Current Opinion in Psychiatry最新文献

Prevention of eating disorders: recent advances. 预防饮食失调：最新进展。

IF 7.5 2区医学

Current Opinion in Psychiatry Pub Date : 2025-07-24 DOI: 10.1097/YCO.0000000000001034

Eric Stice, Carlie Malott, Sareena Shah

{"title":"Prevention of eating disorders: recent advances.","authors":"Eric Stice, Carlie Malott, Sareena Shah","doi":"10.1097/YCO.0000000000001034","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001034","url":null,"abstract":"Purpose of review: Only one in five people with eating disorders ever receive care, making effective prevention critical. This review synthesizes prevention trials from the past 2 years - highlighting new interventions and implementation strategies.Recent findings: A dissonance-based program for Brazilian men reduced muscle dysmorphia and body dissatisfaction, but not eating-disorder symptoms. The Body Advocacy Movement, designed to lessen fatphobia, produced medium declines in weight bias but only small symptom reductions, performing no better than the Body Project. Eat Breathe Thrive, a yoga-based program for female athletes, improved anxiety and interoceptive body trusting but did not reduce eating pathology. Two studies testing the Diabetes Body Project for young women with type 1 diabetes - an open pilot and a multinational randomized trial - produced large, durable reductions in general and diabetes specific symptoms but did not improve glycemic control. An implementation experiment across 63 colleges showed that pairing train-the-trainer workshops with technical assistance and ongoing quality assurance supervision maximized clinical benefit per dollar.Summary: Recent work demonstrates promising population-specific adaptations of dissonance-based programs and underscores that comprehensive implementation support enhances effectiveness. Future work should optimize high-school delivery, boost effect sizes, and verify long-term reductions in future eating disorder onset.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mentalization-based therapy for personality disorder in adolescents. 青少年人格障碍的心理治疗。

IF 7.5 2区医学

Current Opinion in Psychiatry Pub Date : 2025-07-18 DOI: 10.1097/YCO.0000000000001033

Sebastian Simonsen, Sune Bo, Carla Sharp

{"title":"Mentalization-based therapy for personality disorder in adolescents.","authors":"Sebastian Simonsen, Sune Bo, Carla Sharp","doi":"10.1097/YCO.0000000000001033","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001033","url":null,"abstract":"Purpose of review: Mentalization-based therapy for adolescents (MBT-A) is a treatment approach that aligns well with dimensional models of personality disorders. This article reviews recent literature on mentalizing and MBT, proposing ways in which findings may inform future research and clinical innovations.Recent findings: There have been few new treatment studies and meta-analyses, and the evidence generally does not support the superiority of MBT-A over other well structured treatments for personality disorder in adolescents. Long-term follow-up studies suggest heterotypic continuity of personality disorder (PD) and indicate that discrepancies between adolescent and parent reporting may point to important mentalizing problems. A pilot study of MBT-A for conduct disorder has been published and shows promising results, despite a high dropout rate.Summary: MBT was originally developed for BPD in adults, but it is increasingly being recognized as a transdiagnostic common-factor model relevant to many conditions, such as those affecting adolescents who have experienced childhood adversity and juveniles with persistent aggressive behavior. For the field to progress further, there is a strong need for more research and clinical innovation, which should continue to move beyond categorical classification and approach disorder and alleviation of suffering from a developmental and social-ecological starting point.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Scaling up a success story: how do we achieve universal access to transcranial magnetic stimulation? 放大一个成功的故事：我们如何实现经颅磁刺激的普及？

IF 7.5 2区医学

Current Opinion in Psychiatry Pub Date : 2025-07-18 DOI: 10.1097/YCO.0000000000001029

Jonathan Downar

{"title":"Scaling up a success story: how do we achieve universal access to transcranial magnetic stimulation?","authors":"Jonathan Downar","doi":"10.1097/YCO.0000000000001029","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001029","url":null,"abstract":"Purpose of review: Over one billion people suffer from psychiatric and/or neurological disorders for which transcranial magnetic stimulation (TMS) has shown efficacy. Achieving widespread TMS access will require major improvements to cost and convenience. A key figure of merit for a given TMS protocol concerns not its remission rate or tolerability, but simply its treatment time per remission (TTPR).Recent findings: Outcomes for conventional bilateral TMS protocols imply a TTPR of more than 100 h - incompatible with widespread access. However, briefer accelerated and/or theta-burst protocols may improve TTPR to less than 20 h. Personalization strategies that improve remission rates sometime improve TTPR, depending on associated cost-penalties of time or complexity. A potentially groundbreaking new strategy to improve TTPR involves pharmacological augmentation of neuroplasticity, using agents such as D-cycloserine. Plasticity-augmentation may improve TTPR by improving remission rates, and by reducing the number of required sessions. Recent literature suggests that TTPR values of under 5 h per remission may be achievable via neuroplasticity augmentation.Summary: The most recent plasticity-augmented TMS protocols may approach or exceed cost-parity with pharmacotherapy, in terms of reducing the prevalence of depression. With the health economics of TMS improving steadily, a pathway to universal access may be within reach.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Resilience in borderline personality disorder: a scoping review. 边缘型人格障碍的恢复力：范围回顾。

IF 7.5 2区医学

Current Opinion in Psychiatry Pub Date : 2025-07-18 DOI: 10.1097/YCO.0000000000001028

Angelika Rauchlatner, Eva Fleischmann, Frederike T Fellendorf, Eva Z Reininghaus, Nina Dalkner

{"title":"Resilience in borderline personality disorder: a scoping review.","authors":"Angelika Rauchlatner, Eva Fleischmann, Frederike T Fellendorf, Eva Z Reininghaus, Nina Dalkner","doi":"10.1097/YCO.0000000000001028","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001028","url":null,"abstract":"Purpose of review: This review summarizes current research on resilience in individuals with borderline personality disorder (BPD), its role in the development of BPD, and its impact on symptoms and recovery. Low resilience is considered a key factor contributing to emotional dysregulation and difficulty coping with adversity in BPD.Recent findings: A scoping literature search identified 177 records, of which 12 studies met the inclusion criteria. Patients with BPD consistently exhibit lower resilience scores compared to mentally healthy control groups, with higher BPD features linked to reduced resilience. When compared to other mental disorders, such as major depressive disorder, persistent depressive disorder, and posttraumatic stress disorder, individuals with BPD tend to show the lowest resilience levels. Additionally, resilience has been identified as a mediator between childhood maltreatment and BPD features. Treatment interventions like dialectical behavior therapy have been found to significantly improve resilience in patients with BPD.Summary: The findings underline the importance of resilience regarding the development, symptoms, and treatment of BPD, with lower resilience linked to higher BPD features and a history of childhood adversity. Results also suggest that enhancing resilience, particularly through interventions such as dialectical behavior therapy, could be a valuable therapeutic target.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Co-occurrence of personality disorders and anxiety disorders. 人格障碍和焦虑症的共现。

IF 7.5 2区医学

Current Opinion in Psychiatry Pub Date : 2025-07-17 DOI: 10.1097/YCO.0000000000001031

Milan Latas, Nevena Baščarević, Dušanka Vučinić Latas

{"title":"Co-occurrence of personality disorders and anxiety disorders.","authors":"Milan Latas, Nevena Baščarević, Dušanka Vučinić Latas","doi":"10.1097/YCO.0000000000001031","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001031","url":null,"abstract":"Purpose of review: This review explores the high co-occurrence between personality disorders (PDs) and anxiety disorders (ADs), focusing on clinical implications, the frequency of their association, and the challenges these comorbidities pose for diagnosis and treatment. In addition, this review highlights recent research findings and the need for better therapeutic strategies.Recent findings: Contemporary studies have confirmed a strong association between PDs and ADs, particularly borderline personality disorder (BPD), which shows an 85% comorbidity with anxiety disorders. Gender differences are also observed, with women generally exhibiting higher rates of co-occurring psychiatric conditions. These comorbidities contribute to increased symptom severity, a higher suicide risk, and worse long-term outcomes. Recent clinical trials have shown positive results in managing these disorders. However, treatment approaches remain inconsistent, and further research is needed to refine these strategies.Summary: The co-occurrence of PDs and ADs complicates diagnosis and treatment, leading to worse outcomes. Although promising therapies exist, the current lack of a standardized treatment approach for this comorbid population highlights the need for further research. Future studies should explore more targeted treatment options, causal mechanisms linking PDs and ADs, and potential benefits of personalized interventions to improve clinical outcomes.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Transactive response DNA-binding protein 43 (TDP-43) proteinopathy: the complex biological and clinical findings in limbic-predominant age-related TDP-43 encephalopathy (LATE) neuropathological changes, limbic-predominant amnestic neurodegenerative syndrome, and other mixed age-related major neurocognitive disorders. 交互反应dna结合蛋白43 （TDP-43）蛋白病：边缘显性年龄相关性TDP-43脑病（LATE）神经病理改变、边缘显性遗忘性神经退行性综合征和其他混合性年龄相关性重大神经认知障碍的复杂生物学和临床表现。

IF 7.5 2区医学

Current Opinion in Psychiatry Pub Date : 2025-07-17 DOI: 10.1097/YCO.0000000000001025

Marcia Radanovic, Carlos Eduardo Borges Passos Neto, Luiz Henrique Monteiro, Orestes Vicente Forlenza

{"title":"Transactive response DNA-binding protein 43 (TDP-43) proteinopathy: the complex biological and clinical findings in limbic-predominant age-related TDP-43 encephalopathy (LATE) neuropathological changes, limbic-predominant amnestic neurodegenerative syndrome, and other mixed age-related major neurocognitive disorders.","authors":"Marcia Radanovic, Carlos Eduardo Borges Passos Neto, Luiz Henrique Monteiro, Orestes Vicente Forlenza","doi":"10.1097/YCO.0000000000001025","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001025","url":null,"abstract":"Purpose of review: As the term limbic-predominant age-related transactive response DNA-binding protein 43 (TDP-43) encephalopathy (LATE) was coined in 2019, more than 200 articles addressing the subject were published. This review aims to provide an updated synthesis of knowledge regarding LATE-NC as a cause of age-related neurodegeneration and cognitive decline while addressing the challenges posed by overlapping neuropathologies in aging populations.Recent findings: LATE-NC is marked by TDP-43 deposition in limbic structures, such as the amygdala and hippocampus, and is often associated with cognitive decline resembling Alzheimer's disease, though with a slower progression in isolated cases. The frequent coexistence of LATE-NC with other neuropathologies, particularly Alzheimer's disease neuropathologic changes (ADNC) and Lewy body dementia (LBD), exacerbates dementia severity and complicates diagnosis and treatment. Recent efforts have established clinical criteria for in-vivo diagnosis, including neuroimaging markers like hippocampal atrophy and limbic hypometabolism. Genetic studies have identified key risk genes, including GRN, TMEM106B, SORL1, and APOE, while biomarker development in cerebrospinal fluid (CSF) and blood remains in its early stages.Summary: The review highlights the importance of multidisciplinary research and clinical approaches in addressing the complexities of neurodegenerative diseases involving TDP-43 proteinopathy, enhancing diagnostic accuracy, and developing effective treatments tailored to individual patient profiles.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Response prediction for repetitive transcranial magnetic stimulation treatment. 反复经颅磁刺激治疗的疗效预测。

IF 7.5 2区医学

Current Opinion in Psychiatry Pub Date : 2025-07-16 DOI: 10.1097/YCO.0000000000001026

Gábor Csukly, Boglárka Orbán-Szigeti, János M Réthelyi

{"title":"Response prediction for repetitive transcranial magnetic stimulation treatment.","authors":"Gábor Csukly, Boglárka Orbán-Szigeti, János M Réthelyi","doi":"10.1097/YCO.0000000000001026","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001026","url":null,"abstract":"Purpose of review: While rTMS is a safe therapeutic option, its efficacy remains to be improved. Patients with treatment-resistant depression show 50-60% response rates and 30-40% remission rates to standard 10 Hz rTMS protocols. Response prediction is a promising option to improve rTMS efficacy.Recent findings: Most studies test response prediction in patients with depression, schizophrenia, and OCD. Clinical data and structural MRI are primarily used for patient stratification, fMRI is employed to determine the optimal localization, and EEG is utilized for fine-tuning rTMS parameters to achieve the best efficacy. Employing magnetic resonance spectroscopy, PET, and measuring cortical excitability may also be helpful. However, only a few studies tested these methods. Furthermore, a crucial new task is to connect theta-burst accelerated protocols with response prediction, an approach applied in some recent studies.Summary: We propose planning and carrying out multicentre studies to confirm existing results and provide a definitive conclusion for clinicians. Primarily, individual alpha peak (IAPF)-based response prediction results should be replicated in large-sample, multicentre trials, as this approach is the most robust and has the best chance of being implemented in clinical practice. Structural MRI-based patient stratification and fMRI-guided stimulation are possible add-ons.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

TDP-43 proteinopathy: the complex biological and clinical findings in LATE-NC, LANS, and other mixed age-related major neurocognitive disorders. TDP-43蛋白病变：LATE-NC、LANS和其他与年龄相关的混合性主要神经认知障碍的复杂生物学和临床表现

IF 7.5 2区医学

Current Opinion in Psychiatry Pub Date : 2025-07-16 DOI: 10.1097/YCO.0000000000001027

Marcia Radanovic, Carlos Eduardo Borges Passos Neto, Luiz Henrique Monteiro, Orestes Vicente Forlenza

{"title":"TDP-43 proteinopathy: the complex biological and clinical findings in LATE-NC, LANS, and other mixed age-related major neurocognitive disorders.","authors":"Marcia Radanovic, Carlos Eduardo Borges Passos Neto, Luiz Henrique Monteiro, Orestes Vicente Forlenza","doi":"10.1097/YCO.0000000000001027","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001027","url":null,"abstract":"Purpose of review: Since the term limbic-predominant age-related TDP-43 encephalopathy (LATE) was coined in 2019, more than 200 articles addressing the subject were published. This review aims to provide an updated synthesis of knowledge regarding LATE-NC as a cause of age-related neurodegeneration and cognitive decline while addressing the challenges posed by overlapping neuropathologies in aging populations.Recent findings: LATE-NC is marked by TDP-43 deposition in limbic structures, such as the amygdala and hippocampus, and is often associated with cognitive decline resembling Alzheimer's disease, though with a slower progression in isolated cases. The frequent coexistence of LATE-NC with other neuropathologies, particularly Alzheimer's disease neuropathologic changes (ADNC) and Lewy body dementia (LBD), exacerbates dementia severity and complicates diagnosis and treatment. Recent efforts have established clinical criteria for in-vivo diagnosis, including neuroimaging markers like hippocampal atrophy and limbic hypometabolism. Genetic studies have identified key risk genes, including GRN, TMEM106B, SORL1, and APOE, while biomarker development in cerebrospinal fluid (CSF) and blood remains in its early stages.Summary: The review underscores the need for multidisciplinary research and clinical approaches to address the complexities of neurodegenerative diseases involving TDP-43 proteinopathy, improve diagnostic accuracy, and develop effective treatments tailored to individual patient profiles.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Gondal hormones and binge eating in females: developmental and etiologic insights from puberty to adulthood. 性腺激素和女性暴饮暴食：从青春期到成年的发育和病因学见解。

IF 7.5 2区医学

Current Opinion in Psychiatry Pub Date : 2025-07-15 DOI: 10.1097/YCO.0000000000001030

Kristen M Culbert, Cheryl L Sisk, Kelly L Klump

{"title":"Gondal hormones and binge eating in females: developmental and etiologic insights from puberty to adulthood.","authors":"Kristen M Culbert, Cheryl L Sisk, Kelly L Klump","doi":"10.1097/YCO.0000000000001030","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001030","url":null,"abstract":"Purpose of review: Binge eating (BE) is a core symptom of multiple eating disorders and disproportionately affects females during/after puberty. Gonadal hormones (estrogen, progesterone, testosterone) are sex-differentiated and have been posited as key biological contributors to BE risk. This review synthesizes recent findings from animal and human studies regarding gonadal hormone influences on the etiology BE in females during puberty and adulthood.Recent findings: Estrogen may exert organizational effects (i.e., long-lasting) during puberty that shape responsivity to activational effects (i.e., transient) of gonadal hormones on BE in late adolescence/adulthood. In adulthood, estradiol appears to be protective against BE, while progesterone antagonizes this effect. Emerging data also implicate testosterone as an additional hormonal risk factor for BE in women, particularly under conditions of lower estradiol. However, not all females exposed to these high-risk gonadal hormone milieus develop BE; behavior genetic studies provide empirical support for gene-by-hormone interactions in individual susceptibility.Summary: Methodologically rigorous approaches (e.g., daily assessments, behavior genetics, hormone manipulation) have been critical in uncovering the complex etiologic influences of gonadal hormones on BE in females. Future research is needed to identify the specific neural circuits, genetic variants, and transcriptional pathways involved in these processes.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Transcranial magnetic stimulation for the management of late life depression: a critical appraisal of available evidence. 经颅磁刺激治疗晚年抑郁症：对现有证据的批判性评价。

IF 7.5 2区医学

Current Opinion in Psychiatry Pub Date : 2025-07-15 DOI: 10.1097/YCO.0000000000001020

Leandro Valiengo, Valeria Richinho

{"title":"Transcranial magnetic stimulation for the management of late life depression: a critical appraisal of available evidence.","authors":"Leandro Valiengo, Valeria Richinho","doi":"10.1097/YCO.0000000000001020","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001020","url":null,"abstract":"Purpose of review: Late-life depression (LLD) is a prevalent and often underdiagnosed condition in older adults, associated with significant cognitive, functional, and medical burdens. Conventional treatments frequently present limitations in this population, underscoring the need for safer, more effective alternatives. This review evaluates the growing body of evidence supporting transcranial magnetic stimulation (TMS) as a promising nonpharmacological treatment for LLD.Recent findings: Recent meta-analyses and randomized controlled trials suggest that TMS is effective and well tolerated in older adults, even in cases of treatment resistance. Protocol adaptations, such as increased stimulation intensity and the use of theta burst or deep TMS, have demonstrated improved outcomes in this population. TMS also shows potential cognitive benefits and fewer systemic side effects compared to pharmacotherapy. However, barriers such as limited accessibility, insurance restrictions, and logistical challenges persist.Summary: TMS represents a valuable therapeutic option for managing LLD, particularly in patients who are medication-intolerant or at high risk for adverse effects. While evidence supports its efficacy and safety, further research is needed to optimize protocols, identify predictors of response, and assess long-term outcomes. Addressing implementation challenges will be essential for translating these advances into routine clinical practice.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0