Journal of psychiatric research最新文献_第8页

Stimulant and non-stimulant ADHD medication prescriptions for homeless veteran service users with mental illness 为患有精神疾病的无家可归的退伍军人提供兴奋剂和非兴奋剂的ADHD药物处方

IF 3.2 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2026-01-09 DOI: 10.1016/j.jpsychires.2026.01.017

Katherine A. Koh , Dorota Szymkowiak , Jack Tsai

Objective

Prescribing of ADHD medications has not been examined in the US homeless population. This study examined frequency of prescriptions for stimulant and non-stimulant ADHD medications, as well as risky and potentially inappropriate prescribing (RPIP) of stimulants, in three groups of veterans with mental illness.

Methods

Using 2021–2022 national VA administrative data, we compared frequency of stimulant and non-stimulant ADHD medication prescriptions using logistic regression between homeless veterans (n = 105,062), veterans in the Department of Housing and Urban Development-VA Supportive Housing (HUD-VASH; n = 33,884), and independently housed (IH) veterans (n = 1,875,083). We also compared indicators of RPIP of stimulants using chi-square tests between the three groups.

Results

Adjusted for sociodemographic, clinical, and health care utilization characteristics, homeless veterans were less likely to be prescribed stimulants (adjusted odds ratio (aOR) = 0.80, 99 % CI = 0.76–0.85) relative to IH veterans and more likely to be prescribed non-stimulants (aOR = 1.12, CI = 1.06–1.18). However, among veterans prescribed stimulants, homeless veterans had more indicators of RPIP, including being prescribed stimulants in the presence of a psychotic disorder (7.9 % vs. 6.4 % for HUD-VASH vs. 2.2 % for IH, p < .001).

Conclusion

Homeless veterans with mental illness were less likely to be prescribed stimulants and more likely to be prescribed non-stimulant ADHD medications relative to IH veterans with mental illness. However, RPIP of stimulant prescriptions was more common for homeless and HUD-VASH veterans relative to IH veterans.

目的：在美国无家可归的人群中，尚未对ADHD药物的处方进行研究。这项研究调查了三组患有精神疾病的退伍军人中兴奋剂和非兴奋剂药物的处方频率，以及有风险和潜在不适当的兴奋剂处方（RPIP）。方法使用2021-2022年国家退伍军人管理局的数据，我们使用logistic回归比较了无家可归的退伍军人（n = 105,062）、住房和城市发展部-退伍军人保障性住房（HUD-VASH; n = 33,884）和独立居住（IH）退伍军人（n = 1,875,083）之间兴奋剂和非兴奋剂ADHD药物处方的频率。我们还使用卡方检验比较了三组之间兴奋剂的RPIP指标。结果：经社会人口学、临床和卫生保健利用特征调整后，无家可归退伍军人相对于IH退伍军人更不可能开兴奋剂处方（调整优势比(aOR) = 0.80, 99% CI = 0.76-0.85），而更可能开非兴奋剂处方（aOR = 1.12, CI = 1.06-1.18）。然而，在服用兴奋剂的退伍军人中，无家可归的退伍军人有更多的RPIP指标，包括在存在精神障碍的情况下服用兴奋剂（HUD-VASH为7.9%，IH为6.4%，IH为2.2%,p < 0.001）。结论与患有精神疾病的无家可归退伍军人相比，患有精神疾病的无家可归退伍军人服用兴奋剂的可能性更小，而服用非兴奋剂类药物的可能性更大。然而，相对于IH退伍军人，兴奋剂处方的RPIP在无家可归者和HUD-VASH退伍军人中更为常见。

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引用次数: 0

Pre-deployment prediction of partial and full PTSD in a French military cohort 法国军队队列中部分和完全PTSD的部署前预测。

IF 3.2 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2026-01-08 DOI: 10.1016/j.jpsychires.2026.01.013

Héloïse Lauga-Cami , Dominique Fromage , Christel Becker , Jean-Guillaume Houël , Jean-Jacques Benoliel , Frédéric Canini , Marion Trousselard , Damien Claverie

Background

Post-traumatic stress disorder (PTSD), in its partial or full forms, is frequently observed in military populations. It is therefore important to predict the risk of PTSD prior to deployment. Objective. Since elevated allostatic load markers have been described in PTSD, we investigated whether these alterations pre-exist before PTSD onset. Our objective was to explore the ability of four allostatic load markers (urinary and blood cortisol, BDNF and 8-iso-PGF2α) to predict partial/full PTSD onset after a 6-month deployment. Methods. We conducted a prospective study in a French military cohort deployed to Afghanistan. PTSD was assessed before (M₀) and after (M₆) deployment using PTSD Checklist Scale (PCLS). At M₀, only subjects who were medically fit and who scored healthy at PCLS were considered. We evaluated whether biological markers of allostatic load at M₀ would predict partial/full PTSD at M₆. Psychological correlates were assessed, including anxious-depressive symptoms (HAD; Hospital Anxiety and Depression), burnout (BMS; Burnout Measure-Short version), anxiety (STAI; Spielberger State-Trait Anxiety Inventory), general mood (POMS; Profile of Mood State), perceived stress (PSS; Perceived Stress Scale), alexithymia (TAS; Toronto Alexithymia scale) and mental health–related scores (GHQ-28; General Health Questionnaire-28 items). Results. After controlling for age, pre-deployment PCLS scores, and the number of missions, we found that elevated M₀ nocturnal urinary cortisol excretion predicted M₆ partial/full PTSD. Conclusions. Asymptomatic subjects at risk of partial/full PTSD exhibit a common pattern of hypothalamic-pituitary axis dysregulation, similar to that observed in established PTSD.

背景：部分或全部形式的创伤后应激障碍（PTSD）在军人群体中经常观察到。因此，在部署前预测PTSD的风险是很重要的。目的：由于在PTSD中已经描述了适应负荷标志物的升高，我们研究了这些改变是否在PTSD发病前就存在。我们的目的是探讨四种适应负荷标志物（尿和血皮质醇、BDNF和8-iso-PGF2α）在6个月部署后预测部分/完全PTSD发作的能力。方法：我们在部署到阿富汗的法国军队队列中进行了一项前瞻性研究。采用PTSD检查量表（PCLS）对部署前（M0）和部署后（M6）的PTSD进行评估。在M0时，只考虑医学上健康且PCLS评分健康的受试者。我们评估了M0时适应负荷的生物学标记是否能预测M6时的部分/完全PTSD。评估心理相关因素，包括焦虑抑郁症状（HAD；医院焦虑和抑郁）、倦怠（BMS；倦怠量表-短版）、焦虑（STAI； Spielberger状态-特质焦虑量表）、一般情绪（POMS；情绪状态概况）、感知压力（PSS；感知压力量表）、述情障碍（TAS；多伦多述情障碍量表）和心理健康相关评分（GHQ-28；一般健康问卷-28项）。结果：在控制了年龄、部署前PCLS评分和任务数量后，我们发现夜间尿皮质醇水平升高可预测M6部分/完全PTSD。结论：有部分/完全PTSD风险的无症状受试者表现出一种共同的下丘脑-垂体轴失调模式，类似于在已建立的PTSD中观察到的。

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引用次数: 0

Implicit social animations lead to distinct changes of dopaminergic, corticostriatal and thalamocortical functional connectivity in schizophrenia and bipolar disorder 内隐社会动画导致精神分裂症和双相情感障碍患者多巴胺能、皮质纹状体和丘脑皮质功能连通性发生明显变化

IF 3.2 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2026-01-08 DOI: 10.1016/j.jpsychires.2026.01.016

Ricardo Martins , João Valente Duarte , Nuno Madeira , António Macedo , Miguel Castelo-Branco

Objective

Theory of mind (ToM) is a central pillar of social cognition and crucial for effective social interactions. Impairment in ToM is a major predictor of global functioning in schizophrenia (SCZ) and bipolar disorder (BPD). Based on the hypothesis that subcortical and reward circuit functional connectivity is distinct in SCZ and BPD and can be better revealed using ToM task-based approaches, we tested whether functional connectivity patterns of cortico-subcortical networks are a discriminative feature of these disorders.

Methods

We conducted a cross-sectional study (n = 60) to investigate the modulation of task-induced functional connectivity in SCZ (n = 20), BPD (n = 20), and healthy controls (n = 20) during implicit ToM processing with a visual paradigm leading to the interpretation of social meaning based on simple geometric figures with implied social content. Functional connectivity was estimated using generalized psychophysiological analysis of functional magnetic resonance imaging data.

Results

We found unique connectivity patterns in SCZ and BPD within subcortical loops. The SCZ group exhibited specifically disrupted connectivity in corticostriatal and thalamocortical pathways involving ToM and the mesolimbic pathways. A single common pattern of aberrant connectivity in BPD and SCZ occurred between the VTA and dorsal striatum, suggesting increased midbrain-striatal (actor-critic) connectivity in both disorders.

Conclusions

The unique patterns of altered connectivity in SCZ (imbalance between striatothalamic and thalamocortical connectivity), and BPD, while sharing a common pattern of increase between VTA and dorsal striatum, may represent candidate biomarkers of pathophysiological significance, or as biological targets for validating differential therapeutic neuromodulation.

目的心理理论是社会认知的核心支柱，对有效的社会互动至关重要。ToM损伤是精神分裂症（SCZ）和双相情感障碍（BPD）患者整体功能的主要预测因子。假设SCZ和BPD中皮层下和奖励回路的功能连接是不同的，并且可以通过基于ToM任务的方法更好地揭示，基于这一假设，我们测试了皮质-皮层下网络的功能连接模式是否是这些疾病的判别特征。方法采用横断面研究（n = 60），研究了SCZ （n = 20）、BPD （n = 20）和健康对照（n = 20）在内隐ToM加工过程中任务诱发功能连通性的调节，该加工采用视觉范式导致基于简单几何图形隐含社会内容的社会意义解释。使用功能磁共振成像数据的广义心理生理分析来估计功能连通性。结果我们在皮层下环路中发现了SCZ和BPD独特的连接模式。SCZ组在皮质纹状体和丘脑皮质通路中表现出特别的连接中断，包括ToM和中边缘通路。BPD和SCZ中一个共同的异常连通性模式发生在VTA和背侧纹状体之间，表明这两种疾病中中脑纹状体（行为者批评）的连通性增加。结论SCZ（纹状体和丘脑皮质连通性失衡）和BPD的独特连通性改变模式，以及VTA和背侧纹状体之间共同的增加模式，可能是具有病理生理意义的候选生物标志物，或作为验证差异治疗性神经调节的生物学靶点。

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引用次数: 0

The prevalence and risk factors of complex post-traumatic stress disorder in victims of intimate partner violence 亲密伴侣暴力受害者中复杂创伤后应激障碍的患病率和危险因素。

IF 3.2 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2026-01-07 DOI: 10.1016/j.jpsychires.2026.01.015

Jia-Hui Hu , Yun Zhou , Ye Ye , Fu-Jun Jia , Cai-Lan Hou

Introduction

The purpose of this study was to explore risk factors of ICD-11 complex post-traumatic stress disorder (CPTSD) among intimate partner violence (IPV) victims in China.

Methods

We conducted a combination of online and offline surveys of trauma exposure, mental health problems, and psychological factors among IPV victims in hospitals and on social media. A total of 170 participants who had experienced IPV were collected.

Results

According to the International Trauma Questionnaire (ITQ) results, CPTSD prevalence was 31.2 % and PTSD prevalence was 17.1 %. In the one-way ANOVA analysis, the CPTSD group was significantly different from the PTSD and non-PTSD groups on almost all variables, such as anxiety, depression, attachment, personality, and social support. Multiple logistic regression showed that CPTSD was associated with more severe anxiety, higher levels of attachment anxiety, psychoticism (P), and neuroticism (N).

Conclusion

CPTSD was more common than PTSD among IPV victims, and the CPTSD group showed more severe and extensive mental health problems than the PTSD group and Non-CPTSD/PTSD group. In addition, attachment anxiety was considered to be the strongest factor of those mental and psychological factors. These findings may have intervention implications for IPV victims with CPTSD.

前言：本研究旨在探讨中国亲密伴侣暴力（IPV）受害者罹患ICD-11型复杂创伤后应激障碍（CPTSD）的危险因素。方法：我们在医院和社交媒体上对IPV受害者的创伤暴露、心理健康问题和心理因素进行了线上和线下相结合的调查。总共收集了170名经历过IPV的参与者。结果：根据国际创伤问卷（ITQ）调查结果，CPTSD患病率为31.2%，PTSD患病率为17.1%。在单因素方差分析中，CPTSD组在焦虑、抑郁、依恋、人格和社会支持等几乎所有变量上都与PTSD组和非PTSD组有显著差异。多元logistic回归分析显示，CPTSD与更严重的焦虑、更高水平的依恋焦虑、精神质(P)和神经质(N)相关。结论：CPTSD在IPV受害者中比PTSD更常见，且CPTSD组比PTSD组和非CPTSD/PTSD组表现出更严重、更广泛的心理健康问题。此外，依恋焦虑被认为是这些心理因素中最强的因素。这些发现可能对IPV合并CPTSD的受害者具有干预意义。

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引用次数: 0

A novel, experimental design to assess rapid antidepressant action: Results from a phase 1b randomized trial of NV-5138 一种评估抗抑郁药快速作用的新型实验设计：NV-5138的1b期随机试验结果

IF 3.2 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2026-01-07 DOI: 10.1016/j.jpsychires.2026.01.006

Steven D. Targum , Gerard Sanacora , Andrea E. Formella , Gianpiera Ceresoli-Borroni , Randall Owen

Background

Assessment of rapid-acting antidepressants (RAADs) requires rating scales sensitive to symptomatic changes over short time frames (hours to days). An innovative trial design was employed in an exploratory, first-in-human, phase 1b trial assessing rapid-acting effects of NV-5138 (mefluleucine), an intracellular enhancer of mechanistic target of rapamycin 1 synaptic signaling, for treatment-resistant depression.

Methods

This randomized, double-blind, placebo-controlled, multisite inpatient study used centrally rated Montgomery-Åsberg Depression Rating Scale (MADRS) assessments to confirm symptom stability before randomization during a 3-day placebo run-in. Qualifying participants were randomized to single doses of NV-5138 (2400 mg) or matching placebo. Safety and efficacy were assessed over 72 h and included daily centrally rated MADRS assessments and more frequent site-based 6-item Hamilton Depression Rating Scale (HAM-D₆) assessments (5 assessments within 24 h following dosing).

Results

Of 93 individuals screened, 47 received placebo run-in, and 32 were randomized. NV-5138-treated participants experienced significant HAM-D₆ improvement at 4 and 12 h post-dose (both P = .02) versus placebo. Effect sizes for NV-5138–treated participants ranged from −0.5 to −0.8 at all assessments within 24 h. At 12 h, 5 (31 %) participants receiving NV-5138 and none receiving placebo met HAM-D₆ response criteria (50 % score reduction; P = .04). At 24 h, the MADRS favored NV-5138 but was not statistically different from placebo. NV-5138 was well tolerated, with no psychotomimetic, severe, or serious adverse events reported.

Conclusions

The innovative design of this exploratory study facilitated appropriate participant selection and rapid antidepressant response detection. These features may be useful in other trials evaluating RAADs (ClinicalTrials.gov, NCT03606395).

背景：对速效抗抑郁药（RAADs）的评估需要在短时间内（数小时至数天）对症状变化敏感的评定量表。在一项探索性的、首次在人体中进行的1b期试验中，采用了一种创新的试验设计，评估NV-5138（甲氟亮氨酸）对治疗耐药抑郁症的速效作用，甲氟亮氨酸是雷帕霉素1突触信号传导机制靶点的细胞内增强剂。方法：本研究采用随机、双盲、安慰剂对照、多中心住院患者研究，采用蒙哥马利-Åsberg抑郁评定量表（MADRS）进行集中评定，在随机分组前确认症状稳定性。符合条件的参与者被随机分配到单剂量NV-5138 （2400 mg）或匹配的安慰剂组。安全性和有效性在72小时内进行评估，包括每日集中评定MADRS评估和更频繁的基于现场的6项汉密尔顿抑郁评定量表（HAM-D6）评估（给药后24小时内进行5项评估）。结果在93名筛查者中，47名接受安慰剂试验，32名随机分组。与安慰剂相比，nv -5138治疗的参与者在给药后4和12小时的HAM-D6改善显著（P均= 0.02）。在24小时内的所有评估中，NV-5138治疗的参与者的效应值范围为- 0.5至- 0.8。在12小时时，5名（31%）接受NV-5138治疗的参与者和没有接受安慰剂治疗的参与者符合HAM-D6反应标准（评分降低50%；P = 0.04）。24小时时，MADRS倾向于NV-5138，但与安慰剂无统计学差异。NV-5138耐受性良好，无拟精神、严重或严重不良事件报告。结论本探索性研究的创新设计有助于适当的参与者选择和快速的抗抑郁反应检测。这些特征可能在其他评估RAADs的试验中有用（ClinicalTrials.gov, NCT03606395）。

{"title":"A novel, experimental design to assess rapid antidepressant action: Results from a phase 1b randomized trial of NV-5138","authors":"Steven D. Targum , Gerard Sanacora , Andrea E. Formella , Gianpiera Ceresoli-Borroni , Randall Owen","doi":"10.1016/j.jpsychires.2026.01.006","DOIUrl":"10.1016/j.jpsychires.2026.01.006","url":null,"abstract":"<div><h3>Background</h3><div>Assessment of rapid-acting antidepressants (RAADs) requires rating scales sensitive to symptomatic changes over short time frames (hours to days). An innovative trial design was employed in an exploratory, first-in-human, phase 1b trial assessing rapid-acting effects of NV-5138 (mefluleucine), an intracellular enhancer of mechanistic target of rapamycin 1 synaptic signaling, for treatment-resistant depression.</div></div><div><h3>Methods</h3><div>This randomized, double-blind, placebo-controlled, multisite inpatient study used centrally rated Montgomery-Åsberg Depression Rating Scale (MADRS) assessments to confirm symptom stability before randomization during a 3-day placebo run-in. Qualifying participants were randomized to single doses of NV-5138 (2400 mg) or matching placebo. Safety and efficacy were assessed over 72 h and included daily centrally rated MADRS assessments and more frequent site-based 6-item Hamilton Depression Rating Scale (HAM-D<sub>6</sub>) assessments (5 assessments within 24 h following dosing).</div></div><div><h3>Results</h3><div>Of 93 individuals screened, 47 received placebo run-in, and 32 were randomized. NV-5138-treated participants experienced significant HAM-D<sub>6</sub> improvement at 4 and 12 h post-dose (both <em>P</em> = .02) versus placebo. Effect sizes for NV-5138–treated participants ranged from −0.5 to −0.8 at all assessments within 24 h. At 12 h, 5 (31 %) participants receiving NV-5138 and none receiving placebo met HAM-D<sub>6</sub> response criteria (50 % score reduction; <em>P</em> = .04). At 24 h, the MADRS favored NV-5138 but was not statistically different from placebo. NV-5138 was well tolerated, with no psychotomimetic, severe, or serious adverse events reported.</div></div><div><h3>Conclusions</h3><div>The innovative design of this exploratory study facilitated appropriate participant selection and rapid antidepressant response detection. These features may be useful in other trials evaluating RAADs (ClinicalTrials.gov, NCT03606395).</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"194 ","pages":"Pages 211-220"},"PeriodicalIF":3.2,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927686","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

Auditory processing deficits in schizophrenia: Evidence from a novel task 精神分裂症的听觉加工缺陷：来自一项新任务的证据

IF 3.2 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2026-01-07 DOI: 10.1016/j.jpsychires.2026.01.014

Yingding Ma , Zetao Huang , Jiuju Wang , Yanping Song , Xiangqun Wang , Chaojun Hao , Jiaxin Zhang , Daijun Ke , Ziyu Ye , Dafang Ouyang , Wentian Dong

Background

Deficits in basic auditory processing (BAP) are features of schizophrenia (SCZ), contributing to cognitive and psychosocial dysfunction. While pitch discrimination tasks are widely used to assess BAP, conventional tasks conflate auditory processing deficits with impairments in echoic memory. We designed a novel Simultaneous Binaural Pitch Discrimination (SBPD) task to focus more on BAP by eliminating temporal separation between stimuli.

Methods

We administered the SBPD task to 42 patients with SCZ and 42 demographically matched healthy controls (HC). Pure tone pairs were presented simultaneously binaurally by dichotic headphones, requiring participants to judge pitch identity/differences without echoic memory involvement. Accuracy and reaction time were examined and analyzed. Relationships between clinical variables (age at diagnosis, illness duration and antipsychotic dosage) and task performance were assessed.

Results

Patients exhibited significantly lower accuracy than controls (57.87 % vs. 74.33 %, t = −3.688, p < 0.001; Cohen's d = −0.62) and longer reaction times (2111.61 ± 447.18 ms vs. 1906.04 ± 413.88 ms, t = 2.414, P = 0.020, d = 0.40).

Conclusions

We employed a newly designed task and found basic auditory processing deficits in patients compared to healthy individuals. Future studies should investigate the stability and neural mechanisms of binaural integration deficits, particularly brainstem dysfunction implicated in abnormal auditory brainstem responses (ABRs) in SCZ.

基础听觉加工（BAP）缺陷是精神分裂症（SCZ）的特征，有助于认知和社会心理功能障碍。虽然音高辨别任务被广泛用于评估BAP，但传统的任务将听觉加工缺陷与回声记忆障碍混为一谈。我们设计了一个新的同步双耳音高辨别（SBPD）任务，通过消除刺激物之间的时间分离来更多地关注BAP。方法对42例SCZ患者和42例人口统计学匹配的健康对照（HC）进行SBPD任务。纯音对通过双耳耳机同时呈现，要求参与者在不涉及回声记忆的情况下判断音高的同一性/差异性。对准确度和反应时间进行了检验和分析。评估临床变量（诊断年龄、病程和抗精神病药物剂量）与任务表现之间的关系。结果受试者的反应正确率显著低于对照组（57.87% vs. 74.33%, t = - 3.688, p < 0.001; Cohen’s d = - 0.62），反应时间显著长于对照组（2111.61±447.18 ms vs. 1906.04±413.88 ms, t = 2.414, p = 0.020, d = 0.40）。结论：我们采用了一个新设计的任务，发现与健康个体相比，患者存在基本的听觉加工缺陷。未来的研究应探讨双耳整合缺陷的稳定性和神经机制，特别是与SCZ异常听觉脑干反应（ABRs）相关的脑干功能障碍。

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引用次数: 0

Sex differences in the association between chronotype and anxiety: A nationwide population study 睡眠类型与焦虑之间的性别差异：一项全国性的人口研究

IF 3.2 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2026-01-07 DOI: 10.1016/j.jpsychires.2026.01.012

Jungyon Yum , Soomi Cho , Woo-seok Ha , Kyung Min Kim , Wonwoo Lee , Min Kyung Chu

Backgrounds

This study aimed to investigate potential sex differences in the association between anxiety and chronotype.

Methods

Nationwide population-based data were analyzed from 2838 individuals aged 20–59 years who participated in the Circannual Change in Headache and Sleep Study. The chronotype was scored using the Morningness-Eveningness Questionnaire, and anxiety levels were assessed using the Generalized Anxiety Disorder-7 scale. Covariates included sociodemographic factors, depression, employment status, alcohol consumption, current smoker, body mass index, insomnia severity, and average sleep duration.

Results

In this cohort (mean age = 40.5 ± 11.1 years, 1424 women [50.2 %]. 1414 men [49.8 %]), anxiety was more commonly reported by women (12.2 %) than men (7.4 %), with the evening chronotype group showing the highest anxiety prevalence (15.3 %). After adjusting for covariates, men with a morning chronotype showed a significantly lower risk of anxiety than did those with an intermediate chronotype, however, no significant difference in anxiety risk was observed for evening-type men. Among women, chronotype was not significantly associated with anxiety.

Conclusions

Differences in the chronotype–anxiety association were observed between men and women. Specifically, having a morning chronotype may reduce the risk of anxiety in men, whereas this protective effect was not observed in women. These findings suggest the need for sex-specific chronotype-targeted approaches for the prevention and management of anxiety.

背景本研究旨在探讨焦虑与睡眠类型之间潜在的性别差异。方法分析全国范围内2838名年龄在20-59岁之间的人的数据，这些人参加了头痛和睡眠的周期性变化研究。时间型采用晨-晚性问卷进行评分，焦虑水平采用广泛性焦虑障碍-7量表进行评估。协变量包括社会人口学因素、抑郁、就业状况、饮酒、当前吸烟者、体重指数、失眠严重程度和平均睡眠时间。结果在该队列中（平均年龄= 40.5±11.1岁），女性1424人（50.2%）。1414名男性（49.8%）中，女性（12.2%）比男性（7.4%）更常报告焦虑，其中夜间睡眠类型组的焦虑患病率最高（15.3%）。在调整协变量后，晨型男性的焦虑风险明显低于中间型男性，然而，夜型男性的焦虑风险没有显著差异。在女性中，睡眠类型与焦虑没有显著关联。结论时间型与焦虑的关联在男性和女性之间存在差异。具体来说，早起可能会降低男性焦虑的风险，而这种保护作用在女性身上没有观察到。这些发现表明，需要针对特定性别的时间类型的方法来预防和管理焦虑。

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引用次数: 0

Association between pulse width and clinical response to electroconvulsive therapy 脉宽与电休克治疗临床反应的关系

IF 3.2 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2026-01-06 DOI: 10.1016/j.jpsychires.2026.01.010

Richard Braithwaite , Ana Jelovac

Background

The default pulse width setting on a commonly used electroconvulsive therapy (ECT) device, 0.5 ms (ms), is untested against the proven effectiveness of conventional 1.0–1.5 ms brief pulse widths.

Methods

We examined the association between pulse width and clinical response using registry data from 87 centres in the United Kingdom and Republic of Ireland in patients (N = 1956) receiving consecutive acute courses of ECT ending during 2023 for any clinical indication. The outcome was clinical response, defined as an end-of-treatment Clinical Global Impression‒Improvement score of 1 or 2.

Results

Mean age was 61.6 years (SD, 16.3), 66.3 % were female, 84.2 % were treated for depressive episode, and 86.5 % received bilateral ECT. In a multivariable logistic regression analysis of all diagnostic categories, 0.5 ms (adjusted odds ratio 0.64; 95 % CI, 0.50–0.82; p < .001) and 0.25–0.3 ms (adjusted odds ratio 0.56; 95 % CI, 0.38–0.82; p = .003) pulse widths were associated with significantly lower odds of response compared to 1.0 ms. Predicted probabilities of response were 73.4 % (95 % CI, 69.4 %–77.3 %) for 1.0 ms, 64.1 % (95 % CI, 61.4 %–66.8 %) for 0.5 ms, and 61.0 % (95 % CI, 53.8 %–68.3 %) for 0.25–0.3 ms. A subgroup analysis of unipolar or bipolar depressive episodes likewise showed significantly reduced odds of response with both 0.5 ms and 0.25–0.3 ms.

Conclusion

This study demonstrated a previously unreported association between 0.5 ms pulse width and reduced ECT response. Unless cognitive sparing is paramount in an individual case, 1.0 ms ECT should be used as standard.

背景：通常使用的电休克治疗（ECT）设备的默认脉冲宽度设置为0.5 ms (ms)，未经与传统的1.0-1.5 ms短脉冲宽度的有效性进行测试。方法：我们使用来自英国和爱尔兰共和国87个中心的注册数据（N = 1956），检查脉宽与临床反应之间的关系，这些患者在2023年期间因任何临床指征而连续接受急性电痉挛治疗。结果是临床反应，定义为治疗结束时临床总体印象改善评分为1或2。结果患者平均年龄61.6岁（SD, 16.3），女性占66.3%，抑郁症发生率84.2%，双侧电痉挛发生率86.5%。在所有诊断类别的多变量logistic回归分析中，0.5 ms（校正优势比0.64;95% CI, 0.50-0.82; p < .001）和0.25-0.3 ms（校正优势比0.56;95% CI, 0.38-0.82; p = .003）脉宽与1.0 ms相比显著降低的应答几率相关。预测反应概率为1.0 ms为73.4% (95% CI, 69.4% - 77.3%)， 0.5 ms为64.1% (95% CI, 61.4% - 66.8%), 0.25-0.3 ms为61.0% （95% CI, 53.8% - 68.3%）。对单极或双相抑郁发作的亚组分析同样显示，0.5 ms和0.25-0.3 ms的反应几率显著降低。结论：该研究证实了0.5 ms脉冲宽度与ECT反应降低之间的关联，这是以前未报道的。除非在个别病例中认知保护是最重要的，否则1.0 ms电休克应该作为标准。

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引用次数: 0

Altered electroencephalographic microstate dynamics in major depressive disorder and their modulation by melatonergic treatment 重度抑郁症的脑电图微状态动力学改变及其褪黑激素治疗的调节作用

IF 3.2 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2026-01-06 DOI: 10.1016/j.jpsychires.2026.01.011

Che-Sheng Chu , Yen-Yue Lin , Cathy Chia-Yu Huang , Wei-Zhe Liang , Wei-Chou Chang , Alexander T. Sack , Chuan-Chia Chang , Hsin-An Chang

Background

The modulation of brain dynamics by melatonin antidepressants in patients with major depressive disorder (MDD) remains unclear.

Methods

Resting-state electroencephalographic (EEG) was recorded in 84 drug-free patients with MDD and 143 healthy controls. EEG data were collected at baseline and after 8-week agomelatine treatment. K-means clustering identified four canonical microstates (MS-A–D), and topographic analysis of variance assessed group differences.

Results

At baseline, patients with MDD showed increased occurrence and coverage of MS-C and MS-D, along with a higher transition probability between these two states, compared to healthy controls. In contrast, the duration and coverage of MS-A and MS-B, as well as their transition probabilities, were reduced in the MDD group. Following treatment, patients with MDD exhibited increased MS-A coverage and a higher transition probability from MS-A to MS-B, while the transition probability between MS-C and MS-D decreased. Several microstate parameters were normalized to those of healthy controls. Notably, MS-B occurrence negatively correlated with baseline anhedonia severity, although no microstate measures predicted changes in anhedonia over time.

Conclusions

This study demonstrates altered EEG microstate dynamics in patients with MDD and provides insights into the neural mechanisms underlying MDD. Microstate abnormalities may serve as potential clinical biomarkers for MDD.

背景：在重度抑郁症（MDD）患者中，褪黑素抗抑郁药对脑动力学的调节尚不清楚。方法对84例无药MDD患者和143例健康对照者进行静息状态脑电图（EEG）记录。在基线和阿戈美拉汀治疗8周后收集脑电图数据。K-means聚类确定了四种典型微观状态（MS-A-D），地形方差分析评估了群体差异。结果在基线时，与健康对照组相比，MDD患者表现出MS-C和MS-D的发生率和覆盖率增加，并且在这两种状态之间转换的概率更高。相比之下，MDD组MS-A和MS-B的持续时间和覆盖范围以及它们的转移概率都减少了。治疗后，MDD患者的MS-A覆盖率增加，从MS-A到MS-B的转换概率更高，而MS-C到MS-D的转换概率降低。几个微状态参数归一化为健康对照。值得注意的是，MS-B的发生与基线缺乏症严重程度负相关，尽管没有微观状态测量预测缺乏症随时间的变化。结论本研究证实了重度抑郁症患者脑电图微状态动力学的改变，并为重度抑郁症的神经机制提供了新的见解。微状态异常可能是重度抑郁症的潜在临床生物标志物。

{"title":"Altered electroencephalographic microstate dynamics in major depressive disorder and their modulation by melatonergic treatment","authors":"Che-Sheng Chu , Yen-Yue Lin , Cathy Chia-Yu Huang , Wei-Zhe Liang , Wei-Chou Chang , Alexander T. Sack , Chuan-Chia Chang , Hsin-An Chang","doi":"10.1016/j.jpsychires.2026.01.011","DOIUrl":"10.1016/j.jpsychires.2026.01.011","url":null,"abstract":"<div><h3>Background</h3><div>The modulation of brain dynamics by melatonin antidepressants in patients with major depressive disorder (MDD) remains unclear.</div></div><div><h3>Methods</h3><div>Resting-state electroencephalographic (EEG) was recorded in 84 drug-free patients with MDD and 143 healthy controls. EEG data were collected at baseline and after 8-week agomelatine treatment. K-means clustering identified four canonical microstates (MS-A–D), and topographic analysis of variance assessed group differences.</div></div><div><h3>Results</h3><div>At baseline, patients with MDD showed increased occurrence and coverage of MS-C and MS-D, along with a higher transition probability between these two states, compared to healthy controls. In contrast, the duration and coverage of MS-A and MS-B, as well as their transition probabilities, were reduced in the MDD group. Following treatment, patients with MDD exhibited increased MS-A coverage and a higher transition probability from MS-A to MS-B, while the transition probability between MS-C and MS-D decreased. Several microstate parameters were normalized to those of healthy controls. Notably, MS-B occurrence negatively correlated with baseline anhedonia severity, although no microstate measures predicted changes in anhedonia over time.</div></div><div><h3>Conclusions</h3><div>This study demonstrates altered EEG microstate dynamics in patients with MDD and provides insights into the neural mechanisms underlying MDD. Microstate abnormalities may serve as potential clinical biomarkers for MDD.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"194 ","pages":"Pages 294-302"},"PeriodicalIF":3.2,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978073","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

The possibility of patients with adult-onset Niemann-Pick disease type C in cases diagnosed with schizophrenia: Analysis of NPC novel biomarkers 在诊断为精神分裂症的病例中，成人发病的尼曼-皮克病C型患者的可能性：NPC新生物标志物的分析

IF 3.2 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research

Pub Date : 2026-01-05 DOI: 10.1016/j.jpsychires.2026.01.009

Kumiko Fujii , Masamitsu Maekawa , Aya Narita , Yoshikatsu Eto , Masataka Shinozaki , Yosefu Arime , Hiroaki Okayasu , Kazutaka Shimoda , Yuji Ozeki

Background

When patients with schizophrenia on antipsychotic medication present neurological symptoms, it is often considered to be side effects of antipsychotics. In contrast, Niemann-Pick disease type C (NPC) has a wide variety of symptoms, and the diagnosis of adult-onset NPC is difficult. In this study, we measured novel biomarkers of NPC and examined the possibility of NPC in patients diagnosed with schizophrenia.

Methods

Five patients with schizophrenia and neurological symptoms were evaluated using the NPC Suspicion Index, and urinary bile acid and blood oxysterol levels were measured by LC-MS/MS and Q-TOF LC/MS. Lysosphingomyelin (SPC) and Lyso-SM-509(PPCS), reported as novel biomarkers for NPC, were measured in the plasma of 163 patients with schizophrenia and 111 healthy controls using LC-MS/MS. NPC1 and NPC2 gene analyses were performed on 124 patients using the next-generation sequencer. In one patient, Filipin staining was performed using skin fibroblasts.

Results

Among the five patients, one patient had an abnormal urinary bile acid level. Levels of SPC were significantly higher in patients than in healthy controls. Genetic analysis revealed no genetic mutations associated with the etiology. The patient who underwent Filipin staining had cholesterol-stained pale and was determined to be a variant type. However, it would be more accurate to state that no patients were identified as NPC based on these biomarkers.

Conclusion

Among the patients with schizophrenia, there were no cases that were definitively diagnosed as NPC, but some patients had features of NPC. It is important to evaluate mental and neurological symptoms in light of this possibility.

背景：当精神分裂症患者服用抗精神病药物时出现神经系统症状，通常被认为是抗精神病药物的副作用。相比之下，尼曼-皮克病C型（NPC）的症状多种多样，成人发病的NPC诊断困难。在这项研究中，我们测量了鼻咽癌的新生物标志物，并检查了诊断为精神分裂症的患者中鼻咽癌的可能性。方法：采用NPC怀疑指数评价5例精神分裂症患者的神经系统症状，采用LC-MS/MS和Q-TOF LC/MS测定尿胆汁酸和血氧甾醇水平。采用LC-MS/MS对163例精神分裂症患者和111例健康对照者的血浆中溶血鞘磷脂（SPC）和溶血鞘磷脂-509（PPCS）进行了检测。使用新一代测序仪对124例患者进行NPC1和NPC2基因分析。在一名患者中，使用皮肤成纤维细胞进行Filipin染色。结果：5例患者中，1例患者尿胆汁酸异常。患者的SPC水平明显高于健康对照组。遗传分析显示没有与病因相关的基因突变。接受菲利平染色的患者有胆固醇染色的苍白，被确定为变异型。然而，更准确的说法是，没有患者根据这些生物标志物被确定为鼻咽癌。结论：在精神分裂症患者中，没有明确诊断为鼻咽癌的病例，但部分患者具有鼻咽癌的特征。鉴于这种可能性，评估精神和神经症状是很重要的。

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引用次数: 0