) is a pathological obsession with eating only healthy and biologically pure food. The primary aim of this study was to explore the relationships between ON, perfectionism, and obsessive–compulsive symptoms in two cultural contexts, i.e., Romania and Germany. Our sample included 600 participants aged 18 to 73 (M = 29.04, SD = 10.30, 79.2% females), i.e., 310 from Romania and 290 from Germany. We tested a moderated mediation model, exploring the mediating effect of obsessive–compulsive symptoms on the link between socially prescribed and self-oriented perfectionism and ON symptoms and the moderating effect of culture (i.e., Western and non-Western) while controlling for age, sex, education, and monthly income. Socially prescribed perfectionism and self-oriented perfectionism were positively related to obsessive–compulsive and ON. Both socially prescribed and self-oriented perfectionism predicted ON through obsessive–compulsive symptoms, but only in the case of German participants. The present study’s results suggest a better understanding of orthorexic behaviors in a cross-cultural context, which might significantly contribute to developing tailored strategies for preventive educational programs and nutritional interventions across different nations. Full article
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<p>The proposed research model.</p>
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<p>The mediating role of OCD symptoms on the relationship between self-oriented perfectionism and orthorexia nervosa, and the moderating role of culture, while controlling for participants’ age, gender, education, and monthly income. * <span class="html-italic">p</span> &lt; 0.05; ** <span class="html-italic">p</span> &lt; 0.001.</p>
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<p>The mediating role of OCD symptoms on the relationship between socially prescribed perfectionism and orthorexia nervosa, and the moderating role of culture, while controlling for participants’ age, gender, education, and monthly income. * <span class="html-italic">p</span> &lt; 0.05; ** <span class="html-italic">p</span> &lt; 0.001.</p>
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11 pages, 202 KiB  
Brief Report
Identifying Barriers and Pathways to Care Among College Students at Risk of or Diagnosed with First Episode Psychosis
by Annette S. Crisanti, Justine L. Saavedra, Sam Barans, Perla M. Romero, Natasha Dark, Bess Friedman, David T. Lardier, Juan Bustillo, Mauricio Tohen, Rhoshel Lenroot and Cristina Murray-Krezan
Psychiatry Int. 2025, 6(1), 15; https://doi.org/10.3390/psychiatryint6010015 - 12 Feb 2025
Viewed by 346
Abstract
Prolonged untreated psychosis worsens outcomes, thus motivating the study of pathways and perceived barriers to care, especially for high-risk age groups like college students. The primary objective of this study was to explore pathways to coordinated specialty care (CSC) and perceived barriers to [...] Read more.
Prolonged untreated psychosis worsens outcomes, thus motivating the study of pathways and perceived barriers to care, especially for high-risk age groups like college students. The primary objective of this study was to explore pathways to coordinated specialty care (CSC) and perceived barriers to care in college students at high risk for psychosis or with first-episode psychosis and determine any association between them. Twenty-four college students enrolled in CSC completed the Circumstances of Onset and Relapse Schedule and Barriers to Seeking Psychological Help Scale (BSPHS). Non-parametric tests were used for two-group analyses, and medians and interquartile ranges (IQR) were calculated. The median number of total contacts along the pathway to CSC was 5.0 (IQR = 5.2), with more psychiatric contacts (Mdn. = 3.0, IQR = 2.2) than non-psychiatric contacts (Mdn. = 2.0, IQR = 3.0). Students whose first contact was with non-psychiatric services had longer pathways to care overall, with a higher median number of total psychiatric as well as non-psychiatric contacts relative to students whose first contact was with psychiatric services. With the highest possible total BSPHS score being 5, the median score was 2.7 (IQR = 0.8). Targeted psychosis literacy training for non-mental health professionals and anti-stigma campaigns for college students may help reduce the duration of untreated psychosis. Full article
12 pages, 1133 KiB  
Article
Factors Associated with Worsening Post-Earthquake Psychiatric Symptoms in Patients Receiving Psychiatric Visiting Nurse Services During the 2024 Noto Peninsula Earthquake: A Retrospective Study
by Shingo Oe, Hisao Nakai, Yutaka Nagayama, Masato Oe and Chinatsu Yamaguchi
Psychiatry Int. 2025, 6(1), 14; https://doi.org/10.3390/psychiatryint6010014 - 11 Feb 2025
Viewed by 343
Abstract
On 1 January 2024, a magnitude 7.5 earthquake struck the Noto Peninsula in Ishikawa Prefecture, Japan, causing substantial damage to northern Noto. This study aimed to clarify the experiences of patients using a psychiatric visiting nurse service who were affected by the earthquake, [...] Read more.
On 1 January 2024, a magnitude 7.5 earthquake struck the Noto Peninsula in Ishikawa Prefecture, Japan, causing substantial damage to northern Noto. This study aimed to clarify the experiences of patients using a psychiatric visiting nurse service who were affected by the earthquake, and the influencing factors of worsening mental health symptoms after the earthquake. Participants were 114 patients using a psychiatric visiting nurse service in northern Noto. Data were collected retrospectively from nursing records. Factors associated with signs of worsening mental health symptoms were the continued use of home visiting nursing services after the disaster (n = 43, 46.7%; p = 0.040) and the intervention of a disaster psychiatric assistance team (DPAT) (n = 7, 77.8%; p = 0.034). No significant correlation was found between the number of relocations owing to evacuation and signs of worsening mental health symptoms. Although 61.4% of participants experienced more than one evacuation, the number of evacuations and relocations did not seem to directly affect the worsening of mental health symptoms. However, the results suggest a need for more direct interventions, such as the continued use of home visiting nursing services and the involvement of DPATs as an external resource, for patients exhibiting signs of worsening mental health symptoms. Full article
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<p>Spatial distribution of PVNS patients and maximum seismic intensity. PVNS: psychiatric visiting nurse service.</p>
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17 pages, 1250 KiB  
Review
Gender Diversity and Mental Health: A Systematic Review of the Impact of Childhood Trauma
by Jan Francesco Arena, Barbara Adriani, Serena Mancino, Francesca Sarno, Martina Nicole Modesti, Antonio Del Casale and Stefano Ferracuti
Psychiatry Int. 2025, 6(1), 13; https://doi.org/10.3390/psychiatryint6010013 - 11 Feb 2025
Viewed by 456
Abstract
Gender-diverse populations are at a higher risk of experiencing adverse childhood experiences (ACEs) and social stigma, with a significant impact on both mental and overall health. This systematic review, conducted in accordance with PRISMA guidelines, included 14 studies published between 2016 and 2024. [...] Read more.
Gender-diverse populations are at a higher risk of experiencing adverse childhood experiences (ACEs) and social stigma, with a significant impact on both mental and overall health. This systematic review, conducted in accordance with PRISMA guidelines, included 14 studies published between 2016 and 2024. Observational studies were extracted from MEDLINE, CINAHL, APA PsycInfo, and APA PsycArticles to explore the prevalence of ACEs and their effects on mental and physical health in gender-diverse individuals. Studies were assessed for quality using the AXIS tool. The studies included revealed elevated rates of ACEs, particularly in the form of abuse. ACEs were strongly associated with an increased risk of depression, anxiety, stress-related disorders, and suicidality. Discrimination further amplified these effects, particularly among racial and ethnic minorities, leading to a higher engagement in risky behaviors and poorer physical health outcomes. Protective factors identified included secure attachment, access to gender-affirming care, and strong social support. The findings emphasize the urgent need for trauma-informed and culturally sensitive interventions that address both the immediate and long-term effects of ACEs in gender-diverse populations. Future studies should prioritize longitudinal designs and tailored interventions to meet the healthcare needs of these communities and develop mental health prevention strategies. Full article
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<p>Schematic representation of Minority Stress Theory.</p>
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<p>PRISMA flow diagram.</p>
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17 pages, 465 KiB  
Article
The Dual Role of Anxiety in Crisis Response: Emotional Intensification and Prosocial Behavior During the COVID-19 Pandemic
by Soohee Kim
Psychiatry Int. 2025, 6(1), 12; https://doi.org/10.3390/psychiatryint6010012 - 24 Jan 2025
Viewed by 733
Abstract
The COVID-19 pandemic has profoundly impacted mental health, intensifying negative emotions and challenging collective psychological resilience. This study examines the complex psychological interplay between social media engagement, emotional responses, and behavioral outcomes during crises. Using an online survey (N = 500) conducted during [...] Read more.
The COVID-19 pandemic has profoundly impacted mental health, intensifying negative emotions and challenging collective psychological resilience. This study examines the complex psychological interplay between social media engagement, emotional responses, and behavioral outcomes during crises. Using an online survey (N = 500) conducted during the COVID-19 pandemic, the findings reveal that heightened social media use for social interaction is associated with amplified emotional responses—particularly anxiety, anger, and sadness. Among these, anxiety demonstrated a dual role, acting as both a psychological stressor and a motivator for cooperative and prosocial behaviors, such as supporting government policies, volunteering, and donating. In contrast, anger and sadness were not associated with similar behavioral outcomes. These findings highlight the nuanced psychological impact of anxiety during crises, emphasizing its potential to drive adaptive responses amidst heightened emotional distress. This study contributes to a deeper understanding of how emotional and psychological processes, particularly anxiety, influence public behavior during crises, providing insights for mental health interventions and policy strategies. Full article
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<p>Conceptual framework of the study. Note. * <span class="html-italic">p</span> &lt; 0.05, *** <span class="html-italic">p</span> &lt; 0.001.</p>
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13 pages, 1666 KiB  
Article
Navigating Burnout: The Mediating Role of Mindfulness and the Mediterranean Lifestyle in Fostering Job Satisfaction and Well-Being
by Efstratios Christodoulou, Maroula-Eleni Dimitriadou, Tsambika Mpali and Antonios E. Koutelidakis
Psychiatry Int. 2025, 6(1), 11; https://doi.org/10.3390/psychiatryint6010011 - 23 Jan 2025
Viewed by 688
Abstract
This study delves into the intricate interplay between mindfulness, the Mediterranean lifestyle, burnout, job satisfaction, and well-being among employees, offering compelling insights for workplace interventions. Through a cross-sectional survey comprising 407 employees in Greece, we unravel the profound associations among these variables, shedding [...] Read more.
This study delves into the intricate interplay between mindfulness, the Mediterranean lifestyle, burnout, job satisfaction, and well-being among employees, offering compelling insights for workplace interventions. Through a cross-sectional survey comprising 407 employees in Greece, we unravel the profound associations among these variables, shedding light on novel pathways to mitigate burnout and enhance overall employee satisfaction and health. Our findings unveil not only the negative associations between mindfulness, the Mediterranean lifestyle, and burnout but also the pivotal role of mindfulness as a predicting factor of burnout. Moreover, our research underscores the significant impact of burnout on job satisfaction, emphasizing the need for organizational strategies to address employee well-being. Notably, our mediation analyses illuminate the potential benefits of mindfulness and the Mediterranean lifestyle on burnout, accentuating the importance of fostering a workplace culture that embraces holistic well-being practices. With practical implications for designing evidence-based workplace wellness programs, our study advocates for the integration of mindfulness techniques and the adoption of Mediterranean lifestyle principles to cultivate resilient, engaged employees, and foster thriving organizational cultures. By delving into these dynamic relationships, our research not only advances theoretical frameworks but also offers actionable strategies to navigate burnout and promote flourishing in the modern workplace. Full article
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<p>Structural Equation Model with correlations and <span class="html-italic">p</span>-values.</p>
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<p>Correlation between HRQoL and lifestyle/health-related variables.</p>
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<p>Correlation between burnout and lifestyle/health-related variables.</p>
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<p>Relationship between burnout levels and mean scores for mindfulness (MAAS-15) and Mediterranean diet adherence (14-MEDAS).</p>
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<p>Odds ratios for mindfulness across levels of burnout.</p>
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<p>Hazard ratios for burnout across levels of job satisfaction.</p>
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12 pages, 633 KiB  
Article
Effects of Parental Nurturing Attitudes, Peer Victimization, and Depressive Rumination on Anxiety in Japanese Adults
by Jiro Masuya, Masayuki Kikkawa, Miki Ono, Chihiro Morishita, Shunichiro Ito, Rintaro Nibuya, Yu Tamada, Osamu Takashio, Mina Honyashiki and Takeshi Inoue
Psychiatry Int. 2025, 6(1), 10; https://doi.org/10.3390/psychiatryint6010010 - 18 Jan 2025
Viewed by 439
Abstract
Parental attitudes and peer victimization experiences in childhood influence anxiety. Depressive rumination is associated with these factors, but the interrelationship between them remains unclear. In this study, we hypothesized that “inadequate parental attitudes” and “peer victimization” experienced in childhood worsen “depressive rumination” and [...] Read more.
Parental attitudes and peer victimization experiences in childhood influence anxiety. Depressive rumination is associated with these factors, but the interrelationship between them remains unclear. In this study, we hypothesized that “inadequate parental attitudes” and “peer victimization” experienced in childhood worsen “depressive rumination” and “state anxiety”, and that “depressive rumination” is an intermediate factor that worsens anxiety symptoms in adulthood. We verified this interrelationship by structural equation modeling. A cross-sectional questionnaire study was conducted on 576 adult volunteers, who gave written consent. Demographic data and scores from the Parental Bonding Instrument, Childhood Victimization Rating Scale, Ruminative Responses Scale, and state anxiety of State-Trait Anxiety Inventory Form Y were collected. Data were analyzed by multiple regression analysis and structural equation modeling. In the study models, inadequate parental attitudes (low care and high overprotection) and depressive rumination directly worsened anxiety. Inadequate parental attitudes and peer victimization experienced in childhood indirectly worsened anxiety via depressive rumination. Furthermore, inadequate parental attitudes experienced in childhood indirectly worsened depressive rumination via peer victimization in childhood. Our results indicate that depressive rumination influences the relationship between inadequate parental attitudes, peer victimization, and adulthood anxiety. Therefore, assessing the quality of parental attitudes and peer victimization experienced in childhood and depressive rumination may help to clarify the antecedents of anxiety and how to intervene effectively. Full article
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<p>Results of the structural equation modeling with the parental attitude of ‘care’ experienced in childhood as the latent variable, and peer victimization in childhood, depressive rumination (RRS score), and state anxiety evaluated using the STAI-Y as the observed variables. The latent variable is shown as an oval, and the observed variables are shown as rectangles. The arrows with solid lines represent the statistically significant paths, and those with broken lines represent the nonsignificant paths. Direct effects (<b>A</b>) and indirect effects (<b>B</b>) between the variables are shown. In (<b>B</b>), the observed variables of paternal and maternal care have been omitted. The numbers show the standardized path coefficients. *** <span class="html-italic">p</span> &lt; 0.001.</p>
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<p>Results of the structural equation modeling with the parental attitude of ‘overprotection’ in childhood as the latent variable, peer victimization in childhood, depressive rumination (RRS score), and state anxiety evaluated using the STAI-Y as the observed variables. The latent variable is shown as an oval, and the observed variables are shown as rectangles. The arrows with solid lines represent the statistically significant paths, and those with broken lines represent the nonsignificant paths. Direct effects (<b>A</b>) and indirect effects (<b>B</b>) between the variables are shown. In (<b>B</b>), the observed variables of paternal and maternal overprotection have been omitted. The numbers show the standardized path coefficients. * <span class="html-italic">p</span> &lt; 0.05, *** <span class="html-italic">p</span> &lt; 0.001.</p>
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12 pages, 254 KiB  
Article
Non-Suicidal Self-Injury in College Students: Differences Between the Subject Group and Comparison Group
by Hye-seung Kim, Yong-won Seo, Youngil Lee, Chang Min Lee, Do Hyun Kim, Minsun Kim and Myung Ho Lim
Psychiatry Int. 2025, 6(1), 9; https://doi.org/10.3390/psychiatryint6010009 - 17 Jan 2025
Viewed by 534
Abstract
In recent years, self-injury attempts have accounted for 46.2% of emergency room visits by teenagers and young adults. This study aimed to explore the prevalence of non-suicidal self-injury (NSSI) among Korean college students, compare the mean number of NSSI risk factors between those [...] Read more.
In recent years, self-injury attempts have accounted for 46.2% of emergency room visits by teenagers and young adults. This study aimed to explore the prevalence of non-suicidal self-injury (NSSI) among Korean college students, compare the mean number of NSSI risk factors between those with a history of NSSI and a control group with no history of thoughts or experiences of self-injury, and identify which factors have a greater influence on NSSI. The participants consisted of 403 Korean college students aged 18–29 who were divided into a subject group with a history of NSSI (n = 198) and a comparison group (n = 205) with no history of NSSI. The Functional Assessment of Self-Mutilation (FASM), Childhood Trauma Questionnaire (CTQ-SF), Social Experience Questionnaire (SEQ), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7-item scale (GAD-7), Difficulties in Emotion Regulation Scale—16 item version (DERS-16), Experiences in Close Relationship Questionnaire-Revised (ECR-R), Rosenberg Self-Esteem Scale (RSES), Parents as Social Context Questionnaire-Kids (PSCQ-KA), and Barratt Impulsiveness Scale-11-Revised (BIS-11). The collected data were analyzed using SPSS 25.0. Before a regression analysis, a MANOVA was performed to examine the mean difference between groups of each dependent variable, and a multiple regression analysis was performed to confirm the influence. The mean difference in all risk factors in the subject group compared with the comparison group was found to be statistically significant, with an effect size of 0.8 or greater. As a result of examining the relative influence of each variable on NSSI, emotional dysregulation (t = 2.481, p = 0.014), anxiety (t = −2.109, p = 0.036), and adult attachment (t = 2.004, p = 0.046) were found to significantly influence NSSI (p = 0.05). These findings will serve as fundamental data for screening clients at risk of self-injury in counseling and treatment settings, in addition to providing preventive and therapeutic interventions. Full article
24 pages, 565 KiB  
Review
Violence Risk Assessment Tools Used in Forensic and Acute Psychiatry in North America: A Scoping Review
by Maria Alexandra Rosca, Olivier La Charité-Harbec, Jeanne-Marie Allard, Stéphanie Borduas Pagé and Alexandre Hudon
Psychiatry Int. 2025, 6(1), 8; https://doi.org/10.3390/psychiatryint6010008 - 14 Jan 2025
Viewed by 854
Abstract
Violence in psychiatric settings presents a significant risk to patients, staff, and society at large. With over 400 risk assessment tools available globally, their applications and the risks they assess vary, allowing for diverse use in different situations. This scoping review investigated the [...] Read more.
Violence in psychiatric settings presents a significant risk to patients, staff, and society at large. With over 400 risk assessment tools available globally, their applications and the risks they assess vary, allowing for diverse use in different situations. This scoping review investigated the risk management tools utilized in North America’s forensic psychiatry and acute psychiatric units, aiming to identify which ones are mainly used. A comprehensive search was conducted across PubMed, Embase, and PsycINFO databases, following PRISMA Guidelines, covering the literature from their inception date until 2023. Criteria for study inclusion required a focus on risk management tool use in forensic or acute psychiatric settings, originality (original studies, case reports, or systematic reviews), and a North American context. Out of 3059 identified studies, 40 were thoroughly analyzed. Commonly used risk assessment scales include HARM-FV, eHARM-FV, HCR-20, PCL-R, START, BVC, and DASA, with their reliability varying by the clinical context and the assessed population. The review highlights the heterogeneous application of static and dynamic scales across clinical settings, underscoring a need for more precise tools to improve risk assessments in forensic psychiatry, signaling a call for the development and validation of more sophisticated assessment instruments. Full article
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<p>The PRISMA flowchart for the inclusion of studies.</p>
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15 pages, 608 KiB  
Protocol
The Effect of an Individualized Informational Intervention on the Quality of Life, Adherence and Psychosocial Economic Status of Patients with COPD: A Research Protocol
by Antonia Aravantinou Karlatou, Antonios Christodoulakis, Sophia E. Schiza, Evangelos C. Karademas and Ioanna Tsiligianni
Psychiatry Int. 2025, 6(1), 7; https://doi.org/10.3390/psychiatryint6010007 - 14 Jan 2025
Viewed by 683
Abstract
Introduction: Chronic obstructive pulmonary disease (COPD) has a diverse negative impact on patients, affecting them both physically and mentally. Psychosocial factors such as anxiety, depression, social isolation, and financial stress have been found to be positively associated with more exacerbations, hospital readmissions, poor [...] Read more.
Introduction: Chronic obstructive pulmonary disease (COPD) has a diverse negative impact on patients, affecting them both physically and mentally. Psychosocial factors such as anxiety, depression, social isolation, and financial stress have been found to be positively associated with more exacerbations, hospital readmissions, poor adherence to medication, and lower quality of life among patients with COPD. However, healthcare professionals, who have a crucial role in diagnosing and managing COPD, often overlook these psychosocial factors of the disease, despite growing evidence suggesting their crucial role in improving disease outcomes. Consequently, this study will evaluate the effectiveness of a personalized individualized informational intervention on the quality of life, adherence, and psychosocial economic status of patients with COPD in healthcare settings of Greece. Methods: A prospective, mixed-methods design will be used, incorporating both quantitative data through questionnaires, including the Short Form (SF-12), Clinical COPD Questionnaire (CCQ), Test of Adherence to Inhalers (TAI), Patient Health Questionnaire (PHQ-4), Multidimensional Scale of Perceived Social Support (MSPSS), and Financial Ability Scale (FAS), alongside qualitative data with questions exploring themes such as general health perception, treatment adherence, mental status, socioeconomic status, and disease management. Participants will consist of patients receiving care at primary healthcare facilities and respiratory hospital departments in Crete, Greece. The intervention will involve providing structured information on social, financial, and psychological support services, along with psychosocial counseling over a six-month period. The impact of the intervention will be measured using validated tools to assess health status, quality of life, treatment adherence, mental health, and socioeconomic status before and after the intervention. Conversely, qualitative interviews will be conducted to gain deeper insights into the impact of the intervention. Finally, when the analyses of both data types are finalized, they will be triangulated to achieve convergence. This procedure entails the creation of a figure or illustration that demonstrates the convergence or divergence of both data types. Conclusions: The findings of this study are expected to highlight the importance of integrating an individualized informational intervention into the management of COPD. Thus, this study could guide healthcare professionals and policymakers in improving COPD care and patient outcomes. Full article
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<p>The four domains of the individualized informational intervention.</p>
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19 pages, 1663 KiB  
Article
The Impact of Physical/Natural Spaces on the Mental and Emotional Well-Being of Students According to the Report of Rural Female Teachers
by Gerardo Fuentes-Vilugrón, Felipe Caamaño-Navarrete, Enrique Riquelme-Mella, Ingrid Godoy Rojas, Esteban Saavedra-Vallejos, Pablo del Val Martín, Flavio Muñoz-Troncoso and Carlos Arriagada-Hernández
Psychiatry Int. 2025, 6(1), 6; https://doi.org/10.3390/psychiatryint6010006 - 13 Jan 2025
Viewed by 651
Abstract
In rural schools, nature is a space where teachers and students seek to feel states of emotional well-being. Activities carried out in contact with nature could be considered ideal for learning. The objective of the research was to explore the influence of physical/natural [...] Read more.
In rural schools, nature is a space where teachers and students seek to feel states of emotional well-being. Activities carried out in contact with nature could be considered ideal for learning. The objective of the research was to explore the influence of physical/natural spaces on the emotional well-being of schoolchildren as reported by female teachers working in rural and indigenous contexts in the region of La Araucanía, Chile. This research is based on the hermeneutic paradigm with a case study design. The selection of participants was non-probabilistic and intentional, including 15 female teachers working in rural school contexts. The study used a semi-structured interview format, and the data were analyzed using grounded theory. According to the teachers’ discourse, the results generated three categories: (a) culture and diversity, (b) physical/natural spaces, and (c) emotional well-being. These show that natural spaces positively affect learning processes and emotional regulation. The research suggests that encouraging contact with physical/natural spaces can help create classroom climates with lower levels of conflict and tension. This, in turn, leads to higher levels of physical, psychological/mental, social, and spiritual balance, resulting in improved attitudes and motivational processes towards learning by students and teachers in rural and indigenous contexts. Full article
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<p>Communal boundaries of the Nueva Imperial, Cholchol, and Toltén contexts. Note: own elaboration based on the Political Administrative and Census Division 2017 platform.</p>
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<p>Semantic network of the category “culture and diversity”.</p>
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<p>Semantic network of the category “physical/natural environment”.</p>
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<p>Semantic network of the category “emotional well-being”.</p>
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13 pages, 287 KiB  
Article
Impulsive Buying Tendencies and Personality: Cognitive and Affective Aspects
by Fayyaz Hussain Qureshi, Katarina Sokić and Sarwar Khawaja
Psychiatry Int. 2025, 6(1), 5; https://doi.org/10.3390/psychiatryint6010005 - 8 Jan 2025
Viewed by 1347
Abstract
Impulsive buying is a growing problem in modern society with significant financial and psychological consequences, and it is necessary to examine the mechanisms underlying it. Understanding the mechanisms driving this behavior is crucial. Impulsive buying consists of two key aspects: a cognitive aspect, [...] Read more.
Impulsive buying is a growing problem in modern society with significant financial and psychological consequences, and it is necessary to examine the mechanisms underlying it. Understanding the mechanisms driving this behavior is crucial. Impulsive buying consists of two key aspects: a cognitive aspect, characterized by a lack of planning and reflection, and an affective aspect, involving emotional responses that can occur before, during, or after a purchase. This study aims to explore the relationship between personality traits, as measured by the HEXACO model, and tendencies toward impulsive buying. Specifically, it examines how the HEXACO traits differentially predict the cognitive and affective components of impulsive buying tendencies. Data were collected from a sample of 420 students, with 32 excluded due to incomplete responses, resulting in a final sample of 388 students (155 men, 233 women) with an average age of 22.8. Hierarchical regression analyses revealed that HEXACO personality domains significantly predicted overall impulsive buying tendencies. As expected, Honesty–Humility and Conscientiousness were negatively associated with impulsive buying, while Emotionality and Extraversion positively predicted impulsive buying tendencies. Moreover, Honesty–Humility, Conscientiousness, and Extraversion significantly predicted the cognitive component of impulsive buying, while Honesty–Humility and Emotionality were significant predictors of the affective component. These findings suggest the importance of educating individuals, from an early age, on the negative consequences of impulsive buying, effective money-saving strategies, and the principles of mental accounting. Full article
21 pages, 3688 KiB  
Article
Unplugging Youth: Mobile Phone Addiction, Social Impact, and the Call for Digital Detox
by Asimenia Salepaki, Anna Zerva, Dimitris Kourkouridis and Ioannis Angelou
Psychiatry Int. 2025, 6(1), 4; https://doi.org/10.3390/psychiatryint6010004 - 6 Jan 2025
Viewed by 1964
Abstract
This study investigates the impact of excessive mobile phone use on young individuals aged 14–35 in Kastoria, Greece. It explores how smartphone addiction affects daily life and social interactions. A survey with 30 closed-ended questions was conducted among 150 respondents from May to [...] Read more.
This study investigates the impact of excessive mobile phone use on young individuals aged 14–35 in Kastoria, Greece. It explores how smartphone addiction affects daily life and social interactions. A survey with 30 closed-ended questions was conducted among 150 respondents from May to August 2019. Data were analyzed using descriptive statistics and chi-square tests, focusing on gender and employment status differences. Most respondents use their phones for over 5 h daily, primarily for social media and communication. Findings reveal high addiction rates, reduced productivity, and disrupted sleep. Women reported more difficulty disconnecting and a greater need for detoxification than men. Students and unemployed individuals showed higher addiction symptoms and negative productivity impacts compared to employed respondents. Excessive mobile phone use among young people poses significant challenges, including addiction and adverse effects on productivity, relationships, and sleep, influenced by gender and employment status. Full article
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<p>Hours of mobile phone use per day.</p>
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<p>Reasons for using a mobile phone.</p>
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<p>Addiction to mobile phone use.</p>
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<p>Effects of extensive mobile phone use.</p>
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<p>Mood disorders caused by excessive use of a mobile phone.</p>
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<p>Health impact of excessive mobile phone use, responses by gender.</p>
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<p>Effect of excessive mobile use on productivity, responses by gender.</p>
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<p>Inability to get away from the mobile phone, responses by gender.</p>
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<p>Need for mobile phone detoxification, responses by gender.</p>
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<p>Impact of excessive mobile phone use on health, responses by employment status.</p>
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<p>Effect of excessive mobile phone use on interpersonal relationships, responses by employment status.</p>
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<p>Impact of excessive mobile use on productivity, responses by employment status.</p>
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<p>Inability to get off mobile phone, answers by employment status.</p>
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<p>Need for cell phone detoxification, answers by employment status.</p>
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<p>Inability to get away from mobile phone, responses by category of hours of mobile phone use.</p>
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<p>Need for continuous use of the mobile phone, responses by category of hours of mobile phone use.</p>
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<p>Need for mobile phone detoxification, responses by category of mobile phone use hours.</p>
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17 pages, 265 KiB  
Article
The Prevalence and Risk Factors of Workplace Violence at a Psychiatric Hospital in The Gambia
by Amadou D. Jallow, Twisuk Punpeng and Chaweewon Boonshuyar
Psychiatry Int. 2025, 6(1), 3; https://doi.org/10.3390/psychiatryint6010003 - 30 Dec 2024
Viewed by 516
Abstract
Purpose—This study aimed to provide a comprehensive report of workplace violence (WPV) at a psychiatric hospital in Gambia. Design/methodology/approach—A cross-sectional study involving self-administered questionnaires and an in-depth interview was conducted with 54 staff at the hospital and six senior managers of mental health [...] Read more.
Purpose—This study aimed to provide a comprehensive report of workplace violence (WPV) at a psychiatric hospital in Gambia. Design/methodology/approach—A cross-sectional study involving self-administered questionnaires and an in-depth interview was conducted with 54 staff at the hospital and six senior managers of mental health treatment in Gambia. A descriptive statistical approach was applied to determine the prevalence, and a logistic regression approach was used to identify factors associated with violence at the hospital. The data from the in-depth interviews on WPV policies in Gambia were analysed thematically. Results—In the 12 months before the research, 55.6% of the respondents had been exposed to violence; of those, 46.3%, 27.8%, and 5.6% had experienced verbal abuse, physical assault, and sexual harassment, respectively. Inadequate staff, insufficient security measures, and insufficient medications were perceived by respondents as the causes of the violence. However, the level of professionalism, the kind of services provided by staff, and shift of work were strongly connected with violence. As a result of WPV, victims had injuries, posttraumatic stress disorder signs/symptoms, and work dissatisfaction. The interviewees also expressed concern about the lack of WPV polices and the necessity of creating such polices as soon as possible. Value—According to the research, there is an elevated risk of violence among the hospital staff. As a result, the hospital’s structure needs to change, staff members should receive training on how to address aggressive patients, and a constructive WPV policy should be created. Full article
21 pages, 786 KiB  
Systematic Review
Exploring the Role of Masculinity in Male Suicide: A Systematic Review
by Carmen M. Galvez-Sánchez, Julio A. Camacho-Ruiz, Lorys Castelli and Rosa M. Limiñana-Gras
Psychiatry Int. 2025, 6(1), 2; https://doi.org/10.3390/psychiatryint6010002 - 27 Dec 2024
Viewed by 1814
Abstract
(1) Background: Suicide represents a critical global public health concern. In the majority of countries, men have higher rates of suicide completion, while women show higher rates of suicide attempts. Masculinity is a complex construct shaped by socialization processes that begin early in [...] Read more.
(1) Background: Suicide represents a critical global public health concern. In the majority of countries, men have higher rates of suicide completion, while women show higher rates of suicide attempts. Masculinity is a complex construct shaped by socialization processes that begin early in life. The aim of this study is to explore the influence of masculinity on suicidal behaviors among men. (2) Methods: This systematic review was conducted in accordance with the Cochrane and PRISMA guidelines. The review protocol was pre-registered in the International Prospective Register of Systematic Reviews (PROSPERO). (3) Results: This systematic review—which includes 18 studies—highlights the detrimental influence of hegemonic masculinity on both the occurrence and frequency of suicide among men, with a particularly significant negative impact on vulnerable men (e.g., homeless men; adolescents and young men; and men with addiction, depression, and/or other mental health issues), where the consideration of intersectionality is essential. (4) Conclusions: Men who strongly conformed to the norms and values linked to traditional masculinity were more prone to die by suicide and to report experiencing suicidal thoughts and attempts. Analyzing suicidal behavior from a gender perspective is critical for effective prevention and treatment, as gender disparities are clearly observed in both suicide fatalities and nonfatal attempts. Full article
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<p>Flow diagram of the impact of masculinity on suicidal behaviors in the male population.</p>
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15 pages, 690 KiB  
Review
Anhedonia in Youth and the Role of Internet-Related Behavior: A Systematic Review
by Giovanni Cangelosi, Federico Biondini, Marco Sguanci, Cuc Thi Thu Nguyen, Gaetano Ferrara, Orejeta Diamanti, Sara Morales Palomares, Stefano Mancin and Fabio Petrelli
Psychiatry Int. 2025, 6(1), 1; https://doi.org/10.3390/psychiatryint6010001 - 26 Dec 2024
Viewed by 891
Abstract
Introduction: The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defines depression as a persistent period of sadness or a reduced interest in everyday activities lasting at least two weeks. Anhedonia, a key symptom of depression, is notable for its significance and is [...] Read more.
Introduction: The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defines depression as a persistent period of sadness or a reduced interest in everyday activities lasting at least two weeks. Anhedonia, a key symptom of depression, is notable for its significance and is regarded as the second most important factor related to non-somatic issues, following closely behind a depressed mood. This study primarily investigates how excessive or problematic use of Internet-connected devices affects the mood and emotions of young people, with a specific emphasis on anhedonia. Additionally, it explores associated socio-behavioral changes and examines the interaction between IA and depression. Methods: This systematic review was conducted following PRISMA international guidelines. Searches were performed in PubMed, Cochrane Library (Clinical Trials section), Scopus, Embase, PsycInfo, and grey literature sources like Google Scholar. A predefined search strategy using Boolean operators was employed, and two researchers independently selected papers, with a third researcher resolving any discrepancies. Manual reviews were conducted to minimize selection bias. Results: Out of 3812 records, 7 studies were included. The findings suggest that social anhedonia correlates with higher levels of IA, particularly among adolescents and young adults. In some studies, loneliness was identified as a mediator between social anhedonia and social functioning, indicating a complex interplay of emotional factors. Other investigations revealed that increased screen time is associated with a heightened risk of developing addiction-related behaviors. Practical Implications and Conclusions: This review highlights the key role of anhedonia in the development of Internet addiction (IA) among young people, particularly through its impact on emotional regulation and social interactions. Addressing psychological and environmental factors is essential for developing targeted strategies to prevent and manage IA and its related mental health challenges. Full article
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<p>PRISMA flow-chart of the selection process.</p>
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