European Archives Of Psychiatry And Clinical Neuroscience[JOURNAL]
Sun
200 papers
The mediating effect of 24-h movement behaviors in the association between obesity-related comorbidities and depression: evidence from a large-scale cohort study.
Shen J, Cai Y, Gan Y … +13 more , Mo Q, Zhang Y, Chen J, Zhong Q, Huang Y, Ye R, Chen G, Zhang T, Wang Z, Li L, Lin Z, Zhang F, Gao Y
Eur Arch Psychiatry Clin Neurosci · 2026 May · PMID 42176232 · Publisher ↗
OBJECTIVE: This study aims to ascertain the mediating role of 24-h movement behaviors, including moderate-to-vigorous intensity physical activity (MVPA), light-intensity physical activity, sedentary behavior (SB), and sl...
OBJECTIVE: This study aims to ascertain the mediating role of 24-h movement behaviors, including moderate-to-vigorous intensity physical activity (MVPA), light-intensity physical activity, sedentary behavior (SB), and sleep, in the relationship between obesity, obesity-related comorbidities and depression. METHODS: In a large-scale cohort study, 32,861 UK biobank participants aged 40-69 years with wrist-worn accelerometer data were included. The exposure were obesity and obesity-related comorbidities (obesity only, or with 1, 2, or ≥ 3 chronic conditions), with a non-obesity group as reference. Accelerometer-derived 24-h movement behaviors were served as mediators. The main outcome was depression at follow-up that was assessed by Patient Health Questionnaire-9. Compositional mediation model was applied to explore the mediating effect of 24-h movement behaviors. Subsequently, compositional logistic isotemporal substitution model was employed to quantify the changes in depression risk associated with reallocation among different physical activities in individuals with obesity. RESULTS: Compared to the non-obesity group, individuals with obesity exhibited an elevated risk of depression that increased with the number of chronic conditions. 24-h movement behaviors mediated approximately 20% of the association between obesity, obesity-related comorbidities and depression, with significant total indirect odds ratios ranging from 1.16 [95% CI 1.13 to 1.19] to 1.31 [95% CI 1.24 to 1.38]. There was a significant negative association between replacing SB with MVPA and depression risk, which was consistent across all groups with obesity. CONCLUSIONS: Depression risk among the individuals with obesity increased with the number of chronic conditions, and the association was partially mediated by 24-h movement behaviors. Replacing SB with MVPA provided consistent psychological health benefits regardless of the number of chronic conditions among individuals with obesity.
Global and regional burden of major depressive disorder and associated risk factors: analysis from the Global Burden of disease study, 1990-2021.
Qin K, Wei Q
Eur Arch Psychiatry Clin Neurosci · 2026 May · PMID 42154271 · Publisher ↗
INTRODUCTION: Major depressive disorder (MDD) is a leading cause of disability worldwide, placing a heavy burden on individuals and healthcare systems. Understanding global and regional epidemiological patterns is essent...
INTRODUCTION: Major depressive disorder (MDD) is a leading cause of disability worldwide, placing a heavy burden on individuals and healthcare systems. Understanding global and regional epidemiological patterns is essential for designing effective interventions. This study aims to evaluate the burden of MDD and its major risk factors globally and in China, offering evidence for targeted mental health strategies. METHODS: We extracted data on MDD prevalence, incidence, and disability-adjusted life years (DALYs), and selected attributable risk factors between 1990 and 2021 from the Global Burden of Disease (GBD) database. Temporal trends were assessed through estimated annual percentage change (EAPC) with 95% confidence intervals (CIs). To evaluate the association between socio-demographic development and MDD burden, natural cubic spline regression was fitted, with Spearman rank correlation applied as a sensitivity analysis. RESULTS: In 2021, the global MDD incidence rate reached 4,322.65 per 100,000 population, with the highest rate in High-income North America; China's rate (2,717.26 per 100,000) remained below the global average. Between 1990 and 2021, global age-standardized incidence and DALY rates rose slightly (EAPC 0.35% and 0.34%), more slowly in China (0.31% and 0.22%), while absolute case counts increased, strongly influenced by population growth and aging. The SDI-MDD burden association was weak and non-linear. Natural cubic spline analyses indicated non-linear relationships between SDI and age-standardized prevalence, incidence, and DALY rates, while Spearman rank analyses yielded weak positive ecological correlations (all P < 0.001). East Asia and Eastern Europe remained above the fitted SDI-burden trend, whereas Sub-Saharan Africa remained below it. Within the GBD comparative risk assessment framework, childhood maltreatment and intimate partner violence accounted for a substantial proportion of attributable MDD DALY burden, particularly among women. CONCLUSION: The global MDD burden has remained substantial and has risen gradually, with marked age, gender, and regional disparities. The SDI-burden association appears weak and non-linear, suggesting that socioeconomic development alone does not adequately explain this cross-national variation.These findings highlight the urgent need for region-specific, evidence-based mental health policies focused on prevention and support for vulnerable populations.
Effect of meditation on clinical symptoms and gray matter volume in chronic schizophrenia: a randomized controlled trial.
Yang M, Ma Y, Huang J … +4 more , Huang Y, Liu L, Li Z, Cui D
Eur Arch Psychiatry Clin Neurosci · 2026 May · PMID 42154270 · Publisher ↗
BACKGROUND: The neurobiological mechanisms underlying the therapeutic effects of meditation therapy in patients with schizophrenia remain poorly understood, therefore, we aim to investigate the relationship between clini...
BACKGROUND: The neurobiological mechanisms underlying the therapeutic effects of meditation therapy in patients with schizophrenia remain poorly understood, therefore, we aim to investigate the relationship between clinical symptoms and the structural changes in brain gray matter in a meditation intervention trial. METHODS: Han inpatients with schizophrenia admitted to the Shanghai First Civil Affairs Mental Health Centre in 2018 were recruited and randomly assigned to the meditation (Med) or the conventional (CON) treatment group in an eight-months trial. MRI data was collected at the outset, three months, and eight months of treatment. RESULTS: Fifty-eight male subjects completed all evaluations and MRI scans, including 30 in Med and 28 in CON. The findings indicate that meditation can significantly inhibit the extensive regional atrophy of gray matter volume (GMV). A positive correlation was observed between the GMV change rate in the right thalamus and the reduction rate of PANSS positive score (r = 0.3850, p = 0.0028), negative score (r = 0.3789, p = 0.0034) and total score (r = 0.3705, p = 0.0042); The GMV change rate in right insula was positively correlated with PANSS positive score (r = 0.2976, p = 0.0233), negative score (r = 0.3987, p = 0.0019), general score (r = 0.3216, p = 0.0138) and total score (r = 0.3765, p = 0.0035). Additionally, the GMV change rate in the right supplementary motor area was positively correlated with negative scores (r = 0.3633, p = 0.0051). while the right paracentral lobule positively correlated with PANSS general score (r = 0.2791, p = 0.0338). CONCLUSION: These findings demonstrate the effectiveness of meditation in chronic schizophrenia and suggest it as a promising method for the alleviation of clinical symptoms in schizophrenia.
Heterogeneity of composite inflammatory markers in acute schizophrenia: stratification by age, gender, and age at onset.
Zheng Y, Yuan H, Gao H … +2 more , Jiang J, Zhu Q
Eur Arch Psychiatry Clin Neurosci · 2026 May · PMID 42154269 · Publisher ↗
BACKGROUND: Patients with acute schizophrenia (SCZ) exhibit elevated composite inflammatory markers. Although age at onset is known to be associated with clinical progression and treatment response, its relationship with...
BACKGROUND: Patients with acute schizophrenia (SCZ) exhibit elevated composite inflammatory markers. Although age at onset is known to be associated with clinical progression and treatment response, its relationship with systemic inflammatory indices during acute episodes remains unclear. This study aimed to investigate the association between age at onset and commonly used composite inflammatory markers in patients with acute SCZ, with stratification by age group and gender. METHODS: A total of 443 patients with acute SCZ (205 males, 238 females; mean age 41.37 ± 12.14 years) and 366 healthy controls (103 males, 263 females; mean age 49.43 ± 16.46 years) were enrolled. Demographic data and blood parameters were collected, and composite inflammatory markers were calculated, including the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune inflammation value (PIV). RESULTS: Among male patients aged 20-39 years, those with early-onset (EO) SCZ had significantly lower PLR, SII, and PIV levels than non-EO patients, and EO was identified as an independent influencing factor for PLR (P = 0.02, B = - 26.10, β = -0.25, 95% CI -48.34 to - 3.87). In female patients of the same age group, no significant differences in composite inflammatory markers were observed between EO and non-EO groups (all P > 0.05). Among male patients aged 40-59 years, NLR levels differed significantly across the EO, intermediate-onset (IO), and late-onset (LO) subgroups (P < 0.05); however, age at onset was not an independent influencing factor for NLR (P > 0.05). In female patients of this age group, no significant differences in composite inflammatory markers were found among the three onset-age subgroups (all P > 0.05). CONCLUSION: The association between age at onset and composite inflammatory markers in patients with acute SCZ varies significantly across different age groups and gender, highlighting the importance of stratified analyses in future studies.
Heart rate synchrony as an objective biomarker in psychotherapy: a wearable-based pilot study.
Gernert CC, Falter-Wagner CM
Eur Arch Psychiatry Clin Neurosci · 2026 May · PMID 42154268 · Publisher ↗
Therapeutic alliance is a well-known predictor of psychotherapy outcome and is often measured by subjective self-reports prone to biases. This pilot study examined whether interpersonal synchrony (IPS) in movement and he...
Therapeutic alliance is a well-known predictor of psychotherapy outcome and is often measured by subjective self-reports prone to biases. This pilot study examined whether interpersonal synchrony (IPS) in movement and heart rate (HR), derived from wearable wristbands, can serve as an objective measure of therapeutic engagement in naturalistic cognitive behavioral therapy sessions. Twelve transdiagnostic patient-therapist dyads were analyzed in a short-term follow-up design. Physiological signals were continuously recorded with multisensor wrist-worn devices, while head and body movements were extracted from video recordings. After each session, both dyad members completed alliance questionnaires, and patients provided standardized symptom ratings. We quantified IPS for both modalities by lagged-windowed cross-correlations. In-phase HR synchrony during the initial session significantly predicted changes in patients' global severity index and depressive symptomatology over time. Notably, only therapists' alliance ratings were associated with short-term outcomes. While HR data obtained from wristband sensors show potential for assessing interpersonal physiological coupling, results remain preliminary given the small, artifact-filtered subsample analyzed. The convenience and unobtrusive nature of wearable technology allows low-threshold collection of objective data even in the sensitive setting of psychotherapy. However, this pilot study indicates that convenience has to be weighed against data quality. Achieving higher precision with high-resolution devices may require greater intrusiveness. Establishing more consistent methodological standards are essential to advance IPS-based approaches towards characterizing and individualizing evidence-based psychotherapy.
Prevalence and clinical features of depressed adolescents co-occurring insomnia and excessive daytime sleepiness symptoms.
Hao M, Zhao X, Fan H … +10 more , Liu L, Geng F, Mo D, Wang J, Chen C, Liu Z, Luo X, Wen X, Zhang L, Liu H
Eur Arch Psychiatry Clin Neurosci · 2026 May · PMID 42154267 · Publisher ↗
PURPOSE: This study aimed to explore the prevalence and clinical characteristics of depressed adolescents with concurrent insomnia and excessive daytime sleepiness symptoms (EDS). PATIENTS AND METHODS: From January 2021...
PURPOSE: This study aimed to explore the prevalence and clinical characteristics of depressed adolescents with concurrent insomnia and excessive daytime sleepiness symptoms (EDS). PATIENTS AND METHODS: From January 2021 to January 2024, 491 depressed adolescents from eight hospitals in Anhui Province, China, were included in this study. Sociodemographic characteristics and clinical features were compared in four groups: co-occurring insomnia and excessive daytime sleepiness symptoms (INS-EDS), insomnia symptom only (INS-Only), excessive daytime sleepiness symptom only (EDS-Only), and no insomnia and excessive daytime sleepiness symptoms (No INS-EDS). RESULTS: Of 491 depressed adolescents, 73 (14.9%) had both insomnia and EDS symptoms. They had more severe depression (OR = 1.487, 95% CI = 1.067-2.074), more intense suicidal ideation (OR = 1.052, 95% CI = 1.019-1.086), lower quality of life (OR = 0.794, 95% CI = 0.631-0.999), and were more likely to experience dissolution of parental relationships (OR = 2.371, 95% CI = 1.254-4.484). Meanwhile, patients with both insomnia and EDS were more likely to be addicted to the Internet and experience cyberbullying than those in the No INS-EDS group. CONCLUSION: The joint presentation of insomnia and EDS in depressed adolescents was linked to more severe depressive symptoms, more intense suicidal ideation, lower quality of life, and a higher likelihood of parental relationship dissolution. Large-scale studies are needed to investigate sleep abnormalities in adolescents with major depressive disorder.
ADHD and metabolic syndrome: behavioral and weight-related pathways to cardiovascular risk.
Ziegler GC, Kürten K, Roshop K … +7 more , Nieberler M, Warrings B, Kittel-Schneider S, Lesch KP, Herrmann MJ, Störk S, Deckert J
Eur Arch Psychiatry Clin Neurosci · 2026 May · PMID 42154266 · Publisher ↗
BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) has been linked to obesity and type 2 diabetes, suggesting heightened cardiovascular risk. Whether adults with ADHD also show increased rates of metabolic syndr...
BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) has been linked to obesity and type 2 diabetes, suggesting heightened cardiovascular risk. Whether adults with ADHD also show increased rates of metabolic syndrome (MetS), a cluster of central obesity, dyslipidemia, impaired glucose regulation, and hypertension, remains unclear. METHODS: We examined a young to middle-aged adult cohort of 83 patients and 82 healthy controls (HC). The primary objective was to test whether MetS (Joint Interim Statement criteria) was more prevalent in ADHD than in HC. To explore potential pathways linking ADHD with cardiovascular risk, we additionally assessed anthropometric indices, 24-h blood pressure (BP), heart rate (HR), and inflammatory markers (interleukin-6, C-reactive protein). Finally, we fitted a serial mediation model examining whether hyperactivity/impulsivity (HI), eating behavior, and body mass index (BMI) mediated the association between ADHD and BP. RESULTS: A higher proportion of ADHD patients fulfilled MetS criteria (OR 2.29). Adults with ADHD showed higher waist circumference, BMI, and overweight/obesity rates but did not differ in glucose and blood lipid levels. Non-stimulant medication and psychiatric comorbidity were more common among patients with MetS. Inflammatory markers were unrelated to ADHD. However, ADHD patients demonstrated slightly higher mean 24-h HR and nighttime systolic BP. The association between ADHD and nighttime systolic BP was mediated by obesity as a MetS constituent, and by HI and disordered eating as behavioral risk factors. CONCLUSION: Young to middle-aged adults with ADHD displayed increased MetS prevalence and subtle elevations in nighttime BP and HR, suggesting an early cardiovascular risk trajectory. Behavioral factors, particularly overeating and weight gain, and psychiatric comorbidity appear to contribute to this risk. These findings support early cardiovascular screening and weight-management interventions in adults with ADHD.
Exploring the link between dietary indices and depression in American adult population: NHANES 2017-2020 data analysis.
Zhang L, Li R, Li X … +1 more , Shu L
Eur Arch Psychiatry Clin Neurosci · 2026 May · PMID 42154265 · Publisher ↗
Diet is a key modifiable factor influencing depression, with its impact well-documented in clinical studies. However, research on the combined effect of multiple dietary indices remains limited. This study investigates t...
Diet is a key modifiable factor influencing depression, with its impact well-documented in clinical studies. However, research on the combined effect of multiple dietary indices remains limited. This study investigates the relationship between four dietary indices and depression in American adults using data from 5030 participants in the 2017-2020 NHANES dataset. Depression was diagnosed using the Patient Health Questionnaire-9 (PHQ-9), with scores ≥ 10 indicating depression. Dietary indices were derived using the "dietary index" package, based on 24-hour dietary recall data. Various analytical methods, including multivariate logistic regression, sensitivity test, subgroup analysis, receiver operating characteristic (ROC) curves, and decision curve analysis (DCA), were used to assess the associations. Results showed that the Healthy Eating Index 2020 (HEI2020) and Dietary Inflammation Index (DII) were significantly associated with depression after adjusting for confounders. Sensitivity tests validated the strength of these results. Subgroup stratification indicated modified correlations between dietary quality scores and depression across multiple population characteristics, with significant interactive heterogeneity observed only for MEDI and DII. ROC analysis indicates that HEI2020 had the highest AUC among the indices (AUC = 0.606), although its discriminatory performance was modest, with clinical decision curves indicating potential value for depression risk stratification. A meta-analysis of protective factors revealed a notable correlation indicating lowered depression probability (OR = 0.58, 95% CI: 0.49-0.70, P < 0.001). Through the combined evaluation of risk factors, a significantly higher depression rate was observed (OR = 1.59, 95% CI: 1.34-1.88, P < 0.001). These findings suggest that healthy dietary patterns combined with anti-inflammatory diets may serve a function in lowering the chances of depression onset among American adults.
Efficacy and safety of Nrf2 activators for schizophrenia: a systematic review and meta-analysis.
Okazaki M, Sakuma K, Jo H … +6 more , Nagata Y, Hamanaka S, Nishii Y, Kitajima T, Iwata N, Kishi T
Eur Arch Psychiatry Clin Neurosci · 2026 May · PMID 42154264 · Publisher ↗
This systematic review and meta-analysis aimed to investigate the efficacy and safety of adding nuclear factor erythroid 2-related factor 2 (Nrf2) activators to antipsychotic treatments for individuals with schizophrenia...
This systematic review and meta-analysis aimed to investigate the efficacy and safety of adding nuclear factor erythroid 2-related factor 2 (Nrf2) activators to antipsychotic treatments for individuals with schizophrenia. The primary outcome was overall symptom improvement. Other efficacy outcomes involve the improvement of positive symptoms, negative and depressive symptoms, Positive and Negative Syndrome Scale general subscale (PANSS-G) scores, and cognitive function composite scores and individual cognitive domain scores (only for sulforaphane). Further, we included all-cause discontinuation, adverse event-related discontinuation, incidence of individual adverse events, and changes in blood inflammatory biomarkers, lipid profiles, and glucose levels. Our review included 16 randomized-controlled trials (n = 953, mean age = 35.27 years; 66.74% male). Among these, 15 were placebo-controlled, while the remaining study did not utilize a placebo. This systematic review comprised six studies on ascorbic acid, four on curcumin, two on resveratrol, and four on sulforaphane. Curcumin showed marginal superiority over placebo for the primary outcome (standardized mean difference = - 0.53, 95% confidence interval: -1.08, 0.02); however, non-significant subgroup results (all p > 0.05) with wide confidence intervals across formulations and co-interventions suggest that these findings lack robustness. Curcumin significantly outperformed placebo in reducing positive symptoms, negative symptoms, and PANSS-G scores but did not differ from placebo for other outcomes. Sulforaphane showed a lower all-cause discontinuation rate than placebo, suggesting potential efficacy and better treatment adherence. Additionally, sulforaphane reduced total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels, though no significant differences were found in other outcomes. Meta-analysis of efficacy outcomes for ascorbic acid and resveratrol could not be conducted due to insufficient data.
Electric field intensity and EEG microstate dynamics in obsessive-compulsive disorder: a secondary analysis of a randomized sham-controlled HD-tDCS trial.
Wang Y, Cheng J, Li P … +6 more , Jia W, Bai T, Lyu D, Yuan C, Jiang J, Wang Z
Eur Arch Psychiatry Clin Neurosci · 2026 May · PMID 42133008 · Publisher ↗
BACKGROUND: Obsessive-compulsive disorder (OCD) affects 2-3% of the population and is often accompanied by sleep disturbances, which can aggravate symptoms and hinder treatment. High-definition transcranial direct curren...
BACKGROUND: Obsessive-compulsive disorder (OCD) affects 2-3% of the population and is often accompanied by sleep disturbances, which can aggravate symptoms and hinder treatment. High-definition transcranial direct current stimulation (HD-tDCS) shows promise for alleviating both OCD symptoms and sleep-related issues, though its mechanisms remain unclear. This study aimed to explore the role of electric field (EF) intensity and EEG microstates in HD-tDCS outcomes. METHODS: This study is a secondary analysis based on a previously published clinical trial. Forty-four drug-naïve OCD patients participated in a randomized controlled trial, with 34 undergoing MRI and EEG assessments. Participants received either active (n = 18) or sham (n = 16) HD-tDCS targeting the orbitofrontal cortex over 10 sessions in two weeks. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and Pittsburgh Sleep Quality Index (PSQI) assessed OCD symptoms and sleep quality. EF modeling quantified stimulation intensity, and EEG microstate analysis evaluated brain dynamics. RESULTS: No significant treatment × time interaction was found for Y-BOCS or PSQI scores. However, in the active group, higher EF intensity in right frontal regions was significantly associated with improved sleep quality. EEG microstate analysis showed stable topographies. EF intensity in medial orbitofrontal gyrus (mOFG) and rostral anterior cingulate gyrus (rACG) was related to changes in microstate A dynamics and exploratory mediation analysis suggested that the rACG EF-PSQI association may be partly mediated by changes in microstate A coverage. CONCLUSION: In patients with OCD, higher electric field intensity in prefrontal and anterior cingulate regions was associated with changes in microstate A parameters, which were in turn associated with improvements in sleep quality. Due to the limited sample size, the associations observed between electric field measures and EEG microstates should be considered preliminary and primarily hypothesis-generating. TRIAL REGISTRATION: The original clinical trial has been duly registered under the title "Transcranial Direct Current Stimulation (tDCS) in the Treatment of Drug-naïve obsessive-compulsive disorder (OCD)", with the research protocol registered at ClinicalTrials.gov under the identifier NCT04086446. The registration can be accessed via the following URL: https://clinicaltrials.gov/study/NCT04086446 .
Machine learning-based integration identifies a 10-gene predictive signature and its classification patterns in schizophrenia.
Li Y, Sun Q, Shen Y … +7 more , Li X, Li H, Ni J, Wang J, Sun S, Wang Y, Li Z
Eur Arch Psychiatry Clin Neurosci · 2026 May · PMID 42133007 · Publisher ↗
BACKGROUND: Schizophrenia (SCZ) is a highly heritability psychological disorder, however the exact etiology remains unclear, and lack of the reliable and effective biomarkers for diagnosis and treatments in the managemen...
BACKGROUND: Schizophrenia (SCZ) is a highly heritability psychological disorder, however the exact etiology remains unclear, and lack of the reliable and effective biomarkers for diagnosis and treatments in the management of SCZ, thus exploring the novel biomarkers in SCZ may enhance the efficacy of its predictive, preventive, and personalized medicine (PPPM/3PM) approach. METHODS: Based on differentially expressed genes (DEGs) and weighted gene co-expression network (WGCNA) analyses from five brain datasets, we screened SCZ-key genes and then developed a novel machine learning (ML) framework that incorporated 12 MLs and their 84 combinations to construct a consensus diagnostic signature. Meanwhile, we constructed the nomogram with aforementioned signatures to provide a quantitative clinical practice tool for predicting SCZ. Subsequently, we performed the consensus clustering and nonnegative matrix factorization (NMF) algorithms for clustering analysis in SCZ patients. On this basis, the regulation factors of diagnostic signature, enrichment patterns and immune infiltration analysis in SCZ, and protein level among SCZ subtypes were evaluated. RESULTS: We identified 53 SCZ-key genes by intersecting DEGs and module genes of WGCNA, then developed a consensus diagnostic signature using a 84-combination ML framework, and established a nomogram diagnosis model with aforementioned signature for clinical practice, demonstrating promising discriminative performance and potential clinical utility benefits in predicting SCZ. Moreover, consensus clustering analysis could divide SCZ patients into two distinct clusters, and two subgroups were distinguished using NMF algorithm with DEGs of two clusters. Furthermore, we observed distinct biological functions, immune cells and protein functions between subtypes. Finally, hub genes of subgroups, which were closely associated with SCZ. CONCLUSION: Our study constructed a novel diagnostic signature and a nomogram, which all achieved higher accuracy and maybe as the potential diagnostic tools for SCZ. Meanwhile, SCZ subtypes showed distinct inflammation, immune and metabolic patterns, incorporating the subtypes into the 3PM framework will provide a unique opportunity for clinical intelligence and new management approaches.
Evolution of Paris' public hospital psychiatrics outpatients from 2019 to 2023: a retrospective cohort study.
Frajerman A, Barruel D, Legrand A … +2 more , Dauriac-Le Masson V, Martinez G
Eur Arch Psychiatry Clin Neurosci · 2026 May · PMID 42118282 · Publisher ↗
INTRODUCTION: The COVID-19 pandemic increased the prevalence of psychiatric disorders, especially in young people. The University Hospital Group Paris Psychiatry and Neurosciences (also known as the Paris Psychiatry Hosp...
INTRODUCTION: The COVID-19 pandemic increased the prevalence of psychiatric disorders, especially in young people. The University Hospital Group Paris Psychiatry and Neurosciences (also known as the Paris Psychiatry Hospital Group, PPHG) provides psychiatric care for 2.2 million Parisians. We aimed to study the evolution of the psychiatric outpatients' characteristics in the PPHG between 2019 and 2023. MATERIALS AND METHODS: We used data from the PPHG's electronic health record database. We assessed the trend in the number of patients per year between 2019 and 2023 and the number of newly admitted outpatients. We conducted both analyses by sex, age group and clinical diagnoses. RESULTS: The number of ambulatory patients treated at the PPHG remained stable between 2019 and 2023 (n = 30,000). The proportion of new patients among outpatients per year dropped (-20%). We observed a significant increase in young patients (+ 200% for those aged 15-18 and + 40% for those aged 18-25) and a decrease in patients older than 60 (-20%). These evolutions were more important for personality disorders and mood disorders than schizophrenia spectrum disorders, which could explain why the increase was more pronounced in women than men for young people. CONCLUSION: It is one of the most extensive studies on the evolution of psychiatric outpatient care before and after the COVID-19 pandemic. This study highlighted the lack of capacity in public psychiatry, characterised by a decline in the proportion of new patients and delays between hospital discharge or emergency unit consultation and the first consultation at a public psychiatric centre.
Dyslipidemia as a key nexus linking depression and aging acceleration: unraveling the mediating role of lipid accumulation product (LAP).
Zhang L, Yang Q, Xu C … +3 more , Hu Y, Xiao L, Yu J
Eur Arch Psychiatry Clin Neurosci · 2026 May · PMID 42113055 · Publisher ↗
OBJECTIVE: Although depression and biological aging share dyslipidemia as a common pathological feature, the extent to which dyslipidemia is involved in their association remains unclear. This study aimed to explore the...
OBJECTIVE: Although depression and biological aging share dyslipidemia as a common pathological feature, the extent to which dyslipidemia is involved in their association remains unclear. This study aimed to explore the association between depressive symptoms and accelerated biological aging, with a particular focus on whether dyslipidemia, as measured by the lipid accumulation product (LAP), statistically mediates this association. METHODS: A total of 4,150 American adults aged ≥ 20 years from the National Health and Nutrition Examination Survey (NHANES) database were included. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), and accelerated aging was measured via phenotypic age acceleration (PhenoAgeAccel). Weighted multivariable linear regression, restricted cubic spline (RCS) analyses, subgroup analyses, and interaction tests were conducted to examine the associations between depressive symptoms and PhenoAgeAccel. Mediation analysis was subsequently conducted to assess the statistical mediating role of LAP in this association. RESULTS: Among the 4,150 participants, 375 (9.0%) had probable depression (PHQ-9 score ≥ 10). In the fully adjusted model, both depression status and continuous PHQ-9 score were positively associated with PhenoAgeAccel (depression: β = 0.76, 95% CI: 0.03-1.49; PHQ-9: β = 0.06, 95% CI: 0.01-0.11) and with LAP (depression: β = 4.01, 95% CI: 0.25-7.76; PHQ-9: β = 0.34, 95% CI: 0.09-0.60). Mediation analysis revealed that LAP accounted for 12.05% (95% CI: 2.52%-24.95%, P = 0.01) of the association between depression and PhenoAgeAccel in the fully adjusted model. Subgroup analyses indicated that the associations were stronger among individuals with higher income (poverty income ratio [PIR] > 3.5), those with diabetes, and those without cardiovascular disease (CVD) or chronic obstructive pulmonary disease (COPD) (all P < 0.05). Interaction analyses further indicate significant interactions of PIR and diabetes status with the association between depression and PhenoAgeAccel (both P for interaction < 0.05). CONCLUSIONS: Depressive symptoms were significantly associated with accelerated biological aging, and this association was partially statistically mediated by LAP. Further prospective studies with longitudinal designs are warranted to establish temporal precedence and investigate the potential biological pathways linking depression, LAP, and accelerated biological aging.
Ultrastructural disturbances of pericapillary microglia, perioligodendrocyte microglia, oligodendrocytes and their interactions in postmortem caudate nucleus in schizophrenia.
Uranova NA, Vikhreva OV, Rakhmanova VI
Eur Arch Psychiatry Clin Neurosci · 2026 May · PMID 42101496 · Publisher ↗
OBJECTIVES: Previously we reported ultrastructural abnormalities of capillaries, microglia and oligodendrocytes in the prefrontal cortex in schizophrenia. We aimed to estimate the ultrastructural changes of pericapillary...
OBJECTIVES: Previously we reported ultrastructural abnormalities of capillaries, microglia and oligodendrocytes in the prefrontal cortex in schizophrenia. We aimed to estimate the ultrastructural changes of pericapillary microglia (PCapMg), perioligodendrocyte microglia (POlMg) and oligodendrocytes adjacent to microglia in the head of the caudate nucleus (CN) in schizophrenia. METHOD: Electron microscopy and morphometry of microglia and oligodendrocytes in the head of the CN were performed in 21 schizophrenia cases and 20 normal controls. RESULTS: We found age-related lower volume fraction (Vv) and the number (N) of mitochondria in PCapMg, POlMg and in oligodendrocytes and higher Vv and N of lipofuscin in PCapMg in the schizophrenia group as compared to the control group. Area of lipofuscin granules in PCapMg positively correlated with Vv and N of lipofuscin granules in POlMg in the schizophrenia group but not in the control group. Vv and N of mitochondria in PCapMg positively correlated with Vv of mitochondria in POlMg, and Vv and N of mitochondria in oligodendrocytes positively correlated with Vv of mitochondria in POlMg in the control group but not in the schizophrenia group. CONCLUSIONS: These data suggest that disturbed interactions between PCapMg, POlMg and oligodendrocytes in schizophrenia are associated with altered energy and lipid metabolism, mitochondria deficit and accelerated aging of PCapMg in schizophrenia. These changes might contribute to a disturbance of blood-brain barrier in the head of the CN in schizophrenia.
Changes of borderline symptoms, personality functioning, and dysfunctional personality traits after dialectical-behavioral therapy in borderline personality disorder.
Kunz JI, Zwick A, Boll JJ … +9 more , Wolf J, Meinhardt J, Hüttner S, Grigo R, Musil R, Goerigk S, Jobst A, Padberg F, Reinhard MA
Eur Arch Psychiatry Clin Neurosci · 2026 May · PMID 42101495 · Publisher ↗
Borderline Personality Disorder (BPD) is a complex and debilitating condition characterized by limited treatment response and high dropout rates across treatments, even in leading therapeutic approaches, such as Dialecti...
Borderline Personality Disorder (BPD) is a complex and debilitating condition characterized by limited treatment response and high dropout rates across treatments, even in leading therapeutic approaches, such as Dialectical-Behavioral Therapy (DBT). Given the heterogeneity of BPD symptomatology and the current shift toward dimensional assessments of personality disorders, this study investigates whether dimensional measures according to the DSM-5's Alternative Model for Personality Disorders (AMPD) may serve as additional markers of treatment outcome and dropout. Eighty-five participants with BPD were recruited from a naturalistic inpatient DBT program. Associations between BPD symptoms (Borderline Symptom List, Borderline Personality Disorder Severity Index), personality functioning (Level of Personality Functioning Scale - Brief Form 2.0), and dysfunctional personality traits (Personality Inventory for DSM-5 and ICD-11 - Brief Form Plus) were examined at baseline, as well as their sensitivity to change after DBT. At baseline, both personality functioning and dysfunctional personality traits, except antagonism, were associated with BPD symptoms (all r ≥ 0.4). After 10 weeks of DBT, parallel improvements were observed in personality functioning and dysfunctional personality traits, with significant reductions in negative affectivity and detachment. Elevated baseline levels of negative affectivity and psychoticism were associated with less BPD symptom change. DBT dropout was linked to higher impairment in negative affectivity and anankastia at admission. Personality functioning showed greater sensitivity to change throughout DBT compared to dysfunctional personality traits. These findings emphasize how AMPD may yield benefits beyond categorical BPD diagnoses, potentially contributing to more personalized and effective treatment planning and preventing dropouts.
Dynamic functional connectivity in borderline personality disorder: associations with trauma, emotion regulation and symptom severity.
Rana A, Otte ML, Fazio G … +9 more , Olivio D, Le Prieult Y, Schmitgen MM, Balcik Y, Koc M, Tech C, Wolf ND, Sambataro F, Wolf RC
Eur Arch Psychiatry Clin Neurosci · 2026 May · PMID 42101494 · Publisher ↗
BACKGROUND: Altered intrinsic functional connectivity is a well-established marker of borderline personality disorder (BPD). However, recent research suggests that investigating brain dynamics may offer a more detailed p...
BACKGROUND: Altered intrinsic functional connectivity is a well-established marker of borderline personality disorder (BPD). However, recent research suggests that investigating brain dynamics may offer a more detailed perspective on the neural signatures of BPD-related symptoms. METHODS: Resting-state fMRI data were analyzed in female patients with BPD (n = 47) and healthy controls (n = 28) to derive dynamic functional network connectivity (dFNC) indices using both meta-state and cluster-state approaches. Between-group comparisons assessed BPD-related dFNC alterations, while dimensional analyses explored associations between network dynamics and distinct symptom dimensions. RESULTS: Both meta-state and cluster-state analyses revealed strong associations between symptom dimensions and dynamic range and fluidity. Meta-state analysis indicated that greater emotion regulation difficulties corresponded to an expanded state repertoire, reflecting increased variability in large-scale network configurations. Cluster-state analysis showed that fewer state transitions were associated with heightened borderline symptom severity, greater childhood trauma exposure, and increased dissociative symptoms. Furthermore, childhood trauma and emotion regulation difficulties moderated the relationship between time spent in specific cluster-states and borderline symptom severity. CONCLUSION: These findings suggest that reduced dynamic flexibility but increased dynamic range in large-scale brain networks may contribute to core BPD symptoms, particularly in early trauma, emotion dysregulation as well as borderline symptom severity. The results highlight the association between aberrant dFNC and BPD and contribute to a more detailed characterization of neural dynamics relevant to the disorder.
High- and low-frequency accelerated repetitive transcranial magnetic stimulation for major depressive disorder.
Yang C, Kim YJ, Ahn J … +4 more , Jeon S, Lee J, Song SY, Kim SJ
Eur Arch Psychiatry Clin Neurosci · 2026 Apr · PMID 42056263 · Publisher ↗
AIM: This study examined the effects of two accelerated repetitive transcranial magnetic stimulation (rTMS) protocols in patients with major depressive disorder (MDD). METHODS: Twenty-two patients received accelerated hi...
AIM: This study examined the effects of two accelerated repetitive transcranial magnetic stimulation (rTMS) protocols in patients with major depressive disorder (MDD). METHODS: Twenty-two patients received accelerated high-frequency rTMS (HF-rTMS; 10 Hz, left prefrontal cortex), and 18 received accelerated low-frequency rTMS (LF-rTMS; 1 Hz, right prefrontal cortex). Each participant underwent 10 sessions over 2 consecutive days (5 sessions per day). Depression, anxiety, and sleep quality were assessed using the Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), and Pittsburgh Sleep Quality Index (PSQI), respectively. Clinical outcomes were evaluated at baseline and at 1 day, 2 weeks, and 4 weeks after treatment. RESULTS: HAM-D scores significantly decreased from baseline after accelerated rTMS and remained improved over 4 weeks. Both HF-rTMS and LF-rTMS produced comparable early reductions in depression severity, with LF-rTMS showing a greater HAM-D reduction at 4 weeks. HAM-A and PSQI scores also improved at 2 and 4 weeks in both groups, with no significant between-group differences. CONCLUSIONS: Both accelerated HF- and LF-rTMS protocols were associated with improvements in depressive, anxiety and sleep symptoms in patients with MDD, and LF-rTMS may confer more sustained antidepressant effects.
Distinct neural responses to punishment anticipation in violent and non-violent individuals with schizophrenia.
Fortier A, Dumais A, Athanassiou M … +5 more , Lipp O, de Benedictis L, Zouaoui I, Tikàsz A, Potvin S
Eur Arch Psychiatry Clin Neurosci · 2026 Apr · PMID 42056262 · Publisher ↗
Evidence suggests an increased risk of violence in individuals with schizophrenia. While violent behavior in non-psychotic populations has been associated with reduced sensitivity to punishment, the neural mechanisms und...
Evidence suggests an increased risk of violence in individuals with schizophrenia. While violent behavior in non-psychotic populations has been associated with reduced sensitivity to punishment, the neural mechanisms underlying reward and punishment processing in violent individuals with schizophrenia have yet to be investigated. Thus, this study aims to examine the neural responses to reward and punishment processing in this population. Ninety-four participants were divided into three groups: schizophrenia with violent behaviors (SZ + V, n = 31), schizophrenia without violent behavior (SZ-V, n = 31), and healthy controls (HC, n = 32). All participants performed a monetary incentive delay task during a functional magnetic resonance imaging session. Compared to SZ-V and HC groups, the SZ + V group showed alterations in the lingual gyrus, the dorsal anterior cingulate cortex, and the supplementary motor area during punishment anticipation. The SZ + V group also demonstrated alterations in the fusiform gyrus during reward anticipation, as well as in the inferior temporal gyrus during punishment avoidance. Both SZ + V and SZ-V groups exhibited alterations in the ventrolateral prefrontal cortex during reward outcome, in the dorsolateral prefrontal cortex during no reward outcome, and in the lateral and dorsolateral prefrontal cortex during punishment outcome, compared to the HC group. Mainly, we found that violence in schizophrenia is associated with increased activation in brain regions involved in salience and attentional processing, as well as in motor preparation during punishment processing.
Precision non-invasive transcranial electromagnetic stimulation: a thematic review of optimizing spatial, temporal, and dose dimensions.
Lin R, He W, Shaikh UJ … +9 more , Lorentz L, Zeng RR, Kwong PWH, Miller T, Gonzalez PC, Sidarta A, Binkofski F, Mehler DMA, Zhang JJ
Eur Arch Psychiatry Clin Neurosci · 2026 Apr · PMID 42053596 · Publisher ↗
Transcranial magnetic stimulation (TMS) and transcranial electrical stimulation (TES) have been extensively used in experimental and clinical research in psychiatry, neurology, and rehabilitation. Several advanced approa...
Transcranial magnetic stimulation (TMS) and transcranial electrical stimulation (TES) have been extensively used in experimental and clinical research in psychiatry, neurology, and rehabilitation. Several advanced approaches for delivering transcranial electromagnetic stimulation have been proposed to maximize the temporal and spatial precision of conventional stimulation protocols or to optimize stimulation parameters for enhanced efficacy during neuromodulation. Here, we thematically reviewed several advanced neuromodulatory approaches: (1) using prior or real-time brain states to guide the delivery of stimulation through priming protocols or brain-state-dependent stimulation interfaces (temporal precision); (2) facilitating the stimulation target engagement, either from a single brain region to an interregional brain connection using cortico-cortical paired associative stimulation or dual-site in/anti-phase transcranial alternating current stimulation, or from a superficial brain target to a deep brain region using temporal interference stimulation (spatial precision); and (3) strengthening or accelerating the plasticity modulation outcomes using high-dose protocols (dose optimization). While results from these efforts are promising, challenges exist in terms of the optimal timing of brain states and stimulation parameters, treatment durability, as well as the complexity in aggregating different advanced approaches. Future research should focus on exploring the underlying mechanisms, optimizing parameters, and assessing the efficacy in well-designed proof-of-concept experiments and clinical trials.
Altered microRNA expression profiles in the postmortem prefrontal cortex of individuals with alcohol use disorder: a case-control study.
Çaykara Peran B, Alsaadoni H, Çıracı MZ … +5 more , Kuraş S, Pençe HH, Büyük Y, Erdoğan B, Pençe S
Eur Arch Psychiatry Clin Neurosci · 2026 Apr · PMID 42053595 · Publisher ↗
BACKGROUND: MicroRNAs are critical regulators of neuronal plasticity, synaptic signaling, and stress response, and their dysregulation has been implicated in substance use disorders. However, postmortem evidence on their...
BACKGROUND: MicroRNAs are critical regulators of neuronal plasticity, synaptic signaling, and stress response, and their dysregulation has been implicated in substance use disorders. However, postmortem evidence on their involvement in Alcohol Use Disorder (AUD) remains limited. We aimed to investigate the expression patterns of miR-132, miR-133b, miR-140, miR-181a, miR-190, and miR-212 in the prefrontal cortex of individuals with AUD. METHODS: Prefrontal cortex tissues were obtained postmortem from 30 individuals with documented AUD and 30 age- and sex-matched non-alcohol users. Total RNA was isolated, reverse-transcribed into cDNA, and analyzed by quantitative real-time PCR. Relative expression levels were calculated using the 2 method, with U6 RNA as endogenous control. RESULTS: Individuals with AUD exhibited increased expression of miR-133b (fold change: 4.4, p = 0.035), and miR-212 (fold change: 1.57, p = 0.006), while miR-132 (fold change: 3, p < 0.001) and miR-190 (fold change: 2.63, p = 0.003) were markedly downregulated compared with controls. CONCLUSIONS: The differential expression of these miRNAs suggests their involvement in neuronal signaling pathways underlying AUD, particularly those linked to synaptic plasticity and stress-related transcriptional regulation.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe