General Psychiatry最新文献

Post-traumatic stress disorder (PTSD) is a severe neuropsychiatric disorder characterised by re-experiencing, avoidance and hyperarousal. Memory abnormalities manifested as intrusive thoughts and prolonged distressful emotions are postulated as key roles in PTSD development and persistence. Over the past decades, convergent results from human and animal studies have systematically investigated contributions of the amygdala, hippocampus and medial prefrontal cortex (mPFC) in fear memory processes, including fear acquisition, storage, reconsolidation and extinction. These findings provide mechanistic insights for cognitive-behavioural therapy and aid in developing pathological region-targeted neuromodulation treatment for PTSD. Taking advantage of advances in cell-type selective labelling and manipulation technologies, recent studies have focused on the spatiotemporal regulation of neural circuits underlying distinct phases of fear memory processes. These findings have revealed that multiple distributed brain areas participate in the fear memory encoding network. Moreover, the functional role of distinct neuronal ensembles within the amygdala-hippocampus-mPFC pathway, identified by genetic markers and projection profiles, has been assigned to temporally separate features of fear processing, demonstrating the sophistication of the fear encoding circuit. These results provide mechanistic insights into PTSD pathology and might shed light on aetiology-based clinical interventions for PTSD. Therefore, the present review will mainly focus on the recent progress in elucidating neural circuit mechanisms underlying the dynamic regulation of fear memory, with an emphasis on the spatial distribution of fear memory encoding neural networks and the temporal coherence between neuronal ensemble activity and fear expression.

Abstract:

Background: Major depressive disorder (MDD), characterised by persistent anhedonia and elevated suicide risk, represents a global mental health challenge. Recent studies suggest a link between gut-brain axis dysfunction and depression. The natural compound paeoniflorin demonstrates clinically relevant antidepressant effects, yet its underlying neurobiological mechanisms remain elusive.

Aims: This study aims to examine how paeoniflorin alleviates depression-like behaviours in rats subjected to chronic unpredictable mild stress (CUMS) by modulating the function of gut-brain axis, and explore the connections between gut microbiota, metabolites and MDD.

Methods: Depression-like behaviours in rats were induced by CUMS, and the antidepressant effect of paeoniflorin was assessed using behavioural tests. The composition and function of the intestinal microbiota were analysed using 16S rRNA sequencing, and metabolomic analysis was performed on serum, hippocampus, jejunum and faecal samples. Enzyme-linked immunosorbent assay and hematoxylin and eosin staining were used to detect the levels of inflammatory factors and cortisol, as well as the infiltration of inflammatory cells in the jejunum of rats after cohousing. Long-term potentiation assays and Golgi staining were used to detect dendritic spine density and synaptic plasticity, respectively.

Results: Paeoniflorin significantly alleviated depression-like behaviours and cognitive deficits in CUMS rats. 16S rRNA sequencing revealed that paeoniflorin improved the abundance and diversity of the gut microbiota in CUMS rats. Enrichment of differential metabolites in the brain, intestine, faeces and serum revealed a primary accumulation in the amino acid metabolism pathway. We further observed a correlation between the relative abundance of microbial communities and metabolites. Cohousing experiments verified that microbial metabolites of paeoniflorin can reduce neuroinflammation and improve synaptic plasticity.

Conclusions: Disruptions in gut microbiota and its metabolites impair gut-brain interactions. Paeoniflorin's neuroprotective and antidepressant effects are mediated through the modulation of the function of the gut-brain axis.

Abstract:

Background: Antenatal anxiety (AA) is a common mental disorder during pregnancy and adversely affects the well-being of both pregnant women and their offspring. The prevalence of AA is exceptionally high in the first trimester, yet there is a lack of studies focusing exclusively on AA in the first trimester.

Aims: This study aimed to investigate the prevalence and risk factors of AA among Chinese pregnant women during the first trimester.

Methods: We retrospectively retrieved and analysed data on the mental health screening of perinatal women at Shenzhen Baoan Women's and Children's Hospital in China from 1 January 2020 to 31 January 2024. A total of 42 013 pregnant women with less than 14 weeks of gestation were assessed using the 7-item Generalized Anxiety Disorder Scale (GAD-7). A GAD-7 score ≥10 indicates AA. Univariable analyses and multivariable logistic regression were employed to identify risk factors for AA.

Results: Among the participants, 1066 (2.54%) experienced AA in the first trimester. Factors associated with a higher risk of AA included being under 25 years old, temporary residence, below senior high school education, low or moderate economic status, primipara, unplanned pregnancy, smoking, alcohol use, lack of exercise, low or moderate living conditions, low or moderate marital satisfaction and reluctance to discuss troubles with others.

Conclusions: AA manifests as a multifaceted phenomenon influenced by various sociodemographic, obstetrical, lifestyle and psychosocial factors. Preventing AA requires collaboration among hospitals, communities and families.

Background: Although studies in recent years have explored the impact of gut microbiota on various sleep characteristics, the interaction between gut microbiota and insomnia remains unclear.

Aims: We aimed to evaluate the mutual influences between gut microbiota and insomnia.

Methods: We conducted Mendelian randomisation (MR) analysis using genome-wide association studies datasets on insomnia (N=386 533), gut microbiota data from the MiBioGen alliance (N=18 340) and the Dutch Microbiome Project (N=8208). The inverse variance weighted (IVW) technique was selected as the primary approach. Then, Cochrane's Q, Mendelian randomization-Egger (MR-Egger) and MR Pleiotropy RESidual Sum and Outlier test (MR-PRESSO) tests were used to detect heterogeneity and pleiotropy. The leave-one-out method was used to test the stability of the MR results. In addition, we performed the Steiger test to thoroughly verify the causation.

Results: According to IVW, our results showed that 14 gut bacterial taxa may contribute to the risks of insomnia (odds ratio (OR): 1.01 to 1.04), while 8 gut bacterial taxa displayed a protective effect on this condition (OR: 0.97 to 0.99). Conversely, reverse MR analysis showed that insomnia may causally decrease the abundance of 7 taxa (OR: 0.21 to 0.57) and increase the abundance of 12 taxa (OR: 1.65 to 4.43). Notably, the genus Odoribacter showed a significant positive causal relationship after conducting the Steiger test. Cochrane's Q test indicated no significant heterogeneity between most single-nucleotide polymorphisms. In addition, no significant level of pleiotropy was found according to MR-Egger and MR-PRESSO.

Conclusions: Our study highlighted the reciprocal relationships between gut microbiota and insomnia, which may provide new insights into the treatment and prevention of insomnia.

Background: Paranoia exists in the general population, both in adults and in children, and is a key feature of schizotypy and schizophrenia-spectrum disorders. Attempts to develop child-appropriate tools to assess childhood suspiciousness and its correlation with developmental psychopathology are underdeveloped but crucial.

Aims: This study examines the prevalence and structure of childhood mistrust and its correlations with internalising and externalising problems in non-clinical and clinical samples using a newly validated Italian Social Mistrust Scale (SMS).

Methods: Children aged 8-14 years old from a non-clinical (n=242) and a clinical sample with anxiety and/or mood disorder (n=44) were recruited. All children completed the SMS and a standardised battery of tests measuring schizotypal traits, anxiety, depression and internalising/externalising problems.

Results: The total Mistrust Score was positively skewed, with 50% of children scoring≤3 points and 15% scoring≥7 points. Factor analyses revealed a three-factor model (ie, General Mistrust, Home Mistrust and School Mistrust) replicating the original English SMS. As expected, childhood mistrust was positively correlated with schizotypal traits, anxiety and depression in the non-clinical sample (r=0.49, 0.42 and 0.54, respectively) and in the clinical sample (r=0.75, 0.51 and 0.85, respectively). Finally, the SMS showed an overall moderate internal reliability (α) in the non-clinical sample (α=0.74), and a good internal reliability in the clinical sample (α=0.83).

Conclusions: Consistent with previous studies, childhood mistrust-as measured by the newly translated Italian SMS-exists on a continuum of severity and is associated with higher levels of childhood psychopathology. Exploring social mistrust and suspiciousness in childhood can support clinicians and researchers, and could help develop preventive interventions during early development, particularly for children at risk of specific emotional and behavioural challenges.

With the sustained growth of the economy and significant changes in social demographics, the issue of elderly-related diseases has increasingly drawn attention, particularly. Alzheimer's disease (AD), as a representative disease of neurodegenerative diseases, has become a major challenge, affecting the health and quality of life of the elderly population severely. In recent years, the incidence, prevalence and mortality rates of AD have increased in China, imposing substantial economic burdens on families, society and the entire healthcare system. To proactively address this challenge and respond to the national 'Healthy China Action' initiative, leading experts from authoritative institutions jointly authored the China Alzheimer Report 2025. Building on previous editions, this report updates epidemiological data on AD in China, thoroughly analyses the latest economic burdens of the disease and comprehensively evaluates the current status of AD diagnosis and treatment services, as well as the allocation of public health resources in our country. Its release reflects China's progress in AD research and prevention, underscores societal concern for elderly health and aims to provide scientific guidance and data support for AD prevention, diagnosis and treatment. It also facilitates academic exchanges and cooperation, enhancing public awareness and promoting active participation in elderly healthcare, towards achieving 'healthy ageing' in China.

Abstract:

Background: Clinical brain-computer interface (BCI) for mental disorders is an emerging interdisciplinary research field, posing new ethical concerns and challenges, yet lacking practical ethical governance guidelines for stakeholders and the entire community.

Aims: This study aims to establish a multidisciplinary consensus of principles for ethical governance of clinical BCI research for mental disorders and offer practical ethical guidance to stakeholders involved.

Methods: A systematic literature review, symposium and roundtable discussions, and a pre-Delphi (round 0) survey were conducted to form the questionnaire for the three-round modified Delphi study. Two rounds of surveys, followed by a third round of independent interviews of 25 experts from BCI-related research domains, were involved. We conducted quantitative analysis of responses and agreements among experts to reveal the consensus and differences regarding the ethical governance of mental BCI research from a multidisciplinary perspective.

Results: The Delphi panel emphasised important concerns of ethical review practices and ethical principles within the BCI context, identified qualified and highly influential institutions and personnel in conducting and advancing clinical BCI research, and recognised prioritised aspects in the risk-benefit evaluation. Experts expressed diverse opinions on specific ethical concerns, including concerns about invasive technology, its impact on humanity and potential social consequences. Agreement was reached that the practices of ethical governance of clinical BCI for mental disorders should focus on patient voluntariness, autonomy, long-term effects and related assessments of BCI interventions, as well as privacy protection, transparent reporting and ensuring that the research is conducted in qualified institutions with strong data security.

Conclusions: Ethical governance of clinical research on BCI for mental disorders should include interdisciplinary experts to balance various needs and incorporate the expertise of different stakeholders to avoid serious ethical issues. It requires scientifically grounded approaches, continuous monitoring and interdisciplinary collaboration to ensure evidence-based policies, comprehensive risk assessments and transparency, thereby promoting responsible innovations and protecting patient rights and well-being.