General Psychiatry最新文献

{"title":"Exercise type, dose and mental health outcomes in youth: Which types and doses are sufficient?","authors":"Huagen Wang, Yisheng Aku, Shicun Xu, Zhanbing Ren, Yingjie Zhang, Runsen Chen, Jing An","doi":"10.1002/gps3.70031","DOIUrl":"10.1002/gps3.70031","url":null,"abstract":"<p><strong>Background: </strong>Although experimental evidence supports links between exercise and certain mental health indicators, epidemiological research has focused primarily on the dose-response effect of a single type of exercise, overlooking potential differences across exercise types in their associations with overall and specific mental health outcomes.</p><p><strong>Aims: </strong>To examine the associations between different types of exercise and multiple mental health outcomes, including depression, anxiety, post-traumatic stress disorder, suicidal ideation, suicide attempts and nonsuicidal self-injury, and to explore their dose-response relationships in terms of exercise frequency and duration.</p><p><strong>Methods: </strong>Data were drawn from a large-scale, cross-sectional study of 79 011 university students in Jilin Province, China, in 2021 via an online survey. Mental health outcomes were evaluated using validated scales and diagnoses. Propensity score matching was first applied to balance covariates between exercise types. Logistic regression analysis was then used to examine the associations between exercise types and mental health outcomes. Additionally, generalised additive models were employed to explore the dose-response relationships between exercise frequency/duration and mental health outcomes, adjusting for sociodemographic factors.</p><p><strong>Results: </strong>Among the 79 011 students reporting participation in physical exercise, team ball sports showed the strongest protective associations, followed by single anaerobic activities, two-player racket sports, single moderate-intensity aerobic sports and single low-intensity aerobic sports. U-shaped associations were observed between exercise frequency, duration and mental health outcomes. Exercising three to four times per week for 90-120 min was associated with a lower probability of reporting mental health problems, whereas excessive exercise was associated with poorer outcomes.</p><p><strong>Conclusion: </strong>Participation in different types of exercise is differentially associated with mental health outcomes, with team ball sports showing the most favourable associations. Optimal levels of exercise dosage vary between exercise types, suggesting that individuals may benefit from selecting exercise patterns that best support their mental health.</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"39 3","pages":"e70031"},"PeriodicalIF":9.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13261303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148250788","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":"Dissecting the polygenic architecture of psychopathology via singular value decomposition of eight psychiatric genome-wide association studies and evaluation of component-based polygenic scores.","authors":"Fernando Facal, Ana M Pérez-Gutiérrez, Javier Costas","doi":"10.1002/gps3.70027","DOIUrl":"10.1002/gps3.70027","url":null,"abstract":"<p><strong>Background: </strong>Current research suggests that genetic risk for psychiatric disorders is largely due to distinct combinations of many common variants shared by different disorders. This points to the existence of latent components affecting different dimensions of psychopathology.</p><p><strong>Aims: </strong>The aim of this study is to identify and characterise latent genetic components involved in psychopathology using a data-driven approach and evaluate their potential as principal component-based polygenic scores (PC-PGSs).</p><p><strong>Methods: </strong>Singular value decomposition was applied to a matrix of summary statistics from the largest available genome-wide association studies (GWASs) for eight psychiatric disorders to identify latent components. The components were characterised by gene mapping of the top contributing variants, enrichment analysis and genetic correlation with external traits. PC-PGSs were evaluated in the FinnGen dataset by computing group-wise PGSs from summary statistics using Reconstructing Allelic Count.</p><p><strong>Results: </strong>The different components were mainly involved in synapse organisation and neurodevelopment. The first latent component (PC1) explained 30.5% of the total variance and represented a broad transdiagnostic dimension. Neuroticism was the most strongly correlated external trait. Substance use traits and other psychiatric disorders were positively correlated, whereas cognitive traits were negatively correlated. The second latent component (14.7% of the variance) contrasted thought disorders with childhood-onset neurodevelopmental disorders. Educational attainment and creativity were the most correlated external traits. Other components were more related to a single disorder or differentiated between two related disorders. PC-PGSs in FinnGen largely showed associations in the expected direction, indicating a consistent overall trend for the different PC-PGSs. PC1-PGS was associated with all disorders. Other PC-PGSs showed the expected association in case-case comparisons.</p><p><strong>Conclusions: </strong>Decomposing GWAS summary statistic matrices can reveal functionally coherent dimensions of psychiatric genetic risk that could be clinically relevant, offering a potential framework to refine diagnosis, improve prediction and inform personalised treatment.</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"39 3","pages":"e70027"},"PeriodicalIF":9.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148198458","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":"Clinical outcomes of mitochondrial-enhancing nutraceutical supplementation in psychiatric disorders: A systematic review.","authors":"Juan Tortajada, Bengisu Kevser Bulduk, Belén Alfonso-Landete, Paula Alcaide-Barriga, Bernat Ballvé-Gelonch, Glòria Garrabou, Elisabet Vilella, Yolanda Alonso, Alba Valiente-Pallejà, Lourdes Martorell","doi":"10.1002/gps3.70023","DOIUrl":"10.1002/gps3.70023","url":null,"abstract":"<p><strong>Background: </strong>Nutraceutical supplementation targeting mitochondrial function has been proposed as a beneficial therapeutic strategy to improve physical and mental health in psychiatric patients.</p><p><strong>Aims: </strong>To summarise the results of studies evaluating nutraceutical supplementation targeting mitochondrial function in patients with psychiatric disorders.</p><p><strong>Methods: </strong>Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched PubMed, Embase and Scopus databases from 1 January 2007 to 30 April 2024. Reports were included if they evaluated outcomes of nutraceutical supplementation in patients with psychiatric disorders or related conditions. Additionally, we performed a risk-of-bias analysis of the studies compatible with the RoB2 tool.</p><p><strong>Results: </strong>Of the 2061 records identified, 122 studies met the inclusion criteria, evaluating vitamin D3, N-acetylcysteine, acetyl-L-carnitine, coenzyme Q10, alpha-lipoic acid, magnesium, vitamin B6, vitamin B7, folic acid, vitamin B12, vitamin E, vitamin A, vitamin C and vitamin B3. The most studied nutraceuticals were vitamin D3 (27.05%) and N-acetylcysteine (15.6%). Among randomised controlled clinical trials (RCTs), vitamin D3 was the most extensively investigated and accounted for the highest number of trials reporting improvements in clinical outcomes, although findings were heterogeneous. Notably, 14.8% of the studies evaluated combinations of three or more nutraceuticals. Dietary supplements were extensively evaluated for autism spectrum disorder (28 studies), schizophrenia spectrum disorder (27 studies), major depressive disorder or related depressive symptoms (22 studies), attention-deficit hyperactivity disorder (9 studies) and bipolar spectrum disorder (6 studies). A substantial proportion of studies were not RCTs but open-label single-arm trials or case reports. Significant heterogeneity was observed in the nutraceutical components used, treatment duration and the outcomes assessed. Overall, the risk of bias was high, and the methodological quality was generally low.</p><p><strong>Conclusions: </strong>Promising findings in nutraceutical studies for psychiatric disorders face challenges, including small sample sizes, short follow-up periods and a lack of treatment standardisation. Future research requires robust RCTs with standardised protocols and validated biomarkers of efficacy.</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"39 3","pages":"e70023"},"PeriodicalIF":9.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148198418","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":"Establishing clinically important differences in adults with attention deficit/hyperactivity disorder.","authors":"Zhao Fu, Jiahui Deng, Simin Kang, Junbin Tian, Qingjiu Cao, Yufeng Wang, Zongshi Qin, Li Yang","doi":"10.1002/gps3.70030","DOIUrl":"10.1002/gps3.70030","url":null,"abstract":"<p><strong>Background: </strong>The adult attention deficit hyperactivity disorder (ADHD) Self-Report Scale (ASRS) is one of the most widely used patient-reported outcome measures (PROMs) for evaluating ADHD symptom severity and treatment-related changes in clinical trials of adults with ADHD; however, clinically important differences (CIDs) for the ASRS remain poorly defined.</p><p><strong>Aims: </strong>This study aimed to review how CIDs for the ASRS have been reported in randomised controlled trials (RCTs) of adult ADHD and to establish ASRS-specific CID values for this population.</p><p><strong>Methods: </strong>We first conducted a cross-sectional literature search to examine the reporting of CID values in RCTs of adult ADHD interventions. We then conducted a secondary analysis of an RCT involving 56 adults with ADHD who received either active or sham transcranial alternating current stimulation. The ASRS total score served as the PROM. An anchor-based approach using the Clinical Global Impression-Improvement scale was applied. General linear mixed-effects modelling estimated mean differences across patient-defined improvement levels to identify categorical CID thresholds.</p><p><strong>Results: </strong>None of the 11 identified studies reported CID values for the ASRS as a PROM in adults with ADHD. The mixed-effects model indicated that a reduction of approximately 13.39 points in ASRS total score represents a clinically meaningful improvement (CID_within-group), and a reduction of 19.51 points represents substantial improvement, corresponding to reductions of 29.2% and 42.6% from the baseline, respectively. Additionally, a between-group difference of 6.13 points in ASRS total score represents a minimal clinically meaningful difference (CID_{between-group}), and a 12.25-point difference represents a moderately meaningful between-group difference.</p><p><strong>Conclusions: </strong>This study provides adult-ADHD-specific CID estimates that offer practical benchmarks for interpreting treatment response and informing power calculations in future clinical trials.</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"39 3","pages":"e70030"},"PeriodicalIF":9.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148198439","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":"Resilient interpersonal pathways from loneliness to suicidal ideation among Chinese transgender women during global health crises.","authors":"Lulu Xu, Jin Xu, Fengyi Wang, Yawen Zheng, Chen Xu, Shangbin Liu, Jiachen Lu, Ruijie Chang, Shan Qiao, Huachun Zou, Ying Wang, Yong Cai","doi":"10.1002/gps3.70037","DOIUrl":"10.1002/gps3.70037","url":null,"abstract":"","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"39 3","pages":"e70037"},"PeriodicalIF":9.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13266365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148264181","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":"China launches its first diagnostic criteria for occupational post-traumatic stress disorder.","authors":"Bangshan Liu, Junzhe Cheng, Wei Jiang, Jin Liu, Yumeng Ju, Mi Wang, Gang Wang, Yan Zhang","doi":"10.1002/gps3.70024","DOIUrl":"10.1002/gps3.70024","url":null,"abstract":"","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"39 ","pages":"e70024"},"PeriodicalIF":9.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147867897","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":"Depression meets obesity: Co-occurrence patterns, temporal trends and socioeconomic correlates across 199 countries and territories.","authors":"Yang Yang, Jingqi Kong, Jing Chen, Yihang Yang, Jingyao Liu, Runze Hu, Dexing Zhang, Zheng Liu","doi":"10.1002/gps3.70034","DOIUrl":"10.1002/gps3.70034","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Depression and obesity are major global health burdens, yet the co-occurrence patterns and temporal trends of their comorbidity remain poorly characterised at the global level.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;To map the global patterns of co-occurring depression and obesity, quantify temporal trends of depression, obesity and comorbidity, forecast the prevalence of comorbidity up to 2035 and compare social indicators across groups stratified by their combined temporal trends of depression and obesity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data were sourced from the Global Burden of Disease Study 2023, the NCD Risk Factor Collaboration and the World Bank Open Data repository. Countries and territories (&lt;i&gt;n&lt;/i&gt; = 199) were classified into four co-occurrence patterns based on the current prevalence of depression and obesity. Average annual percentage changes (AAPCs) were calculated to quantify temporal trends and define four trend groups. We forecast the prevalence of depression-obesity comorbidity across 199 countries and territories up to 2035 using an autoregressive integrated moving average model. The Kruskal-Wallis &lt;i&gt;H&lt;/i&gt; test and Mann-Whitney &lt;i&gt;U&lt;/i&gt; test were used to compare seven social indicators relevant to socioeconomic status and healthcare resources across these trend groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;For the four co-occurrence patterns, the consistently-low-prevalence group was primarily concentrated in Asia, the consistently-high-prevalence group in the Americas, the depression-dominant group in Africa and the obesity-dominant group in the Americas and Oceania. Concerning temporal trends, the prevalence of depression-obesity comorbidity increased globally (median AAPC: 4.66%; interquartile range [IQR]: 3.49%-6.30%). Notably, countries and territories in East Asia, Southeast Asia and sub-Saharan Africa had higher comorbidity AAPCs despite their low current prevalence. Temporal trends were categorised into four patterns: 44 (22.11%) countries and territories were classified into the double-fast-growing group (Southeast Asia, sub-Saharan Africa), 56 (28.14%) into the depression-driven-growing group (West Asia, North Africa, North America, Oceania), 56 (28.14%) into the obesity-driven-growing group (East Asia, Latin America and the Caribbean) and the remaining 43 (21.61%) into the double-slow-growing group (Europe, Australia and New Zealand). Predictive analysis indicated the median prevalence of depression-obesity comorbidity may increase to 833.32 (IQR: 532.07-1367.42) per 100 000 in 2030 and 869.35 (IQR: 544.11-1403.71) per 100 000 in 2035. Compared with the double-slow-growing group, the obesity-driven and double-fast-growing groups showed poorer socioeconomic status and healthcare resources; the depression-driven-growing group showed poorer healthcare resources.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The prevalence of depression-obesity comorbidity increased globally. Particular attention is warranted fo","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"39 3","pages":"e70034"},"PeriodicalIF":9.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13261309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148250602","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":"From challenges to solutions: Strengthening mental health support for university students and young researchers in China.","authors":"Yuqian Chen, Shaohua Hu","doi":"10.1002/gps3.70021","DOIUrl":"10.1002/gps3.70021","url":null,"abstract":"","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"39 ","pages":"e70021"},"PeriodicalIF":9.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147867875","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":"Bilateral repetitive transcranial magnetic stimulation modulates the hemispheric imbalance in major depressive disorder.","authors":"Yaqun Chen, Li Wan, Shuqi He, Qinghui Zhang, Tao Yang, Shuang Zheng, Wen Xie, Xinyang Wang","doi":"10.1002/gps3.70020","DOIUrl":"10.1002/gps3.70020","url":null,"abstract":"<p><strong>Background: </strong>Major depressive disorder (MDD) is characterised by interhemispheric functional imbalance, yet the neuromodulatory mechanisms underlying its correction remain poorly understood. Repetitive transcranial magnetic stimulation (rTMS) has shown promise in restoring hemispheric balance, but evidence regarding its effects on alpha-band functional connectivity (FC) is limited.</p><p><strong>Aims: </strong>This randomised, two-arm controlled trial aims to elucidate the neural mechanisms by which bilateral rTMS ameliorates interhemispheric functional imbalance in patients with MDD by reducing alpha-band functional hyperconnectivity in the left hemisphere.</p><p><strong>Methods: </strong>Fifty-two patients with MDD were randomised to active (<i>n</i> = 31) or sham (<i>n</i> = 21) bilateral rTMS targeting the dorsolateral prefrontal cortex (dlPFC). Active stimulation involved 20 Hz over the left dlPFC and 1 Hz over the right dlPFC. Participants underwent emotional attention network task testing with simultaneous electroencephalography recording before and after 10 sessions of rTMS. Phase slope index (PSI) was used to quantify directional FC in the alpha band (8-13 Hz). Clinical symptoms and behavioural performance were also assessed.</p><p><strong>Results: </strong>Active rTMS significantly improved sleep quality (PSQI, <i>F</i> = 5.52, <i>p</i> = 0.023) and reduced reaction times under both congruent and incongruent emotional conditions (-in-: <i>t</i> = -2.23, <i>p</i> = 0.031, +in-: <i>t</i> = -2.01, <i>p</i> = 0.05). Alpha-band FC analysis revealed decreased left hemispheric hyperconnectivity in the active group, particularly in the occipital, left temporoparietal and left frontocentral regions (<i>t</i> ranging from 2.42 to 3.65, all <i>p</i> = 0.038). The sham group showed placebo-driven improvements in subjective mood but no significant FC changes.</p><p><strong>Conclusions: </strong>Bilateral rTMS modulates interhemispheric imbalance in patients with MDD by reducing pathological alpha-band FC in left hemispheric regions, which is correlated with improved emotional processing and attentional performance. These findings support the use of alpha-band FC as a biomarker for rTMS efficacy and highlight the potential of network-targeted stimulation protocols for the individualised treatment of MDD.</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"39 3","pages":"e70020"},"PeriodicalIF":9.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148198427","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":"Development and validation of a Cog-Free risk predicting tool for dementia in a community setting.","authors":"Jiwen Che, Na Liu, Guirong Cheng, Lu Liu, Yu Luo, Juan Zhou, Ming Chen, Wen Zhou, Dan Liu, Feifei Hu, Xinyan Xie, Xiaochang Liu, Yuanyuan Peng, Yueyi Zhang, Zhiming Wang, Congxia Li, Heqianxi Dong, Chenying Zhang, Wei Tan, Yan Zeng","doi":"10.1002/gps3.70028","DOIUrl":"10.1002/gps3.70028","url":null,"abstract":"<p><strong>Background: </strong>Dementia poses a growing global public health burden, particularly in low- and middle-income countries where cognitive screening coverage remains limited. Current risk estimation tools often depend on cognitive testing or biomarkers, restricting their applicability in community and primary care settings.</p><p><strong>Aims: </strong>To establish and validate a data-driven analytical framework for developing a cognitive-testing-free dementia risk estimation tool (Cog-Free) using routinely collected health examination data.</p><p><strong>Methods: </strong>For this prospective cohort study, we developed Cog-Free, an internet-based dementia risk estimation tool, using 38 Least Absolute Shrinkage and Selection Operator-selected risk-associated variables and the optimal machine-learning algorithm (logistic regression). The optimal algorithm was internally validated with bootstrap resampling and externally tested in the Chinese Longitudinal Healthy Longevity Survey cohort. The tool was trained and internally validated in 2962 dementia-free adults aged ≥ 65 years (2018-2024), and its performance was compared with three established cognitive-testing-free tools.</p><p><strong>Results: </strong>Cog-Free achieved the highest area under the receiver operating characteristics curve in the internal validation set (0.86 [95% confidence interval (CI) 0.82-0.89]) with an accuracy of 0.81 (95% CI 0.78-0.83), sensitivity 0.78 (95% CI 0.68-0.85) and specificity 0.81 (95% CI 0.78-0.84), significantly outperforming three existing tools (DeLong's test, <i>p</i> < 0.001). Several previously under-recognized risk-associated variables for dementia were identified, such as right-hand grip strength, cognitive activity, having worse memory than peers, nighttime awakenings and income satisfaction.</p><p><strong>Conclusions: </strong>Cog-Free provides a data-driven, cognitive-testing-free and easily accessible approach for early dementia risk screening using routine health data. Its performance and web-based design suggest potential utility as a pre-screening and risk stratification tool within community health systems, including settings with limited access to cognitive testing.</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"39 3","pages":"e70028"},"PeriodicalIF":9.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148198480","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}