Psychiatry Res [JOURNAL]
Sun
200 papers
The impacts of trauma and stress on orexin expression and signalling: A systematic review.
Xiao K, Sayed H, Xing J … +5 more , Zhang XY, Ai J, Dri CE, Bruggen FV, McIntyre RS
Psychiatry Res · 2026 Sep · PMID 42134275 · Publisher ↗
BACKGROUND: Orexins are excitatory hypothalamic neuropeptides which modulate various stress-related physiological functions. This systematic review aims to evaluate the current literature on the impacts of trauma and str...
BACKGROUND: Orexins are excitatory hypothalamic neuropeptides which modulate various stress-related physiological functions. This systematic review aims to evaluate the current literature on the impacts of trauma and stress on orexin expression and signalling. METHODS: A systematic review of primary research was conducted using Embase, PsycInfo, MEDLINE, and PubMed databases from inception to December 2025, following PRISMA criteria. Our search strings included keywords related to trauma, stress, posttraumatic stress disorder (PTSD), and orexins. Both preclinical and clinical studies evaluating the impacts of trauma and stress on orexin expression and signalling were included. RESULTS: In preclinical studies (n = 6), acute stress is associated with increased orexin neuronal activation and concentration (1.55-fold increase, p< 0.05), as well as increased orexin receptor expression in the posterior hypothalamus (1.3-fold increase, p<0.01). Chronic stress and PTSD is associated with increased orexin receptor responsivity (t = 3.51, p= 0.011). Childhood trauma is associated with decreased orexin receptor 1 (OX₁ receptor) expression in the hypothalamus (p< 0.05) and amygdala (2-fold decrease, p<0.05). In a clinical study, childhood trauma was associated with increased plasma orexin-B concentration and Major Depressive Disorder (p < 0.001). CONCLUSIONS: Acute trauma exposure and stress are associated with increased orexin expression, and chronic trauma exposure and PTSD are associated with increased receptor responsivity and decreased receptor expression. The research strategic priority is to replicate these findings in clinical samples not taking medication, and examine differences by age, sex, and type and length of trauma exposure.
Perceived treatment assignment influences the effects of transcranial direct current stimulation on anxiety during an internet-based psychosocial stressor.
Hyde J, Huneke NTM, Baldwin DS … +1 more , Garner M
Psychiatry Res · 2026 Aug · PMID 42127498 · Publisher ↗
Social anxiety disorder is the most prevalent anxiety disorder. Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that represents a promising tool for modulating anxiety-related...
Social anxiety disorder is the most prevalent anxiety disorder. Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that represents a promising tool for modulating anxiety-related cortical activity. Psychosocial stressors, such as the InterneT-based Stress test for Social Anxiety Disorder (ITSSAD), are useful tools for controlled induction of acute social anxiety symptoms. We tested whether tDCS might reduce anxiety induced by the ITSSAD. This was a randomized, sham-controlled, double-blinded study. Ninety-six university students were randomized to receive 20 min of active or sham 2 mA tDCS over the dorsolateral prefrontal cortex (dlPFC) in a unilateral (anodal left dlPFC only) or bilateral (anodal left and cathodal right dlPFC) montage. Participants then underwent a challenging social interaction with an experimenter over videoconferencing software (ITSSAD). Subjective anxiety and mood, and autonomic nervous system activity measures were taken. Perceived treatment assignment was measured after the interaction. The ITSSAD increased subjective anxiety and negative mood, as reported previously. No differential effects of active versus sham tDCS were found on any of the subjective or autonomic measures. Significant effects of perceived treatment were found on subjective anxiety, such that participants who believed they had received active stimulation reported smaller increases following the ITSSAD. The findings of this study do not provide support for the effectiveness of tDCS for anxiety symptoms in response to an acute psychosocial stressor but instead suggest that perceived treatment plays an important role in observed outcomes. This study highlights the importance of measuring treatment expectations and blinding integrity in tDCS trials.
Is it time for AI to take a leading role in mass trauma mental health response?
Brenner GH, Koyfman S, Mehendale R
Psychiatry Res · 2026 Aug · PMID 42119256 · Publisher ↗
Machine learning (ML) and artificial intelligence (AI) offer opportunity and risk in mass trauma response, disasters and crisis. This narrative review synthesizes material from our "AI to the Rescue" panel at the inaugur...
Machine learning (ML) and artificial intelligence (AI) offer opportunity and risk in mass trauma response, disasters and crisis. This narrative review synthesizes material from our "AI to the Rescue" panel at the inaugural PreAct Mass Trauma conference in June 2025, integrating relevant literature and the authors' expertise. We examine AI approaches beyond large language models (LLMs), including traditional ML and multimodal systems, while grounding the concept of "AI-made disasters" as a necessary third disaster type alongside Human-made and Natural, supported by emerging evidence of AI-caused psychiatric harm. We present the AI Safety Levels for Mental Health (ASL-MH) framework with six levels - from supportive applications, to autonomous packages, to experimental, high-risk systems - positioned as a practical heuristic for graduated risk governance given the nascent regulatory landscape and the demonstrated fragility of voluntary industry safety commitments. Using the Model for Adaptive Response to Complex Cyclical Disasters (MARCCD) framework, we organize AI applications across four phases: Anticipation, Impact, Adaptation, and Growth & Recovery, with attention to core disaster mental health sequelae and the challenge of differentiating normative distress from psychopathology. Recommendations address research/evidence, governance/regulation, training/literacy, and equity/access. Given our presentation involved live demos of AI applications, we have distilled key elements into this review which cannot be directly shown.
Spoken language biomarkers in Turkish-speaking schizophrenia patients: Evidence from linguistic analysis and word embeddings.
Bozdağ MÇ, Kumcu A, Şenel LK … +5 more , Temizkan HN, Özil Ö, Arslanyürek İ, Ertekin PN, Candansayar S
Psychiatry Res · 2026 Aug · PMID 42119255 · Publisher ↗
BACKGROUND AND HYPOTHESIS: Schizophrenia (SZ) disrupts language in ways that may be universal across languages. This study investigated whether linguistic anomalies previously observed in SZ also occur in Turkish, a morp...
BACKGROUND AND HYPOTHESIS: Schizophrenia (SZ) disrupts language in ways that may be universal across languages. This study investigated whether linguistic anomalies previously observed in SZ also occur in Turkish, a morphologically rich and agglutinative language. We hypothesised that SZ patients would differ from healthy controls (HCs) across multiple linguistic domains, including features typically sensitive to cross-linguistic variation. METHODS: Speech characteristics of 50 native Turkish-speaking SZ patients were compared with 50 HCs matched for age, sex, length of education, and handedness. Speech data were collected in 15-minute interviews. The interview recordings were transcribed and analysed for various lexical, syntactic, and phonological measures using CLAN, and compared for discourse measures using fastText word embedding models. RESULTS: The number of words produced per minute, mean length of utterance, average word frequency, the number of filled pauses, discourse coherence, and question-response similarity were lower in the patient group than in the control group. The content word-function word ratio, sentence prediction loss, type-token ratio, number of silent pauses, and silent pauses-to-total speech ratio were higher in the patient group than in the control group. Specific clinical and sociodemographic variables were identified as predictors of speech abnormalities in patients. CONCLUSION: The hypothesis was confirmed. Turkish-speaking SZ patients displayed speech patterns similar to those reported in other language groups, including language-sensitive variables. This supports the idea of universal linguistic disruptions in SZ. The findings are particularly valuable given the scarcity of research on Turkish, a low-resource and typologically distinct language.
Effects of fronto-occipital transcranial alternating current stimulation for treating schizophrenia with prominent negative symptoms: A double-blind, randomized, sham-controlled trial.
Wu G, Shen M, Lin Y … +11 more , Chen H, Qian Z, Zhang J, Guo Q, Hu H, Jiao X, Liu X, Wang Z, Hu Q, Wang J, Tang Y
Psychiatry Res · 2026 Aug · PMID 42114330 · Publisher ↗
BACKGROUND: Developing novel technologies to effectively alleviate negative symptoms of schizophrenia remains challenging. While non-invasive brain stimulation targeting the dorsolateral prefrontal cortex (DLPFC) has sho...
BACKGROUND: Developing novel technologies to effectively alleviate negative symptoms of schizophrenia remains challenging. While non-invasive brain stimulation targeting the dorsolateral prefrontal cortex (DLPFC) has shown potential, its outcomes have been inconsistent. Transcranial alternating current stimulation (tACS), which modulates specific frequency synchronization across long-range brain networks, offers new insights into optimizing the therapeutic efficacy for negative symptoms. OBJECTIVE: To examine the efficacy and safety of a 7 Hz, right DLPFC-occipital tACS protocol for negative symptoms. METHODS: Sixty schizophrenia patients with prominent negative symptoms were randomized to receive 10 sessions of active or sham tACS. The primary outcome was reduction rate of Positive and Negative Syndrome Scale (PANSS) negative subscale. Secondary outcomes included changes in Scale for the Assessment of Negative Symptoms (SANS) scores and other PANSS scores. General linear mixed model analysis of covariance was used for an intent-to-treat sample. RESULTS: No significant interaction between group and time of assessment was found for the PANSS negative subscale (F = 0.614, p = 0.543). Only SANS Anhedonia-Asociality showed a significant interaction between group and time (F = 4.596, p = 0.012), whereas all other secondary outcomes showed no significant interaction. In the active tACS group, significant interactions between time and illness duration were observed for SANS Affective Flattening scores (F = 3.689, p = 0.020) and PANSS negative subscale (F = 3.868, p = 0.024). CONCLUSION: The application of 7 Hz, fronto-occipital tACS did not yield significant immediate or short-term effects in alleviating negative symptoms, suggesting that stimulation parameters require further optimization.
The relationship between loneliness and childhood traumatic experiences among patients with late-life depression.
Wang AY, Chi DC, Chen WY … +3 more , Huang CY, Chiu CC, Stewart R
Psychiatry Res · 2026 Aug · PMID 42107417 · Publisher ↗
OBJECTIVE: The aims of this study are to investigate the relationship between loneliness and childhood traumatic experiences among patients with late-life depression (LLD) and to examine which subtypes of childhood traum...
OBJECTIVE: The aims of this study are to investigate the relationship between loneliness and childhood traumatic experiences among patients with late-life depression (LLD) and to examine which subtypes of childhood trauma are more specifically associated with loneliness. We also explored whether family support modifies the association of interest. METHODS: This cross-sectional study was conducted in older adults aged 60 years or more with LLD but not in the acute stage. Questionnaires including Childhood Trauma Questionnaire (CTQ), Geriatric Depression Scale (GDS), loneliness scale (UCLA version 3), and the Chinese version of the family adaptation, partnership, growth, affection, and resolve (APGAR-C) were administered. RESULTS: The 51 enrolled participants had a mean age of 68.7±6.2 years and a mean education of 10.5±4.0 years; 82.4% were female. After adjusting for potential confounders, loneliness score was positively associated with CTQ (ß = 0.45, p = 0.004). Among CTQ subtypes, emotional abuse (ß = 0.28, p = 0.033) and emotional neglect (ß = 0.32, p = 0.047) were significantly associated with loneliness whereas physical neglect, physical abuse, and sexual abuse were not. Perceived family support did not significantly moderate the association of interest; however, this null finding should be interpreted cautiously given the small sample size, cross-sectional design, and the narrow family-centered assessment of social support. CONCLUSION: Childhood emotional abuse and neglect are significantly associated with loneliness in patients with LLD. Clinical management of LLD should include assessments of early-life trauma to better tailor interventions aimed at reducing social isolation and loneliness in this vulnerable population.
Examining adverse effects in a large clinical trial of rTMS application as a treatment for Alzheimer's disease.
Uehara MA, Bretecher CA, Teschuk JM … +6 more , Verot A, Saha C, Fitzgerald PB, Koski L, Millikin C, Moussavi Z
Psychiatry Res · 2026 Aug · PMID 42105452 · Publisher ↗
BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) has several advantages compared to other interventions for neurological and psychological disorders. However, various adverse effects have been reported in...
BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) has several advantages compared to other interventions for neurological and psychological disorders. However, various adverse effects have been reported in rTMS research, and little is known about who is most susceptible to rTMS adverse effects, or how they can be minimized. AIMS: We aimed to identify risk factors for adverse effects reported in a recent clinical trial examining rTMS as a treatment for Alzheimer's disease (AD). We hypothesized that higher stimulation intensity would be associated with experiencing unspecified pain/discomfort, dental pain, headache, jaw pain, and muscle contractions, but not be associated with other adverse effects. METHODS: Using detailed notes from treatment sessions, 10 adverse effects were identified. Spearman correlations were conducted to assess relationships between the highest applied stimulation intensity and normalized frequency of each adverse effect amongst those who experienced that adverse effect. Demographic information, cognitive scores, and withdrawal status were compared between the binarized groups of participants who experienced adverse effects versus those who did not. Spearman correlations were also conducted on the binarized adverse effects and the highest applied stimulation intensity. Logistic regressions were conducted to identify potential risk factors. RESULTS: In both the sham and active treatment groups, unspecified pain/discomfort was the most common adverse effect, followed by muscle contractions and dizziness. In both the active and sham treatment groups, stimulation intensity was positively associated with muscle contractions, but was not significantly related to any other adverse effect. In evaluating groups with/without adverse effects, we found there was a significantly higher proportion of males reporting adverse effects in both the active treatment group and the sham treatment group compared to females. CONCLUSION: The findings of this study are a step toward understanding how researchers can minimize such adverse effects, and thereby, create a less aversive experience for rTMS participants.
Executive dysfunction in military PTSD with ecological sleep assessment: A cross-sectional study.
Sipahimalani G, Sauvet F, Quiquempoix M … +6 more , Feingold D, Jacques C, Guillard M, Lahutte B, Chennaoui M, Saguin E
Psychiatry Res · 2026 Aug · PMID 42102530 · Publisher ↗
BACKGROUND: Post-Traumatic Stress Disorder (PTSD) is consistently linked to deficits in executive functions, including attention, working memory, and inhibitory control, which impact clinical outcomes. This study examine...
BACKGROUND: Post-Traumatic Stress Disorder (PTSD) is consistently linked to deficits in executive functions, including attention, working memory, and inhibitory control, which impact clinical outcomes. This study examined these cognitive functions in military personnel with PTSD and its associations with clinical symptoms and objective sleep parameters. METHODS: French active-duty and veteran service members with PTSD (n = 130) and healthy military controls (n = 65) completed computerized cognitive tasks: inhibition (Go/No-Go), sustained attention (0-Back), and working memory (2-Back). Sleep was monitored under ecological conditions using a polysomnographic headband. Clinical assessments included PTSD severity (PCL-5) and depression (BDI). Efficiency scores combining accuracy and speed were calculated for each task. Group comparisons, correlations, and multiple regressions were conducted. Executive impairment thresholds were derived from the controls to estimate prevalence in the PTSD group. RESULTS: PTSD participants showed lower performance across the three cognitive tasks. Using normative thresholds, 36.6% met criteria for executive impairment. In the PTSD group, clinical and sleep variables explained only a small proportion of the variance in cognitive performance (R² = 0.12), with REM sleep and PTSD severity showing the largest albeit modest contributions. In contrast, predictors explained a greater proportion of variance in controls (R² = 0.35), suggesting stronger predictive utility. Exploratory analyses indicated that medication burden was the strongest individual predictor of executive performance in PTSD. CONCLUSION: Executive dysfunction is frequent among military personnel with PTSD and only partially explained by standard clinical and sleep measures. Cognitive impairment likely reflects multiple interacting mechanisms not captured by standard assessments, underscoring the need for integrative and multimodal approaches.
Functional dysconnectivity of large-scale functional brain networks in young adults with bipolar disorder with and without low-grade inflammation.
Hsu TW, Li JR, Tsai SJ … +6 more , Bai YM, Su TP, Chen TJ, Hsu JW, Chen MH, Liang CS
Psychiatry Res · 2026 Aug · PMID 42096722 · Publisher ↗
Bipolar disorder (BD) is associated with both functional brain network disruptions and low-grade peripheral inflammation, yet their interplay remains poorly understood. This study aimed to investigate whether low-grade i...
Bipolar disorder (BD) is associated with both functional brain network disruptions and low-grade peripheral inflammation, yet their interplay remains poorly understood. This study aimed to investigate whether low-grade inflammation is linked to altered functional connectivity across major brain networks in young individuals with BD. A total of 160 young adults with BD and 93 age-and sex-matched controls were included. Resting-state functional images were obtained using 3T magnetic resonance imaging (fMRI), and seed-based connectivity (SBC) analyses were conducted to map functional connectivity (FC) patterns with specific regions of interest (ROIs) from well-established resting-state networks, including the Default Mode Network (DMN), Salience Network (SN), Frontoparietal Network (FPN), and reward network. Fasting plasma C-reactive protein (CRP) level were measured, and low-grade inflammation (LGI) was defined based on CRP levels of ≥3 mg/L. There was a total of 27 participants with BD in the LGI group and 133 in the non-LGI group. SBC analyses showed increased FC within the SN in the LGI group compared with HCs, whereas the non-LGI group showed numerically intermediate values (e.g. ACC-precentral gyrus connectivity: LGI > non-LGI > HC, all pairwise comparisons significant). A similar pattern was observed for FC between the ventral tegmental area and the bilateral supramarginal gyrus (LGI > non-LGI > HC) within the reward network. Within the DMN, both BD groups showed decreased functional connectivity between the medial prefrontal cortex and the left putamen compared with the HC group. Low-grade inflammation is linked to distinct brain connectivity changes in young individuals with bipolar disorder, highlighting the role of neuroimmune mechanisms in its pathophysiology.
Anxiety, depression, and post-traumatic stress disorder among Palestinian refugees in Egypt: Gender-stratified item-level Bayesian network analysis.
Fadl N, Shahtou A, Own HM … +8 more , Alkasaby MA, Abdel-Fattah MA, Tafesh RMA, Alzaanin SH, Zourob HMM, Aljedaili MWA, Shaheen FIA, Abdullah RG
Psychiatry Res · 2026 Aug · PMID 42090876 · Publisher ↗
BACKGROUND: Mental disorders pose a substantial global burden, particularly among conflict-affected populations. This study aimed to examine gender-stratified, item-level networks of anxiety, depression, and posttraumati...
BACKGROUND: Mental disorders pose a substantial global burden, particularly among conflict-affected populations. This study aimed to examine gender-stratified, item-level networks of anxiety, depression, and posttraumatic stress disorder (PTSD) among Palestinian refugees in Egypt following the 2023 war on Gaza. METHODS: A cross-sectional study was conducted among 558 Palestinians aged > 18 years displaced to Egypt. Anxiety, depression, and PTSD were assessed using the Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and Impact of Event Scale-6, respectively. Bayesian network analyses were applied to identify central symptoms and the strongest within- and cross-diagnostic associations. RESULTS: In the male network, suicidal ideation and loss of energy emerged as the most central symptoms. The strongest cross-diagnostic association was observed between anticipatory fear and depressed mood. Within diagnostic domains, the strongest associations were found between uncontrollable worry and excessive worrying (anxiety), loss of energy and appetite change (depression), and war-related intrusive thoughts and hypervigilance (PTSD). In the female network, psychomotor agitation or retardation and suicidal ideation were the most central symptoms. The strongest cross-diagnostic association was between trouble relaxing and anhedonia. The strongest within-domain associations were observed between feeling anxious and being easily annoyed (anxiety), loss of energy and depressed mood (depression), and war-related intrusive thoughts and reminders of war (PTSD). CONCLUSIONS: Identifying gender-specific core symptoms and both within- and cross-diagnostic associations in this vulnerable population is crucial to inform targeted interventions and reduce comorbidity.
Speech as an objective measure of psychomotor dysfunction in major depressive disorder: validation from non-speech motor measures.
Exton EL, Klemballa D, Walther S … +5 more , Letkiewicz AM, Keshet J, Mittal VA, Shankman SA, Goldrick M
Psychiatry Res · 2026 Aug · PMID 42086001 · Full text
Psychomotor dysfunction, which can manifest as slowing (psychomotor retardation; PmR) and jerkiness or restlessness (psychomotor agitation; PmA) often occurs in individuals with major depressive disorder (MDD). As psycho...
Psychomotor dysfunction, which can manifest as slowing (psychomotor retardation; PmR) and jerkiness or restlessness (psychomotor agitation; PmA) often occurs in individuals with major depressive disorder (MDD). As psychomotor dysfunction predicts a worse treatment response, accurately measuring and tracking PmR and PmA may improve outcomes. Traditionally, psychomotor dysfunction has been assessed using self-report or observer-based methods, which are often insensitive to subtle but potentially relevant movement abnormalities. Instrumental probes often require specialized equipment. Speech presents a promising option as it requires a significant motor component and is easy to collect. This study serves as a preliminary test of the association between speech indicators of PmR and PmA and manual motor tasks (handwriting velocity and force variability). Participants with current MDD (n = 36) and remitted MDD (n = 78) completed a diadochokinetic speech task, quickly repeating syllables in a sequence ("pataka" and "katapa"), as well as a test of handwriting velocity while drawing loops (PmR) and a test of variability in force applied to a transducer (PmA). Velocity of speech production and speech rate variability were automatically measured. For current MDD individuals, speech velocity was positively associated with the manual PmR measure (t(29) = 2.59, p < 0.05), and speech rate variability was positively associated with the manual PmA measure (t(33) = 2.952, p < 0.01). Effects were not significant for remitted MDD individuals, suggesting that this method may detect PmR/PmA only in those with acute depressive symptoms. These results suggest that diadochokinetic speech is a promising, objective measure of psychomotor dysfunction.
Is the Structure of ADHD stable across adulthood? Insights from the CAARS 2.
Clark H, Erhardt D, Sparrow E … +1 more , Solomon J
Psychiatry Res · 2026 Aug · PMID 42070363 · Publisher ↗
It is well established that ADHD persists into adulthood with some changes in the clinical presentation, but structural stability of ADHD across different stages of adulthood has rarely been examined. This study used a m...
It is well established that ADHD persists into adulthood with some changes in the clinical presentation, but structural stability of ADHD across different stages of adulthood has rarely been examined. This study used a multiple-group confirmatory factor analysis (CFA) approach to examine the measurement invariance of the latent 5-factor structure of the Conners Adult ADHD Rating Scales, 2nd Edition (CAARS 2) across stages of emerging (18-24 years), early (25-39 years), and middle adulthood (40-64 years). Data were drawn from the CAARS 2 general population and ADHD subsamples, including self-reported (n = 1684) and observer-generated (n = 1606) ratings. Results provide very strong evidence for configural, threshold, metric, and scalar invariance of the 5-factor correlated traits model across these three adult age groups for both Self-Report and Observer forms of the CAARS 2. This finding suggests a stable latent structure of ADHD across emerging, early, and middle adulthood. Evaluation and treatment of ADHD in adults may be enhanced by expanding beyond the two-factor DSM-5-TR model to reflect this 5-factor model (viz., Inattention/Executive Dysfunction, Hyperactivity, Impulsivity, Emotional Dysregulation, Negative Self-Concept), though further research on this important topic is needed. Additional clinical implications of the stability of the latent structure of ADHD across adulthood are discussed, along with methodological limitations and directions for future research.
Iron dysregulation across the schizophrenia lifespan: A systematic review from prenatal risk to postmortem findings.
Ramos MA, Hernández C, Arranz B
Psychiatry Res · 2026 Aug · PMID 42068734 · Publisher ↗
Iron plays a central role in neurodevelopment and dopaminergic regulation, yet its relationship with schizophrenia remains conceptually unresolved. Research conducted across the life span, from prenatal exposure to postm...
Iron plays a central role in neurodevelopment and dopaminergic regulation, yet its relationship with schizophrenia remains conceptually unresolved. Research conducted across the life span, from prenatal exposure to postmortem brain tissue, has produced fragmented findings without an integrating physiological framework. We aimed to systematically synthesize this literature and reinterpret prior findings through core principles of iron regulation, with particular attention to the distinction between absolute iron depletion and inflammation-driven functional restriction. We conducted a PROSPERO-registered systematic review (CRD42022382842) following PRISMA guidelines and included 51 studies spanning genetic risk, gestational exposure, peripheral biomarkers, neuroimaging, and postmortem analyses. Genetic studies do not implicate core iron-regulatory pathways in inherited schizophrenia risk. Large population-based cohorts consistently associate maternal iron deficiency during pregnancy with increased schizophrenia risk in offspring. Sixteen studies assessed adult peripheral iron markers; most report lower serum iron, although heterogeneity remains substantial. Few investigations evaluated regulatory markers such as hepcidin, and only one examined the hepcidin-ferroportin pathway directly. Neuroimaging studies in early psychosis report reduced subcortical iron alongside increased dopaminergic activity, whereas postmortem investigations describe cortical iron-ferritin decoupling in chronic stages. Across levels of analysis, apparent inconsistencies converge when iron physiology is considered. Absolute iron depletion and inflammation-driven functional iron restriction represent biologically distinct states that share reduced circulating iron but arise from different mechanisms. Stratifying schizophrenia according to iron phenotype offers a coherent framework to reinterpret prior evidence and guide future mechanistic research.
Characteristics of subjective well-being and communication in individuals with social anxiety disorder assessed through virtual reality tasks.
Cho Y, Kim S, Kim E … +4 more , Kim HE, Kim BH, Kim J, Kim JJ
Psychiatry Res · 2026 Aug · PMID 42068733 · Publisher ↗
Individuals with social anxiety disorder (SAD) have difficulty coping with social situations, resulting in a diminished quality of life. This study aimed to investigate subjective well-being and communication-related cha...
Individuals with social anxiety disorder (SAD) have difficulty coping with social situations, resulting in a diminished quality of life. This study aimed to investigate subjective well-being and communication-related characteristics using virtual reality (VR) tasks. Twenty-eight individuals with SAD and 25 healthy controls performed VR subjective well-being tasks (recognizing experience-based problems, expressing a future self-based success story, and expressing strengths) and VR communication tasks (exploring the communication style, practicing functional communication, and expressing empathy). The SAD group reported lower anti-difficulty, resolvability, and strength utilization scores and showed lower communication score in response to all dysfunctional communication styles (placating, blaming, computing, distracting) than the control group. These results suggest that diminished quality of life in individuals with SAD can be measured in terms of subjective well-being and communication using VR tasks. Multiple training regimes, including repeated execution of these tasks, may be necessary to improve their quality of life.
Transdiagnostic symptom networks of impulsivity, problematic smartphone use, and social media addiction: replication across two samples.
Gong Y, Zhou T, Zhou W … +6 more , Yang L, Li Y, Miao D, Qiu R, Zhu X, Guo Z
Psychiatry Res · 2026 Aug · PMID 42068732 · Publisher ↗
BACKGROUND: Impulsivity is associated with problematic smartphone use (PSU) and social media addiction (SMA). However, it remains unclear which specific impulsivity dimension and which dimension-symptom connections were...
BACKGROUND: Impulsivity is associated with problematic smartphone use (PSU) and social media addiction (SMA). However, it remains unclear which specific impulsivity dimension and which dimension-symptom connections were most important to these associations. In this study, network analysis was applied to examine the connections between impulsivity dimensions and the separate and comorbid symptoms of PSU and SMA. METHODS: Using cross-sectional data from two independent samples of Chinese adults-a main sample (n = 1047, aged 18-26, collected in 2023) and a replication sample (n = 325, aged 18-36, collected in 2022)-three regularized partial-correlation networks were constructed for each sample: an impulsivity-PSU network, an impulsivity-SMA network, and a combined impulsivity-PSU-SMA network. Bridge centrality was calculated to identify key transdiagnostic nodes, and network comparison tests (NCTs) were performed to evaluate the consistency of findings across samples. RESULTS: Across all the networks, motor impulsivity consistently emerged as the most central bridge node, showing robust connections to individual symptoms of both the PSU and the SMA, whether examined separately or comorbidly. Network comparison tests further confirmed that both the bridge centrality of motor impulsivity and its specific symptom-edge weights were comparable between the main and replication samples. CONCLUSIONS: These findings provide novel, symptom-level insight into how impulsivity-particularly motor impulsivity-contributes to the development and comorbidity of PSU and SMA. Motor impulsivity is identified as a key transdiagnostic bridge and a promising target for early intervention. The replication of the core results across independent samples strengthens the reliability of the findings.
Impact of second-generation antipsychotics on white matter microstructure in schizophrenia: A DTI study.
Chen W, Xu C, Deng W … +3 more , Liang J, Zhang C, Xie G
Psychiatry Res · 2026 Aug · PMID 42068731 · Publisher ↗
BACKGROUND: Second-generation antipsychotics are widely prescribed for schizophrenia and other psychiatric disorders; however, their potential effects on cerebral white matter (WM) microstructure and associated cognitive...
BACKGROUND: Second-generation antipsychotics are widely prescribed for schizophrenia and other psychiatric disorders; however, their potential effects on cerebral white matter (WM) microstructure and associated cognitive changes remain poorly characterized. METHODS: Diffusion tensor imaging (DTI) was performed in 43 drug-naïve patients with schizophrenia and 44 healthy controls at baseline, and repeated after 8 weeks during which patients received antipsychotic treatment. Tract-based spatial statistics (TBSS) were applied to assess changes in WM microstructural integrity. Cognitive performance was evaluated using selected measures from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), including story recall, line orientation, picture naming, semantic fluency, digit span, coding, and word recall. RESULTS: At baseline, no significant group differences were observed in fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), or mean diffusivity (MD). Following treatment, compared with healthy controls, patients exhibited decreased FA in the body of the corpus callosum; increased MD across nearly all WM regions; and elevated RD in the genu and body of the corpus callosum, bilateral anterior corona radiata, left superior corona radiata, and left superior longitudinal fasciculus. Spearman correlation analyses revealed that RD values in RD_cluster1 and RD_cluster2 were negatively correlated with digit span scores (r = -0.359, p = 0.018; r = -0.35, p = 0.021). Although clinical symptoms improved during this period, changes in FA, MD, and RD were not associated with symptom improvement or antipsychotic dosage. CONCLUSION: These findings suggest that antipsychotic treatment exerts potential effects on WM microstructure and cognitive function in drug-naïve patients with schizophrenia.
The effects of physical exercise on simple inflammatory markers, systemic immune inflammation index, and systemic immune response index in patients with schizophrenia.
Koç İ, Koç EA
Psychiatry Res · 2026 Aug · PMID 42066483 · Publisher ↗
OBJECTIVE: This study aimed to investigate the effects of physical exercise on simple inflammation markers, systemic immune inflammation index and systemic immune response index in patients with schizophrenia. METHODS: A...
OBJECTIVE: This study aimed to investigate the effects of physical exercise on simple inflammation markers, systemic immune inflammation index and systemic immune response index in patients with schizophrenia. METHODS: A total of 35 individuals diagnosed with schizophrenia participated in the study (exercise group: n = 17, control group: n = 18). Participants continued their routine psychiatric treatments. The exercise group underwent a 12-week supervised exercise program, while the control group did not receive any additional intervention. Simple inflammatory markers, systemic immune inflammatory index (SII) and systemic immune response index (SIRI) and positive and negative syndrome scale (PANNS) scores were assessed at baseline, after 12 weeks, and after a 12-week follow-up without exercise following the completion of the exercise. RESULTS: In the exercise group, inflammatory markers, SII and SIRI values significantly decreased during the first 12 weeks, whereas the control group showed stability or increases. Similarly, all of the PANSS subgroup scores decreased significantly in the exercise group, but increased in the control group. During the follow-up, these improvements diminished, and group differences were no longer significant. Over the total 24-week period, control group exhibited significant increases in both inflammatory markers and PANSS scores, while the exercise group remained stable. CONCLUSIONS: A 12-week exercise program reduced systemic inflammation and improved clinical symptoms in patients with schizophrenia. However, these benefits diminished after discontinuation. Regular physical activity may serve as a practical adjunctive strategy in schizophrenia management, though long-term and larger studies are needed to confirm sustainability.
The efficacy of cognitive behavioral therapy for persecutory delusions: A systematic review and meta-analysis.
Liu X, Wang H, Wang S … +5 more , Wang R, Zhao Q, Tian S, Guo X, Cao H
Psychiatry Res · 2026 Aug · PMID 42066482 · Publisher ↗
BACKGROUND: Persecutory delusions, prevalent in disorders like schizophrenia, significantly impair daily functioning and cause distress. Although cognitive behavioral therapy (CBT) has shown promise in treating delusions...
BACKGROUND: Persecutory delusions, prevalent in disorders like schizophrenia, significantly impair daily functioning and cause distress. Although cognitive behavioral therapy (CBT) has shown promise in treating delusions, no meta-analysis has specifically evaluated its effectiveness for persecutory delusions. OBJECTIVES: To identify studies on CBT specifically designed for patients with persecutory delusions and to evaluate its impact on delusion-related symptoms, including the conviction of persecutory delusions, paranoia severity, and psychological well-being. METHODS: A comprehensive search of 10 electronic databases was conducted until December 4, 2025, to identify randomized controlled trials on CBT for persecutory delusions. Two independent reviewers screened studies, assessed quality, and extracted data. RESULTS: Ten studies including 904 participants were included. CBT was associated with a small reduction in the conviction of persecutory delusions (SMD = -0.31, 95% CI, -0.45 to -0.18, p < 0.001; moderate-quality evidence), a small reduction in the severity of paranoia (SMD = -0.29, 95% CI: -0.43 to -0.15, p < 0.001; high-quality evidence), and a small improvement in psychological well-being (SMD = 0.36, 95% CI: 0.09 to 0.63, p = 0.01; moderate-quality evidence). Subgroup analyses revealed comparable effect sizes across intervention duration, session frequency, gender composition, and follow-up interval, with no evidence of effect modification. CONCLUSIONS: CBT shows promising efficacy for treating persecutory delusions. Further rigorous trials are required to determine optimal intervention parameters and long-term effects.
Perceived stress and addiction severity in adults with ADHD: A multi-domain analysis.
Romo L, Getin C, Therribout N … +3 more , Icick R, Fouques D, Zerhouni O
Psychiatry Res · 2026 Aug · PMID 42066481 · Publisher ↗
BACKGROUND: Attention deficit/hyperactivity disorder (ADHD) is associated with an increased risk of addiction. However, few studies have compared multiple addiction domains within the same analytic framework using harmon...
BACKGROUND: Attention deficit/hyperactivity disorder (ADHD) is associated with an increased risk of addiction. However, few studies have compared multiple addiction domains within the same analytic framework using harmonized metrics. This study examined the predictors of addiction severity across alcohol, tobacco, cannabis, internet gaming, and gambling in adults with ADHD symptoms. METHODS: Adults reporting ADHD symptoms completed an online survey. Z-standardized severity scores were analyzed via linear mixed-effects models (N = 847 observations from 394 participants) alongside demographics, stress (PSS-10), and ADHD symptoms. An exploratory logistic regression (N = 82) predicted gambling problems. RESULTS: Mixed-effects models revealed no significant main effect of addiction type (all p > .650), indicating that relative severity was comparable across domains. Perceived stress was a significant positive predictor of severity. Current and retrospective ADHD symptoms were not significantly associated with addiction severity. Binary logistic regression identified internet gaming severity as a significant risk factor for the presence of gambling problems (OR = 1.09, p = .037). Alcohol use was not a significant predictor. CONCLUSIONS: Internet gaming severity was associated with the presence of gambling problems. However, general addiction severity appears to be driven more by perceived stress than by ADHD symptoms themselves. Furthermore, internet gaming may represent a risk factor for gambling problems, though this preliminary finding requires replication.
The global burden of autism spectrum disorders in children aged 0-14 years from 1990 to 2021: A population-based study.
Guo J, Chen M, Zhou Y … +4 more , Wang J, Huang Q, Ding J, Li M
Psychiatry Res · 2026 Aug · PMID 42066480 · Publisher ↗
BACKGROUND: Autism Spectrum Disorder (ASD) significantly impacts patients and their families. This study analyzes the global burden and trends of ASD in children (aged 0-14) from 1990 to 2021 using the Global Burden of D...
BACKGROUND: Autism Spectrum Disorder (ASD) significantly impacts patients and their families. This study analyzes the global burden and trends of ASD in children (aged 0-14) from 1990 to 2021 using the Global Burden of Disease Study 2021 (GBD 2021) data, providing epidemiological insights for prevention and early intervention. METHODS: We utilized GBD 2021 data and conducted various analyses including descriptive analysis, correlation analysis, age-period-cohort analysis, decomposition analysis, and projection analysis to evaluate the burden and trends of ASD in children. Statistical analyses and visualizations were performed using R 4.3.3. RESULTS: From 1990 to 2021, the age-standardized incidence rate (ASIR) of ASD initially increased, then declined, while the age-standardized prevalence rate (ASPR) and disability-adjusted life years (DALYs) showed an upward trend. Projections suggest further increases in ASPR and DALYs through 2030. In 2021, the global ASIR of ASD in children was 61.88 (95 % UI: 52.20, 72.92) per 100,000, with ASPR at 857.92 (95 % UI: 723.24, 1009.34) and DALYs at 165.09 (95 % UI: 111.88, 232.19). The onset of ASD is predominantly before the age of 5, with a higher burden in males. Severe burdens are more prominent in higher Socio-Demographic Index (SDI) regions, although low-SDI regions also exhibit notable burdens. Population growth is a key factor in increasing ASD burden, while aging has a mitigating effect. CONCLUSION: Although the ASIR of ASD has declined, ASPR and DALYs continue to rise and are expected to increase further, requiring enhanced efforts to reduce ASD's global burden.
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