European Journal of Psychiatry最新文献

Sex differences in the efficacy of cognitive behavioral therapy for adults with attention-deficit/hyperactivity disorder 成人注意缺陷/多动障碍认知行为治疗效果的性别差异

IF 1.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2026-02-07 DOI: 10.1016/j.ejpsy.2026.100345

Juan Jesús Crespín , Montse Corrales , Vanesa Richarte , Gemma Parramón , Santiago Biel , Ferran Mestres , Carolina Ramos-Sayalero , Pol Ibáñez , Gemma Nieva , Carla Torrent , Derek Clougher , Christian Fadeuilhe , Silvia Amoretti , Josep Antoni Ramos-Quiroga

Background and objectives

Cognitive Behavioral Therapy (CBT) is an effective adjunctive treatment for Attention-Deficit/Hyperactivity Disorder (ADHD). This study examined sex differences in the efficacy of a brief 6-session CBT program versus a traditional 12-session format, combined with stable pharmacotherapy, in adults with ADHD.

Methods

A total of 81 adults (58 % male; 41.27 ± 9.26 years) were randomly assigned to 6- or 12-session CBT. ADHD symptoms, psychopathology, and functioning were assessed at baseline, post-treatment, and 3- and 6-month follow-up. Mixed-effects models analyzed interactions between time, treatment group, and sex.

Results

At baseline, females exhibited greater symptom severity (p = 0.019), higher inattention (p < 0.001), and more pronounced impairments (p = 0.004). CBT led to significant clinical improvements regardless of sex. A significant time-by-sex interaction emerged for inattention (CAARS:O:L, p = 0.043), although it did not remain significant after adjusting for baseline severity. Regarding time × group × sex interactions, females in the 6-session group showed smaller reductions in clinical severity during follow-up (CGI-S, p = 0.047); however, this effect was no longer statistically significant after controlling for baseline ADHD severity. Findings should be interpreted with caution given the limited female sample at follow-up and the significant influence of initial symptom burden on long-term trajectories.

Conclusions

CBT improves ADHD symptoms and related impairments in adults, with comparable overall benefits across sexes. Treatment response follow-up differences were better explained by baseline severity and treatment intensity rather than sex-specific differences.

背景与目的认知行为疗法（CBT）是治疗注意力缺陷/多动障碍（ADHD）的有效辅助疗法。这项研究考察了在成人多动症患者中，简短的6期CBT治疗方案与传统的12期CBT治疗方案（结合稳定的药物治疗）在疗效上的性别差异。方法81例成人（男性58%，41.27±9.26岁）随机分为6期和12期CBT组。在基线、治疗后以及3个月和6个月的随访中评估ADHD症状、精神病理和功能。混合效应模型分析了时间、治疗组和性别之间的相互作用。结果在基线时，女性表现出更严重的症状（p = 0.019）、更严重的注意力不集中（p < 0.001）和更明显的损伤（p = 0.004）。无论性别，CBT都能显著改善临床症状。注意力不集中出现了显著的时间-性别交互作用（CAARS: 0:L, p = 0.043），尽管在调整基线严重程度后它仍然不显著。在时间×组×性别互动方面，6次治疗组的女性在随访期间的临床严重程度降低较小（CGI-S, p = 0.047）；然而，在控制了基线ADHD严重程度后，这种效应不再具有统计学意义。考虑到随访时女性样本有限，以及初始症状负担对长期发展轨迹的显著影响，研究结果应谨慎解释。结论：scbt可改善成人ADHD症状和相关损伤，在两性中具有相当的总体益处。治疗反应的随访差异更好地解释了基线严重程度和治疗强度，而不是性别特异性差异。

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引用次数: 0

Disentangling empathy for psychological and physical pain in borderline personality disorder: the interplay with clinical features and emotional competence 边缘型人格障碍心理和生理疼痛的共情解缠：与临床特征和情绪能力的相互作用

IF 1.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2026-01-01 DOI: 10.1016/j.ejpsy.2025.100339

Margherita Bechi , Martin Brüne , Giulia Agostoni , Roberta Bortolla , Maria Vittoria Bongiorno , Gea Spada , Martina Ceresi , Anna Rosini , Laura Sforzini , Marta Bosia , Roberto Cavallaro , Vera Flasbeck

Background and objectives

: Patients with Borderline Personality Disorder (BPD) often struggle in social interactions, exhibiting altered empathy and biased emotion recognition. Understanding how these aspects intertwine and relate to BPD symptoms remains unclear. This study aims at evaluating the ability to perceive both psychological and physical pain from a third-person and first-person perspective in BPD people and healthy controls, as well as to explore the interplay with childhood traumas, subjective empathy, alexithymia, emotion dysregulation and severity of symptoms.

Methods

: We utilized the 'Social Interaction Empathy Task' on an Italian sample (49 BPD patients, 52 healthy controls) to explore empathy for physical and psychological pain. We also evaluated emotion recognition alongside traits like alexithymia, childhood trauma, parenting style, dissociation, and impulsivity.

Results

: BPD patients perceived psychologically painful and neutral social situations as more distressing than controls, especially in the first-person perspective. A linear regression analysis revealed that 'Difficulty Describing Feelings' (DDF) subscale of the Toronto Alexithymia Scale (TAS-20) predicted ratings for psychologically painful images from a third-person view. Additionally, BPD patients frequently misinterpreted happy and neutral faces. We also observed correlations between emotion recognition and adverse childhood experiences, parenting style, and symptom severity.

Conclusion

: These findings suggest altered empathy for psychological pain in BPD patients, partly influenced by challenges in articulating emotions.

背景和目的：边缘型人格障碍（BPD）患者经常在社会交往中挣扎，表现出改变的同理心和有偏见的情绪识别。目前尚不清楚这些方面是如何相互交织并与BPD症状相关的。本研究旨在评估BPD患者和健康对照者以第三人称和第一人称视角感知心理和身体疼痛的能力，并探讨其与童年创伤、主观共情、述情障碍、情绪失调和症状严重程度的相互作用。方法：采用“社会互动共情任务”对意大利样本（49例BPD患者，52例健康对照）探讨共情对生理和心理疼痛的影响。我们还评估了情感识别以及述情障碍、童年创伤、父母教养方式、分离和冲动等特征。结果：BPD患者认为心理痛苦和中性的社会情境比对照组更令人痛苦，尤其是在第一人称视角下。线性回归分析显示，多伦多述情障碍量表（TAS-20）的“情感描述难度”（DDF）子量表预测了第三人称视角下心理痛苦图像的评分。此外，BPD患者经常误解快乐和中性的面孔。我们还观察到情绪识别与不良童年经历、父母教养方式和症状严重程度之间的相关性。结论：这些发现表明BPD患者对心理疼痛的共情改变，部分受表达情绪困难的影响。

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引用次数: 0

Heterogeneity in the association between CYP2D6 genotype and antipsychotic-induced extrapyramidal symptoms: A systematic review CYP2D6基因型与抗精神病药物诱导的锥体外系症状相关性的异质性：一项系统综述

IF 1.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2026-01-01 DOI: 10.1016/j.ejpsy.2025.100338

Antonina Luca , Maria Luca , Paolo Olgiati , Alessandro Serretti

Introduction

Cytochrome‑P450 2D6 (CYP2D6) activity modulates the biotransformation of many antipsychotics and neuroactive endobiotics. Functional polymorphisms yielding poor (PM), intermediate (IM), normal (NM) or ultrarapid (UM) metabolic phenotypes could therefore influence vulnerability to extrapyramidal symptoms (EPS). Aim of the present review was to critically summarize the evidence linking CYP2D6 genotype with antipsychotic‑induced EPS.

Methods

A systematic search of PubMed, MEDLINE and EBSCO (1 January 1997 – 28 April 2025) identified studies that: (i) examined CYP2D6 genotype or phenotype in relation to antipsychotic exposure, (ii) quantitatively assessed EPS, and (iii) enrolled ≥ 10 participants.

Results

Eighteen studies (7 prospective cohorts, 10 cross‑sectional studies, 1 randomized controlled trial; total n= 2037 participants) met inclusion criteria. Typical antipsychotics—particularly haloperidol and zuclopenthixol—dominated the exposure profile (64 % of participants). Eleven studies reported a genotype‑EPS association, consistently showing greater EPS prevalence or severity in PM and IM carriers. Reported odds ratios for EPS across included studies ranged ∼2–5 for PM/IM vs EM/UM. Risperidone and haloperidol were the antipsychotics most frequently associated with EPS. Null findings were primarily reported by studies devoid of PM genotypes and enrolling adolescent cohorts receiving second‑generation antipsychotics.

Conclusion

Some studies summarized in the present review supported the role of CYP2D6 genotype in the occurrence of EPS in patients treated with antipsychotics, particularly with high-potency D₂ antagonists. Prospective, genotype‑stratified trials that incorporate concomitant inhibitors/inducers, polygenic scores and pharmacodynamic modifiers are still required before cost‑effective implementation algorithms can be finalized.

细胞色素P450 2D6 （CYP2D6）活性调节许多抗精神病药物和神经活性内源性药物的生物转化。因此，产生不良（PM）、中等（IM）、正常（NM）或超快速（UM）代谢表型的功能多态性可能影响对锥体外系症状（EPS）的易感性。本综述的目的是批判性地总结CYP2D6基因型与抗精神病药物诱导的EPS相关的证据。方法对PubMed， MEDLINE和EBSCO（1997年1月1日- 2025年4月28日）进行系统检索，确定了以下研究：(i)检查CYP2D6基因型或表型与抗精神病药物暴露的关系，（ii）定量评估EPS，（iii）招募≥10名参与者。结果18项研究（7项前瞻性研究，10项横断面研究，1项随机对照试验，共n= 2037名受试者）符合纳入标准。典型的抗精神病药物——尤其是氟哌啶醇和zuclopenthol——在暴露情况中占主导地位（64%的参与者）。11项研究报告了基因型与EPS的关联，一致显示PM和IM携带者中EPS的患病率或严重程度更高。在纳入的研究中，PM/IM与EM/UM的EPS优势比为~ 2-5。利培酮和氟哌啶醇是最常与EPS相关的抗精神病药物。无效结果主要由缺乏PM基因型和纳入接受第二代抗精神病药物的青少年队列的研究报道。结论本综述总结的一些研究支持CYP2D6基因型在抗精神病药物，特别是高效d2拮抗剂治疗患者发生EPS中的作用。在最终确定具有成本效益的实施算法之前，仍需要前瞻性的基因型分层试验，包括伴随抑制剂/诱导剂、多基因评分和药效学调节剂。

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引用次数: 0

Translating human rights into perinatal mental health policy in Spain 将人权转化为西班牙的围产期心理健康政策

IF 1.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2026-01-01 DOI: 10.1016/j.ejpsy.2026.100344

Rocío Paricio-del-Castillo

引用次数: 0

Cognitive reserve and brain plasticity in cannabis-using psychosis patients: A systematic review of neuroimaging and intervention studies 大麻使用精神病患者的认知储备和大脑可塑性：神经影像学和干预研究的系统综述

IF 1.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2026-01-01 DOI: 10.1016/j.ejpsy.2025.100332

Valerio Ricci , Giovanni Martinotti , Giuseppe Maina

Background

Cognitive reserve—the brain's capacity to maintain function despite neural damage—and brain plasticity—the capacity for neural reorganization—represent critical factors influencing outcomes in psychotic disorders. Their interaction with cannabis use in patients with psychotic disorders remains poorly understood.

Objective

To examine relationships between cognitive reserve, brain plasticity, and cannabis use in patients with psychotic disorders specifically investigating neuroimaging outcomes including brain structure (gray matter volume, white matter integrity) and function (neural network connectivity).

Methods

Following PRISMA guidelines, we searched four databases from 2010–2025. Studies examining patients with psychotic disorders (schizophrenia, schizoaffective disorder, first-episode psychosis) with documented cannabis use were included, encompassing the full spectrum of exposure patterns from occasional to daily use. Participants were predominantly male (69 %) with mean age 28.7 ± 8.4 years. Cognitive reserve was assessed through educational attainment, premorbid intellectual functioning (estimated IQ), or composite measures combining these indicators. Brain plasticity was measured via training-induced neuroimaging changes.

Results

Twenty-seven studies representing 3164 participants met inclusion criteria. In observational studies (n = 20), higher cognitive reserve was consistently associated with preserved gray matter volume and white matter integrity despite cannabis exposure (effect sizes d = 0.41–0.52). Intervention studies (n = 7) demonstrated that cognitive training produced measurable neuroplastic changes (d = 0.38–0.62 for structural; d = 0.45–0.59 for functional improvements). Cognitive reserve maintained network integrity specifically in cannabis-using patients. Females showed greater training-induced changes, while neuroprotection was most evident in daily cannabis users.

Conclusions

Cognitive reserve provides neuroprotection against cannabis-related brain alterations in psychotic disorders, while neuroplasticity interventions induce significant brain changes. Findings support precision medicine approaches targeting cognitive enhancement based on individual characteristics.

认知储备——大脑在神经损伤的情况下维持功能的能力——和大脑可塑性——神经重组的能力——是影响精神疾病结果的关键因素。它们与精神病患者使用大麻的相互作用仍然知之甚少。目的研究精神障碍患者的认知储备、脑可塑性和大麻使用之间的关系，特别是研究神经影像学结果，包括脑结构（灰质体积、白质完整性）和功能（神经网络连通性）。方法按照PRISMA指南，检索2010-2025年的4个数据库。纳入了对有大麻使用记录的精神病患者（精神分裂症、分裂情感性障碍、首发精神病）的研究，涵盖了从偶尔使用到日常使用的全部暴露模式。参与者以男性为主（69%），平均年龄28.7±8.4岁。认知储备通过受教育程度、病前智力功能（估计智商）或结合这些指标的综合测量来评估。通过训练引起的神经影像学变化来测量大脑的可塑性。结果27项研究3164名受试者符合纳入标准。在观察性研究中（n = 20），尽管大麻暴露，较高的认知储备始终与保留的灰质体积和白质完整性相关（效应量d = 0.41-0.52）。干预研究（n = 7）表明，认知训练产生了可测量的神经可塑性变化（结构改善d = 0.38-0.62；功能改善d = 0.45-0.59）。认知储备维持网络完整性，特别是在使用大麻的患者。女性表现出更大的训练引起的变化，而神经保护在日常大麻使用者中最为明显。结论认知储备对大麻相关的精神障碍脑改变具有神经保护作用，而神经可塑性干预可诱导显著的脑改变。研究结果支持基于个体特征的以认知增强为目标的精准医学方法。

{"title":"Cognitive reserve and brain plasticity in cannabis-using psychosis patients: A systematic review of neuroimaging and intervention studies","authors":"Valerio Ricci , Giovanni Martinotti , Giuseppe Maina","doi":"10.1016/j.ejpsy.2025.100332","DOIUrl":"10.1016/j.ejpsy.2025.100332","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive reserve—the brain's capacity to maintain function despite neural damage—and brain plasticity—the capacity for neural reorganization—represent critical factors influencing outcomes in psychotic disorders. Their interaction with cannabis use in patients with psychotic disorders remains poorly understood.</div></div><div><h3>Objective</h3><div>To examine relationships between cognitive reserve, brain plasticity, and cannabis use in patients with psychotic disorders specifically investigating neuroimaging outcomes including brain structure (gray matter volume, white matter integrity) and function (neural network connectivity).</div></div><div><h3>Methods</h3><div>Following PRISMA guidelines, we searched four databases from 2010–2025. Studies examining patients with psychotic disorders (schizophrenia, schizoaffective disorder, first-episode psychosis) with documented cannabis use were included, encompassing the full spectrum of exposure patterns from occasional to daily use. Participants were predominantly male (69 %) with mean age 28.7 ± 8.4 years. Cognitive reserve was assessed through educational attainment, premorbid intellectual functioning (estimated IQ), or composite measures combining these indicators. Brain plasticity was measured via training-induced neuroimaging changes.</div></div><div><h3>Results</h3><div>Twenty-seven studies representing 3164 participants met inclusion criteria. In observational studies (n = 20), higher cognitive reserve was consistently associated with preserved gray matter volume and white matter integrity despite cannabis exposure (effect sizes d = 0.41–0.52). Intervention studies (n = 7) demonstrated that cognitive training produced measurable neuroplastic changes (d = 0.38–0.62 for structural; d = 0.45–0.59 for functional improvements). Cognitive reserve maintained network integrity specifically in cannabis-using patients. Females showed greater training-induced changes, while neuroprotection was most evident in daily cannabis users.</div></div><div><h3>Conclusions</h3><div>Cognitive reserve provides neuroprotection against cannabis-related brain alterations in psychotic disorders, while neuroplasticity interventions induce significant brain changes. Findings support precision medicine approaches targeting cognitive enhancement based on individual characteristics.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"40 1","pages":"Article 100332"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145876953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pharmacogenetics in refractory psychiatric disorders: Clinical utility in two consanguineous patients 难治性精神疾病的药物遗传学：两名近亲患者的临床应用

IF 1.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2026-01-01 DOI: 10.1016/j.ejpsy.2025.100335

Mar Panisello-Cardona , Ivan Martin da Silva , Pau Riera , Sara Bernal , David Almenta , María Gámez Lechuga

引用次数: 0

Exploring the nexus of cognition and insight in euthymic bipolar patients 探索常怀双相情感障碍患者认知与洞察力的关系

IF 1.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2026-01-01 DOI: 10.1016/j.ejpsy.2025.100336

Carmen Massons , Jesus Cobo , Guillem Navarra-Ventura , Muriel Vicent-Gil , Maria Serra-Blasco , Abigail Jubert , Mireia Agut , Diego J Palao , Narcís Cardoner

Background and Objectives

Although the relationship between clinical and cognitive insight in individuals with bipolar disorder remains unclear, both concepts are potentially related to cognitive performance, particularly to executive function. We aimed to explore associations among cognitive variables, cognitive insight, and clinical insight.

Methods

We assessed 64 clinically stable bipolar patients with a battery of clinical and cognitive tests, the Insight Scale for Affective Disorders to assess clinical insight, and the Beck Cognitive Insight Scale (BCIS) to assess cognitive insight. We used bivariate linear regression models to explore associations between cognitive insight, clinical insight, cognition, and sociodemographic and clinical variables, followed by stepwise multiple regression analyses to account for potential confounders.

Results

Global (F = 4.149; B = 0.201; p = 0.047; R2=0.071) and self-reflectiveness BCIS subscale (F = 4.690; B = 0.265; p = 0.043; R2=0.153) scores were positively associated with executive functions. Self-reflectiveness was negatively associated with premorbid intelligence quotient (F = 4.156; B=-0.170; p = 0.046; R2=0.071). Clinical insight was associated only with the self-certainty subscale of the BCIS (F = 4.120; B = 0.360; p = 0.047; R2=0.063).

Conclusions

Reduced cognitive insight is associated with cognitive impairment, especially diminished executive functioning. Elevated self-certainty scores are associated with diminished clinical insight.

背景和目的虽然双相情感障碍患者的临床和认知洞察力之间的关系尚不清楚，但这两个概念都可能与认知表现，特别是执行功能有关。我们的目的是探讨认知变量、认知洞察力和临床洞察力之间的关系。方法采用一系列临床和认知测试对64例临床稳定型双相情感障碍患者进行评估，其中情感障碍洞察力量表评估临床洞察力，贝克认知洞察力量表（BCIS）评估认知洞察力。我们使用双变量线性回归模型来探索认知洞察力、临床洞察力、认知、社会人口学和临床变量之间的关系，然后采用逐步多元回归分析来解释潜在的混杂因素。结果整体评分（F = 4.149; B = 0.201; p = 0.047; R2=0.071）和自我反思BCIS子量表评分（F = 4.690; B = 0.265; p = 0.043; R2=0.153）与执行功能呈正相关。自我反思与病前智商呈负相关（F = 4.156； B=-0.170; p = 0.046; R2=0.071）。临床洞察力仅与BCIS的自我确定性分量表相关（F = 4.120; B = 0.360; p = 0.047; R2=0.063）。结论认知洞察力下降与认知功能障碍有关，尤其是执行功能下降。自我肯定得分升高与临床洞察力下降有关。

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引用次数: 0

Risk of severe bacterial infection among offspring of patients with bipolar disorder: A family-linkage study 双相情感障碍患者后代严重细菌感染的风险：一项家庭连锁研究

IF 1.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2026-01-01 DOI: 10.1016/j.ejpsy.2025.100340

Dian-Jeng Li , Shih-Jen Tsai , Ya-Mei Bai , Tung-Ping Su , Tzeng-Ji Chen , Mu-Hong Chen , Chih-Sung Liang

Background and objectives

The medical comorbidities associated with bipolar disorder (BD) impose a heavy burden on society. We aimed to investigate the association between parental BD and severe bacterial infection among their offspring.

Methods

We used data from the Taiwan National Health Insurance Research Database. Individuals whose parents were diagnosed with BD were identified as the index group, and a demographically matched control group was also selected. The primary outcome was hospitalization due to bacterial infection, and the bacterial pathogens were recorded. Cox regression models with multiple adjustments were used to estimate the hazard ratios (HRs) with 95 % confidence intervals (CIs).

Results

The study included 8707 offspring of parents with BD and 87,070 offspring of parents without severe mental disorders. After adjustments, the offspring of parents with BD had higher risks of severe bacterial infection (HR: 1.2, 95 % CI: 1.03–1.39), meningitis (HR: 1.45, 95 % CI: 1.02–2.06), and Klebsiella infection (HR: 3.76, 95 % CI: 1.58–8.94) than the controls. In addition, the offspring of fathers with BD had higher risks of severe bacterial infection, repeated severe bacterial infection, and septicemia than the offspring of fathers without a severe mental disorder.

Conclusions

We identified an association between parental BD and an increased risk of bacterial infection in their offspring. Further research is warranted to better clarify the detailed mechanisms behind it.

背景与目的双相情感障碍（BD）相关的医学合并症给社会带来了沉重的负担。我们的目的是调查父母双相障碍与其后代严重细菌感染之间的关系。方法采用台湾全民健康保险研究数据库数据。父母被诊断为双相障碍的个体被确定为指标组，并选择一个人口统计学匹配的对照组。主要终点是因细菌感染而住院，并记录细菌病原体。采用多重调整的Cox回归模型估计风险比（hr），置信区间为95%。结果共纳入8707名双相障碍父母的后代和87070名无严重精神障碍父母的后代。调整后，父母患有BD的后代发生严重细菌感染（HR: 1.2, 95% CI: 1.03-1.39）、脑膜炎（HR: 1.45, 95% CI: 1.02-2.06）和克雷伯氏菌感染（HR: 3.76, 95% CI: 1.58-8.94）的风险高于对照组。此外，患有双相障碍父亲的后代发生严重细菌感染、反复严重细菌感染和败血症的风险高于无严重精神障碍父亲的后代。结论：我们发现父母双相障碍与其后代细菌感染风险增加之间存在关联。有必要进一步研究以更好地阐明其背后的详细机制。

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引用次数: 0

Factors involved in working memory in patients with schizophrenia and bipolar disorder: The role of peripheral biomarkers 精神分裂症和双相情感障碍患者工作记忆的相关因素：外周生物标志物的作用

IF 1.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2026-01-01 DOI: 10.1016/j.ejpsy.2025.100334

Gonzalo Paniagua , Julia Rodríguez-Revuelta , Leticia González-Blanco , Manuel Couce-Sánchez , Ainoa García-Fernández , Francesco Dal Santo , Pilar A. Sáiz , M.Paz García-Portilla

Background and objectives

Cognitive impairment, especially working memory (WM) dysfunction, is a core feature of schizophrenia (SZ) and bipolar disorder (BD), influenced by various factors including lifestyle, psychopathology, pharmacological factors, inflammation, and metabolic dysfunction. This study aimed to investigate the role of metabolic, inflammatory, and intestinal permeability biomarkers in WM impairments in SZ and BD patients.

Methods

A cross-sectional, observational study included 146 outpatients (SZ=96, BD=50). We assessed sociodemographic, clinical, metabolic, and inflammatory markers. Cognitive performance was evaluated using the Screen for Cognitive Impairment in Psychiatry. Biomarkers included glycohemoglobin, C-reactive protein, and lipopolysaccharide-binding protein/soluble CD14. Multivariate analyses identified factors associated with WM dysfunction and, secondarily, with other cognitive deficits.

Results

WM impairment was present in 56.3 % of SZ and 52 % of BD patients, without inter-group differences. Independent predictors of WM dysfunction were antipsychotic polypharmacy (OR=2.415, p = 0.011), abdominal obesity (OR=2.884, p = 0.016), and elevated glycohemoglobin (OR=1.126, p = 0.020). While inflammatory and intestinal permeability markers correlated with metabolic parameters, they were not independent predictors of WM impairment.

Conclusion

WM deficits in SZ and BD are primarily associated with metabolic and pharmacological factors. Addressing modifiable metabolic factors, optimizing antipsychotic treatment, and exploring interventions such as metformin and lifestyle modifications may improve cognitive outcomes in these populations.

背景与目的认知功能障碍，尤其是工作记忆功能障碍是精神分裂症（SZ）和双相情感障碍（BD）的核心特征，受生活方式、精神病理、药理因素、炎症和代谢功能障碍等多种因素的影响。本研究旨在探讨代谢、炎症和肠通透性生物标志物在SZ和BD患者WM损伤中的作用。方法采用横断面观察性研究，纳入146例门诊患者（SZ=96， BD=50）。我们评估了社会人口学、临床、代谢和炎症指标。使用精神病学认知障碍筛查评估认知表现。生物标志物包括糖蛋白、c反应蛋白和脂多糖结合蛋白/可溶性CD14。多变量分析确定了与WM功能障碍相关的因素，其次是与其他认知缺陷相关的因素。结果56.3%的SZ和52%的BD患者存在swm损伤，组间差异无统计学意义。WM功能障碍的独立预测因子为抗精神病药物多药（OR=2.415, p = 0.011）、腹部肥胖（OR=2.884, p = 0.016）和糖蛋白升高（OR=1.126, p = 0.020）。虽然炎症和肠通透性标志物与代谢参数相关，但它们并不是WM损伤的独立预测因子。结论SZ和BD的wm缺陷主要与代谢和药理因素有关。解决可改变的代谢因素，优化抗精神病药物治疗，探索干预措施，如二甲双胍和生活方式的改变，可能会改善这些人群的认知结果。

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引用次数: 0

Mild motor signs in major depressive disorder: prevalence and clinical profile 重度抑郁症的轻度运动症状：患病率和临床概况

IF 1.5 4区医学 Q2 PSYCHIATRY

European Journal of Psychiatry

Pub Date : 2026-01-01 DOI: 10.1016/j.ejpsy.2026.100342

Antonina Luca , Alessandro Serretti , Stefano Barlati , Lisa Buson , Valentina Menesello , Anna Magistrali , Rosana Carvalho Silva , Giulia Perusi , Gabriele Nibbio , Stefano Bignotti , Giovanni Battista Tura , Raffaele Ferri , Massimo Gennarelli , Antonio Vita , Alessandra Minelli , PANDORA study group

Background and objectives

Motor abnormalities are recognized features of major depressive disorder (MDD). However, subtle forms of motor dysfunction are still largely unexamined in adults with MDD. The aims of the present study were to: 1) assess the prevalence of mild motor signs (MMS) in adults with moderate to severe depression, and 2) evaluate whether patients with MMS exhibit specific depressive symptom profiles.

Methods

Two-hundred forty-four participants (172 (70.5 %) women, mean age 46.8 ± 14.5, mean education 12.5 ± 3.6 years) from the PANDORA trial were enrolled. All the participants were assessed using the Hamilton Depression Rating Scale (HAM-D). MMS were assessed using the UKU Side Effects Rating Scale.

Results

Out of the 244 participants, 34 (13.9 %) were MMS+: 20 (58.8 %) had myoclonus, 11 (32.3 %) hyperkinesia, 7 (20.6 %) rigidity, 6 (17.6 %) tremor, and 3 (8.8 %) hypokinesia. The percentage of patients reaching a ≥ 20 % improvement in the HAM-D total score was higher in the MMS- group than in the MMS+ (95.1 % vs. 75.0 %, respectively). MMS+ participants had higher HAM-D total score and sub-items exploring work and abilities, psychomotor retardation, agitation, and hypochondriasis. These associations between MMS and depression severity, as well as the specific symptomatology profile, were confirmed in the multivariate analysis, adjusted for age and sex.

Conclusions

Our findings suggest that MMS may reflect a distinct subgroup within MDD, potentially characterized by greater sensitivity to motor adverse effects and subtle differences in treatment response.

背景与目的运动异常是重度抑郁症（MDD）公认的特征。然而，在成人重度抑郁症患者中，细微的运动功能障碍在很大程度上仍未得到检查。本研究的目的是：1)评估轻度运动体征（MMS）在中度至重度抑郁症成人患者中的患病率，2)评估MMS患者是否表现出特定的抑郁症状特征。方法纳入来自PANDORA试验的244名参与者（172名（70.5%）女性，平均年龄46.8±14.5岁，平均受教育12.5±3.6年）。所有参与者均采用汉密尔顿抑郁评定量表（HAM-D）进行评估。使用UKU副作用评定量表对MMS进行评估。结果244例患者中，MMS+ 34例（13.9%），肌阵挛20例（58.8%），运动亢进11例（32.3%），强直7例（20.6%），震颤6例（17.6%），运动不足3例（8.8%）。MMS-组HAM-D总分改善≥20%的患者比例高于MMS+组（分别为95.1%和75.0%）。MMS+组的HAM-D总分和工作能力、精神运动迟缓、躁动、疑病症等分项得分较高。MMS与抑郁症严重程度之间的这些关联，以及特定的症状特征，在多变量分析中得到了证实，并根据年龄和性别进行了调整。结论：我们的研究结果表明，MMS可能反映了MDD中一个不同的亚组，其潜在特征是对运动不良反应更敏感，治疗反应存在细微差异。

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