General Psychiatry最新文献

{"title":"Deep magnetic stimulation targeting the medial prefrontal and anterior cingulate cortices for methamphetamine use disorder: a randomised, double-blind, sham-controlled study.","authors":"Di Zhao, Ningning Zeng, Hang-Bin Zhang, Yi Zhang, Jiatong Shan, Huichun Luo, Abraham Zangen, Ti-Fei Yuan","doi":"10.1136/gpsych-2023-101149","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101149","url":null,"abstract":"© Author(s) (or their employer(s)) 2023. Reuse permitted under CC BYNC. No commercial reuse. See rights and permissions. Published by BMJ. Craving is a key component of substance use disorders (SUDs). In recent decades, repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising treatment for individuals with SUDs by reducing their drug cravings and drugassociated cues, including methamphetamine, heroin, cocaine, nicotine and alcohol. Recently, the transdiagnostic consistency of the medial prefrontal cortex (MPFC) and anterior cingulate cortex (ACC) as neural substrates underlying cue reactivity was proposed. A recent study using highdensity, 128channel electroencephalography (EEG) reported that betaband (13–30 Hz) activity in the MPFC could serve as a neurophysiological signature for the incubation of cravings in individuals with methamphetamine use disorder (MUD). Previous neuroimaging evidence has shown that the MPFC and ACC are critical neural substrates that generate cravings in patients with MUD. Recently, the MPFC and ACC were posited as promising targets for the deep transcranial magnetic stimulation (TMS) treatment of SUD owing to their involvement in reward, emotions and habit formation. 13 However, the potential effects of rTMS to the MPFC and ACC on the cravings of patients with MUD have yet to be elucidated. Several studies on substance abuse treatment have reported the use of the H7 coil (Brainsway, Jerusalem, Israel), a TMS coil that can selectively target the MPFC and ACC. 13 In the present study, chronic rTMS was delivered via the H7 coil to the MPFC and ACC of subjects with MUD (figure 1A). We hypothesised that modulating the methamphetamine cueprocessing circuitry by targeting the MPFC might reduce cueinduced cravings and investigate the potential changes in the largescale EEG neural network and neural oscillation signature (eg, MPFC beta oscillation) of cravings that may occur in response to brain stimulation treatment. The doubleblind, shamcontrolled, randomised trial was registered at ClinicalTrials. gov (NCT04202926). In accordance with the Declaration of Helsinki, all subjects provided written informed consent and voluntarily participated in the study. The criteria for inclusion in this study are as follows: WhaT is already knoWn on This TopiC","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":11.9,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/13/dd/gpsych-2023-101149.PMC10533780.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41121930","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":"Cognitive control subprocess deficits and compensatory modulation mechanisms in patients with frontal lobe injury revealed by EEG markers: a basic study to guide brain stimulation.","authors":"Sinan Liu,&nbsp;Chaoqun Shi,&nbsp;Huanhuan Meng,&nbsp;Yu Meng,&nbsp;Xin Gong,&nbsp;Xiping Chen,&nbsp;Luyang Tao","doi":"10.1136/gpsych-2023-101144","DOIUrl":"10.1136/gpsych-2023-101144","url":null,"abstract":"<p><strong>Background: </strong>Frontal lobe injury (FLI) is related to cognitive control impairments, but the influences of FLI on the internal subprocesses of cognitive control remain unclear.</p><p><strong>Aims: </strong>We sought to identify specific biomarkers for long-term dysfunction or compensatory modulation in different cognitive control subprocesses.</p><p><strong>Methods: </strong>A retrospective case-control study was conducted. Event-related potentials (ERP), oscillations and functional connectivity were used to analyse electroencephalography (EEG) data from 12 patients with unilateral frontal lobe injury (UFLI), 12 patients with bilateral frontal lobe injury (BFLI) and 26 healthy controls (HCs) during a Go/NoGo task, which included several subprocesses: perceptual processing, anticipatory preparation, conflict monitoring and response decision.</p><p><strong>Results: </strong>Compared with the HC group, N2 (the second negative peak in the averaged ERP waveform) latency, and frontal and parietal oscillations were decreased only in the BFLI group, whereas P3 (the third positive peak in the averaged ERP waveform) amplitudes and sensorimotor oscillations were decreased in both patient groups. The functional connectivity of the four subprocesses was as follows: alpha connections of posterior networks in the BFLI group were lower than in the HC and UFLI groups, and these alpha connections were negatively correlated with neuropsychological tests. Theta connections of the dorsal frontoparietal network in the bilateral hemispheres of the BFLI group were lower than in the HC and UFLI groups, and these connections in the uninjured hemisphere of the UFLI group were higher than in the HC group, which were negatively correlated with behavioural performances. Delta and theta connections of the midfrontal-related networks in the BFLI group were lower than in the HC group. Theta across-network connections in the HC group were higher than in the BFLI group but lower than in the UFLI group.</p><p><strong>Conclusions: </strong>The enhancement of low-frequency connections reflects compensatory mechanisms. In contrast, alpha connections are the opposite, therefore revealing more abnormal neural activity and less compensatory connectivity as the severity of injury increases. The nodes of the above networks may serve as stimulating targets for early treatment to restore corresponding functions. EEG biomarkers can measure neuromodulation effects in heterogeneous patients.</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":11.9,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/10/35/gpsych-2023-101144.PMC10503333.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10652936","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":"Why caution should be applied when interpreting and promoting findings from Mendelian randomisation studies.","authors":"Alice R Carter, Abigail Fraser, Laura D Howe, Sian Harris, Amanda Hughes","doi":"10.1136/gpsych-2023-101047","DOIUrl":"10.1136/gpsych-2023-101047","url":null,"abstract":"","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":5.3,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10423826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10012692","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":"The mediating role of sleep quality on the relationship between internet gaming disorder and perceived stress and suicidal behaviour among Indian medical students.","authors":"Sunny Garg, Aakanksha Kharb, Deepika Verma, Ritu Antil, Binika Khanna, Ritika Sihag, Divya Lamba","doi":"10.1136/gpsych-2022-100997","DOIUrl":"10.1136/gpsych-2022-100997","url":null,"abstract":"<p><strong>Background: </strong>In the recent digital era, individuals with internet gaming disorder (IGD) have reported a much higher prevalence of poor sleep quality, perceived stress and suicidal behaviour. However, the underlying mechanisms for these psychological problems remain unknown.</p><p><strong>Aims: </strong>The primary aims of this study were to explore the mediating role of sleep quality on the relationship between IGD and the health outcomes of perceived stress and suicidal behaviour and to assess the prevalence and risk factors for IGD among medical students.</p><p><strong>Methods: </strong>A cross-sectional study enrolling 795 medical students from two medical colleges in a rural area of North India was conducted from April to May 2022. The study participants were chosen using a stratified random sampling approach. A self-administered questionnaire was used to collect data, including sociodemographic and personal information and gaming characteristics. The study also included the Gaming Disorder and Hazardous Gaming Scale, the Pittsburgh Sleep Quality Index, the Perceived Stress Scale-10 and the Suicide Behaviors Questionnaire-Revised to measure IGD, sleep quality, perceived stress and suicidal behaviour, respectively. Multiple logistic regression for the risk factors and Pearson's correlation test for the relationship between variables were used. Hayes' PROCESS macro for SPSS was employed to carry out mediation analysis.</p><p><strong>Results: </strong>Among the 348 gamers with a mean age of 21.03 (SD 3.27) years, the prevalence of IGD was 15.23% (95% confidence interval: 11.6% to 19.4%). In the correlational analysis, small to large (r: 0.32-0.72) significant relationships between scores of IGD and other health outcomes were established. The indirect effect (B=0.300) via sleep quality accounted for 30.62% of the total effect (B=0.982) of IGD on perceived stress (partially mediated), while sleep quality (B=0.174) accounted for 27.93% of the total effect (B=0.623) of IGD on suicidal behaviour (partially mediated). The factors of being male, living in a single-parent family, using the internet for other than academic purposes (1-3 hours and more than 3 hours/day), playing games for more than 3 hours/day and playing games with violent content were associated with IGD symptoms.</p><p><strong>Conclusions: </strong>Using a dimensional measure, the results specified the relationship between IGD and perceived stress and suicidal behaviour by demonstrating that sleep quality meditated them. This modifiable mediating factor can be addressed by psychotherapy to mitigate the risk of perceived stress and suicidal behaviour among the future medical workforce.</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":5.3,"publicationDate":"2023-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8c/55/gpsych-2022-100997.PMC10254597.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9623248","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":"Improved lifestyle is associated with improved depression, anxiety and well-being over time in UK healthcare professionals during the COVID-19 pandemic: insights from the CoPE-HCP cohort study.","authors":"Mohammed Y Khanji, George Collett, Thomas Godec, Carmela Maniero, Sher May Ng, Imrana Siddiqui, Jaya Gupta, Vikas Kapil, Ajay Gupta","doi":"10.1136/gpsych-2022-100908","DOIUrl":"10.1136/gpsych-2022-100908","url":null,"abstract":"<p><strong>Background: </strong>One potential modifiable factor to improve the mental health of healthcare professionals (HCPs) during the pandemic is lifestyle.</p><p><strong>Aims: </strong>This study aimed to assess whether an improved lifestyle during the pandemic is associated with improved mental health symptoms and mental well-being in HCPs over time.</p><p><strong>Methods: </strong>This was a cohort study involving an online survey distributed at two separate time points during the pandemic (baseline (July-September 2020) and follow-up (December 2020-March 2021)) to HCPs working in primary or secondary care in the UK. Both surveys assessed for major depressive disorder (MDD) (Patient Health Questionnaire-9 (PHQ-9)), generalised anxiety disorder (GAD) (Generalised Anxiety Disorder-7 (GAD-7)), mental well-being (Short Warwick-Edinburgh Mental Well-being Score (SWEMWBS)) and self-reported lifestyle change (compared with the start of the pandemic) on multiple domains. Cumulative scores were calculated to estimate overall lifestyle change compared with that before the pandemic (at both baseline and follow-up). At each time point, separate logistic regression models were constructed to relate the lifestyle change score with the presence of MDD, GAD and low mental well-being. Linear regression models were also developed relating the change in lifestyle scores from baseline to follow-up to changes in PHQ-9, GAD-7 and SWEMWBS scores.</p><p><strong>Results: </strong>613 HCPs completed both baseline assessment and follow-up assessment. Consistent significant cross-sectional associations between increased lifestyle change scores and a reduced risk of MDD, GAD and low mental well-being were observed at both baseline and follow-up. Over the study period, a whole unit increase in the change in novel scores (ie, improved overall lifestyle) over 4 months was inversely associated with changes in PHQ-9 (adjusted coefficient: -0.51, 95% confidence interval (CI): -0.73 to -0.30, p<0.001) and GAD-7 scores (adjusted coefficient: -0.32, 95% CI: -0.53 to -0.10, p=0.004) and positively associated with the change in SWEMWBS scores (adjusted coefficient: 0.37, 95% CI: 0.18 to 0.55, p<0.001).</p><p><strong>Conclusions: </strong>Improved lifestyle over time is associated with improved mental health and mental well-being in HCPs during the pandemic. Improving lifestyle could be a recommended intervention for HCPs to help mitigate the mental health impact during the current and future pandemics.</p><p><strong>Trial registration number: </strong>NCT04433260.</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":5.3,"publicationDate":"2023-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a5/90/gpsych-2022-100908.PMC9895916.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10666275","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":"Alteration of faecal microbiota balance related to long-term deep meditation.","authors":"Ying Sun, Peijun Ju, Ting Xue, Usman Ali, Donghong Cui, Jinghong Chen","doi":"10.1136/gpsych-2022-100893","DOIUrl":"10.1136/gpsych-2022-100893","url":null,"abstract":"<p><strong>Background: </strong>Advancements in research have confirmed that gut microbiota can influence health through the microbiota-gut-brain axis. Meditation, as an inner mental exercise, can positively impact the regulation of an individual's physical and mental health. However, few studies have comprehensively investigated faecal microbiota following long-term (several years) deep meditation. Therefore, we propose that long-term meditation may regulate gut microbiota homeostasis and, in turn, affect physical and mental health.</p><p><strong>Aims: </strong>To investigate the effects of long-term deep meditation on the gut microbiome structure.</p><p><strong>Methods: </strong>To examine the intestinal flora, 16S rRNA gene sequencing was performed on faecal samples of 56 Tibetan Buddhist monks and neighbouring residents. Based on the sequencing data, linear discriminant analysis effect size (LEfSe) was employed to identify differential intestinal microbial communities between the two groups. Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt) analysis was used to predict the function of faecal microbiota. In addition, we evaluated biochemical indices in the plasma.</p><p><strong>Results: </strong>The α-diversity indices of the meditation and control groups differed significantly. At the genus level, <i>Prevotella</i> and <i>Bacteroides</i> were significantly enriched in the meditation group. According to the LEfSe analysis, two beneficial bacterial genera (<i>Megamonas</i> and <i>Faecalibacterium</i>) were significantly enriched in the meditation group. Functional predictive analysis further showed that several pathways-including glycan biosynthesis, metabolism and lipopolysaccharide biosynthesis-were significantly enriched in the meditation group. Moreover, plasma levels of clinical risk factors were significantly decreased in the meditation group, including total cholesterol and apolipoprotein B.</p><p><strong>Conclusions: </strong>Long-term traditional Tibetan Buddhist meditation may positively impact physical and mental health. We confirmed that the gut microbiota composition differed between the monks and control subjects. The microbiota enriched in monks was associated with a reduced risk of anxiety, depression and cardiovascular disease and could enhance immune function. Overall, these results suggest that meditation plays a positive role in psychosomatic conditions and well-being.</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":5.3,"publicationDate":"2023-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9896348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10684476","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":"Causal associations between major depressive disorder and COVID-19.","authors":"Ancha Baranova,&nbsp;Yi Zhao,&nbsp;Hongbao Cao,&nbsp;Fuquan Zhang","doi":"10.1136/gpsych-2022-101006","DOIUrl":"https://doi.org/10.1136/gpsych-2022-101006","url":null,"abstract":"<p><strong>Background: </strong>We aimed to evaluate whether major depressive disorder (MDD) could aggravate the outcomes of coronavirus disease 2019 (COVID-19) or whether the genetic liability to COVID-19 could trigger MDD.</p><p><strong>Aims: </strong>We aimed to assess bidirectional causal associations between MDD and COVID-19.</p><p><strong>Methods: </strong>We performed genetic correlation and Mendelian randomisation (MR) analyses to assess potential associations between MDD and three COVID-19 outcomes. Literature-based network analysis was conducted to construct molecular pathways connecting MDD and COVID-19.</p><p><strong>Results: </strong>We found that MDD has positive genetic correlations with COVID-19 outcomes (r_g: 0.10-0.15). Our MR analysis indicated that genetic liability to MDD is associated with increased risks of COVID-19 infection (odds ratio (OR)=1.05, 95% confidence interval (CI): 1.00 to 1.10, p=0.039). However, genetic liability to the three COVID-19 outcomes did not confer any causal effects on MDD. Pathway analysis identified a panel of immunity-related genes that may mediate the links between MDD and COVID-19.</p><p><strong>Conclusions: </strong>Our study suggests that MDD may increase the susceptibility to COVID-19. Our findings emphasise the need to increase social support and improve mental health intervention networks for people with mood disorders during the pandemic.</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":11.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/db/97/gpsych-2022-101006.PMC10083530.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9317640","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 selective literature review exploring the role of the nicotinic system in schizophrenia.","authors":"Guna Kanniah,&nbsp;Rishi Kumar","doi":"10.1136/gpsych-2022-100756","DOIUrl":"https://doi.org/10.1136/gpsych-2022-100756","url":null,"abstract":"<p><p>Nicotine use is more prevalent in patients with psychiatric disorders, especially those diagnosed with psychotic illnesses. Previously, this higher prevalence has been partially attributed to the potential ameliorative effects of nicotine on symptom severity and cognitive impairment. Some healthcare professionals and patients perceive there is a beneficial effect of nicotine on mental health. Emerging data show that the harm associated with nicotine in the population of patients with mental health conditions outweighs any potential benefit. This paper will review the evidence surrounding the nicotinic system and schizophrenia, with a focus on any causality between nicotine and psychosis.</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":11.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fb/3f/gpsych-2022-100756.PMC10016241.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9498930","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":"The mean age of gender dysphoria diagnosis is decreasing.","authors":"Ching-Fang Sun,&nbsp;Hui Xie,&nbsp;Vemmy Metsutnan,&nbsp;John H Draeger,&nbsp;Yezhe Lin,&nbsp;Maria Stack Hankey,&nbsp;Anita S Kablinger","doi":"10.1136/gpsych-2022-100972","DOIUrl":"https://doi.org/10.1136/gpsych-2022-100972","url":null,"abstract":"Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA Zilber School of Public Health, University of WisconsinMilwaukee, Milwaukee, Wisconsin, USA Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, Tongji University, Shanghai, Shanghai, China Health Analytics Research Team (HART), Carilion Clinic, Roanoke, Virginia, USA","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":11.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/15/50/gpsych-2022-100972.PMC10314610.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9747993","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":"On testing proportional odds assumptions for proportional odds models.","authors":"Anqi Liu,&nbsp;Hua He,&nbsp;Xin M Tu,&nbsp;Wan Tang","doi":"10.1136/gpsych-2023-101048","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101048","url":null,"abstract":"<p><p>Proportional odds models are commonly used to model ordinal responses, but the proportional odds assumption may not hold in practice, leading to biased inference. Tests such as score, Wald and likelihood ratio (LR) have been proposed to evaluate the proportional odds assumption based on models without the assumption. Brant has proposed an independent binary model-based Wald-type test, and Wolfe and Gould have extended the idea to propose an LR-type test. This paper provides a brief review of the Brant and Wolfe-Gould tests for evaluating the proportional odds assumption and evaluates their performance through simulation studies and a real data example. Sample programs are provided in SAS, SPSS and Stata to facilitate the implementation of these tests using standard statistical software packages. This study highlights the importance of evaluating the proportional odds assumption when using proportional odds models for ordinal responses. The sample programs provided in this paper make it easy for researchers to apply these tests in their own analyses using standard statistical software packages.</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":null,"pages":null},"PeriodicalIF":11.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4d/93/gpsych-2023-101048.PMC10410795.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10304512","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}