Journal of psychiatric research最新文献_第3页

Parenting style and deliberate self-harm among children and adolescents: A hospital-based case-control study in Japan 日本儿童和青少年的父母教养方式和故意自残：一项基于医院的病例对照研究。

IF 3.2 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2026-04-01 Epub Date: 2026-01-23 DOI: 10.1016/j.jpsychires.2026.01.025

Yoshikazu Komura , Saiko Ema , Nobuyuki Nomura , Keisuke Kodama , Satoru Takabatake , Fuminari Misawa , Hiroyoshi Takeuchi

Background

Although inappropriate parenting styles have been shown to be associated with deliberate self-harm (DSH), few studies have assessed parenting styles from both the perspectives of patients and their parents.

Methods

We conducted a hospital-based case-control study at a psychiatric ward in Japan, including patients aged 7–20 years. Histories of DSH were collected from electronic health records in the hospital. Parenting styles were assessed using the Family Diagnostic Test (FDT), which evaluates parenting style from both the patients' and parents’ perspectives. Multivariable logistic regression was performed to estimate odds ratios (ORs) of DSH by 10 % increase of FDT score, adjusting for age, sex, primary diagnosis, history of abuse, school refusal, the number of previous hospitalizations, and family structure.

Results

Of the 272 patients (mean age, 15.2 [SD, 2.4] years; 57.4 % female), 115 (42.3 %) had a history of DSH. Patients who felt rejection from their mothers, avoided contact with their mothers, and felt less attached to their mothers were more likely to have histories of DSH, independent of covariates (sense of rejection, OR = 1.15 [95 %CI, 1.01–1.30]; active avoidance, OR = 1.14 [95 %CI, 1.00–1.29]; emotional closeness, OR = 0.89 [95 % CI, 0.79–1.00]; In contrast, parents’ self-assessments of their parenting style were not significantly associated with DSH.

Conclusions

Our findings underscore the importance of patient-reported perceptions for revealing the underlying mechanisms linking parenting style and DSH.

背景：虽然不恰当的父母教养方式被证明与故意自残（DSH）有关，但很少有研究从患者和父母的角度来评估父母教养方式。方法：我们在日本的一个精神科病房进行了一项基于医院的病例对照研究，包括7-20岁的患者。从医院的电子健康记录中收集DSH病史。采用家庭诊断测试（Family Diagnostic Test， FDT）对父母教养方式进行评估，该测试从患者和父母的角度对父母教养方式进行评估。采用多变量logistic回归，通过FDT评分增加10%来估计DSH的优势比（ORs），调整年龄、性别、初诊、虐待史、拒绝上学、以前住院次数和家庭结构。结果：272例患者（平均年龄15.2 [SD， 2.4]岁，女性57.4%）中，115例（42.3%）有DSH病史。感觉被母亲排斥、避免与母亲接触、对母亲依恋程度较低的患者有DSH病史的可能性更大，独立于协变量（排斥感，OR = 1.15 [95% CI, 1.01-1.30]；主动回避，OR = 1.14 [95% CI, 1.00-1.29]；情感亲近，OR = 0.89 [95% CI, 0.79-1.00]）；相反，父母对其养育方式的自我评价与DSH无显著相关。结论：我们的研究结果强调了患者报告的感知对于揭示父母教养方式和DSH之间联系的潜在机制的重要性。

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引用次数: 0

Is it time for a paradigm shift? Trauma in the development of anorexia nervosa in adolescents 现在是转变思维模式的时候了吗？创伤在青少年神经性厌食症发展中的作用

IF 3.2 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2026-04-01 Epub Date: 2026-01-28 DOI: 10.1016/j.jpsychires.2026.01.037

Katarzyna Jowik-Krzemińska , Agnieszka Słopień , Marta Tyszkiewicz-Nwafor

Context

Anorexia nervosa (AN) in adolescents is a severe disorder with complex aetiology. The role of childhood maltreatment (CM) in the development and course of AN remains unclear. The study aimed to analyse the co-occurrence of CM with the severity of psychopathology in patients with AN and to assess their relationship with the dynamics of clinical improvement.

Methods

The study included only girls under 18 years of age: 39 patients hospitalised for the first time with a diagnosis of AN and 43 healthy participants from the control group (CG). Questionnaires were used to assess trauma (CTQ), symptoms of depression (BDI), anxiety (STAI), eating disorders (EAT), impulsivity (BIS), self-harm (NSSI), and suicidal behaviour (SB).

Results

The analysis did not reveal any statistically significant differences between the AN and control groups in overall frequency or specific CM subtypes. Despite no differences in trauma exposure, the clinical group showed a significant co-occurrence of emotional abuse with higher levels of self-destructive behaviour and anxiety as a trait, while emotional neglect correlated with anxiety as a state. Notably, the presence of reported trauma did not differentiate patients in terms of response to hospital treatment or rate of symptom reduction.

Conclusions

In the sample of adolescent girls studied, the mere occurrence of reported trauma was not a factor differentiating patients with AN from healthy peers, nor was it a negative predictor of early hospital treatment outcomes. These results suggest that although specific forms of emotional abuse may co-occur with a more severe psychopathological picture (anxiety, self-destruction), childhood maltreatment does not necessarily constitute a direct obstacle to symptomatic improvement during the first hospitalisation.

青少年神经性厌食症是一种病因复杂的严重疾病。儿童虐待（CM）在AN的发展和过程中的作用尚不清楚。本研究旨在分析AN患者CM与精神病理严重程度的共存情况，并评估其与临床改善动态的关系。方法本研究仅纳入18岁以下的女孩：39例首次诊断为AN住院的患者和43例对照组（CG）的健康参与者。使用问卷评估创伤（CTQ）、抑郁症状（BDI）、焦虑（STAI）、饮食失调（EAT）、冲动（BIS）、自残（NSSI）和自杀行为（SB）。结果分析未发现AN组与对照组在总频率或特定CM亚型上有统计学差异。尽管在创伤暴露方面没有差异，但临床组显示，情绪虐待与更高水平的自我毁灭行为和焦虑共同出现，而情绪忽视与焦虑作为一种状态相关。值得注意的是，在对医院治疗的反应或症状减轻率方面，报告创伤的存在并没有区分患者。结论：在研究的青春期女孩样本中，仅报告创伤的发生并不是区分AN患者与健康同龄人的因素，也不是早期住院治疗结果的负面预测因子。这些结果表明，虽然特定形式的情绪虐待可能与更严重的精神病理症状（焦虑、自我毁灭）同时发生，但儿童时期的虐待并不一定构成首次住院期间症状改善的直接障碍。

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引用次数: 0

Modulating inhibitory control in test-anxious individuals via tDCS: An ERP study 通过tDCS调节考试焦虑个体的抑制控制：一项ERP研究。

IF 3.2 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2026-04-01 Epub Date: 2026-02-01 DOI: 10.1016/j.jpsychires.2026.01.055

Peibing Liu , Zhaonian Hu , Renlai Zhou

Test anxiety is a common emotional problem that often negatively affects academic performance. To examine the potential of transcranial direct current stimulation (tDCS) in modulating neural inhibitory control efficiency in individuals with high test anxiety, this study investigated the intervention effects and underlying neural mechanisms. A total of 42 participants with high or low levels of test anxiety were recruited. Each participant received both active (anodal) and sham tDCS targeting the left dorsolateral prefrontal cortex (DLPFC), while event-related potentials (ERPs) were recorded during a Flanker task that indexes inhibitory control by requiring participants to respond to a central target while ignoring distracting flankers. Results showed that, compared to sham stimulation, active tDCS significantly reduced the amplitude of the P3 component—a late positive potential associated with attentional allocation—in the high test anxiety group, but had no significant effect in the low test anxiety group. These findings suggest that tDCS modulates neural inhibitory control in individuals with high test anxiety by activating the left DLPFC. This study provides electrophysiological evidence for non-invasive neuromodulation as a potential intervention strategy and identifying a promising neural target.

考试焦虑是一种常见的情绪问题，通常会对学习成绩产生负面影响。为了探讨经颅直流电刺激（tDCS）对高考试焦虑个体神经抑制控制效率的调节作用，本研究探讨了其干预效果和潜在的神经机制。总共招募了42名或高或低水平考试焦虑的参与者。每个参与者都接受了针对左背外侧前额叶皮层（DLPFC）的活跃（无节点）和假性tDCS，而在侧翼任务期间记录事件相关电位（ERPs），该任务通过要求参与者对中心目标做出反应而忽略分散注意力的侧翼来指示抑制控制。结果显示，与假性刺激相比，活跃的tDCS显著降低了高焦虑组P3成分的振幅，而低焦虑组无显著影响。这些发现表明，tDCS通过激活左侧DLPFC来调节高考试焦虑个体的神经抑制控制。该研究为非侵入性神经调节作为潜在的干预策略和确定有希望的神经靶点提供了电生理学证据。

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引用次数: 0

Persistence of autistic symptom differences by severity among individuals at clinical high risk for psychosis and with first-episode psychosis: An 18-month longitudinal follow-up study 临床精神病高危患者和首发精神病患者自闭症症状持续程度差异：一项为期18个月的纵向随访研究

IF 3.2 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2026-04-01 Epub Date: 2026-01-27 DOI: 10.1016/j.jpsychires.2026.01.033

Hiroshi Komatsu , Yutaro Sato , Kazuho Tomimoto , Goh Onoguchi , Kaori Sora , Yoshiaki Shiozawa , Masato Takahama , Yusuke Utsumi , Yumiko Hamaie , Atsushi Sakuma , Noriyuki Ohmuro , Masahiro Katsura , Fumiaki Ito , Takashi Ono , Nobuhisa Kanahara , Kazunori Matsumoto , Hiroaki Tomita

Autistic symptoms influence functional outcomes in individuals at high clinical risk for psychosis (CHR-P) and in those with first-episode psychosis (FEP). Our recent findings suggest that these symptoms encompass both enduring trait-like and transient state-like features that improve with treatment over a 12-month period. This study aimed to clarify the long-term course of autistic and non-autistic symptoms by comparing individuals with high and low levels of autistic symptoms at the CHR-P and FEP over an extended 18-month period. Sixty-two participants who completed the 18-month follow-up assessment (CHR-P, n = 37; FEP, n = 25) were included. At baseline, the high autistic symptoms (HA) group exhibited a significantly greater severity of autistic symptoms, more severe non-autistic psychiatric symptoms, and lower global functioning than the low autistic symptoms (LA) group. Over the 12- and 18-month follow-up periods, both groups showed significant improvements in non-autistic psychiatric symptoms and global functioning, and the initial group differences in these domains were no longer statistically significant. In contrast, although the autistic symptoms in the HA group decreased over time, a significant difference in the PAUSS total scores between the HA and LA groups persisted throughout the follow-up. While non-autistic psychiatric symptoms and functional impairments are responsive to treatment, autistic symptoms in individuals with CHR-P and FEP may encompass both modifiable, state-like features, and stable, trait-like characteristics, persisting over an 18-month period. Further research is warranted to elucidate the underlying mechanisms and clinical implications of persistent autistic symptoms in early psychosis.

自闭症症状影响精神病临床高风险（chrp）和首发精神病（FEP）患者的功能结局。我们最近的研究结果表明，这些症状包括持久的特征样和短暂的状态样特征，这些特征在12个月的治疗期间得到改善。本研究旨在通过比较高水平和低水平自闭症症状的个体在延长的18个月期间的chrp和FEP，来阐明自闭症和非自闭症症状的长期病程。纳入62名完成18个月随访评估的参与者（chrp, n = 37； FEP, n = 25）。在基线时，高自闭症症状（HA）组比低自闭症症状（LA）组表现出更严重的自闭症症状，更严重的非自闭症精神症状和更低的整体功能。在12个月和18个月的随访期间，两组在非自闭症精神症状和整体功能方面都有显著改善，这些领域的初始组差异不再具有统计学意义。相比之下，虽然HA组的自闭症症状随着时间的推移而减少，但HA组和LA组之间PAUSS总分的显著差异在整个随访过程中持续存在。虽然非自闭症精神症状和功能障碍对治疗有反应，但chrp - p和FEP患者的自闭症症状可能包括可改变的、类似状态的特征和稳定的、类似特质的特征，持续时间超过18个月。需要进一步的研究来阐明早期精神病患者持续自闭症症状的潜在机制和临床意义。

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引用次数: 0

The impact of mindfulness-based stress reduction therapy on individuals with autism spectrum disorder and their caregivers: A systematic review 正念减压疗法对自闭症谱系障碍患者及其照顾者的影响：一项系统综述。

IF 3.2 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2026-04-01 Epub Date: 2026-01-29 DOI: 10.1016/j.jpsychires.2026.01.052

Dandan Luo , Wenjun Dang , Jie Luo , Yuwei Jiang

Background

Individuals with autism spectrum disorder (ASD) and their caregivers often face challenges such as emotional distress and stress management, which severely impact their quality of life. Mindfulness-Based Stress Reduction (MBSR) holds potential value in emotional regulation; however, there is a lack of systematic evaluation targeting the ASD population, particularly caregivers. This systematic review aims to clarify the clinical effects of MBSR interventions on individuals with ASD and their caregivers, providing a reference for the clinical implementation of targeted interventions.

Method

We systematically searched PubMed, the Cochrane Library, Web of Science, Embase, Ovid, and CINAHL databases using predefined search terms and combinations, with supplementary handsearching for relevant literature. The search timeframe covered the period from the establishment of each database to October 1, 2025. This systematic review protocol has been prospectively registered in PROSPERO with the registration number CRD420251159313.

Results

A total of 13 clinical studies were included. The results indicate that MBSR demonstrates certain intervention potential for adults with ASD and their caregivers. Specifically, among adults with ASD (N = 8), MBSR may help improve emotional symptoms such as anxiety and depression. For ASD caregivers (N = 4), MBSR has shown preliminary effects in relieving psychological stress and improving emotional states, suggesting that it may provide potential psychological support for this population. It should be noted that only one study in the current evidence focuses on children with ASD, and the adolescent population remains uncovered.

Conclusion

Preliminary research suggests that MBSR may hold potential value in improving anxiety and depression symptoms among adults with ASD, as well as alleviating caregiving stress and emotional distress among ASD caregivers. However, due to limitations such as the small number of included studies, limited sample sizes, and high heterogeneity, the current evidence remains insufficient in strength, and conclusions should be interpreted with caution. Future research should focus on conducting larger-scale, high-quality studies to enhance the reliability of findings.

背景：自闭症谱系障碍（ASD）患者及其照顾者经常面临情绪困扰和压力管理等挑战，这严重影响了他们的生活质量。正念减压（MBSR）在情绪调节中具有潜在的价值；然而，缺乏针对ASD人群，特别是护理人员的系统评估。本系统综述旨在阐明正念减压干预对ASD个体及其照顾者的临床效果，为临床实施有针对性的干预提供参考。方法：系统检索PubMed、Cochrane Library、Web of Science、Embase、Ovid、CINAHL等数据库，使用预定义的检索词和组合进行检索，并辅以人工检索相关文献。检索时间范围为各数据库建立至2025年10月1日。该系统评价方案已在PROSPERO前瞻性注册，注册号为CRD420251159313。结果：共纳入13项临床研究。结果表明，正念减压对ASD成人及其照顾者具有一定的干预潜力。具体来说，在患有ASD的成人（N = 8）中，正念减压疗法可能有助于改善焦虑和抑郁等情绪症状。对于ASD照顾者（N = 4），正念减压在缓解心理压力和改善情绪状态方面已显示出初步效果，表明正念减压可能为这一人群提供潜在的心理支持。值得注意的是，在目前的证据中，只有一项研究关注的是患有自闭症的儿童，而青少年群体仍未被发现。结论：初步研究表明，正念减压疗法可能在改善成年ASD患者的焦虑和抑郁症状，以及减轻ASD照顾者的照顾压力和情绪困扰方面具有潜在价值。然而，由于纳入的研究数量少、样本量有限、异质性高等局限性，目前的证据仍然不足，结论应谨慎解释。未来的研究应侧重于进行更大规模、高质量的研究，以提高研究结果的可靠性。

{"title":"The impact of mindfulness-based stress reduction therapy on individuals with autism spectrum disorder and their caregivers: A systematic review","authors":"Dandan Luo , Wenjun Dang , Jie Luo , Yuwei Jiang","doi":"10.1016/j.jpsychires.2026.01.052","DOIUrl":"10.1016/j.jpsychires.2026.01.052","url":null,"abstract":"<div><h3>Background</h3><div>Individuals with autism spectrum disorder (ASD) and their caregivers often face challenges such as emotional distress and stress management, which severely impact their quality of life. Mindfulness-Based Stress Reduction (MBSR) holds potential value in emotional regulation; however, there is a lack of systematic evaluation targeting the ASD population, particularly caregivers. This systematic review aims to clarify the clinical effects of MBSR interventions on individuals with ASD and their caregivers, providing a reference for the clinical implementation of targeted interventions.</div></div><div><h3>Method</h3><div>We systematically searched PubMed, the Cochrane Library, Web of Science, Embase, Ovid, and CINAHL databases using predefined search terms and combinations, with supplementary handsearching for relevant literature. The search timeframe covered the period from the establishment of each database to October 1, 2025. This systematic review protocol has been prospectively registered in PROSPERO with the registration number CRD420251159313.</div></div><div><h3>Results</h3><div>A total of 13 clinical studies were included. The results indicate that MBSR demonstrates certain intervention potential for adults with ASD and their caregivers. Specifically, among adults with ASD (N = 8), MBSR may help improve emotional symptoms such as anxiety and depression. For ASD caregivers (N = 4), MBSR has shown preliminary effects in relieving psychological stress and improving emotional states, suggesting that it may provide potential psychological support for this population. It should be noted that only one study in the current evidence focuses on children with ASD, and the adolescent population remains uncovered.</div></div><div><h3>Conclusion</h3><div>Preliminary research suggests that MBSR may hold potential value in improving anxiety and depression symptoms among adults with ASD, as well as alleviating caregiving stress and emotional distress among ASD caregivers. However, due to limitations such as the small number of included studies, limited sample sizes, and high heterogeneity, the current evidence remains insufficient in strength, and conclusions should be interpreted with caution. Future research should focus on conducting larger-scale, high-quality studies to enhance the reliability of findings.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"195 ","pages":"Pages 299-308"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparison of the effects of aerobic exercise and computer-based cognitive stimulation in patients with schizophrenia - A randomized controlled trial 有氧运动和基于电脑的认知刺激对精神分裂症患者效果的比较——一项随机对照试验

IF 3.2 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2026-04-01 Epub Date: 2026-01-28 DOI: 10.1016/j.jpsychires.2026.01.039

İsmail Koç , Ebru Akbuğa Koç , Nilgün Çınar , Türker Şahiner

Objective

This study aimed to compare of the effects of aerobic exercise (AE) and computer-based cognitive stimulation (CS) in terms of cognition, clinical symptoms, depression, and quality of life (QOL) in patients with schizophrenia.

Methods

A total of 58 individuals diagnosed with schizophrenia completed to the study (aerobic exercise group (AEG): n = 18, cognitive stimulation group (CSG): n = 20, control group (CG): n = 20). The AEG participated in a 12-week AE program, whereas the CSG engaged in computer-based CS over the same period. Also, the CG did not receive any intervention. Cognition with Montreal Cognitive Assessment scale and Frontal Assessment Battery, clinical symptoms with Positive and Negative Syndrome Scale, depression with Calgary Depression Scale for Schizophrenia, and QOL with Quality of Life Scale for Schizophrenia Patients scale were assessed at baseline and post-intervention.

Results

Within-group improvements were observed in general cognitive function, clinical symptoms, and selected QOL domains in the AEG, whereas the CSG showed significant improvements across cognitive functions, clinical symptoms, depressive symptoms, and multiple QOL domains. In contrast, the CG exhibited significant deterioration in cognitive functions, selected clinical symptoms, depressive symptoms, and certain QOL domains over the 12-week period. Between-group comparisons revealed no statistically significant differences in general cognitive function, executive function, and depression at week 12. However, significant differences were observed in specific PANSS and QOL subscales.

Conclusions

These findings suggested that computer-based CS and AE may offer domain-specific and complementary effects in cognitive and clinical domains in PwS.

目的比较有氧运动（AE）和计算机认知刺激（CS）对精神分裂症患者认知、临床症状、抑郁和生活质量的影响。方法共有58例精神分裂症患者完成研究，其中有氧运动组（AEG） 18例，认知刺激组（CSG） 20例，对照组（CG） 20例。AEG组参加了一个为期12周的AE项目，而CSG组在同一时期进行了基于计算机的CS。此外，中央政府没有接受任何干预。在基线和干预后分别用蒙特利尔认知评估量表和额叶评估组进行认知评估，用阳性和阴性综合征量表进行临床症状评估，用精神分裂症卡尔加里抑郁量表进行抑郁评估，用精神分裂症患者生活质量量表进行生活质量评估。结果AEG组在一般认知功能、临床症状和部分生活质量领域均有改善，而CSG组在认知功能、临床症状、抑郁症状和多个生活质量领域均有显著改善。相比之下，在12周的时间里，CG在认知功能、选定的临床症状、抑郁症状和某些生活质量领域表现出明显的恶化。组间比较显示，第12周时，一般认知功能、执行功能和抑郁无统计学差异。然而，在PANSS和QOL的特定分量表上观察到显著差异。结论基于计算机的脑电刺激和脑电刺激可能在PwS的认知和临床领域具有领域特异性和互补作用。

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引用次数: 0

Retrospective chart review on psychiatric manifestations of GLP-1 agonist usage GLP-1激动剂使用后精神症状的回顾性分析

IF 3.2 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2026-04-01 Epub Date: 2026-01-28 DOI: 10.1016/j.jpsychires.2026.01.042

Brianna Sa , Anthony Maristany , Ashwin Subramaniam , Nayha Kumbkarni , Rachel Lange , Sean Oldak , Adela-Georgiana Buciuc , Vanessa Padilla

Background

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly prescribed for type 2 diabetes mellitus and obesity. Beyond metabolic effects, GLP-1 signaling influences central pathways involved in mood, reward, and stress regulation, raising interest in possible psychiatric implications.

Methods

We conducted a retrospective chart review of adults (≥18 years) prescribed GLP-1 RAs at a private university hospital between January 2021 and April 2024. Demographic, medication, and psychiatric data were extracted from electronic health records. Primary outcomes included stability, improvement, worsening, or new onset of psychiatric disorders during treatment.

Results

Among 226 patients (mean age 53.5 years; 66.8 % female; mean BMI 33.6 kg/m²), semaglutide was most frequently prescribed (73 %). The mean treatment duration was 20.2 months, with an average 6.7 % weight loss. Major depressive disorder (MDD) and generalized anxiety disorder (GAD) were most prevalent (68.6 % and 65.9 % of patients, respectively). Most remained stable (MDD: 73.6 %; GAD: 78.5 %). New-onset MDD occurred in 9.0 % and GAD in 8.7 % of affected patients, with mean latencies of 15.8 and 16.8 months, respectively. Adjustment disorder, ADHD, and insomnia also emerged in a subset, with ADHD showing the shortest latency to onset (7.8 months). Rare new-onset alcohol use disorder, trichotillomania, and opioid use disorder were observed.

Conclusions

GLP-1 RAs appear psychiatrically well-tolerated for most patients, though new-onset or worsening symptoms occur in a minority, underscoring the need for monitoring, particularly in high-risk populations. Prospective studies are warranted to clarify causality, mechanisms, and potential therapeutic roles in psychiatric care.

胰高血糖素样肽-1受体激动剂（GLP-1 RAs）越来越多地被用于治疗2型糖尿病和肥胖症。除了代谢作用外，GLP-1信号还影响涉及情绪、奖励和压力调节的中枢通路，这提高了人们对可能的精神病学影响的兴趣。方法对某私立大学医院2021年1月至2024年4月期间开具GLP-1 RAs处方的成人（≥18岁）进行回顾性图表分析。从电子健康记录中提取人口统计、药物和精神病学数据。主要结局包括治疗期间精神疾病的稳定性、改善、恶化或新发。结果226例患者（平均年龄53.5岁，66.8%为女性，平均BMI为33.6 kg/m2）中，使用西马鲁肽最多（73%）。平均治疗时间为20.2个月，平均体重减轻6.7%。重度抑郁症（MDD）和广泛性焦虑症（GAD）最为普遍（分别占68.6%和65.9%）。大多数保持稳定（MDD: 73.6%; GAD: 78.5%）。新发MDD发生率为9.0%，GAD发生率为8.7%，平均潜伏期分别为15.8个月和16.8个月。适应障碍、注意力缺陷多动障碍和失眠也出现在一个亚群中，其中注意力缺陷多动障碍的发病潜伏期最短（7.8个月）。观察到罕见的新发酒精使用障碍、拔毛癖和阿片类药物使用障碍。结论：大多数患者对glp -1 RAs的精神耐受性良好，但少数患者出现新发或症状恶化，这强调了监测的必要性，特别是在高危人群中。有必要进行前瞻性研究，以阐明精神病学护理中的因果关系、机制和潜在的治疗作用。

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引用次数: 0

Lithium treatment and risk of neurocognitive disorders in older patients with bipolar disorder: A systematic review 老年双相情感障碍患者的锂治疗和神经认知障碍风险：一项系统综述。

IF 3.2 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2026-04-01 Epub Date: 2026-01-16 DOI: 10.1016/j.jpsychires.2026.01.022

Eleni Parlapani , Anna Kirka , Vasiliki Holeva , Stergios Kaprinis

Objective

Bipolar disorder is a chronic mental illness that requires long-term treatment. Reports from patients of cognitive dulling have prompted research into the impact of long-term Lithium treatment on cognition. The present systematic review aimed to investigate the effects of Lithium on neurocognitive disorder outcomes in older patients with bipolar disorder.

Method

A systematic literature search was conducted in four databases: PubMed, Scopus, ScienceDirect and EBSCO. Study inclusion was based on concrete inclusion/exclusion criteria. The literature search and the final study selection were conducted in four stages. Included studies were assessed for quality using the Newcastle-Ottawa Quality Assessment Scale for cohort studies, and the Modifications to the Newcastle-Ottawa Scale for cross-sectional studies.

Results

The original search yielded a total of 8285 records. Among these, nine studies were included in the systematic review. Eight out of nine studies did not support an association between Lithium treatment and increased risk of neurocognitive disorders. One study found that the association between bipolar disorder and neurocognitive disorder may be mediated by Lithium treatment.

Conclusion

There is no conclusive evidence that long-term Lithium treatment is harmful with respect to neurocognitive outcomes in older patients with bipolar disorder. Beyond its efficacy as a mood-stabilizer, accumulating evidence supports Lithium's neurotrophic effects. To date, there is enough evidence to support Lithium maintenance as a first-line treatment for older patients with bipolar disorder.

目的：双相情感障碍是一种需要长期治疗的慢性精神疾病。来自认知迟钝患者的报告促使人们研究长期锂离子治疗对认知的影响。本系统综述旨在探讨锂对老年双相情感障碍患者神经认知障碍结局的影响。方法：系统检索PubMed、Scopus、ScienceDirect和EBSCO 4个数据库的文献。研究纳入基于具体的纳入/排除标准。文献检索和最后的研究选择分四个阶段进行。纳入的研究采用纽卡斯尔-渥太华质量评估量表对队列研究进行质量评估，对纽卡斯尔-渥太华量表的修改对横断面研究进行质量评估。结果：最初的搜索总共产生了8285条记录。其中9项研究纳入系统评价。九项研究中有八项不支持锂治疗与神经认知障碍风险增加之间的联系。一项研究发现，双相情感障碍和神经认知障碍之间的关联可能是由锂治疗介导的。结论：没有确凿的证据表明长期锂治疗对老年双相情感障碍患者的神经认知结果有害。除了作为情绪稳定剂的功效，越来越多的证据支持锂的神经营养作用。迄今为止，有足够的证据支持锂维持作为老年双相情感障碍患者的一线治疗。

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引用次数: 0

“When is it late”? Optimal threshold for duration of untreated illness (DUI) to predict SSRI-treatment resistance in individuals with obsessive-compulsive disorder (OCD) “什么时候晚？”未治疗疾病持续时间（DUI）预测强迫症（OCD）患者抗ssri治疗的最佳阈值

IF 3.2 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2026-04-01 Epub Date: 2026-01-29 DOI: 10.1016/j.jpsychires.2026.01.056

Luca Pellegrini , Gabriele Di Salvo , Nicola Rizzo Pesci , Gianluca Rosso , Giuseppe Maina , Umberto Albert

Background

Obsessive-compulsive disorder (OCD) is a chronic psychiatric condition in which delays to appropriate treatment—known as duration of untreated illness (DUI)—are common and clinically consequential. Although prolonged DUI has been associated with poor response, the specific time point beyond which treatment resistance becomes likely remains unclear.

Methods

We analysed 220 adults with DSM-5 OCD consecutively recruited at the University of Turin OCD clinic (2015–2023). DUI was defined as the interval between onset of clinically significant symptoms and the initiation of an adequate selective serotonin reuptake inhibitor (SSRI) trial (moderate-to-high dose for ≥12 weeks). Response was defined as a ≥35 % reduction in Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score and a Clinical Global Impression–Improvement (CGI-I) rating ≤2. Receiver-operating-characteristic (ROC) analysis identified the DUI cut-off predicting SSRI non-response.

Results

Mean age was equal to 34.5 ± 12.4 years; mean DUI was 107.2 ± 116.7 months. Half of the sample (50.4 %) responded to first-line SSRIs. ROC analysis yielded area under the curve = 0.634 (p < 0.001). The optimal cut-off was 42 months, corresponding to a sensitivity of 70.1 % and a specificity of 53.9 %.

Conclusions

A DUI exceeding about 3.5 years is associated with a substantially lower probability of SSRI response. These data suggest that a duration of untreated illness beyond forty-two months may predict reduced responsiveness to first-line SSRI therapy in OCD, though replication in larger, multicentric samples is warranted.

背景：强迫症（OCD）是一种慢性精神疾病，在这种情况下，延迟适当的治疗——被称为未治疗疾病的持续时间（DUI）——是常见的和临床后果。虽然长期酒后驾车与不良反应有关，但超过治疗耐药性的具体时间点仍不清楚。方法：我们分析了都灵大学强迫症诊所（2015-2023）连续招募的220名患有DSM-5强迫症的成年人。DUI定义为出现临床显著症状和开始适当的选择性5 -羟色胺再摄取抑制剂（SSRI）试验（中至高剂量，持续≥12周）之间的间隔。缓解被定义为耶鲁-布朗强迫症量表（Y-BOCS）得分降低≥35%，临床总体印象改善（CGI-I）评分≤2。受试者工作特征（ROC）分析确定DUI截止值预测SSRI无反应。结果：平均年龄34.5±12.4岁；平均DUI为107.2±116.7个月。一半的样本（50.4%）对一线SSRIs有反应。ROC分析得出曲线下面积= 0.634 (p)。结论：酒后驾车超过3.5年与SSRI反应的概率显著降低相关。这些数据表明，持续未治疗的疾病超过42个月可能预示着强迫症患者对一线SSRI治疗的反应性降低，尽管在更大的多中心样本中得到了证实。

{"title":"“When is it late”? Optimal threshold for duration of untreated illness (DUI) to predict SSRI-treatment resistance in individuals with obsessive-compulsive disorder (OCD)","authors":"Luca Pellegrini , Gabriele Di Salvo , Nicola Rizzo Pesci , Gianluca Rosso , Giuseppe Maina , Umberto Albert","doi":"10.1016/j.jpsychires.2026.01.056","DOIUrl":"10.1016/j.jpsychires.2026.01.056","url":null,"abstract":"<div><h3>Background</h3><div>Obsessive-compulsive disorder (OCD) is a chronic psychiatric condition in which delays to appropriate treatment—known as duration of untreated illness (DUI)—are common and clinically consequential. Although prolonged DUI has been associated with poor response, the specific time point beyond which treatment resistance becomes likely remains unclear.</div></div><div><h3>Methods</h3><div>We analysed 220 adults with DSM-5 OCD consecutively recruited at the University of Turin OCD clinic (2015–2023). DUI was defined as the interval between onset of clinically significant symptoms and the initiation of an adequate selective serotonin reuptake inhibitor (SSRI) trial (moderate-to-high dose for ≥12 weeks). Response was defined as a ≥35 % reduction in Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score and a Clinical Global Impression–Improvement (CGI-I) rating ≤2. Receiver-operating-characteristic (ROC) analysis identified the DUI cut-off predicting SSRI non-response.</div></div><div><h3>Results</h3><div>Mean age was equal to 34.5 ± 12.4 years; mean DUI was 107.2 ± 116.7 months. Half of the sample (50.4 %) responded to first-line SSRIs. ROC analysis yielded area under the curve = 0.634 (p < 0.001). The optimal cut-off was 42 months, corresponding to a sensitivity of 70.1 % and a specificity of 53.9 %.</div></div><div><h3>Conclusions</h3><div>A DUI exceeding about 3.5 years is associated with a substantially lower probability of SSRI response. These data suggest that a duration of untreated illness beyond forty-two months may predict reduced responsiveness to first-line SSRI therapy in OCD, though replication in larger, multicentric samples is warranted.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"195 ","pages":"Pages 181-184"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Neurobiological, molecular, and systemic mechanisms of exercise in the treatment of mental health disorders 运动治疗精神健康障碍的神经生物学、分子和系统机制

IF 3.2 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2026-04-01 Epub Date: 2026-01-28 DOI: 10.1016/j.jpsychires.2026.01.043

Tony R. Montgomery Jr., DeMond M. Grant

Exercise is a potent modulator of mental health, with accumulating evidence highlighting its ability to produce structural and functional changes in the brain. This review synthesizes findings across neurobiological, molecular, and systemic domains to explain how exercise improves outcomes in mood, anxiety, and stress-related disorders. We examine how exercise stimulates brain-derived neurotrophic factor (BDNF), regulates monoaminergic systems (serotonin, dopamine, norepinephrine), modulates inflammatory and oxidative stress pathways, and promotes neurogenesis and synaptic plasticity. The review also explores systemic mechanisms including the gut–brain axis, myokine signaling (e.g., irisin, cathepsin B), and the regulation of the hypothalamic–pituitary–adrenal (HPA) axis. Furthermore, we discuss how exercise influences key psychological mechanisms, including emotion regulation, self-efficacy, and cognitive reappraisal, offering a translational bridge between physiology and psychotherapy. Understanding these overlapping mechanisms can guide clinicians in prescribing exercise as an evidence-based adjunct or standalone therapy for mental health disorders. This model of exercise as medicine has the potential to enhance both accessibility and efficacy of mental health care. Implications for clinical integration, mechanistic research, and policy development are discussed.

运动是一种有效的心理健康调节剂，越来越多的证据表明，它能够在大脑中产生结构和功能上的变化。这篇综述综合了神经生物学、分子和系统领域的研究结果，解释了运动如何改善情绪、焦虑和压力相关疾病的结果。我们研究了运动如何刺激脑源性神经营养因子（BDNF），调节单胺能系统（血清素，多巴胺，去甲肾上腺素），调节炎症和氧化应激途径，促进神经发生和突触可塑性。综述还探讨了包括肠-脑轴、肌因子信号（如鸢尾素、组织蛋白酶B）和下丘脑-垂体-肾上腺（HPA）轴的调节在内的系统机制。此外，我们讨论了运动如何影响关键的心理机制，包括情绪调节、自我效能和认知重新评估，为生理学和心理治疗之间的翻译提供了桥梁。了解这些重叠的机制可以指导临床医生将运动作为一种基于证据的辅助或独立治疗精神健康障碍的方法。这种作为医学的运动模式有可能提高精神卫生保健的可及性和有效性。对临床整合、机制研究和政策制定的影响进行了讨论。

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引用次数: 0