Ulker Isayeva

Background: Artificial intelligence (AI)-driven conversational systems are increasingly capable of simulating empathy, adapting to individual users, and fostering emotional bonds that blur the boundary between tool and companion. This scoping review maps the extent and nature of published evidence regarding psychological mechanisms underlying emotional reliance on AI chatbots and associated mental health implications. Methods: Conducted in accordance with PRISMA-ScR guidelines, we systematically searched PubMed/MEDLINE, PsycINFO, Web of Science, Scopus, and IEEE Xplore from database inception to March 2026. Two independent reviewers screened records and extracted data using the PCC (Population, Concept, Context) framework. Thematic synthesis was performed to map evidence across psychological, clinical, and developmental domains. Results: Of 1847 records identified, 46 studies met inclusion criteria. Key themes included: (1) the ELIZA effect as a foundational mechanism of human–AI attachment, with documented cases of severe dependency including fatal outcomes; (2) anthropomorphization and artificial intimacy fostered by adaptive, personalized AI design; (3) proposal of Generative AI Dependency (GAID) as a conceptual framework mapping onto behavioral addiction components, pending empirical validation; (4) particular vulnerability of adolescents and lonely individuals to exclusive affective bonds with AI; and (5) potential erosion of human relational capacities, empathy development, and tolerance for interpersonal complexity. Significant gaps were identified in longitudinal research, validated screening tools, and intervention protocols. Conclusions: Emotional reliance on AI represents an emerging clinical phenomenon with addiction-like features requiring specific diagnostic frameworks, evidence-based interventions, and ethical design guidelines. Future research should prioritize longitudinal studies examining developmental impacts and neurobiological investigations of AI-mediated reinforcement mechanisms.

People with severe mental illness (SMI), including schizophrenia (SCZ) and bipolar disorder (BD), show elevated risk for somatic conditions and premature mortality. Both genetic liability and modifiable lifestyle factors have been implicated in this comorbidity, yet large-scale studies examining their independent and combined effects across multiple somatic conditions are lacking. We therefore examined whether modifiable lifestyle factors (i.e. smoking, alcohol intake, diet, and exercise) and polygenic risk scores (PRS) for SCZ and BD are associated with the risk of developing somatic illnesses. Data were drawn from 315,313 unrelated individuals in the UK Biobank cohort, with a median follow up of 14 years. Cox proportional hazards models were used to estimate the independent, joint, and interaction effects of PRS-SCZ and PRS-BD and lifestyle factors on the incidence of nine chronic somatic illnesses. Healthy lifestyle was associated with lower risks of type 2 diabetes (T2D), cardiovascular disease (CVD), dementia, rheumatoid arthritis, asthma, chronic liver disease (CLD), and cancer (HRs ranging from 0.43 to 0.80). In addition, higher PRS for SCZ was associated with increased risks of asthma and dementia and lower risk of T2D, while higher PRS for BD was associated with increased risk of T2D. Moreover, likelihood ratio tests confirmed that PRS-SCZ and PRS-BD each contribute independent information to the joint Cox model for T2D, indicating that the opposing directions of their associations with T2D risk are not driven by shared genetic variance between the two scores. Finally, individuals with a healthy lifestyle consistently showed lower risks of CLD, T2D, CVD, and dementia across genetic risk strata; however, no significant additive interaction was observed between genetic risk and lifestyle factors. In conclusion, these findings indicate that genetic liabilities for SCZ and BD show outcome-specific associations with somatic illnesses, while a healthy lifestyle is associated with lower somatic illness risk regardless of genetic risk level.

Therapeutic writing practices have gained increasing attention as supportive tools within psychological interventions. Cognitive Behavioral Therapy (CBT) techniques aim to identify individuals’ negative automatic thoughts and distorted cognitive patterns and replace them with more adaptive and balanced thought patterns. For this purpose, journaling is one of the effective techniques that facilitates the identification and processing of thoughts, emotions, and experiences. By externalizing internal cognitive and emotional states, individuals can gain deeper self-awareness and challenge maladaptive patterns of thinking. Within therapeutic contexts, particularly in CBT-based approaches, journaling serves as a practical tool for cognitive restructuring and the improvement of psychological well-being. The aim of this narrative review is to investigate the role of journaling (structured daily writing), based on CBT techniques, in psychological well-being and self-esteem of the individuals. Empirical and theoretical studies on the topic were identified through academic databases, and synthesized to examine common findings and theoretical perspectives. The findings of this review show that CBT-based journaling supports cognitive restructuring by enhancing emotional self-awareness and thought monitoring in individuals. This process may contribute to modifying negative thinking patterns, improving emotional regulation, strengthening coping strategies, and ultimately increasing psychological well-being and self-esteem.

Background and aims: Despite the last decade's significant development in the scientific study of work addiction/workaholism, this area of research is still facing a fundamental challenge, namely the need for a valid and reliable measurement tool that shows cross-cultural invariance and, as such, allows for worldwide studies on this phenomenon. Methods: An initial 16-item questionnaire, developed within an addiction framework, was administered alongside job stress, job satisfaction, and self-esteem measures in a total sample of 31,352 employees from six continents and 85 cultures (63.5% females, mean age of 39.24 years). Results: Based on theoretical premises and psychometric testing, the International Work Addiction Scale (IWAS) was developed as a short measure representing essential features of work addiction. The seven-item version (IWAS-7), covering all seven components of work addiction, showed partial scalar invariance across 81 cultures, while the five-item version (IWAS-5) showed it across all 85 cultures. Higher levels of work addiction on both versions were associated with higher job stress, lower job satisfaction, and lower self-esteem across cultures. The optimal cut-offs for the IWAS-7 (24 points) and IWAS-5 (18 points) were established with an overall accuracy of 96% for both versions. Discussion and conclusions: The IWAS is a valid, reliable, and short screening scale that can be used in different cultures and languages, providing comparative and generalizable results. The scale can be used globally in clinical and organizational settings, with the IWAS-5 being recommended for most practical and clinical situations. This is the first study to provide data supporting the hypothesis that work addiction is a universal phenomenon worldwide.

Identifying phenotypes at high risk of suicidal behaviour is a relevant objective of clinical and translational research and can facilitate the identification of possible candidate biomarkers. We probed the potential association and eventual stability of neuropsychological profiles and serum BDNF concentrations with lifetime suicide ideation and attempts (LSI and LSA, respectively) in individuals with schizophrenia (SCZ) and schizoaffective disorder (SCA) in a 2-year follow-up study. A secondary analysis was conducted on a convenience sample of previously recruited subjects from a single outpatient clinic. Retrospectively assessed LSI and LSA were recorded by analysing the available longitudinal clinical health records. LSI + LSA subjects consistently exhibited lower PANSS-defined negative symptoms and better performance in the BACS-letter fluency subtask. There was no significant association between BDNF levels and either LSI or LSA. We found a relatively stable pattern of lower negative symptoms over two years among patients with LSI and LSA. No significant difference in serum BDNF concentrations was detected. The translational viability of using neuropsychological profiles as a possible avenue for the identification of populations at risk for suicide behaviours rather than the categorical diagnosis represents a promising option but requires further confirmation.

Schizophrenia (SCZ) and schizoaffective disorder (SAD) are severe and complex psychiatric disorders whose liability threshold is modulated by the interplay of biological, mainly genetic, and environmental factors. Consistent evidence has pointed to the role of serum brain‐derived neurotrophic factor (BDNF) as a plausible illness biomarker in SCZ spectrum disorders. There is no consensus, however, on the temporal trajectory of this decline. Here, we present a secondary analysis of the Longitudinal Assessment of BDNF in Sardinian Psychotic patients (LABSP) study, focusing on the impact of antipsychotic therapy, particularly long‐acting injectable (LAI), on the longitudinal trajectory of serum BDNF levels and analyzing the effect of BDNF genetic variants. LABSP patients were assessed every 6 months for a series of measures, including the assessment of BDNF serum levels over 24 months. Blood samples for each patient were taken at the same time of the day (between 8:00 and 10:00 a.m.). BDNF serum levels were determined using the BDNF ELISA Kit. Four tag single nucleotide polymorphisms (SNPs) within the BDNF gene (rs1519480, rs11030104, rs6265 [Val66Met], and rs7934165) were selected using standard parameters and analyzed with polymerase chain reaction (PCR). Mixed‐effects linear regression models (MLRMs) were used to analyze longitudinal data. Twenty‐four patients out of 105 LABSP (22.9%) patients received therapy with LAI. Analysis with MLRM showed a significant effect of LAI treatment associated with increasing serum BDNF levels (Z = 2.2, p = 0.02). However, oral antipsychotics did not significantly impact the longitudinal trajectory of serum BDNF levels (Z = 0.15, p = 0.9). There was no moderating effect of variants within the BDNF gene on the identified association. We identified a significant longitudinal increase in serum BDNF in SCZ and SAD patients treated with LAI antipsychotic therapy. The significant impact of this preparation of antipsychotic treatment on serum BDNF, despite the limited sample size, points to a moderate to large magnitude of effect that should be investigated in future prospective studies.

The term severe mental illness (SMI) encompasses those psychiatric disorders exerting the highest clinical burden and socio-economic impact on the affected individuals and their communities. Pharmacogenomic (PGx) approaches hold great promise in personalizing treatment selection and clinical outcomes, possibly reducing the burden of SMI. Here, we sought to review the literature in the field, focusing on PGx testing and particularly on pharmacokinetic markers. We performed a systematic review on PUBMED/Medline, Web of Science, and Scopus. The last search was performed on the 17 September 2022, and further augmented with a comprehensive pearl-growing strategy. In total, 1979 records were screened, and after duplicate removal, 587 unique records were screened by at least 2 independent reviewers. Ultimately, forty-two articles were included in the qualitative analysis, eleven randomized controlled trials and thirty-one nonrandomized studies. The observed lack of standardization in PGx tests, population selection, and tested outcomes limit the overall interpretation of the available evidence. A growing body of evidence suggests that PGx testing might be cost-effective in specific settings and may modestly improve clinical outcomes. More efforts need to be directed toward improving PGx standardization, knowledge for all stakeholders, and clinical practice guidelines for screening recommendations.

Brain-derived neurotrophic factor (BDNF) is a key modulator of neuroplasticity and has an important role in determining the susceptibility to severe psychiatric disorder with a significant neurodevelopmental component such as major psychoses. Indeed, a potential association between BDNF serum levels and schizophrenia (SCZ) and schizoaffective disorder (SAD) has been tested in diverse studies and a considerable amount of them found reduced BDNF levels in these disorders. Here, we aimed at testing the association of BDNF serum levels with several demographic, clinical, and psychometric measures in 105 patients with SCZ and SAD, assessing the moderating effect of genetic variants within the BDNF gene. We also verified whether peripheral BDNF levels differed between patients with SCZ and SAD. Our findings revealed that BDNF serum levels are significantly lower in patients affected by SCZ and SAD presenting more severe depressive symptomatology. This finding awaits replication in future independent studies and points to BDNF as a possible prognostic indicator in major psychoses.