Frontiers in Psychiatry最新文献

Background: This study aimed to investigate the functional connectivity characteristics of brain networks in secondary school students with depressive symptoms and to analyze the effects of exercise combined with virtual reality intervention on improving brain networks and emotional states, providing a neurobiological basis for early identification and precise intervention.

Methods: This study recruited 98 middle school students aged 13 to 18 as research subjects, including 50 in the subclinical depression (ScD) group and 48 in the healthy control (HC) group. The experimental intervention employed a 2×3 two-way mixed design analysis of variance (Two-way ANOVA). All exercise intervention groups underwent 15 minutes of moderate-intensity (50%-80% HRmax) power cycling training. The exercise intervention combined with virtual reality technology group completed their training in an immersive natural landscape environment. Resting-state EEG signals were recorded before and after the intervention, and emotional state changes were assessed using the Positive and Negative Affect Schedule (PANAS). The cerebral cortex was segmented into 78 regions based on the Schaefer template. Phase-locked value ( $PLV=\frac{1}{T}\left|{\sum }_{t=1}^T{e}^{i\left({\varphi }_i\right(t)-{\varphi }_j(t\left)\right)}\right|$ ) was used as a functional connectivity metric to quantify brain network synchrony in the theta, alpha, and beta frequency bands. Statistical comparisons were performed using independent samples t-tests and two-way analysis of variance (ANOVA).

Results: Exercise intervention combined with virtual reality technology significantly improved θ and α band SMN-DMN, DAN-SN connectivity, and DMN/DAN activity (p < 0.05), outperforming conventional exercise. β band SMN-DMN and CEN-DMN activity increased (p< 0.05). The exercise intervention combined with virtual reality technology significantly increased positive emotions (t = -22.351, p < 0.05) and reduced negative emotions (t = 27.257, p < 0.001).

Conclusion: Depressive symptoms in adolescents are associated with multifrequency brain network dysregulation. Combining exercise intervention with virtual reality technology (VR-EI) optimizes key brain network connectivity and activity in the theta and alpha bands through multisensory stimulation. Its mood-enhancing effects surpass those of conventional exercise, offering a promising new strategy for personalized intervention in adolescent depression.

This descriptive article offers an inside perspective of the experience of writing a publishable paper by an autistic early-career researcher. From an external perspective, this experience might be described as involving hyperfocus, indecision about framing, and conflicting norms of academic writing. The article develops an inside perspective on such experiences. The author adopts a philosophical approach, using phenomenological reflection on breakdowns as a method to explicate what is implicitly given in experience. Reflection on three types of research breakdown in academic writing results in an inside description of the complexities of this particular experience by someone who is both autistic and an academic researcher.

Objectives: The 7-item Hamilton Depression Rating Scale (HAM-D7) is commonly used to assess depression severity and remission; however, its standard cut-off scores may not be optimal for elderly populations. This study aimed to establish GRID-HAM-D7 remission thresholds among elderly Thai patients diagnosed with depressive disorders, including both any depressive disorder and major depressive disorder (MDD).

Methods: A total of 803 elderly participants were recruited from four tertiary care hospitals across Thailand as part of a larger psychiatric study. Diagnoses were determined using the Mini International Neuropsychiatric Interview, and depression severity was assessed via the GRID-HAM-D7. Statistical analyses, including sensitivity, specificity, predictive values, and Receiver Operating Characteristic curves, were performed to determine optimal remission cut-off scores.

Results: For any depressive disorder, a GRID-HAM-D7 score of ≤ 4 yielded sensitivities of 88.86% and specificity of 77.66%. In major depressive disorder, the optimal threshold was ≤ 6, resulting in 91.68% sensitivity and 79.73% specificity. Both values surpassed the diagnostic accuracy of conventional lower thresholds. These results suggest that higher GRID-HAM-D7 remission cut-offs better reflect depressive symptomatology in older adults.

Conclusions: The study underscores the necessity of tailoring standardized assessment tools for specific populations to enhance clinical management and decision-making in geriatric psychiatry.

Deprivation of sleep (DS) is widespread in modern societies and is associated with cardiometabolic, cognitive, and psychiatric disturbances. Acute DS has also been reported to produce short-lived improvements in mood in some individuals with depression, suggesting the involvement of specific biological mediators. Ghrelin, a stomach-derived peptide with central actions in hypothalamic and limbic circuits, has emerged as a candidate linking DS with alterations in sleep, circadian regulation, mood, and cognition. Both acylated and unacylated isoforms exhibit distinct biological activities, and accumulating evidence points to roles in sleep architecture, stress responsivity, and neuroplasticity, as well as in disorders such as insomnia, obstructive sleep apnea, and narcolepsy. Experimental studies indicate that DS frequently coincides with changes in circulating ghrelin, although findings remain heterogeneous and influenced by methodological and contextual factors. Overall, ghrelin may contribute to the pathways through which DS influences emotional regulation and cognitive functioning. A more detailed understanding of its isoform-specific, sex-dependent, and circadian-stage effects could help guide future research and support the development of therapeutic approaches that complement existing strategies for mood and sleep disorders.

Objective: Xanomeline and trospium (XT) is a novel medication for schizophrenia that was approved by the United States (U.S.) Food and Drug Administration (FDA) in September 2024. The purpose of this study is to evaluate the effectiveness and safety of using XT in the Texas state hospital setting.

Methods: Data were analyzed retrospectively from five hospitals within the Texas Health and Human Services Commission state hospital system. Adults aged ≥ 18 years administered XT between October 2024 and October 2025 were included. A chart extracted Clinical Global Impression (CGI) of Severity of Illness/Improvement was used to determine XT effectiveness. Patient demographics, clinical characteristics and documented adverse effects are reported.

Results: All patients (N = 20) had treatment-resistant schizophrenia and were classified as markedly or severely ill prior to XT initiation. All patients except one were prescribed ≥ 1 dopamine receptor blocking agents (DRBA)s while taking XT, with olanzapine (n=9; 45%) and clozapine (n=6; 30%) being most common. Fourteen patients (70%) discontinued XT during the study time frame due to intolerability (n=9; 45%) and/or lack of effectiveness (n=12; 60%). The average global improvement CGI score was 4 (no change). Gastrointestinal side-effects were most common, specifically, vomiting (n=9; 45%), dyspepsia (n=5; 25%), and sialorrhea (n=5; 25%).

Conclusion: In inpatients with TRS taking adjunct DRBAs (including anticholinergic DRBAs) XT use was commonly discontinued due to intolerability/ineffectiveness. Larger controlled trials are needed to further investigate XT's effectiveness for treating TRS and determine how adjunct anticholinergic use impacts its safety/efficacy.

Introduction: The lack of objective biomarkers and mechanistic understanding of adolescent Major Depressive Disorder (MDD) impedes early diagnosis and targeted intervention.

Methods: To elucidate peripheral molecular biomarkers for adolescent MDD, we performed RNA sequencing on peripheral blood mononuclear cells (PBMCs) from 15 adolescents with MDD and 15 age- and sex-matched healthy controls. Differential expression analysis and protein-protein interaction (PPI) network construction were utilized to identify key regulatory genes. The expression of core targets was validated using RT-qPCR and ELISA. To establish a robust diagnostic model, an integrated feature selection strategy combining Least Absolute Shrinkage and Selection Operator (LASSO), Support Vector Machine-Recursive Feature Elimination (SVM-RFE), and Random Forest algorithms was applied to screen candidate biomarkers.

Results: Transcriptomic profiling identified 367 differentially expressed genes characterized by a dual signature of innate immune activation and compensatory hypoxic responses. Eight core hub genes were identified and experimentally validated, revealing a dichotomous expression pattern: upregulation of erythroid-related and inflammatory factors (SLC4A1, HBB, GYPA, IL6) and downregulation of neurotrophic and remodeling factors (IGF1, CSF2, MMP9, CXCR1). Notably, lower expression levels of MMP9 and CXCR1 were significantly correlated with higher Hamilton Depression Rating Scale (HAMD) scores, indicating greater symptom severity. The multi-algorithm machine learning approach identified a consensus three-gene diagnostic panel comprising SLC4A1, IGF1, and MMP9, which achieved a high classification accuracy with an Area Under the Curve (AUC) of 0.867.

Conclusion: This study delineates a systemic molecular landscape of adolescent MDD defined by the coexistence of hypoxic compensation and neurotrophic/remodeling failure. The identified three-gene biosignature (SLC4A1, IGF1, MMP9) offers a promising, objective tool for the early diagnosis of adolescent depression, highlighting the immune-metabolic interface as a critical avenue for future precision medicine.

Auditory verbal hallucinations (AVH) are a core symptom of schizophrenia and contribute substantially to patient suffering and disability. They are among the most persistent symptoms and do not respond to medication in a substantial portion of patients. Here, we report the application of task-based functional magnetic resonance imaging (fMRI)-guided repetitive transcranial magnetic stimulation (rTMS) in a patient with treatment-resistant AVH. An individualized stimulation target was identified in the left temporal cortex near Heschl's gyrus using a validated fMRI task. Over a period of 18 months, the patient underwent three cycles of inhibitory 1 Hz rTMS of this target. As a result, AVH severity decreased by 33% and the global symptom score improved by 40%. Functional connectivity analyses revealed an increase in coupling between the temporal target seed and a fronto-cingulate-insular network that has been implicated in reality and performance monitoring. This case highlights the potential of fMRI-guided rTMS as a personalized neuromodulatory therapy for refractory AVH in schizophrenia, warranting further systematic investigation.

Introduction: Suicide is a leading global cause of mortality (~800,000 deaths annually) driven by complex biological and environmental determinants; although microRNAs (miRNAs) regulate gene expression implicated in psychiatric disorders, their contributions to suicidality-related phenotypes remain incompletely defined.

Methods: We searched Web of Science, PubMed, Scopus, Embase, and Ovid through July 14, 2025, for human case-control studies comparing individuals with suicidality-related phenotypes to non-suicidal controls. Risk of bias was assessed with the Newcastle-Ottawa Scale. Differentially expressed miRNAs were compiled and analyzed to identify brain-specific gene targets, followed by pathway and disease enrichment.

Results: Of 1,437 records screened, 13 studies met inclusion criteria, encompassing 285 suicidal participants and 291 controls. Across studies, 43 unique miRNAs showed significant differential expression between cases and controls. Three miRNAs-miR-30a, miR-30e, and miR-218-were consistently dysregulated across brain samples from individuals who died by suicide. Bioinformatic analyses indicated that these miRNAs converge on brain-expressed targets and processes relevant to psychiatric biology. Enrichment highlighted pathways involved in transcriptional regulation, forkhead box O (FoxO) signaling, Ras-associated protein-1 (Rap1) signaling, long-term depression, and dopaminergic synapse function.

Conclusion: miR-30a, miR-30e, and miR-218 emerge as recurrently altered miRNAs in suicide and may serve as mechanistic mediators and candidate biomarkers. Mapping their brain-specific targets and enriched pathways suggests actionable avenues for risk stratification and therapeutic development.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier PROSPERO CRD42024582398.

Introduction: Tinnitus is commonly accompanied by emotional distress and sleep disturbances, yet the extent to which these characteristics relate to cochlear electrophysiologic findings remains unclear. This study examined associations between electrophysiologic measures and emotional and sleep parameters in adults with subjective tinnitus.

Methods: This retrospective study included 120 adults with tinnitus. Data collected included demographics, cochlear electrophysiologic measures (electrocochleography and auditory brainstem response), emotional characteristics (perceived stress, depressive symptoms, anxiety, emotion regulation), and sleep parameters (sleep quality, insomnia severity, daytime sleepiness). Correlation analyses and multivariate regression models were applied.

Results: The mean age of the cohort was 62.35 years (SD 9.45), and 64.17% were male. A very weak negative correlation was observed between depressive symptoms and Wave III latency (r = -0.196, P = 0.03), but the small magnitude suggests minimal explanatory value. The summating potential/action potential ratio was not significantly correlated with sleep quality (r = -0.181, P = 0.05). In multivariate models, anxiolytic use was associated with a lower risk of poor sleep (adjusted odds ratio [aOR] = 0.262; 95% confidence interval [CI]: 0.078-0.881; P = 0.030), whereas antidepressant use was associated with a higher risk (aOR = 2.628; 95% CI: 1.027-6.724; P = 0.044). For insomnia, higher pure-tone average thresholds (aOR = 0.948 per dB; 95% CI: 0.906-0.992; P = 0.007) and hearing aid use (aOR = 3.396; 95% CI: 1.085-10.623; P = 0.036) were significant determinants. The only significant factor associated with quality of life was tinnitus duration, with longer duration associated with lower WHOQOL-BREF scores (β = -2.74; P = 0.020). No electrophysiologic parameter demonstrated significant associations in the multivariate models.

Conclusion: Within the constraints of this study, cochlear electrophysiologic measures showed limited observable associations with emotional or sleep characteristics. Factors related to hearing status and medication use demonstrated stronger statistical associations with sleep outcomes, while tinnitus duration was linked to quality-of-life scores. These findings contribute to the growing body of descriptive evidence on tinnitus-related characteristics, although further research with larger cohorts and longitudinal designs is needed to clarify these relationships.

Empathic pain is defined as the experience of vicarious pain resulting from the observation of another person's suffering, and it involves complex neurobiological pathways that parallel those involved in direct pain perception. The intricate link between nonsuicidal self-injury (NSSI) and empathic pain lies in the fact that they share certain neurobiological mechanisms, particularly in the areas of emotion regulation and pain perception, and both phenomena involve brain networks involved in pain processing, emotion regulation, and social cognition. This review examines the current understanding of these mechanisms, including cellular and molecular pathways, changes in neural networks, and factors that influence the development of empathic pain. It also explores potential therapeutic strategies to address the complex interactions between empathic pain and NSSI, focusing on psychological interventions, pharmacological approaches, and novel neurostimulation techniques.