Frontiers in Psychiatry最新文献

Background: As adolescent cannabis use becomes more common, questions remain about the potential for neurocognitive recovery after stopping cannabis use.

Method: This study examined whether short-term abstinence from cannabis leads to cognitive improvements. A total of 238 adolescents (ages 13-19; 51% female; 55% White, 18% Black, 9% Asian, 18% other races) from Greater Boston participated, including 154 adolescents who regularly used cannabis (CB) and 84 adolescents with no cannabis use (NU). Participants who used cannabis were randomized to incentivized abstinence (CB-Abst) or a non-contingent monitoring control (CB-Mon). Non-users completed four weeks of monitoring (NU). Participants completed tests of executive function, memory, and attention weekly for four weeks.

Results: At baseline, CB adolescents demonstrated worse verbal memory and processing speed than NU on (p <.006). CB-Abst performance was similar to that of the NU group at week 4. At week 4, those in the CB-Abst group showed greater improvements in inhibitory control compared to the CB-Mon group (β = -10.9, p = .037). There were no significant differences between CB groups in memory or attention task performance at week 4. Exploratory analyses revealed modest gains across all groups in some tasks.

Discussion: Brief cannabis abstinence may be associated with improvements in executive function among adolescents, supporting the idea of neurocognitive recovery, which has important implications for treatment, prevention, and public health policies.

Introduction: Homelessness during pregnancy is a significant public health issue in the US that increases the risk of adverse maternal and infant mental and physical health outcomes. The COVID-19 pandemic exacerbated these risks through disruptions in health and social services, employment, and housing stability. Our study aimed to explore how early and cumulative adverse life experiences, mental health challenges, and the pandemic shaped the experience of homelessness during pregnancy.

Methods: We used ​an action-oriented approach for this qualitative exploratory study. We conducted 20 in-depth semi-structured interviews in 2022 among a sample of pregnant, postpartum, and parenting people in Washington DC who experienced homelessness during the COVID-19 pandemic. We conducted a directed content analysis and utilized a life course perspective as the guiding analytic framework.

Results: We identified six themes: early family instability - childhood through adolescence, vulnerability and conflict as an emerging adult, economic precarity during adulthood, desire for intergenerational family stability and wellbeing, impacts of COVID on homelessness and housing instability for pregnant people, and mental health and housing instability during pregnancy.

Discussion: Findings highlight that homelessness during pregnancy reflects cumulative adversity which compound across the life course, with the potential to cause intergenerational consequences for maternal and infant health. Policies that ensure stable, safe housing during the perinatal period, integrated mental health care, and economic supports are urgently needed. We identify critical opportunities for policy and practice reforms, emphasizing the need for trauma-informed solutions using a life-course approach.

Objective: Cognitive decline has become a major concern with global population ageing, profoundly affecting quality of life and social participation in older adults. Resistance exercise has recently gained attention as a promising strategy to promote neuroplasticity and mitigate cognitive deterioration; however, evidence from randomized controlled trials (RCTs) remains inconsistent. This systematic review and meta-analysis aimed to evaluate the effects of resistance exercise on cognitive function in older adults and to examine whether improvements vary by age and whether exercise parameters-such as type, duration, session length, and weekly frequency-show dose-response relationships.

Methods: PubMed, Web of Science, Cochrane Library, Embase, and Science Direct were systematically searched from database inception to September 2024 for RCTs investigating the effects of resistance training on cognitive function in older adults (≥60 years). Study quality was assessed using the Cochrane Risk of Bias 2 (ROB2) tool, and meta-analyses were conducted using RevMan 5.4 and Stata 17.

Results: 17 RCTs (n =739) met the inclusion criteria. Pooled analyses showed that resistance training significantly improved overall cognitive function (SMD = 0.40, P < 0.05), working memory (SMD = 0.44, P < 0.001), verbal learning and memory (MD = 3.01, P < 0.001), and spatial memory span (SMD = 0.63, P < 0.001), whereas effects on processing speed, executive function, and attention were not significant (P > 0.05). Heterogeneity and publication bias analyses indicated stable and unbiased results.

Conclusion: Resistance exercise exerts selective benefits on cognitive domains in older adults, particularly enhancing overall cognition, working memory, verbal learning, and spatial memory. The magnitude of improvement appears to depend on age and exercise parameters, suggesting a potential dose-response relationship. These findings provide evidence-based guidance for resistance training into cognitive health promotion and rehabilitation programs for ageing populations.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023407397.

Introduction: Stillbirth is a traumatic experience for parents who expect to welcome a living baby into their family, but find out during their pregnancy or during birth that their baby has died. Some stillbirth literature focuses on the lived experiences of parents such as memory making activities; however, few articles offer peer advice to newly bereaved parents.

Methods: A self-administered online survey was utilized to collect parent-to-parent advice for newly bereaved parents. After data cleaning, 194 parent participant responses to the question "What should new loss parents know before the birth of their stillborn baby?" remained. Content analysis was used to analyze the responses.

Results: Content analysis generated four main clusters respondents felt newly bereaved parents should know before the birth of their stillborn baby: (1) the birthing process, (2) the decisions about their baby, (3) memory making activities, and (4) the emotions before and after their baby's birth.

Discussion: This manuscript builds on limited previous literature by focusing on advice parents who experienced the birth of a stillborn baby would give to new loss parents experiencing stillbirth before going to the hospital. Advice from parent participants may be helpful for newly bereaved parents, healthcare and mental health providers, and organizations or non-profits supporting newly bereaved families.

Background: The coupling between global blood-oxygen-level-dependent (gBOLD) signals and cerebrospinal fluid (CSF) flow has been established in humans and is thought to reflect the function of the brain's glymphatic system. This study aimed to investigate glymphatic system dysfunction in insomnia disorder (ID) and its correlation with clinical symptoms, and to evaluate whether transcranial direct current stimulation (tDCS) can modulate glymphatic system and alleviate insomnia.

Methods: We totally enrolled 33 IDs (20 females, 42.3±15.0 years) and 27 healthy controls (HCs, 15 females, 53.6±17.7 years). Among them, 19 IDs (9 females, 38.4±16.1 years) received 2-week tDCS treatment. gBOLD-CSF coupling strength was compared between groups and correlated with clinical scale scores (PSQI, PHQ-9, GAD-7). Changes in gBOLD-CSF coupling strength and clinical scores after tDCS were also examined.

Results: IDs showed significantly weaker gBOLD-CSF coupling than HCs (p=0.003). Coupling strength was negatively correlated with PSQI score (r=-0.363, p=0.045) and GAD-7 score (r=-0.435, p=0.014), but not with PHQ-9. After tDCS, patients exhibited significantly reducing in PSQI score(p=0.014), GAD-7 score (p=0.0001) and PHQ-9 score (p<0.0001), along with increasing in gBOLD-CSF coupling strength (p=0.002).

Conclusion: Our results indicate that IDs exhibit impaired glymphatic system function, as reflected by reduced gBOLD-CSF coupling strength. This reduction was correlated with the severity of both insomnia and anxiety symptoms. Moreover, we demonstrated that tDCS can not only improve symptoms of insomnia, anxiety, and depression but also enhance glymphatic activity in IDs.

Introduction: Emotion regulation is a key domain of social cognition, and its impairment contributes to poor psychosocial functioning in schizophrenia (SZ). The "Managing Emotions" (ME) branch of the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) is widely used to assess this ability, yet its neural correlates remain unclear.

Methods: We examined resting-state functional connectivity (rsFC) associated with MSCEIT-ME performance in 56 patients with schizophrenia and 56 healthy controls matched for age, sex, and years of education. Seed-based correlation analyses focused on three large-scale networks previously implicated in emotion regulation: the salience network (SN), the language network (LN), and the ventral attention network (VAN). Between-group differences and brain-behavior relationships were tested while controlling for IQ scores on the Wechsler Abbreviated Scale of Intelligence (WASI). False discovery rate Benjamini-Yekutieli (FDR-BY) correction was applied to all analyses.

Results: Patients with SZ scored significantly lower on the MSCEIT-ME compared to healthy subjects (HCs). Moreover, SZ patients exhibited reduced left-lateralized rsFC between SN and LN regions relative to HCs. These findings indicate altered language-salience connectivity in schizophrenia and show that, while connectivity is associated with emotion regulation ability in healthy individuals, no significant brain-behavior association was detected in patients. Therefore, the neural mechanisms underlying emotion regulation deficits in schizophrenia remain to be clarified.

Conclusion: Schizophrenia was characterized by altered left-lateralized language-salience connectivity. However, because no significant brain-behavior associations were found in patients, the neural basis of emotion-regulation deficits in schizophrenia remains unresolved, highlighting the need for network-level investigations in larger samples.

Neuroscientific explorations of the self acknowledge the central role of the body and dynamic sensory-motor interactions in sense of self and mental functioning. The multidimensional self-concept comprises pre-reflexive bodily dimensions scaffolding higher-order mental self-representations, which relate to and rely on movement-based relational foundations. Disruptions in ongoing self-constitution, development and expansion call for psychotherapeutic work that recognizes and utilizes dynamic bodily aspects, and formulation of personalized treatment plans. This manuscript discusses the brain-body-mind interface, encompassing experiential and temporal-spatial dynamics supported by integrated hierarchical neural processes, in line with predictive processing accounts. Epistemic affordances, or action possibilities, are anchored in neural mechanisms and interlaced with psychotherapeutic work facilitating the generation of predictive models of the body in the world. Movement within the peripersonal space is linked to self-modeling, along with insights into interoceptive awareness covering multimodal sensory-motor integration that facilitates emotional and cognitive processing. Bodily-anchored, and movement-based temporal aspects of the self are discussed in terms of the 'temporal thickness' of experience and further elaborated in relation to mental time travel and autobiographical memory. This grounds the analysis of the implicit and explicit movement within therapeutic relationships. Intersubjective neural mechanisms of mirror-simulation and synchronization are shown to be associated with kinesthetic empathy, embodied mentalization and communicative means of mirroring, attuning, and synchronizing movement. By bridging neuroscientific and clinical perspectives on the embodied, multifaceted dynamics across the nested dimensions of the self, this manuscript outlines pathways for transformative interventions that foster neuroplastic movement toward self-integration.

Background: Attention Deficit/Hyperactivity Disorder (ADHD) is a highly prevalent neurodevelopmental disorder, but its diagnosis remains constrained. This study aimed to identify potential candidate indicators and construct an interpretable machine learning model for the identification of ADHD.

Methods: A total of 8,598 children were enrolled and classified into three groups: ADHD (n=3,678), subthreshold ADHD (s-ADHD) (n=1,495), and healthy controls (HC) (n=3,425). Data collection covered 40 variables, including demographics, routine blood counts, serum biochemical parameters, body composition and systemic inflammation markers. Analysis of Variance (ANOVA) compared differences among the three groups, and key predictors were selected via Least Absolute Shrinkage and Selection Operator (LASSO) regression. Five machine learning models (Decision Tree, Random Forest, Multilayer Perceptron, Extreme Gradient Boosting, and Light Gradient Boosting Machine [LightGBM]) were developed for three clinically relevant binary classification tasks. SHapley Additive exPlanations (SHAP) values were applied to interpret the optimal model.

Results: ANOVA indicated significant differences (P < 0.05) in most parameters among the three groups. However, post-hoc Least Significant Difference (LSD) tests showed that compared with HC, the ADHD group showed elevated inflammatory markers (NLR, PLR, SII), glucose, body mass index(BMI), and body fat percentage, but reduced albumin, total cholesterol, and lymphocyte counts. Similar alterations were observed in the s-ADHD group, showing a pattern consistent with that of the ADHD group. LASSO regression (λ.1se=0.038) selected 11 core predictors, with age, RDW-SD, sex, calcium, glucose, and albumin among the most contributing variables. Among the models, LightGBM demonstrated the best performance when distinguishing ADHD from HC (AUC = 0.924 with 36 features vs. AUC = 0.885 with 11 features). However, the model failed to effectively distinguish between ADHD and s-ADHD.

Conclusions: This study reveals potential candidate indicators of ADHD and establishes an interpretable, low-cost machine learning model based on routine clinical data, offering a promising tool for early screening and clinical decision support.

Dissociation is a complex and transdiagnostic phenomenon defined as a disruption of, or discontinuity in, the normal, subjective integration of one or more aspects of psychological functioning. Dissociation has been identified as one of the most frequently occurring adverse effects associated with the use of esketamine nasal sprays. Individuals with high trait dissociation may be at a higher risk of experiencing an induced dissociative state and a significantly higher risk of experiencing severe induced dissociation. High esketamine-induced dissociation may act as a predictor of optimal therapeutic response, rather than solely an adverse effect. This case report describes an unusually intense and persistent dissociative reaction in a patient with histrionic personality disorder (HPD) undergoing esketamine therapy. The patient's marked dissociation upon treatment initiation raises the possibility that certain personality traits characteristic of HPD may heighten vulnerability to esketamine-induced dissociation. By explicitly examining a potential link between HPD and dissociation severity, this case highlights the importance of identifying patient-level factors that may amplify dissociative responses. Such knowledge has practical clinical implications for risk stratification, patient education regarding expected side effects, ensuring increased attention during the procedure.

Bipolar II disorder is traditionally understood as a condition of mood dysregulation, yet beneath its psychological manifestations lies a physiological rhythm often overlooked: the regulation of the autonomic nervous system. This perspective proposes that while bipolar II is not caused by a dysregulated nervous system, its course-and particularly the depth and duration of depressive episodes-is shaped by it. Drawing from psychophysiological literature and lived observation, the paper introduces the concept of regulation as modulation, suggesting that autonomic flexibility functions as a physiological buffer influencing mood stability over time. Heart-rate variability (HRV), vagal tone, and neurovisceral integration are discussed as key biomarkers linking emotional resilience and physiological coherence. When these systems are compromised, recovery from depressive episodes slows; when strengthened through conscious regulation-such as breathwork, interoception, grounding, and somatic awareness-recovery accelerates. The paper integrates evidence from existing studies on HRV and affective regulation with longitudinal self-monitoring data, noting consistent patterns between periods of autonomic dysregulation and the intensity of bipolar lows. This perspective argues that somatic regulation should be regarded as integral to treatment alongside medication and psychotherapy. Rather than framing regulation as auxiliary self-care, it should be viewed as a core therapeutic pathway that restores coherence between body and brain. For clinicians, this approach expands the framework of bipolar care; for researchers, it opens new avenues for investigating physiological mechanisms underlying mood stability. Ultimately, nervous-system regulation is not merely about achieving calm-it is about restoring rhythm, remembering safety, and redefining recovery for those living with bipolar II disorder.