CNS Spectrums最新文献

{"title":"Pharmacotherapy for social anxiety disorder: An evidence-based treatment review.","authors":"Jeffrey Robert Strawn, Stephen M Stahl, Azmi Nasser, Andrew J Cutler, Márcio Bernik","doi":"10.1017/S1092852926101254","DOIUrl":"https://doi.org/10.1017/S1092852926101254","url":null,"abstract":"<p><p>Social anxiety disorder (SAD) is a common and often chronic psychiatric illness characterized by persistent fear of social or performance situations and associated functional impairment and avoidance. Although multiple pharmacologic treatments have been studied, questions remain regarding optimal sequencing of therapies, long-term treatment strategies, and the management of partial or treatment-resistant illness. This narrative review synthesizes the evidence for pharmacologic treatments for SAD across medication classes, including antidepressants, benzodiazepines, monoamine oxidase inhibitors, GABA-related agents, second-generation antipsychotics, and emerging interventions. It also examines as-needed (PRN) interventions and steroid-based approaches, deprescribing and proposes a definition of treatment-resistant SAD. Randomized controlled trials, open-label studies, and guideline recommendations were reviewed to provide a framework for pharmacologic decision-making. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) remain the best-supported first-line pharmacotherapies for SAD. Evidence supports switching within or across antidepressant classes and integrating pharmacotherapy with behavioral interventions in patients with incomplete response. Additional treatments, including benzodiazepines, monoamine oxidase inhibitors, pregabalin, and selected augmentation strategies, may be considered for patients with persistent symptoms, although the evidence base is more limited. Data regarding long-term outcomes and treatment-resistant populations remain relatively sparse. While serotonergic antidepressants remain the cornerstone of treatment, optimal management requires individualized sequencing of therapies, integration with behavioral interventions, and consideration of alternative mechanisms in patients with incomplete response. Future studies should prioritize comparative effectiveness, long-term outcomes, and interventions for treatment-resistant SAD.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":"31 1","pages":"e45"},"PeriodicalIF":4.6,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes following five-day accelerated intermittent theta burst stimulation for treatment-resistant depression in routine clinical practice: A prospective naturalistic cohort study.","authors":"Asmi Khanna, Adrian Espiritu, Lynn Zhu, Mervin Blair, Olivia Giovannetti, Amanda Abate, Janice Knight, Luisa Deutsch, Robyn Waxman, Amer M Burhan","doi":"10.1017/S1092852926101205","DOIUrl":"https://doi.org/10.1017/S1092852926101205","url":null,"abstract":"<p><strong>Objectives: </strong>Treatment-resistant depression (TRD) is a debilitating condition occurring in major depressive disorder (MDD) and bipolar II disorder (BP-II). Intermittent theta burst stimulation (iTBS) is an established neuromodulation approach for TRD, but standard delivery requires once-daily sessions over several weeks. Accelerated iTBS (aiTBS) may reduce treatment burden by temporally compressing delivery. We evaluated the implementation, tolerability, and clinical outcomes associated with a 5-day aiTBS schedule for adults experiencing TRD in MDD and BP-II.</p><p><strong>Methods: </strong>In this single-center, open-label, uncontrolled, prospective naturalistic cohort study, adults with MDD or BP-II experiencing TRD received 30 iTBS sessions (600 pulses/session; total 18 000 pulses) over 5 days with 50-minute inter-session intervals. HAMD-17 was assessed at baseline, post-treatment, and 2-month follow-up. Secondary outcomes included Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), baseline Clinical Global Impression-Severity (CGI-S), post-treatment/follow-up CGI-I, response/remission rates, and adverse events. Longitudinal changes were evaluated using linear mixed-effects models.</p><p><strong>Results: </strong>Forty-six participants contributed longitudinal data (mean age 44.3 years; 54.4% male). HAMD-17 response rates were 28.3% (<i>n</i> = 13) post-treatment and 37.0% (<i>n</i> = 17) at follow-up; remission rates were 26.1% (<i>n</i> = 12) and 32.6% (<i>n</i> = 15), respectively. Improvements were also observed on PHQ-9 and GAD-7. On CGI-I, 52.2% were rated improved post-treatment and 60.9% at follow-up. The most common adverse event was transient, non-serious stimulation-site pain.</p><p><strong>Conclusions: </strong>The 5-day aiTBS schedule was logistically feasible, well-tolerated, and associated with reductions in depressive and anxiety symptom scores in a real-world TRD cohort. Randomized sham-controlled trials are needed to confirm these findings.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":"31 1","pages":"e43"},"PeriodicalIF":4.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Merging art with science: the reflex hammer meets the algorithm.","authors":"Jagannadha Avasarala","doi":"10.1017/S1092852926101278","DOIUrl":"https://doi.org/10.1017/S1092852926101278","url":null,"abstract":"<p><p>The neurological examination is a carefully choreographed sequence of observations and elicited responses that transforms clinical signs into meaningful data, providing the trainee with a framework for formulating a possible diagnosis. This art form of examination still lives on among a few masters of the craft, but the precision of digitized data points is gaining ground, as it should.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":"31 1","pages":"e44"},"PeriodicalIF":4.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing eating behavioral phenotypes in mood disorders: A cross-sectional investigation.","authors":"Elena Koning, Jill A Jacobson, Elisa Brietzke","doi":"10.1017/S1092852926101230","DOIUrl":"https://doi.org/10.1017/S1092852926101230","url":null,"abstract":"<p><strong>Background: </strong>Maladaptive eating behaviors in mood disorders are diverse and clinically relevant but have only been characterized into phenotypes based on theoretical evidence. The objective of the current study is to assess the prevalence of maladaptive eating behavior phenotypes (EBP) in mood disorders based on empirical evidence.</p><p><strong>Methods: </strong>An online survey package including five questionnaires was administered to assess the prevalence and proportion of maladaptive eating behaviors in a mood disorder population (<i>n</i> = 100). Principal component analysis (PCA) and mixed measures analysis of variance (mANOVA) were conducted to characterize maladaptive EBPs.</p><p><strong>Results: </strong>Numerous maladaptive eating behaviors were identified in MDD and BD, including poor dietary quality, emotional eating, binge eating, and night eating behaviors. Differences between diagnostic groups are discussed. Three EBPs were characterized according to the PCA: (1) food impulsivity; (2) emotional eating; and (3) mindfulness in eating, with a significant influence of age and medication on the characterizations according to the mANOVA.</p><p><strong>Conclusions: </strong>Maladaptive eating behaviors occur in mood disorders and can be characterized into distinct EBPS. These findings should be interpreted as preliminary and hypothesis-generating given the sample size, absence of a healthy comparator group, and potential confounds. As psychiatry moves toward a more comprehensive, personalized approach to diagnosis and treatment, EBPs require prospective validation in larger, controlled investigations to determine clinical relevance.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":"31 1","pages":"e42"},"PeriodicalIF":4.6,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodal predictors of response to intravenous ketamine in treatment-resistant depression: toward personalized treatment in major depressive and bipolar disorders.","authors":"Magda Malewska-Kasprzak, Filip Rybakowski, Monika Dmitrzak-Weglarz","doi":"10.1017/S1092852926101187","DOIUrl":"https://doi.org/10.1017/S1092852926101187","url":null,"abstract":"<p><p>Intravenous ketamine is a rapid-acting intervention for treatment-resistant depression (TRD) in adults with major depressive disorder and bipolar disorder (BD). While efficacy is established, a comprehensive integration of clinical, neurophysiological, biomarker, metabolic, and cognitive predictors remains lacking, limiting precision CNS-targeted therapy. To synthesize recent evidence on multimodal predictors of intravenous ketamine response in TRD and propose a preliminary clinical framework to guide personalized treatment. Following PRISMA guidelines, Scopus, PubMed, EMBASE, and MEDLINE were searched for English-language, peer-reviewed studies published within the last 5 years. Eligible studies included adults receiving intravenous ketamine for depressive disorders. Data were descriptively synthesized to identify consistent predictors, evidence clusters, and research gaps. The review included 150 studies. Key predictors of ketamine response included baseline depressive severity, comorbid anxiety, atypical depression and sleep phenotypes, inflammatory and neuroplastic biomarkers (eg, monocyte count, BDNF), metabolic factors (BMI, vitamin B12), genetic/epigenetic variants, neurophysiological signatures (EEG, TMS, fMRI connectivity), cognitive performance, and early symptomatic improvement. Integrative analysis suggests that glutamatergic, circadian, and inflammatory mechanisms interact to shape interindividual variability. Limitations include methodological heterogeneity and scarce long-term outcome data. Intravenous ketamine response in TRD is multifactorial, reflecting clinical phenotype, CNS biomarkers, neurophysiology, metabolism, and genetics. This review proposes a preliminary research framework and pilot clinical questionnaire intended to facilitate future investigation of individualized treatment approaches. However, most proposed predictors remain exploratory and require prospective validation before clinical implementation.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":"31 1","pages":"e41"},"PeriodicalIF":4.6,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fibromyalgia neurobehavioral phenotypes remain distinct across varying levels of pharmacologic exposure: evidence from a multisite cohort (<i>n</i> = 695).","authors":"Kevin V Hackshaw, Michelle M Osuna-Diaz, Katherine R Sebastian, Shreya Madhav Nuguri, Silvia deLamo Castellvi, Lianbo Yu, M Monica Giusti, Zhanna Mikulik, Luis Rodriguez-Saona","doi":"10.1017/S1092852926101199","DOIUrl":"10.1017/S1092852926101199","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether pharmacologic exposure is associated with differences in fibromyalgia neurobehavioral phenotypes and whether medication burden explains symptom variability within phenotypes.</p><p><strong>Methods: </strong>We analyzed a multisite cohort of 695 adults meeting fibromyalgia criteria, stratified into low- and high-impact phenotypes using a disability-based classification. Medication burden was quantified as total, centrally acting, and noncentrally acting medication counts. Between-phenotype differences and within-phenotype associations between medication burden and symptom severity were evaluated using nonparametric tests, Spearman correlation analyses, and multivariable linear regression models. Phenotypes were interpreted within the framework of centrally mediated neurobehavioral dysfunction.</p><p><strong>Results: </strong>Participants classified within the high-impact neurobehavioral phenotype (<i>n</i> = 175) demonstrated substantially greater symptom burden across fibromyalgia impact, central sensitization, depressive symptoms, pain severity, and vitality compared with low-impact participants (<i>n</i> = 520). Centrally acting medication burden increased stepwise with phenotype severity, whereas noncentrally acting medication use did not differ between phenotypes. Within phenotypes, centrally acting medication burden showed weak and nonsignificant associations with symptom severity after adjustment for demographic covariates, explaining minimal variance in fibromyalgia impact (<i>R</i>² < 0.05).</p><p><strong>Conclusions: </strong>Fibromyalgia symptom phenotypes remained distinct across varying levels of pharmacologic exposure, and medication burden explained little within-phenotype symptom variability. Medication burden primarily reflects downstream clinical response to symptom severity rather than a determinant of phenotype organization. These findings support the use of stable multidimensional phenotypes for mechanistic, neurobiological, and stratified intervention studies in chronic pain and related central nervous system disorders.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":"31 1","pages":"e38"},"PeriodicalIF":4.6,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How many suspected adult ADHD cases actually receive the diagnosis? Related factors in an assessment-seeking sample.","authors":"Gianluca Rosso, Camilla Perotti, Beatrice Defilippi, Camilla Garrone, Giuseppe Maina, Gabriele Di Salvo","doi":"10.1017/S1092852926101175","DOIUrl":"https://doi.org/10.1017/S1092852926101175","url":null,"abstract":"<p><strong>Objective: </strong>Adult ADHD assessments have increased sharply in recent years, yet the diagnostic yield and predictors of confirmed ADHD among assessment-seeking individuals remain insufficiently understood. This study aimed to examine the sociodemographic and clinical characteristics of adults self-referred or referred by clinicians for suspected ADHD, to determine confirmation rates, factors associated with confirmation, and alternative diagnoses.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on 232 adults evaluated at a regional ADHD referral center. Assessments included semi-structured clinical interviews and standardized instruments (DIVA, SCID-5, ADHD-RS). Logistic regression was used to examine factors associated with the final clinical ADHD diagnosis.</p><p><strong>Results: </strong>Overall, 64.2% of individuals received an ADHD diagnosis. Compared with non-ADHD participants, those diagnosed with ADHD were more frequently referred by other healthcare professionals and displayed greater academic impairment. They also showed higher rates of mood swings and delayed sleep onset. Childhood inattention emerged as the only DIVA interview score significantly associated with an ADHD diagnosis. Among individuals without ADHD, the most frequent alternative diagnoses were anxiety disorders and depressive disorders, followed by personality disorders, substance use disorders, and bipolar disorders.</p><p><strong>Conclusions: </strong>Adult ADHD emerges as a multifactorial condition shaped by clinical and functional factors. The final clinical diagnosis was most strongly associated with structured clinical tools, functional impairments (in the academic domain), emotional-regulation difficulties, and childhood inattention, whereas self-reported and more general factors were less informative. These findings underscore the importance of a developmentally informed and comprehensive assessment approach, given the high prevalence of psychiatric conditions that may mimic ADHD.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":"31 1","pages":"e39"},"PeriodicalIF":4.6,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Valbenazine improves quality of life, functionality, and movement severity in patients with tardive dyskinesia: findings from the KINECT-PRO™ study.","authors":"Christoph U Correll, M Mercedes Perez-Rodriguez, Joseph P McEvoy, David V Sheehan, Gustavo Alva, Susan Mathias, Morgan Bron, Robert H Farber, Hui Zhang, Eduardo Dunayevich, Ashok Parameswaran","doi":"10.1017/S1092852926101138","DOIUrl":"10.1017/S1092852926101138","url":null,"abstract":"<p><strong>Background/objective: </strong>Once-daily INGREZZA® (valbenazine), a selective vesicular monoamine transporter 2 (VMAT2) inhibitor, is approved for tardive dyskinesia (TD) and Huntington's chorea. KINECT-PRO™ (NCT05859698) is currently the only study to assess the effects of a VMAT2 inhibitor (valbenazine) on quality of life (QoL) and functionality in patients with TD using multiple validated patient-reported outcomes (PROs).</p><p><strong>Methods: </strong>Adults with mild-to-severe TD movement severity (per Abnormal Involuntary Movement Scale [AIMS] item 8) and awareness of TD with mild-to-severe associated distress (per AIMS item 10) received open-label valbenazine (40, 60, or 80 mg) for 24 weeks. Primary endpoints included changes from baseline (CFBs) at Week 24 in 3 validated QoL/functionality PROs: Tardive Dyskinesia Impact Scale (TDIS), the only psychometrically validated PRO developed specifically for TD; Sheehan Disability Scale (SDS); and EuroQoL Group's EQ-Visual Analogue Scale (EQ-VAS). Secondary endpoints included CFB in AIMS total score.</p><p><strong>Results: </strong>Substantial and clinically meaningful improvements in patient-reported QoL/functionality and clinician-reported TD severity were observed throughout treatment with valbenazine in the overall study population and regardless of psychiatric diagnosis (mood disorders, psychotic disorders) or TD severity at baseline (mild, moderate/severe). At Week 24 (<i>N</i> = 45), mean CFBs were: TDIS (-8.0); SDS Social/Leisure (-2.3); SDS Family/Home (-1.6); EQ-VAS (+13.1); AIMS (-6.8). Previously established minimal clinically important difference (MCID) thresholds for TD were exceeded for TDIS and AIMS. Safety and tolerability were consistent with valbenazine's known profile.</p><p><strong>Conclusions: </strong>KINECT-PRO is the first study of its kind, and valbenazine is the only VMAT2 inhibitor to demonstrate QoL/functional improvements in patients with TD across multiple validated PROs.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e30"},"PeriodicalIF":4.6,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between dextromethorphan/bupropion with diabetes mellitus and hyperglycemia: reports to the Food and Drug Administration Adverse Event Reporting System (FAERS).","authors":"Yang Jing Zheng, Sabrina Wong, Gia Han Le, Angela T H Kwan, Christine E Dri, Roger Ho, Taeho Greg Rhee, Hernan F Guillen-Burgos, Roger S McIntyre","doi":"10.1017/S1092852926101163","DOIUrl":"10.1017/S1092852926101163","url":null,"abstract":"<p><p>Dextromethorphan/bupropion (DXM/BUP) is the first orally administered antidepressant combining dextromethorphan, a non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist and sigma-1 receptor agonist, and bupropion, a CYP2D6 inhibitor and antidepressant. DXM/BUP was approved by the United States Food and Drug Administration for Major Depressive Disorder (MDD) in adults in August 2022. Given that select psychotropic agents prescribed for MDD may alter glucose and insulin homeostasis, we investigated whether DXM/BUP was associated with disproportionate reporting of diabetes mellitus or hyperglycemia. Disproportionality analyses were conducted using reporting odds ratios (RORs), with DXM/BUP and comparator agents evaluated relative to a reference agent (acetaminophen). Data were obtained from the Food and Drug Administration Adverse Event Reporting System (FAERS) from the year of approval to April 26, 2026. A sensitivity analysis was performed on a restricted dataset from January 1, 2022, to April 30, 2026. Statistical significance was defined as a 95% confidence interval (CI) excluding 1.0. DXM/BUP was not associated with disproportionate reporting of diabetes mellitus (ROR = 0.33, 95% CI [0.07, 1.65], <i>p</i> = 0.18) or hyperglycemia (ROR = 0.10, 95% CI [0.01, 1.67], <i>p</i> = 0.11) relative to acetaminophen. Findings from the restricted 2022-2026 analysis were directionally consistent with the primary analysis. Given the sparse number of reports and wide CIs, these findings should be interpreted as preliminary and underpowered, rather than evidence of metabolic neutrality. Continued pharmacovigilance and prospective investigation are needed to further characterize the metabolic profile of DXM/BUP.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e36"},"PeriodicalIF":4.6,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatial working memory across psychiatric disorders in young adults.","authors":"Kenneth Wang, Jon E Grant","doi":"10.1017/S1092852926101151","DOIUrl":"10.1017/S1092852926101151","url":null,"abstract":"<p><strong>Objective: </strong>Impairments in spatial working memory (SWM) have been observed in several disparate psychiatric conditions. The present study investigated how SWM varied across a range of psychiatric disorders in a large sample of young adults using the SWM test from the Cambridge Neuropsychological Test Automated Battery.</p><p><strong>Methods: </strong>A sample of 575 participants aged 18-29 years was enrolled from the general community and evaluated for psychiatric disorders using several screening evaluations. Performance on the SWM test was assessed, with outcome measures of strategy and total errors. Using <i>Z</i>-scores and Cohen's <i>d</i> effect sizes, SWM was compared between each psychiatric disorder and healthy controls.</p><p><strong>Results: </strong>The majority of psychiatric diagnoses examined demonstrated SWM deficits in both strategy and total errors. Large effect sizes in strategy were observed for bulimia, post-traumatic stress disorder, major depressive disorder, social phobia, and agoraphobia. Large effect sizes in total errors were observed for agoraphobia, major depressive disorder, social phobia, intermittent explosive disorder, obsessive-compulsive disorder, bulimia, post-traumatic stress disorder, and gambling disorder.</p><p><strong>Conclusions: </strong>Our findings suggest that SWM impairment is a transdiagnostic element of psychiatric illness rather than serving as a specific feature of any one diagnosis. Future directions include the exploration of how SWM deficits may be utilized in prognostic and therapeutic interventions.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e32"},"PeriodicalIF":4.6,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}