Negative symptoms and cognitive deficits play a major role in psychosis and significantly influence the functional outcomes of patients, particularly those with a first episode of psychosis (FEP). However, limited research has explored the predictive capacity of cognitive deficits during FEP for subsequent negative symptomatology. Drawing from the Athens FEP research study, we conducted a retrospective longitudinal study in 80 individuals with FEP. All patients were drug naive at admission. Cognitive tests were administered at 1-month and 1-year post-admission, while negative symptomatology was assessed at the same time points using PANSS by trained raters. We considered confounding factors such as age, gender, duration of untreated psychosis (DUP), treatment received, premorbid social adjustment, and premorbid IQ. Univariate regression analysis identified cognitive domains that correlated with negative symptomatology. These, along with the confounders, were incorporated into a multiple regression, with the 1-year PANSS negative scale serving as the dependent variable. Employing the backward elimination technique, we found a statistically significant inverse relationship between the categories completed in the Wisconsin card sorting test (WCST) and the 1-year PANNS negative scale (p = 0.01), beyond the associations with DUP and the 1-month PANSS negative scale. Our results suggest that cognitive flexibility, a key component of executive functions, predicts negative symptom severity one year after FEP.

Background: Head and neck cancer (HNC) uniquely threatens communication through its impact on voice and speech. The neural systems linking depressive symptoms with perceived voice handicap remain poorly characterized. We examined whether these symptom domains show dissociable associations with regional brain glucose metabolism. Methods: We conducted a cross-sectional ^18F FDG-PET study in 63 HNC patients following diagnosis. Regional cerebral glucose metabolism (standardized uptake value ratios) was quantified in five a priori regions of interest: Broca’s area, Wernicke’s area, bilateral insula, and bilateral hippocampus. Depressive symptoms (Zung Self-Rating Depression Scale, SDS) and perceived voice handicap (Voice Handicap Index, VHI) were assessed. Spearman correlations with false discovery rate correction, partial correlations, and unique variance analyses were performed. Brain-behavior associations were examined using Spearman correlations with FDR correction. Results: Depression and perceived voice handicap were strongly correlated (ρ = 0.64, p < 0.001) and exhibited partially dissociable metabolic correlates. Depressive symptom severity was associated with reduced metabolism in Broca’s area (ρ = −0.31, p_FDR = 0.041) and higher metabolism in the left insula (ρ = 0.36, p_FDR = 0.039), with graded insular elevation in moderate–severe depression (+14%, p = 0.008). Voice handicap was associated with reduced hippocampal metabolism (ρ = −0.34, p = 0.016 after covariate adjustment) in exploratory analyses. Conclusions: Depression and voice handicap in HNC arise from partially independent neurobiological processes despite their clinical co-occurrence. This dissociation supports parallel rather than hierarchical supportive care pathways. Routine clinical imaging can be leveraged to generate testable hypotheses for psychosomatic and rehabilitation research. Abstract Figure: Graphical abstract Depressive symptoms were associated with reduced Broca’s area metabolism and elevated left insula metabolism, consistent with limbic-cortical dysregulation. Perceived voice handicap was uniquely associated with reduced bilateral hippocampal metabolism, implicating contextual memory and adaptation processes. Arrows indicate direction of association.

Background: Borderline Personality Disorder (BPD) is a growing health concern, characterized by emotional dysregulation, impulsivity, and unstable interpersonal relationships. One of the core features of BPD is self-harm, which has significant implications for clinical management, risk assessment, and treatment planning. Accurate assessment tools are essential in evaluating symptom severity and identifying individuals at high risk of self-injurious behaviors, thereby guiding clinical interventions effectively. This study aimed to assess the psychometric properties, factor structure, and diagnostic utility of the Greek version of the Borderline Personality Disorder Severity Index-IV (BPDSI-IV), providing preliminary evidence for its reliability and validity. Methods: A total of 128 individuals with BPD and 32 healthy controls were assessed using the BPDSI-IV together with the Brief Symptom Inventory-53 (BSI-53), the BPD Checklist, the Rosenberg Self-Esteem Scale, the WHOQOL-BREF, and the Defense Style Questionnaire-40 (DSQ-40). BPD diagnoses were confirmed using the Structured Clinical Interview for DSM-5 Personality Disorders (SCID-5-PD). Internal consistency, confirmatory factor analysis (CFA) of previously suggested models, exploratory and confirmatory bifactor modeling, and validity assessments were conducted. Results: The BPDSI-IV showed strong internal consistency (α = 0.92, ωt = 0.96), with most subscales demonstrating adequate reliability. Exploratory bifactor analysis using the Schmid–Leiman transformation supported a model with a dominant severity factor (ωh = 0.69), reinforcing the dimensional nature of BPD. CFA supported this bifactorial approach. BPDSI-IV scores significantly discriminated BPD patients from controls (p < 0.001). Strong correlations with measures of psychopathology and self-esteem, and correlations with quality of life further supported its validity. Conclusions: The Greek BPDSI-IV demonstrated strong reliability and validity indicators. Structured assessment tools, such as the BPDSI-IV, can enhance early intervention and research on the course of borderline personality disorder symptoms.