Clinical Psychopharmacology and Neuroscience最新文献

{"title":"Guanfacine as a Treatment Option for Persistent Mental Restlessness and Deliberate Self-harm Thoughts in a Patient with Attention-deficit/Hyperactivity Disorder, Autism Spectrum Disorder, Borderline Personality Disorder, and Post-traumatic Stress Disorder: Case Report.","authors":"Jun-Ting Yeung, Phoebe Wan, Wai Chen","doi":"10.9758/cpn.25.1352","DOIUrl":"https://doi.org/10.9758/cpn.25.1352","url":null,"abstract":"<p><p>Deliberate self-harm (DSH) in adolescents presents a significant clinical challenge, particularly when compounded by comorbidities such as attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), borderline personality disorder (BPD), and post-traumatic stress disorder (PTSD). We describe a case of a 16-year-old transgender Māori male with ADHD, ASD traits, BPD, and PTSD, who presented with persistent mental restlessness experienced as intrusive DSH ideation. He had limited benefit and intolerable side effects with atomoxetine but responded to guanfacine modified-release. Guanfacine modified-release (1 mg nocte) treatment coincided with a marked reduction in mental restlessness and intrusive DSH ideation. During the follow-up period, there was a decrease in acute healthcare utilisation. Then the patient self-ceased guanfacine, coinciding with a return of DSH ideation and behaviours. We hypothesise that the ADHD-related mental restlessness was associated with intrusive DSH ideation; amelioration of mental restlessness and self-harm ideation by guanfacine can be interpreted as the 'dechallenge' phase of a 'challenge-dechallenge' natural experiment. This case provides novel evidence for the potential therapeutic role of guanfacine in mitigating persistent self-harm thoughts, via modulation of mental restlessness and impulsivity. Our observation provides preliminary evidence of the potential benefit of guanfacine in treating DSH, in the context of patients with co-occurring cognitive rigidity, trauma exposure, and emotional dysregulation. This case aligns with emerging evidence for the efficacy of guanfacine for ASD and trauma-related disorders, but is the first - in the existing literature - for ADHD and trauma history in an adolescent with BPD and transgender intersectionality.</p>","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"24 2","pages":"419-424"},"PeriodicalIF":2.7,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clozapine-induced Myocarditis in Korea: Analysis of a Nationwide Database and Comparison to Other Countries.","authors":"Jeonghoon Lee, Hyunsu Jeong, Jung Su Park, Nuree Kang, Jae Hoon Jeong, Se Hyun Kim","doi":"10.9758/cpn.25.1356","DOIUrl":"https://doi.org/10.9758/cpn.25.1356","url":null,"abstract":"<p><strong>Objective: </strong>Clozapine, though the mainstay treatment for treatment-resistant schizophrenia, is associated with potentially fatal adverse reactions, including myocarditis. The incidence of clozapine-induced myocarditis (CIM) demonstrates geographic and ethnic variability; however, reports from Asia remain scarce. This study aimed to provide a comprehensive overview of CIM in Korea and compare findings with reports from other countries.</p><p><strong>Methods: </strong>CIM cases were identified from Korean National Health Insurance Service (NHIS) database based on diagnostic codes, prescription timelines, and clinical details. Patient characteristics and concomitant medications were analyzed. A PubMed search using a validated query was conducted to compare CIM in Korea with those reported in other regions.</p><p><strong>Results: </strong>From the NHIS database of 36,286 patients with schizophrenia spectrum disorders who were prescribed clozapine, 29 patients (0.08%) received myocarditis diagnosis. Among them, 9 patients (0.02%) who discontinued clozapine after the diagnosis could be considered probable CIM. Among these probable CIM cases, 4 male patients (0.01%) developed myocarditis within 30 days of clozapine initiation, while 5 patients developed myocarditis during the maintenance period. Two patients were found to have died from CIM. The literature review yielded 38 relevant articles on CIM incidence, including 4 from Asia, 4 from Europe, 3 from the Americas, 16 from Australia, and 4 from New Zealand. A comparison between countries demonstrated a lower incidence of CIM in Korea.</p><p><strong>Conclusion: </strong>Consistent with the previous report, the incidence of CIM in Korea was less than 0.1%, which is lower than the incidences in other countries.</p>","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"24 2","pages":"308-319"},"PeriodicalIF":2.7,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurophysiological Effects of a Digital Therapeutic for Attention-deficit/Hyperactivity Disorder: A Quantitative Electroencephalography Analysis of Theta-Gamma Coupling.","authors":"Seungheon Yang, Jun Won Kim, Sejeong Lee, Jaehyung Kwon","doi":"10.9758/cpn.25.1359","DOIUrl":"https://doi.org/10.9758/cpn.25.1359","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the neurophysiological effects of ADAM-101, a game-based digital therapeutic, in children with attention-deficit/hyperactivity disorder (ADHD) using quantitative electroencephalography (qEEG). We focused on theta-gamma coupling (TGC), a neural synchrony marker linked to attentional control and executive function.</p><p><strong>Methods: </strong>Eighteen children with ADHD were randomized to an intervention group (n = 9; pharmacotherapy + ADAM-101) or a control group (n = 9; pharmacotherapy only). qEEG was recorded at baseline and after 4 weeks. TGC in the prefrontal cortex was quantified using the synchronization index method with gamma frequencies subdivided into 3-Hz bins between 30 and 51 Hz.</p><p><strong>Results: </strong>The intervention group showed increased prefrontal TGC following the 4-week program, while the control group demonstrated decreases. These findings suggest that gamified cognitive training via ADAM-101 may enhance cross-frequency coupling mechanisms underlying attention and cognitive regulation.</p><p><strong>Conclusion: </strong>ADAM-101, when combined with pharmacotherapy, improved neural synchrony in pediatric ADHD, as evidenced by increased prefrontal TGC. This exploratory trial supports the potential of digital therapeutics as adjunctive interventions targeting neurophysiological mechanisms of attentional control. Larger studies are needed to validate these preliminary results.</p>","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"24 2","pages":"344-352"},"PeriodicalIF":2.7,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic-induced Microbiome Depletion Selectively Reduces Baseline Hypothalamic Oxytocin Signaling without Affecting MDMA-induced Oxytocin Response in Rats.","authors":"Yong Yue, Yi Cai, Rumi Murayama, Xin Ding, Xiayun Wan, Guilin Liu, Hirofumi Hashimoto, Naohiko Anzai, Kenji Hashimoto","doi":"10.9758/cpn.25.1381","DOIUrl":"https://doi.org/10.9758/cpn.25.1381","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether antibiotic-induced microbiome depletion influences baseline or 3,4-methylenedioxymethamphetamine (MDMA)-induced oxytocin signaling in rats.</p><p><strong>Methods: </strong>Male Wistar rats received broad-spectrum antibiotics (ABX) or water for 7 days, followed by a single oral administration of MDMA (30 mg/kg). Plasma oxytocin levels were measured by ELISA, and oxytocin-immunoreactivity in the paraventricular (PVN) and supraoptic (SON) nuclei were quantified by immunofluorescence.</p><p><strong>Results: </strong>ABX treatment induced marked cecal enlargement without affecting body weight, confirming microbiome disruption while maintaining systemic stability. Peripheral oxytocin concentrations were unchanged; however, baseline central oxytocin expression in both the PVN and SON was significantly reduced after ABX treatment. MDMA increased central oxytocin expression, and this response was not significantly altered by microbiome depletion. Similarly, MDMA-induced peripheral oxytocin levels did not differ between control and ABX-treated rats.</p><p><strong>Conclusion: </strong>Antibiotic-induced microbiome depletion selectively attenuates baseline central oxytocin signaling while leaving peripheral oxytocin regulation intact. In contrast, MDMA-induced oxytocin responses in both the brain and circulation are preserved despite microbiome disruption. These findings suggest that gut microbiota contribute to central oxytocin homeostasis under basal conditions but are not essential for acute MDMA-induced oxytocin activation.</p>","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"24 2","pages":"402-407"},"PeriodicalIF":2.7,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Individualized Psychological Intervention Using Virtual Reality-assisted Decision System Reduces Decisional Conflict in Patients with Pulmonary Nodules: A Randomized Controlled Trial.","authors":"Yuhang Hu, Qiong Wu, Xidong Jin, Hao Meng, Shumin Wang, Dazhi Liu","doi":"10.9758/cpn.25.1367","DOIUrl":"https://doi.org/10.9758/cpn.25.1367","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the impact of early individualized psychological intervention utilizing a virtual reality-assisted decision system (VR-ADS) on preoperative decisional conflict and postoperative recovery quality in patients with pulmonary nodules.</p><p><strong>Methods: </strong>A prospective, single-center, randomized controlled trial enrolled 304 surgical patients with pulmonary nodules (June 2022-June 2024). Patients were randomized into an early intervention group (n = 155) and a conventional intervention group (n = 149). The early intervention group received individualized psychological intervention within 24-48 hours after diagnosis, incorporating decision-making style assessment, VR-ADS, and a decision partner mechanism. The primary endpoint was the Decisional Conflict Scale (DCS) score. Secondary endpoints included Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), EORTC QLQ-C30, postoperative pain, chest tube duration, hospital stay, pulmonary function, and complication rates over a 6-month follow-up.</p><p><strong>Results: </strong>Baseline characteristics were comparable between groups (<i>p</i> > 0.05). The early intervention group showed significantly lower DCS total scores (32.4 ± 12.8 vs. 45.7 ± 15.3, <i>p</i> < 0.001). Intervention timing was the strongest independent predictor of decisional conflict (β = -0.412, <i>p</i> < 0.001). Preoperative HAMA and HAMD scores were significantly lower in the early intervention group (both <i>p</i> < 0.001), with sustained improvement through follow-up. The early intervention group also demonstrated lower postoperative pain scores, shorter chest tube duration (2.8 ± 1.2 vs. 3.6 ± 1.5 days, <i>p</i> = 0.008), fewer hospital days (5.2 ± 1.8 vs. 6.7 ± 2.3 days, <i>p</i> < 0.001), lower complication rates (12.9% vs. 22.6%, <i>p</i> = 0.032), higher decision satisfaction (85.7 ± 12.3 vs. 78.2 ± 15.6, <i>p</i> < 0.001), and lower decision regret rates (8.6% vs. 18.3%, <i>p</i> = 0.014).</p><p><strong>Conclusion: </strong>Early individualized psychological intervention combined with VR-ADS reduces preoperative decisional conflict, improves psychological status, promotes postoperative recovery, and enhances quality of life in patients with pulmonary nodules.</p>","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"24 2","pages":"389-401"},"PeriodicalIF":2.7,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Transcranial Alternating Current Stimulation Compared to Transcranial Direct Current Stimulation in the Treatment of Psychiatric & Neurological Disorders: A Systematic Review of Head-to-head Trials.","authors":"Priyavarshini Boopathy, Harsh Pathak, Rujuta Parlikar, Vanteemar S Sreeraj, Vijay Kumar, Biswa Ranjan Mishra, Ganesan Venkatasubramanian","doi":"10.9758/cpn.25.1363","DOIUrl":"10.9758/cpn.25.1363","url":null,"abstract":"<p><p>Transcranial direct and alternating current simulations (tDCS and tACS) are non-invasive neuromodulators with emerging evidence in neuropsychiatric disorders. This review compares their efficacy and tolerability in head-on trials. Following PRISMA guidelines, 955 studies were identified from Scopus, MEDLINE, and trial registries. After screening and reviewing abstracts and full texts by 2 independent authors, 11 studies comparing tACS and tDCS in neuropsychiatric disorders were included. Four studies in schizophrenia, 1 each in depression, mild cognitive impairment (MCI), and ataxia; 2 in tinnitus and epilepsy. Sessions ranged from 1-10 delivering 1-2 mA, with most sessions lasting 20 minutes. tACS frequency varied from delta to high gamma, and were symptom specific. In psychiatric disorders, alpha-tACS was associated with improvements in auditory hallucinations, whereas tDCS showed relatively greater cognitive benefits. However, delta-high-definition-tACS was linked to improvements in cognitive deficits and general psychopathology, while theta-tACS fared better in depression. In neurological disorders, gamma-tACS was associated with improvement in MCI and epilepsy. In contrast, bifrontal-tDCS was associated with improvement in tinnitus, while cerebellar-tDCS significantly outperformed gamma-tACS in neurodegenerative ataxia. Most studies had some or major risk of bias. This review suggests both tACS and tDCS are safe and promising but vary in effectiveness across disorders. Different parameter spaces of these two techniques, especially the montage and stimulation frequency, would drive the outcomes. In view of single-session protocols, especially in neurological disorders, we need larger, replicable and rigorously designed studies to confirm differential superiority and guide clinical utility.</p>","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"24 2","pages":"207-225"},"PeriodicalIF":2.7,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Long-acting Injectable Antipsychotic Drugs in the Elderly: A Retrospective Study.","authors":"Ayşe Nur İnci Kenar, Selin Balki Tekin","doi":"10.9758/cpn.25.1320","DOIUrl":"https://doi.org/10.9758/cpn.25.1320","url":null,"abstract":"<p><strong>Objective: </strong>Despite the increasing use of long-acting injectable antipsychotics (LAIA) in the elderly population, there is still a lack of studies. This study aims to assess the treatment safety and tolerability of LAIAs in elderly patients.</p><p><strong>Methods: </strong>This retrospective study was conducted with patients over 60 years of age who were treated in the psychiatry clinic of a university hospital between 2014 and 2024 and underwent LAIA. Sociodemographic data, diagnoses, LAIA medications and side effects were obtained by accessing hospital records.</p><p><strong>Results: </strong>A total of 186 patients with a mean age of 70.20 (± 5.20) years were included in the study. The majority of patients were diagnosed with schizophrenia (53.2%), bipolar disorder (23.7%), and schizoaffective disorder (20.4%). The most commonly prescribed LAIA was paliperidone palmitate once-monthly 100 mg, with 19.9% of the patients. The most frequently used oral antipsychotic in combination with LAIA was olanzapine, used in 64 (34.2%) cases. No significant adverse effects related to the use of long-acting injectable drugs were observed.</p><p><strong>Conclusion: </strong>The utilisation of LAIAs in elderly patients appears to be both tolerable and safe. It can be considered for elderly patients suffering from chronic mental illness who are non-compliant with treatment.</p>","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"24 2","pages":"277-285"},"PeriodicalIF":2.7,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Naltrexone and Baclofen Combination in Reducing Craving among Patients with Alcohol Dependence: An Open-label Trial.","authors":"Aman Naqvi, Anil Nischal, Amit Singh, Anuradha Nischal","doi":"10.9758/cpn.25.1365","DOIUrl":"https://doi.org/10.9758/cpn.25.1365","url":null,"abstract":"<p><strong>Objective: </strong>Alcohol use disorder is among the most prevalent mental disorders worldwide. Craving, a key feature of alcohol dependence, is also a major reason for relapse. We aimed to determine the efficacy of naltrexone, baclofen, and naltrexone-baclofen combination in reducing craving among patients with alcohol dependence.</p><p><strong>Methods: </strong>In this open-label, randomised trial of eight weeks duration, 97 participants were randomly allocated to three groups, namely naltrexone alone, baclofen alone, and naltrexone-baclofen combination, using a computer-generated random number table. The dosage was 40 to 60 mg/day for baclofen and 50 mg a day for naltrexone. Tools used for assessment included the Obsessive Compulsive Drinking Scale (OCDS), the visual analogue scale (VAS) for craving, World Health Organization Quality of Life BREF (WHOQoL BREF), and World Health Organization Well-being Scale (WHO-5). Mixed design ANOVA was used for analysis.</p><p><strong>Results: </strong>The naltrexone-baclofen combination group had a significantly greater decline in OCDS score as compared to the naltrexone group, but not as compared to the baclofen alone group. Also, there was a greater reduction in VAS, WHOQoL BREF, and WHO-5 score in the naltrexone-baclofen group compared to the other two groups; however, the difference was not significant. No significant differences were found in relapse rates and heavy episodic drinking between groups.</p><p><strong>Conclusion: </strong>The naltrexone-baclofen combination may be better in comparison to naltrexone used alone in reducing craving in alcohol dependence and is well tolerated.</p>","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"24 2","pages":"379-388"},"PeriodicalIF":2.7,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosis Related to Nitrous Oxide Misuse: A Case Series and Systematic Review.","authors":"Laura Garriga-Solé, Germán Ortega-Hernández, Xico Alberto Acosta-Villalobos, Lara Grau-López, Josep Antoni Ramos-Quiroga, Raúl Felipe Palma-Álvarez","doi":"10.9758/cpn.25.1394","DOIUrl":"https://doi.org/10.9758/cpn.25.1394","url":null,"abstract":"<p><p>Nitrous oxide (N₂O) has been linked to several neuropsychiatric complications. This paper aims to systematically review reported cases of psychosis associated with N₂O use. Additionally, five new cases of N₂O-related psychosis are presented. A systematic search was conducted in MedLine for cases of psychosis associated with N₂O use, from database inception to April 2025. The five new cases are thoroughly analyzed, and the Naranjo criteria were applied to assess causality in both the new cases and those identified in the systematic review. A total of 15 articles were included, encompassing 15 patients. Including these and the five newly reported cases, the current manuscript analyzes 20 individuals (17 men and 3 women) aged 20 to 45 years. Most cases reported a history of substance use disorder (mainly alcohol) and escalating N₂O use prior to the psychotic episode. Clinical manifestations included psychotic symptoms (delusions and hallucinations) as well as other psychopathological features. Neurological complications were also commonly described. Laboratory tests showed vitamin B12 abnormalities in some cases. All patients were hospitalized; abstinence from substance use was the first intervention, and most received antipsychotic treatment. N₂O may be associated with psychotic episodes, particularly among young, heavy users with underlying vulnerabilities. Psychiatric and neurological symptoms are frequently observed. Although outcomes vary, treatment involving abstinence, vitamin B12 supplementation, and antipsychotic medication typically leads to improvement. Further research is warranted on this topic.</p>","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"24 2","pages":"252-276"},"PeriodicalIF":2.7,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time-limited Moderating Effect of Neuroticism on the Cortisol-Depression Relationship after Physical Injury.","authors":"Jae-Min Kim, Hee-Ju Kang, Ju-Wan Kim, Hyunseok Jang, Jung-Chul Kim, Byung Jo Chun, Ju-Yeon Lee, Sung-Wan Kim, Il-Seon Shin","doi":"10.9758/cpn.25.1388","DOIUrl":"https://doi.org/10.9758/cpn.25.1388","url":null,"abstract":"<p><strong>Objective: </strong>This study examined whether neuroticism moderates the association between baseline serum cortisol levels and the development of depressive disorder over two years following physical injury.</p><p><strong>Methods: </strong>Adults hospitalized for moderate-to-severe injuries were recruited within one month of trauma and completed baseline assessments of serum cortisol and personality traits. Depressive disorders were evaluated at 3, 6, 12, and 24 months using the Mini-International Neuropsychiatric Interview. Logistic regression models tested the independent and interactive effects of cortisol and neuroticism on depressive disorder at each time point, adjusting for demographic, clinical, and psychosocial covariates. Bonferroni correction was applied for repeated testing across four follow-up assessments.</p><p><strong>Results: </strong>Among 923 participants, 239 (25.9%) developed depressive disorder at least once during follow-up. Neither cortisol nor neuroticism independently predicted depressive disorder; however, their interaction was significant specifically at the 3-month post-injury assessment, indicating that individuals with higher neuroticism and lower cortisol were at increased early risk. Interaction terms at 6 and 12 months did not survive multiple comparison correction. Serum cortisol and neuroticism were modestly and inversely correlated.</p><p><strong>Conclusion: </strong>A time-limited interaction between low cortisol and high neuroticism predicted early depressive disorder after physical injury. These findings highlight a transient window in which personality-dependent modulation of hypothalamic- pituitary-adrenal axis function may confer vulnerability, underscoring the importance of early identification and targeted support for high-risk individuals.</p>","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"24 2","pages":"408-413"},"PeriodicalIF":2.7,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}