Pub Date : 2025-11-26DOI: 10.1001/jamapsychiatry.2025.3580
Akira Sawa,Kun Yang,Nicola G Cascella,Toshifumi Tomoda
{"title":"Autophagy in Stress-Induced Neuropsychiatric Disorders and Depression.","authors":"Akira Sawa,Kun Yang,Nicola G Cascella,Toshifumi Tomoda","doi":"10.1001/jamapsychiatry.2025.3580","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.3580","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"1 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145599780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-26DOI: 10.1001/jamapsychiatry.2025.3584
Erin J Stringfellow,Tse Yang Lim,Zeynep Hasgul,Mohammad S Jalali
{"title":"Structural Drivers of the Drop in Opioid Overdose Deaths in the US.","authors":"Erin J Stringfellow,Tse Yang Lim,Zeynep Hasgul,Mohammad S Jalali","doi":"10.1001/jamapsychiatry.2025.3584","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.3584","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"103 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145599781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-26DOI: 10.1001/jamapsychiatry.2025.3572
Stephen R Marder,Sean Ostlund
{"title":"Dopamine-Blocking Antipsychotics-Time for a New Conversation With Patients?","authors":"Stephen R Marder,Sean Ostlund","doi":"10.1001/jamapsychiatry.2025.3572","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.3572","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"67 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145599783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-26DOI: 10.1001/jamapsychiatry.2025.3575
Mark Olfson,Chandler McClellan,Samuel H Zuvekas,Carlos Blanco
ImportanceAlthough the recent proliferation of telemental health care has transformed the delivery of outpatient mental health care for many individuals in the US, little is known about how outpatients are distributed across telehealth, hybrid, and in-person care.ObjectiveTo characterize the national distribution of sociodemographic and clinical outpatient mental health groups across telehealth, hybrid, and in-person mental health care.Design, Setting, and ParticipantsThis was a cross-sectional analysis of all telehealth, hybrid, and all in-person mental health care by adults (aged ≥18 years) in the 2021-2022 Medical Expenditure Panel Survey (n = 4720). Data were analyzed from January to August 2025.Main Outcomes and MeasuresAverage annual percentages of adult mental health outpatients who used all telemental health care, hybrid, and all in-person mental health care were calculated overall and stratified by sociodemographic and clinical characteristics. Differences in percentages using each modality were evaluated by sociodemographic and clinical strata adjusted for age, sex, and distress level (Kessler-6 scale).ExposuresType of mental health treatment used (telemental health, hybrid, or in-person).ResultsThe analysis involved 4720 participants (2235 aged 18-44 years; 3007 female). Approximate one-fourth (27.8%; 95% CI, 25.7-29.8) of mental health outpatients received all telemental health care, 21.5% (95% CI, 19.8-23.1) received hybrid care, and 50.6% (95% CI, 48.2-53.1) received all in-person care. The percentage of patients receiving all telemental health care was higher for younger (aged 18-44 years; 31.7%; 95% CI, 29.0-34.3) than middle age (aged 45-64 years; 24.2%; 95% CI, 21.1-27.4) or older (aged ≥65 years; 19.4%; 95% CI, 16.1-22.7) adults, high school (23.1% 95% CI, 20.4-25.8) and college (34.5%; 95% CI, 31.5-37.5) graduates than those without a high school diploma (19.9%; 95% CI, 13.7-26.1), patients with incomes >400% federal poverty level (33.8%; 95% CI, 30.9-36.7) than lower (range, 20.6% to 23.7%), private (30.8%; 95% CI, 28.5-33.1) than public (20.2%; 95% CI, 17.4-23.0) insurance, and urban (29.2%; 95% CI, 27.0-31.3) than rural (14.0%; 95% CI, 8.6-19.3) residence. Compared to patients receiving medication alone (15.4%; 95% CI, 12.5-18.3), those receiving psychotherapy with (25.9%; 95% CI, 23.2-28.6) or without (41.6%; 95% CI, 38.0-45.2) medication were more likely to use all telemental health. Patients with less than moderate distress (29.2%; 95% CI, 26.1-32.3) were also more likely than those with serious distress (21.2%; 95% CI, 16.7-25.6) to use all telemental health. In adjusted analyses, patients treated by mental health counselors (10.9%; 95% CI, 7.0-14.7) or social workers (8.4%; 95% CI, 4.1-12.7) were also more likely to receive all telemental health than were patients treated by other mental health clinicians.Conclusions and RelevanceThe findings of this cross-sectional study indicate that telehealth has become a common me
{"title":"Telemental Health, Hybrid, and In-Person Outpatient Mental Health Care in the US.","authors":"Mark Olfson,Chandler McClellan,Samuel H Zuvekas,Carlos Blanco","doi":"10.1001/jamapsychiatry.2025.3575","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.3575","url":null,"abstract":"ImportanceAlthough the recent proliferation of telemental health care has transformed the delivery of outpatient mental health care for many individuals in the US, little is known about how outpatients are distributed across telehealth, hybrid, and in-person care.ObjectiveTo characterize the national distribution of sociodemographic and clinical outpatient mental health groups across telehealth, hybrid, and in-person mental health care.Design, Setting, and ParticipantsThis was a cross-sectional analysis of all telehealth, hybrid, and all in-person mental health care by adults (aged ≥18 years) in the 2021-2022 Medical Expenditure Panel Survey (n = 4720). Data were analyzed from January to August 2025.Main Outcomes and MeasuresAverage annual percentages of adult mental health outpatients who used all telemental health care, hybrid, and all in-person mental health care were calculated overall and stratified by sociodemographic and clinical characteristics. Differences in percentages using each modality were evaluated by sociodemographic and clinical strata adjusted for age, sex, and distress level (Kessler-6 scale).ExposuresType of mental health treatment used (telemental health, hybrid, or in-person).ResultsThe analysis involved 4720 participants (2235 aged 18-44 years; 3007 female). Approximate one-fourth (27.8%; 95% CI, 25.7-29.8) of mental health outpatients received all telemental health care, 21.5% (95% CI, 19.8-23.1) received hybrid care, and 50.6% (95% CI, 48.2-53.1) received all in-person care. The percentage of patients receiving all telemental health care was higher for younger (aged 18-44 years; 31.7%; 95% CI, 29.0-34.3) than middle age (aged 45-64 years; 24.2%; 95% CI, 21.1-27.4) or older (aged ≥65 years; 19.4%; 95% CI, 16.1-22.7) adults, high school (23.1% 95% CI, 20.4-25.8) and college (34.5%; 95% CI, 31.5-37.5) graduates than those without a high school diploma (19.9%; 95% CI, 13.7-26.1), patients with incomes >400% federal poverty level (33.8%; 95% CI, 30.9-36.7) than lower (range, 20.6% to 23.7%), private (30.8%; 95% CI, 28.5-33.1) than public (20.2%; 95% CI, 17.4-23.0) insurance, and urban (29.2%; 95% CI, 27.0-31.3) than rural (14.0%; 95% CI, 8.6-19.3) residence. Compared to patients receiving medication alone (15.4%; 95% CI, 12.5-18.3), those receiving psychotherapy with (25.9%; 95% CI, 23.2-28.6) or without (41.6%; 95% CI, 38.0-45.2) medication were more likely to use all telemental health. Patients with less than moderate distress (29.2%; 95% CI, 26.1-32.3) were also more likely than those with serious distress (21.2%; 95% CI, 16.7-25.6) to use all telemental health. In adjusted analyses, patients treated by mental health counselors (10.9%; 95% CI, 7.0-14.7) or social workers (8.4%; 95% CI, 4.1-12.7) were also more likely to receive all telemental health than were patients treated by other mental health clinicians.Conclusions and RelevanceThe findings of this cross-sectional study indicate that telehealth has become a common me","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"148 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145599974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-26DOI: 10.1001/jamapsychiatry.2025.3565
Kenneth S Kendler,Henrik Ohlsson,Jan Sundquist,Kristina Sundquist
ImportanceTraditional adoption studies examine disorder-to-disorder parent-offspring transmission. The role of parental genetic risk in offspring disorder transmission can capture indirect genetic effects from parental genotype to parental phenotype to offspring risk.ObjectiveTo assess the relative importance of genetic and rearing effects from paternal family genetic risk scores (FGRSs) in 3 pairs of disorders: internalizing (major depression [MD] and anxiety disorders [AD]), substance use (alcohol use disorder [AUD] and drug use disorder [DUD]), and severe (bipolar disorder [BD] and schizophrenia [SZ]).Design, Setting, and ParticipantsThis cohort study examined fathers in intact families, not-lived-with fathers, stepfathers, adoptive fathers of adoptees, and biological fathers of adoptees, all born in Sweden, and their biological and adoptive offspring born between 1955 and 1990 using data from Swedish National Registries. Follow-up extended through December 2018. Data were analyzed from May to August 2025.ExposuresPaternal FGRSs for MD, AD, AUD, DUD, BD, and SZ.Main Outcomes and MeasuresCox proportional hazard ratios (HRs) for offspring diagnoses focusing on the paternal effect of genes-and-rearing fathers in intact families, genes only (not-lived-with fathers and biological fathers of adoptees), and rearing only (stepfathers and adoptive fathers of adoptees).ResultsThe study sample included 2 584 384 offspring (mean [SD] age at follow-up, 41.7 [10.5] years; 1 329 558 [51.5%] male). We present results for MD, AUD, and BD with findings broadly similar for, respectively, AD, DUD, and SZ. The HRs (95% CIs) for genes and rearing fathers, genes-only, and rearing-only relationships were, respectively, for MD 1.19 (1.18-1.19), 1.13 (1.12-1.15), and 1.02 (1.01-1.04); for AUD 1.25 (1.25-1.26), 1.16 (1.14-1.18), and 1.08 (1.06-1.09), and for BD, 1.19 (1.18-1.20), 1.17 (1.14-1.20), and 1.01 (0.98-1.05). In rearing-only relationships, offspring risks for MD and AUD were significantly predicted by paternal genetic risk for DUD, AUD, AD, and MD, while offspring risk for BD was not predicted by any paternal genetic risk.Conclusions and RelevanceUsing a more incisive measure of genetic effects, the novel adoption design used in this cohort study provides findings broadly similar to traditional adoption models. Rearing effects were strongest for substance use disorders, modest for internalizing disorders, and absent for severe disorders. Indirect genetic effects in the father on offspring risk were clearly observed and were not diagnostically specific. In rearing-only paternal-offspring relationships, elevated paternal genetic risk for internalizing and substance use disorders increased offspring risk for MD and AUD.
{"title":"A Genetic Risk Adoption Design for Psychiatric and Substance Use Disorders.","authors":"Kenneth S Kendler,Henrik Ohlsson,Jan Sundquist,Kristina Sundquist","doi":"10.1001/jamapsychiatry.2025.3565","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.3565","url":null,"abstract":"ImportanceTraditional adoption studies examine disorder-to-disorder parent-offspring transmission. The role of parental genetic risk in offspring disorder transmission can capture indirect genetic effects from parental genotype to parental phenotype to offspring risk.ObjectiveTo assess the relative importance of genetic and rearing effects from paternal family genetic risk scores (FGRSs) in 3 pairs of disorders: internalizing (major depression [MD] and anxiety disorders [AD]), substance use (alcohol use disorder [AUD] and drug use disorder [DUD]), and severe (bipolar disorder [BD] and schizophrenia [SZ]).Design, Setting, and ParticipantsThis cohort study examined fathers in intact families, not-lived-with fathers, stepfathers, adoptive fathers of adoptees, and biological fathers of adoptees, all born in Sweden, and their biological and adoptive offspring born between 1955 and 1990 using data from Swedish National Registries. Follow-up extended through December 2018. Data were analyzed from May to August 2025.ExposuresPaternal FGRSs for MD, AD, AUD, DUD, BD, and SZ.Main Outcomes and MeasuresCox proportional hazard ratios (HRs) for offspring diagnoses focusing on the paternal effect of genes-and-rearing fathers in intact families, genes only (not-lived-with fathers and biological fathers of adoptees), and rearing only (stepfathers and adoptive fathers of adoptees).ResultsThe study sample included 2 584 384 offspring (mean [SD] age at follow-up, 41.7 [10.5] years; 1 329 558 [51.5%] male). We present results for MD, AUD, and BD with findings broadly similar for, respectively, AD, DUD, and SZ. The HRs (95% CIs) for genes and rearing fathers, genes-only, and rearing-only relationships were, respectively, for MD 1.19 (1.18-1.19), 1.13 (1.12-1.15), and 1.02 (1.01-1.04); for AUD 1.25 (1.25-1.26), 1.16 (1.14-1.18), and 1.08 (1.06-1.09), and for BD, 1.19 (1.18-1.20), 1.17 (1.14-1.20), and 1.01 (0.98-1.05). In rearing-only relationships, offspring risks for MD and AUD were significantly predicted by paternal genetic risk for DUD, AUD, AD, and MD, while offspring risk for BD was not predicted by any paternal genetic risk.Conclusions and RelevanceUsing a more incisive measure of genetic effects, the novel adoption design used in this cohort study provides findings broadly similar to traditional adoption models. Rearing effects were strongest for substance use disorders, modest for internalizing disorders, and absent for severe disorders. Indirect genetic effects in the father on offspring risk were clearly observed and were not diagnostically specific. In rearing-only paternal-offspring relationships, elevated paternal genetic risk for internalizing and substance use disorders increased offspring risk for MD and AUD.","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"19 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145599782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-19DOI: 10.1001/jamapsychiatry.2025.3439
Claudia Liu,John Torous,Matthew Fuller-Tyszkiewicz,Mariel Messer,Cleo Anderson,Olivia M Soliman,Jake Linardon
ImportanceRandomized clinical trials (RCTs) support apps as scalable, cost-efficient tools for managing depression and anxiety, but concerns about engagement and attrition remain. With the field's rapid growth, there is now an opportunity to generate more precise insights on uptake, attrition, and adherence.ObjectiveTo examine patterns of uptake (initial activation of the app), adherence (use meeting the trial's definition of adequate engagement), and attrition (failure to complete outcome assessments) from RCTs of mental health apps for depression and anxiety.Data SourcesStudies were identified from a 2024 review of RCTs on depression and anxiety apps (search through January 2024), with an updated search in Medline and PsycINFO conducted from January 2024 to May 2025.Study SelectionTrials of mental health apps delivered to participants with depression or anxiety were eligible if they reported rates of uptake, adherence, or attrition.Data Extraction and SynthesisStudy characteristics were extracted by 2 independent reviewers. The Cochrane Risk of Bias tool was used. Meta-analyses were conducted using multilevel random-effects models.Main Outcomes and MeasuresMeta-analyses were conducted on app uptake, posttest and follow-up attrition, and adherence. Absolute rates were estimated using pooled event rates, while relative rates (apps vs controls on attrition) were calculated using pooled risk ratios.ResultsSeventy-nine trials, including 92 app conditions and 78 control conditions, were included (k = 39 for depression, k = 26 for anxiety, and k = 14 for transdiagnostic samples). The meta-analytic rate of app uptake was 92.4% (95% prediction interval [PI], 48.4%-99.4%) from 56 conditions. The meta-analytic rate of app adherence was 61.8% (95% PI, 53.2%-69.7%) from 21 conditions. The meta-analytic posttest attrition rate was 18.6% (95% PI, 2.4%-68.3%), and at follow-up, it was 28.4% (95% PI, 3.0%-83.7%). Attrition rates were lower among trials that offered reminders, human contact, and no gamification features. Attrition was higher in app conditions than wait-lists (risk ratio, 1.49; 95% PI, 0.34-6.48) but did not differ significantly to other controls.Conclusions and RelevanceThe findings of this meta-analysis offer benchmarks for future trial planning while highlighting modifiable design features that may enhance user engagement.
{"title":"Uptake, Adherence, and Attrition in Clinical Trials of Depression and Anxiety Apps: A Systematic Review and Meta-Analysis.","authors":"Claudia Liu,John Torous,Matthew Fuller-Tyszkiewicz,Mariel Messer,Cleo Anderson,Olivia M Soliman,Jake Linardon","doi":"10.1001/jamapsychiatry.2025.3439","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.3439","url":null,"abstract":"ImportanceRandomized clinical trials (RCTs) support apps as scalable, cost-efficient tools for managing depression and anxiety, but concerns about engagement and attrition remain. With the field's rapid growth, there is now an opportunity to generate more precise insights on uptake, attrition, and adherence.ObjectiveTo examine patterns of uptake (initial activation of the app), adherence (use meeting the trial's definition of adequate engagement), and attrition (failure to complete outcome assessments) from RCTs of mental health apps for depression and anxiety.Data SourcesStudies were identified from a 2024 review of RCTs on depression and anxiety apps (search through January 2024), with an updated search in Medline and PsycINFO conducted from January 2024 to May 2025.Study SelectionTrials of mental health apps delivered to participants with depression or anxiety were eligible if they reported rates of uptake, adherence, or attrition.Data Extraction and SynthesisStudy characteristics were extracted by 2 independent reviewers. The Cochrane Risk of Bias tool was used. Meta-analyses were conducted using multilevel random-effects models.Main Outcomes and MeasuresMeta-analyses were conducted on app uptake, posttest and follow-up attrition, and adherence. Absolute rates were estimated using pooled event rates, while relative rates (apps vs controls on attrition) were calculated using pooled risk ratios.ResultsSeventy-nine trials, including 92 app conditions and 78 control conditions, were included (k = 39 for depression, k = 26 for anxiety, and k = 14 for transdiagnostic samples). The meta-analytic rate of app uptake was 92.4% (95% prediction interval [PI], 48.4%-99.4%) from 56 conditions. The meta-analytic rate of app adherence was 61.8% (95% PI, 53.2%-69.7%) from 21 conditions. The meta-analytic posttest attrition rate was 18.6% (95% PI, 2.4%-68.3%), and at follow-up, it was 28.4% (95% PI, 3.0%-83.7%). Attrition rates were lower among trials that offered reminders, human contact, and no gamification features. Attrition was higher in app conditions than wait-lists (risk ratio, 1.49; 95% PI, 0.34-6.48) but did not differ significantly to other controls.Conclusions and RelevanceThe findings of this meta-analysis offer benchmarks for future trial planning while highlighting modifiable design features that may enhance user engagement.","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"107 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145545265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-19DOI: 10.1001/jamapsychiatry.2025.3459
Brandan K Penaluna,Robert J Morgan,Nicholas D Allen
{"title":"Enough to Promote Changes to Current Management of Catatonia?","authors":"Brandan K Penaluna,Robert J Morgan,Nicholas D Allen","doi":"10.1001/jamapsychiatry.2025.3459","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.3459","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"1 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145545266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-19DOI: 10.1001/jamapsychiatry.2025.3456
Satish Suhas,Guru S Gowda,Venkata Senthil Kumar Reddi
{"title":"Enough to Promote Changes to Current Management of Catatonia?-Reply.","authors":"Satish Suhas,Guru S Gowda,Venkata Senthil Kumar Reddi","doi":"10.1001/jamapsychiatry.2025.3456","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.3456","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"129 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145545263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ImportanceClose social relationships are linked to improved individual health and even longevity. These effects are hypothesized to be mediated through improved neuroendocrine and immune functioning, particularly in individuals who engage in positive and affectionate interactions. However, systematic data examining these factors in humans are currently lacking.ObjectiveTo investigate the interacting effects of repeated intranasal oxytocin administration, a behavioral microintervention, and daily physical intimacy on neuroendocrine stress responses and dermatological wound healing.Design, Setting, and ParticipantsThis randomized clinical trial was a double-blind, randomized, placebo-controlled study whereby participants completed 3 laboratory visits and a 5-day ecological momentary assessment (EMA). During the first laboratory visit, participants received 4 small suction-blister wounds applied to their forearms. Data were collected from November 20, 2011, to July 25, 2013; final analyses were conducted from December 2023 to February 2025.InterventionsOver the following 7 days, participants were instructed to self-administer either oxytocin or a placebo twice daily and to engage in structured positive interaction (Partner Appreciation Task [PAT]) up to 3 times in total or not.Main Outcomes and MeasuresWound healing was assessed at 24 hours and 7 days after wounding. Throughout the week, participants collected saliva samples for cortisol analyses and reported their stress levels and experiences of partner interaction 6 times per day (5760 measurement points in total).ResultsThe volunteer sample was 80 healthy, heterosexual couples (N = 160 participants, mean [SD] age, 27.6 [5.0] years). Couples in the PAT condition who received daily oxytocin showed improved wound healing (b = -0.125, t286 = -1.983; P = .048). However, these effects were not consistently robust in sensitivity analyses (b = -0.090, t282 = -1.643; P = .10). Notably, the administration of oxytocin combined with daily affectionate touch (b = -0.038, t137 = -2.091; P = .04) and sexual activity (b = -0.145, t137 = -2.122; P = .04) was linked to a reduction in wound severity. These associations remained largely consistent in sensitivity analyses (affectionate touch: b = -0.037, t135 = -2.057; P = .04; sexual activity: b = -0.131, t135 = -1.900; P = .06). Additionally, greater sexual activity was associated with reduced daily cortisol levels (b = -373.084, t488 = -2.813; P = .005).Conclusions and RelevanceThis study found that intimate physical contact can reduce cortisol responses and, along with oxytocin administration, promote wound healing. These findings provide a foundation for future interventions that integrate relationship dynamics and neurohormonal modulation to improve health and recovery from illness.Trial RegistrationClinicalTrials.gov Identifier: NCT01594775.
密切的社会关系与个人健康状况的改善甚至寿命的延长有关。这些影响被假设是通过改善神经内分泌和免疫功能来调节的，特别是在那些参与积极和深情互动的个体中。然而，目前还缺乏在人类中检查这些因素的系统数据。目的探讨反复鼻内注射催产素、行为微干预和日常肢体亲密对神经内分泌应激反应和皮肤创面愈合的相互作用。设计、环境和参与者本随机临床试验是一项双盲、随机、安慰剂对照研究，参与者完成3次实验室访问和5天生态瞬时评估（EMA）。在第一次实验室访问期间，参与者在前臂上接受了4个小的吸吮性水泡伤口。数据采集时间为2011年11月20日至2013年7月25日；最终分析于2023年12月至2025年2月进行。干预措施在接下来的7天里，参与者被指示每天两次自我使用催产素或安慰剂，并参与结构化的积极互动（伴侣欣赏任务[PAT]），总共最多3次或不3次。主要观察结果和测量方法分别于伤口愈合后24小时和7天进行评估。整个星期，参与者收集唾液样本进行皮质醇分析，并报告他们的压力水平和伴侣互动的经历，每天6次（总共5760个测量点）。结果志愿者样本为80对健康的异性恋夫妇（N = 160），平均[SD]年龄27.6[5.0]岁。PAT组每日接受催产素治疗的夫妻伤口愈合改善（b = -0.125, t286 = -1.983; P = 0.048）。然而，这些效应在敏感性分析中并不稳定（b = -0.090, t282 = -1.643; P = .10）。值得注意的是，催产素与日常爱抚相结合(b = -0.038, t137 = -2.091；04)和性活动(b = -0.145, t137 = -2.122; P =。04)与伤口严重程度的降低有关。这些关联在敏感性分析中基本保持一致（深情触摸：b = -0.037, t135 = -2.057; P = 0.04；性行为：b = -0.131, t135 = -1.900; P = 0.06）。此外，更频繁的性活动与每日皮质醇水平降低相关（b = -373.084, t488 = -2.813; P = 0.005）。本研究发现，亲密的身体接触可以降低皮质醇的反应，并与催产素一起促进伤口愈合。这些发现为未来整合关系动力学和神经激素调节的干预提供了基础，以改善健康和从疾病中恢复。临床试验注册号：NCT01594775。
{"title":"Intranasal Oxytocin and Physical Intimacy for Dermatological Wound Healing and Neuroendocrine Stress: A Randomized Clinical Trial.","authors":"Ekaterina Schneider,Cristóbal Hernández,Robert Brock,Monika Eckstein,Guy Bodenmann,Markus Heinrichs,Ulrike Ehlert,Severin Läuchli,Beate Ditzen","doi":"10.1001/jamapsychiatry.2025.3705","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.3705","url":null,"abstract":"ImportanceClose social relationships are linked to improved individual health and even longevity. These effects are hypothesized to be mediated through improved neuroendocrine and immune functioning, particularly in individuals who engage in positive and affectionate interactions. However, systematic data examining these factors in humans are currently lacking.ObjectiveTo investigate the interacting effects of repeated intranasal oxytocin administration, a behavioral microintervention, and daily physical intimacy on neuroendocrine stress responses and dermatological wound healing.Design, Setting, and ParticipantsThis randomized clinical trial was a double-blind, randomized, placebo-controlled study whereby participants completed 3 laboratory visits and a 5-day ecological momentary assessment (EMA). During the first laboratory visit, participants received 4 small suction-blister wounds applied to their forearms. Data were collected from November 20, 2011, to July 25, 2013; final analyses were conducted from December 2023 to February 2025.InterventionsOver the following 7 days, participants were instructed to self-administer either oxytocin or a placebo twice daily and to engage in structured positive interaction (Partner Appreciation Task [PAT]) up to 3 times in total or not.Main Outcomes and MeasuresWound healing was assessed at 24 hours and 7 days after wounding. Throughout the week, participants collected saliva samples for cortisol analyses and reported their stress levels and experiences of partner interaction 6 times per day (5760 measurement points in total).ResultsThe volunteer sample was 80 healthy, heterosexual couples (N = 160 participants, mean [SD] age, 27.6 [5.0] years). Couples in the PAT condition who received daily oxytocin showed improved wound healing (b = -0.125, t286 = -1.983; P = .048). However, these effects were not consistently robust in sensitivity analyses (b = -0.090, t282 = -1.643; P = .10). Notably, the administration of oxytocin combined with daily affectionate touch (b = -0.038, t137 = -2.091; P = .04) and sexual activity (b = -0.145, t137 = -2.122; P = .04) was linked to a reduction in wound severity. These associations remained largely consistent in sensitivity analyses (affectionate touch: b = -0.037, t135 = -2.057; P = .04; sexual activity: b = -0.131, t135 = -1.900; P = .06). Additionally, greater sexual activity was associated with reduced daily cortisol levels (b = -373.084, t488 = -2.813; P = .005).Conclusions and RelevanceThis study found that intimate physical contact can reduce cortisol responses and, along with oxytocin administration, promote wound healing. These findings provide a foundation for future interventions that integrate relationship dynamics and neurohormonal modulation to improve health and recovery from illness.Trial RegistrationClinicalTrials.gov Identifier: NCT01594775.","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"6 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145491506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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