CNS Spectrums最新文献

{"title":"Treatment instability in generalized anxiety disorder (GAD): a U.S. real-world evidence study.","authors":"Derek Louie, Erin Ferries, Susan Suponcic, Katie Robinson, Felix Lam, Abigail Silber, Matthew O'Hara, Phong Duong, Daniel Karlin, Jeffrey R Strawn, Roger S McIntyre","doi":"10.1017/S1092852926101059","DOIUrl":"10.1017/S1092852926101059","url":null,"abstract":"<p><strong>Objective: </strong>To characterize the treatment burden of generalized anxiety disorder (GAD) using real-world data on pharmacotherapy use, treatment changes, and treatment progression.</p><p><strong>Methods: </strong>This retrospective analysis used closed claims from the Komodo Healthcare Map (2021-2024) to identify U.S. adults (≥18 years) with newly diagnosed or established GAD. Treatment patterns were assessed at the drug level.</p><p><strong>Results: </strong>Among the 259 158 newly diagnosed and 1 018 288 established GAD patients, GAD-related pharmacotherapy use during the 12 months post-index was 76% and 98%, respectively. Treatment patterns were further analyzed in 59 275 newly diagnosed and 86 920 established GAD patients with ≥1 pharmacy claim. Among newly diagnosed patients, 55% discontinued and 28% added or switched treatments; among established patients, 16% discontinued and 55% added or switched treatments. The median time to first treatment event varied by cohort and event type: discontinuation occurred at a median of 84 days in newly diagnosed and 119 days in established patients, combination therapy at 49 and 32 days, and switching at 31 and 42 days, respectively. Of those who discontinued, 57% of newly diagnosed and 26% of established GAD patients did not resume treatment; among those who restarted, the median treatment gap was 146 and 96 days, respectively. Overall, 75% of newly diagnosed and 94% of established GAD patients who underwent treatment modification experienced at least one additional therapy change during the study.</p><p><strong>Conclusion: </strong>This study underscores the significant unmet needs in the current treatment of GAD, evidenced by high rates of pharmacotherapy switching, discontinuation, and prolonged gaps in care.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e22"},"PeriodicalIF":4.6,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148263667","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":"Frequency and Correlates of Inaccurate Psychiatric Diagnoses in 401 Adults Hospitalized for Major Depressive Disorder: A Comparison of Clinical vs. Research Interview-Based Diagnoses.","authors":"Viktor Benjamin Nöhles, Till Julius Adam, Felix Bermpohl, Nikola Schoofs, Rouven Bathe-Peters, Nina Hilpert, Forugh Salimi Dafsari, Peter Falkai, Cornelius Schüle, Elena Wang, Christine Reif-Leonhard, Andreas Reif, Susanne Schillo, Rabia Sana Arshad, Patricia Getty, Christian Otte, Dominique Piber, Livia Graumann, Sebastian Weyn-Banningh, Mazda Adli, René Papenfuß, Andreas Meyer-Lindenberg, Stefan Fritze, Michael Bauer, Ute Lewitzka, Maik Spreer, Clemens Karl Krug, Kerstin Rubarth, Christoph Ulrich Correll","doi":"10.1017/S109285292610100X","DOIUrl":"https://doi.org/10.1017/S109285292610100X","url":null,"abstract":"","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"1-35"},"PeriodicalIF":4.1,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204168","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":"Trajectories of gray and white matter volume in children at elevated risk for schizophrenia.","authors":"Shuqing Si, Matthew Kempton, Emily Hedges, Mathilde Antoniades, Ruth E Roberts, Alexis E Cullen, Kristin R Laurens","doi":"10.1017/S1092852926101047","DOIUrl":"10.1017/S1092852926101047","url":null,"abstract":"<p><strong>Objective: </strong>Longitudinal investigation of brain alterations in children putatively at risk of developing schizophrenia may identify early markers of pathophysiology associated with vulnerability for the disorder.</p><p><strong>Methods: </strong>Children aged 9-12 years with multiple antecedents of schizophrenia (psychotic-like experiences; speech and/or motor delays; and social, emotional, and/or behavioral difficulties; ASz, <i>n</i> = 31), with a family history of schizophrenia/schizoaffective disorder (FHx, <i>n</i> = 21), and typically developing children (TD, <i>n</i> = 35) were recruited through community screening using questionnaires. T1-weighted structural MRI scans were obtained at baseline and after approximately 2 and 4 years of follow-up, and processed using the FreeSurfer longitudinal pipeline. Across these 3 assessment waves, total gray matter (GM) and white matter (WM) volume, and regional GM volumes in 12 regions of interest, were compared among the groups using linear mixed models.</p><p><strong>Results: </strong>Children were aged 11.21 (±1.61) years at baseline and the average lapse-of-time between each assessment was 1.76 (±0.36) years. The ASz group exhibited consistently higher total WM volume (<i>b</i> = 29.45) compared to the TD group, with no statistically significant time-related volumetric WM or GM differences in any region. The FHx group also demonstrated higher total WM volume (<i>b</i> = 36.49), and time-related total and regional GM volume changes were observed; however, these effects were attenuated after correction.</p><p><strong>Conclusion: </strong>Global and regionally specific brain abnormalities distinguished children with different risk profiles for schizophrenia relative to their typically developing peers. Follow-up is required to determine how these changes may relate to later schizophrenia.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e23"},"PeriodicalIF":4.6,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204254","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":"Nephroprotective effects of GLP-1 receptor agonists in patients receiving lithium treatment: a multinational cohort study using the TriNetX network.","authors":"Roger S McIntyre, Yanli Zhang-James, Joseph F Goldberg, Angela T H Kwan","doi":"10.1017/S1092852926101023","DOIUrl":"10.1017/S1092852926101023","url":null,"abstract":"<p><strong>Background: </strong>Use of GLP-1 receptor agonists (GLP-1 RAs) is an established therapy that delays progression of chronic kidney disease in type 2 diabetes mellitus (T2DM), but their impact on lithium-associated nephrotoxicity is unclear. We evaluated whether GLP-1 RA use is associated with reduced renal risk in adults receiving long-term lithium therapy.</p><p><strong>Methods: </strong>We conducted a retrospective, propensity score-matched cohort study using TriNetX electronic health records (>127 million patients across 109 healthcare organizations). Adults (≥18 years) with T2DM and lithium exposure within 2 years prior to index were included. The primary outcome was renal nephrotoxicity, defined as a composite of ICD-10 and CPT-coded renal disease. Incidence and time-to-event outcomes were assessed using Kaplan-Meier curves and Cox proportional hazards models.</p><p><strong>Results: </strong>In a 24-month analysis of 452 matched patient pairs, GLP-1 RA initiation during lithium therapy was associated with a marked reduction in renal events versus lithium alone (23.5% vs 44.7%), corresponding to a risk difference of -21.2% (95% CI -36.9 to -5.5) and a risk ratio of 0.53 (95% CI 0.30-0.91; p = 0.013). Event-free survival was higher (62.5% vs 43.4%; log-rank p = 0.0115), with a hazard ratio of 0.45 (95% CI 0.23-0.85; p = 0.0089). This represents a 47% relative risk reduction and a number needed to treat (NNT) of 5 over 24 months.</p><p><strong>Conclusion: </strong>These findings support further mechanistic and prospective studies of GLP-1 RAs as a renoprotective strategy for patients receiving lithium treatment.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e25"},"PeriodicalIF":4.6,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204251","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":"Lithium and long-term cognitive outcomes in bipolar disorder and early dementia: a systematic review.","authors":"Rosalyn Deng, Alisa Shargorodsky, Kayla Teopiz, Christine E Dri, Sabrina Wong, Gia Han Le, Yang Jing Zheng, Roger S McIntyre","doi":"10.1017/S1092852926100996","DOIUrl":"10.1017/S1092852926100996","url":null,"abstract":"<p><p>Cognitive impairment is a major determinant of disability in bipolar disorder (BD) and a defining feature of both mild cognitive impairment (MCI) and Alzheimer's disease (AD). Lithium, a first-line maintenance treatment for BD, is implicated in neuroprotective mechanisms including glycogen synthase kinase-3β inhibition, amyloid and tau modulation, and neurogenesis promotion. The overarching aim of this systematic review is to evaluate the long-term effects of lithium on cognition across BD, MCI, and early-to-moderate AD using randomized controlled trial (RCT) evidence. Online databases were searched from inception through May 2025 for RCTs reporting lithium's effect on cognitive outcomes in BD, MCI, or early-to-moderate AD with ≥8 weeks of follow-up. Risk of bias was assessed using the Cochrane RoB 2 tool. Eight RCTs met the inclusion criteria, ranging from 10 weeks to 3 years in duration. Across four BD trials, lithium did not exhibit consistent improvement or worsening on composite cognitive scores. Three of four MCI/AD trials reported attenuated global cognitive deterioration with low-dose lithium, especially when exposure was ≥12 months. Methodological limitations included small sample sizes, exploratory endpoints, and variable measures for cognitive function as well as lithium strategies. Lithium demonstrates preliminary signals of slower cognitive decline in MCI/AD. Available evidence suggests lithium has neutral effects on cognitive impairment in BD. Future adequately powered RCTs with cognition as a primary endpoint, functional measures, and biomarker outcomes are warranted to clarify lithium's role as a maintenance treatment in psychiatric disorders and its potential neuroprotective effects in neurodegenerative diseases.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e18"},"PeriodicalIF":4.6,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204239","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":"Quality over quantity: association between autistic traits and daily-life social interactions in adolescents and young adults from the TwinssCan cohort.","authors":"Laura Fusar-Poli, Thanavadee Prachason, Natascia Brondino, Marta Nola, Bochao D Lin, Lotta-Katrin Pries, Melike Karaçam Doğan, Claudia Menne-Lothmann, Jeroen Decoster, Ruud van Winkel, Dina Collip, Philippe Delespaul, Marc De Hert, Catherine Derom, Evert Thiery, Nele Jacobs, Jim van Os, Bart Pf Rutten, Pierluigi Politi, Sinan Guloksuz","doi":"10.1017/S1092852926100947","DOIUrl":"10.1017/S1092852926100947","url":null,"abstract":"<p><strong>Objective: </strong>Autistic traits (ATs) are associated with difficulties in social functioning, but their impact on the quantity and the quality of daily-life social interactions is not yet fully understood. Hereby, we examined the relationship between AT and daily-life social interactions in adolescents and young adults.</p><p><strong>Methods: </strong>Data were derived from the TwinssCan cohort (<i>N</i> = 593). ATs were assessed using the Autism Spectrum Quotient (AQ), while the quantity and the quality of daily-life social interactions were evaluated using the Experience Sampling Methodology. Multilevel regressions were performed, with the AQ as the independent variable and each social/solitary quantity/quality variable as the dependent variable. Models were adjusted for age, sex, and general psychopathology, measured with the Symptom Checklist-90.</p><p><strong>Results: </strong>No significant association was found between AQ total scores and quantity of social interactions. However, AQ total scores were significantly associated with quality of social interactions. Higher ATs were associated with an increased preference to be alone (<i>B</i> = 0.04, 95% CI 0.01-0.07), less pleasure while in-company (<i>B</i> = -0.02, 95% CI -0.04 to -0.01), less feeling of safety while in-company (<i>B</i> = -0.02, 95% CI -0.04 to -0.002), and less feeling of belongingness (<i>B</i> = -0.02, 95% CI -0.03 to -0.001). ATs were differently associated with the quality of social interactions depending on the familiarity. No significant associations were found between ATs and solitary qualities.</p><p><strong>Conclusions: </strong>Our findings highlight the importance of evaluating ATs during clinical assessments, especially in adolescents and young adults, to evaluate the impact on social interactions and the potential psychopathological consequences.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e14"},"PeriodicalIF":4.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136870","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":"Functional neurological symptoms occur commonly in healthy adults: implications for the pathophysiology of FND.","authors":"David D G Palmer, Mark J Edwards, Jason B Mattingley","doi":"10.1017/S1092852926100972","DOIUrl":"10.1017/S1092852926100972","url":null,"abstract":"<p><strong>Objectives: </strong>Functional neurological symptoms that do not meet clinical definitions of functional neurological disorder (FND) are common in clinical practice. Understanding the distinction between these \"benign\" functional symptoms and FND is crucial in defining FND as an entity for study and a clinical syndrome. We aimed to measure the frequency of functional symptoms in people who do not have FND.</p><p><strong>Methods: </strong>A survey was administered to 95 clinicians who attended an international conference on FND. Participants were asked to report the occurrence and characteristics of experiences with features of functional sensory or motor symptoms, or dissociation, which they had experienced at any time.</p><p><strong>Results: </strong>Of the 95 people who responded to the survey, 57.4% reported having experienced any functional symptoms, and 47.9% reported having experienced functional motor or sensory symptoms. The symptoms reported were generally short-lived and caused only mild distress and disruption. Most respondents who reported having experienced a functional symptom reported having had multiple events through their lives.</p><p><strong>Conclusions: </strong>The results suggest that the lifetime occurrence of functional neurological symptoms is at least an order of magnitude higher than FND. The high prevalence of functional symptoms in people who have never had FND challenges the assumption that the occurrence of functional neurological symptoms is synonymous with FND. We propose that FND is better conceived of as a failure of the mechanisms by which functional neurological symptoms resolve, rather than the occurrence of functional symptoms per se. This reconceptualization implies new research directions for the underlying etiology of FND.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e13"},"PeriodicalIF":4.1,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147970942","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":"Exploring resting-state network dysconnectivity in schizophrenia with single-subject ICA.","authors":"Margherita Biondi, Marco Marino, Dante Mantini, Chiara Spironelli","doi":"10.1017/S1092852926100959","DOIUrl":"10.1017/S1092852926100959","url":null,"abstract":"<p><strong>Objective: </strong>Resting-state networks (RSNs) consist of coherent spontaneous activity patterns that support a wide range of sensorimotor and higher-order cognitive functions. In schizophrenia (SZ), RSN alterations reflect disruptions in the brain's functional architecture. Given the heterogeneity of SZ, accurate spatial mapping of RSNs at the individual level is crucial for characterizing altered brain connectivity in a more personalized manner. To achieve this, we used single-subject independent component analysis (ICA) to extract RSNs at the individual level, preserving unique functional patterns and accounting for variability among SZ patients.</p><p><strong>Methods: </strong>We analyzed a resting-state functional magnetic resonance imaging dataset from 74 SZ patients and 74 matched healthy controls (HCs) obtained from the publicly available COINS database. Using single-subject ICA, we extracted 14 distinct RSNs associated with sensory, motor, and higher-order cognitive functions. Voxel-wise statistical comparisons were performed to identify spatial differences between the groups.</p><p><strong>Results: </strong>The SZ group exhibited widespread RSN alterations in regions associated with visual, motor, and cognitive processing. Significant spatial differences were observed within each network, with the most extensive changes occurring in the somatomotor network and three cognitive networks: the cingulo-insular, medial prefrontal, and left frontoparietal networks. Within the default mode network, differences between SZ patients and HC were observed exclusively in visual areas.</p><p><strong>Conclusions: </strong>Single-subject ICA provides a valuable approach for investigating RSN alterations in SZ and enables a detailed, individualized characterization of functional connectivity disruptions. The extensive connectivity alterations in visual, motor, and cognitive networks highlight the complex interplay among these systems in SZ.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e15"},"PeriodicalIF":4.1,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147970951","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":"Longitudinal coupling between depressive symptoms and divided attention during transcranial magnetic stimulation in treatment-resistant depression.","authors":"Mao-Hsuan Huang, Yee-Lam E Chan, Jun-Ding Zhu, Wei-Chung Mao, Wei Yuan, Yia-Ping Liu, Li-Chi Chen, Feng-Chang Yen, Wei-Shen Huang, Tung-Ping Su","doi":"10.1017/S1092852926100935","DOIUrl":"10.1017/S1092852926100935","url":null,"abstract":"<p><strong>Background: </strong>Cognitive dysfunction is a core feature of major depressive disorder. During transcranial magnetic stimulation (TMS) for treatment-resistant depression (TRD), the temporal relationship between symptom changes and cognitive performance remains unclear. We examined depressive symptoms and cognitive trajectories during TMS and tested whether time-varying cognitive change was associated with symptom trajectories.</p><p><strong>Methods: </strong>This retrospective naturalistic study included 89 patients with TRD who completed 20 sessions of left dorsolateral prefrontal cortex TMS (high-frequency repetitive TMS or intermittent theta-burst stimulation). Depression severity (Hamilton Depression Rating Scale [HAMD-17]) and computerized attentional control measures from the Test of Attentional Performance were assessed at baseline, day 10, and day 20. Generalized estimating equations examined time effects and time-adjusted symptom-cognition associations. Exploratory analyses evaluated whether early cognitive change was associated with subsequent symptom improvement. Multiple comparisons were controlled.</p><p><strong>Results: </strong>Depressive symptoms decreased significantly (p < 0.001), with response and remission rates of 65.2% and 51.7%. Several attentional indices showed significant time effects; however, after false discovery rate correction, only visual divided-attention commission errors were independently associated with depressive severity beyond time effects. Person-mean centering indicated that this association was driven by within-person change (B = 0.209, p < 0.001), not between-person differences. Greater early reduction in visual divided-attention commission errors was associated with larger overall symptom improvement (B = 0.172, p = 0.016).</p><p><strong>Conclusion: </strong>Within-person changes in divided attention tracked depressive symptom trajectories during TMS. Attentional control measures may therefore help track symptom-cognition dynamics during TMS in real-world clinical settings.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e34"},"PeriodicalIF":4.6,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147927315","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":"Machine learning-based differentiation of major depressive disorder and bipolar disorder using entropy-derived EEG biomarkers in drug-naïve patients.","authors":"Hyeon-Ho Hwang, Kang-Min Choi, Hyeon-Ah Lee, Sungkean Kim, Ji Sun Kim","doi":"10.1017/S1092852926100923","DOIUrl":"10.1017/S1092852926100923","url":null,"abstract":"<p><strong>Objective: </strong>Major depressive disorder (MDD) and bipolar disorder (BD) exhibit overlapping depressive presentations, making early differentiation difficult and misdiagnosis clinically consequential. Entropy-based resting-state electroencephalography (EEG) markers were evaluated for differentiating drug-naïve patients with stable MDD, converted BD, and diagnosed BD.</p><p><strong>Methods: </strong>Resting-state EEG was acquired from 92 drug-naïve patients: 50 with stable MDD, 16 who converted to bipolar II disorder over 3 years, and 26 with diagnosed BD. Band-scale entropy and cross-sample entropy (CSE) were analyzed. Group differences were tested by analysis of covariance adjusted for depressive severity; classification was evaluated by nested cross-validation with permutation testing.</p><p><strong>Results: </strong>Relative to stable MDD, diagnosed BD showed higher theta- and alpha-band entropy in frontal and central regions and lower values for selected intra- and inter-regional CSE measures. Two CSE measures correlated positively with non-planning impulsiveness in diagnosed BD. Converted BD showed intermediate values without significant pairwise differences. Prospective discrimination of stable MDD versus converted BD was modest (balanced accuracy, 65.4%; area under the receiver operating characteristic curve [ROC-AUC], 0.661). Classification was strongest for stable MDD versus diagnosed BD, yielding 78.9% pooled accuracy, 76.6% balanced accuracy, and an ROC-AUC of 0.832 when entropy features were combined with depressive severity; combined entropy outperformed either single-family configuration.</p><p><strong>Conclusions: </strong>Entropy-derived EEG measures differentiated stable MDD from diagnosed BD and suggested a weaker, intermediate profile in converted BD. They may serve as candidate adjunctive biomarkers for mood disorder differentiation, although larger prospective cohorts are required to clarify their value in predicting conversion to bipolar II disorder.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e40"},"PeriodicalIF":4.6,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147867238","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}