European Journal of Psychiatry最新文献

{"title":"Current state and future directions of biomarkers for bipolar disorder: A systematic review of studies from 2013 to 2025","authors":"Guocan Ma ,&nbsp;Fengyi Hao ,&nbsp;Soon-Kiat Chiang ,&nbsp;Dewen Zhou ,&nbsp;Roger C. Ho ,&nbsp;Roger S. McIntyre","doi":"10.1016/j.ejpsy.2025.100317","DOIUrl":"10.1016/j.ejpsy.2025.100317","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Bipolar disorder (BD) is a severe mental disorder whose diagnosis heavily relies on subjective symptomatic assessments, thus a need for an objective tool to assist in the timely identification and treatment of BD.</div></div><div><h3>Methods</h3><div>We systematically reviewed the performance of objective diagnostic biomarkers for classification of BD that presented sensitivity and specificity values. A search on Ovid MEDLINE® ALL, PubMed, as well as manual searching were performed for literature dating from December 2013 to February 2025.</div></div><div><h3>Results</h3><div>Sixty-one studies were included in the review. Twenty-four of them reported mainly molecular, fluid-based biomarkers, twenty-five reported neurophysiological examinations as biomarkers, and six reported other forms of biomarkers. The most accurate biomarkers included voice features, apoptosis-related long non-coding RNAs, PIK3R1 (Phosphoinositide-3-kinase regulatory subunit 1) and FYN mRNAs, electroencephalography (EEG), functional near-infrared spectroscopy (fNIRS)<strong>,</strong> multimodal magnetic resonance imaging (MRI), and serum VGF protein, with area under the receiver operating characteristic curve (AUC) or accuracy values of greater than 0.93. The majority (thirty-six) of the studies utilized machine learning-based classification algorithms.</div></div><div><h3>Conclusions</h3><div>The results have been promising and replicated for some biomarkers, but these results still need to be validated in larger samples. Future studies should focus on constructing larger cohorts of specific clinical subtypes of BD, predictive utility studies for BD patients initially diagnosed as major depressive disorder (MDD), and utilization of multimodal assessment and machine learning techniques.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 4","pages":"Article 100317"},"PeriodicalIF":2.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686224","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}

{"title":"Impact of suicide and COVID-19 in different countries: Epidemiological data for 2020","authors":"Jimena María Merayo-Cano ,&nbsp;Alejandro Porras-Segovia ,&nbsp;Luis Gutiérrez-Rojas ,&nbsp;Enrique Baca-García","doi":"10.1016/j.ejpsy.2025.100316","DOIUrl":"10.1016/j.ejpsy.2025.100316","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>Suicide is a major public health problem. The number of years of potential life lost (YPLL) provides a complementary perspective for mortality assessment and health policy development. Previous studies have compared YPLL due to suicide with YPLL due to COVID-19 in the United States and Spain. However, no previous studies have explored these data worldwide to establish an adequate comparison. We believe that suicide deaths do not receive adequate attention when compared, for example, to deaths attributable to COVID-19. 1 In this case we have performed a comparative analysis of the years of life lost due to suicide and the pandemic, based on data that have been published in recent years. This study aims to quantify the global impact of suicide versus COVID-19 in terms of YPLL.</div></div><div><h3>Methods</h3><div>Our source was the World Health Organization mortality database as of September 2023. We included countries that had data on all-cause mortality for ages 0-75, presented by age groups in 2020. For suicide and COVID-19, YPLL and the percentage of YPLL over total causes of death were analyzed.</div></div><div><h3>Results</h3><div>In 10 out of 22 countries (45 %), YPLL due to suicide exceeded those due to COVID-19.</div></div><div><h3>Conclusions</h3><div>The countries where the impact of suicide was greater than that produced by COVID-19 were Australia and Germany. Although all countries in the world for which data was available were analyzed, Europe was the region with the highest representation. In the case of Europe, the world region with the largest number of countries for which data are available, half of the countries analyzed have a higher number of years of potential life lost as a result of suicide than those lost due to COVID-19, the disease that became one of the leading causes of death in record time, with devastating socio-economic impact and damage. It is necessary to raise awareness about the impact of suicide. Suicide prevention requires a coordinated effort worldwide.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 4","pages":"Article 100316"},"PeriodicalIF":2.5,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665998","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}

{"title":"National suicide prevention Spanish platform: Creation and components","authors":"Elizabeth Suárez-Soto ,&nbsp;Yolanda Sánchez-Carro ,&nbsp;Andrés Pemau ,&nbsp;Adriana García-Ramos ,&nbsp;Marina Díaz-Marsá ,&nbsp;Iria Grande ,&nbsp;Pilar Alejandra Sáiz ,&nbsp;Miguel Ruiz-Veguilla ,&nbsp;Ángela Palao-Tarrero ,&nbsp;Annabel Cebrià ,&nbsp;Matilde Elices ,&nbsp;Ana González-Pinto ,&nbsp;José Luis Ayuso ,&nbsp;Víctor Pérez Solà ,&nbsp;Alejandro de la Torre-Luque","doi":"10.1016/j.ejpsy.2025.100314","DOIUrl":"10.1016/j.ejpsy.2025.100314","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>Suicide represents a significant global public health challenge, with a concerning increase in Spain, particularly among young adults. In response, the National Platform for the Study and Prevention of Suicide was established. This article provides a descriptive overview of its creation, structural components, and public engagement data.</div></div><div><h3>Methods</h3><div>The platform integrates multiple components, including geospatial and temporal epidemiological surveillance models, annual reports on suicide trends, and user-friendly data visualization tools that provide regional and national insights. It also addresses public interest by disseminating evidence-based information and preventive resources.</div></div><div><h3>Results</h3><div>Since its launch in October 2021 through January 13, 2025, the platform recorded 53,159 visits, indicating significant public interest in geographic suicide data and preventive resources. Most visitors are from Spain (86 %), with notable international interest, particularly from the United States and Latin America.</div></div><div><h3>Conclusion</h3><div>The National Platform has proven to be a valuable tool for suicide prevention in Spain, leveraging digital innovation to enhance public awareness and epidemiological monitoring. Its focus on geospatial data and user interaction underscores its potential to inform public health responses and support evidence-based interventions.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 3","pages":"Article 100314"},"PeriodicalIF":2.5,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167460","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}

{"title":"Treatment-resistant depression and intranasal esketamine: Spanish clinical consensus on practical aspects","authors":"J. Antoni Ramos-Quiroga ,&nbsp;Fernando Mora ,&nbsp;Silvia Arostegui ,&nbsp;Narcís Cardoner ,&nbsp;Jon-Inaki Etxeandia-Pradera ,&nbsp;Rocío Gómez-Juanes ,&nbsp;Marcos Gómez-Revuelta ,&nbsp;José Manuel Montes ,&nbsp;Eduard Vieta","doi":"10.1016/j.ejpsy.2025.100313","DOIUrl":"10.1016/j.ejpsy.2025.100313","url":null,"abstract":"<div><h3>Background</h3><div>Pharmacological management of major depressive disorder has traditionally relied on antidepressants targeting the monoaminergic pathway. Treatment-resistant depression (TRD) patients have been frequently excluded from registrational trials, resulting in a lack of clear clinical recommendations for an optimised management. In recent years, treatments based on other mechanisms of action have been developed and approved. Intranasal esketamine is a novel non-monoaminergic treatment directed to improve neuroplasticity through the modulation of the glutamatergic system. In this clinical consensus we aimed to provide expert guidance on the use of intranasal esketamine for TRD patients based in our clinical practice in Spain.</div></div><div><h3>Methods</h3><div>A scientific committee of nine psychiatrists, experts in TRD in Spain, reviewed the literature (grey literature and articles/scientific communications published in English or Spanish between January 2014 and January 2024 in PubMed). Statements on practical aspects of TRD management with intranasal esketamine were developed in a first meeting following a discussion group approach, refined in a second meeting with a nominal group technique, and finally drafted after consensus in a third meeting.</div></div><div><h3>Results</h3><div>We recommend a treatment algorithm for the management of TRD with intranasal esketamine. Recommendations were made for specific clinical profiles with other psychiatric comorbidities, which are not contraindications, and for patients who do not have at least a 50 % reduction in symptoms during the first induction phase (partial responders at the end of an induction phase). Treatment should be given in the same health centre where the patient normally receives mental care. The patient’s clinical progress will determine early optimisation of intranasal esketamine dose during the induction phase, the need for flexible doses/repeating the induction treatment phase, customisation of management, and treatment duration. We described factors impacting the use of intranasal esketamine and made recommendations on the characteristics of the ideal setting for its administration. Socio-economic aspects of intranasal esketamine were reviewed.</div></div><div><h3>Conclusions</h3><div>This is the first consensus developed in Spain regarding practical aspects of TRD management with intranasal esketamine, with a treatment algorithm for patients who are only partial responders at the end of the induction phase.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 3","pages":"Article 100313"},"PeriodicalIF":2.5,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143899456","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}

{"title":"Effectiveness of a 12-month telemedicine-based follow-up in reducing suicide reattempts: A multicentre non-randomized controlled study","authors":"María Irigoyen-Otiñano ,&nbsp;Vicent Llorca-Bofí ,&nbsp;Purificación López-Pena ,&nbsp;Andrea Gabilondo Cuéllar ,&nbsp;Guillermo Cano Escalera ,&nbsp;Raquel Roca ,&nbsp;Iñaki Zorrilla ,&nbsp;Ana González-Pinto","doi":"10.1016/j.ejpsy.2025.100311","DOIUrl":"10.1016/j.ejpsy.2025.100311","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Suicide attempts are a significant public health issue, with a high risk of relapse within 3–12 months following an initial attempt. Telemedicine-based follow-up interventions have emerged as a promising low-cost strategy for preventing reattempts, but the optimal duration and structure of these programs remain unclear. This study aimed to evaluate the effectiveness of a 12-month telemedicine-based follow-up intervention in reducing suicide reattempts compared to treatment as usual (TAU).</div></div><div><h3>Methods</h3><div>This multicenter, prospective, non-randomized controlled study was conducted in two hospitals in the Basque Country, Spain. A total of 140 patients with a recent suicide attempt were included, with 70 receiving a structured 12-month telephone follow-up in addition to TAU, and 70 receiving TAU alone. The primary outcome was the proportion of patients who reattempted suicide within 12 months. Secondary outcomes included time to first reattempt and the impact of adherence to the intervention response.</div></div><div><h3>Results</h3><div>Patients in the intervention group had a significantly lower rate of reattempts (21.4 % vs. 41.4 %, <em>p</em> = 0.011), fewer total reattempts (<em>p</em> = 0.031), and a longer time to first reattempt (<em>p</em> = 0.032) compared to the control group. Cox regression analysis showed a 54 % reduction in the risk of reattempts in the intervention group (HR=0.46, <em>p</em> = 0.001).</div></div><div><h3>Conclusion</h3><div>A 12-month telemedicine-based follow-up significantly reduces suicide reattempts and delays relapse, supporting its integration into standard mental health care for individuals at high risk of suicide.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 3","pages":"Article 100311"},"PeriodicalIF":2.5,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864815","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}

{"title":"Association of HSV2 infection and depression in adults: a cross-sectional study of NHANES from 2005–2016","authors":"Mingbo Wei ,&nbsp;Yi Feng ,&nbsp;Hongyan Peng ,&nbsp;Binbin Chen ,&nbsp;Yifan Wu ,&nbsp;Weiming Mao ,&nbsp;Qing Cai ,&nbsp;Jiajin Xu ,&nbsp;Laibao Yang ,&nbsp;Panpan Chen ,&nbsp;Huimin Zheng ,&nbsp;Licheng Yu","doi":"10.1016/j.ejpsy.2025.100312","DOIUrl":"10.1016/j.ejpsy.2025.100312","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Depression is a major mental system disorder, and previous studies have found an association between herpes simplex virus 2 (HSV-2) infection and depression. However, recently researches report that depression can be divided into two categories, cognitive symptoms and somatic symptoms, but the relationship between the subtypes of depression is still unknown.</div></div><div><h3>Methods</h3><div>We obtained NHANES data from cycles 2005–2016, and a total of 1124 depressed cases and 4253 matched controls were selected achieving a 1:4 matching ratio. Logistic regression was used to explore the association of HSV-2 infection with depression status and severity. Zero-inflated negative binomial regression was employed to assess associations between HSV-2 infection and specific cognitive/somatic symptoms of depression.</div></div><div><h3>Results</h3><div>HSV2 infection was positively associated with depression status (OR=1.33, 1.11∼1.59) and severity (OR=1.24, 1.05∼1.45), but these associations were only observed in female, not in male. Furtherly, result of Zero-inflated negative binomial regression suggested that HSV2 infection increased total score of somatic symptoms (RR=1.15, 1.16∼1.25) rather than cognitive symptoms in female. Moreover, HSV2 infection was related to increasing somatic symptoms, including sleeping difficulties, fatigue and appetite problems, but not any cognitive symptoms.</div></div><div><h3>Conclusion</h3><div>HSV-2 infection is positively associated with depression status only in females, but not in males. HSV-2 infection appears to be primarily related to somatic symptoms rather than cognitive symptoms in the female population.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 3","pages":"Article 100312"},"PeriodicalIF":2.5,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143842555","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}

{"title":"Functional impairments in attention-deficit/hyperactivity disorder and emotional dysregulation subgroups: A latent profile analysis in a large cohort of 13,207 children and adolescents","authors":"Wenyan Zhang ,&nbsp;Xiaohui Song ,&nbsp;Xianbin Wang ,&nbsp;Zhongliang Jiang ,&nbsp;Xu Hong ,&nbsp;Tianyuan Lei ,&nbsp;Yonghua Cui","doi":"10.1016/j.ejpsy.2025.100310","DOIUrl":"10.1016/j.ejpsy.2025.100310","url":null,"abstract":"<div><h3>Background and objectives</h3><div>The co-occurrence of attention-deficit/hyperactivity disorder (ADHD) symptoms and emotional dysregulation is highly prevalent. This study aims to explore potential subgroups within child and adolescent cohorts concerning ADHD symptoms and emotional dysregulation.</div></div><div><h3>Methods</h3><div>The sample comprised 13,207 children and adolescents aged 4–16 years diagnosed with ADHD recruited from outpatient services at the Beijing Children's Hospital. Latent profile analysis (LPA) was used to identify subgroups based on ADHD symptoms and emotional dysregulation across different age groups (children, 4–9 years, vs. adolescents, 10–16 years). Furthermore, analysis of covariance (ANCOVA) was employed to compare differences in behavioral problems, cognitive impairments, and social dysfunctions among these subgroups.</div></div><div><h3>Results</h3><div>We identified four distinct latent subgroups in children and three in adolescents. Significant differences in behavioral problems, cognitive impairments, and social dysfunctions were observed across these subgroups in both cohorts. Subgroups with high levels of ADHD symptoms and emotional dysregulation exhibited more severe functional impairments across both age groups.</div></div><div><h3>Conclusions</h3><div>This study highlights developmental variations in the relationship between ADHD symptoms and emotional dysregulation, underscoring the need for tailored interventions based on age-specific profiles.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 3","pages":"Article 100310"},"PeriodicalIF":2.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143821264","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}

{"title":"Impact of pet ownership and animal-assisted therapy on suicidal ideation and suicide deaths: A scoping review","authors":"Carl Zhou ,&nbsp;Nicholas Fabiano ,&nbsp;Stanley Wong ,&nbsp;Philip Yu ,&nbsp;Henry Cheng ,&nbsp;Risa Shorr ,&nbsp;Marco Solmi","doi":"10.1016/j.ejpsy.2025.100309","DOIUrl":"10.1016/j.ejpsy.2025.100309","url":null,"abstract":"<div><h3>Background</h3><div>There is growing research on therapeutic benefits of animals. However, their impact on suicide-related outcomes such as suicidal ideation (SI), suicide attempts (SA), and suicide deaths remains unclear. This scoping review consolidates existing literature on the role of pet ownership and animal assisted therapy (AAT) on suicide-related outcomes.</div></div><div><h3>Methods</h3><div>A PRISMA-compliant systematic search of MEDLINE, EMBASE, and PsycINFO was conducted up to March 10, 2025. Articles reporting the impact of pet ownership or AAT on SI, SA, or suicide deaths were included. Screening and data extraction were performed in duplicate, with risk of bias assessed using appropriate tools for each study design except for case reports and interviews. Study findings were descriptively summarized.</div></div><div><h3>Results</h3><div>25 studies were included: one RCT, five pre- and post-studies, two cohort studies, one case-control study, three case reports/series, and 13 surveys/interviews. For pet ownership, a cohort study (n=709) found a positive association between time with dog and SI (r=0.17, p&lt;0.001). Two other observational studies yielded non-significant results against suicide deaths. For AAT, one pre- and post-study of veterans (n=71) reported significant SI reductions (t(54)=4.87, p&lt;0.001) while another pre- and post-study of adolescents (n=30) also found significant SI reductions (χ² McNemar=6.75; p&lt;0.05). Four other experimental studies, including one RCT, yielded non-significant results. Qualitative findings suggested pet ownership and AAT may have a perceived protective effect against SI. No articles reported on SA. Most articles had a high or moderate risk of bias.</div></div><div><h3>Conclusion</h3><div>While there is a reported perceived protective effect of pet ownership and AAT against SI, the evidence for pet ownership and AAT remains inconclusive in relations to SI, SA, and suicide deaths. Future research should focus on high-quality with stringent methodology, large-scale, experimental studies with standardized outcome measures to clarify the role of animals in suicide prevention.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 3","pages":"Article 100309"},"PeriodicalIF":2.5,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143808068","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}

{"title":"Hyperprolactinemia in drug-naïve first episode psychosis and its association with BDNF levels","authors":"A Toll ,&nbsp;D Bergé ,&nbsp;L Martínez-Sadurní ,&nbsp;A Trabsa ,&nbsp;V Perez-Sola ,&nbsp;A Mané","doi":"10.1016/j.ejpsy.2025.100307","DOIUrl":"10.1016/j.ejpsy.2025.100307","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>Hyperprolactinemia is a common and well-known side effect of antipsychotic treatment. However, prolactin levels are elevated in drug-naïve first-episode psychosis (FEP) patients, which suggests that the association between prolactin and psychosis may be more complex than previously thought. One possible hypothesis to explain this association is that prolactin has a neuroprotective effect mediated by BDNF.</div></div><div><h3>Methods</h3><div>50 drug- naïve FEP were included and clinical characteristics as DUP; tobacco and cannabis use; and BMI were assessed. The PANSS and GAF questionnaires were administered. Fasting blood samples were obtained to determine prolactin, TSH, and BDNF levels. All statistical analyses were performed in the whole sample and stratified by sex.</div></div><div><h3>Results</h3><div>Of the 50 patients, 42 % had hyperprolactinemia (33.3 % of males and 55 % of females). Prolactin levels were negatively correlated with baseline GAF scores in the whole sample and in females but not in males. Prolactin levels were positively and independently associated (regardless of sex, age, BMI, TSH level, tobacco or cannabis use) with BDNF levels.</div></div><div><h3>Conclusions</h3><div>Prolactin secretion may be dysregulated in drug-naïve FEP, which implies that hyperprolactinemia—a common condition in FEP —may not be solely attributable to antipsychotic treatment. Elevated prolactin levels could reflect a physiological response designed to protect the central nervous system in certain critical situations. This neuroprotective effect could be mediated by increasing BDNF levels. Hyperprolactinemia is common in antipsychotic-naïve FEP. This study shows that higher prolactin levels are associated with elevated BDNF levels, suggesting a neuroprotective effect mediated through BDNF in this patient population.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 3","pages":"Article 100307"},"PeriodicalIF":2.5,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800461","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}

{"title":"Association between neutrophil-to-lymphocyte ratio and bipolar disorder: A systematic review and meta-analysis","authors":"Ling Gui ,&nbsp;Haiyan Yu ,&nbsp;Yuxin Wei ,&nbsp;Qichao Huang ,&nbsp;Yuyao Liu ,&nbsp;Yixiao Fu","doi":"10.1016/j.ejpsy.2025.100308","DOIUrl":"10.1016/j.ejpsy.2025.100308","url":null,"abstract":"<div><h3>Objective</h3><div>The neutrophil-to-lymphocyte ratio (NLR), a systemic indicator of inflammation and stress, shows inconsistent associations with bipolar disorder (BD). This meta-analysis will investigate NLR's diagnostic, prognostic, and therapeutic relevance in BD.</div></div><div><h3>Methods</h3><div>A systematic search across PubMed, Embase, Web of Science, PsycINFO, and Cochrane Library, using key terms ‘bipolar disorder’, ‘neutrophils’, ‘lymphocytes’, and ‘ratio’ yielded 31 studies assessed via Newcastle-Ottawa Scale. Sensitivity analyses, subgroup analyses and publication bias assessments were conducted to explore heterogeneity sources and result stability.</div></div><div><h3>Results</h3><div>The NLR values in BDs were significantly higher than those in healthy controls (HCs) (standardized mean difference [SMD] = 0.51, 95 % confidence interval [CI]: 0.40–0.62, <em>p</em> &lt; 0.0001; odds ratio [OR] = 1.87, 95 % CI: 1.27–2.74, <em>p</em> = 0.001). The association was most pronounced between bipolar mania (BDM) and HC (SMD = 0.67, 95 % CI: 0.57–0.76, <em>p</em> &lt; 0.0001, I² = 47 %). Additionally, BDM exhibited higher NLR than bipolar depression (BDD) and bipolar patients in euthymic episode (BDE) (SMD = 0.22, 95 % CI: 0.07–0.38, <em>p</em> = 0.04, I² = 42 %; SMD = 0.31, 95 % CI: 0.15–0.48, <em>p</em> = 0.0001, I² = 60 %, respectively). No significant differences were observed between BDD and HC (SMD = 0.30, 95 % CI: -0.05–0.64, <em>p</em> = 0.09). Subgroup analyses suggested that age may influence the association between NLR and BD.</div></div><div><h3>Conclusion</h3><div>An elevated NLR value is found in BD, particularly in BDM. However, the difference between BDD and HC is not statistically significant. NLR may be a potent biomarker for the identification and evaluation of BD.</div></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":"39 3","pages":"Article 100308"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747856","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}