European Archives Of Psychiatry And Clinical Neuroscience[JOURNAL]
Sun
200 papers
Sex differences in higher-order cognition in schizophrenia and unaffected first-degree relatives: a longitudinal, family study.
Balanzá-Martínez V, Sánchez-Ortí JV, Correa-Ghisays P … +3 more , Selva-Vera G, Van Rheenen TE, Tabarés-Seisdedos R
Eur Arch Psychiatry Clin Neurosci · 2026 Jun · PMID 42329320 · Publisher ↗
BACKGROUND: Although sex differences in the epidemiology and clinical expression of schizophrenia (SZ) are well established, sex differences in cognition during the chronic stage of SZ remains controversial and merits fu...
BACKGROUND: Although sex differences in the epidemiology and clinical expression of schizophrenia (SZ) are well established, sex differences in cognition during the chronic stage of SZ remains controversial and merits further investigation. We aimed to examine sex differences in executive function and working memory within a longitudinal family study of SZ, hypothesizing that sex effects would be negligible. METHODS: A total of 266 participants, including 113 individuals with SZ, 58 unaffected first-degree relatives (SZR), and 95 healthy controls (HC), were assessed twice over one year using a comprehensive neuropsychological battery. Mixed one-way analyses of covariance were performed to compare these participant groups, accounting for sex. RESULTS: No significant sex differences were found in performance on executive functioning and working memory tasks across SZ and SZR (p > 0.05). This performance pattern was also maintained for HC. However, the SZ group performed significantly worse than other two groups in most tasks (p < 0.0001; η²p = 0.09 to 0.14). CONCLUSION: The present results support previous evidence reporting the absence of sex differences in higher-order cognition in schizophrenia and provide new evidence that there are no sex effects in these domains in unaffected relatives of individuals with SZ.
Association between questionnaire-based and accelerometer-based physical activity and the incidence of psychiatric disorders in people with loneliness or social isolation: findings from the UK Biobank.
Jin B, Zhang X, Yan T … +5 more , Yao M, Fei J, Zheng Y, Yang H, Li H
Eur Arch Psychiatry Clin Neurosci · 2026 Jun · PMID 42307664 · Publisher ↗
BACKGROUND: Physical activity (PA) has been associated with a lower risk of psychiatric disorders; however, it remains unclear whether a similar association exists for individuals experiencing social isolation or lonelin...
BACKGROUND: Physical activity (PA) has been associated with a lower risk of psychiatric disorders; however, it remains unclear whether a similar association exists for individuals experiencing social isolation or loneliness. METHODS: This study analyzed two cohorts, including the questionnaire-based PA cohort and the accelerometer-based PA cohort. Social isolation and loneliness were assessed using self-reported questionnaires. PA was assessed by questionnaire and accelerometer and was categorized into light-intensity, moderate-intensity, and vigorous-intensity PA (LPA, MPA, VPA) and total PA. The questionnaire-based cohort included 12,072 lonely participants and 26,037 socially isolated participants at baseline, all without prior psychiatric disorders. The accelerometer-based cohort included 2,462 lonely and 5,516 socially isolated participants. Psychiatric disorders were identified from hospital inpatient records, primary care data, self-reported medical conditions, and death registers. Cox proportional hazard models were employed to assess the associations. RESULTS: In the questionnaire-based cohort, 2,609 (21.6%) of lonely individuals and 4,761 (18.3%) of socially isolated individuals developed psychiatric disorders during a median follow-up of 13 years. After full adjustment, higher levels of VPA were associated with a lower risk of psychiatric disorders in both lonely participants (HR: 0.856; 95% CI: 0.791, 0.926) and in socially isolated participants (HR: 0.916; 95% CI: 0.863, 0.972). Higher VPA levels were also associated with a lower risk of depression in both groups and anxiety in lonely participants alone. In the accelerometer-based cohort, 241 (10.8%) lonely individuals and 472 (8.5%) socially isolated individuals developed a psychiatric disorder during 7.9 years of follow-up. After full adjustment, higher VPA levels were associated with a lower risk of psychiatric disorders in lonely participants(HR: 0.704; 95% CI: 0.535, 0.927) and socially isolated participants (HR: 0.749; 95% CI: 0.616, 0.910). These associations are robust in a series of subgroups and sensitivity analyses. CONCLUSION: This study suggests that higher levels of VPA are associated with a lower risk of psychiatric disorders among individuals experiencing loneliness or social isolation. This evidence supports the potential of VPA as a viable intervention to alleviate the psychiatric impacts of social isolation and loneliness.
Superoxide dismutase and glutathione interact to determine cognitive outcome among people with subjective cognitive decline (SCD): a prospective study.
Lin CH, Lane HY
Eur Arch Psychiatry Clin Neurosci · 2026 Jun · PMID 42289601 · Publisher ↗
BACKGROUND: Subjective cognitive decline (SCD) is an early sign of Alzheimer's disease, in which oxidative stress is implicated. Three primary endogenous antioxidants include superoxide dismutase (SOD), glutathione (GSH)...
BACKGROUND: Subjective cognitive decline (SCD) is an early sign of Alzheimer's disease, in which oxidative stress is implicated. Three primary endogenous antioxidants include superoxide dismutase (SOD), glutathione (GSH), and catalase (CAT). This current study aimed to explore the roles of these antioxidants in cognitive outcome of SCD. METHODS: Sixty-seven adults with SCD were recruited. Cognitive function (assessed by the Alzheimer's disease assessment scale-cognitive subscale [ADAS-cog]), global function (by Alzheimer's Disease Cooperative Study scale for ADL [ADCS-ADL]), and plasma GSH, CAT, and SOD were measured at baseline and two years later. RESULTS: Over the two-year course, the 67 participants' cognitive performance (mean ADAS-cog score: 5.2 ± 3.4 at baseline vs. 6.1 ± 5.2 at endpoint, P = .062) and global function (ADCS-ADL score: 68.5 ± 10.2 vs. 62.5 ± 13.3, P < .001) showed a deteriorating trend. Their GSH levels fell significantly (3.67 ± 2.70 vs. 2.81 ± 2.51 μm, P = .016), CAT rose (67.7 ± 23.4 vs. 91.9 ± 35.1 nmol/min/mL, P < .001), but SOD remained pretty constant (0.145 ± 0.053 vs. 0.158 ± 0.068 U/mL). Using generalized estimating equations to assess longitudinal changes in ADAS-Cog, we discovered that baseline ADAS-cog score (P < .001), BMI (P = .009), and baseline SOD×GSH interaction (P = .034) were associated with cognitive outcomes. CONCLUSIONS: Cognitive decline in people with SCD was influenced by baseline cognitive level, BMI, and the interaction between SOD and GSH, suggesting that antioxidant interplay may play a crucial role in regulating oxidative stress and consequently cognitive aging.
Cerebral arteriopathy and its role in persistent post-COVID headache and brain fog: a quantitative study.
Wu JW, Chen ST, Chang FC … +5 more , Chen YL, Leung J, Chen MC, Lirng JF, Chou YH
Eur Arch Psychiatry Clin Neurosci · 2026 Jun · PMID 42287361 · Publisher ↗
BACKGROUND: Headache and brain fog are common after COVID-19 infection, and inflammation and vasculopathy might be the potential underlying mechanisms. This study aimed to delineate the extent and impact of cerebrovascul...
BACKGROUND: Headache and brain fog are common after COVID-19 infection, and inflammation and vasculopathy might be the potential underlying mechanisms. This study aimed to delineate the extent and impact of cerebrovascular involvement in patients with persistent long-COVID syndrome in a large Asian cohort. METHODS: We prospectively collected data from patients with persistent (≥ 3 months) post-COVID headache or brain fog, and controls were free from neurological symptoms within 3 months after COVID-19 resolution. The anterior and posterior Focal Cerebral Arteriopathy Severity Score (FCASS) was used to assess the severity of arteriopathy and was modified to account for bilateral involvement (total score: anterior: 0-40; posterior: 0-52). Symptom severity was assessed using monthly headache days, Migraine Disability Assessment (MIDAS), and brain fog severity scale (0-10). RESULTS: A total of 108 patients (M: F = 27:81) were divided into four groups based on symptoms categories. The presence of more symptom categories was associated with higher anterior-FCASS (combined 6.6 [2.1] vs. headache 3.6 [1.6] vs. brain-fog 4.7 [1.7] vs. control 0.8 [0.6], p < 0.001 by one-way ANOVA) and a posterior-FCASS (combined 5.5 [2.2] vs. headache 4.2 [1.6] vs. brain-fog 4.4 [2.3] vs. control 0.8 [0.8], p < 0.001 by one-way ANOVA). Pure brain- fog was more likely have predominance of anterior circulation involvement than pure headache (80.8% vs. 48.0%, p = 0.020), but the severity of brain fog was correlated with only the posterior-FCASS (Pearson's r = 0.338, p = 0.009) rather than the anterior-FCASS (Pearson's r = 0.173, p = 0.195). CONCLUSIONS: Anterior circulation arteriopathy and hypoperfusion may underlie persistent post-COVID brain fog. However, post-COVID headaches may not depend solely on changes in intracranial vessels.
Letter to the Editor, European archives of psychiatry and clinical neuroscience 31st May 2026.
Lewis S, EMPOWER trial group
Eur Arch Psychiatry Clin Neurosci · 2026 Jun · PMID 42287360 · Publisher ↗
Abstract loading — click title to view on PubMed.
Efficacy of mindfulness-based cognitive therapy in mitigating depressive symptoms and suicidal ideation among institutionalized patients with major depressive disorder: findings from a randomized controlled trial.
Argungu ZM, Alhaiti A, Jibreel EA
Eur Arch Psychiatry Clin Neurosci · 2026 Jun · PMID 42283746 · Publisher ↗
OBJECTIVE: Major Depressive Disorder (MDD) represents a significant global health challenge, with elevated risks of suicidal ideation. This study evaluated the efficacy of Mindfulness-Based Cognitive Therapy (MBCT) in mi...
OBJECTIVE: Major Depressive Disorder (MDD) represents a significant global health challenge, with elevated risks of suicidal ideation. This study evaluated the efficacy of Mindfulness-Based Cognitive Therapy (MBCT) in mitigating depressive symptoms and suicidal ideation among institutionalized patients with MDD in Nigeria. METHOD: A randomized controlled trial was conducted with 101 participants (MBCT: n = 50, Control: n = 51) in two psychiatric institutions in northern Nigeria. The 8-week MBCT intervention was compared to standard pharmacological care. Outcomes were assessed at baseline, week 4, week 8 (primary endpoint), and 3-month follow-up using the BDI-II and BSI. The primary analysis used linear mixed-effects models; repeated-measures ANOVA was conducted as a supplementary analysis. RESULT: MBCT significantly reduced BDI-II scores compared to controls at week 8 (between-group difference: -9.4, 95% CI: -12.0 to -6.8, p < 0.001) and 3-month follow-up (-6.7, 95% CI: -9.5 to -3.9, p < 0.001). Similar reductions were observed in BSI scores at week 8 (-5.7, 95% CI: -7.7 to -3.7, p < 0.001) and follow-up (-3.9, 95% CI: -6.0 to -1.8, p < 0.001). Large effect sizes were observed for both measures (Cohen's d: 0.92-1.38). MBCT demonstrated significant efficacy in reducing depressive symptoms and suicidal ideation among institutionalised Nigerian patients with MDD, with effects maintained at 3-month follow-up. CONCLUSION: These findings suggest that MBCT is a promising adjunct to standard care for institutionalized patients with MDD in this setting. Larger, multisite trials with active comparators are warranted before broader clinical integration in LMICs is recommended. TRIAL REGISTRATION: Pan African Clinical Trial Registry (identifier: PACTR201902545863137).
Efficacy of different exercise interventions on cognitive function in adults with major depressive disorder and subthreshold depression: a systematic review with pairwise and network meta-analyses.
Jiang P, Gao Y, Ren X … +8 more , Li Y, Zhang S, Zhang S, Zixuan F, Shao X, Wang Y, Zhang L, Duan L
Eur Arch Psychiatry Clin Neurosci · 2026 Jun · PMID 42262564 · Publisher ↗
BACKGROUND: While exercise is widely recognized as an intervention to assist in the treatment of depression, its effects on cognitive function in adults with major depressive disorder or subthreshold depression remain in...
BACKGROUND: While exercise is widely recognized as an intervention to assist in the treatment of depression, its effects on cognitive function in adults with major depressive disorder or subthreshold depression remain inconsistent. METHODS: A comprehensive search was conducted across 11 databases from database inception to April 2025. Randomized controlled trials and quasi-experimental studies investigating exercise interventions for cognitive enhancement in adults with major depressive disorder or subthreshold depression were included. Pairwise and network meta-analyses were performed to compare the effects of aerobic exercise, resistance exercise, multicomponent exercise, and mind-body exercise. RESULTS: Twenty-six studies were included in the analysis. Traditional pairwise meta-analysis indicated that exercise interventions significantly improved global cognition (SMD = 0.71, 95% CI: 0.34 to 1.08), short-term memory (SMD = 0.29, 95% CI: 0.03 to 0.54), visuospatial memory (SMD = 0.25, 95% CI: 0.06 to 0.45), and attention (SMD = -1.09, 95% CI: -1.59 to -0.59). Network meta-analysis ranked mind-body exercise as the most effective modality for enhancing global cognition (SUCRA = 72.2%). Similarly, mind-body exercise also significantly improved attention (SMD = 0.67, 95%CI : 0.08 to 1.25), processing speed (SMD = 0.30, 95% CI: 0.02 to 0.58), and language function (SMD = 0.37, 95% CI: 0.08 to 0.67). Resistance exercise demonstrated significant benefits for processing speed (SMD = 0.46, 95% CI: 0.03 to 0.89). Multicomponent exercise yielded significant improvements in short-term memory (SMD = 0.96, 95% CI: 0.28 to 1.63). CONCLUSIONS: Despite methodological heterogeneity, this study provides preliminary evidence that exercise, particularly mind-body modalities, effectively enhances cognitive function in adults with major depressive disorder and subthreshold depression.
Affective forecasting in people with autistic traits, social anhedonia, and subthreshold depression: a multi-method study.
Gao Y, Wang Y, Huang Y … +7 more , Yan C, Huang J, Wang K, Yao Z, Lui SSY, Yang T, Chan RCK
Eur Arch Psychiatry Clin Neurosci · 2026 Jun · PMID 42262563 · Publisher ↗
The ability to predict future emotions for upcoming events (affective forecasting, AF) is crucial for mental health. This study compared the distinct and shared characteristics of AF in participants with high levels of a...
The ability to predict future emotions for upcoming events (affective forecasting, AF) is crucial for mental health. This study compared the distinct and shared characteristics of AF in participants with high levels of autistic traits (AT, n = 76), social anhedonia (SA, n = 107), subthreshold depression (SD, n = 102), and 99 controls. Participants completed the laboratory-based and real-life AF tasks, and resting-state functional magnetic resonance imaging. Compared with controls, the AT group reported fewer mental simulation details in the laboratory-based task, and the SA group displayed less anticipated pleasure and fewer mental simulation details in both laboratory-based and real-life AF tasks, whereas the SD group showed relatively intact AF. The three subclinical groups showed larger AF bias than controls. Moreover, the three subclinical groups showed altered functional connectivity (FC) compared with controls, and the altered FC was associated with laboratory-based and real-life AF performance. These findings advance our understanding of early identification and prevention strategies of transdiagnostic populations.
Anomalous self-experiences in biotypes of psychosis.
Sobrino-Conde L, Arjona-Valladares A, Osorio-Iriarte E … +5 more , de la Sierra RB, Rodríguez-Valbuena C, Fiorini-Talavera JC, Hernández-García M, Molina V
Eur Arch Psychiatry Clin Neurosci · 2026 Jun · PMID 42246963 · Publisher ↗
Biotypes of psychoses represent transdiagnostic clusters based on pathological characteristics relevant to this syndrome. This approach seeks to help with the delimitation of groups with external validity within the psyc...
Biotypes of psychoses represent transdiagnostic clusters based on pathological characteristics relevant to this syndrome. This approach seeks to help with the delimitation of groups with external validity within the psychotic syndrome beyond current categories. Our group has previously proposed two biotypes characterized by different cognitive performance and anatomical and functional alterations. Here, we propose that these groups may also differ in the presence and/or severity of anomalous self-experiences. We included 113 patients with psychotic disorders, classified as biotypes into clusters 1 (n = 30, with severe cognitive deficit) and 2 (n = 83, with moderate cognitive deficit) according to criteria established in previous studies (Comparelli et al in Compr Psychiatry 65:44-49, 2016) and (Nelson et al in Schizophr Res 152:20-27) healthy controls. The Inventory of Psychotic-Like Anomalous Self-Experiences (IPASE) was used to score anomalous self-experiences. Cluster 1 patients (severe cognitive impairment) showed significantly higher IPASE scores than healthy controls and Cluster 2 patients, whereas differences between Cluster 2 patients and healthy controls were less pronounced. We conclude that severe anomalous self-experiences characterize the biotype 1 of psychoses, alongside marked cognitive deficits, anatomical alterations, functional basal hyperactivity and higher negative symptoms scores.
Employment trends in schizophrenia and bipolar disorder in Spain: a nationwide register-based study (2018-2023).
Llorca-Bofí V, Anmella G, Guinart D … +4 more , Paredes-Coronel C, Hidalgo-Mazzei D, Vieta E, Bioque M
Eur Arch Psychiatry Clin Neurosci · 2026 Jun · PMID 42236526 · Publisher ↗
BACKGROUND: Employment is a key determinant of recovery in severe mental illness, yet longitudinal evidence from Southern Europe is limited. We aimed to examine national trends in employment status among individuals with...
BACKGROUND: Employment is a key determinant of recovery in severe mental illness, yet longitudinal evidence from Southern Europe is limited. We aimed to examine national trends in employment status among individuals with schizophrenia and bipolar disorder in Spain between 2018 and 2023. METHODS: We conducted a register-based trend study using the Spanish Primary Care Clinical Database (BDCAP), including adults aged 20-64 years with schizophrenia (n = 139,594), bipolar disorder (n = 148,968), or other diagnoses (n = 25,953,622). Employment status was classified as employed, unemployed, economically inactive, disability pensions, or other statuses. Trends were analysed with Joinpoint regression, reporting Average Annual Percent Change (AAPC) with 95% CIs. RESULTS: In 2023, 15.2% of people with schizophrenia and 38.3% with bipolar disorder were employed, versus 62.5% with other conditions. Disability pensions were received by 49.3% and 26.5%, compared with 6.3% in other diagnoses. Between 2018 and 2023, employment rose modestly in schizophrenia (AAPC = + 2.2; 95% CI 0.8-3.6; p < 0.001) and bipolar disorder (+ 2.4; 95% CI 1.6-3.2; p < 0.001), while disability pensions declined (-5.5; 95% CI - 8.9 to - 2.1; p = 0.003; and - 7.2; 95% CI - 9.4 to - 5.1; p < 0.001). The "other statuses" category grew sharply (schizophrenia + 52.8; bipolar disorder + 35.4; both p < 0.001). Sex-stratified analyses showed parallel trends, except for economic inactivity, which declined more steeply among women (Δ trend = + 3.1, p = 0.029; + 2.7, p = 0.031; + 3.2, p = 0.008). CONCLUSIONS: Employment outcomes remain poor for people with schizophrenia and bipolar disorder in Spain. Most improvements likely reflect administrative changes rather than genuine integration into work.
Psychosocial predictors of persistent non-suicidal self-injury in adolescents with major depressive disorder: a longitudinal study.
Fan H, Liu L, Zhang Y … +11 more , Hao M, Zhang X, Zhao L, Tian Y, Yang C, Wang J, Zhao X, Mo D, Geng F, Xia L, Liu H
Eur Arch Psychiatry Clin Neurosci · 2026 Jun · PMID 42234139 · Publisher ↗
BACKGROUND: Major depressive disorder (MDD) is a common mental illness during adolescence, with non-suicidal self-injury (NSSI) as a characteristic manifestation of adolescents with MDD. Research has shown that persisten...
BACKGROUND: Major depressive disorder (MDD) is a common mental illness during adolescence, with non-suicidal self-injury (NSSI) as a characteristic manifestation of adolescents with MDD. Research has shown that persistent NSSI has a more significant impact on the prognosis of MDD that begins during adolescence. This study aimed to explore the psychosocial predictors of persistent NSSI. METHODS: A total of 206 adolescents with MDD were finally included in the statistical analysis. Patients were assessed for NSSI at baseline and one year after enrollment. Multivariate logistic regression was used to identify influencing factors for persistent NSSI. The predictive performance of the models was assessed using receiver operating characteristic (ROC) curve analysis. RESULTS: Among adolescents with MDD who engage in NSSI, the 1-year prevalence rate of persistent NSSI was 32.23%. The Toronto Alexithymia Scale (TAS) score was essential for predicting persistent NSSI (OR 1.098, 95% CI 1.017-85, P = 0.016). Age (OR 0.620, 95% CI 0.415-0.925, P = 0.019) can also be used to predict the occurrence of persistent NSSI. The combined predictive value of TAS score and age for persistent NSSI was higher, with an AUC of 0.792 (95% CI 0.685-0.899, P < 0.001). CONCLUSION: This study found that Chinese adolescents with MDD who engage in NSSI are at increased risk for persistent NSSI. Specifically, age and alexithymia are predictive of its occurrence. In clinical practice, healthcare professionals should pay particular attention to younger adolescents with MDD who engage in NSSI and screen them for alexithymia, in order to implement early intervention and prevent persistent NSSI.
Loneliness is associated with cognitive impairment in patients with schizophrenia: the mediating roles of sleep quality and anxiety.
Zhou W, Zhu Z, Zhang J … +9 more , Zhu Y, Lu J, Luo X, Zhang H, Cao W, Wang Y, Zhang X, Li S, Li Z
Eur Arch Psychiatry Clin Neurosci · 2026 Jun · PMID 42223493 · Publisher ↗
Cognitive dysfunction is a common feature of schizophrenia and is crucial to long-term prognosis. Loneliness may be associated with poorer cognitive function, potentially through sleep quality and anxiety, but the pathwa...
Cognitive dysfunction is a common feature of schizophrenia and is crucial to long-term prognosis. Loneliness may be associated with poorer cognitive function, potentially through sleep quality and anxiety, but the pathways underlying these associations remain unclear. In this study, we aimed to explore the relationship between loneliness and cognitive function using a clinical cohort from China and to examine the mediating roles of sleep quality and anxiety. Using cross-sectional data from a Chinese clinical cohort, we recruited 299 patients with schizophrenia who met DSM-5 diagnostic criteria. Participants completed the University of California Los Angeles (UCLA) Loneliness Scale, the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Pittsburgh Sleep Quality Index (PSQI), and the Hamilton Anxiety Rating (HAMA) Scale. We first conducted univariable analyses to identify demographic and clinical correlates of cognitive performance to be included as covariates. To examine the robustness of the findings, we further performed subgroup analyses by age (18-44, 45-59, ≥ 60 years), sex (male/female), and education level (≤ 9 years/ > 9 years). We then tested a serial mediation model of "UCLA → PSQI → HAMA → RBANS" using structural equation modelling while adjusting for the identified covariates. The significance of indirect effects was evaluated using bootstrapping with 5,000 resamples. After adjustment for age, sex, and years of education, the structural equation model showed a good fit (χ/df = 1.287, CFI = 0.996, RMSEA = 0.031). Path analyses indicated that the association between UCLA scores and RBANS scores was partially explained by significant indirect pathways comprising two components. First, anxiety acted as an independent mediator. Higher UCLA scores were associated with higher HAMA scores (β = 0.135, P < 0.001), which in turn were associated with lower RBANS scores (β = -0.710, P < 0.001). Higher UCLA scores were also associated with higher PSQI scores (β = 0.068, P < 0.001), which were associated with higher HAMA scores (β = 0.283, P < 0.001). Bootstrapping confirmed a significant total indirect effect (effect = -0.109, 95% CI [-0.179, -0.055]). The anxiety-only pathway accounted for 13.7% of the total effect and the sleep-anxiety serial pathway for 2.0%. Subgroup analyses revealed that the anxiety-mediated pathway was significant across most strata, with larger effect sizes in males, older adults (≥ 60 years), and individuals with lower education (≤ 9 years), while the serial pathway was uniquely significant in the 45-59 years age group. These findings indicate that anxiety accounted for a larger proportion of the observed indirect association, whereas the contribution of the sleep-anxiety serial pathway was relatively modest. Nevertheless, given the cross-sectional design, the findings should be interpreted cautiously with respect to causality, and the observed relationships among loneliness, sleep quality, anxiety, and cognitive function may reflect clinically relevant interrelated processes in patients with schizophrenia.
Increased beta-band salience network connectivity predicts 12-month longitudinal changes in depressive and anxiety symptom severity in young adults: a resting-state EEG study.
Imperatori C, Adenzato M, Messerotti Benvenuti S … +6 more , De Rossi E, Allegrini G, Dell'Acqua C, Carbone GA, Ardito RB, Farina B
Eur Arch Psychiatry Clin Neurosci · 2026 Jun · PMID 42223492 · Publisher ↗
The neural dynamics of large-scale brain networks that may be longitudinally associated with changes in depression and anxiety (DEPANX) symptom severity remain relatively understudied. We aimed to examine the relationshi...
The neural dynamics of large-scale brain networks that may be longitudinally associated with changes in depression and anxiety (DEPANX) symptom severity remain relatively understudied. We aimed to examine the relationship between the electrophysiological dynamics of the three-core resting-state networks (RSNs) and 12-month longitudinal changes in DEPANX symptom severity. Ninety-five participants (70 females; mean age: 21.35 ± 2.65 years) completed baseline (Time #1) and 12-month follow-up (Time #2) assessments. At Time #1 data about DEPANX symptoms and related variables (e.g., emotion regulation, familiarity for depression and anxiety) were collected. A resting-state electroencephalogram (EEG) recording was also collected. At Time #2 levels of DEPANX symptoms were assessed again. EEG data were analysed using the Exact Low-Resolution Electromagnetic Tomography software (eLORETA). We found that baseline SN connectivity, particularly bilateral insula beta coherence, was associated (r = 0.371; p = 0.015) with DEPANX symptom changes over 12 months, whereas no comparable longitudinal associations were observed for other RSNs. When controlling for the presence of other variables, this connectivity pattern remained positively and independently associated with change in DEPANX symptoms (β = 0.328; p = 0.002). Our results suggest a key role of the bilateral insula connectivity in predicting 12-month longitudinal changes in DEPANX symptoms, with potential implications for prevention and treatment.
When systems fail: institutional responsibility for physician suicide.
Sher L
Eur Arch Psychiatry Clin Neurosci · 2026 Jun · PMID 42223491 · Publisher ↗
Abstract loading — click title to view on PubMed.
Dose or time? Comparing early prediction of intermittent theta-burst stimulation response across accelerated and daily protocols for depression.
Suen PJC, Cavendish BA, Batista MP … +3 more , Passos IC, Vidal KSM, Brunoni AR
Eur Arch Psychiatry Clin Neurosci · 2026 Jun · PMID 42223490 · Publisher ↗
OBJECTIVE: To compare early response prediction across accelerated and standard intermittent theta-burst stimulation (iTBS) protocols for major depressive disorder, examining whether predictive performance differs when a...
OBJECTIVE: To compare early response prediction across accelerated and standard intermittent theta-burst stimulation (iTBS) protocols for major depressive disorder, examining whether predictive performance differs when assessments are matched by cumulative pulse exposure versus calendar time. METHODS: Pooled analysis of two prospective iTBS trials conducted at Instituto de Psiquiatria, Hospital das Clínicas, Universidade de São Paulo: the open-label BRAEN-MAP trial (once-daily; N = 65; 20 sessions over 4 weeks) and the active arm of the triple-blind, sham-controlled randomized TTT trial (accelerated; N = 50; 45 sessions over 3 weeks). Assessments were matched by cumulative pulses (18,000 pulses), calendar time (Weeks 1 and 2), or session count (15 sessions). Early improvement was defined as ≥ 20% HDRS-17 reduction. Positive predictive values (PPV) and negative predictive values (NPV) were compared using bootstrap resampling. RESULTS: Response rates did not differ between trials (BRAEN-MAP: 55.4%; TTT: 54.0%; p = 0.95). For response prediction, PPV ranged from 66.7% to 75.0% across protocol-timepoint combinations, with no significant differences between protocols at pulse-matched (66.7% vs. 68.9%, p = 0.84), time-matched, or session-matched (66.7% vs. 68.8%, p = 0.86) comparisons (all bootstrap p > 0.43). NPV for non-response prediction ranged from 69.0% to 82.4%, also without significant between-protocol differences. Trajectory analyses demonstrated that early improvers maintained steeper improvement through endpoint. CONCLUSION: Early symptom improvement predicts iTBS response consistently across accelerated and standard protocols regardless of whether assessments are matched by cumulative pulses, calendar time, or number of sessions. These preliminary findings support early response assessment as a protocol-independent clinical tool, though the accuracy levels observed (PPV 67-75%) are insufficient to justify treatment discontinuation and may be most useful within adaptive, measurement-based care frameworks.
Triglyceride-glucose waist-to-height ratio improves risk stratification for depressive symptoms: evidence from NHANES.
Liu X, Liu X, Li J … +1 more , Zhang D
Eur Arch Psychiatry Clin Neurosci · 2026 May · PMID 42215708 · Publisher ↗
BACKGROUND: The triglyceride-glucose (TyG) index is linked to metabolic dysfunction that may contribute to depressive symptoms, but its value for population risk stratification is unclear. We aimed to examine TyG-related...
BACKGROUND: The triglyceride-glucose (TyG) index is linked to metabolic dysfunction that may contribute to depressive symptoms, but its value for population risk stratification is unclear. We aimed to examine TyG-related indices and develop an internally validated prediction model for depressive symptoms in U.S. adults. METHODS: Data were obtained from the National Health and Nutrition Examination Survey (NHANES). Survey-weighted logistic regression was used to evaluate associations between TyG-related indices, including the TyG-waist-to-height ratio (TyG-WHtR), and depressive symptoms. Predictors were selected using least absolute shrinkage and selection operator (LASSO) regression and entered into a multivariable logistic regression model to construct a nomogram. Discrimination was assessed using the area under the receiver operating characteristic curve (AUC) and internally validated using bootstrap resampling and leave-one-out cross-validation. RESULTS: Among 3,870 adults, higher TyG-related indices were associated with greater odds of depressive symptoms, with TyG-WHtR showing the strongest association [highest versus lowest tertile: odds ratio (OR) = 2.37, 95% Confidence Intervals (CI) : 1.59-3.52]. Poverty income ratio, smoking status, and TyG-WHtR were retained in the final parsimonious model, which demonstrated acceptable discrimination (AUC = 0.715) and stable internal performance after bootstrap correction (optimism-corrected AUC = 0.711). CONCLUSION: TyG-WHtR was independently associated with depressive symptoms and improved population-level risk stratification in U.S. adults. The internally validated model requires external validation before any clinical implementation.
Associations between plasma BDNF, VEGF, and EGF and cognition in drug-naïve schizophrenia with and without sleep disturbances.
Zhou B, Su Q, Wang Z … +6 more , Huo Y, Wang S, Feng Z, Xu Y, Qiu Y, Li J
Eur Arch Psychiatry Clin Neurosci · 2026 May · PMID 42215707 · Publisher ↗
BACKGROUND: Cognitive impairment is core symptom in schizophrenia (SCZ), and sleep disturbances (SD) are common and linked to worse cognition. The roles of plasma brain-derived neurotrophic factor (BDNF), vascular endoth...
BACKGROUND: Cognitive impairment is core symptom in schizophrenia (SCZ), and sleep disturbances (SD) are common and linked to worse cognition. The roles of plasma brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF), and epidermal growth factor (EGF) in drug-naïve SCZ, particularly across SD strata, remain unclear. METHODS: We enrolled 138 drug-naïve patients with SCZ at Tianjin Anding Hospital and stratified them by Pittsburgh Sleep Quality Index (PSQI) into the sleep disturbance group (SCZ-SD) (n = 81) and the non-sleep disturbance group (SCZ-NSD) (n = 57). Cognition was assessed with the MATRICS Consensus Cognitive Battery (MCCB). Plasma BDNF, VEGF, and EGF were quantified by enzyme-linked immunosorbent assay (ELISA). Group comparisons, partial correlations, receiver operating characteristic (ROC) analyses, and sensitivity analyses were conducted. RESULTS: SCZ-SD patients showed more severe cognitive impairment than SCZ-NSD, particularly in Verbal Learning, Visual Learning, and composite scores (P < 0.05). In SCZ-SD, BDNF was positively correlated with multiple cognitive domains (FDR-adjusted P < 0.05) and showed modest discriminative ability for cognitive impairment with an area under the curve (AUC) of 0.648. In SCZ-NSD, EGF showed a nominal, exploratory association with use of sleep medication (uncorrected P < 0.05), and the combined plasma-marker model demonstrated fair discrimination of cognitive impairment (AUC = 0.694). CONCLUSIONS: SCZ-SD patients showed more severe cognitive impairment, and higher BDNF was robustly associated with better cognitive performance. In contrast, SCZ-NSD patients showed associations between EGF and sleep-related measures. These findings suggest distinct biological pathways linking sleep and cognition in SCZ with and without SD, though their current discriminative accuracy suggests an adjunctive rather than standalone diagnostic role.
Familial high-risk (FHR) for severe mental illness in clinical high-risk for psychosis (CHR-P): a systematic review and meta-analysis.
Raballo A, Poletti M, Preti A
Eur Arch Psychiatry Clin Neurosci · 2026 May · PMID 42207289 · Publisher ↗
Preventive interventions for young help-seekers at clinical high risk for psychosis (CHR-P) critically depend on the progressive improvement of risk stratification. However, there is evidence that the transparent reporti...
Preventive interventions for young help-seekers at clinical high risk for psychosis (CHR-P) critically depend on the progressive improvement of risk stratification. However, there is evidence that the transparent reporting of relevant variables plausibly affecting longitudinal outcomes (e.g. pre-assessment pharmacological exposure) remains suboptimal. In this study we focused on familial high-risk (FHR) for severe mental illness in CHR-P studies, as regards reporting habits, prevalence and possible role in the transition to psychosis. We performed a systematic review and meta-analysis on studies published on Medline and the Cochrane Library on CHR-P individuals with possible transition as outcome, and published from inception to March 31, 2024. The literature review identified 93 independent samples. Up to 26% of studies included information on first-degree relatives with psychosis. The estimated proportions of FHR for severe mental illness were 29.9% (95% CI: 28.2%-31.6%) for a broad family history of psychiatric illness, 21.0% (95% CI: 19.7%-22.4%) for a family history of psychosis in first-degree relatives, and 24.6% (95% CI: 21.7%-27.7%) for a family history of psychosis in either first- or second-degree relatives. In the small subgroup of studies reporting this information, a family history of psychosis in a first- or second-degree relative was negatively associated with the risk of transition to psychosis. No other significant associations were found between features of familial high risk (FHR) and transition to psychosis. Overall, FHR for severe mental illness is poorly reported in observational cohorts of CHR-P individuals, although it should be ordinarily screened during assessment according to validated instruments. Several limitations may account for the current lack of evidence, highlighting the need for further empirical investigation.
Family structure, depressive symptoms, and childhood maltreatment in Chinese adolescents: a mediation analysis.
Wang M, Li Y, Fang S … +5 more , Dai J, Yan C, Xu Z, Xiu M, Qu M
Eur Arch Psychiatry Clin Neurosci · 2026 May · PMID 42183864 · Publisher ↗
This study examined the mediating role of childhood maltreatment between family structure and adolescent depressive symptoms, utilizing a nationally representative sample of Chinese adolescents (N = 30,234). Depressive s...
This study examined the mediating role of childhood maltreatment between family structure and adolescent depressive symptoms, utilizing a nationally representative sample of Chinese adolescents (N = 30,234). Depressive symptoms and childhood maltreatment were assessed with the Patient Health Questionnaire (PHQ-9) and the Childhood Trauma Questionnaire (CTQ), respectively. Compared to adolescents in two-parent biological families, those in single-parent, grandparent-headed, and other families exhibited a significantly higher risk of depression. Conversely, multigenerational families demonstrated a protective effect. Emotional abuse (OR = 4.565, 95% CI: 4.118-5.061), physical abuse (OR = 1.774, 95% CI: 1.584-1.986), sexual abuse (OR = 1.884, 95% CI: 1.637-2.169), emotional neglect (OR = 1.658, 95% CI: 1.540-1.785), and physical neglect (OR = 1.301, 95% CI: 1.211-1.397) were all identified as significant risk factors for adolescent depression. Mediation analysis revealed that childhood maltreatment significantly partially mediated the link between family structure and depression, explaining 21.32% of the risk in single-parent families, 8.46% in grandparent-headed families, and 9.40% in other families. These family structures are associated with elevated risks of adolescent depression, partially through the pathway of increased childhood maltreatment. These findings underscore the necessity for targeted interventions that address family-based adversity to improve mental health outcomes in vulnerable adolescent populations.
Altered long-range temporal correlations in delta oscillatory amplitude dynamics in gambling disorder.
Xue C, Zhong G, Chen T … +7 more , Wei Y, Liu J, Zhang X, Cui Y, Yang P, Zhao M, Du J
Eur Arch Psychiatry Clin Neurosci · 2026 May · PMID 42176233 · Publisher ↗
Understanding the neural oscillations underlying gambling disorder (GD) is essential for developing effective prevention and treatment strategies. While the spatial coordination of neural activity in GD patients has been...
Understanding the neural oscillations underlying gambling disorder (GD) is essential for developing effective prevention and treatment strategies. While the spatial coordination of neural activity in GD patients has been extensively studied, the temporal dynamics of neural activity have not yet been investigated. In this study, we aim to investigate the long-range temporal correlations (LRTC) of the instantaneous amplitude of resting-state Electroencephalography (EEG) in GD patients. EEG activity was recorded during eyes-closed wakeful rest in 87 patients with GD and 40 age-, gender-, and education-matched healthy controls. LRTC in amplitude fluctuations was quantified using detrended fluctuation analysis (DFA) to estimate Hurst exponents across delta (1-4 Hz), theta (4-8 Hz), alpha (8-13 Hz), beta (13-30 Hz), and gamma (30-45 Hz) frequency bands. Participants also completed measures of impulsivity and gambling severity. Group differences were assessed using parametric or non-parametric statistical tests, depending on data distribution. Compared with healthy controls, the GD group exhibited significantly higher LRTC in the delta band over middle-frontal and parietal regions (p < .001, rank-biserial correlation = 0.44), whereas no significant group differences were observed in the theta, alpha, beta, or gamma bands. Additionally, GD participants also showed higher scores on the "motor impulsivity" construct of impulsivity (p < .001, Cohen's d = 1.35), which was positively associated with higher LRTC in the delta band in the GD group (p = .034). These increased LRTC in the delta band effectively differentiated individuals with GD from healthy controls (p < .001). We identified disrupted temporal correlations in the brain networks of GD patients, suggesting that elevated delta-band LRTC may represent a candidate electrophysiological marker warranting further replication and longitudinal validation.
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