General Psychiatry最新文献

{"title":"Advances in functional MRI research in bipolar disorder: from the perspective of mood states","authors":"Yankun Wu, Yun-Ai Su, Linlin Zhu, Jitao Li, Tianmei Si","doi":"10.1136/gpsych-2023-101398","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101398","url":null,"abstract":"Bipolar disorder is characterised by recurrent and alternating episodes of mania/hypomania and depression. Current breakthroughs in functional MRI techniques have uncovered the functional neuroanatomy of bipolar disorder. However, the pathophysiology underlying mood instability, mood switching and the development of extreme mood states is less well understood. This review presents a comprehensive overview of current evidence from functional MRI studies from the perspective of mood states. We first summarise the disrupted brain activation patterns and functional connectivity that have been reported in bipolar disorder, irrespective of the mood state. We next focus on research that solely included patients in a single mood state for a better understanding of the pathophysiology of bipolar disorder and research comparing patients with different mood states to dissect mood state-related effects. Finally, we briefly summarise current theoretical models and conclude this review by proposing potential avenues for future research. A comprehensive understanding of the pathophysiology with consideration of mood states could not only deepen our understanding of how acute mood episodes develop at a neurophysiological level but could also facilitate the identification of biological targets for personalised treatment and the development of new interventions for bipolar disorder.","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"167 1","pages":""},"PeriodicalIF":11.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139583763","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":"The burden of depression, anxiety and schizophrenia among the older population in ageing and aged countries: an analysis of the Global Burden of Disease Study 2019","authors":"Ying Cheng, Yu Fang, Jinxin Zheng, Shiyang Guan, Meiti Wang, Wu Hong","doi":"10.1136/gpsych-2023-101078","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101078","url":null,"abstract":"Background Depression, anxiety and schizophrenia among older persons have become global public health challenges. However, the burden of these disorders in ageing and aged countries has not been analysed. Aims To investigate the burden of depression, anxiety and schizophrenia among older adults in ageing and aged countries. Methods Using data from the Global Burden of Disease Study 2019, we calculated the estimated annual percentage change (EAPC) in the age-standardised incidence rates (ASIR) and age-standardised disability-adjusted life years (DALYs) rates (ASDR) for depression, anxiety and schizophrenia of older people in ageing countries (China, India, Indonesia) and aged countries (Japan, Italy, Portugal) between 1990 and 2019. Trends in incidence and DALYs were analysed by gender and age. Results In 2019, the highest incidence of depression, anxiety and schizophrenia in the older population in aged countries was in Japan (927 271.3 (752 552.3–1 125 796.5), 51 498.2 (37 625.7–70 487.3) and 126.0 (61.0–223.2), respectively), while the highest incidence in ageing countries was in China (5 797 556.9 (4 599 403.4–7 133 006.5), 330 256.1 (246 448.9–445 987.4) and 1067.7 (556.2–1775.9), respectively). DALYs for these disorders were similar, with the highest in Japan and China. From 1990 to 2019, the ASIR for depressive disorders decreased in aged countries but increased in ageing countries; the ASIR for anxiety disorders and schizophrenia declined in both ageing and aged countries. The ASDR for depressive disorders was consistent with the ASIR but not for anxiety disorders and schizophrenia. The ASIR for depressive disorders was higher in older women, while the opposite was observed in anxiety disorders and schizophrenia. Notably, the conditions of burden of depressive disorders, anxiety disorders and schizophrenia in the 65–70-year-old age group were the most burdensome. Conclusions The incidence and DALYs of these three mental disorders increased while exhibiting differences between ageing and aged countries. Raising awareness about formulating health policies for preventing and treating mental disorders in the older population is necessary to reduce the future burden posed by the ageing challenge. All data relevant to the study are included in the article or uploaded as supplementary information.","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"28 1","pages":""},"PeriodicalIF":11.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139506359","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":"MicroRNA-451a is a candidate biomarker and therapeutic target for major depressive disorder","authors":"Panpan Hu, Qiuchen Cao, Hu Feng, Yun Liu, Yan Chen, Jingfan Xu, Weixi Feng, Huaiqing Sun, Huachen Ding, Chun Wang, Junying Gao, Ming Xiao","doi":"10.1136/gpsych-2023-101291","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101291","url":null,"abstract":"Background Increasing evidence supports the role of microRNAs (miRNAs) in major depressive disorder (MDD), but the pathophysiological mechanism remains elusive. Aims To explore the mechanism of microRNA-451a (miR-451a) in the pathology and behaviours of depression. Methods Abnormal miRNAs such as miR-451a reported previously in the serum of patients with MDD were screened and then confirmed in a mouse model of depression induced by chronic restraint stress (CRS). Eight-week-old male C57BL/6 mice had miR-451a overexpression in the medial prefrontal cortex (mPFC) via adeno-associated virus serotype 9 vectors encoding a pri-mmu-miR-451a-GFP fusion protein followed by behavioural and pathological analyses. Finally, molecular biological experiments were conducted to investigate the potential mechanism of miR-451a against depression. Results The serum levels of miRNA-451a were significantly lower in patients with MDD, with a negative correlation with the Hamilton Depression Scale scores. Additionally, a negative association between serum miR-451a and behavioural despair or anhedonia was observed in CRS mice. Notably, miR-451a expression was significantly downregulated in the mPFC of CRS-susceptible mice. Overexpressing miR-451a in the mPFC reversed the loss of dendritic spines and the depression-like phenotype of CRS mice. Mechanistically, miR-451a could inhibit CRS-induced corticotropin-releasing factor receptor 1 expression via targeting transcription factor 2, subsequently protecting dendritic spine plasticity. Conclusions Together, these results highlighted miR-451a as a candidate biomarker and therapeutic target for MDD. Data are available upon reasonable request.","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"39 1","pages":""},"PeriodicalIF":11.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139658015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychiatric comorbidities in epilepsy: population co-occurrence, genetic correlations and causal effects","authors":"Viktor H Ahlqvist, Christina Dardani, Paul Madley-Dowd, Harriet Forbes, Jessica Rast, Caichen Zhong, Renee M Gardner, Christina Dalman, Kristen Lyall, Craig Newschaffer, Torbjörn Tomson, Michael Lundberg, Daniel Berglind, Neil M Davies, Brian K Lee, Cecilia Magnusson, Dheeraj Rai","doi":"10.1136/gpsych-2023-101201","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101201","url":null,"abstract":"Background Psychiatric comorbidities are common in patients with epilepsy. Reasons for the co-occurrence of psychiatric conditions and epilepsy remain poorly understood. Aim We aimed to triangulate the relationship between epilepsy and psychiatric conditions to determine the extent and possible origins of these conditions. Methods Using nationwide Swedish health registries, we quantified the lifetime prevalence of psychiatric disorders in patients with epilepsy. We then used summary data from genome-wide association studies to investigate whether the identified observational associations could be attributed to a shared underlying genetic aetiology using cross-trait linkage disequilibrium score regression. Finally, we assessed the potential bidirectional relationships using two-sample Mendelian randomisation. Results In a cohort of 7 628 495 individuals, we found that almost half of the 94 435 individuals diagnosed with epilepsy were also diagnosed with a psychiatric condition in their lifetime (adjusted lifetime prevalence, 44.09%; 95% confidence interval (CI) 43.78% to 44.39%). We found evidence for a genetic correlation between epilepsy and some neurodevelopmental and psychiatric conditions. For example, we observed a genetic correlation between epilepsy and attention-deficit/hyperactivity disorder (rg=0.18, 95% CI 0.09 to 0.27, p<0.001)—a correlation that was more pronounced in focal epilepsy (rg=0.23, 95% CI 0.09 to 0.36, p<0.001). Findings from Mendelian randomisation using common genetic variants did not support bidirectional effects between epilepsy and neurodevelopmental or psychiatric conditions. Conclusions Psychiatric comorbidities are common in patients with epilepsy. Genetic correlations may partially explain some comorbidities; however, there is little evidence of a bidirectional relationship between the genetic liability of epilepsy and psychiatric conditions. These findings highlight the need to understand the role of environmental factors or rare genetic variations in the origins of psychiatric comorbidities in epilepsy. No data are available. All genetic data produced in this study are publicly available in their original publication and upon reasonable request from the authors. Swedish privacy laws prohibit the authors from making registry data publicly available. The data supporting these findings were used under licence and ethical approval for this study. Readers interested in obtaining microdata or replicating this study may seek similar approval and enquiries from Statistics Sweden. For further advice, see <https://www.scb.se/en/services/guidance-for-researchers-and-universities/>, or contact Statistics Sweden at mikrodata{at}scb.se.","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"10 1","pages":""},"PeriodicalIF":11.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139648107","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":"Cardiovascular risk burden, dementia risk and brain structural imaging markers: a study from UK Biobank","authors":"Yaying Cao, Gaohong Zhu, Chengwu Feng, Jing Chen, Wei Gan, Yuan Ma, Yonghua Hu, Klodian Dhana, Trudy Voortman, Jie Shen, Ting Li, Yan Zheng, Changzheng Yuan, Geng Zong","doi":"10.1136/gpsych-2023-101209","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101209","url":null,"abstract":"Background Cardiovascular risk burden is associated with dementia risk and neurodegeneration-related brain structure, while the role of genetics and incident cardiovascular disease (CVD) remains unclear. Aims To examine the association of overall cardiovascular risk burden with the risk of major dementia subtypes and volumes of related brain regions in a large sample, and to explore the role of genetics and CVD onset. Methods A prospective study among 354 654 participants free of CVD and dementia (2006–2010, mean age 56.4 years) was conducted within the UK Biobank, with brain magnetic resonance imaging (MRI) measurement available for 15 104 participants since 2014. CVD risk burden was evaluated by the Framingham General Cardiovascular Risk Score (FGCRS). Dementia diagnosis was ascertained from inpatient and death register data. Results Over a median 12.0-year follow-up, 3998 all-cause dementia cases were identified. Higher FGCRS was associated with increased all-cause dementia risk after adjusting for demographic, major lifestyle, clinical factors and the polygenic risk score (PRS) of Alzheimer’s disease. Comparing the high versus low tertile of FGCRS, the odds ratios (ORs) and 95% confidence intervals (CIs) were 1.26 (1.12 to 1.41) for all-cause dementia, 1.67 (1.33 to 2.09) for Alzheimer’s disease and 1.53 (1.07 to 2.16) for vascular dementia (all ptrend<0.05). Incident stroke and coronary heart disease accounted for 14% (95% CI: 9% to 21%) of the association between FGCRS and all-cause dementia. Interactions were not detected for FGCRS and PRS on the risk of any dementia subtype. We observed an 83% (95% CI: 47% to 128%) higher all-cause dementia risk comparing the high–high versus low–low FGCRS–PRS category. For brain volumes, higher FGCRS was associated with greater log-transformed white matter hyperintensities, smaller cortical volume and smaller grey matter volume. Conclusions Our findings suggest that the positive association of cardiovascular risk burden with dementia risk also applies to major dementia subtypes. The association of cardiovascular risk burden with all-cause dementia is largely independent of CVD onset and genetic predisposition to dementia. Data may be obtained from a third party and are not publicly available. Data access to the UK Biobank is available upon application.","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"154 1","pages":""},"PeriodicalIF":11.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139583133","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":"High frequency strong current tACS：a new dawn of non-drug therapy for patients with major depressive disorder","authors":"Linling Hu, Xingxing Li, Dongsheng Zhou, Shaochang Wu","doi":"10.1136/gpsych-2023-101261","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101261","url":null,"abstract":"A commentary on: Transcranial alternating current stimulation for treating depression: a randomized controlled trial. By Wang H, Wang K, Xue Q, et al . Brain. 2022;1451:83-91.doi:10.1093/brain/awab252. Major depressive disorder (MDD) is a common severe mental illness with recurring episodes. The most commonly used treatment is drug therapy, which is associated with a series of side effects and has an efficacy rate below 50%.1 Non-invasive brain stimulation technique has been gradually applied in clinical practice. Transcranial alternating current stimulation (tACS), a form of non-invasive brain stimulation, is a light, wearable piece of equipment for cortical stimulation. It modulates cortical excitability and spontaneous brain activity by applying an electric current to the scalp, generating an alternating current that flows through the specified area between the stimulation electrodes. A recent study published in Brain proved the clinical potential of tACS stimulation for patients with MDD. The study investigated the clinical safety and efficacy of tACS in first-episode, drug-naive patients with MDD. The results showed that patients who received 20 daily 40 min, 77.5 Hz, 15 mA, one forehead and two mastoid sessions of active stimulation over four consecutive weeks achieved significantly higher remission rates than those who received sham stimulation. In addition, tACS treatment alleviated the depression state with lasting effects shown in 4 weeks of follow-up measurements; only some mild treatment-emergent adverse events were reported.2 This is consistent with previous reports that tACS is associated with fewer …","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"29 1","pages":""},"PeriodicalIF":11.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138555856","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":"Connectome-based predictive modelling can predict follow-up craving after abstinence in individuals with opioid use disorders","authors":"Wenhan Yang, Jungong Han, Jing Luo, Fei Tang, Li Fan, Yanyao Du, Longtao Yang, Jun Zhang, Huiting Zhang, Jun Liu","doi":"10.1136/gpsych-2023-101304","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101304","url":null,"abstract":"Background Individual differences have been detected in individuals with opioid use disorders (OUD) in rehabilitation following protracted abstinence. Recent studies suggested that prediction models were effective for individual-level prognosis based on neuroimage data in substance use disorders (SUD). Aims This prospective cohort study aimed to assess neuroimaging biomarkers for individual response to protracted abstinence in opioid users using connectome-based predictive modelling (CPM). Methods One hundred and eight inpatients with OUD underwent structural and functional magnetic resonance imaging (fMRI) scans at baseline. The Heroin Craving Questionnaire (HCQ) was used to assess craving levels at baseline and at the 8-month follow-up of abstinence. CPM with leave-one-out cross-validation was used to identify baseline networks that could predict follow-up HCQ scores and changes in HCQ (HCQfollow-up−HCQbaseline). Then, the predictive ability of identified networks was tested in a separate, heterogeneous sample of methamphetamine individuals who underwent MRI scanning before abstinence for SUD. Results CPM could predict craving changes induced by long-term abstinence, as shown by a significant correlation between predicted and actual HCQfollow-up (r=0.417, p<0.001) and changes in HCQ (negative: r=0.334, p=0.002；positive: r=0.233, p=0.038). Identified craving-related prediction networks included the somato-motor network (SMN), salience network (SALN), default mode network (DMN), medial frontal network, visual network and auditory network. In addition, decreased connectivity of frontal-parietal network (FPN)-SMN, FPN-DMN and FPN-SALN and increased connectivity of subcortical network (SCN)-DMN, SCN-SALN and SCN-SMN were positively correlated with craving levels. Conclusions These findings highlight the potential applications of CPM to predict the craving level of individuals after protracted abstinence, as well as the generalisation ability; the identified brain networks might be the focus of innovative therapies in the future. Data are available on reasonable request.","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"14 1","pages":""},"PeriodicalIF":11.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139061727","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":"Enhancing pain modulation: the efficacy of synchronous combination of virtual reality and transcutaneous electrical nerve stimulation","authors":"Yanzhi Bi, Xu Liu, Xiangyue Zhao, Shiyu Wei, Jingwei Li, Faguang Wang, Wenbo Luo, Li Hu","doi":"10.1136/gpsych-2023-101164","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101164","url":null,"abstract":"Introduction Virtual reality (VR) and transcutaneous electrical nerve stimulation (TENS) have emerged as effective interventions for pain reduction. However, their standalone applications often yield limited analgesic effects, particularly in certain painful conditions. Aims Our hypothesis was that the combination of VR with TENS in a synchronous manner could produce the best analgesic effect among the four experimental conditions. Methods To address this challenge, we proposed a novel pain modulation strategy that synchronously combines VR and TENS, aiming to capitalise on both techniques’ complementary pain modulation mechanisms. Thirty-two healthy subjects participated in the study and underwent three types of interventions: VR alone, a combination of VR with conventional TENS, and a combination of VR with synchronous TENS. Additionally, a control condition with no intervention was included. Perceived pain intensity, pain unpleasantness, positive and negative affect scores, and electroencephalographic (EEG) data were collected before and after the interventions. To delve into the potential moderating role of pain intensity on the analgesic efficacy of VR combined with synchronous TENS, we incorporated two distinct levels of painful stimuli: one representing mild to moderate pain (ie, low pain) and the other representing moderate to severe pain (ie, high pain). Results Our findings revealed that both combination interventions exhibited superior analgesic effects compared with the VR-alone intervention when exposed to low and high pain stimuli. Notably, the combination of VR with synchronous TENS demonstrated greater analgesic efficacy than the combination of VR with conventional TENS. EEG data further supported these results, indicating that both combination interventions elicited a greater reduction in event-related potential magnitude compared with the VR-alone intervention during exposure to low and high pain stimuli. Moreover, the synchronous combination intervention induced a more significant reduction in N2 amplitude than the VR-alone intervention during exposure to low pain stimuli. No significant differences in EEG response changes were detected between the two combination interventions. Both combination interventions resulted in a greater reduction in negative affect compared with the VR-alone intervention. Conclusions Altogether, our study highlights the effectiveness of the synchronous combination of VR and TENS in enhancing pain modulation. These findings offer valuable insights for developing innovative pain treatments, emphasising the importance of tailored and multifaceted therapeutic approaches for various painful conditions. The data in the present study are available upon reasonable request to the corresponding author.","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"248 1","pages":""},"PeriodicalIF":11.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139018031","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":"Electroencephalography microstates as novel functional biomarkers for insomnia disorder","authors":"Yongjian Guo, Xumeng Zhao, Xiaoyang Liu, Jiayi Liu, Yan Li, Lirong Yue, Fulai Yuan, Yifei Zhu, Xiaona Sheng, Dahua Yu, Kai Yuan","doi":"10.1136/gpsych-2023-101171","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101171","url":null,"abstract":"Insomnia disorder (ID) is one of the most common mental disorders. Research on ID focuses on exploring its mechanism of disease, novel treatments and treatment outcome prediction. An emerging technique in this field is the use of electroencephalography (EEG) microstates, which offer a new method of EEG feature extraction that incorporates information from both temporal and spatial dimensions.To explore the electrophysiological mechanisms of repetitive transcranial magnetic stimulation (rTMS) for ID treatment and use baseline microstate metrics for the prediction of its efficacy.This study included 60 patients with ID and 40 age-matched and gender-matched good sleep controls (GSC). Their resting-state EEG microstates were analysed, and the Pittsburgh Sleep Quality Index (PSQI) and polysomnography (PSG) were collected to assess sleep quality. The 60 patients with ID were equally divided into active and sham groups to receive rTMS for 20 days to test whether rTMS had a moderating effect on abnormal microstates in patients with ID. Furthermore, in an independent group of 90 patients with ID who received rTMS treatment, patients were divided into optimal and suboptimal groups based on their median PSQI reduction rate. Baseline EEG microstates were used to build a machine-learning predictive model for the effects of rTMS treatment.The class D microstate was less frequent and contribute in patients with ID, and these abnormalities were associated with sleep onset latency as measured by PSG. Additionally, the abnormalities were partially reversed to the levels observed in the GSC group following rTMS treatment. The baseline microstate characteristics could predict the therapeutic effect of ID after 20 days of rTMS, with an accuracy of 80.13%.Our study highlights the value of EEG microstates as functional biomarkers of ID and provides a new perspective for studying the neurophysiological mechanisms of ID. In addition, we predicted the therapeutic effect of rTMS on ID based on the baseline microstates of patients with ID. This finding carries great practical significance for the selection of therapeutic options for patients with ID.","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"385 1","pages":""},"PeriodicalIF":11.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139021654","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":"Social isolation, loneliness and subsequent risk of major adverse cardiovascular events among individuals with type 2 diabetes mellitus","authors":"Yannis Yan Liang, Yilin Chen, Hongliang Feng, Huachen Xue, Yu Nie, Qi-Yong H Ai, Jiacheng Ma, Lulu Yang, Jihui Zhang, Sizhi Ai","doi":"10.1136/gpsych-2023-101153","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101153","url":null,"abstract":"Background Individuals with type 2 diabetes mellitus (T2DM) are more vulnerable to social disconnection compared with the general population; however, there are few relevant studies investigating this issue. Aims To investigate whether social isolation or loneliness may be associated with subsequent risk of developing major adverse cardiovascular events, whether these associations vary according to fatal and non-fatal outcomes and how behavioural, psychological and physiological factors mediate these associations. Methods This longitudinal analysis included data from 19 360 individuals with T2DM at baseline (2006–2010) from the UK Biobank. Social isolation and loneliness were measured using self-report questionnaires. The study outcomes included the first events of myocardial infarction (MI) or stroke (n=2273) and all-cause (n=2820) or cardiovascular disease-related mortality through linked hospital data or death registries. Results Over a median follow-up of 12.4 years (interquartile range (IQR): 11.6–13.3 years), participants who were more socially isolated (most social isolation vs least social isolation) experienced increased risks for all-cause (hazard ratio (HR) : 1.33, 95% confidence interval (CI): 1.19 to 1.47) and cardiovascular disease (HR: 1.36, 95% CI: 1.17 to 1.59) mortality but not first MI or stroke. Loneliness (yes vs no) was associated with a greater risk for a composite of incident MI or stroke (HR: 1.37, 95% CI: 1.19 to 1.57) but not mortality. Social isolation was associated with fatal MI and stroke, whereas loneliness was associated with non-fatal MI and stroke. The significant associations of social isolation and loneliness with outcomes were mainly mediated by behavioural factors (mediating proportion: 17.8%–28.2% and 17.6%–17.8%, respectively). Conclusions Among individuals with T2DM, social isolation and loneliness are associated with a greater risk of developing major adverse cardiovascular events, with differences in both risks stratified according to fatal and non-fatal events and underlying mediating factors. Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available. Individual-level data from the UK Biobank are not publicly available due to their policy, but the data will be made available after the application to the UK Biobank (<https://www.ukbiobank.ac.uk/>).","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"45 1","pages":""},"PeriodicalIF":11.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139055859","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}