Annals Of General Psychiatry[JOURNAL]
Sun
200 papers
Accelerated repetitive transcranial magnetic stimulation in the treatment of depressive disorder resistant to a course of antidepressant medication.
Motamed M, Fathi A, Hajikarim-Hamedani A … +1 more , Alaghband-Rad J
Ann Gen Psychiatry · 2025 May · PMID 40389945 · Full text
AIMS: It is generally known that 30% of Major depressive disorder (MDD) patients do not respond to traditional pharmacological and psychosocial therapy. Transcranial magnetic stimulation (TMS), introduced first in 1985,...
AIMS: It is generally known that 30% of Major depressive disorder (MDD) patients do not respond to traditional pharmacological and psychosocial therapy. Transcranial magnetic stimulation (TMS), introduced first in 1985, was a non-invasive neural network research method. Later, repetitive Transcranial Magnetic Stimulation (rTMS) was approved by the FDA to treat treatment-resistant depression (TRD) in 2008. Over the past two decades, rTMS has been extensively developed using various protocols in order to stimulate superficial brain nerve cells non-invasively. We planned to see if high-frequency accelerated left prefrontal rTMS can improve symptoms of treatment resistant depression given its convenience it provides by having patients for fewer treatment sessions. METHODS: A total of 25 patients were enrolled in the study. Inclusion criteria were age between 18 and 60 and a history of at least one failed treatment with antidepressants. The treatment was conducted over six days scattered over three weeks and each day consisted of three 30-minute sessions (83, 83, and 84 trains for each session). The sessions were separated with 15-minute breaks. rTMS protocol: 120% of the motor threshold and frequency of 10 Hz. Consisting of 2.4 s trains with an intertrain interval of 15-seconds. RESULT: The study included 25 individuals (male: 12/13) with an average age of 36.88 ± 10.61. We compared outcome indicators at baseline and week three after confirming the normality of the data. After three weeks, Hamilton Depression Rating Scale and Clinician Global Impression showed a substantial improvement. There was a remission rate of 24% (6/25) and a response rate of 52% (13/25). CONCLUSION: This work adds to the evidence that rTMS can treat TRD and shows that a more convenient high-frequency accelerated rTMS can improve symptoms in treatment resistant depression.
Interactions of factors in self-injuries among enrolled students: a network approach.
Zhang YM, Jiang XM, Xie Y … +8 more , Lang N, Liang ML, Zhang P, OuYang LC, Lv ZW, Liu CW, Zhang LP, Wang C
Ann Gen Psychiatry · 2025 May · PMID 40380309 · Full text
PURPOSE: Suicidal and non-suicidal self-injuries are types of self-directed violence that can become complex health issues. This study assessed how and to what degree the factors of self-injuries are interrelated among e...
PURPOSE: Suicidal and non-suicidal self-injuries are types of self-directed violence that can become complex health issues. This study assessed how and to what degree the factors of self-injuries are interrelated among enrolled students. METHODS: A total of 1481 students were recruited from college and middle or secondary schools, and 1465 (98.92%) subjects comprised the final sample. Mixed graphical models were used to establish network structures. Also explore their shortest paths and conduct a regression analysis. RESULTS: Of the 1465 students, we observed intersections that connected the cluster of early experiences and psychiatric/psychological using network analysis. Shortest paths analysis and regression analysis suggest that symptoms of schizoid (edge-weights = 0.336, OR = 2.79, p < 0.01) and narcissistic (edge-weights=-0.177, OR = 0.35, p < 0.05) personality disorders (PD), acceptance (edge-weights = 0.470, OR = 12.80, p < 0.01) and positive refocusing (edge-weights=-0.171, OR = 0.12, p < 0.05) strategies of emotion-regulation, mindfulness awareness (edge-weights=-0.263, OR = 0.24, p < 0.05), and emotional-neglect in childhood (edge-weights = 0.239, OR = 5.54, p < 0.05) were found with non-suicidal self-injury (NSSI). Symptoms of anxiety (edge-weights = 0.280, OR = 2.00, p < 0.01) and avoidant-PD (edge-weights = 0.229, OR = 1.75, p < 0.01) were associated with suicidal ideation, and symptoms of borderline-PD (edge-weights = 0.432, OR = 5.38, p < 0.05) and mindfulness awareness (edge-weights=-0.180, OR = 0.28, p < 0.05) were associated with suicide attempt. CONCLUSIONS: Relying exclusively on acceptance strategy may constitute an avoidance pattern, impeding the ability to confront emotional distress. Clinical intervention aimed at repairing father-child relationship may be helpful to recover from emotional trauma and improve current symptoms and self-injuries.
Bibliometric and visual analysis of circadian rhythms in depression from 2004 to 2024.
Zhou C, Ji S, Zhang A … +3 more , Yu H, Liu C, Li S
Ann Gen Psychiatry · 2025 May · PMID 40369622 · Full text
INTRODUCTION: Understanding the intricate relationship between circadian rhythms and depression is crucial for developing effective interventions and treatments for individuals affected by depression. Circadian rhythms r...
INTRODUCTION: Understanding the intricate relationship between circadian rhythms and depression is crucial for developing effective interventions and treatments for individuals affected by depression. Circadian rhythms regulate various physiological and behavioral processes, while depression manifests as persistent feelings of sadness and disturbances in sleep, appetite, and energy levels. Emerging research suggests a significant interplay between circadian rhythm disruption and depression, highlighting the need for comprehensive analysis in this area. METHODOLOGY: A bibliometric and visual analysis of literature on circadian rhythms in depression from 2004 to 2024 was conducted using the Web of Science Core Collection. Data were analyzed using bibliometric tools including VOSviewer, CiteSpace, and Bibliometrix to identify publication trends, geographical distribution, authorship patterns, institutional collaborations, journal preferences, keyword co-occurrence, and highly cited references. RESULTS: Analysis revealed a steady increase in publications and citations related to circadian rhythms in depression. The United States emerged as the leading contributor, with strong global collaborations. Key journals included Chronobiology International and Journal of Affective Disorders. Top keywords included circadian rhythm, depression, sleep, melatonin, and bipolar disorder. The most cited article is a review titled "Practice parameters for the indications for polysomnography and related procedures: An update for 2005". CONCLUSIONS: This study offers a comprehensive overview of research on circadian rhythms in depression, highlighting key trends, contributors, and interdisciplinary intersections.
Prevalence and correlates of depression and anxiety in caregivers of children with attention-deficit/hyperactivity disorder during the fifth wave of COVID-19 and school closure in Hong Kong.
Hung SC, Chau AKC, Lei JH … +15 more , Lai ET, Wong GH, Leung IK, Chang WC, Ho C, Leung BM, Wong WS, Chan JK, Lee KC, Cheng CP, Chan WC, Wong CS, Chan GH, Leung PW, Yu ZH
Ann Gen Psychiatry · 2025 May · PMID 40361152 · Full text
BACKGROUND: Caregivers of children with attention-deficit/hyperactivity disorder (ADHD) are vulnerable to increased psychological distress during COVID-19. However, specific pandemic- and child-related factors contributi...
BACKGROUND: Caregivers of children with attention-deficit/hyperactivity disorder (ADHD) are vulnerable to increased psychological distress during COVID-19. However, specific pandemic- and child-related factors contributing to their poor mental health have not been fully investigated. We aimed to comprehensively examine prevalence and correlates of depression and anxiety among caregivers of ADHD children in Hong-Kong during the peak of fifth pandemic wave with territory-wide school closure. METHOD: One-hundred-ninety-nine caregivers of ADHD children were assessed with self-rated questionnaires between 29 March-14 April, 2022. Questionnaires encompassed socio-demographics, pre-existing physical/psychiatric morbidity, COVID-19 related factors, children's ADHD and other psychiatric symptoms. Caregivers' psychological distress was quantified by Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder Scale-7 (GAD-7). Caregivers who scored ≥ 10 in PHQ-9 and GAD-7 were classified as having probable depression and probable anxiety, respectively. Univariate and multivariate logistic regression analyses were conducted to identify correlates associated with caregivers' probable depression and anxiety status. RESULTS: Forty-four (22.4%) and 33 (16.9%) caregivers had probable depression and anxiety, respectively. Multivariate regression analyses revealed that caregivers' pre-existing mental disorder, greater COVID-19 stressor burden, and more severe emotional symptoms and insomnia of ADHD children were independently associated with both caregivers' depression and anxiety status. CONCLUSION: A significant proportion of caregivers of ADHD children experienced clinically-significant depressive and anxiety symptoms during the peak of fifth pandemic wave and school closure. Findings suggest that optimizing management of caregivers' pre-existing mental health conditions, addressing emotional and sleep symptoms in ADHD children, and implementing strategies to alleviate pandemic-related stressors may reduce caregivers' psychological distress.
Exploring the relationship between the density of the iris color and bipolar disorder: a case-control study, Egypt.
Youssef UM, Raya YM, Sehlo MG … +4 more , Gado OM, Hussien FM, Gad AA, Said M
Ann Gen Psychiatry · 2025 Apr · PMID 40296136 · Full text
BACKGROUND: The eyes serve as a portal to the brain and are highly connected neurologically, making them the only externally visible part of the brain. Moreover, the correlation between the physical attributes of the eye...
BACKGROUND: The eyes serve as a portal to the brain and are highly connected neurologically, making them the only externally visible part of the brain. Moreover, the correlation between the physical attributes of the eye and psychiatric disorders has been increasingly established in recent years. Therefore, this study examined the association between iris color density and bipolar I disorder (BD). METHODS: In a case-control study, 48 subjects diagnosed with BD are compared to an equal number of healthy controls. A semi-structured interview questionnaire is designed to collect sociodemographic, psychiatric, medical history, and clinical data from all participants. The Group with BD is diagnosed based on clinical assessment by the Consultant/specialist by using a semi-structured clinical interview for DSM 5 Clinician Version (SCID-5-CV) to diagnose BD's current episode and to exclude the other comorbid mental disorders. Additionally, the group with BD is further assessed by The Young Mania Rating Scale (YMRS) and Hamilton Depression Rating Scale (HDRS) to evaluate the severity of manic and depressive symptoms. The iris color of participants in both groups was evaluated using a standardized photographic system for iris imaging. RESULTS: It showed a statistically significant increase in the percentage of the colored iris in the patients' group compared with the control group, and the presence of a colored iris significantly increases the risk of BD by 2.36 folds. There is no statistically significant difference between iris color and either hospitalization, suicide, Electroconvulsive Therapy (ECT), family history, medical history, duration, or frequency of episodes. CONCLUSION: Our findings revealed a strong association between iris color and bipolar disorder (BD) but no significant association between iris color and clinical factors such as hospitalization, suicide, electroconvulsive therapy (ECT), family history, medical history, or the duration and frequency of episodes. These results suggest that iris color may serve as a trait marker rather than a state marker in BD, potentially offering a simple and non-invasive indicator of bipolarity.
Non-invasive brain stimulation for borderline personality disorder: a systematic review and network meta-analysis.
Mansour MEM, Alsaadany KR, Ahmed MAE … +2 more , Elmetwalli AE, Serag I
Ann Gen Psychiatry · 2025 Apr · PMID 40241170 · Full text
INTRODUCTION: Borderline Personality Disorder (BPD) is a complex neuropsychiatric condition characterized by four main symptom domains: emotion dysregulation, behavioral dysregulation, self-image disturbances, and interp...
INTRODUCTION: Borderline Personality Disorder (BPD) is a complex neuropsychiatric condition characterized by four main symptom domains: emotion dysregulation, behavioral dysregulation, self-image disturbances, and interpersonal instability. While psychotherapy remains the primary treatment, there is a need for additional effective interventions. Given the neuromodulatory effects of non-invasive brain stimulation (NIBS) techniques, such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), these methods may hold potential for addressing BPD symptoms. METHODS: A systematic review and network meta-analysis were conducted following PRISMA guidelines. A literature search (PubMed, Scopus, Web of Science, Cochrane CENTRAL) identified comparative studies assessing the effects of NIBS in BPD. The primary outcome was impulsivity, measured by the Barratt Impulsivity Scale (BIS-11). Secondary outcomes included Depressive symptoms, which were evaluated using different scales such as the Hamilton Depression Rating Scale (HAMD) and the Beck depression Inventory (BDI) scale, and anxiety symptoms were evaluated using the Hamilton Anxiety Rating Scale (HAMA). RESULTS: Five studies with a total of 103 patients were included. Regarding impulsivity, tDCS 2 mA showed a significant reduction compared to the control group (MD = -11.67, 95% CI [-21.44, -1.90]). For depressive symptoms, TMS 20 Hz ranked highest (SMD = -1.97, 95% CI [-3.51, -0.43]), followed by tDCS 2 mA (SMD = -1.65, 95% CI [-2.97, -0.34]). In terms of anxiety, both TMS 5 Hz (MD = -12.29, 95% CI [-24.57, -0.01]) and tDCS 2 mA (MD = -11.81, 95% CI [-17.39, -6.23]) showed significant differences. CONCLUSION: Preliminary evidence suggests potential efficacy of non-invasive brain stimulation for BPD, with well-tolerated side effects with well-tolerated side effects. Although there are noticeable statistically significant differences between the interventions and control groups, the results are inconclusive due to the small sample.
Prevalence and comorbidity of attention deficit hyperactivity disorder in Chinese school-attending students aged 6-16: a national survey.
Liu J, Jiang Z, Li F … +4 more , Zheng Y, Cui Y, Xu H, Li Y
Ann Gen Psychiatry · 2025 Apr · PMID 40223102 · Full text
BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder. Despite its significance, no large-scale epidemiological study assessing ADHD, and its associated comorbidities in c...
BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder. Despite its significance, no large-scale epidemiological study assessing ADHD, and its associated comorbidities in children and adolescents has been conducted in China. METHODS: Within a national epidemiological survey of 73,992 children and adolescents aged between 6 and 16 in China, we used the CBCL, MINI-KID, and DSM-IV to identify ADHD and its comorbid conditions. Chi-square tests were utilized to compare the prevalence estimates across varied age and sex groups. RESULTS: The overall ADHD prevalence was estimated at 6.4% (95% CI: 6.2-7.0%). Broken down by subtypes, ADHD-I had a prevalence of 3.9%, ADHD-C was at 1.7%, and ADHD-H was at 0.9%. Boys and the younger age bracket recorded higher prevalence rates for ADHD and its subtypes (p < 0.001). Among ADHD-diagnosed individuals, 53% exhibited at least one comorbid psychiatric disorder. Oppositional defiant disorder/conduct disorder (ODD/CD) was the most prevalent comorbidity for ADHD-C and ADHD-H, at 58%, while anxiety disorders, at 17%, were predominant among ADHD-I cases. ODD/CD was notably higher among younger subjects (p < 0.001). In contrast, anxiety disorders were more frequent in older children and in girls (p < 0.001). Tic disorders showed a higher prevalence in younger boys, whereas mood and substance use disorders were more common in older boys (p < 0.001). CONCLUSIONS: ADHD is a common neurodevelopmental disorder with high comorbidity rates that vary substantially across subtypes, age, and sex. These clinical heterogeneities complicate management and highlight the need for tailored interventions.
Global, regional, and national burden of geriatric depressive disorders in people aged 60 years and older: an analysis of the Global Burden of Disease Study 2021.
Fei Y, Yu H, Liu J … +1 more , Gong S
Ann Gen Psychiatry · 2025 Apr · PMID 40188071 · Full text
BACKGROUND: Late-life depression (LLD) stands as a prevalent mental health issue among older adults, frequently intertwined with cardiovascular and cerebrovascular diseases as well as cognitive decline. The occurrence of...
BACKGROUND: Late-life depression (LLD) stands as a prevalent mental health issue among older adults, frequently intertwined with cardiovascular and cerebrovascular diseases as well as cognitive decline. The occurrence of LLD in the older adults, who often present with multiple aging-related conditions, frequently results in this disorder being overlooked. However, the astronomical treatment costs and the considerable societal burden associated with LLD necessitate urgent and sustained attention. MATERIALS AND METHODS: Utilizing data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 (GBD 2021), we extracted incidence rates and disability-adjusted life years (DALYs) of LLD in individuals aged 60 and older. The extracted data underwent rigorous evaluation through the application of age-period-cohort models, the health inequality concentration index, and frontier analysis. RESULTS: From 1990 to 2021, a global increase was observed in both the age-standardized incidence rate (ASIR) and DALY rate of LLD. Specifically, the ASIR ascended by 0.01 per 100,000 annually, while the DALY rate rose by 0.03 per 100,000 each year. Notably, a statistically significant inverse relationship was identified between ASIR and the Socio-demographic Index (SDI) (p < 0.001). Additionally, a notable linear correlation was discerned between age-standardized death rate (ASDR) and SDI, albeit without a discernible downward trend (p < 0.001). According to the SDI, the Estimated average percentage change (EAPC) of five SDI districts showed no increase or decrease. Globally, the incidence of LLD showed an upward trend in the high SDI, middle SDI, and low-middle SDI regions, a downward trend in the high-middle SDI region, and no significant increase or decrease in the low SDI region. In the age-period-cohort analysis, we found that the incidence of LLD increased with age in high and middle SDI regions compared with low SDI regions, and the results were the opposite in low SDI regions, with significant regional characteristics. The period effect analysis revealed that irrespective of gender, the trends in incidence and DALY rates remained relatively unchanged globally from 1992 to 2021. As SDI levels rose, the SDI-adjusted disparities in incidence and DALY rates tended to stabilize. A comparative analysis of data from 1990 to 2021 highlighted a relative decline in health inequalities. CONCLUSION: This comprehensive assessment of the disease burden of LLD among the global population aged 60 and older underscores significant accomplishments while simultaneously emphasizing areas requiring ongoing vigilance. In the context of relentless population growth and aging, the favorable downturns in incidence and DALY rates reflect tangible advancements in managing LLD.
Epigenetics factors in schizophrenia: future directions for etiologic and therapeutic study approaches.
Yang H, Sun W, Li J … +1 more , Zhang X
Ann Gen Psychiatry · 2025 Apr · PMID 40186258 · Full text
Schizophrenia is a complex, heterogeneous, and highly disabling severe mental disorder whose pathogenesis has not yet been fully elucidated. Epigenetics, as a bridge between genetic and environmental factors, plays an im...
Schizophrenia is a complex, heterogeneous, and highly disabling severe mental disorder whose pathogenesis has not yet been fully elucidated. Epigenetics, as a bridge between genetic and environmental factors, plays an important role in the pathophysiology of schizophrenia. Over the past decade, epigenetic-wide association studies have rapidly become an important branch of psychiatric research, especially in deciphering the molecular mechanisms of schizophrenia. This review systematically analyzes recent advances in epigenome-wide association studies (EWAS) of schizophrenia, focusing on technological developments. We synthesize findings from large-scale EWAS alongside emerging evidence on DNA methylation patterns, histone modifications, and regulatory networks, emphasizing their roles in disease mechanisms and treatment responses. In addition, this review provides a prospective outlook, evaluating the impact that technological developments may have on future studies of schizophrenia. With the continuous advancement of high-throughput sequencing technology and the increasing maturity of big data analysis methods, epigenetics is expected to have a significant impact on the early diagnosis, prognosis assessment and even personalized treatment of schizophrenia.
The independent role of fine particulate matter and genetic liability on cognition in older adults.
Liao SF, Chan TC, Su MH … +4 more , Lin MC, Wu CS, Fan CC, Wang SH
Ann Gen Psychiatry · 2025 Apr · PMID 40181397 · Full text
BACKGROUND: Genetic susceptibility to mental health and cognitive traits, as well as air pollution, significantly impact cognition. The interplay between polygenic liability and fine particulate matter (PM) remains uncle...
BACKGROUND: Genetic susceptibility to mental health and cognitive traits, as well as air pollution, significantly impact cognition. The interplay between polygenic liability and fine particulate matter (PM) remains unclear due to the limited number of large-scale studies in Asia. This study utilized the Taiwan Biobank, a nationwide community-based database, to investigate the main and modified effect of PM on individuals' polygenic susceptibility in cognition. METHODS: Polygenic risk score (PRS) for cognitive performance (CP PRS), Alzheimer's disease (AD PRS), schizophrenia (SCZ PRS), and major depression (MDD PRS) were computed representing genetic susceptibility for an individual. APOE genotype was classified into E3/E3, E3/E4, and E4/E4. The five-year average concentration of PM from satellite images was used for defining environmental exposure. Cognitive performance was evaluated via the Mini-Mental State Examination (MMSE) score. The association between personal genetic susceptibility, PM, and cognitive performance was examined using multilevel linear regression with the adjustment of age, sex, batch effect, and population stratification effect. The gene-environment synergism was examined with the inclusion of product term of PM and PRS in the multivariate model. RESULTS: Our analyses included 25,593 participants from 164 townships. Participants exposed to higher PM concentrations had a lower MMSE score (Beta=-0.0830 corresponding to a 1 µg/m increase in PM concentration, 95% CI, -0.0973 to -0.0688, p-value < 0.0001). After controlling for PM concentration, CP PRS (Beta = 0.1729, 95% CI, 0.1470 to 0.1988, p-value < 0.0001), SCZ PRS (Beta=-0.0632, 95% CI, -0.0891 to -0.0374, p-value < 0.0001), and AD PRS (Beta=-0.0321, 95% CI, -0.0580 to -0.0062, p-value = 0.0153) were associated with MMSE score. After further examination of gene-environment synergism, no interaction effect was identified, indicating different mechanism of PM and genetic liability to influence cognitive performance. CONCLUSIONS: Human polygenic loading and PM may impact cognition via an independent pathway. A prevention strategy targeting air pollution reduction may effectively improve the cognitive performance. Multiple exposures and their influences on the long-term change of cognition were required in future research.
Exploring the predictive role of the first mood episode on the predominant polarity in bipolar disorder: insights from a path analysis.
Cavaleri D, Crocamo C, Riboldi I … +5 more , Boniello F, Clerici B, Molendini M, Carrà G, Bartoli F
Ann Gen Psychiatry · 2025 Mar · PMID 40165214 · Full text
BACKGROUND: The predominant polarity in bipolar disorder (BD) is defined by the skewness of mood episodes towards either the manic or depressive pole. However, since the predominant polarity can only be established over...
BACKGROUND: The predominant polarity in bipolar disorder (BD) is defined by the skewness of mood episodes towards either the manic or depressive pole. However, since the predominant polarity can only be established over the long term, it is crucial to identify predictors of illness trajectory. Among these factors, the polarity at onset has been suggested to hold important implications, even though research in this field is not entirely consistent so far. In this retrospective study, we thus explored whether the polarity of the first episode can predict the predominant polarity in BD. METHODS: We included subjects with BD consecutively referred to two acute inpatient units in the Milan metropolitan area from May 2020 to January 2024. Following Barcelona criteria, a manic (mPP) and a depressive (dPP) predominant polarity were defined as having a ratio ≥ 2:1 of past manic/hypomanic or depressive episodes, respectively. The relationship between first episode polarity and either mPP or dPP was examined using multivariable logistic regression models. A path analysis was then performed to jointly test the associations between putative variables and the predominant polarity. RESULTS: This study included 128 participants. Regression models estimated an association between a manic onset and a mPP (β = 3.23, p < 0.001) as well as between a depressive onset and a dPP (β = 3.65, p < 0.001). Participants with a mPP showed a lower age at onset (β = - 0.13, p = 0.004), while subjects diagnosed with BD type I were less likely to show a dPP (β = - 2.09, p = 0.024). The path analysis highlighted an association between earlier onset and the likelihood of a first episode of manic polarity (coeff. = - 1.39, p = 0.021). A manic onset was associated with a higher likelihood of mPP (coeff. = 3.46, p < 0.001) and a lower likelihood of dPP (coeff. = - 3.71, p < 0.001). Consistently, participants with a manic onset were more likely to experience a lower number of depressive episodes (coeff. = - 1.36, p < 0.001). Finally, cannabis use disorder was associated with a lower number of depressive episodes (coeff. = - 0.57, p = 0.011). CONCLUSIONS: These results provide important insights into the likely predictive value of first episode polarity in relation to the predominant polarity in BD. Though future studies validating these findings are needed, the polarity at onset may serve as an early marker for illness trajectory.
Preconception paternal mental health history as predictor of antenatal depression in pregnant women.
Orsolini L, Yılmaz-Karaman IG, Bottaro M … +3 more , Bellagamba S, Francesconi G, Volpe U
Ann Gen Psychiatry · 2025 Mar · PMID 40119441 · Full text
BACKGROUND: Depression occurring during the perinatal period (PND) could affect both future mother and father. PND may lead to several adverse physical and mental health outcomes for the whole family. Several psychopatho...
BACKGROUND: Depression occurring during the perinatal period (PND) could affect both future mother and father. PND may lead to several adverse physical and mental health outcomes for the whole family. Several psychopathological determinants have been identified, even though few studies investigated the role of paternal mental health in the onset of maternal perinatal depression (MPND). Hence, a retrospective cohort study was carried out in order to investigate the relationship between paternal mental health and the occurrence of antenatal maternal depression as well as identifying potential sociodemographic, clinical and obstetrical predictors in the development of MPND. METHODS: All pregnant women afferent to the Perinatal Mental Health Outpatient Service of the Unit of Clinical Psychiatry at the University Hospital of Marche, Polytechnic University of Marche, Ancona, Italy, between April 2021 to February 2022, were consecutively recruited and longitudinally screened for antenatal depression. The sample was divided in two groups, based on the screening by using the Edinburgh Postpartum Depression Scale (EPDS) for PND. A stepwise binary logistic regression analysis was performed in order to evaluate the predictors associated with the presence of antenatal depression (vs. the absence of antenatal depression). RESULTS: A total of 106 participants among all 460 screened from April 2021 to February 2022, were retrospectively included. In our sample, a prevalence of 13.2% in antenatal depression was found. The binary logistic regression model showed that the higher maternal age (OR = 1.320; p = 0.005), gestational comorbidity (OR = 10.931; p = 0.010), pregnant women's (OR = 19.001; p = 0,001) and their partner's positive history (OR = 16.536; p = 0.004) for mental disorder significantly predicted the presence of antenatal depression in our sample. CONCLUSIONS: Our study suggests the need to investigate the pre-existing psychopathology of the pregnant woman's partner as a potential risk factor for MPND, particularly for antenatal depression. Overall, a better understanding and investigation of all potential risk and/or protective factors for the onset and/or maintenance and/or worsening of MPND could help clinicians in early identifying treatment strategies to improve maternal mental health as well as future father's mental health.
Insights on the cognitive enhancement effect of desvenlafaxine in major depressive disorder.
Vicent-Gil M, Trujols J, Sagués T … +6 more , Serra-Blasco M, Navarra-Ventura G, Mantellini CL, Crivillés S, Portella MJ, Cardoner N
Ann Gen Psychiatry · 2025 Mar · PMID 40108685 · Full text
BACKGROUND: Desvenlafaxine, a serotonin-norepinephrine reuptake inhibitor, has demonstrated efficacy in improving affective symptoms of Major Depressive Disorder (MDD); however, its effects on associated cognitive and fu...
BACKGROUND: Desvenlafaxine, a serotonin-norepinephrine reuptake inhibitor, has demonstrated efficacy in improving affective symptoms of Major Depressive Disorder (MDD); however, its effects on associated cognitive and functional difficulties remain underexplored. This study seeks to assess the antidepressant effects of desvenlafaxine in patients with SSRI-resistant MDD, its impact on both objective and subjective cognitive performance, where cognitive improvements occur independently of clinical recovery or not, and its influence on psychosocial functioning. METHODS: An observational case-control prospective study with 66 participants was conducted, including 26 patients with a current MDD episode, with an inadequate SSRI response, and with the prescription of desvenlafaxine as the next antidepressant therapeutic option, and 40 healthy controls. Sociodemographic, clinical, cognitive, and functional assessments were conducted both before and after a 12-week treatment period. Changes were analyzed using two tailed paired-samples t-tests, with Cohen's d for effect sizes. Cognitive improvements were compared between the patients who achieved remission and those who did not. RESULTS: Patients showed significant improvements in depressive and anxiety symptoms, attention/working memory and processing speed, self-perceived cognitive difficulties and psychosocial functioning. Highlighting the fact these cognitive enhancements occurred independently of patients' clinical improvement. CONCLUSIONS: The findings of this study focus on the therapeutic potential of desvenlafaxine, demonstrating its efficacy not only in ameliorating clinical and functional symptoms but also in addressing specific cognitive impairments in patients with depression. Further research is needed to elucidate the mechanisms underlying desvenlafaxine's effects and optimize treatment strategies for individuals with MDD. TRIAL REGISTRATION NUMBER: NCT03432221 (clinical. TRIALS: gov). Registration date: 08-01-2018.
Clinical manifestations of children and adolescents with anxiety disorders with and without specific learning disorders.
Lazzaro G, Bellantoni D, Varuzza C … +3 more , Vicari S, Menghini D, Pontillo M
Ann Gen Psychiatry · 2025 Mar · PMID 40108641 · Full text
BACKGROUND: Anxiety disorders (ADs) are common among children and adolescents and frequently co-occur with specific learning disorder (SLD). Approximately 20% of children with SLD meet criteria for ADs, while those with...
BACKGROUND: Anxiety disorders (ADs) are common among children and adolescents and frequently co-occur with specific learning disorder (SLD). Approximately 20% of children with SLD meet criteria for ADs, while those with anxiety are six times more likely to have a premorbid SLD. The strong relationship between premorbid SLD and ADs underscores the importance of examining developmental trajectories and manifestations of neuropsychiatric conditions like ADs, particularly when SLD is present. In this context, this study investigates the clinical profiles of children and adolescents with a first diagnosis of an AD and a history of SLD compared to those with a first diagnosis of an AD without a history of SLD. The analysis focuses on various clinical characteristics, including developmental history, demographic aspects, age of anxiety onset, global functioning, types of ADs, self-report anxiety and depressive symptoms, and adaptive behavior. Additionally, the study aims to explore the relationship between anxiety symptoms and depressive symptoms, adaptive behavior, and age. METHODS: We conducted a cross-sectional, retrospective study with 78 participants from the Child and Adolescent Neuropsychiatry Unit, divided into two groups: those with ADs alone (Group AD, n = 42) and those with both ADs and premorbid SLD (Group AD + SLD, n = 36). We collected data on developmental history, demographic information, age of anxiety onset, global functioning, anxiety and depressive symptoms, and adaptive behavior. RESULTS: Our findings revealed that Group AD experienced more stressful life events and had higher cognitive levels, whereas Group AD + SLD showed a greater impairment in global functioning. Notably, Group AD exhibited lower social adaptive behavior and higher self-reported anxiety and depressive symptoms than Group AD + SLD, possibly indicating a greater awareness of their emotional distress. CONCLUSIONS: These findings highlight the impact of premorbid neurodevelopmental disorders into clinical manifestations of psychopathological symptoms. In particular, results underline the importance of developing tailored clinical interventions for children with co-occurring ADs and learning difficulties, focusing more on their emotional awareness to better address the unique challenges posed by the comorbidity.
Can dextromethorphan-bupropion reduce mental pain in depressed individuals? A generating hypothesis overview perspective.
Pompili M, Berardelli I, Erbuto D … +1 more , Caraci F
Ann Gen Psychiatry · 2025 Mar · PMID 40098206 · Full text
Globally, major depressive disorder, or MDD, is a leading cause of disability. It negatively impacts social interactions and significantly limits daily functioning, ultimately reducing life satisfaction. The prevalence r...
Globally, major depressive disorder, or MDD, is a leading cause of disability. It negatively impacts social interactions and significantly limits daily functioning, ultimately reducing life satisfaction. The prevalence rate is about twice as high in women as in males. It is believed that the genesis of major depressive disorder is complicated and includes biological, genetic, environmental, and psychological factors. Mental pain, although distinguishable, constitutes a crucial framework in major depressive disorder (MDD) as the pair may precipitate suicide risk. Mental pain, as conceptualized in Panksepp's emotional theory, is especially relevant when considering the key role of the opioid system, which can influence feelings tied to grief and separation. There has been a renewed interest in targeting the opioid system for antidepressant treatment in MDD and to soothe mental pain. Antidepressant drugs endowed with partial mu-opioid receptor (MOR) agonism and kappa-opioid receptor (KOR) antagonism might represent novel pharmacological tools to address unmet needs in MDD patients. The combination of dextromethorphan and bupropion is a well-tolerated, rapid-acting treatment option for adults affected by MDD. We hypothesized that dextromethorphan-bupropion could impact the reduction of mental pain in MDD patients by targeting the opioid system, as supported by Panksepp's theory. The combination of dextromethorphan with bupropion might deal with various aspects of mental pain, possibly improving treatment results.
Altered resting-state network connectivity in internet gaming disorder.
Gao G, Rong B, Huang J … +6 more , Zhou M, Zhao H, Tu N, Bu L, Xiao L, Wang G
Ann Gen Psychiatry · 2025 Mar · PMID 40098002 · Full text
BACKGROUND: The growing popularity of internet gaming among adolescents and young adults has driven an increase in both casual and excessive gaming behavior. Nevertheless, it remains unclear how progressive increases in...
BACKGROUND: The growing popularity of internet gaming among adolescents and young adults has driven an increase in both casual and excessive gaming behavior. Nevertheless, it remains unclear how progressive increases in internet gaming engagement led to changes within and between brain networks. This study aims to investigate these connectivity alterations across varying levels of gaming involvement. METHODS: In this cross-sectional study, 231 participants were recruited and classified into three groups according to Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for Internet Gaming Disorder (IGD): IGD group, highly engaged gaming(HEG) group, and lowly engaged gaming (LEG) group. Resting-state fMRI data from 217 participants (143 males, 74 females) were included in the final analysis. Independent component analysis was used to examine differences in intra- and inter-network functional connectivity (FC)across the three groups. RESULTS: No significant differences were found in intra-network FC across the three groups. However, significant inter-network differences between the dorsal attention network(dAN)and the visual network (VN) among the three groups were observed. The HEG group exhibited significantly higher dAN-VN functional network connectivity (FNC) compared to the LEG group. Linear correlation analyses showed no significant correlation between the dAN-VN FNC values and IGD-20T scores. CONCLUSION: Throughout the development of IGD, increasing levels of engagement are associated with a rise and subsequent decline in FNC of DAN-VN. This pattern may reflect top-down attentional regulation in the early stages of addiction, followed by attentional bias as addiction progresses.
Physical illness in schizophrenia and the role of tolerability in antipsychotic selection: an expert consensus with a focus on cariprazine.
Cuomo A, Forleo GB, Ghodhbane T … +9 more , Johnsen J, Montejo AL, Oliveira CV, Pillinger T, Ramos-Quiroga JA, Samara M, Seerden PHB, Thomas Stoeckl T, Fagiolini A
Ann Gen Psychiatry · 2025 Mar · PMID 40075512 · Full text
BACKGROUND: Schizophrenia is a highly heterogeneous disease, and a high percentage of patients are at high risk of developing somatic comorbidities, which must be taken into account in disease management and treatment se...
BACKGROUND: Schizophrenia is a highly heterogeneous disease, and a high percentage of patients are at high risk of developing somatic comorbidities, which must be taken into account in disease management and treatment selection. MAIN BODY: Antipsychotics are often associated with side effects that worsen the somatic comorbidities. Among the different options, cariprazine is generally safe and usually well tolerated in both acute and long-term treatment and is often a good choice when balancing clinical benefits and side effects. Given the lack of consensus on the priority of symptoms to treat and the reasons for switching therapy based on the balance between side effects and symptom resolution, twelve psychiatrists met for an expert meeting to discuss the most common and worrisome antipsychotic side effects leading to switching, the most important somatic comorbidities, and the best way to address specific symptoms in both the acute and maintenance phases of treatment in schizophrenia. Special attention was given to metabolic comorbidities, sexual dysfunction, and cardiovascular disease. This paper aims to examine the relationship between schizophrenia and specific somatic comorbidities, to discuss how the balance between efficacy and tolerability influences treatment choice in the acute and maintenance treatment of schizophrenia, and how these two variables may have different priorities at different stages of treatment. CONCLUSION: The choice of treatment is based primarily on efficacy and tolerability. Cariprazine is beneficial in patients with positive and negative symptoms, and it has a side-effect profile with low rates of metabolic side effects, sedation, and sexual dysfunction.
A multicenter cross-sectional study of gambling disorder among patients with methamphetamine use disorder in drug rehabilitation centers: prevalence, correlates, and network analysis.
Peng P, Hao Y, Zhang X … +12 more , Ma Y, Liu X, Shen D, Shen W, Zhao B, Li D, Beck SE, Nunez YZ, Potenza MN, Gelernter J, Liu T, Yang BZ
Ann Gen Psychiatry · 2025 Mar · PMID 40033412 · Full text
BACKGROUND: This study sought to investigate the prevalence, correlates, and network structure of the manifested symptoms in gambling disorder (GD) among methamphetamine (MA) use disorder (MUD) patients in China. METHODS...
BACKGROUND: This study sought to investigate the prevalence, correlates, and network structure of the manifested symptoms in gambling disorder (GD) among methamphetamine (MA) use disorder (MUD) patients in China. METHODS: We interviewed 1069 patients using the Semi-Structured Assessment for Drug Dependence and Alcoholism (SSADDA), Chinese version. Besides MA and other substance use disorders, GD was also ascertained by SSADDA. Other psychiatric diagnoses were ascertained, including major depressive episodes (MDEs), antisocial personality disorder, suicide and self-harm, and environmental factors, including childhood experiences. RESULTS: Of 1069 participants, 711 met the DSM-5 diagnostic criteria for MUD. Among the 711 participants with MUD, 52.3% met DSM-5 diagnostic criteria for GD. We found that alcohol use together with MA, childhood violent experiences, MDEs, severe MUD, and gambling duration significantly differed between MUD participants with and without GD. In the GD-MUD network, the central symptoms were gambling preoccupation (GD1), giving up important activities (MUD6), financial trouble (GD9), and MA tolerance (MUD5). MA tolerance (MUD5) also served as a bridge symptom across the network, exhibiting substantial associations with gambling preoccupation (GD1). CONCLUSION: GD is prevalent among individuals in treatment for MUD in China. Network analysis suggests that gambling preoccupation and MA tolerance represent central features, and that MA tolerance serves as a bridge across GD and MUD.
Genetic overlap between schizophrenia and constipation: insights from a genome-wide association study in a European population.
Luo Q, An M, Wu Y … +4 more , Wang J, Mao Y, Zhang L, Wang C
Ann Gen Psychiatry · 2025 Mar · PMID 40033405 · Full text
BACKGROUND: Patients with schizophrenia (SCZ) experience constipation at significantly higher rates compared with the general population. This relationship suggests a potential genetic overlap between these two condition...
BACKGROUND: Patients with schizophrenia (SCZ) experience constipation at significantly higher rates compared with the general population. This relationship suggests a potential genetic overlap between these two conditions. METHODS: We analyzed genome-wide association study (GWAS) data for both SCZ and constipation using a five-part approach. The first and second parts assessed the overall and local genetic correlations using methods such as linkage disequilibrium score regression (LDSC) and heritability estimation from summary statistics (HESS). The third part investigated the causal association between the two traits using Mendelian randomization (MR). The fourth part employed conditional/conjunctional false discovery rate (cond/conjFDR) to analyze the genetic overlap with different traits based on the statistical theory. Finally, an LDSC-specifically expressed gene (LDSC-SEG) analysis was conducted to explore the tissue-level associations. RESULTS: Our analyses revealed both overall and specific genetic correlations between SCZ and constipation at the genomic level. The MR analysis suggests a positive causal relationship between SCZ and constipation. The ConjFDR analysis confirms the genetic overlap between the two conditions and identifies two genetic risk loci (rs7583622 and rs842766) and seven mapped genes (GPR75-ASB3, ASB3, CHAC2, ERLEC1, GPR75, PSME4, and ACYP2). Further investigation into the functions of these genes could provide valuable insights. Interestingly, disease-related tissue analysis revealed associations between SCZ and constipation in eight brain regions (substantia nigra, anterior cingulate cortex, hypothalamus, cortex, hippocampus, cortex, amygdala, and spinal cord). CONCLUSION: This study provides the first genetic evidence for the comorbidity of SCZ and constipation, enhancing our understanding of the pathophysiology of both conditions.
Efficacy of atypical antipsychotics in schizophrenia patients: effects of 5-HTR SNPs.
Liu K, Zhang B, Chen Z … +6 more , Chen F, Li Z, Gao Y, Zhao Y, Liu Y, Wang Y
Ann Gen Psychiatry · 2025 Feb · PMID 39966797 · Full text
The 5-hydroxytryptamine receptor (5-HTR) is a key protein responsible for the effects of 5-hydroxytryptamine (5-HT) and an important target for many antipsychotics. 5-HTR has a high degree of genetic polymorphism, and at...
The 5-hydroxytryptamine receptor (5-HTR) is a key protein responsible for the effects of 5-hydroxytryptamine (5-HT) and an important target for many antipsychotics. 5-HTR has a high degree of genetic polymorphism, and atypical antipsychotics are 5-HTR antagonists widely used in treating schizophrenia. With the increasing development of medical technology, antipsychotics are being updated rapidly, and their efficacy and safety are being optimised. However, owing to the complexity of patients' genetic polymorphisms and psychiatric disorders, there are still individual differences in clinical efficacy. This article reviews the typing of 5-HTR, a common target of clinical atypical antipsychotics, and the effects of 5-HTR gene single nucleotide polymorphisms (SNPs) on the efficacy of atypical antipsychotics. Specific genotypes of six types of 5-HTR genes are associated with differential responses to atypical antipsychotics, which may help guide the development of individualized clinical treatments for patients with schizophrenia.
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