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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 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 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
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 Pub 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
Exploring the relationship between ADHD symptoms and suicide risk through the lens of the Integrated Motivational-Volitional Model of suicidal behaviour 通过自杀行为的综合动机-意志模型来探索ADHD症状与自杀风险之间的关系。
IF 3.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2026-01-27 DOI: 10.1016/j.jpsychires.2026.01.036
Seonaid Cleare, Rory C. O'Connor

Introduction

Attention Deficit-Hyperactivity Disorder (ADHD) is associated with increased vulnerability to suicide. However, understanding of the psychological factors associated with increased risk is limited. Therefore, we investigated the extent to which psychological factors from the Integrated Motivational–Volitional (IMV) model of suicidal behaviour were associated with suicide risk.

Methods

696 adults who were recruited to a study on ADHD, mental health and suicide risk completed validated measures that assessed components of the IMV model, ADHD symptoms and mental health history.

Results

642 (92.2 %) participants scored 4 or more on the Adult ADHD Self-Report screener (ASRS; Kessler et al., 2005), indicating recent ADHD symptoms. Analyses of IMV model factors were conducted in this subgroup. More than nine out of ten (93 %) participants reported lifetime suicidal thoughts (n = 597), and 41.7 % (n = 268) reported a history of suicide attempts. Multivariable analyses showed higher defeat, internal entrapment and perceived burdensomeness were associated with recent suicidal thoughts, while mental imagery distinguished those with suicide attempt from suicidal thought histories. Perceived burdensomeness moderated the entrapment-to-suicidal thoughts relationship. Exploratory mediation analysis indicated entrapment may mediate the defeat-to-suicidal thoughts relationship.

Conclusions

This is the first study to apply the IMV model to understanding the ADHD-suicide risk relationship. Psychological factors from the IMV model warrant investigation longitudinally as potentially targets for suicide prevention in people with ADHD.
导读:注意缺陷多动障碍(ADHD)与自杀倾向增加有关。然而,对与风险增加相关的心理因素的了解是有限的。因此,我们调查了自杀行为综合动机-意志(IMV)模型中的心理因素与自杀风险的关联程度。方法:696名成年人被招募参加一项关于多动症、心理健康和自杀风险的研究,他们完成了评估IMV模型组成部分、多动症症状和精神健康史的有效测量。结果:642名(92.2%)参与者在成人ADHD自我报告筛查(ASRS; Kessler et al, 2005)中得分为4分或以上,表明最近有ADHD症状。对该亚组进行IMV模式因素分析。超过九成(93%)的参与者报告了一生的自杀念头(n = 597), 41.7% (n = 268)的参与者报告了自杀企图史。多变量分析显示,较高的挫败感、内心陷阱和感知负担与最近的自杀念头有关,而心理意象将自杀企图与自杀思想历史区分开来。感知负担调节了诱捕与自杀念头的关系。探索性中介分析表明,诱捕可能中介失败-自杀念头的关系。结论:这是首次应用IMV模型来理解adhd与自杀风险关系的研究。来自IMV模型的心理因素值得纵向调查,作为ADHD患者自杀预防的潜在目标。
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引用次数: 0
Dissociative symptoms in depressive and anxiety disorders: prevalence and clinical correlates in a real-world outpatient sample 抑郁和焦虑障碍中的解离症状:在现实世界门诊样本中的患病率和临床相关性
IF 3.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2026-01-27 DOI: 10.1016/j.jpsychires.2026.01.032
Anna Dunalska , Andrzej Jakubczyk , Agata Szulc , Natalia Szejko
Dissociative symptoms are increasingly recognized beyond trauma-related and dissociative disorders, yet their role in depressive and anxiety disorders remains understudied, particularly in routine clinical settings. This cross-sectional study examined the prevalence and clinical correlates of dissociative symptoms in 133 adult outpatients with depressive and/or anxiety disorders prior to pharmacological treatment. Dissociation was assessed using the Dissociative Experiences Scale-Revised (DES-R) and the Somatoform Dissociation Questionnaire-20 (SDQ-20), distinguishing between psychoform and somatoform dissociation subtypes. Clinically significant dissociation was observed in 12 % of participants (DES-R) and 18.8 % (SDQ-20). Preoccupation and imaginal involvement were the most common psychoform symptoms, whereas somatoform symptoms were widespread, with no significant difference between the positive and negative subtypes. Somatoform dissociation showed a moderate correlation with anxiety, especially somatic anxiety, whereas psychoform dissociation was only weakly associated with anxiety severity. Interaction and mediation analyses revealed distinct pathways: psychoform dissociation was independently associated with both depression and anxiety, and the nonlinear interaction suggested a saturation effect at high levels of depression. In contrast, somatoform dissociation was indirectly associated with depression via anxiety, suggesting a mediating role. These findings support the disconnection and compartmentalization theory and indicate that dissociative symptoms, even in the absence of trauma, can complicate the clinical presentation of depressive and anxiety disorders. Given that more than 10 % of participants met criteria for both severe depressive and anxiety symptoms and pathological dissociation, routine screening for dissociation seems warranted in psychiatric assessment and treatment planning.
分离症状越来越多地被认为是创伤相关和分离性障碍之外的疾病,但它们在抑郁症和焦虑症中的作用仍未得到充分研究,特别是在常规临床环境中。本横断面研究调查了133名患有抑郁症和/或焦虑症的成年门诊患者在药物治疗前的解离症状的患病率和临床相关性。使用解离体验量表修订版(DES-R)和躯体形式解离问卷-20 (SDQ-20)评估解离,区分精神形式和躯体形式解离亚型。在12%的参与者(DES-R)和18.8% (SDQ-20)中观察到有临床意义的分离。精神症状最常见,而躯体症状普遍存在,阳性亚型和阴性亚型之间无显著差异。躯体形式解离与焦虑呈中等相关性,尤其是躯体焦虑,而精神形式解离与焦虑严重程度仅呈弱相关性。相互作用和中介分析揭示了不同的途径:精神形态分离与抑郁和焦虑独立相关,非线性相互作用表明在高水平抑郁时存在饱和效应。相反,躯体形式分离通过焦虑与抑郁间接相关,表明其具有中介作用。这些发现支持分离和区隔化理论,并表明分离症状,即使在没有创伤的情况下,也会使抑郁和焦虑障碍的临床表现复杂化。考虑到超过10%的参与者符合严重抑郁和焦虑症状以及病理性分离的标准,在精神评估和治疗计划中,分离的常规筛查似乎是有必要的。
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引用次数: 0
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 Pub 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
A systematic review of transcranial direct current stimulation (tDCS) for adults with attention deficit/hyperactivity disorder (ADHD) 经颅直流电刺激(tDCS)治疗成人注意缺陷/多动障碍(ADHD)的系统评价
IF 3.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2026-01-23 DOI: 10.1016/j.jpsychires.2026.01.030
Tianran Zhang , Dimitrios Adamis

Background

Transcranial direct current stimulation (tDCS) has been proposed as a potential non-pharmacological intervention for Attention-Deficit/Hyperactivity Disorder (ADHD). While evidence from pediatric populations is growing, the effects of tDCS in adults with ADHD remain insufficiently characterized, increasing recognition of ADHD as a lifelong neurodevelopmental condition with persistent functional impairments.

Objective

This systematic review aimed to evaluate the effects of tDCS in adults with ADHD across clinical, cognitive, and neurophysiological outcome domains.

Methods

Six electronic databases were systematically searched to identify peer-reviewed controlled trials evaluating tDCS interventions in adults with clinically diagnosed ADHD through May 2025. Data extraction encompassed clinical symptom outcomes, cognitive task performance, neurophysiological findings, adverse events, medication status, and stimulation protocols. Study quality was assessed using the Downs and Black checklist. Where sufficient data were available, an exploratory random-effects meta-analysis was conducted for clinical symptom outcomes; all other outcomes were synthesized narratively.

Results

Eleven controlled studies (n = 415) met inclusion criteria and were included in the qualitative synthesis. Two randomized controlled trials provided sufficient data for exploratory meta-analysis of clinical symptoms. Pooled results suggested a possible beneficial effect of tDCS on inattention symptoms, accompanied by substantial heterogeneity (I2 = 79.95 %), while no significant effect was observed for hyperactivity/impulsivity. Cognitive outcomes were heterogeneous and domain-specific, with some evidence of post-stimulation improvements in inhibitory control, working memory, and attentional measures. Two studies reported tDCS-induced modulation of frontal neurophysiological markers associated with cognitive control. Stimulation protocols varied considerably across studies, with no consistent association between specific parameters and outcomes. Adverse events were generally mild and transient, and follow-up data were limited.

Conclusions

Current evidence suggests that tDCS may exert domain-specific effects on inattention and selected cognitive functions in adults with ADHD. However, conclusions remain tentative due to methodological heterogeneity, small sample sizes, and limited quantitative evidence. Future research should prioritize standardized protocols, adequately powered trials with extended follow-up periods, integration of neurophysiological biomarkers, and systematic evaluation of individual difference factors to clarify the therapeutic potential and mechanisms, and advance precision neuromodulation approaches for adult ADHD.
经颅直流电刺激(tDCS)已被提出作为一种潜在的非药物干预注意缺陷/多动障碍(ADHD)。虽然来自儿科人群的证据越来越多,但tDCS对成年ADHD患者的影响仍然不够明确,这使得人们越来越认识到ADHD是一种终身神经发育疾病,伴有持续的功能障碍。目的:本系统综述旨在评估tDCS在成人ADHD患者的临床、认知和神经生理结果领域的影响。方法系统检索6个电子数据库,以确定截至2025年5月评估tDCS干预对临床诊断为ADHD的成人的同行评审对照试验。数据提取包括临床症状结果、认知任务表现、神经生理发现、不良事件、药物状态和刺激方案。使用Downs和Black检查表评估研究质量。在数据充足的情况下,对临床症状结局进行探索性随机效应荟萃分析;所有其他结果以叙述方式综合。结果6项对照研究(n = 415)符合纳入标准,纳入定性综合。两项随机对照试验为临床症状的探索性荟萃分析提供了足够的数据。综合结果表明,tDCS对注意力不集中症状可能有有益影响,但存在很大的异质性(I2 = 79.95%),而对多动/冲动没有显著影响。认知结果是异质的和特定领域的,在抑制控制、工作记忆和注意力测量方面有一些刺激后改善的证据。两项研究报道了tdcs诱导的与认知控制相关的额叶神经生理标记的调节。不同研究的增产方案差异很大,具体参数与结果之间没有一致的联系。不良事件通常是轻微和短暂的,随访数据有限。结论目前的证据表明,tDCS可能对成人ADHD患者的注意力不集中和选择性认知功能产生特定领域的影响。然而,由于方法的异质性、样本量小和定量证据有限,结论仍然是暂定的。未来的研究应优先考虑标准化的方案,延长随访期的充分有力的试验,整合神经生理生物标志物,系统评估个体差异因素,以阐明成人ADHD的治疗潜力和机制,并推进精确的神经调节方法。
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引用次数: 0
Core insomnia symptoms associated with cognitive flexibility in insomnia disorder: A network analysis 失眠障碍中与认知灵活性相关的核心失眠症状:网络分析
IF 3.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2026-01-22 DOI: 10.1016/j.jpsychires.2026.01.029
Shiyan Yang , Zilu Zhang , Xu Lei

Objective

Cognitive flexibility, as a key component of executive function, is often impaired in people with insomnia. This study combined network analysis and multiple linear regression methods aimed to systematically explore the insomnia symptoms associated with cognitive flexibility in individuals with insomnia.

Method

Based on 426 insomnia individuals who completed the Insomnia Severity Index (ISI) and the Cognitive Flexibility Inventory (CFI). The network model was construct between ISI items and CFI subdimensions. Furthermore, multiple linear regression analyses were performed to examine the predictive effects of specific insomnia symptoms on the subdimensions of cognitive flexibility.

Results

Network analysis revealed that ISI6 (noticeability of impaired quality of life) exhibited the highest node strength and expected influence in the network. Linear regression findings indicated that ISI4 (dissatisfaction about current sleep pattern), ISI6 (noticeability of impaired quality of life) and ISI7 (worry about current sleep pattern) could significantly predict CFI_C; ISI2 (difficulty staying asleep) significantly predicted CFI_A.

Conclusion

These findings indicate that impaired quality of life is the core symptom of the “Insomnia-Cognitive Flexibility Network”, and different dimensions of cognitive flexibility may be affected by different insomnia symptoms. This study enhances our understanding of the relationship between insomnia and cognitive flexibility in individuals and suggests new targets for personalized intervention in insomnia.
作为执行功能的关键组成部分,认知灵活性在失眠症患者中经常受损。本研究结合网络分析和多元线性回归方法,系统探讨失眠症患者的失眠症状与认知灵活性的关系。方法对426例失眠症患者进行失眠严重程度指数(ISI)和认知灵活性量表(CFI)调查。构建了ISI项目与CFI子维度之间的网络模型。此外,采用多元线性回归分析来检验特定失眠症状对认知灵活性子维度的预测作用。结果网络分析显示,ISI6(生活质量受损的显著性)在网络中表现出最高的节点强度和预期影响。线性回归结果表明,ISI4(对当前睡眠模式的不满意)、ISI6(生活质量受损的显著性)和ISI7(对当前睡眠模式的担忧)可以显著预测CFI_C;ISI2(难以入睡)显著预测CFI_A。结论生活质量下降是“失眠-认知灵活性网络”的核心症状,不同的失眠症状可能影响不同维度的认知灵活性。本研究增强了我们对失眠与个体认知灵活性之间关系的理解,并为失眠的个性化干预提供了新的目标。
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引用次数: 0
Unmet Promise or Missed Potential? A pairwise and network meta-analysis on efficacy and safety of metabotropic glutamate receptor agonists and positive allosteric modulators in schizophrenia 未实现的承诺还是错过的潜力?代谢性谷氨酸受体激动剂和阳性变构调节剂治疗精神分裂症的有效性和安全性的配对和网络meta分析
IF 3.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2026-01-21 DOI: 10.1016/j.jpsychires.2026.01.023
Archana Mishra , Amiya Shaju , Nidhi Surendra Ibrahimpur , Biswa Ranjan Mishra , Anand Srinivasan , Rituparna Maiti

Objective

Metabotropic glutamate receptor(mGluR) agonists and allosteric modulators like pomaglumetad methionil(POMA) and AZD8529 offer a novel pharmacotherapeutic option in schizophrenia. The results of individual trials on these agents being inconclusive, this meta-analysis was planned to assess the safety and efficacy of mGluR modulators in schizophrenia.

Methods

Following PRISMA guidelines, a systematic search was performed on MEDLINE/PubMed, Embase, Web of Science, Scopus, Cochrane, Google Scholar and WHO-ICTRP, and randomized controlled trials(RCTs) that compared POMA or AZD8529 with either a placebo or second-generation antipsychotics(SGAs) were included. Change in PANSS-Total score was the primary outcome, and PANSS subscales, Clinical Global Impressions-Severity(CGI-S), treatment-emergent adverse events(TEAE) and discontinuation rates were secondary outcomes. A random-effects model was used to estimate the effect size for pairwise and network meta-analysis, and the risk of bias done by RoB2 tool.

Results

A total of ten RCTs (3715 participants) were included in the meta-analysis. mGluR modulators did not show significant improvement in PANSS-T (MD:3.20,95 %CI:0.64,5.76) or PANSS-subscales and CGI-S over the control group. The pooled odds ratio for TEAE (OR:1.08; 95 %CI:0.93,1.27) indicates a statistically nonsignificant incidence of adverse events in the experimental group. Discontinuation due to adverse events was higher in the experimental group (OR:1.43; 95 %CI:1.08,1.89), but discontinuation due to lack of efficacy was not significantly different between the groups (OR:1.24,95 %CI:0.86,1.77). Certainty of evidence ranged from high to low. None of the mGluR modulators were better than placebo or SGAs in network meta-analysis.

Conclusion

mGluR modulators did not show efficacy in terms of improving symptom severity in schizophrenia. However, their therapeutic potential in specific subgroups may be explored by employing strategic trial designs and relevant biomarkers.

PROSPERO id

CRD420251066533
目的:促代谢谷氨酸受体(mGluR)激动剂和变构调节剂如POMA和AZD8529为精神分裂症提供了一种新的药物治疗选择。这些药物的个体试验结果尚无定论,因此本荟萃分析计划评估mGluR调节剂在精神分裂症中的安全性和有效性。方法遵循PRISMA指南,在MEDLINE/PubMed、Embase、Web of Science、Scopus、Cochrane、谷歌Scholar和WHO-ICTRP上进行系统检索,并纳入将POMA或AZD8529与安慰剂或第二代抗精神病药物(SGAs)进行比较的随机对照试验(rct)。PANSS总分的变化是主要结局,PANSS亚量表、临床总体印象严重程度(CGI-S)、治疗不良事件(TEAE)和停药率是次要结局。采用随机效应模型估计两两和网络meta分析的效应大小,并使用RoB2工具估计偏倚风险。结果共纳入10项随机对照试验(rct),共3715名受试者。与对照组相比,mGluR调节剂在PANSS-T (MD:3.20, 95% CI:0.64,5.76)或panss亚量表和CGI-S方面没有显着改善。TEAE的合并优势比(OR:1.08; 95% CI:0.93,1.27)表明实验组不良事件发生率无统计学意义。实验组因不良事件而停药的发生率较高(OR:1.43; 95% CI:1.08,1.89),但两组因缺乏疗效而停药的发生率无显著差异(OR:1.24, 95% CI:0.86,1.77)。证据的确定性从高到低不等。在网络荟萃分析中,没有一种mGluR调节剂优于安慰剂或SGAs。结论glur调节剂在改善精神分裂症症状严重程度方面无明显疗效。然而,它们在特定亚群中的治疗潜力可以通过采用战略性试验设计和相关生物标志物来探索。普洛斯彼罗idCRD420251066533
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引用次数: 0
The effect of lavender herbal tea on the mental health of individuals with misophonia: A randomized controlled trial 薰衣草凉茶对恐音症患者心理健康的影响:一项随机对照试验
IF 3.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2026-01-21 DOI: 10.1016/j.jpsychires.2026.01.028
Sevgi Koroglu Gokbel , Gulgun Durat
Misophonia is a disorder characterized by heightened sensitivity to certain sounds, triggering symptoms such as sympathetic nervous system activation, anger, anxiety, and depression. This study aimed to evaluate the potential role of lavender tea in alleviating these symptoms due to its anxiolytic and antidepressant properties. A single-center, single-blind, randomized clinical trial was conducted with 60 participants aged 18 and over, diagnosed with misophonia. Participants were divided equally into experimental and control groups using block randomization. The experimental group consumed 2 g of lavender tea twice daily for 14 days, while the control group received no intervention. Data were collected using the Misophonia Scale, Beck Depression Inventory II, Anxiety Rating Scale, and Trait Anger Scale and analyzed with SPSS 25.0. Baseline characteristics, including age, gender, marital status, education level, income level, and scores for misophonia, anxiety, depression, and anger, were comparable between groups. The mixed ANOVA results suggested that positive changes were observed in misophonia and related psychological symptoms in the lavender tea group, and that these changes may have been more pronounced compared to the control group. The results suggest that the intervention may correlate with enhancements in misophonia, quality of life, and coping strategies. Lavender tea consumption may have helped alleviate symptoms of misophonia, anxiety, depression, and anger. However, due to the lack of participant blinding and the use of self-report measures, the findings should be interpreted cautiously in terms of placebo effects and expectancy bias.

Registration

ClinicalTrials.gov Number (NCT06785649).
恐音症是一种疾病,其特征是对某些声音高度敏感,引发交感神经系统激活、愤怒、焦虑和抑郁等症状。本研究旨在评估薰衣草茶在缓解这些症状方面的潜在作用,因为它具有抗焦虑和抗抑郁的特性。一项单中心、单盲、随机临床试验对60名年龄在18岁及以上、被诊断为恐音症的参与者进行了研究。采用分组随机法将参与者平均分为实验组和对照组。实验组每天饮用2 g薰衣草茶,持续14天,而对照组则不进行干预。采用恐音症量表、贝克抑郁量表、焦虑评定量表和特质愤怒量表收集数据,并使用SPSS 25.0进行分析。基线特征,包括年龄、性别、婚姻状况、教育水平、收入水平,以及恐惧症、焦虑、抑郁和愤怒的得分,在两组之间具有可比性。混合方差分析结果表明,薰衣草茶组在恐音症和相关心理症状方面观察到积极的变化,并且与对照组相比,这些变化可能更为明显。结果表明,干预可能与恐音症、生活质量和应对策略的改善有关。饮用薰衣草茶可能有助于缓解恐音症、焦虑、抑郁和愤怒的症状。然而,由于缺乏参与者盲法和使用自我报告测量,研究结果应根据安慰剂效应和预期偏倚来谨慎解释。
{"title":"The effect of lavender herbal tea on the mental health of individuals with misophonia: A randomized controlled trial","authors":"Sevgi Koroglu Gokbel ,&nbsp;Gulgun Durat","doi":"10.1016/j.jpsychires.2026.01.028","DOIUrl":"10.1016/j.jpsychires.2026.01.028","url":null,"abstract":"<div><div>Misophonia is a disorder characterized by heightened sensitivity to certain sounds, triggering symptoms such as sympathetic nervous system activation, anger, anxiety, and depression. This study aimed to evaluate the potential role of lavender tea in alleviating these symptoms due to its anxiolytic and antidepressant properties. A single-center, single-blind, randomized clinical trial was conducted with 60 participants aged 18 and over, diagnosed with misophonia. Participants were divided equally into experimental and control groups using block randomization. The experimental group consumed 2 g of lavender tea twice daily for 14 days, while the control group received no intervention. Data were collected using the Misophonia Scale, Beck Depression Inventory II, Anxiety Rating Scale, and Trait Anger Scale and analyzed with SPSS 25.0. Baseline characteristics, including age, gender, marital status, education level, income level, and scores for misophonia, anxiety, depression, and anger, were comparable between groups. The mixed ANOVA results suggested that positive changes were observed in misophonia and related psychological symptoms in the lavender tea group, and that these changes may have been more pronounced compared to the control group. The results suggest that the intervention may correlate with enhancements in misophonia, quality of life, and coping strategies. Lavender tea consumption may have helped alleviate symptoms of misophonia, anxiety, depression, and anger. However, due to the lack of participant blinding and the use of self-report measures, the findings should be interpreted cautiously in terms of placebo effects and expectancy bias.</div></div><div><h3>Registration</h3><div>ClinicalTrials.gov Number (NCT06785649).</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"195 ","pages":"Pages 39-46"},"PeriodicalIF":3.2,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146036713","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
期刊
Journal of psychiatric research
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