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Background: A growing body of evidence explored symptom burden of somatic symptom disorder (SSD) and its complex etiology involving psychosocial aspects. Child abuse has been linked to numerous psychopathologies including somatic symptoms as well as impaired personality functioning and disruptions in epistemic trust. This work aims to investigate personality functioning and epistemic trust in the association between child abuse and somatic symptom burden., Methods: We conducted structural equation modelling (SEM) using representative data of the German population (N = 2436). Personality functioning (OPD-SQS) was applied as a mediator between retrospectively recalled child abuse (ICAST-R) and somatic symptom burden (SSS-8, SSD-12, 6 month time criterion), while epistemic trust was added as a predictor of personality functioning., Results: 6.8 % (n = 166) of participants self-reported SSD. Prevalence of child abuse (53.6 % vs. 31.7 %; χ 2  = 33.44, p < .001) was significantly higher among those with SSD. Child abuse was significantly associated with somatic symptom burden (criterion A: β = 0.23, 95 %-CI: 0.19-0.27, p < .001; criterion B (β = 0.24, 95 %-CI: 0.20-0.28, p < .001) and explained 6 % and 5 % of its variance respectively. Adding personality functioning as a mediator increased the explained variance to 28 % for both somatic symptom burden criterion A and B. Including epistemic trust further increased the explained variance of personality functioning (from 15 to 36 %)., Limitations: All assessments and results are based on self-report and cross-sectional data., Conclusions: Impairments in personality functioning and disruptions in epistemic trust might play an important role in experiencing symptoms of SSD. Both domains thus present new avenues for treatment improvement and further research in patients with SSD., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 The Authors. Published by Elsevier B.V. All rights reserved.)

Electroconvulsive therapy (ECT) is an effective intervention for severe unipolar and bipolar depression, yet its drawbacks often lead to its underutilization. Accurate prediction of ECT outcomes is crucial for optimizing patient care and increasing remission rates. This study synthesized existing evidence on the relationship between baseline inflammatory markers and ECT outcomes. Additionally, we explored whether changes in these markers during ECT correlated with symptom improvement. A correlation meta-analysis was conducted according to the PRISMA statement, including a total of fourteen studies (n = 556 patients). The analyses revealed that higher baseline CRP and IL-6 levels were significantly associated with greater depressive symptom reduction post-ECT. Additionally, our findings suggested that increases in kynurenine metabolites and IL-8 during treatment correlated with improved depressive symptoms, offering insights into the mechanistic aspects of depression and ECT. In conclusion, peripheral inflammation in depression, as measured by CRP and IL-6, is associated with better ECT outcomes and may guide treatment stratification. Further research on a broader range of cytokines and kynurenine metabolites is needed to confirm these findings., (Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objective: Impairment in personality functioning (PF) has been linked to a number of mental disorders, including eating disorders (EDs). However, the precise relationship between PF and symptom severity, as well as the potential impact on outcome, remains unclear. The study aimed to analyse the association of PF and its change with severity of ED symptomatology as well as outcome of hospital treatment., Method: The sample consisted of 397 patients with EDs, treated in 19 university hospitals for Psychosomatic Medicine and Psychotherapy in Germany between 1/2019 and 12/2020. PF was measured with the Structure Questionnaire of the Operationalised Psychodynamic Diagnosis (OPD-SQ, short version), eating psychopathology with the ED examination questionnaire (EDE-Q). Outcome was defined as a change in the EDE-Q total score. We used Latent Change Score Modelling to analyse changes in ED pathology during treatment and a 1-year follow-up period., Results: A higher level of impairment in PF at admission correlated with more eating psychopathology and a less favourable outcome. Additionally, greater improvement in PF correlated with greater improvements in ED symptomatology at discharge., Conclusion: Impairment in PF needs to be part of diagnostic assessments and should be considered an important treatment target for psychotherapeutic interventions., Trial Registration: The MEPP study was registered in the German Clinical Trials Register (DRKS, www.drks.de; ID: DRKS00016412)., (© 2025 The Author(s). European Eating Disorders Review published by Eating Disorders Association and John Wiley & Sons Ltd.)

Despite the growing body of research on self-report measures of personality functioning, tests of measurement invariance in immigrant samples have mostly been neglected. The present study aimed to fill this gap by testing measurement invariance of the OPD-Structure Questionnaire (OPD-SQS) across immigrant groups and evaluating the association between personality functioning and mental distress. Methods: Based on representative population samples in Germany comprising N  = 6,999 participants, the factor structure and the measurement invariance of the OPD-SQS across different immigrant groups (1st generation immigrants, 2nd generation immigrants, non-immigrants) were examined. Associations of personality functioning and mental distress depending on immigration and generation status were investigated using multiple linear regression. Confirmatory factor analysis showed an acceptable to good model fit of the proposed three-factor structure for all investigated groups. Furthermore, the OPD-SQS was strictly measurement invariant across different immigration groups. The regression model showed a strong, positive association between impairment in personality functioning and mental distress in all groups. The OPD-SQS can be assumed to be strictly invariant. Hence, the OPD-SQS provides a valid and economic screening tool for personality functioning across immigrant groups that can be applied in research on immigrants' mental health.

Background: Childhood maltreatment (CM) significantly increases the risk of developing post-traumatic stress disorder (PTSD) for which the prevalence in Europe is higher than initially assumed. While the high economic burden of PTSD is well-documented, little is known about the health care cost differences between individuals with PTSD-CM and those without PTSD in Germany. This study aimed to determine the excess health care and absenteeism costs associated with PTSD-CM in Germany., Methods: Baseline data from a multi-center randomized controlled trial on individuals with PTSD-CM (n = 361) were combined with data from individuals without PTSD (n = 4760). Entropy balancing was used to balance the data sets with regard to sociodemographic characteristics. Six-month excess health care costs from a societal perspective were calculated for 2022, using two-part models with logit specification for the first part and a generalized linear model for the second part., Results: The total six-month excess costs associated with PTSD-CM were €8864 (95% CI: €6855 to €10,873) per person. Of this, the excess health care costs accounted for €4647 (95% CI €3296 to €5997) and the excess costs of absenteeism for €4217 (95% CI: €3121 to €5314). Individuals with mild to moderate PTSD symptoms incurred total excess costs of €6038 (95% CI: €3879 to €8197), while those with severe to extreme symptoms faced €11,433 (95% CI: €8220 to €14,646)., Conclusions: Excess health care and absenteeism costs associated with PTSD-CM were substantial, with absenteeism accounting for roughly half of the total excess costs.