Philipp Mench, T Koppius, J Ewen, W Rippe, J O Radecke, B Tari, M Heath, S Borgwardt, B Wilms, A Sprenger, R Lencer
{"title":"Cognitive control in schizophrenia spectrum disorders is associated with long-term movement activity rather than single-bout exercise.","authors":"Philipp Mench, T Koppius, J Ewen, W Rippe, J O Radecke, B Tari, M Heath, S Borgwardt, B Wilms, A Sprenger, R Lencer","doi":"10.1007/s00406-025-02101-0","DOIUrl":"https://doi.org/10.1007/s00406-025-02101-0","url":null,"abstract":"<p><strong>Background: </strong>Patients with schizophrenia spectrum disorder (SSD) suffer from impaired cognitive functions. Previous studies in healthy individuals have shown that a single bout of physical exercise benefits cognitive functions. Such enhancements in cognitive function would be highly beneficial, particularly for patients with SSD, as cognitive abilities play a vital role in both mental and physical health.</p><p><strong>Methods: </strong>We examined the impact of a single bout of aerobic exercise on cognitive function in 25 patients with SSD and 24 healthy controls. Participants performed a single bout of aerobic exercise adjusted to their individual fitness level. Cognitive function was examined pre- and postexercise via oculomotor tasks consisting of saccadic (i.e., pro- and antisaccades) and smooth pursuit eye movements (SPEM). Furthermore, long-term physical fitness and movement activity were assessed through an anaerobic threshold testing and self-reports of physical activity.</p><p><strong>Results: </strong>As expected, SSD-patients showed higher antisaccade error rates and were impaired in both SPEM initiation and maintenance with higher disorganization levels being related to lower SPEM performance. Neither the patient nor control group benefited from a single bout of exercise in terms of improved saccade or SPEM performance. However, higher fitness levels and more extensive long-term movement activity were associated with lower antisaccade error rates in patients.</p><p><strong>Conclusion: </strong>These findings do not demonstrate a single bout postexercise benefit in cognition; however, results indicate an association between greater cognitive control and long-term movement activity and thus underscore the importance of conducting further investigations into long-term exercise interventions as a complementary therapeutic approach.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006053","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}
Xiaoying Dong, Tina Gupta, Gretchen Haas, Kristen L Eckstrand, Jennifer S Silk, Neal D Ryan, Erika E Forbes
{"title":"Psychotic-like experiences in adolescents enriched for high-risk for developing severe mental illness: change over two-years and associations with neural reward processing and affective symptoms.","authors":"Xiaoying Dong, Tina Gupta, Gretchen Haas, Kristen L Eckstrand, Jennifer S Silk, Neal D Ryan, Erika E Forbes","doi":"10.1007/s00406-025-02095-9","DOIUrl":"10.1007/s00406-025-02095-9","url":null,"abstract":"<p><p>Psychotic-like experiences (PLEs) -subclinical experiences or symptoms that resemble psychosis, such as hallucinations and delusional thoughts-often emerge during adolescence and are predictive of serious psychopathology. Understanding PLEs during adolescence is crucial due to co-occurring developmental changes in neural reward systems that heighten the risk for psychotic-related and affective psychopathology, especially in those with a family history of severe mental illness (SMI). We examined associations among PLEs, clinical symptoms, and neural reward function during this critical developmental period. Over two-years, 117 adolescents (aged 13-19 years at baseline) at high-risk (n = 74) or low-risk (n = 43) for SMI based on family history of affective or psychotic disorder completed symptom questionnaires annually and fMRI scanning at study entry during a guessing reward task. We assessed changes in PLEs over two-years and evaluated whether clinical symptoms (anxiety, depression, anhedonia) and response to rewards of the dorsal medial prefrontal cortex (dmPFC) and ventral striatum (VS) predicted PLEs two-years later. PLEs total scores and distress increased over time, with the high-risk group showing a greater rise in PLEs than the low-risk group. Heightened right VS neural activation and higher anxiety at baseline (but not left VS or dmPFC neural activation, depression, or anhedonia) predicted more PLEs at 24-months. Heightened vigilance and sensitivity to external stimuli may be important precursors to the development of PLEs for adolescents.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thomas Bastelica, Karoline Huth, Maarten Marsman, Louis-Ferdinand Lespine, Guillaume Barbalat, Julien Plasse, Isabelle Chéreau-Boudet, Benjamin Gouache, Emilie Legros-Lafarge, Catherine Massoubre, Nathalie Guillard-Bouhet, Frédéric Haesebaert, Thierry d'Amato, Nicolas Franck, Romain Rey
{"title":"Exploring interrelationships between cognition, functioning and quality of life in schizophrenia spectrum disorders: a Bayesian analysis of networks.","authors":"Thomas Bastelica, Karoline Huth, Maarten Marsman, Louis-Ferdinand Lespine, Guillaume Barbalat, Julien Plasse, Isabelle Chéreau-Boudet, Benjamin Gouache, Emilie Legros-Lafarge, Catherine Massoubre, Nathalie Guillard-Bouhet, Frédéric Haesebaert, Thierry d'Amato, Nicolas Franck, Romain Rey","doi":"10.1007/s00406-025-02084-y","DOIUrl":"https://doi.org/10.1007/s00406-025-02084-y","url":null,"abstract":"","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991816","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 high-density lipoprotein-related inflammation index and prevalence of sleep disorders with depression as a mediator.","authors":"Shuo Gao, Pu-Le Liu, Qiang-Li Dong, Xin-Ru Liu, Zhi-Qiang Dong, Ya-Wen Pan","doi":"10.1007/s00406-025-02099-5","DOIUrl":"10.1007/s00406-025-02099-5","url":null,"abstract":"<p><strong>Background: </strong>Sleep disorders have a significant impact on physical health, mental health, and daily functioning, exacerbated by the accelerating pace of life and rising work-related stress in contemporary society. The incidence of sleep disorders continues to rise annually, becoming a significant global public health issue. The white blood cell-to-HDL-cholesterol ratio (WHR), lymphocyte-to-HDL-cholesterol ratio (LHR), monocyte-to-HDL-cholesterol ratio (MHR), neutrophil-to-HDL-cholesterol ratio (NHR), and platelet-to-HDL-cholesterol ratio (PHR) are emerging, convenient, and cost-effective biomarkers that reflect systemic inflammation and immunometabolic status. Given the growing evidence linking chronic inflammation and dysregulated immune responses to prevalence of sleep disorders, exploring the association between these hematologic-lipid ratios and prevalence of sleep disorders may provide novel insights into underlying pathophysiological mechanisms.</p><p><strong>Methods: </strong>The study included a diverse and extensive sample of 43,273 participants, selected from the National Health and Nutrition Examination Survey (NHANES) conducted between 2005 and March 2020. The association between HDL- associated inflammatory biomarkers and prevalence of sleep disorders was explored using a multivariate logistic regression model with weighted analysis. In addition, the mediating role of depression levels (PHQ-9) between HDL-associated inflammatory markers and prevalence of sleep disorders was examined.</p><p><strong>Results: </strong>This study suggests that higher levels of MHR and PHR were associated with an increased risk of sleep disorders, with a more pronounced association observed for MHR among male smokers and individuals with comorbidities, and for PHR among males and those with comorbidities. Mediation analysis demonstrates that depression level (PHQ-9) plays a significant mediating role between prevalence of sleep disorders and MHR or PHR.</p><p><strong>Conclusion: </strong>Elevated MHR and PHR levels were significantly associated with an increased risk of sleep disorders. The association of MHR was particularly pronounced among male smokers and individuals with comorbidities, while PHR showed stronger associations in males and those with comorbidities. Depression levels partially mediated these associations. MHR and PHR may serve as clinically useful biomarkers for identifying high-risk individuals, supporting the need for early screening and intervention. Future longitudinal studies are warranted to confirm causality and assess whether targeting these indices can improve sleep outcomes.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947215","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}
Anastasia Demina, Benjamin Petit, Vincent Meille, Anne Sauvaget, Florent Lebon, Benoit Trojak
{"title":"Combination of non-invasive brain stimulation with mindfulness-based interventions for anxiety and depression symptoms: systematic review and meta-analysis of randomized controlled trials.","authors":"Anastasia Demina, Benjamin Petit, Vincent Meille, Anne Sauvaget, Florent Lebon, Benoit Trojak","doi":"10.1007/s00406-024-01928-3","DOIUrl":"10.1007/s00406-024-01928-3","url":null,"abstract":"<p><p>In this article we aimed synthesize all available evidence regarding the effects of non-invasive brain stimulation (NIBS) techniques combined with mindfulness-based interventions (MBIs) on mental health indicators. We performed a systematic review of randomized controlled trials evaluating NIBS/MBIs combinations in clinical populations and a random effects pairwise meta-analysis of studies evaluating anxiety and depression symptoms. After independent trial selection by two authors based on titles/abstracts, and then on full texts, twelve trials were retrieved. There was a large effect size favoring the NIBS/MBIs over the control intervention for anxiety symptoms (Cohen's d = - 0.82 (- 1.35, - 0.30), I<sup>2</sup> = 55%, moderate certainty of evidence). As for depression symptoms, there was a small-to-medium effect size that did not reach statistical significance (Cohen's d = - 0.24 (- 0.61, 0.13), I<sup>2</sup> = 30%, low certainty of evidence). MBIs/NIBS combination is feasible and well tolerated. There is preliminary evidence for its therapeutic promise. Future studies should inform combination choices by neural correlates of respective interventions and offer patients mindfulness familiarization before implementation of the NIBS/MBIs treatment.Trial registration CRD42022353971.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":"1739-1785"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647066","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}
Florian Freudenberg, Christine Reif-Leonhard, Andreas Reif
{"title":"Advancing past ketamine: emerging glutamatergic compounds for the treatment of depression.","authors":"Florian Freudenberg, Christine Reif-Leonhard, Andreas Reif","doi":"10.1007/s00406-024-01875-z","DOIUrl":"10.1007/s00406-024-01875-z","url":null,"abstract":"<p><p>Changes in glutamatergic neuroplasticity has been proposed as one of the core mechanisms underlying the pathophysiology of depression. In consequence components of the glutamatergic synapse have been explored as potential targets for antidepressant treatment. The rapid antidepressant effect of the NMDA receptor antagonist ketamine and subsequent approval of its S-enantiomer (i.e. esketamine), have set the precedent for investigation into other glutamatergic rapid acting antidepressants (RAADs). In this review, we discuss the potential of the different glutamatergic targets for antidepressant treatment. We describe important clinical outcomes of several key molecules targeting components of the glutamatergic synapse and their applicability as RAADs. Specifically, here we focus on substances beyond (es)ketamine, for which meaningful data from clinical trials are available, including arketamine, esmethadone, nitrous oxide and other glutamate receptor modulators. Molecules only successful in preclinical settings and case reports/series are only marginally discussed. With this review, we aim underscore the critical role of glutamatergic modulation in advancing antidepressant therapy, thereby possibly enhancing clinical outcomes but also to reducing the burden of depression through faster therapeutic effects.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":"1547-1557"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12500823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Siegfried Kasper, Hans-Peter Volz, Hans-Jürgen Möller, Sandra Schläfke, Stephan Klement, Ion-George Anghelescu, Erich Seifritz
{"title":"Lavender oil preparation Silexan is effective in mild-to-moderate major depression: a randomized, placebo- and reference-controlled trial.","authors":"Siegfried Kasper, Hans-Peter Volz, Hans-Jürgen Möller, Sandra Schläfke, Stephan Klement, Ion-George Anghelescu, Erich Seifritz","doi":"10.1007/s00406-024-01783-2","DOIUrl":"10.1007/s00406-024-01783-2","url":null,"abstract":"<p><p>Anxiety and depressive disorders have overlapping symptoms and share common neurobiological pathways. Antidepressant drugs have been demonstrated to be efficacious in anxiety as well. Vice versa, it may also be promising to investigate the efficacy of anxiolytic drugs such as silexan in major depressive disorder (MDD). Patients with a mild or moderate, single or recurrent episode of MDD and a total score of 19-34 points on the Montgomery Åsberg Depression Rating Scale (MADRS) were randomized to receive 1 × 80 mg/d silexan, 1 × 50 mg/d sertraline, or placebo double-blind, double-dummy for 56 days. The primary outcome measure was the MADRS total score change between baseline and treatment end. Treatment groups were compared using a treatment policy estimand. 498 subjects (silexan 170, sertraline 171, placebo 157) were treated and analyzed. After 8 weeks, silexan and sertraline were superior to placebo for MADRS total score reduction, with absolute differences to placebo of 2.17 (95% confidence interval: 0.58; 3.76) points and 2.59 (1.02; 4.17) points, respectively (p < 0.01). Moreover, silexan was superior to placebo for alleviation of functional impairment according to the Sheehan Disability Scale with a difference of 2.40 (1.04; 3.76) points (p < 0.001). Both treatments were well tolerated; eructation was the most frequent adverse effect of silexan. The study confirms the antidepressant efficacy of silexan in mild or moderate MDD, including significant improvements in the subjects' functional capacity. The results for sertraline confirm the assay sensitivity of the trial. Both drugs were well tolerated.Trial registrationEudraCT2020-000688-22 first entered on 12/08/2020.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":"1693-1703"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12500811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140335179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lorina Zapf, Tyler S Kaster, Fidel Vila-Rodriguez, Zafiris J Daskalakis, Jonathan Downar, Daniel M Blumberger
{"title":"The effect of once-daily vs. twice-daily intermittent theta burst stimulation on suicidal ideation in treatment-resistant depression.","authors":"Lorina Zapf, Tyler S Kaster, Fidel Vila-Rodriguez, Zafiris J Daskalakis, Jonathan Downar, Daniel M Blumberger","doi":"10.1007/s00406-024-01929-2","DOIUrl":"10.1007/s00406-024-01929-2","url":null,"abstract":"<p><p>Intermittent theta burst stimulation (iTBS) has demonstrated potential in reducing suicidal ideation (SI) in patients with depression, however, stimulation protocols vary greatly across studies. For this secondary analysis, data from a three-site double-blind, randomized and sham-controlled clinical trial was analyzed to investigate the efficacy of a once-daily versus twice-daily iTBS protocol in the treatment of SI in patients with treatment resistant depression. Secondarily we aimed to explore the associations among SI, anhedonia and quality of life (QOL) measures. The primary outcome for this analysis was SI, which was assessed by computing an average score from four suicidality items on separate depression scales. 158 participants who experienced some degree of SI at baseline were included in the analysis. After 10 days of treatment, 15 (18.3%) participants from the once-daily group and 19 (25%) from the twice-daily group achieved remission from SI which was defined as a SI score of 0. After 30 days of treatment the remission rates were 27 (32.9%) and 30 (39.5%), respectively. There were no significant differences in remission rates between the groups. Moderate correlations between change in SI and change in depressive symptoms were observed. In addition, correlations between change in SI, anhedonia and QOL were observed that remained significant after controlling for change in depressive symptoms. Achieving remission from SI appears to be at least partially correlated to the anti-depressant effect of iTBS. Further studies investigating optimal treatment protocols for the treatment of suicidality with different iTBS schedules are urgently needed. Trial registration Clinicaltrials.gov ID: NCT02729792 ( https://clinicaltrials.gov/ct2/show/NCT02729792 ).</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":"1787-1798"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638593","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}
Aldo Soldini, Ulrike Vogelmann, Sabine Aust, Stephan Goerigk, Christian Plewnia, Andreas Fallgatter, Claus Normann, Lukas Frase, Peter Zwanzger, Thomas Kammer, Carlos Schönfeldt-Lecuona, Gizem Vural, Malek Bajbouj, Frank Padberg, Gerrit Burkhardt
{"title":"Neurocognitive function as outcome and predictor for prefrontal transcranial direct current stimulation in major depressive disorder: an analysis from the DepressionDC trial.","authors":"Aldo Soldini, Ulrike Vogelmann, Sabine Aust, Stephan Goerigk, Christian Plewnia, Andreas Fallgatter, Claus Normann, Lukas Frase, Peter Zwanzger, Thomas Kammer, Carlos Schönfeldt-Lecuona, Gizem Vural, Malek Bajbouj, Frank Padberg, Gerrit Burkhardt","doi":"10.1007/s00406-024-01759-2","DOIUrl":"10.1007/s00406-024-01759-2","url":null,"abstract":"<p><p>Transcranial direct current stimulation (tDCS) of the prefrontal cortex might beneficially influence neurocognitive dysfunctions associated with major depressive disorder (MDD). However, previous studies of neurocognitive effects of tDCS have been inconclusive. In the current study, we analyzed longitudinal, neurocognitive data from 101 participants of a randomized controlled multicenter trial (DepressionDC), investigating the efficacy of bifrontal tDCS (2 mA, 30 min/d, for 6 weeks) in patients with MDD and insufficient response to selective serotonin reuptake inhibitors (SSRI). We assessed whether active tDCS compared to sham tDCS elicited beneficial effects across the domains of memory span, working memory, selective attention, sustained attention, executive process, and processing speed, assessed with a validated, digital test battery. Additionally, we explored whether baseline cognitive performance, as a proxy of fronto-parietal-network functioning, predicts the antidepressant effects of active tDCS versus sham tDCS. We found no statistically significant group differences in the change of neurocognitive performance between active and sham tDCS. Furthermore, baseline cognitive performance did not predict the clinical response to tDCS. Our findings indicate no advantage in neurocognition due to active tDCS in MDD. Additional research is required to systematically investigate the effects of tDCS protocols on neurocognitive performance in patients with MDD.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":"1715-1724"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12500756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Iris Dalhuisen, Tom Biemans, Cornelis F Vos, Sophie Ter Hark, Iris van Oostrom, Jan Spijker, Ben Wijnen, Eric van Exel, Hans van Mierlo, Dieuwertje de Waardt, Martijn Arns, Indira Tendolkar, Joost Janzing, Philip van Eijndhoven
{"title":"A comparison between rTMS and antidepressant medication on depressive symptom clusters in treatment-resistant depression.","authors":"Iris Dalhuisen, Tom Biemans, Cornelis F Vos, Sophie Ter Hark, Iris van Oostrom, Jan Spijker, Ben Wijnen, Eric van Exel, Hans van Mierlo, Dieuwertje de Waardt, Martijn Arns, Indira Tendolkar, Joost Janzing, Philip van Eijndhoven","doi":"10.1007/s00406-025-02012-0","DOIUrl":"10.1007/s00406-025-02012-0","url":null,"abstract":"<p><strong>Background: </strong>Antidepressive treatment outcomes can be assessed using sum scores from measurement scales, but symptom clusters may better capture the multidimensional structure of depression. Little is known about the comparative effectiveness of different treatment modalities on these clusters. We sought to evaluate the effects of rTMS and antidepressant medication on four symptom clusters and the extent to which these differ between treatments. In addition, we assessed whether baseline cluster scores predicted (non)response.</p><p><strong>Methods: </strong>Data were obtained from two clinical trials (DETECT: rTMS vs. medication; PITA: tricyclic antidepressants). Primary outcomes were symptom cluster scores: 'General Depression', 'Anxiety', 'Somatic Symptoms' and 'Insomnia'. In the primary analysis based on DETECT, a MANCOVA comparing rTMS with medication was performed. For validation, a MANCOVA was performed replacing medication data from DETECT with data from PITA. Baseline symptom cluster scores were compared between responders and non-responders, as well as treatment groups.</p><p><strong>Results: </strong>In both the primary and validation analyses, no difference was seen between rTMS and medication on the symptom clusters. Similar patterns of response were observed in all groups, with 'Insomnia' showing the greatest effect of treatment. Baseline cluster scores did not predict treatment response.</p><p><strong>Conclusions: </strong>We did not find a differential effect of rTMS or antidepressant medication on depressive symptom clusters. Both treatments demonstrated comparable response patterns for all clusters, and baseline cluster scores did not differ between responders and non-responders. Future studies with larger samples or more homogeneous treatments may elucidate the role of symptom clusters as a tool for more individualized treatment.</p><p><strong>Trial registration: </strong>PITA NCT03548675 DETECT The Netherlands Trial Register NL7628.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":"1799-1807"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12500816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}