European Archives of Psychiatry and Clinical Neuroscience最新文献

{"title":"The importance of incorporation of real-world evidence into the guidelines on the pharmacological treatment of schizophrenia.","authors":"Istvan Bitter, Lajos Katona, Peter Falkai, Pal Czobor","doi":"10.1007/s00406-024-01938-1","DOIUrl":"10.1007/s00406-024-01938-1","url":null,"abstract":"<p><p>The quantity and quality of real-world data and real-world evidence in schizophrenia research are at a high level. However, these results are not included in the grading systems used to develop treatment guidelines for schizophrenia. A meta-analysis and a network meta-analysis have independently provided evidence that the results of randomized clinical trials in schizophrenia adequately translate to real-world settings. The authors propose the incorporation of a synthesis of evidence derived from analyses of randomized controlled trials and real-world data as a novel and highest level of evidence in grading instruments used to develop treatment guidelines for schizophrenia.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":"1521-1523"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616595","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}

{"title":"How esketamine influences inflammatory cytokines, cortisol and anhedonia in TRD patients is an open question.","authors":"Thalles Rodrigues Alves Leite, Déborah Araújo Leitão, Letícia Braga Martins, Luísa Weber Bisol","doi":"10.1007/s00406-025-01960-x","DOIUrl":"10.1007/s00406-025-01960-x","url":null,"abstract":"","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":"1527-1529"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032752","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":"Genetic determinants of antidepressant and antipsychotic drug response.","authors":"Hans H Stassen, S Bachmann, R Bridler, K Cattapan, A M Hartmann, D Rujescu, E Seifritz, M Weisbrod, Chr Scharfetter","doi":"10.1007/s00406-024-01918-5","DOIUrl":"10.1007/s00406-024-01918-5","url":null,"abstract":"<p><p>Today, more than 90% of inpatients hospitalized with Major Depression or Schizophrenia are treated with psychotropic drugs. Since none of the treatment options is causal, response rates are modest and the course of recovery is very heterogeneous. Genetic studies on the etiology and pathogenesis of major psychiatric disorders over the past decades have been largely unsuccessful. Likewise, genetic studies to predict response to psychopharmacological treatment have also not been particularly successful. In this project we have recruited 902 inpatients with ICD-10 diagnoses of schizophrenic (\"F2 patients\") or depressive disorders (\"F3 patients\"). The study assessed today's acute inpatient treatment regimens with up to 8 repeated measurements regarding the time course of recovery and adverse side effects. The genotyping included 100 candidate genes with genotypic patterns computed from 549 Single Nucleotide Polymorphisms (SNPs). To predict response to psychopharmacological treatment, we relied on a multidimensional approach to analyzing genetic diversity in combination with multilayer Neural Nets (NNs). Central to this new method were the \"gene vectors\" that (1) assessed the multidimensional genotypic patterns observed with genes; and (2) evaluated the correlations between genes. By means of these methods, we searched for combinations of multidimensional genotypic patterns that were characteristic of treatment responders while being rare among non-responders. The chosen method of approach provided a powerful technique to detail the complex structures of SNP data that are not detectable by conventional association methods. Molecular-genetic NNs enabled correct classification of 100% \"non-responders\", along with 94.7% correctly classified \"responders\" among the F2 patients, and 82.6% correctly classified \"responders\" among the F3 patients. The F2 and F3 classifiers were not disjoint but showed an overlap of 29.6% and 35.7% between the diagnostic groups, thus indicating that clinical diagnoses may not constitute etiologic entities. Our results suggested that patients may have an unspecific physical-genetic disposition that enables, facilitates, impedes or prevents recovery from major psychiatric disorders by setting various thresholds for exogenous triggers that initiate improvement (\"recovery disposition\"). Even though this disposition is not causally linked to recovery, it can nonetheless be clinically used in the sense of a \"surrogate\". Indeed, clinicians are also interested in reliable tools that can \"do the job\", despite the fact that etiology and pathogenesis of the treated disorders remain unknown.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":"1419-1435"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388995","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}

{"title":"Ketamine-induced altered states of consciousness: a systematic review of implications for therapeutic outcomes in psychiatric practices.","authors":"Kaike Thiê da Costa Gonçalves, Vagner Deuel O de Tavares, Maria Luiza de Morais Barros, Aldielyson Jorge Cavalcante de Brito, Patrícia Cavalcanti-Ribeiro, Fernanda Palhano-Fontes, Marcelo Falchi-Carvalho, Emerson Arcoverde, Rafael Guimarães Dos Santos, Jaime E C Hallak, Draulio Barros de Araujo, Nicole Leite Galvão-Coelho","doi":"10.1007/s00406-024-01925-6","DOIUrl":"10.1007/s00406-024-01925-6","url":null,"abstract":"<p><p>This systematic review aims to elucidate the nexus between ketamine's psychoactive properties and its efficacy in treating a broad spectrum of psychiatric disorders. We searched three databases and used citation tracking to include 29 studies. Predominantly, mood disorders, including bipolar disorder (BD) and major depressive disorder (MDD) (MDD + BD: + n = 25 studies), a large part of them involve treatment-resistant patients (n = 14 studies), substance use disorder (SUD, n = 3 studies), and social anxiety disorder (SAD, n = 1 study). From all included studies (n = 29), 15 (51.72%) of them identified a positive relation between ketamine-induced altered states of consciousness and clinical outcomes, while 13 studies (44.83%) showed no linkage between them, and one study (3.45%) delineated a negative association. Focusing solely on intravenous (IV) ketamine infusions (n = 25), 14 studies (56%) reported a positive modulation of ketamine's psychoactive effects and therapeutic benefits, whereas 10 studies (40%) confirmed no relationship, and one study (4%) showed a negative association. The single study (33.34%) involving subcutaneous ketamine and all three studies (66.6%) intranasal administration did not demonstrate a significant interaction between ketamine's psychoactive effects and therapeutic response. All three SUD studies reported a positive correlation between ketamine's psychoactive effects and therapeutic response. In contrast, the single SAD study did not find a relationship between these parameters. For studies involving mood disorders (n = 25), 12 studies (48%) reported a positive relationship between psychoactive effects and therapeutic response. Others 12 studies (48%) identified a null relationship, and one study (4%) found a significant negative association. Although we have found a larger association than previous studies between ketamine's psychoactive properties and its efficacy in treating a broad spectrum of psychiatric disorders, its topic remains indeterminate, mainly due to the high heterogeneity.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":"1271-1299"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521422","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":"A stratified treatment algorithm in psychiatry: a program on stratified pharmacogenomics in severe mental illness (Psych-STRATA): concept, objectives and methodologies of a multidisciplinary project funded by Horizon Europe.","authors":"B T Baune, S E Fromme, M Aberg, M Adli, A Afantitis, I Akkouh, O A Andreassen, C Angulo, S Barlati, C Brasso, P Bucci, M Budde, P Buspavanich, V Cavone, K Demyttenaere, C M Diaz-Caneja, M Dierssen, S Djurovic, M Driessen, U W Ebner-Priemer, J Engelmann, S Englisch, C Fabbri, P Fossati, H Fröhlich, S Gasser, N Gottlieb, E Heirman, A Hofer, O Howes, L Ilzarbe, H Jeung-Maarse, L V Kessing, T D Kockler, M Landén, L Levi, K Lieb, N Lorenzon, J Luykx, M Manchia, M Martinez de Lagran, A Minelli, C Moreno, A Mucci, B Müller-Myhsok, P Nilsson, C Okhuijsen-Pfeifer, K D Papavasileiou, S Papiol, A F Pardinas, P Paribello, C Pisanu, M-C Potier, A Reif, R Ricken, S Ripke, P Rocca, D Scherrer, C Schiweck, K O Schubert, T G Schulze, A Serretti, A Squassina, C Stephan, A Tsoumanis, E Van der Eycken, E Vieta, A Vita, J T R Walters, D Weichert, M Weiser, I R Willcocks, I Winter-van Rossum, A H Young, M J Ziller","doi":"10.1007/s00406-024-01944-3","DOIUrl":"10.1007/s00406-024-01944-3","url":null,"abstract":"<p><p>Schizophrenia (SCZ), bipolar (BD) and major depression disorder (MDD) are severe psychiatric disorders that are challenging to treat, often leading to treatment resistance (TR). It is crucial to develop effective methods to identify and treat patients at risk of TR at an early stage in a personalized manner, considering their biological basis, their clinical and psychosocial characteristics. Effective translation of theoretical knowledge into clinical practice is essential for achieving this goal. The Psych-STRATA consortium addresses this research gap through a seven-step approach. First, transdiagnostic biosignatures of SCZ, BD and MDD are identified by GWAS and multi-modal omics signatures associated with treatment outcome and TR (steps 1 and 2). In a next step (step 3), a randomized controlled intervention study is conducted to test the efficacy and safety of an early intensified pharmacological treatment. Following this RCT, a combined clinical and omics-based algorithm will be developed to estimate the risk for TR. This algorithm-based tool will be designed for early detection and management of TR (step 4). This algorithm will then be implemented into a framework of shared treatment decision-making with a novel mental health board (step 5). The final focus of the project is based on patient empowerment, dissemination and education (step 6) as well as the development of a software for fast, effective and individualized treatment decisions (step 7). The project has the potential to change the current trial and error treatment approach towards an evidence-based individualized treatment setting that takes TR risk into account at an early stage.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":"1453-1464"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893083","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}

{"title":"Association between epigenetic age acceleration and psychiatric disorders: a bidirectional Mendelian randomization study.","authors":"Yanggang Hong","doi":"10.1007/s00406-025-02069-x","DOIUrl":"https://doi.org/10.1007/s00406-025-02069-x","url":null,"abstract":"<p><p>Aging is a complex process influenced by genetic, environmental, and psychiatric factors. Recent evidence suggests that epigenetic age acceleration (EAA), a biomarker of biological aging, may be linked to psychiatric disorders, yet the causal direction remains unclear. This study employed a bidirectional two-sample Mendelian randomization (MR) analysis to explore the causal relationships between EAA (IEAA, HannumAA, GrimAA, PhenoAA) and ten psychiatric disorders. Genome-wide association study (GWAS) summary statistics from large European ancestry cohorts were used, and sensitivity analyses were conducted to ensure robustness. Forward MR analysis demonstrated that PhenoAge acceleration (PhenoAA) significantly increased the risk of attention-deficit hyperactivity disorder (ADHD) (OR = 1.043, P = 0.004), suggesting that cumulative biological aging may contribute to neurodevelopmental vulnerabilities. Conversely, Hannum age acceleration (HannumAA) was associated with a protective effect against obsessive-compulsive disorder (OCD) (OR = 0.904, P = 0.004). Reverse MR analysis revealed that autism spectrum disorder (ASD) was linked to a decrease in intrinsic epigenetic age acceleration (IEAA) (OR = 0.811, P = 0.027), while major depressive disorder (MDD) significantly increased both HannumAA (OR = 1.318, P = 0.005) and IEAA (OR = 1.226, P = 0.049). These findings suggest that psychiatric conditions may both influence and be influenced by biological aging processes. This study reveals a bidirectional link between psychiatric disorders and biological aging, showing that early-life mental health conditions may accelerate epigenetic aging and increase age-related disease risk. As psychiatric disorders are recognized as aging risk factors, these findings highlight the need for research on aging-targeted interventions in psychiatric populations.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759480","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":"Pathways to professional mental care in the Swiss young adult community: a case-control study.","authors":"N Osman, C Michel, B G Schimmelmann, L Schilbach, E Meisenzahl, F Schultze-Lutter","doi":"10.1007/s00406-024-01757-4","DOIUrl":"10.1007/s00406-024-01757-4","url":null,"abstract":"<p><p>Treatment success for mental health (MH) problems depends, among others, on the timeliness of help-seeking. Therefore, we studied the effect of symptoms and reasons for help-seeking on the point-of-contact and the most intensive professional treatment in a community sample. Participants were recruited as part of the 'Bern Epidemiological At-Risk' (BEAR) study on 16-40-year-old community persons of the Swiss canton Bern. Of the 2,683 participants, 615 (22.9%) reported at least one instance of help-seeking for MH problems and were selected for the presented analyses. Help-seeking behavior was assessed by a modified version of the 'WHO pathway-to-care questionnaire', from which the outcome 'most intensive MH professional contact' was generated. The effect of symptoms and reasons for help-seeking were analyzed in separate models using path analyses. Most help-seeking persons sought MH professional help (n = 405; 65.9%) with a high number of medical pre-contacts (n = 233; 37.9%). The 'most intensive MH professional contact' was provided after an average of 1.47 contacts. Both models showed negative associations between non-MH professional pre-contacts and the most intensive, likely most adequate MH treatment. In the symptom model, 'substance misuse' and 'central-vegetative problems' increased the general likelihood of MH professional contact. Our findings highlight the importance of the first point-of-contact in pathways to adequate MH care and, when seeking help from non-MH professional, of quick referrals to MH professionals. Awareness campaigns or training of health professionals, such as general practitioners, may support timely contact with MH professionals to improve diagnosis, prognosis, and outcome.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":"1509-1520"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140012458","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}

{"title":"Oral ketamine effects on dynamics of functional network connectivity in patients treated for chronic suicidality.","authors":"Zack Y Shan, Adem T Can, Abdalla Z Mohamed, Megan Dutton, Daniel F Hermens, Vince D Calhoun, Leanne M Williams, Maxwell Bennett, Jim Lagopoulos","doi":"10.1007/s00406-024-01831-x","DOIUrl":"10.1007/s00406-024-01831-x","url":null,"abstract":"<p><p>The underlying brain mechanisms of ketamine in treating chronic suicidality and the characteristics of patients who will benefit from ketamine treatment remain unclear. To address these gaps, we investigated temporal variations of brain functional synchronisation in patients with suicidality treated with ketamine in a 6-week open-label oral ketamine trial. The trial's primary endpoint was the Beck Scale for Suicide Ideation (BSS). Patients who experienced greater than 50% improvement in BSS scores or had a BSS score less than 6 at the post-treatment and follow-up (10 weeks) visits were considered responders and persistent responders, respectively. The reoccurring and transient connectivity pattern (termed brain state) from 29 patients (45.6 years ± 14.5, 15 females) were investigated by dynamic functional connectivity analysis of resting-state functional MRI at the baseline, post-treatment, and follow-up. Post-treatment patients showed significantly more (FDR-Q = 0.03) transitions among whole brain states than at baseline. We also observed increased dwelling time (FDR-Q = 0.04) and frequency (FDR-Q = 0.04) of highly synchronised brain state at follow-up, which were significantly correlated with BSS scores (both FDR-Q = 0.008). At baseline, persistent responders had higher fractions (FDR-Q = 0.03, Cohen's d = 1.39) of a cognitive control network state with high connectivities than non-responders. These findings suggested that ketamine enhanced brain changes among different synchronisation patterns and enabled high synchronisation patterns in the long term, providing a possible biological pathway for its suicide-prevention effects. Moreover, differences in cognitive control states at baseline may be used for precise ketamine treatment planning.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":"1347-1357"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141075339","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}

{"title":"A network analysis of voice hearing, emotional distress and subjective recovery before and after cognitive behavioural interventions.","authors":"Sofia Loizou, Björn Schlier, David Fowler, Mark Hayward","doi":"10.1007/s00406-024-01916-7","DOIUrl":"10.1007/s00406-024-01916-7","url":null,"abstract":"<p><strong>Background: </strong>There is a need to identify and to better understand key processes involved in voice hearing, which can inform the targeting and development of psychological interventions for distressing voices. The current study aimed to examine interrelations between the negative impact of voices, voice characteristics, emotional distress and recovery before and after cognitive behavioural interventions for voices (Coping Strategy Enhancement, guided self-help Cognitive Behavioural Therapy, Relating Therapy and Person-Based Cognitive Therapy).</p><p><strong>Methods: </strong>The sample consisted of 172 participants from the Sussex Voices Clinic who completed pre- and post-treatment assessments. The negative impact of voices, voice characteristics, emotional distress and recovery were used to estimate two networks, before and after cognitive behavioural interventions, using the graphical lasso method with the extended Bayesian information criterion. Centrality indices were also computed, and the two networks were compared on connectivity, structure and individual edge weights.</p><p><strong>Results: </strong>Depression, anxiety and the negative impact of voices were identified as key central symptoms and acted as bridge symptoms in pre- and post-treatment networks. There were no significant differences in network structure (M = 0.155, p = .57), global strength (S = 0.188, p = .07) and centralities (C = -0.318, p = -.06) between the two networks.</p><p><strong>Conclusion: </strong>Our findings suggest that anxiety and depression are promising treatment targets, that can lead to reductions in voice-related distress, whereas the characteristics of voices and subjective recovery play little role in the network structure. Limitations include the lack of a control group and the lack of diversity within the sample.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":"1477-1489"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460918","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}

{"title":"Effects of cognitive behavioural therapy and exposure-response prevention on brain activation in obsessive-compulsive disorder patients: systematic review and meta-analysis.","authors":"Callum Stephenson, Aaron Philipp-Muller, Elnaz Moghimi, Joseph Y Nashed, Douglas J Cook, Amirhossein Shirazi, Roumen Milev, Nazanin Alavi","doi":"10.1007/s00406-024-01852-6","DOIUrl":"10.1007/s00406-024-01852-6","url":null,"abstract":"<p><p>Current psychotherapeutic treatments for OCD, while effective, have complex outcomes with mixed efficacy. Previous research has observed baseline brain activation patterns in OCD patients, elucidating some of the implications of this disorder. Observing the effects of evidence-based psychotherapeutics for OCD on brain activation (through MRI) may provide a more comprehensive outline of pathology. This systematic review and meta-analysis evaluated the effects of cognitive behavioural therapy (CBT) with exposure-response prevention (ERP) on brain activation in OCD patients. Academic databases were systematically searched, and the outcomes evaluated included changes in brain activation and symptom severity between baseline and post-treatment. Patients (n = 193) had confirmed OCD diagnosis and underwent protocolized CBT with ERP programs delivered by trained therapists. Participants in the CBT with ERP programs demonstrated significant improvements in symptom severity (Cohen's d = - 1.91). In general, CBT with ERP resulted in decreased activation post-treatment in the frontal (Cohen's d = 0.40), parietal (Cohen's d = 0.79), temporal (Cohen's d = 1.02), and occipital lobe (Cohen's d = 0.76), and cerebellum (Cohen's d = - 0.78). The findings support CBT with ERP's ability to improve brain activation abnormalities in OCD patients. By identifying regions that improved activation levels, psychotherapy programs may benefit from the addition of function-specific features that could improve treatment outcomes.</p>","PeriodicalId":11822,"journal":{"name":"European Archives of Psychiatry and Clinical Neuroscience","volume":" ","pages":"1491-1507"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141456024","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}