Annals Of General Psychiatry[JOURNAL]
Sun
200 papers
The burden of anxiety, depression, and substance use disorders attributable to childhood maltreatment among adolescents in Africa: insights from the global burden of disease study 2021.
Mackay LE, Shiferaw BD, Luo Y … +10 more , Yan N, Wang Y, Wang Y, Wang Y, Hu X, Tian S, Tian J, Lan H, Liu Y, Wang W
Ann Gen Psychiatry · 2025 Nov · PMID 41254717 · Full text
BACKGROUND: Childhood maltreatment is a major risk factor for mental and substance use disorders particularly among adolescents however, there's no comprehensive report of its attributable burden on anxiety, depression,...
BACKGROUND: Childhood maltreatment is a major risk factor for mental and substance use disorders particularly among adolescents however, there's no comprehensive report of its attributable burden on anxiety, depression, and substance use disorder in Africa. This research sort to delineate the Disability-adjusted life years (DALYs) trend and age-period-cohort effects on these disorders attributable to childhood maltreatment among 10-24-year-olds in Africa. METHODS: DALY estimates and 95% uncertainty intervals for anxiety, depression, and substance use disorder attributable to childhood maltreatment among adolescents in Africa were extracted from the Global Burden of Disease Study (GBD) 2021. Trends between 1990 and 2021 were analyzed using Joinpoint regression analysis. The Age-Period-Cohort model was used to determine the effect of age, period, and cohort on these disorders. RESULTS: In 2021, the DALY rate for anxiety was 95.41 (37.32-185.13), 117.57 (54.31-209.16) for depression, and 3.82 (0.63-10.38) for substance use disorder per 100,000 population among adolescents in Africa. Trend analysis showed an increase in anxiety [AAPC: 0.88 (0.84-0.91)] and depressive disorders [AAPC: 0.71(0.68-0.74)]. Niger recorded the highest growth in average annual percentage change (AAPC): 3.17 [95% CI 3.08-3.27] for anxiety, Burkina Faso recorded the highest rise in AAPC: 1.96 [95% CI 1.85-2.08] for depression, and Uganda recorded the highest incline in AAPC: 0.65 [95% CI 0.59-0.72] for substance use disorder. Higher age effects were noted in all disorders, particularly in the 15-19-year group. Period effects were higher for anxiety and depressive disorders and lower for substance use disorders. A higher cohort effect was observed in all disorders during the study period. CONCLUSIONS: Anxiety and depressive disorders due to childhood maltreatment have been on the rise for 3 decades in Africa. Given the implications of the early onset and lifetime burden of mental and substance use disorders, a comprehensive policy framework that facilitates increased access to specialists in childhood maltreatment-related mental disorder services is essential.
Vortioxetine effectiveness in the treated major depressive disorder patients in Saudi Arabia.
Garatli A, Saad S, Alowesei R … +7 more , Xavier F, Zeina M, Lofty W, Khalid M, Alharthi N, Talaat T, Asiri SA
Ann Gen Psychiatry · 2025 Nov · PMID 41254696 · Full text
BACKGROUND: Major Depressive Disorder (MDD) is a prevalent mental health condition characterized by persistent feelings of sadness, loss of interest or pleasure, and a range of physical and cognitive symptoms. Despite th...
BACKGROUND: Major Depressive Disorder (MDD) is a prevalent mental health condition characterized by persistent feelings of sadness, loss of interest or pleasure, and a range of physical and cognitive symptoms. Despite the availability of various treatment options, many MDD patients continue to experience significant impairment in their daily lives. PURPOSE: This multicenter study aimed to evaluate the therapeutic benefits of vortioxetine in routine clinical practice for patients with MDD in Saudi Arabia. METHODS: A total of 499 eligible patients participated in the study. This is a Phase IV study that included 30 psychiatric sites across Saudi Arabia. Data collection occurred at baseline and routine visits. Patients treated with vortioxetine experienced a significant reduction in depressive symptom severity, as indicated by the PHQ-9 total score, throughout the study period (p < 0.001). RESULTS: Significant improvements were also observed in various areas of functioning and cognitive depression symptoms, and safety. Results demonstrated a significant reduction in depressive symptoms, and sexual well-being, indicating vortioxetine as an effective treatment option for MDD in the Middle East and Africa (MEA) region. CONCLUSIONS: These findings support the real-world effectiveness of vortioxetine as a promising treatment option for MDD patients in the MEA region, highlighting its potential to reduce depressive symptoms.
The association between sleep onset time and depression among U.S. adults: a cross-sectional study from NHANES 2015-2020.
Bao K, Bao D, Li X … +8 more , Xie R, Zhang Y, Jiang J, Li Z, Huang Z, Chen L, Gu W, Chen K
Ann Gen Psychiatry · 2025 Nov · PMID 41254686 · Full text
BACKGROUND: The link between sleep onset time and depression is not well understood. We aimed to investigate the association of sleep onset time with depression. METHODS: Data from the 2015 to March 2020 National Health...
BACKGROUND: The link between sleep onset time and depression is not well understood. We aimed to investigate the association of sleep onset time with depression. METHODS: Data from the 2015 to March 2020 National Health and Nutrition Examination Survey were analyzed. Sleep onset time was categorized into five intervals: [22:00-23:00), [23:00-00:00), [00:00-01:00), [01:00-20:00), and [20:00-22:00). Depression was assessed using the Patient Health Questionnaire. Multivariate logistic regression and generalized linear regression analyses were conducted to evaluate the association of sleep onset time with depression. RESULTS: The study sample consisted of 6991 adults (weighted mean age 45.6 years [SE, 0.5]; 49.5% female). Depression prevalence varied by sleep onset time intervals: 4.12% for [00:00-01:00), 5.94% for [01:00-20:00), 3.89% for [20:00-22:00), 1.98% for [22:00-23:00), and 3.26% for [23:00-00:00). After adjusting for sleep duration and other covariates, the odds ratios (ORs) for depressive symptoms were significantly greater at sleep onset time during [01:00-20:00) (OR, 2.39; 95% CI 1.20-4.74) and marginally higher at [20:00-22:00) (OR, 1.78; 95% CI 0.99-3.20) compared to the sleep onset time during [22:00-23:00). Higher PHQ-9 scores were associated with sleep onset time outside [22:00-23:00). CONCLUSION: Sleep onset time between [22:00-23:00) was associated with the lowest odds of depression. This suggests new directions for depression research and interventions, emphasizing the importance of considering sleep onset time in mental health strategies.
Pet ownership and risk of depression: a systematic review and meta-analysis.
Moshfeghinia R, Rostamipourfard S, Kamran M … +4 more , Mostafavi S, Golabi F, Ayano G, Ahmadi J
Ann Gen Psychiatry · 2025 Nov · PMID 41194144 · Full text
BACKGROUND: Pet ownership is often believed to confer psychological benefits, such as reducing loneliness and providing emotional support. However, evidence on its relationship with depression is mixed, and no clear cons...
BACKGROUND: Pet ownership is often believed to confer psychological benefits, such as reducing loneliness and providing emotional support. However, evidence on its relationship with depression is mixed, and no clear consensus currently exists. This systematic review and meta-analysis aimed to evaluate the association between pet ownership and the risk of depression. METHODS: A comprehensive systematic review and meta-analysis were performed following PRISMA guidelines. Three electronic databases (PubMed, Scopus, Web of Science) were searched for observational studies assessing the impact of pet ownership on depression. Two independent reviewers screened and extracted data, and study quality was evaluated using the Newcastle-Ottawa Scale. Random-effects models were used to compute pooled odds ratios (ORs) and 95% confidence intervals (CIs) using STATA-17. RESULTS: A total of 21 studies involving 159,322 participants were included. Overall, pet ownership was not associated with a significant change in depression risk compared to non-ownership (OR: 1.03; 95% CI: 0.995-1.07). However, sensitivity analyses by pet type revealed that cat ownership was associated with a modestly increased risk of depression (OR: 1.06; 95% CI: 1.02-1.09), whereas dog ownership showed no significant association (OR: 0.93; 95% CI: 0.789-1.10). CONCLUSION: This study reveals a complex relationship between pet ownership and depression. Cat ownership is linked to a higher risk, while dog ownership shows mixed results. Overall, pet ownership isn't significantly associated with depression, highlighting the need for further research into its psychosocial dynamics and mental health implications.
Exploring physicians' emotional reactions to suicidal patients: the impact of physician- and patient-related issues.
Kiakos D, Bourquin-Sachse C, Richard-Devantoy S … +2 more , Stiefel F, Michaud L
Ann Gen Psychiatry · 2025 Oct · PMID 41137054 · Full text
BACKGROUND: The physician-patient relationship is essential in the care of suicidal patients, yet factors shaping this relationship remain insufficiently explored. This study aimed to explore physicians' emotional reacti...
BACKGROUND: The physician-patient relationship is essential in the care of suicidal patients, yet factors shaping this relationship remain insufficiently explored. This study aimed to explore physicians' emotional reactions to suicidal patients and how both physician- and patient-related issues influence these responses. METHODS: Interviews were conducted with six physicians from the Douglas Mental Health University Institute in Montreal. A thematic analysis was performed using Hayes' structural model of countertransference as the analytical framework. RESULTS: Three primary emotional reactions emerged: emotional connection/avoidance, confidence/doubts, and powerlessness attributed to own limitations/to the patient. Clinicians' core needs-the need to help, need for security, and need for efficacy-were found to be pivotal in shaping these emotional responses. Similarly, patient-related factors, notably life experiences, disease, suicidality, and attitudes significantly influenced these reactions. Patterns linking physicians' emotional responses to their underlying needs and patient-related factors were analyzed, leading to the development of a conceptual framework. CONCLUSIONS: This framework offers implications for research, clinical supervision, and medical training, fostering deeper insight into the physician-patient relationship in the context of suicidality.
Mitochondrial dysfunction, a new marker warning of neuropsychiatric disorder risk: evidence from genetics and epidemiology.
Fu Q, Li J, Zhu H … +5 more , Yu Q, Shen T, Liu Z, Liu Y, Zhou W
Ann Gen Psychiatry · 2025 Oct · PMID 41126246 · Full text
BACKGROUND: Mitochondrial dysfunction has been implicated in the pathogenesis of a variety of neuropsychiatric disorders, but its causal role remains unclear. Mitochondrial DNA copy number (mtDNA-CN) and methylmalonic ac...
BACKGROUND: Mitochondrial dysfunction has been implicated in the pathogenesis of a variety of neuropsychiatric disorders, but its causal role remains unclear. Mitochondrial DNA copy number (mtDNA-CN) and methylmalonic acid (MMA) are well-recognized biomarkers of mitochondrial function, but their association with psychiatric disorders has not yet been fully assessed. METHODS: We performed two-step two-sample Mendelian randomization (MR) analyses using genome-wide association study (GWAS) data to assess causal associations between mtDNA-CN and 13 major neuropsychiatric disorders. In addition, we conducted a cross-sectional analysis using National Health and Nutrition Examination Survey (NHANES) data 2011-2014 to examine the association between serum MMA levels and cognitive impairment and depressive symptoms to further validate the correctness and robustness of the results of the MR analysis. RESULTS: MR analysis showed a significant negative causal effect of mtDNA-CN on bipolar disorder, Alzheimer's disease, dementia, depressive symptoms, and autism spectrum disorders (OR ranged from 0.15 to 0.84, all p < 0.05). Reverse MR analysis showed that only depressive symptoms had a significant causal effect on reducing mtDNA-CN. NHANES analysis further showed that higher MMA levels were significantly associated with an increased risk of cognitive impairment (OR = 1.56, p = 0.036) and depression (OR = 1.53, p = 0.020), suggesting that mitochondrial dysfunction and neuropsychiatric disorders have a close association. CONCLUSION: The mitochondrial function biomarkers mtDNA-CN and MMA are expected to be potential therapeutic targets for depression and cognitive dysfunction, emphasizing the need for mitochondrial function monitoring and interventions in future therapies targeting neuropsychiatric disorders.
A novel approach to exploring youth non-suicidal self-injury heterogeneity: individual differential psychopathology network analysis.
Jiang Z, Liu Z, Yang Q … +6 more , Zhang W, Wang X, Yang K, Jun J, Cui Y, Lei T
Ann Gen Psychiatry · 2025 Oct · PMID 41107950 · Full text
BACKGROUND: Non-suicidal self-injury (NSSI) is a common behavioral problem among children and adolescents. Previous studies of NSSI have been mostly group-based and lacked specific characterization of individuals with NS...
BACKGROUND: Non-suicidal self-injury (NSSI) is a common behavioral problem among children and adolescents. Previous studies of NSSI have been mostly group-based and lacked specific characterization of individuals with NSSI. METHODS: Using convenience sampling, we surveyed all students from three junior high schools in a county in China, totaling 2,376 participants (mean age 13.66, SD 0.98). Assessments included NSSI, anxiety, depression, personality traits, and family environment. Based on the network template perturbation approach, we employed three steps-constructing the reference network, constructing the perturbed network, and computing the individual differential psychopathology network (IDPN). The IDPN was then constructed from questionnaire scores to capture the degree to which abnormal individuals deviate from the normative level. K-means clustering was then applied to explore the internal heterogeneity of NSSI. RESULTS: Among 2,376 students, 881 (37.1%) exhibited NSSI. Following IDPN construction, we selected 8 characteristics for clustering analysis based on significant changes in at least 2% of the samples. The elbow method indicated 2 clusters. Fisher discriminant analysis showed a classification accuracy of 95.8%, reflecting a good clustering effect. Severity of NSSI in Group 1 was lower than in Group 2, with scores for 7 out of 8 characteristics also lower in Group 1, except for "Control-Organization." NSSI was associated with personality traits, depression, and family environment, with stronger connections between individual features linked to higher NSSI severity. CONCLUSION: We introduced the concept of IDPN in psychometrics, which can reveal relationships among individual characteristics and identify distinct patient subgroups. Further research is needed to confirm its reproducibility and generalizability.
Efficacy and safety of Bifidobacterium combined with high-frequency repetitive transcranial magnetic stimulation in the treatment of depression in adolescents: a preliminary randomised controlled trial.
Ding JJ, Zhang JK, Zhao FF … +3 more , Chen M, Lin ZY, Chen CC
Ann Gen Psychiatry · 2025 Oct · PMID 41094655 · Full text
OBJECTIVE: This study aimed to explore the efficacy and safety of Bifidobacterium combined with high-frequency repetitive transcranial magnetic stimulation (rTMS) in treating depression in adolescents. METHODS: A total o...
OBJECTIVE: This study aimed to explore the efficacy and safety of Bifidobacterium combined with high-frequency repetitive transcranial magnetic stimulation (rTMS) in treating depression in adolescents. METHODS: A total of 100 patients were selected and divided into an experimental group (n = 50) and a control group (n = 50) using a random number table. Patients in the experimental group were treated with Bifidobacterium and high-frequency rTMS, and those in the control group were treated with oral escitalopram oxalate. After 8 weeks of treatment, the Hamilton Rating Scale for Depression (HAMD-24) score, serum inflammatory factors, neuroendocrine indicators and microRNAs were determined in both groups. The single-blind principle was strictly followed throughout the study. RESULTS: The HAMD-24 score after treatment significantly decreased in the experimental group compared with the control group, with a statistically significant difference (p < 0.05). The levels of serum tumour necrosis factor-α, interleukin (IL)-1β and IL-6 also decreased significantly in the experimental group compared with the control group (p < 0.05). Additionally, the elevated levels of dopamine, serotonin and cortisol, including dopamine, 5-hydroxytryptamine and cortisol, was more pronounced in the experimental group than in the control group. The serum levels of miR-16 and miR-195 also showed statistically significant differences (p < 0.05). CONCLUSION: Bifidobacterium combined with high-frequency rTMS is effective in the treatment of depression in adolescents with a favourable safety profile, providing references for the clinical treatment of this disease. CLINICAL TRIAL NUMBER: ISRCTN16752763 ( https://doi.org/10.1186/ISRCTN16752763 ), Date: 19/03/2025.
Discrimination of first-onset patients with bipolar disorder or major depressive disorder using screened biochemical parameters.
Zhu Y, Li S, Gao J … +11 more , Wang F, Zhou N, Wu C, Huang X, Li N, Wu X, Liu H, Yang L, Guo X, Wang Z, Fang Y
Ann Gen Psychiatry · 2025 Oct · PMID 41088422 · Full text
BACKGROUND: Theoretical hypotheses suggest differing oxidative stress levels in mood disorders. We evaluated eight oxidative stress-related biochemical markers for further verification in first-onset patients with bipola...
BACKGROUND: Theoretical hypotheses suggest differing oxidative stress levels in mood disorders. We evaluated eight oxidative stress-related biochemical markers for further verification in first-onset patients with bipolar disorder (BD) or major depressive disorder (MDD). METHODS: We extracted 224 first-onset patients (BD = 93 and MDD = 131) from the overall sample database of 4647 candidates. And we analyzed eight parameters: direct bilirubin (DBIL), indirect bilirubin (IBIL), uric acid (UA), lactate dehydrogenase (LDH), thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), prealbumin, and progesterone.The above parameters enter the hierarchical multiple linear regression model for analysis. RESULTS: When compared to MDD, the BD group showed decreased prealbumin and elevated UA, LDH, and FT3 in males while decreased prealbumin and DBIL and elevated IDBIL, LDH, FT3 and progesterone in females (p's < 0.05). The model effectively differentiated between BD and MDD, achieving AUCs of 0.894 for men and 0.897 for women. CONCLUSION: This result elucidates the validity of these biomarkers for identifying first-episode patients with BD or MDD. The discrimination was satisfactory, with good diagnostic accuracy for both gender subgroups.
Perinatal depression and anxiety symptoms as mediators between grief and PTSD: the moderated effect of social support.
Zeng J, Guo SB, Zheng QX … +2 more , Lin ZM, Liu XW
Ann Gen Psychiatry · 2025 Oct · PMID 41074048 · Full text
BACKGROUND: Posttraumatic stress symptoms are prevalent mental phenomenon in women with previous perinatal loss due to high grief, high perinatal depression and anxiety or low social support. Although posttraumatic stres...
BACKGROUND: Posttraumatic stress symptoms are prevalent mental phenomenon in women with previous perinatal loss due to high grief, high perinatal depression and anxiety or low social support. Although posttraumatic stress symptoms are known to have serious negative implications for women with previous perinatal loss, families and society, the mechanism through which it functions is less clear. OBJECTIVE: The aim of this study was to examine the moderated mediating effect of social support on perinatal anxiety and depression and its associations with grief and posttraumatic stress symptoms in women with previous perinatal loss. We hypothesized that perinatal depression and anxiety would mediate relationships between grief and posttraumatic stress symptoms and that its mediating effects would differ depending on social support. METHODS: This study was a multicentre cross-sectional survey conducted from December 2021 to October 2022, involving 346 women during hospitalization for perinatal loss as participants from two public hospitals in China. Self-reported scales were used to measure the level of perinatal depression and anxiety, grief, posttraumatic stress symptoms and social support. The Pearson's correlation analysis, the PROCESS Macro Model 4 and Model 14 on SPSS were used to analyse the available data. RESULTS: The positive effect of perinatal grief on posttraumatic stress symptoms was found to be mediated by perinatal depression and anxiety, and this mediating effect was moderated according to social support: the more social support, the weaker the mediating effect of perinatal depression and anxiety was between perinatal grief and posttraumatic stress symptoms. The positive effect of perinatal depression and anxiety on posttraumatic stress symptoms was lowest in the high social support group. CONCLUSIONS: Healthcare providers should closely monitor the psychological well-being of pregnant individuals and implement targeted interventions-such as antenatal education course, group-based prenatal care models, and mindfulness-based therapies (e.g., cognitive behaviour therapy) -to mitigate perinatal anxiety and depression. These measures may also significantly reduce post-traumatic stress symptoms in women with previous perinatal loss and high perinatal grief, particularly among those with insufficient social support.
Effect of lacticaseibacillus paracasei PS23 on anxiety and sleep difficulties among office workers: a double-blind, randomized controlled pilot trial.
Wu SI, Kao KL, Lin CJ … +3 more , Lin YJ, Lin IC, Chen WL
Ann Gen Psychiatry · 2025 Oct · PMID 41068940 · Full text
BACKGROUND: Over the past decade, sleep disturbances and stress have markedly increased within the general population. Conditions such as insomnia and poor stress management are linked to a range of physical and psycholo...
BACKGROUND: Over the past decade, sleep disturbances and stress have markedly increased within the general population. Conditions such as insomnia and poor stress management are linked to a range of physical and psychological symptoms, including cardiovascular diseases, sleep disorders, depression, or anxiety. Recent studies have shown that heat-treated Lacticaseibacillus paracasei PS23 (PS23) can alleviate anxiety in clinical nurses experiencing high stress. However, the potential benefits of live PS23- particularly its effects on sleep quality, anxiety, and stress- remain unexplored. METHODS: This study recruited office workers aged 20-65 years who reported moderate to high levels of perceived stress. Participants in the intervention group received a daily dose of 20 billion colony-forming units of live PS23 for six weeks, while the control group received two placebo capsules containing microcrystalline cellulose powder. Outcomes were assessed at baseline and at the end of the trial, including measures of stress, anxiety, sleep quality, fatigue, activity levels, depression, and overall quality of life. Additionally, changes in salivary stress markers and antioxidant levels were evaluated. RESULTS: Of the 50 eligible participants initially enrolled, 45 completed the six-week trial with high compliance (> 80%), including 24 in the PS23 group and 21 in the placebo group. Compared to the placebo group, the PS23 group showed statistically significant improvements in overall insomnia symptoms (group × time interaction, p = 0.011), sleep latency (p = 0.045), sleep maintenance (p = 0.002), and trait anxiety levels (group × time interaction, p = 0.044). CONCLUSION: This pilot randomized controlled trial suggests that live L. paracasei PS23 may offer meaningful improvements in sleep quality and anxiety reduction among office workers experiencing elevated stress levels. REGISTRATION: ClinicalTrials.gov Identifier: NCT05826704; registration date: 4/11/2023. Exploring the Effects of Lactobacillus paracasei PS23 on Workplace-related Stress Symptoms Among Office Workers; URL: https://clinicaltrials.gov/study/NCT05826704.
A multi-level exploration of the genetic basis between lung cancer and schizophrenia.
Wu L, Wu Y, Gan Y
Ann Gen Psychiatry · 2025 Oct · PMID 41063312 · Full text
BACKGROUND: The relationship between schizophrenia (SCZ) and lung cancer (LC) remains inadequately understood, necessitating further exploration through a genetic perspective. METHODS: Utilizing extensive genome-wide ass...
BACKGROUND: The relationship between schizophrenia (SCZ) and lung cancer (LC) remains inadequately understood, necessitating further exploration through a genetic perspective. METHODS: Utilizing extensive genome-wide association study databases, a comprehensive multi-level genetic analytical framework was implemented to examine the genetic association patterns between SCZ and distinct LC subtypes. Initially, genome-wide genetic correlations were assessed through linkage disequilibrium score regression and high-definition likelihood approaches. Subsequently, local variance association analysis (LAVA) was employed to identify key genomic regions exhibiting significant genetic associations. Mendelian randomization (MR) was employed to assess causal effects. Finally, the degree of genetic overlap and shared genetic loci between these diseases were quantitatively evaluated by integrating the conditional/conjunctional false discovery rate methodology. RESULTS: Genetic correlation analyses demonstrated significant positive associations between SCZ and LC, particularly its squamous cell subtype, at the genome-wide level, whereas no statistically significant associations were detected concerning lung adenocarcinoma or small cell lung cancer. Moreover, LAVA identified distinct genetic association patterns within multiple chromosomal segments. A systematic evaluation incorporating a joint false discovery rate confirmed the existence of genetic overlap phenomena between these diseases and successfully pinpointed multiple shared pathogenic risk loci. CONCLUSION: This study furnishes novel theoretical evidence regarding the comorbidity mechanisms linking various LC subtypes with SCZ from a genetic perspective, thereby enhancing the comprehension of their intrinsic interconnections.
Treatment-resistant depression with poor response to deep brain stimulation improves with psychotherapy: case series.
Fang S, Kang Y, Zhang J
Ann Gen Psychiatry · 2025 Sep · PMID 41029456 · Full text
BACKGROUND: Deep brain stimulation (DBS) is regarded as an efficacious treatment for treatment-resistant depression (TRD), exhibiting a response rate of approximately 60%. However, certain patients exhibit limited respon...
BACKGROUND: Deep brain stimulation (DBS) is regarded as an efficacious treatment for treatment-resistant depression (TRD), exhibiting a response rate of approximately 60%. However, certain patients exhibit limited responsiveness to DBS, necessitating further exploration of alternative interventions. In this paper, we present two cases of TRD patients who exhibited poor response to DBS surgery but showed significant improvement after receiving psychotherapy. CASE PRESENTATION: In case 1, a 20-year-old female patient exhibited a slight initial positive response after DBS surgery; however, her symptoms continued to deteriorate progressively. Following systematic cognitive behavioral therapy (CBT), she demonstrated remarkable improvement in depressive symptoms. In case 2, a 36-year-old male patient experienced short-term symptomatic improvement post-DBS surgery but relapsed due to treatment interruption caused by financial constraints. After CBT intervention, the symptoms of his depression exhibited significant improvement. CONCLUSIONS: No previous studies have reported on the effects of CBT in postoperative depressive symptoms following DBS. The combination of DBS surgery and postoperative psychological therapy may enhance the therapeutic outcomes of DBS. This study emphasizes the significance of incorporating psychotherapy into the management after DBS surgery and calls for future research to further investigate the potential and mechanisms underlying this comprehensive treatment strategy.
Mental health spending in Colombia: an analysis of rural and urban areas.
Espinosa O, Bejarano V, Mejía A … +3 more , Arias ML, Vargas-Gonzalez JC, Sanchez-Pedraza R
Ann Gen Psychiatry · 2025 Sep · PMID 41029439 · Full text
BACKGROUND: Mental health expenditures are increasing worldwide. In developed countries there is evidence that increased health spending is associated with improved outcomes. However, this information may not apply to th...
BACKGROUND: Mental health expenditures are increasing worldwide. In developed countries there is evidence that increased health spending is associated with improved outcomes. However, this information may not apply to the Colombian health system that is significantly different and underfunded in comparison with developed countries. METHODOLOGY: We used data from Colombia “Gestion de la Demanda” information system grouped for analysis by geographical areas, age groups, and ICD-10 sub-chapters for mental and behavioural disorders. We performed descriptive analytical techniques and Tufte’s statistical visualisations, with all monetary analysis presented in US Dollars (USD) adjusted for purchasing power parity (PPP). FINDINGS: We found that rural females with disorders of adult personality and behaviour in 2021 had the highest spending of 2,490 USD PPP. When analysing the averages, the highest values were found for males with mental and behavioural disorders related to psychoactive substance use between 12 and 26 years old with a mean spending of 1,074 USD PPP. Regarding the frequency of health services use per patient, the highest was 45 consultations per patient and was associated with the highest per capita health spending. INTERPRETATION: This study represents a pioneering effort in the analysis of mental health expenditure in Colombia to partition costs, providing a novel economic perspective about which areas in Colombia and for whom spend is greatest.
Time to efficacious steady state plasma concentrations with slow titration of Vortioxetine drops versus oral tablets: a Pharmacokinetic model.
Fagiolini A, Reines EH, Farovik A … +1 more , Areberg J
Ann Gen Psychiatry · 2025 Sep · PMID 41029428 · Full text
BACKGROUND: The antidepressant vortioxetine is available as an immediate-release (IR) tablet formulation and as a bioequivalent oral drops solution (20 mg/mL) to allow personalised titration. METHODS: This pharmacokineti...
BACKGROUND: The antidepressant vortioxetine is available as an immediate-release (IR) tablet formulation and as a bioequivalent oral drops solution (20 mg/mL) to allow personalised titration. METHODS: This pharmacokinetic modelling analysis used data from a single-dose, crossover study to simulate the time taken to reach steady-state plasma concentrations using 'low and slow' titration approaches with drops compared with standard IR-tablet schedules. RESULTS: All dosing regimens approached 10 mg steady-state concentrations within 2 weeks. The time to reach full steady-state was 12 days when starting with a 10 mg IR-tablet, 14 days when starting with 5 mg drops and increasing to 10 mg (1 mg/day increments), 17 days when starting with a 5 mg IR-tablet for 7 days before increasing to 10 mg, and 18 days when starting with 1 mg drops and increasing to 10 mg (1 mg/day increments). CONCLUSIONS: These data support the utility of vortioxetine drops in offering flexibility for personalised titration without relevant impact on the time taken to reach steady-state plasma concentrations.
Associations of ANKK1 (rs1800497) polymorphism with glucose and lipid metabolism in patients with schizophrenia treated with olanzapine: a retrospective study.
Gao W, Xu Y, Shan F … +2 more , Liang J, Xia Q
Ann Gen Psychiatry · 2025 Sep · PMID 41029371 · Full text
OBJECTIVE: Antipsychotic-induced metabolic disturbance (AIMD) represents a prevalent adverse effect associated with antipsychotic medications, with genetic factors partially contributing to the variability in susceptibil...
OBJECTIVE: Antipsychotic-induced metabolic disturbance (AIMD) represents a prevalent adverse effect associated with antipsychotic medications, with genetic factors partially contributing to the variability in susceptibility observed among patients with schizophrenia (SCZ). This study examined the effect of ANKK1 (rs1800497) polymorphism on glucose and lipid metabolism in Chinese patients diagnosed with SCZ and undergoing olanzapine treatment. METHODS: A cohort of 104 SCZ patients receiving olanzapine treatment was recruited retrospectively for the investigation. The polymorphism in the ANKK1 (rs1800497) gene were identified and analyzed. The clinical and demographic characteristics of subjects with ANKK1 (rs1800497) genotypes were compared at baseline. The associations between ANKK1 rs1800497 genotypes and glucose and lipid indicators at baseline were examined. Following a 4-week olanzapine treatment, changes in glucose and lipid indicators among subjects with ANKK1 (rs1800497) genotypes were evaluated. Additionally, the relationship between these genotypes and the alterations in glucose and lipid indicators after olanzapine treatment was analyzed. RESULTS: At baseline, individuals carrying the T allele of the ANKK1 rs1800497 polymorphism exhibited significantly lower serum total cholesterol (TC) levels compared to those possessing the CC genotype (P = 0.024). Moreover, under an additive allelic model (coded as 1 = CC, 2 = CT, 3 = TT), the TT genotype of the ANKK1 rs1800497 polymorphism demonstrated a negative correlation with serum TC (r = -0.237, P = 0.015) and glucose levels (r = -0.276, P = 0.005). Furthermore, following olanzapine treatment, patients who were carriers of the TT genotype of ANKK1 rs1800497 had a smaller reduction in glucose levels compared to those with the CC genotype (P = 0.027). Additionally, the TT genotype of the ANKK1 rs1800497 polymorphism demonstrated a positive correlation with changes in glucose levels (r = 0.237, P = 0.015). CONCLUSION: These findings suggest a potential association between the ANKK1 rs1800497 polymorphism and blood glucose variability in Chinese patients with SCZ undergoing olanzapine treatment.
Sertraline and inflammatory markers in major depression: a systematic review and meta-analysis.
Xie Z, Gao Z, Li X … +3 more , Li S, Tang F, Zhang C
Ann Gen Psychiatry · 2025 Sep · PMID 41023687 · Full text
BACKGROUND: Increasing evidence suggests a link between major depressive disorder (MDD) and inflammatory pathways. Sertraline, a commonly used selective serotonin reuptake inhibitor (SSRI), may influence inflammatory cyt...
BACKGROUND: Increasing evidence suggests a link between major depressive disorder (MDD) and inflammatory pathways. Sertraline, a commonly used selective serotonin reuptake inhibitor (SSRI), may influence inflammatory cytokine levels. This systematic review and meta-analysis aimed to elucidate the association between the antidepressant sertraline and inflammatory processes and to delineate the roles of key cytokines within this context. METHODS: Electronic searches of the Web of Science, MEDLINE, and Embase databases (from inception to August 8, 2025) yielded 890 unique records. The included studies measured serum concentrations of inflammatory cytokines in patients with major depressive disorder (MDD) before and after sertraline treatment, with subsequent analysis of the effects of sertraline on these biomarkers. Two independent investigators performed the literature screening and data extraction. Pooled effect estimates were calculated using random effects meta-analysis models. RESULTS: Eleven studies (406 participants) were included. The results demonstrated significant increases in both IL-6 levels (SMD = 0.87; 95% CI: 0.16 to 1.58; Z = 2.41; p = 0.02) and TNF-α levels (SMD = 0.76; 95% CI: 0.14 to 1.71; Z = 2.30; p = 0.02) following sertraline treatment. CONCLUSION: Sertraline significantly modulates IL-6/TNF-α levels, suggesting that this pathway may partly mediate its antidepressant effects.
Combined effect of cognitive dysfunction and sleep disturbance on mortality risk: NHANES 2011-2014.
Yeh TS, Huang YC, Ho SC … +5 more , Siow CY, Lee HC, Recio-Rodriguez JI, Sung JY, Tani J
Ann Gen Psychiatry · 2025 Sep · PMID 40898257 · Full text
BACKGROUND: Both cognitive dysfunction and sleep disturbances are individually linked to heightened risks of chronic illnesses and mortality. However, their combined impact on all-cause and cardiovascular mortality remai...
BACKGROUND: Both cognitive dysfunction and sleep disturbances are individually linked to heightened risks of chronic illnesses and mortality. However, their combined impact on all-cause and cardiovascular mortality remains underexplored. METHODS: This study utilized data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014, focusing on participants aged ≥ 60 years who completed cognitive tests and sleep-related questionnaires. Cognitive function was evaluated using three standardized tests: The Consortium to Establish a Registry for Alzheimer's Disease (CERAD), the Animal Fluency Test, and the Digit Symbol Substitution Test. Participants with global cognitive z-scores below - 1 were classified as having low cognitive function. Sleep disturbance was identified based on self-reported diagnoses of sleep disorders or complaints of trouble sleeping. Mortality data were sourced from the National Death Index. Cox proportional hazards regression was used to calculate adjusted hazard ratios (aHR) for all-cause and cardiovascular mortality, with adjustments for potential confounders. RESULTS: A total of 3,170 participants ≥ 60 years of age were included for analysis. Participants with low cognitive function alone had an adjusted hazard ratio (aHR) of 1.59 (95% CI: 1.12-2.26) for all-cause mortality. The risk increased to an aHR of 1.73 (95% CI: 1.07-2.79) when both low cognitive function and sleep disturbances were present. Stratified analyses revealed that the associations between cognitive function, sleep disturbance, and mortality risks varied across sex, BMI, and chronic kidney disease status. CONCLUSIONS: The combination of low cognitive function and sleep disturbances is associated with a higher risk of all-cause and cardiovascular mortality, exceeding the risk of either condition alone. These findings emphasize the need to consider both factors together when assessing mortality risk in older adults.
Feasibility and structure of a state hospital botulinum neurotoxin clinic for clozapine-induced sialorrhea.
Arias AW, Cummings MA, Proctor GJ … +1 more , Meyer JM
Ann Gen Psychiatry · 2025 Aug · PMID 40859322 · Full text
Clozapine is uniquely effective for treatment-resistant schizophrenia, treatment-resistant mania, and for aggression, suicide, or psychogenic polydipsia related to schizophrenia. Among its adverse effects, sialorrhea is...
Clozapine is uniquely effective for treatment-resistant schizophrenia, treatment-resistant mania, and for aggression, suicide, or psychogenic polydipsia related to schizophrenia. Among its adverse effects, sialorrhea is an important barrier to clozapine treatment. Topical anticholinergic medications show limited efficacy, while systemic anticholinergics carry elevated risks of constipation, bowel impaction, or ileus. A superior treatment option for clozapine-induced sialorrhea exists in the form of periodic injection of major salivary glands with botulinum neurotoxin. This paper describes the feasibility and logistical issues involved in establishing a botulinum treatment clinic within a forensic psychiatric hospital. Critical elements in establishing a successful botulinum clinic for treatment of sialorrhea include adequate hospital administrative support, sufficient nursing staff, clinician injection training, education of treating psychiatrists regarding the availability and effectiveness of botulinum treatment for sialorrhea, and development of a clinic protocol, including procedural elements and relevant rating scales. Finally, botulinum treatment was evaluated to be cost-effective.
Correction: Serum L-selectin levels as predictive markers for chronic major depressive disorder progression.
Yun Y, Mun S, Lee S … +2 more , Kang HG, Lee J
Ann Gen Psychiatry · 2025 Aug · PMID 40846974 · Full text
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