European Archives of Psychiatry and Clinical Neuroscience最新文献

{"title":"What autism features in first episode psychosis? Results from a 2-year follow-up study.","authors":"Lorenzo Pelizza, Antonio Federico, Emanuela Leuci, Emanuela Quattrone, Derna Palmisano, Simona Pupo, Giuseppina Paulillo, Clara Pellegrini, Pietro Pellegrini, Marco Menchetti","doi":"10.1007/s00406-025-01986-1","DOIUrl":"https://doi.org/10.1007/s00406-025-01986-1","url":null,"abstract":"<p><p>The PANSS Autism Severity Score (PAUSS) is a popular measure of autistic features in First Episode Psychosis (FEP) samples. However, evidence on its longitudinal stability, course and treatment response is poor. Therefore, the main aim of this research was to compare clinical outcomes between FEP individuals with or without \"autistic features\" enrolled within an \"Early Intervention in Psychosis\" (EIP) service across 2 years of follow-up, as well as any significant association with EIP treatment components. FEP subjects completed the Positive And Negative Syndrome Scale (PANSS), the Global Assessment of Functioning (GAF), and the Health of the Nation Outcome Scale (HoNOS) at entry and across the follow-up. Statistical tests included Kaplan-Meyer survival analysis, mixed-design ANOVA, and multiple linear logistic regression analysis. 301 FEP subjects were enrolled (85 [28.0%] scored above the PAUSS cut-off score). Across the follow-up, the PAUSS + subgroup showed lower incidence rates of both symptomatic and functional remission. No PAUSS long-term stability was observed, but a statistically significant reduction in its values. This longitudinal change was mainly predicted by the total number of case management sessions offered within the EIP program. Our results suggest that the PAUSS could not represent a valid instrument to assess \"trait-like\" autistic features in FEP subjects. On contrary, it seems to capture a FEP subgroup characterized by higher severity levels in psychopathology and poorer outcomes and prognosis.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566327","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":"Higher neutrophil-lymphocyte ratio predicts poor response to repetetive transcranial magnetic stimulation(rTMS) in treatment resistant depression.","authors":"Buket Koparal, Havva Nur Temizkan, Muhammed Hakan Aksu, Rukiye Filiz Karadağ","doi":"10.1007/s00406-025-01977-2","DOIUrl":"https://doi.org/10.1007/s00406-025-01977-2","url":null,"abstract":"<p><p>Repetitive transcranial magnetic stimulation (rTMS) has emerged as a noninvasive therapy for treatment resistant depression (TRD). The results of studies on the mechanism of rTMS and the predictive parameters for determining which patients will respond to rTMS are inconclusive. This study aims to investigate the relationship between pre-treatment systemic inflammatory markers and the response to rTMS in TRD patients. We retrospectively reviewed 86 patients with TRD who received 10 Hz rTMS to the left dorsolateral prefrontal cortex (DLPFC) at Gazi University between June 2017 and June 2023. Inflammatory markers, including neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and systemic immune-inflammatory index (SII), were evaluated. Treatment response was assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS), with a ≥50% reduction in MADRS score and a score ≤8 at the end of treatment considered as a positive response. Patients divided in to two groups accoording to rTMS response. 53 patients were responders and 33 patients were non-responders. Significant differences in inflammatory parameters were observed, with non-responders showing higher NLR (p=0.001), PLR (p=0.008), and SII (p=0.002) values. Logistic regression analysis revealed that higher NLR was significantly associated with a poorer response to rTMS (OR=0.373, p=0.022). Additionally, early improvement in MADRS score in the first week predicted overall treatment outcome (OR=1.070, p<0.001). Our findings suggest that systemic inflammation plays a role in TRD and that higher pre-treatment NLR is associated with a poorer response to rTMS. Largerscale studies are needed to further understand the mechanisms and improve treatment strategies for TRD patients.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556174","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":"Psychosomatic - psychotherapeutic treatment of stress-related disorders impacts the sphingolipid metabolism towards increased sphingosine and sphingosine-1-phosphate levels.","authors":"Franziska Werner, Fabian Schumacher, Christiane Mühle, Werner Adler, Caterina Schug, Eva Schäflein, Eva Morawa, Burkhard Kleuser, Johannes Kornhuber, Yesim Erim, Cosima Rhein","doi":"10.1007/s00406-025-01985-2","DOIUrl":"https://doi.org/10.1007/s00406-025-01985-2","url":null,"abstract":"<p><strong>Objective: </strong>Chronic stress is a risk factor for developing stress-induced mental disorders like major depression and post-traumatic stress disorder. Low-grade inflammatory processes seem to mediate this association. The sphingolipid metabolism with its most important lipid messengers ceramide and sphingosine-1-phosphate (S1P) was shown to play an important role in the pathophysiology of affective disorders and inflammation.</p><p><strong>Method: </strong>We conducted an exploratory trial to investigate the effect of intensive psychosomatic - psychotherapeutic treatment of stress-induced disorders on the biological level. Before and after eight weeks of treatment, blood plasma of 67 patients was analyzed for sphingolipid levels and their metabolizing enzymes. Symptom severity of depression (PHQ-9), anxiety (GAD-7), and somatization (PHQ-15) was assessed in parallel.</p><p><strong>Results: </strong>During psychosomatic - psychotherapeutic treatment, symptom severity of depression, anxiety, and somatization decreased significantly. Levels of the stress molecule cortisol decreased upon treatment. Enzymatic activities of secreted acid sphingomyelinase (S-ASM) and neutral sphingomyelinase (NSM) increased significantly upon treatment, as well as of neutral ceramidase (NC). Regarding the lipid level, the molar ratio of ceramide species Cer16:0 and Cer18:0 decreased upon treatment, whereas sphingosine and S1P levels increased.</p><p><strong>Conclusions: </strong>Psychosomatic - psychotherapeutic treatment was associated with a reduction in specific ceramide ratios and an increase in sphingosine and S1P levels potentially resulting from increased activity of sphingolipid metabolizing enzymes. Stress-induced mental disorders might be associated with disturbed sphingolipid levels that seem to be balanced during psychosomatic treatment. This study offers a further piece of evidence that the sphingolipid metabolism could be involved in the pathophysiology of stress-induced disorders, and its analysis could be helpful for treatment monitoring.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556176","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 overt aggression and suicidal ideation in patients with major depressive disorder: the mediational role of cognitive symptoms.","authors":"Ningning Chen, Meiti Wang, Yiming Chen, Fan Wang, Qinte Huang, Dongbin Lyu, Chenglin Wu, Vivien Yang, Shuang He, Xirui Liu, Yixia Xie, Qinting Zhang, Wu Hong","doi":"10.1007/s00406-025-01979-0","DOIUrl":"https://doi.org/10.1007/s00406-025-01979-0","url":null,"abstract":"<p><p>Suicidal ideation, under the dominion of suicidal behavior, represents the most severe consequence of depressive disorders. Overt aggressive behaviors leading to agitated symptoms, coupled with cognitive symptoms during a depressive episode, both impact suicidal ideation and behavior. However, the precise mechanisms by which cognitive symptoms and overt aggressive behaviors influence suicidal ideation in patients with depressive disorders remain unclear. This cross-sectional study analyzed 301 MDD patients from the Shanghai Mental Health Centre between May 2017 and July 2020. Depression severity and cognitive symptoms were assessed using the 17-item Hamilton Depression Rating Scale (HAMD-17), overt aggression with the Modified Overt Aggression Scale (MOAS), and suicidal ideation with the Beck Scale for Suicide Ideation (BSSI). A multivariate logistic regression was conducted to identify risk factors for suicidal ideation. Patients with suicidal ideation had higher levels of cognitive impairment and overt aggression (Z = - 5.527, P < 0.01; Z = - 3.482, P < 0.01). Overt aggressive symptoms positively correlated with suicide ideation (r = 0.177, P = 0.006) and cognitive performance scores (r = 0.173, P = 0.035). And cognitive performance scores also positively correlated with suicide ideation (r = 0.308, P < 0.001). Logistic regression identified cognitive symptoms (OR 1.47) and overt aggression (OR 1.40) as predictors of suicidal ideation in MDD patients (P < 0.05). Mediation analysis revealed that cognitive symptoms mediated the relationship between overt aggression and suicidal ideation (indirect effect: 0.1903). In MDD, cognitive symptoms and overt aggression are significant predictors of suicidal ideation, with cognitive symptoms playing a mediating role. These findings suggest potential targets for therapeutic intervention.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540699","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":"Cannabis use disorder: an overview of treatment approaches in Europe.","authors":"Eva Hoch, Monika Murawski, Marica Ferri, Daniel Feingold","doi":"10.1007/s00406-025-01964-7","DOIUrl":"https://doi.org/10.1007/s00406-025-01964-7","url":null,"abstract":"<p><p>Between 8 and 22% of lifetime cannabis users develop Cannabis Use Disorder (CUD). It is the most frequent reason for first-time drug-related treatment admissions in Europe. Many countries have general substance use treatment programs for individuals with cannabis use disorders. This study presents an updated overview of cannabis-specific treatment availability across Europe. Data on treatment programs in 27 EU member states, United Kingdom, Norway and Turkey was gathered. The study used a mixed-methods approach, combining (1) a quantitative survey among the National Focal Points of the European Drugs Agency (EUDA), (2) a qualitative analysis of \"Drug Workbooks 2021\" and 'Treatment Workbooks 2020 and 2021' published by the National Focal Points of the EUDA. Data for 30 countries on the European continent was analyzed. Sixteen countries reported the existence of specific cannabis-specific programs. Fifteen countries provided specific face-to-face interventions, which mostly have limited national coverage. Cannabis-specific online-treatment has been used more systematically since the COVID-pandemic in some countries. Automated and brief web-based interventions have emerged with a large potential to cover the needs of many clients in rural areas. First Cannabis Clinics opened, but specific forms of treatment for vulnerable target groups (e.g. adolescents, people with mental disorders) are generally still rare. Most programs are not evidence-based. In sum, some growth in cannabis-specific treatments has been observed in the past decade in Europe. Their coverage is still limited.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540722","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":"Cognitive function and social cognition in adolescents with bipolar disorder: comparison between manic episode and remission period.","authors":"Celal Yeşilkaya, Sezen Alarslan, Mustafa Tuncturk, Cagatay Ermis, Serkan Turan, Gul Karacetin","doi":"10.1007/s00406-025-01987-0","DOIUrl":"https://doi.org/10.1007/s00406-025-01987-0","url":null,"abstract":"<p><strong>Background: </strong>We aimed to investigate the extent of cognitive impairments in early-onset bipolar disorder (EBD) during manic episode in comparison to remission period.</p><p><strong>Method: </strong>30 healthy controls (HC) and 95 patients with EBD, with manic episode (n = 55) and remission period (n = 40) were included. Additionally, 31 (%56.4) of 55 patients with manic episode were re-evaluated during remission. A comprehensive cognitive battery was implemented to asses verbal and visual learning/memory, attention, inhibition, problem-solving, working memory, processing speed, and verbal fluency skills and global cognitive factor was calculated to estimate overall cognitive ability. Theory of mind (ToM) was evaluated using the Reading the Mind in the Eyes and Faux-Pas tests.</p><p><strong>Findings: </strong>Individuals in patient groups and HC were matched for gender and education. Patients in remission had a significantly older mean age than the other groups. Antipsychotic dosage was also higher in cases with mania. Patients with manic episode had moderate impairments in processing speed (Cohen's d: 0.51-0.78), attention (d: 0.57), inhibition (d: 0.56-0.63) and global cognitive function (d: 0.54) compared to patients in remission period. Individuals in remission period had poorer performance in verbal memory (d: 1.03-1.32), working memory (d: 0.88-1.13), ToM (d: 0.60-0.87), processing speed (d: 1.21-1.27), problem solving (d: 0.56-0.67), attention (d: 0.58), inhibition (d: 0.89-1.00) and visual memory (d: 1.28-1.37) in comparison with HC.</p><p><strong>Conclusion: </strong>Our findings indicated that impairments in social cognition, processing speed, inhibition, and attention were more prominent in the manic episode. Future studies should focus on pharmaco- and psychotherapeutic interventions aimed to treat neurocognitive impairments.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540764","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":"Obstructive sleep apnea's causal links to depression, well-being, and negative moods: a bidirectional mendelian randomized study.","authors":"Jianhong Liao, Xiang Gao, Ting Fang, Yanru Li, Demin Han","doi":"10.1007/s00406-025-01969-2","DOIUrl":"https://doi.org/10.1007/s00406-025-01969-2","url":null,"abstract":"<p><p>Previous observational studies showed associations between obstructive sleep apnea (OSA) and depression and other negative moods. However, the causality has not been determined. Single nucleotide polymorphisms were identified as instrumental variables by screening from genome-wide association studies. Bidirectional two-sample mendelian randomization (MR) was applied to assess the potential causal relationship between OSA and depression, subjective well-being, negative moods. Inverse variance weighting (IVW) method and weight median were chosen as the main methods to estimate possible causal effects. MR-Egger, MR pleiotropy residual sum and outlier and leave-one-out analysis methods, were used as sensitivity analysis methods to ensure robust results. MR analyses indicated significantly causal association of OSA on depression (OR = 1.22, P = .010) and major depressive disorder (OR = 1.02, P = .006). Furthermore, genetically predicted OSA was negatively associated with subjective well-being (β_IVW = -0.06, P = .009), and was positively associated with negative moods including depressed affect (OR = 1.04, P = .012), irritable mood (P = .006), feeling lonely (P = .011), feeling fed-up (P = .005) and mood swings (P = .017). There is no reverse effect of the above psychiatric traits on OSA. Genetic predisposition to OSA causally increased depression and major depressive disorder. Consistently, OSA has causal impacts on both subjective well-being, representing positive emotions, and negative moods.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536915","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":"Psychiatric antecedents in young patients with first episode psychosis: what relevance for clinical outcomes?","authors":"Lorenzo Pelizza, Fabio Catalano, Emanuela Leuci, Emanuela Quattrone, Derna Palmisano, Simona Pupo, Giuseppina Paulillo, Clara Pellegrini, Pietro Pellegrini, Marco Menchetti","doi":"10.1007/s00406-025-01981-6","DOIUrl":"https://doi.org/10.1007/s00406-025-01981-6","url":null,"abstract":"<p><p>Examining psychiatric antecedents and help-seeking behavior for people with First Episode Psychosis (FEP) could help understand determinants for timely care pathways, decrease the \"Duration of Untreated Psychosis\" (DUP), and consequently improve their prognosis. The aims of this study were: (1) to calculate the proportion of FEP participants with previous contact with mental healthcare services recruited within a specialized \"Early Intervention in Psychosis\" service, and (2) to longitudinally compare sociodemographic, clinical, and treatment parameters between FEP patients with and without psychiatric antecedents across a 2-year follow-up period. All participants (aged 12-35 years) were enrolled within the \"Parma Early Psychosis\" (Pr-EP) program. At baseline, they completed the Health of the Nation Outcome Scale (HoNOS). A mixed-design ANOVA and a Kaplan-Meier survival analysis were used. Of the 489 FEP participants, 204 (41.7%) patients had prior contact with mental health services. In 83% of cases, a care discontinuity was observed. Main psychiatric antecedents at entry were personality disorders (32.8%), anxious-depressive disorder (28.9%), conduct disorder (16.2%), and learning disorder (9.8%). FEP subjects with antecedents were more likely to receive a diagnosis of schizophrenia at baseline. Having previous contact with psychiatric services resulted to be a predictor of poorer clinical and functional outcome. It is very important to carefully monitor mental health suffering and related help-seeking-behavior in young patients typically manifested in their early 20s, especially in terms of psychosis prevention. Particular attention should also be given to service engagement as care continuity within adolescent-adult transition.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531321","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 lipid profile with cognitive function: 12-year follow-up of Guangzhou Biobank cohort study.","authors":"Yu Meng Tian, Wei Sen Zhang, Chao Qiang Jiang, Feng Zhu, Ya Li Jin, Shiu Lun Au Yeung, Jiao Wang, Kar Keung Cheng, Tai Hing Lam, Lin Xu","doi":"10.1007/s00406-025-01974-5","DOIUrl":"https://doi.org/10.1007/s00406-025-01974-5","url":null,"abstract":"<p><p>Studies on the trajectories of lipid profile with cognitive decline are scarce and inconsistent. We examined this association and explored potential effect modification. Lipid profiles including high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG) and total cholesterol (TC) were measured at baseline, first and second follow-ups, and classified into trajectory groups. Immediate, delayed memory recall and cognitive function were assessed by the immediate (IWRT) and delayed 10-word recall test (DWRT), and mini-mental state examination (MMSE), respectively, at baseline and follow-ups, and converted into standardized scores. Linear mixed-effect model was used. Results show that elevated HDL-C was associated with increasing annual change rates in DWRT and MMSE scores (β (95% confidence intervals) = 0.005 (-0.001 to 0.011) SD/year and 0.020 (0.014 to 0.027) SD/year, respectively), while LDL-C and TC were associated with a decrease in DWRT scores (-0.005 (-0.008 to -0.001) SD/year and - 0.009 (-0.011 to -0.006) SD/year, respectively). Moderate-increasing HDL-C, high-decreasing LDL-C or moderate-decreasing TC trajectories were associated with increases in DWRT, IWRT and MMSE scores. Stronger associations were identified for HDL-C with an increase in MMSE scores within the lower family income group and for LDL-C with a decrease in IWRT scores among individuals taking lipid-lowering drug. In conclusion, HDL-C was associated with improvements, while LDL-C and TC with decline in memory and cognitive function. Increasing HDL-C and decreasing LDL-C and TC trajectories predicted better memory and cognitive performance. The observed effect modifications highlight the importance of personalized approaches in lipid management to optimize cognitive outcomes.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523082","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":"Objectifying persistent subjective cognitive impairment following COVID-19 infection: cross-sectional data from an outpatient memory-clinic in Germany.","authors":"Luca Tarantini, Corina Möller, Victoria Schiestl, Sabrina Sordon, Michael Noll-Hussong, Miriam Wittemann, Nicole Menzie, Matthias Riemenschneider","doi":"10.1007/s00406-025-01978-1","DOIUrl":"https://doi.org/10.1007/s00406-025-01978-1","url":null,"abstract":"<p><strong>Objective: </strong>Subjective cognitive impairment is frequently reported by patients experiencing Post-COVID symptoms. This study aims to assess objective impairment in attention, memory, and executive functions among these patients. Further, we investigated potential determinants of objective cognitive impairment.</p><p><strong>Methods: </strong>In this cross-sectional study, standardized neuropsychological testing (Vienna Testing System), assessment of cognitive symptom aggravation, psychiatric anamnesis, and psychometrics (BDI-II, Fatigue Severity Scale) were conducted in 229 patients who voluntarily presented to our outpatient memory-clinic due to subjective cognitive impairment following COVID-19. Blood-samples were collected to assess peripheral immune markers (IL-6, CRP) and APOE-ε4 genotype.</p><p><strong>Results: </strong>Objective cognitive impairment in at least one domain was present in 39% of the patients and 47% showed symptoms of moderate or severe depression. The APOE-ε4 allele was present in 32% of the patients. Higher rates of depressive symptoms (OR = 1.41, 95%-CI = 1.02-1.95) and higher burden of the APOE-ε4 allele (OR = 3.29, 95%-CI = 1.51-7.40) predicted objective cognitive impairment, regardless of age, sex, years of formal education, time since infection, and medication for diabetes or hypertension. Fatigue severity, acute COVID-19 severity or inflammation markers had no impact.</p><p><strong>Conclusions: </strong>In our study, subjective cognitive impairment following COVID-19 was more likely associated with high rates of depression rather than relatively low rates of objective cognitive performance. Thus, the study emphasizes the necessity for extensive neuropsychological testing and evaluation of depression when examining Post-COVID patients in clinical practice. Further, the link between objective cognitive impairment, depression and APOE-ε4 does not appear to be specific to Post-COVID symptoms. Therefore, depression- and APOE-ε4-mediated neurodegenerative pathomechanisms might be a promising therapeutical target.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531320","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}