Journal of affective disorders最新文献_第3页

Male sexual dysfunction associated with selective serotonin reuptake inhibitors (SSRIs): A pharmacovigilance disproportionality analysis of FAERS data 男性性功能障碍与选择性血清素再摄取抑制剂（SSRIs）相关：FAERS数据的药物警戒性歧化分析。

IF 4.9 2区医学 Q1 CLINICAL NEUROLOGY

Journal of affective disorders

Pub Date : 2026-06-01 Epub Date: 2026-02-07 DOI: 10.1016/j.jad.2026.121336

Shouying Li , Jiaxin Feng , Shilin Zhang

Objective

To describe and compare the reporting patterns and signal strengths of male sexual dysfunction associated with six commonly prescribed SSRIs in the FDA Adverse Event Reporting System.

Methods

Adverse event data for six representative SSRIs, fluoxetine, paroxetine, sertraline, fluvoxamine, citalopram, and escitalopram, were retrieved from the FAERS database, spanning from the first quarter of 2004 to the first quarter of 2025. Disproportionality analysis was conducted using both the reporting odds ratio (ROR) and proportional reporting ratio (PRR) to identify potential signals of adverse drug events associated with these medications.

Results

We analyzed 6,631,746 adverse drug event reports associated with SSRIs and detected significant disproportionality signals indicative of male sexual dysfunction in patients with depression. Across all SSRIs, erectile dysfunction was the most commonly reported adverse event [fluoxetine (ROR: 4.97, 95%CI: 4.25–5.82), paroxetine (ROR: 3.99, 95%CI: 3.53–4.5), sertraline (ROR: 6.11, 95%CI: 5.53–6.75), fluvoxamine (ROR: 1.08, 95%CI: 0.35–3.36), citalopram (ROR: 7.7, 95%CI: 6.81–8.69), and escitalopram (ROR: 7.93, 95%CI: 6.99–8.99)], followed by sexual dysfunction [fluoxetine (ROR: 11.94, 95%CI: 10.01–14.23), paroxetine (ROR: 11.39, 95%CI: 10.05–12.91), sertraline (ROR: 13.34, 95%CI: 11.86–15.01), fluvoxamine (ROR: 9.64, 95%CI: 5.01–18.56), citalopram (ROR: 15.09, 95%CI: 12.98–17.54), and escitalopram (ROR: 16.42, 95%CI: 14.11–19.12)].

Conclusion

This FAERS analysis detected significant disproportionality signals for male sexual dysfunction across SSRIs. Signal variation reflects reporting differences, not comparative risk, due to database limitations. These findings highlight the need for clinical vigilance and further investigation.

目的：描述和比较FDA不良事件报告系统中6种常用SSRIs类药物与男性性功能障碍相关的报告模式和信号强度。方法：从FAERS数据库中检索2004年第一季度至2025年第一季度氟西汀、帕罗西汀、舍曲林、氟伏沙明、西酞普兰和艾司西酞普兰6种代表性SSRIs的不良事件数据。使用报告优势比（ROR）和比例报告比（PRR）进行歧化分析，以识别与这些药物相关的药物不良事件的潜在信号。结果：我们分析了6,631,746份与SSRIs相关的药物不良事件报告，并在抑郁症患者中发现了指示男性性功能障碍的显著歧化信号。在所有SSRIs中，勃起功能障碍是最常见的不良事件[氟西汀（ROR: 4.97, 95%CI: 4.25-5.82），帕罗西汀（ROR: 3.99, 95%CI: 3.53-4.5），谢曲林（ROR: 6.11, 95%CI: 5.53-6.75），氟伏沙明（ROR: 1.08, 95%CI: 0.35-3.36），西酞普兰（ROR: 7.7, 95%CI: 6.81-8.69），艾司西酞普兰（ROR: 7.93, 95%CI: 6.99-8.99）]，其次是性功能障碍[氟西汀（ROR: 11.94, 95%CI: 10.01-14.23），帕罗西汀（ROR: 11.39, 95%CI: 10.05-12.91），谢曲林（ROR: 13.34, 95%CI: 10.05-12.91）]。11.86-15.01)、氟伏沙明（ROR: 9.64, 95%CI: 5.01-18.56）、西酞普兰（ROR: 15.09, 95%CI: 12.98-17.54）和艾司西酞普兰（ROR: 16.42, 95%CI: 14.11-19.12）]。结论：FAERS分析发现了SSRIs中男性性功能障碍的显著歧化信号。由于数据库的限制，信号变化反映了报告的差异，而不是比较风险。这些发现强调了临床警惕和进一步调查的必要性。

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引用次数: 0

Prognostic implications of social anxiety comorbidity in major depressive disorder. Evidence from three large samples with adult and older patients 重度抑郁症患者社交焦虑共病的预后意义。来自成人和老年患者的三个大样本的证据。

IF 4.9 2区医学 Q1 CLINICAL NEUROLOGY

Journal of affective disorders

Pub Date : 2026-06-01 Epub Date: 2026-01-30 DOI: 10.1016/j.jad.2026.121308

Paolo Olgiati , Maria Luca , Antonina Luca , Antonino Messina , Daniel Souery , Siegfried Kasper , Joseph Zohar , Stuart Montgomery , Panagiotis Ferentinos , Dan Rujescu , Raffaella Zanardi , Raffaele Ferri , Julien Mendlewicz , Alessandro Serretti

Background/objectives

Social anxiety disorder (SAD) frequently co-occurs with major depressive disorder (MDD). We examined the prevalence and clinical correlates of SAD across three heterogeneous MDD cohorts.

Methods

Secondary analyses were conducted in adult (CO-MED: n = 482; GSRD: n = 1398) and late-life (IRL-GREY: n = 438) patients. SAD was assessed dimensionally (PDSQ) and categorically (MINI; SCID-1). Cohort-specific instruments were used to assess depressive severity (QIDS; MADRS), suicidality (CHRT; MADRS; SIS) and hypomanic symptoms (ASRM; YMRS). In late-life depression, neurocognitive tests were administered. Multivariate models were adjusted for depression and anxiety levels.

Results

SAD prevalence varied markedly by samples and diagnostic definitions (CO-MED: 46.7% with PDSQ≥6; 17.0% with PDSQ>12; GSRD: 3.0%; IRL-GREY: 8.7%). Across cohorts, SAD was associated with earlier MDD onset (CO-MED: p < 0.001 d = −0.36; GSRD: p = 0.014 d = −0.39; IRL-GREY: p = 0.002 d = −0.54) and greater anxiety comorbidity (CO-MED: GAD: p < 0.001 d = 1.24; panic: p < 0.001 d = 1.29; GSRD: GAD: p < 0.001; panic: p < 0.001; IRL-GREY: agoraphobia: p < 0.001). After controlling for depression and anxiety levels, SAD was linked to higher suicide risk in both adult cohorts (CO-MED: OR 1.04 (1.01–1.08); GSRD: OR 1.29 (1.04–1.64)) and to lower 6-week remission in CO-MED cohort (OR 0.51 (0.29–0.91)).

Conclusions

In MDD, SAD has consistent associations with earlier illness onset and anxiety burden, modest associations with suicidality and antidepressant outcomes, and reduced impact in late life.

背景/目的：社交焦虑障碍（SAD）常与重度抑郁障碍（MDD）共存。我们检查了三个异质性重度抑郁症队列中SAD的患病率和临床相关性。方法：对成年（CO-MED: n = 482;GSRD: n = 1398）和老年（IRL-GREY: n = 438）患者进行二次分析。对SAD进行维度评定（PDSQ）和分类评定（MINI; SCID-1）。使用特定队列的工具评估抑郁严重程度（QIDS； MADRS）、自杀倾向（CHRT； MADRS； SIS）和轻躁症状（ASRM； YMRS）。对老年抑郁症患者进行神经认知测试。根据抑郁和焦虑水平调整多变量模型。结果：不同样本和诊断定义的SAD患病率差异显著（CO-MED: PDSQ≥6者为46.7%；PDSQ≥12者为17.0%;GSRD: 3.0%; IRL-GREY: 8.7%）。在所有队列中，SAD与早期MDD发病相关（CO-MED: p ）。结论：在MDD中，SAD与早期发病和焦虑负担一致，与自杀和抗抑郁结局有适度关联，对晚年的影响较小。

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引用次数: 0

Hierarchical cluster analysis reveals replicable trait approach-avoidance motivation profiles and heterogeneous dysfunction in mood disorders 层次聚类分析揭示了情绪障碍中可复制的特质回避动机特征和异质性功能障碍。

IF 4.9 2区医学 Q1 CLINICAL NEUROLOGY

Journal of affective disorders

Pub Date : 2026-06-01 Epub Date: 2026-01-31 DOI: 10.1016/j.jad.2026.121274

Travis C. Evans , Kristen K. Ellard , Tracy Barbour , Sofia Uribe , Alexis Worthley , Audreyana Jagger-Rickels , Joshua Roffman , Joan A. Camprodon

Mood disorders such as major depressive disorder (MDD) and bipolar disorder (BD) are characterized by core approach and avoidance (AA) motivational system dysfunction. However, patterns of AA motivation dysfunction in mood disorders are markedly heterogeneous across studies, which is inconsistent with a singular pattern of AA motivation dysfunction in mood disorders. Thus, we utilized hierarchical cluster analysis (HCA) to classify multiple, distinct AA motivational profiles in both healthy control samples (Study 1: n = 427 and n = 462) and patients with MDD or BD (Study 2: n = 111). In both healthy control and clinical samples, we identified and replicated three distinct AA motivational profiles that were generally characterized as: 1). High Approach + Moderate Avoid, 2). Low Approach + Low Avoid, or 3). Low Approach + High Avoid. In both studies, AA motivational profiles were further characterized by multivariate, non-linear differences in self-reported reward and threat sensitivity. Compared to healthy controls, patients with mood disorders exhibited AA motivation dysfunction that systematically varied in severity across AA motivational profiles. Together, these results suggest that mood disorders may be more accurately characterized by multiple, distinct patterns of AA motivational dysfunction, which may ultimately be useful towards informing precision-medicine frameworks.

心境障碍如重度抑郁症（MDD）和双相情感障碍（BD）以核心接近和回避（AA）动机系统功能障碍为特征。然而，在不同的研究中，情绪障碍的AA动机功能障碍模式具有明显的异质性，这表明情绪障碍可能具有多种不同的AA动机功能障碍模式。因此，我们利用层次聚类分析（HCA）对健康对照样本（研究1:n = 431和n = 462）和重度抑郁症或双相障碍患者（研究2:n = 111）的多个不同的AA动机特征进行分类。在健康对照和临床样本中，我们确定并复制了三种不同的AA动机特征，通常表征为1)。高进路 + 中度避免，2)。低进近 + 低避，或3)。低进近 + 高避。在这两项研究中，AA动机谱的进一步特征是自我报告的奖励和威胁敏感性的多变量差异。与健康对照组相比，情绪障碍患者表现出AA动机功能障碍，其严重程度在AA动机特征上有系统差异。总之，这些结果表明，情绪障碍可能更准确地表征为多种不同的AA动机功能障碍模式，这可能最终有助于为精准医学框架提供信息。

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引用次数: 0

Changes in suicide rates in Malaysia during the COVID-19 pandemic: An interrupted time series analysis 2019冠状病毒病大流行期间马来西亚自杀率的变化：中断时间序列分析

IF 4.9 2区医学 Q1 CLINICAL NEUROLOGY

Journal of affective disorders

Pub Date : 2026-06-01 Epub Date: 2026-02-04 DOI: 10.1016/j.jad.2026.121337

Glenn Chuan Seng Foo , Minjae Choi , Shamsul Azhar Shah , Nurashikin Ibrahim , Noor Raihan Khamal , Shu-Sen Chang , Lai Fong Chan

Background

Limited research examined changes in suicide trends during COVID-19 outbreaks and related factors in lower-middle-income countries. We investigated the impact of the COVID-19 pandemic on suicide across different outbreak periods by sex, age, region, ethnicity, and method of suicide, and assessed potential factors associated with suicide rates in Malaysia.

Methods

Suicide data for Malaysia (January 2016–December 2022) were extracted from the Integrated Police Reporting System. Changes in monthly suicide rates across different COVID-19 outbreak periods and subgroups were examined using interrupted time series (ITS) analyses. We also examined the associations of suicide rates with indicators of economic performance (unemployment rate), outbreak control (Google mobility and Stringency Index of outbreak control measures), and outbreak severity (COVID-19 incidence and mortality).

Results

A marked increase in suicides above the expected number, based on past trends, was observed during the 3rd (October 2020–May 2021) and 4th (June 2021–December 2021) outbreaks, as well as the post-outbreak period (January–December 2022). These increases were found across nearly all sex, age, ethnicity, region, and suicide method groups. By contrast, no changes or lower-than-expected suicide rates were found in the early pandemic periods (January–September 2020). Higher suicide rates were associated with higher unemployment rates, higher stringency levels of outbreak control measures, and increased outbreak severity during the pandemic period.

Conclusion

Malaysian suicide rates increased above expectations in the later and post-outbreak periods and were associated with unemployment, outbreak control measures, and outbreak severity during the COVID-19 pandemic. These increases underscore the importance of continuous monitoring and prompt responses.

背景：有限的研究调查了中低收入国家2019冠状病毒病暴发期间自杀趋势的变化及其相关因素。我们按性别、年龄、地区、种族和自杀方式调查了COVID-19大流行在不同爆发时期对自杀的影响，并评估了与马来西亚自杀率相关的潜在因素。方法：从综合警察报告系统中提取马来西亚（2016年1月至2022年12月）的自杀数据。使用中断时间序列（ITS）分析检查了不同COVID-19爆发时期和亚组的每月自杀率变化。我们还研究了自杀率与经济表现（失业率）、疫情控制（谷歌流动性和疫情控制措施严格指数）和疫情严重程度（COVID-19发病率和死亡率）指标之间的关系。结果：根据过去的趋势，在第3次（2020年10月至2021年5月）和第4次（2021年6月至2021年12月）爆发期间以及爆发后时期（2022年1月至12月），自杀人数明显增加，高于预期数字。几乎在所有性别、年龄、种族、地区和自杀方式组中都发现了这种增长。相比之下，在大流行早期（2020年1月至9月），自杀率没有变化或低于预期。在大流行期间，较高的自杀率与较高的失业率、更严格的疫情控制措施以及更严重的疫情有关。结论：在2019冠状病毒病大流行期间，马来西亚的自杀率在疫情后期和爆发后高于预期，并与失业、疫情控制措施和疫情严重程度有关。这些增加强调了持续监测和迅速反应的重要性。

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引用次数: 0

Negative emotional inflexibility underlies biological inflexibility: An ecological momentary assessment and passive digital sensing study 消极的情绪不灵活性是生物不灵活性的基础：生态瞬间评估和被动数字传感研究。

IF 4.9 2区医学 Q1 CLINICAL NEUROLOGY

Journal of affective disorders

Pub Date : 2026-06-01 Epub Date: 2026-02-07 DOI: 10.1016/j.jad.2026.121352

Olivia M. Losiewicz , Alainna Wen , Zachary D. Cohen , Samir Akre , Alex A.T. Bui , Michelle G. Craske

Emotional flexibility, thought to reflect the ability to adapt to internal and external environmental stimuli, is associated with psychological well-being. Emotional inertia and network density, defined as stability and interconnectedness, respectively, of emotions, are aspects of emotion dynamics that represent low emotional flexibility. Studies examining biological substrates of emotional persistence are largely limited to emotional inertia and non-depressed samples. Heart-rate variability (HRV) is a transdiagnostic biomarker for psychopathology thought to be associated with emotional flexibility. This study examined whether emotional inertia and network density were associated with HRV in adults with moderate-to-severe depression (N = 315). Participants completed three 8-day epochs of ecological momentary assessment (EMA) five times daily. Smartwatches measured HRV throughout the study. Emotional inertia and idiographic networks were calculated separately for EMA-rated negative and positive affect. Bayesian dynamic structural equation models with noninformative prior distributions examined the association between emotional inertia and HRV; hierarchical linear modeling examined associations between network density and HRV. Both daytime and bedrest HRV were inversely associated with contemporaneous network density of negative emotions. HRV was not associated with inertia, positive network density, or average EMA-reported affect, though it was associated with age, antidepressant medication, and physical exercise. This was the first study to examine HRV in relation to these emotion dynamics in a depressed sample. The results suggest that experiencing a variety of negative emotions within a short period of time may be associated with underlying biological inflexibility. Future studies should examine the directionality and mechanisms behind this effect and explore potential clinical interventions.

情绪灵活性被认为反映了适应内部和外部环境刺激的能力，与心理健康有关。情绪惯性和网络密度分别被定义为情绪的稳定性和互联性，是情绪动态的两个方面，代表着低情绪灵活性。研究情绪持续的生物基础很大程度上局限于情绪惯性和非抑郁样本。心率变异性（HRV）是一种精神病理学的跨诊断生物标志物，被认为与情绪灵活性有关。本研究考察了情绪惯性和网络密度是否与中度至重度抑郁症成人HRV相关（N = 315）。参与者每天完成3次为期8天的生态瞬时评估（EMA）。在整个研究过程中，智能手表都在测量心率。情绪惯性和具体网络分别计算ema评级的消极和积极情绪。具有非信息先验分布的贝叶斯动态结构方程模型检验了情绪惯性与HRV的关系；分层线性模型检验了网络密度和HRV之间的关系。日间和卧床HRV均与负性情绪的时间网络密度呈负相关。HRV与惰性、正网络密度或平均ema报告的影响无关，尽管它与年龄、抗抑郁药物和体育锻炼有关。这是第一个在抑郁样本中检验心率变异与这些情绪动态之间关系的研究。结果表明，在短时间内经历各种负面情绪可能与潜在的生物不灵活性有关。未来的研究应该检查这种效应背后的方向性和机制，并探索潜在的临床干预措施。

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引用次数: 0

Effectiveness of an integrated prevention programme (“JoyAge”) for depressive symptoms, anxiety, and loneliness in older adults in Hong Kong: A pragmatic quasi-experimental trial 综合预防计划（“欢乐时光”）对香港老年人抑郁症状、焦虑和孤独的有效性：一项实用的准实验试验。

IF 4.9 2区医学 Q1 CLINICAL NEUROLOGY

Journal of affective disorders

Pub Date : 2026-06-01 Epub Date: 2026-02-06 DOI: 10.1016/j.jad.2026.121333

Tianyin Liu , Dara Kiu Yi Leung , Daniel Wong , Samson Tse , Paul Wong , Siu Man Ng , Wai Chi Chan , Vivian Lou , Jennifer Yee-Man Tang , Reynold Cheng , Shiyu Lu , Frankie Ho Chun Wong , Wen Zhang , Lesley Cai Yin Sze , Wai Wai Kwok , Martin Knapp , Terry Yat Sang Lum , Gloria Wong

Background

With population ageing and insufficient mental health workforce, there are huge treatment gaps for late-life depression. Real-world evidence of scalable preventive services is scarce. This study examines the effectiveness of an integrated selective and indicated prevention programme for late-life depression in a large group of older adults in Hong Kong.

Methods

This was a pragmatic quasi-experimental trial of a new service (“JoyAge”) for older people with risk factors for late-life depression or subsyndromal depressive symptoms. Participants were recruited and allocated, based on their district of residence, to receive JoyAge (N = 2975) or usual care (N = 441). The primary outcome was depressive symptoms (PHQ-9) at 12-month follow-up; secondary outcomes were anxiety symptoms (GAD-7) and loneliness (UCLA-3). Analyses were conducted in an intention-to-treat framework using mixed modelling, with subgroup analyses based on baseline depressive symptoms, and sensitivity analyses in a 1:1 (N = 422 each group) propensity score-matched sample.

Results

The JoyAge participants had a greater reduction in depressive symptoms over the 12-month period compared to those assigned to usual care (adjusted mean difference [AMD] = 1.65, 95% CI = 1.24–2.07, p < .001), similarly in anxiety symptoms (AMD = 1.47, 95% CI = 1.01–1.93, p < .001), and loneliness (AMD = 1.29, 95% CI = 0.98–1.60, p < .001). Results were similar in propensity-score matched analyses. Subgroup analysis showed that JoyAge was particularly effective among people with moderate to moderately severe symptoms and those with risk factors only.

Conclusions

Integrated late-life depression prevention can be effectively implemented at scale in rapidly ageing settings with a limited specialist mental health workforce. Economic analyses are needed to support further implementation.

背景：随着人口老龄化和精神卫生人力资源不足，老年抑郁症的治疗存在巨大缺口。可扩展预防服务的实际证据很少。本研究在香港一大批老年人中检验了一项综合选择性和指示性预防计划对老年抑郁症的有效性。方法：这是一个实用的准实验试验的新服务（“JoyAge”）为老年人的风险因素的晚年抑郁或亚综合征性抑郁症状。参与者被招募并分配，根据他们的居住地区，接受JoyAge （N = 2975）或常规护理（N = 441）。随访12个月时主要终点为抑郁症状（PHQ-9）；次要结局是焦虑症状（GAD-7）和孤独感（UCLA-3）。使用混合模型在意向治疗框架中进行分析，基于基线抑郁症状进行亚组分析，并在1:1 （N = 422每组）倾向评分匹配的样本中进行敏感性分析。结果：与常规护理组相比，JoyAge组的参与者在12个月的时间内抑郁症状有更大的减轻（调整后的平均差[AMD] = 1.65,95% CI = 1.24-2.07,p ）结论：在快速老龄化的环境中，在专业精神卫生人员有限的情况下，综合晚年抑郁预防可以有效地大规模实施。需要进行经济分析以支持进一步的实施。

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引用次数: 0

The clinician rated suicide crisis syndrome checklist (SCS-C): Structure, reliability, and concurrent validity among adult psychiatric inpatients 临床医师对成人精神科住院病人自杀危机综合征量表（SCS-C）的结构、信度和并发效度进行评定。

IF 4.9 2区医学 Q1 CLINICAL NEUROLOGY

Journal of affective disorders

Pub Date : 2026-06-01 Epub Date: 2026-02-06 DOI: 10.1016/j.jad.2026.121341

Sarah Bloch-Elkouby , Rawad El-Hayek , Lisa Cohen , Jimmy Pengyu Chen , Bernard Gorman , Yael Apter , Erin Wheeler , Byounyoung Park , Anna Stefania Prekas , Igor Galynker

Background

The Suicide Crisis Syndrome (SCS) is a suicidal mental state and a proposed DSM diagnostic condition shown to predict short-term suicidal behaviors among clinical and non-clinical populations in the United States and worldwide. The goal of this study was to develop and assess the psychometric properties of a short clinician-rated SCS diagnostic tool, the SCS Checklist (SCS-C), to provide a structured assessment of patients' SCS through clinical interview.

Method

The SCS-C, a clinician-rated measure composed of 15 binary (yes/no) items was developed and administered to 219 patients upon admission into an inpatient psychiatric unit. Factor structure, internal and interrater reliability, concurrent construct validity (i.e., convergent and divergent validity), and concurrent criterion validity (within one week prior to inpatient admission) were respectively assessed using Confirmatory Factor Analysis, Cronbach's Alpha and McDonald's Omega, Cohen's Kappa, and linear and logistic regressions.

Results

The SCS-C demonstrated excellent fit for a one factor solution, high internal consistency (Cronbach's α = 0.87; McDonalds' Ω = 0.89), moderate convergent validity, good divergent validity, as well as good concurrent criterion validity with regards to suicidal behaviors.

Discussion

This study's findings suggest that the SCS-C is a psychometrically valid and reliable diagnostic tool to assess the presence of the SCS through a swift clinical interview, regardless of patients' disclosure of suicidal ideation. Given the persistent difficulty in evaluating suicide risk through patient self-report, this concise diagnostic tool holds substantial clinical promise for improving suicide risk detection and prevention. Future studies will need to investigate the predictive validity of the instrument.

背景：自杀危机综合征（SCS）是一种有自杀倾向的精神状态，在美国和世界范围内的临床和非临床人群中被提出用于预测短期自杀行为的DSM诊断条件。本研究的目的是开发和评估一种简短的临床评价的SCS诊断工具的心理测量特性，即SCS检查表（SCS- c），通过临床访谈对患者的SCS进行结构化评估。方法：采用由15个二元（是/否）项目组成的临床评定量表（SCS-C），对219例住院精神科患者进行评定。采用验证性因子分析、Cronbach’s Alpha和McDonald’s Omega、Cohen’s Kappa、线性和逻辑回归分别评估因子结构、内部信度和量表间信度、并发构式效度（即收敛效度和分散效度）和并发效度（入院前一周内）。结果：量表对自杀行为具有良好的单因素拟合性、较高的内部一致性（Cronbach's α = 0.87;McDonalds' s Ω = 0.89）、中等的收敛效度、较好的发散效度和较好的并发效度。讨论：本研究的结果表明，SCS- c是一种心理测量学上有效和可靠的诊断工具，通过快速临床访谈来评估SCS的存在，无论患者是否披露自杀意念。鉴于通过患者自我报告评估自杀风险的持续困难，这种简洁的诊断工具在改善自杀风险检测和预防方面具有实质性的临床前景。未来的研究将需要调查该工具的预测有效性。

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引用次数: 0

Gut–brain axis biomarkers link intestinal inflammation to post-traumatic stress disorder vulnerability 肠脑轴生物标志物将肠道炎症与创伤后应激障碍脆弱性联系起来

IF 4.9 2区医学 Q1 CLINICAL NEUROLOGY

Journal of affective disorders

Pub Date : 2026-06-01 Epub Date: 2026-01-26 DOI: 10.1016/j.jad.2026.121284

Runming Liu , Gaomeng Luo , Xiaobing Wang , Ziyue Xu , Jiazhi Jiang , Peng Huang , Fei Zeng , Junhui Liu , Xiang Li , Sha Liu , Wei Wei

Background

Patients with ulcerative colitis (UC) exhibit an elevated risk for post-traumatic stress disorder (PTSD) and frequently demonstrate severe symptomatology, suggesting a gut–brain axis connection. UC-associated chronic inflammation and immune dysregulation can influence central nervous system function via neuroimmune signaling, potentially reshaping molecular and transcriptional programs within fear-related neural circuits. However, the molecular mechanisms underlying this clinical association remain poorly characterized.

Methods

We analyzed PTSD and UC microarray data from the Gene Expression Omnibus (GEO) following background correction and normalization. Disease-associated genes were identified through differentially expressed gene (DEG) analysis and weighted gene co-expression network analysis (WGCNA), followed by gene set enrichment analysis (GSEA), Gene Ontology (GO) enrichment, CIBERSORT immune profiling, and protein–protein interaction (PPI) analysis. Key targets were validated in intestinal tissue from a murine model of UC and blood samples from a murine model of PTSD. A combined UC–PTSD mouse model was established for behavioral validation; viral knockdown targeting the prelimbic cortex (PL) was employed to test candidate genes functionally.

Conclusion

We identified shared molecular pathways and core genes linking UC and PTSD. The comorbid model demonstrated that UC intensifies PTSD-like behaviors. Furthermore, Knockdown of Glrx in the PL alleviated fear retrieval following UC induction, establishing Glrx as a mechanistic node along the gut–brain axis in UC-associated PTSD vulnerability.

背景溃疡性结肠炎（UC）患者出现创伤后应激障碍（PTSD）的风险升高，并且经常表现出严重的症状，提示肠-脑轴连接。uc相关的慢性炎症和免疫失调可以通过神经免疫信号影响中枢神经系统功能，潜在地重塑恐惧相关神经回路中的分子和转录程序。然而，这种临床关联的分子机制仍然不清楚。方法对背景校正和归一化后的基因表达综合数据库（Gene Expression Omnibus， GEO）的PTSD和UC芯片数据进行分析。通过差异表达基因（DEG）分析和加权基因共表达网络分析（WGCNA）鉴定疾病相关基因，随后进行基因集富集分析（GSEA）、基因本体（GO）富集、CIBERSORT免疫谱分析和蛋白-蛋白相互作用（PPI）分析。关键靶点在UC小鼠模型的肠道组织和PTSD小鼠模型的血液样本中得到验证。建立UC-PTSD联合小鼠模型进行行为验证；采用靶向前边缘皮层（PL）的病毒敲低方法对候选基因进行功能检测。结论我们发现了UC和PTSD之间的共同分子通路和核心基因。共病模型表明UC加剧了ptsd样行为。此外，PL中Glrx的敲低可减轻UC诱导后的恐惧恢复，这表明Glrx在UC相关的PTSD易感性中是肠脑轴上的一个机制节点。

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引用次数: 0

Recommendations for repeated dosings of ketamine/esketamine rest on an uncertain evidence base. Response to Le et al., 2025 氯胺酮/艾氯胺酮重复剂量的建议基于不确定的证据基础。应对。

IF 4.9 2区医学 Q1 CLINICAL NEUROLOGY

Journal of affective disorders

Pub Date : 2026-06-01 Epub Date: 2026-02-05 DOI: 10.1016/j.jad.2026.121351

Martin Plöderl , Florian Naudet

引用次数: 0

Relationship between regional homogeneity changes and cognitive dysfunction in patients with first-episode drug-naïve bipolar II disorder in the depressive phase 区域同质性改变与首发drug-naïve双相情感障碍患者抑郁期认知功能障碍的关系。

IF 4.9 2区医学 Q1 CLINICAL NEUROLOGY

Journal of affective disorders

Pub Date : 2026-06-01 Epub Date: 2026-02-05 DOI: 10.1016/j.jad.2026.121353

Jun Zhou , Aijun Liao , Xiaoqian Ma , Zihao Yang , Chunwang Li , Ying He , Xiaogang Chen

Background

Cognitive dysfunction is a prevalent symptom in patients with bipolar II disorder (BD-II) depression, yet its underlying neural mechanisms remain insufficiently understood. This study aimed to investigate the relationship between local spontaneous neural activity and cognitive dysfunction in BD-II depression using the Regional Homogeneity (ReHo) method.

Methods

A total of 77 first-episode drug-naïve patients with BD-II depression and 69 healthy controls (HC) underwent magnetic resonance imaging (MRI) scans. Cognitive function was assessed using the Hopkins Verbal Learning Test-Revised (HVLT-R), Stroop Color and Word Test (SCWT), Verbal Fluency Test (VFT), and Wisconsin Card Sorting Test (WCST).

Results

Patients with BD-II depression exhibited widespread cognitive impairments across multiple domains, including verbal learning and memory, reaction time, executive function, working memory, semantic retrieval, and cognitive flexibility. Moreover, significant alterations in ReHo values were observed in several key brain regions, such as the precentral and postcentral gyri, precuneus, medial frontal gyrus (MFG), triangular part of inferior frontal gyrus, and Rolandic operculum. Notably, after Bonferroni correction, ReHo values in the right MFG were significantly correlated with both immediate and delayed recall scores on the HVLT-R (all P < 0.0002), suggesting a crucial role of this region in cognitive processes.

Conclusion

These findings indicate that abnormal neural activity in specific brain regions may serve as potential neurobiological markers of cognitive dysfunction in BD-II depression. Identifying these neural correlates could contribute to a better understanding of the pathophysiology of BD-II and inform the development of targeted therapeutic strategies.

背景：认知功能障碍是双相情感障碍（BD-II）抑郁症患者的普遍症状，但其潜在的神经机制尚不清楚。本研究旨在利用区域均匀性（Regional homogenous, ReHo）方法探讨BD-II型抑郁症患者局部自发神经活动与认知功能障碍的关系。方法：对77例首发drug-naïve BD-II型抑郁症患者和69例健康对照（HC）进行磁共振成像（MRI）扫描。认知功能评估采用霍普金斯语言学习测试（HVLT-R）、Stroop颜色和单词测试（SCWT）、语言流畅性测试（VFT）和威斯康星卡片分类测试（WCST）。结果：BD-II型抑郁症患者在多个领域表现出广泛的认知障碍，包括言语学习记忆、反应时间、执行功能、工作记忆、语义检索和认知灵活性。此外，在几个关键的大脑区域，如中央前和中央后回、楔前叶、额内侧回（MFG）、额下回三角形部分和罗兰底盖，观察到ReHo值的显著变化。值得注意的是，在Bonferroni校正后，右侧MFG的ReHo值与HVLT-R的即时和延迟回忆得分均显著相关（P均为 ）。结论：这些发现表明，特定脑区异常的神经活动可能是BD-II型抑郁症认知功能障碍的潜在神经生物学标志物。确定这些神经相关因素有助于更好地理解BD-II的病理生理，并为制定靶向治疗策略提供信息。

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