Clinical Psychopharmacology and Neuroscience最新文献

{"title":"Comparisons of Virtual Reality-based vs. Conventional Biofeedback for Panic Symptoms: A Randomized Controlled Study.","authors":"Jesung Chun, Yaehee Cho, Dong Jun Kim, Min-Ji Kim, Hyewon Kim, Hong Jin Jeon","doi":"10.9758/cpn.25.1373","DOIUrl":"10.9758/cpn.25.1373","url":null,"abstract":"<p><strong>Objective: </strong>Virtual reality (VR)-based biofeedback (BF) is being studied as a new type of treatment in the field of psychiatry. We explored the potential of VR-based BF on panic symptoms.</p><p><strong>Methods: </strong>Participants who scored ≥ 10 on Patient Health Questionnaire-9 or ≥ 9 on Panic Disorder Severity Scale (PDSS) were grouped as participants with depressive or anxiety symptoms (DAS), and were randomly distributed into two intervention groups: the VR-based BF (DAS/VR group) and the conventional BF with a therapist (DAS/BF group). Those who did not meet the criteria were classified as the healthy control group and received the VR-based BF intervention (VR group). The interventions were administered three times over the course of one month. A total of 116 participants were analyzed.</p><p><strong>Results: </strong>The DAS/VR group and DAS/BF group showed a significant decrease in PDSS, indicating that both VR-based BF and conventional BF significantly decreased panic symptoms in individuals with DAS. The mean reduction of PDSS total score for the DAS/VR group was 1.51 (standard deviation [SD] = 2.28), and for the DAS/BF group it was 1.11 (SD = 2.31). However, agoraphobic fear and avoidance (<i>p</i> = 0.003), panic and limited symptoms attacks (<i>p</i> = 0.002), and interference of panic on social activities (<i>p</i> = 0.008) showed a significant decrease only in the VR-based BF but not in conventional BF between baseline and 4 weeks of treatment. Both therapies showed improvement in severity of panic attacks and interference of panic on work.</p><p><strong>Conclusion: </strong>VR-based BF was effective in decreasing panic symptoms. Notably, it showed a significant reduction in agoraphobic fear and avoidance, whereas conventional BF did not.</p>","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"24 3","pages":"537-546"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618478","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":"Factors Associated with Treatment Dropout in Patients with Mood Disorders.","authors":"Hwagyu Suh, Eunsoo Moon, Hyunju Lim, Kyungwon Kim, Young-Min Lee, Byung-Dae Lee","doi":"10.9758/cpn.26.1458","DOIUrl":"10.9758/cpn.26.1458","url":null,"abstract":"<p><strong>Objective: </strong>Treatment dropout is common among patients with mood disorders and adversely affects long-term outcomes. This study investigated clinical and psychological factors associated with dropout, with a particular focus on stress coping strategies.</p><p><strong>Methods: </strong>This retrospective cohort study included 321 patients with mood disorders who completed diagnostic evaluations and psychological assessments at a specialized mood disorder clinic between April 2010 and March 2021. Treatment dropout was defined as failure to attend scheduled outpatient appointments for more than 30 days without consultation, combined with no outpatient visit for at least 90 days.</p><p><strong>Results: </strong>Kaplan-Meier analyses showed significant differences in treatment retention according to diagnostic category. In univariate Cox analyses, younger age, diagnostic category, emotion-oriented coping, and pleasure-seeking activities were associated with dropout. In the clinically informed multivariable Cox model, younger age remained significantly associated with a higher hazard of dropout (hazard ratio = 0.987, 95% confidence interval = 0.976-0.999, <i>p</i> = 0.034). Diagnostic category was also significantly associated with dropout (Wald χ² = 25.433, df = 4, <i>p</i> < 0.001). Compared with bipolar I disorder, bipolar II disorder, other specified bipolar and related disorder, major depressive disorder, and other depressive disorders showed significantly higher hazards of dropout. Emotion-oriented coping and pleasure-seeking activities were no longer significant after adjustment.</p><p><strong>Conclusion: </strong>Diagnostic category and younger age were the most robust factors associated with treatment dropout. Coping variables showed exploratory associations in univariate analyses, but these associations were attenuated after adjustment for demographic and clinical factors.</p>","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"24 3","pages":"641-649"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618651","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":"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":3.4,"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":"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":"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":3.4,"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":"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":"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":3.4,"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":"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":"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":3.4,"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":"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":3.4,"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":"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":"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":3.4,"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":"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":"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":3.4,"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":"Psychosis in a 47,XXX Adolescent: Clinical Management and Multidisciplinary Follow-up.","authors":"Anaëlle Bain, Stéphanie Bioulac, Florence Amblard, Isabelle Marey, Clément Dondé","doi":"10.9758/cpn.25.1375","DOIUrl":"10.9758/cpn.25.1375","url":null,"abstract":"<p><p>Triple X (47,XXX) syndrome is a sex chromosome aneuploidy associated with learning disabilities, attentional deficits, and social impairments. Its psychiatric manifestations, particularly psychosis, remain underrecognized. This case report describes a 13-year-old girl with 47,XXX syndrome who developed two recurrent psychotic episodes during adolescence and ultimately achieved sustained remission under clozapine, illustrating the need for individualized, genetically informed care. The patient initially presented with persecutory delusions, auditory hallucinations, behavioral changes, and functional decline. Comprehensive neurological, neuropsychological, and audiological assessments showed average overall cognitive functioning and no syndrome-specific sensory abnormalities. Psychotic symptoms emerged years after methylphenidate initiation and persisted during medication-free periods, arguing against stimulant-induced psychosis. Following partial response and poor tolerability to risperidone and aripiprazole, clozapine was introduced using a \"start low, go slow\" strategy. Low-dose clozapine (150 mg/day) produced complete remission within two months without hematological or cardiovascular adverse effects. Preventive metformin successfully mitigated antipsychotic-associated weight gain. A coordinated multidisciplinary follow-up integrating psychiatry, general medicine, neuropsychology, genetics, and school-based interventions proved essential to maintaining stability, supporting adherence, and promoting academic and social functioning. At one-year follow-up, the patient remained asymptomatic with improved daily functioning. This case reinforces emerging evidence that women with 47,XXX syndrome have an elevated lifetime risk of psychosis and may require tailored antipsychotic strategies due to syndrome-associated comorbidities. It highlights clozapine's potential effectiveness at low doses in genetically vulnerable adolescents, the value of preventive metabolic management, and the importance of integrating psychoeducational and environmental supports. More systematic data are needed to guide evidence-based management of psychosis in sex chromosome aneuploidies.</p>","PeriodicalId":10420,"journal":{"name":"Clinical Psychopharmacology and Neuroscience","volume":"24 2","pages":"425-428"},"PeriodicalIF":3.4,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764454","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}