Journal of psychiatric research最新文献_第4页

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 : 2026-01-28 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

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 : 2026-01-28 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

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 : 2026-01-28 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

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 : 2026-01-28 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

Trends in anticholinergic drug exposure and associated risk factors in older Australian patients with dementia 澳大利亚老年痴呆患者抗胆碱能药物暴露趋势及相关危险因素

IF 3.2 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2026-01-28 DOI: 10.1016/j.jpsychires.2026.01.048

Woldesellassie M. Bezabhe , Jan Radford , Mohammed S. Salahudeen , Ivan Bindoff , Tristan Ling , Peter Gee , Gregory M. Peterson

Background

Awareness of anticholinergic drug exposure and its harm in people with dementia has been increasing. We investigated whether this had transpired into reduced use and determined factors associated with high anticholinergic burdens.

Methods

We used the anticholinergic cognitive burden (ACB) scale to measure the mean daily ACB score from 135 medicines in patients with dementia using data from 400 general practices across Australia from 2013 to 2020. We determined factors associated with exposure to high anticholinergic burden.

Results

Included patients with dementia (1:1 matched controls) ranged from 3989 in 2013 to 6278 in 2020. The proportion of patients with a mean total daily ACB score ≥3 declined from 26.1% (95% CI 24.7–27.5%) in 2013 to 19.2% (95% CI 18.3–20.2%) in 2020 in the dementia groups (p <0.001). Schizophrenia (adjusted odds ratio [aOR], 3.51; 95% CI, 2.62–4.78), depression (aOR, 2.31; 95% CI, 2.11–2.54) and anxiety (aOR, 1.41; 95% CI, 1.26–1.57) were associated with a high daily mean ACB score in patients with dementia. Living in outer regional, remote and very remote areas (compared with major cities) (aOR, 1.43; 95% CI, 1.22–1.68) and living in disadvantaged areas, compared with most advantaged areas (aOR 1.25; 95% CI, 1.07–1.46), were also associated with a higher ACB score.

Conclusions

While the use of anticholinergic medicines had significantly reduced, nearly one-fifth of the patients with dementia had high anticholinergic exposure at the end of the study period. The findings support the rationale for efforts to deprescribe antidepressants, antipsychotics, and opioids, especially in relatively disadvantaged areas.

背景：人们对痴呆症患者抗胆碱能药物暴露及其危害的认识日益提高。我们调查了这是否会导致使用减少，并确定了与高抗胆碱能负荷相关的因素。方法采用抗胆碱能认知负担（ACB）量表，利用2013年至2020年澳大利亚400家全科医院的数据，对135种痴呆患者药物的平均每日ACB评分进行测量。我们确定了与暴露于高抗胆碱能负荷相关的因素。结果纳入的痴呆患者（1:1匹配对照）从2013年的3989例到2020年的6278例不等。痴呆组平均每日总ACB评分≥3的患者比例从2013年的26.1% （95% CI 24.7-27.5%）下降到2020年的19.2% (95% CI 18.3-20.2%) （p <0.001）。精神分裂症（校正优势比[aOR]， 3.51; 95% CI, 2.62-4.78）、抑郁（aOR, 2.31; 95% CI, 2.11-2.54）和焦虑（aOR, 1.41; 95% CI, 1.26-1.57）与痴呆患者较高的日平均ACB评分相关。生活在外围地区、偏远地区和非常偏远地区（与主要城市相比）（aOR, 1.43; 95% CI, 1.22-1.68）和生活在贫困地区（aOR, 1.25; 95% CI, 1.07-1.46）也与较高的ACB评分相关。结论：虽然抗胆碱能药物的使用明显减少，但在研究结束时，近五分之一的痴呆患者的抗胆碱能药物暴露水平较高。研究结果支持了减少抗抑郁药、抗精神病药和阿片类药物处方的基本原理，特别是在相对不利的地区。

{"title":"Trends in anticholinergic drug exposure and associated risk factors in older Australian patients with dementia","authors":"Woldesellassie M. Bezabhe , Jan Radford , Mohammed S. Salahudeen , Ivan Bindoff , Tristan Ling , Peter Gee , Gregory M. Peterson","doi":"10.1016/j.jpsychires.2026.01.048","DOIUrl":"10.1016/j.jpsychires.2026.01.048","url":null,"abstract":"<div><h3>Background</h3><div>Awareness of anticholinergic drug exposure and its harm in people with dementia has been increasing. We investigated whether this had transpired into reduced use and determined factors associated with high anticholinergic burdens.</div></div><div><h3>Methods</h3><div>We used the anticholinergic cognitive burden (ACB) scale to measure the mean daily ACB score from 135 medicines in patients with dementia using data from 400 general practices across Australia from 2013 to 2020. We determined factors associated with exposure to high anticholinergic burden.</div></div><div><h3>Results</h3><div>Included patients with dementia (1:1 matched controls) ranged from 3989 in 2013 to 6278 in 2020. The proportion of patients with a mean total daily ACB score ≥3 declined from 26.1% (95% CI 24.7–27.5%) in 2013 to 19.2% (95% CI 18.3–20.2%) in 2020 in the dementia groups (p <0.001). Schizophrenia (adjusted odds ratio [aOR], 3.51; 95% CI, 2.62–4.78), depression (aOR, 2.31; 95% CI, 2.11–2.54) and anxiety (aOR, 1.41; 95% CI, 1.26–1.57) were associated with a high daily mean ACB score in patients with dementia. Living in outer regional, remote and very remote areas (compared with major cities) (aOR, 1.43; 95% CI, 1.22–1.68) and living in disadvantaged areas, compared with most advantaged areas (aOR 1.25; 95% CI, 1.07–1.46), were also associated with a higher ACB score.</div></div><div><h3>Conclusions</h3><div>While the use of anticholinergic medicines had significantly reduced, nearly one-fifth of the patients with dementia had high anticholinergic exposure at the end of the study period. The findings support the rationale for efforts to deprescribe antidepressants, antipsychotics, and opioids, especially in relatively disadvantaged areas.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"195 ","pages":"Pages 212-218"},"PeriodicalIF":3.2,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118954","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

Use or no use? Young People's engagement with mental health services 有用还是没用？青年人对精神卫生服务的参与。

IF 3.2 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2026-01-28 DOI: 10.1016/j.jpsychires.2026.01.034

Corine Driessens , Kim Markham-Jones , Nicole Davenport , Mahdi Hassan , Shahrbano Iqbal , Friday Skelton , Fiona Lacey , Peter WF. Smith

Mental health challenges among young people are a significant concern in the United Kingdom, with an estimated 16 % of young people experiencing common mental health problems like anxiety and/or depression on any given day, yet only one in four of these are able to access mental health services. This study seeks to identify the key determinants influencing young people's mental health care utilization and to examine the experiences faced by those who do not engage with mental health services, using a co-produced adaptation of Andersen's Behavioral Model of Health Care Utilization to analyze linked health care data from the NEXT STEPS cohort. Imputation addressed missing data, while logistic regression assessed need, enablers, and predispositions influencing care use. Key findings indicate that young people's mental health care utilization is primarily driven by clinically assessed need, while factors such as female gender, presence of psychiatric-level symptoms, limited social support, external locus of control, parental unemployment emerged as weaker predictors of service engagement. Young people with common mental health problems who had not accessed mental health services were less likely than service users to be female, live in single-parent households, have caring responsibilities, or report bullying, but were more likely to report positive parental relationships. Adults who had accessed mental health services as a young person experienced less favourable adult outcomes and quality of life relative to non-users. These findings highlight the need to reform youth mental health care models towards more inclusive, preventative, and holistic approaches.

在英国，年轻人面临的心理健康挑战是一个重大问题，估计有16%的年轻人在任何一天都会遇到焦虑和/或抑郁等常见心理健康问题，但其中只有四分之一的人能够获得心理健康服务。本研究旨在确定影响年轻人精神卫生保健利用的关键决定因素，并检查那些不从事精神卫生服务的人所面临的经历，使用共同制作的Andersen的卫生保健利用行为模型来分析来自NEXT STEPS队列的相关卫生保健数据。归因处理了缺失的数据，而逻辑回归评估了影响护理使用的需求、促成因素和倾向。主要发现表明，青少年的心理保健利用主要受临床评估需求的驱动，而女性性别、精神水平症状的存在、有限的社会支持、外部控制点、父母失业等因素对服务参与的预测作用较弱。与服务使用者相比，没有获得心理健康服务的有常见心理健康问题的年轻人是女性、生活在单亲家庭、有照顾责任或报告受欺凌的可能性更小，但更有可能报告积极的父母关系。与不使用心理健康服务的成年人相比，年轻时接受过心理健康服务的成年人的成年结果和生活质量较差。这些发现强调需要改革青年精神卫生保健模式，使之朝着更具包容性、预防性和整体性的方向发展。

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引用次数: 0

Correlates of alcohol use and alcohol use disorder among youth with bipolar disorder 青少年双相情感障碍患者酒精使用与酒精使用障碍的相关性

IF 3.2 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2026-01-28 DOI: 10.1016/j.jpsychires.2026.01.045

Alysha A. Sultan , Chon Hei Wong , Benjamin I. Goldstein

Background

Despite increased prevalence of alcohol use and alcohol use disorder (AUD) in youth with bipolar disorder (BD), little is known about the clinical correlates of this comorbidity.

Methods

Participants included 250 youth aged 13–20 years with BD (n = 135 with no alcohol use; n = 76 with alcohol use; and n = 39 with lifetime AUD). Multinomial logistic regression examined associations between demographic and clinical characteristics and alcohol use group (reference: no alcohol use), adjusting for age and sex. Binary logistic regression compared the alcohol use and AUD groups.

Results

Relative to youth with no alcohol use, those with alcohol use or AUD had higher rates of drug use disorder, smoking and impulsivity; these were also higher in youth with AUD versus alcohol use. Compared to no alcohol use, youth with alcohol use had higher current mania, whereas youth with AUD were older and had higher rates of oppositional defiant disorder (ODD), conduct disorder (CD), eating disorder, current and lifetime depression, emotional dysregulation and interpersonal problems. Compared to alcohol use, youth with AUD had higher rates of ODD and CD.

Conclusion

In addition to the expected association of alcohol use and AUD with use of other substances, youth with BD and alcohol use or AUD had greater impulsivity. Furthermore, AUD was associated with increased rates of multiple internalizing and externalizing comorbidities. Adverse clinical correlates were significantly more common among youth with AUD vs. alcohol use. Pending findings from longitudinal research, these correlates provide potential prevention and treatment targets to mitigate adverse effects of alcohol.

背景：尽管酒精使用和酒精使用障碍（AUD）在青年双相情感障碍（BD）中的患病率增加，但对这种合并症的临床相关性知之甚少。方法：参与者包括250名13-20岁的BD青年（n = 135，无饮酒；n = 76，有饮酒；n = 39，终生AUD）。多项逻辑回归检验了人口统计学和临床特征与酒精使用组（参考：无酒精使用）之间的关联，并对年龄和性别进行了调整。二元逻辑回归比较了酒精使用组和AUD组。结果：与未饮酒的青少年相比，饮酒或AUD的青少年吸毒障碍、吸烟和冲动发生率较高；与酒精使用相比，这些在患有澳元的青少年中也更高。与不使用酒精的青少年相比，使用酒精的青少年有更高的当前躁狂，而患有AUD的青少年年龄更大，有更高的对立违抗性障碍（ODD）、行为障碍（CD）、饮食障碍、当前和终身抑郁、情绪失调和人际关系问题的发生率。与酒精使用相比，患有AUD的青少年有更高的ODD和cd率。结论：除了预期的酒精使用和AUD与其他物质使用的关联外，患有BD和酒精使用或AUD的青少年有更大的冲动性。此外，AUD与多种内在化和外在化合并症的发生率增加有关。不良临床相关性在青少年AUD患者中比酒精使用患者更为常见。纵向研究有待发现，这些相关因素提供了潜在的预防和治疗目标，以减轻酒精的不良影响。

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引用次数: 0

Cabergoline and impulse control disorders: Screening patients with pituitary adenomas in an endocrinology clinic 卡麦角林与冲动控制障碍：内分泌门诊垂体腺瘤患者的筛查

IF 3.2 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2026-01-28 DOI: 10.1016/j.jpsychires.2026.01.041

Max Lydiatt , Bryndis Grissom , Jake Givens , Mukanya Tchombela , Andjela Drincic

Background

Cabergoline, a dopamine agonist, is a first-line treatment for prolactinoma. However, de novo impulse control disorders (ICDs) are an increasingly recognized side effect, with reported prevalence up to 59.8 %. This study evaluated risk factors for ICD development and assessed the effectiveness of current screening practices.

Methods

Electronic medical records were reviewed for patients seen by endocrinology with a diagnosis of “Benign neoplasm of pituitary gland (D35.2∗)” who had been prescribed cabergoline. Records were examined for ICD risk factors, clinical evidence of ICDs, and documented screening. A subgroup analysis was perfomed among the patients that had been screened.

Results

Among 282 patients on cabergoline, 14 (5 %) developed clinically significant ICDs. ICD development was significantly more common in males (86 % of ICD cases vs. 41 % of non-ICD cases, p = 0.001). No significant associations were observed with race (p = 0.17), ethnicity (p = 1.00), smoking status (p = 0.77), testosterone therapy in males (p = 0.80), psychiatric diagnoses (p = 0.37), or psychotropic medication use (p = 0.48). Patients with ICDs had a higher mean maximum weekly cabergoline dose (2.2 mg vs. 1.3 mg, p = 0.01). Only 26.6 % of patients were screened or informed of ICD risk at the initial visit. Screening was associated with ICD identification: 93 % of ICD patients were screened compared with 17 % of non-ICD patients (p < 0.0001). In the screened cohort, no significant associations with sex or cabergoline dose were observed.

Conclusion

Male sex and higher cabergoline doses were associated with ICD development in the overall population but not in the subgrop of patients that had a documented screening. Other suspected risk factors, including psychiatric comorbidity and testosterone therapy, were not associated with development of ICD—adding nuance to prior findings. Screening was infrequent and disproportionately associated with ICD detection, suggesting underdiagnosis due to lack of proactive assessment. These results highlight the need for universal, standardized ICD screening in prolactinoma patients prior to and during cabergoline treatment.

卡麦角林是一种多巴胺激动剂，是催乳素瘤的一线治疗药物。然而，从头开始的冲动控制障碍（ICDs）是越来越多的人认识到的副作用，据报道患病率高达59.8%。本研究评估了ICD发展的危险因素，并评估了当前筛查实践的有效性。方法对经内分泌科诊断为“垂体良性肿瘤（D35.2 *）”并服用卡麦角林的患者进行电子病历分析。检查ICD危险因素、ICD临床证据和筛查记录。对接受筛查的患者进行亚组分析。结果282例卡麦角林患者中，14例（5%）发生临床显著性icd。ICD的发展在男性中更为常见（86%的ICD病例对41%的非ICD病例，p = 0.001）。与种族（p = 0.17）、种族（p = 1.00）、吸烟状况（p = 0.77）、男性睾酮治疗（p = 0.80）、精神诊断（p = 0.37）或精神药物使用（p = 0.48）均无显著相关性。icd患者的卡麦角林平均最大周剂量更高（2.2 mg vs. 1.3 mg, p = 0.01）。只有26.6%的患者在初次就诊时被筛查或告知ICD风险。筛查与ICD诊断相关：93%的ICD患者接受了筛查，而非ICD患者的这一比例为17% （p < 0.0001）。在筛选的队列中，没有观察到与性别或卡麦角林剂量的显著关联。结论在总体人群中，男性和较高的卡麦角林剂量与ICD的发展相关，但在有记录筛查的患者亚组中没有相关。其他可疑的危险因素，包括精神合并症和睾酮治疗，与icd的发展无关，这与先前的发现有细微差别。筛查不频繁且与ICD检测不成比例地相关，表明由于缺乏主动评估而导致诊断不足。这些结果强调了在卡麦角林治疗前和治疗期间对催乳素瘤患者进行普遍、标准化的ICD筛查的必要性。

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引用次数: 0

Gut-brain axis in Attention Deficit Hyperactivity Disorder (ADHD): A narrative review of the links between gut microbiota and ADHD pathophysiology 注意缺陷多动障碍（ADHD）的肠脑轴：肠道微生物群与ADHD病理生理之间联系的叙述性回顾。

IF 3.2 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2026-01-28 DOI: 10.1016/j.jpsychires.2026.01.038

Barbara Luyens , Francisco Felgueroso-Bueno , Amandine Everard , Isabelle Massat

Characterized by developmentally inappropriate levels of inattention, hyperactivity, and impulsivity, Attention-Deficit Hyperactivity Disorder (ADHD) is the most prevalent neurodevelopmental disorder, posing a significant public health concern. Its etiopathogenesis is considered multifactorial with complex determinism but remains unclear. Recent research highlights the gut microbiota and the gut-brain axis as promising avenues for understanding and potentially treating ADHD, with a growing number of studies exploring alterations in gut microbiota composition among affected individuals. This narrative review examines the current literature on the role of the gut microbiota in ADHD and focuses on key findings about bacterial composition, how it may be linked to ADHD symptomatology, and the possible mechanisms involved.

While studies consistently report changes in microbial composition and diversity in individuals with ADHD, results remain heterogeneous across taxonomic levels. Some compelling evidence also suggests a link between gut microbial profiles and ADHD symptom severity. The involvement of microbiota in influencing neurodevelopment is proposed to be mediated through mechanisms related to SCFA production, immune modulation, and neurotransmitter synthesis. These findings pave the way for microbiota-targeted interventions as adjunct therapies for ADHD.

This review evaluates areas of consensus and discrepancies between studies, while addressing the methodological limitations present in this field of research. Although the gut microbiota appears to play a meaningful role in the complex and multifactorial origins of ADHD, more rigorous and comprehensive studies are needed to confirm these findings and translate them into effective clinical applications. This could ultimately improve both our understanding and treatment of this heterogeneous disorder.

注意缺陷多动障碍（ADHD）的特点是注意力不集中、多动和冲动，是最普遍的神经发育障碍，引起了重大的公共卫生问题。其发病机制被认为是多因素的，具有复杂的确定性，但仍不清楚。最近的研究强调肠道微生物群和肠-脑轴是理解和潜在治疗ADHD的有希望的途径，越来越多的研究探索受影响个体肠道微生物群组成的改变。本文回顾了目前关于肠道微生物群在ADHD中的作用的文献，并着重于细菌组成的关键发现，它如何与ADHD症状相关联，以及可能涉及的机制。虽然研究一致报告了ADHD个体的微生物组成和多样性的变化，但在分类学水平上的结果仍然不一致。一些令人信服的证据也表明，肠道微生物特征与多动症症状严重程度之间存在联系。微生物群参与影响神经发育被认为是通过与SCFA产生、免疫调节和神经递质合成相关的机制介导的。这些发现为针对微生物群的干预作为ADHD的辅助治疗铺平了道路。本综述评估了研究之间的共识和差异，同时解决了该研究领域中存在的方法局限性。尽管肠道微生物群似乎在ADHD的复杂和多因素起源中发挥了重要作用，但需要更严格和全面的研究来证实这些发现并将其转化为有效的临床应用。这可能最终提高我们对这种异质性疾病的理解和治疗。

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引用次数: 0

The beneficial effect of a multispecies probiotic intervention on quality of sleep – a randomized, double-blinded, placebo-controlled study 多物种益生菌干预对睡眠质量的有益影响——一项随机、双盲、安慰剂对照研究。

IF 3.2 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2026-01-28 DOI: 10.1016/j.jpsychires.2026.01.040

Angela Horvath , Rosa Haller , Karin Schmid-Zalaudek , Nandu Goswami , Jolana Wagner-Skacel , Hansjörg Habisch , Tobias Madl , Vanessa Stadlbauer

Study objectives

Sleep disorders are common and impair performance and health. The intestinal microbiome regulates human chronobiology. Microbiome modulation through probiotic intervention might therefore harbor the potential to treat sleep disorders. We tested this hypothesis in a randomized, double-blind, placebo-controlled study.

Methods

We randomized 130 volunteers with self-reported impaired quality of sleep (PSQI>5) in a 1:1 ratio to a 28-day intervention with either a multispecies probiotic (OMNiBiOTiC® STRESS Repair) or a placebo. Participants completed validated questionnaires to estimate quality of sleep, quality of life and perceived stress, and collected stool samples for 16S rRNA sequencing before and after the intervention. Ninety-four participants finished the study and were included in the analysis.

Results

Baseline characteristics were similar between the probiotic group (n = 50; 88.6 % female, 41.2 ± 10.6 years old) and the placebo group (n = 44; 88.0 % female, 40.1 ± 10.7 years old), including the initial PSQI score (10.1 ± 2.7 vs. 10.5 ± 2.6). The probiotic intervention led to an improved sleep efficiency and latency, and thereby improved quality of sleep beyond an observable placebo effect (6.8 ± 2.9 vs. 7.7 ± 3.1; p = 0.036, probiotic and placebo group, respectively). Probiotic bacteria were partially recovered in the microbiome, causing a slight shift in beta diversity in the probiotic group. The intervention did not influence quality of life or perceived stress.

Conclusions

In conclusion, this well-powered RCT shows that the intervention with a multispecies probiotic improved quality of sleep beyond the effect of a placebo intervention, and that the modulation of the microbiome may therefore be of clinical benefit in alleviating sleep disturbances.

研究目的：睡眠障碍是一种常见的疾病，会影响工作表现和健康。肠道微生物组调节人类的时间生物学。因此，通过益生菌干预调节微生物组可能具有治疗睡眠障碍的潜力。我们在一项随机、双盲、安慰剂对照的研究中验证了这一假设。方法：我们将130名自我报告睡眠质量受损（PSQI bbbb5）的志愿者按1:1的比例随机分配到28天的多物种益生菌（OMNiBiOTiC®STRESS Repair）或安慰剂干预组。参与者完成有效的问卷来评估睡眠质量、生活质量和感知压力，并收集粪便样本进行干预前后的16S rRNA测序。94名参与者完成了研究，并被纳入分析。结果：益生菌组（n = 50； 88.6%女性，41.2±10.6岁）和安慰剂组（n = 44； 88.0%女性，40.1±10.7岁）的基线特征相似，包括初始PSQI评分（10.1±2.7比10.5±2.6）。益生菌干预改善了睡眠效率和潜伏期，从而改善了睡眠质量，超出了可观察到的安慰剂效应（益生菌组和安慰剂组分别为6.8±2.9比7.7±3.1;p = 0.036）。益生菌在微生物组中部分恢复，导致益生菌组的β多样性略有变化。干预没有影响生活质量或感知压力。结论：总之，这项强有力的随机对照试验显示，多物种益生菌的干预改善了睡眠质量，其效果超过了安慰剂干预的效果，因此微生物组的调节可能在缓解睡眠障碍方面具有临床益处。

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引用次数: 0