Dialogues in Clinical Neuroscience最新文献

Background: Non suicidal self injury (NSSI) is a public health concern, and its prevalence has increased significantly following the COVID-19 pandemic. Despite its rising incidence, the neurobiological mechanisms underlying NSSI behaviour in adolescents remain poorly understood.

Methods: A sample of 89 adolescents (46 NSSI positive, 43 NSSI negative) aged 15.39 ± 1.77 years was recruited from clinical settings. NSSI behaviour and psychological resilience were evaluated. Resting-state functional magnetic resonance imaging (Rs-fMRI) was conducted to examine brain connectivity patterns. Data analysis incorporated descriptive and inferential statistics, as well as support vector machine algorithms, to identify the neural correlates of NSSI and resilience.

Results: The NSSI positive group had significantly lower resilience scores (M = 23.41, SD = 7.95). Connectivity between the sensorimotor and limbic networks was negatively associated with NSSI (r = -0.222, p < 0.05), while connectivity between the sensorimotor and subcortical networks showed a positive association (r = 0.201, p < 0.05). Stronger connectivity between dorsal attention and default mode networks indirectly reduced NSSI by enhancing psychological resilience, highlighting resilience as a critical protective factor.

Conclusion: These findings underscore the importance of targeting specific brain connectivity patterns and enhancing psychological resilience as crucial components of neurobiologically informed interventions.

People spend most of their waking hours detached from external stimuli, remembering the past, foreseeing the future, imagining situations in which they did not attend or that have never existed, or, simply, thinking. Such a process is crucial for mental health. A common feature of many mental disorders is recurrent stress-related thoughts, the so-called 'perseverative thinking'. In this review, we describe how perseverative thinking represents a dysfunctional self-regulatory strategy that maintains and increases the effects of mental suffering and arises from the maladaptive interplay between discrepancy monitoring, strategy selection, executive regulation, and information representation. We further argue that perseverative thinking can change how the mind represents the world through memory updating, resulting in an increased perceived need for regulation of the external and internal inputs. Lastly, we propose a new integrated model incorporating the different features of perseverative thinking, offering a more unified perspective on psychopathology.

Background: Bright light therapy (BLT) demonstrates efficacy in alleviating subthreshold depression (StD) among young adults. The amygdala plays a critical role in depression.

Methods: StD subjects were divided into BLT group (N=47) and placebo group (N=42). Depression severity was assessed using HAM-D, Centre for Epidemiologic Studies Depression Scale (CES-D) and Beck Depression Inventory (BDI) pre-/post-8-week intervention. Structural/resting-state fMRI scan was conducted. Seed-based static FC (sFC) and dynamic FC (dFC) analyses of the bilateral amygdala and their subfields were conducted.

Results: Compared to placebo, BLT showed reduced depression scale, and increased sFC of right basolateral amygdala (BLA)/superficial amygdala (SFA)-right middle temporal gyrus (MTG) and dFC of right centralmedial amygdala (CMA) and right inferior orbital frontal gyrus, and decreased sFC of right amygdalostriatal transition/CMA- left thalamus and dFC of right SFA- right medial prefrontal cortex after intervention; while the whole amygdala and its subnuclei volume did not change significantly after BLT. Right BLA-MTG sFC changes positively correlated with BDI improvement. Baseline amygdala sFC/dFC predicted post-BLT symptom changes. BLT-induced right BLA sFC alterations spatially correlated with 5-HT1A/5-HT2A receptor distributions, and right CMA dFC changes with 5-HT1A.

Conclusions: Findings suggest BLT modulates amygdala-thalamocortical circuits and serotonergic pathways, highlighting FC biomarkers for treatment efficacy assessment.

Trial registration clinicaltrials.gov identifier: ChiCTR2000032633.

Introduction: Depression includes different phenotypes. Modern-type depression (MTD) is a gateway disorder to pathological social withdrawal, known as hikikomori. Adverse childhood experiences (ACEs) are also important aetiologies of depression. Recently, immune imbalance has been proposed as a biological basis of depression. We hypothesised that peripheral immunological characteristics may be involved in subtyping of depression.

Methods: 21 patients with major depressive disorder (MDD) and 24 healthy controls (HC) were recruited. Peripheral blood mononuclear cells (PBMCs) were examined for surface antigens by flow cytometry. Participants were administered psychological scales such as Patient Health Questionnaire (PHQ)-9, Modern-Type Depression Trait Scale (TACS-22), Hikikomori Questionnaire (HQ-25), Child Abuse and Trauma Scale (CATS).

Results: MDD group showed significantly higher percentage of B cells than HC group (p = 0.032). MDD group presented a negative correlation between: PHQ-9 and CD8 T effector memory cells (r= -0.639, p = 0.002), TACS-22 and monocytes (r= -0.459, p = 0.036), HQ-25 and NK T cells (r= -0.638, p = 0.004), CATS and Intermediate monocytes (r= -0.594, p = 0.009).

Conclusions: MTD traits, hikikomori tendencies, and ACEs were correlated with specific characteristics of peripheral immune cells. Our results suggest that immune imbalance influences the diverse presentations of depression. Further validation is warranted by large-scale prospective studies.

Introduction: Psychedelics were explored for their potential in the mental health field. However, research was delayed by concerns over short-term side effects and long-term consequences of substance use. Technological advances enabled the development of Hallucinatory Visual Virtual Experiences (HVVEs), namely psychedelic experiences simulations in immersive virtual reality. This study investigated HVVEs' impact on cognitive flexibility, affective response, and autonomic activity.

Methods: 50 healthy participants underwent assessments of cognitive flexibility, control inhibition, emotional response, and autonomic activity at baseline. Participants were then exposed to two 10-minute immersive virtual reality (IVR) experiences: 'The Secret Garden' and its hallucinated counterpart created using Google DeepDream algorithm. All measures were presented after each video, in addition to the flow experience assessment.

Results: Post-HVVE, participants demonstrated enhanced cognitive flexibility and inhibitory control. They reported increased flow-absorption and decreased flow-fluency. Both IVR experiences reduced positive affects and state anxiety compared to baseline; additionally, IVR reduced heart rate and sympathetic activity compared to baseline.

Conclusions: HVVEs produced psychedelic positive effects on cognitive and emotional functioning. The complex emotional and autonomic profile mimicked awakened relaxation that, in conjunction with the cognitive flexibility enhancement, could offer the unique opportunity to exploit psychedelic advantages while mitigating risks, opening new avenues for therapeutic approaches.

Background: Psychotropic medications are critical in managing severe mental illnesses (SMI) such as schizophrenia, major depressive disorder (MDD) and bipolar disorder. However, these treatments often lead to adverse side effects that can impair patients' quality of life (QoL) and affect treatment adherence.

Objective: This study aims to investigate the specific side effects of psychotropic treatments that contribute to a decline in QoL among patients with SMI, independently of treatment adherence.

Methods: We conducted a cross-sectional study with 1248 patients diagnosed with SMI, recruited from a university psychiatric unit in Marseille, France. QoL was assessed using the Schizophrenia Quality of Life Scale (SQoL-18), and side effects were measured using the UKU Side Effect Rating Scale. Treatment adherence was evaluated using the Medication Adherence Rating Scale (MARS). Statistical analyses included Pearson correlations and multiple linear regression models to identify predictors of QoL.

Results: The study found that side effects, as identified by the UKU scores, could significantly predict a reduction in QoL across multiple domains, including multiple dimensions of QoL and the overall QoL index, independent of treatment adherence. Patients on antipsychotics and benzodiazepines reported higher levels of adverse side effects, which correlated with lower QoL scores. An increase in the number of psychotropic treatment classes was also associated with a significant decline in QoL (p < 0.001).

Conclusion: Managing psychic side effects and minimising polypharmacy are critical to improving QoL in patients with SMI. Clinicians should consider these factors when developing personalised treatment strategies to enhance patient outcomes.

Introduction: Research suggests that affective temperaments influence adherence to pharmacotherapy; however, this has not been investigated in infertility treatment. Our prospective longitudinal study assessed the impact of affective temperaments on medication adherence during infertility treatments.

Methods: 179 women presenting at an Assisted Reproduction Centre completed the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego (TEMPS-A) questionnaire before treatment, and the Morisky Medication Adherence Scale (MMAS) six months later. Univariate linear regression assessed whether affective temperaments predict medication adherence; multivariate and interaction models examined the influence of sociodemographic and medical variables on this relationship, and potential moderating effects of age and education.

Results: Higher cyclothymic, depressive, irritable, and anxious affective temperament scores predicted significantly poorer adherence to pharmacotherapeutic recommendations (β = -0.122, p < 0.001, β = -0.178, p < 0.001, β = -0.114, p = 0.002, β = -0.071, p = 0.08; respectively). These results remained significant in multivariate models including sociodemographic and medical factors, which did not influence adherence. Increasing age intensified the negative impact of anxious temperament on medication adherence (β = -0.015, p = 0.024).

Conclusions: Affective temperaments impact adherence to pharmacotherapeutic recommendations among women experiencing infertility, possibly influencing treatment outcomes. Screening for affective temperaments can identify patients at risk of medication non-adherence. Applying patient-tailored psychological interventions to aid adherence could increase the chances of successful pregnancies.

Objective: This study investigated the emotional symptom profiles and treatment responses in patients exhibiting overlapping physical symptoms to compare differences between Somatic Symptom Disorder (SSD) and Panic Disorder (PD).

Methods: Pharmacotherapy outcomes were analysed in 208 outpatients with SSD (n = 94) and PD (n = 114). Stepwise multivariable logistic regression identified predictors of treatment response, considering variables such as the Clinical Global Impression-Severity (CGI-S), Beck Depression Inventory-II (BDI-II), State-Trait Anxiety Inventory, and State-Trait Anger Expression Inventory. Network analysis explored emotional patterns by estimating network structures for each group.

Results: The overall response rate to pharmacotherapy was 23.6% (49/208), with no significant difference between groups. Baseline CGI-S and BDI-II scores were significant predictors of treatment response in both groups, while social phobia score was a significant predictor in PD. Depression and anxiety were related to physical symptoms in both groups, but anger was significantly associated only in SSD. Network analysis revealed that depression was central to other symptoms in SSD, while anxiety was the core symptom in PD, indicating different emotional drivers between the disorders.

Conclusions: This study suggests the differences in emotional symptom profiles between SSD and PD. Findings suggest different mechanisms, considering the role of anger in SSD, highlighting the need for more personalised treatments for each disorder.

Introduction: Genetic variations in oestrogen receptor (ER) genes are associated with inter-individual differences in the sensitivity of ER-α, ER-β and G protein-coupled oestrogen receptor (GPER). These sensitivity differences may modulate susceptibility to mood changes during phases of endogenous oestrogen fluctuations, thereby explaining individual vulnerability. This study examined the association between ER gene variations, oestradiol and perinatal mood disturbances.

Methods: A total of 159 women were observed during the perinatal period, providing saliva samples for oestradiol assessment and completing self-report measures of depressive and anxiety symptoms at five time points. Polymorphisms in ER genes were determined from dried blood spots. The associations were analysed using linear mixed models.

Results: The ER-α gene haplotypes were associated with perinatal mood disturbances. The CG haplotype was associated with perinatal depressive (p = 0.0162, F-test) and anxiety symptoms (p = 2.396e-05, F-test), whereas the TA haplotype was associated with perinatal anxiety symptoms (p = 0.004, F-test). The interaction between ER gene variations, oestradiol and perinatal mood disturbances was not significant.

Conclusions: ER-α gene variations are associated with an increased susceptibility to perinatal mood disturbances. Sensitivity differences in ER-α appear to play a more important role for emotional processes than those in ER-β and GPER, independently of oestradiol levels. This might be explained by ER-α's more dominant expression in the hypothalamus and amygdala.

The global population is ageing rapidly, with the number of individuals aged 60 and older reaching 1 billion in 2019 and expected to double by 2050. As people age, neuropsychological health often deteriorates, leading to a higher prevalence of age-related depression. Symptoms may include anxiety, apathy, mood instability, sadness, and, in severe cases, suicidal thoughts. Depression in the elderly is a widespread concern, and conventional treatments such as antidepressants are often limited by side effects, reduced efficacy, and complications arising from polypharmacy. In response, novel therapeutic approaches are being explored, including psychedelic interventions. Recent clinical and preclinical studies suggest that psychedelics could offer a promising treatment for major depressive disorder (MDD) in older adults. These compounds, known for their profound neurobiological effects, have gained attention for their potential to address depression where traditional therapies fall short. This review aims to examine the therapeutic promise of psychedelic substances, focusing on those that show potential for treating MDD in the elderly. We also explore the underlying mechanisms through which psychedelics may exert their effects and highlight the preclinical models that support their use. Finally, we address safety considerations and propose strategies to enhance the effectiveness and safety of psychedelics in future clinical trials, offering new hope for treating age-related depressive disorders.