Frontiers in Psychiatry最新文献

{"title":"Efficacy of stem cell-derived extracellular vesicles in animal models of autism spectrum disorder: a systematic review and meta-analysis.","authors":"Zhen Zheng, Manfen Ji, Yayong Liang, Sinian Pan","doi":"10.3389/fpsyt.2026.1956214","DOIUrl":"10.3389/fpsyt.2026.1956214","url":null,"abstract":"<p><strong>Background: </strong>Autism spectrum disorder (ASD) is a complicated neurodevelopmental condition that currently lacks a targeted therapy. Although stem cell-derived extracellular vesicles (EVs) represent a potential therapeutic approach for neurological disorders, their efficacy in ASD remains unclear. The objective of this study was to investigate the efficacy of stem cell-derived EVs on autistic-like behaviors in animal models of ASD and to explore the underlying mechanisms.</p><p><strong>Methods: </strong>Relevant studies published up to April 20, 2026 were searched across five databases. Data were pooled using Review Manager 5.4. Outcome measures included behavioral tests and inflammatory cytokine levels.</p><p><strong>Results: </strong>Out of 1,165 initially retrieved articles, five animal studies met the inclusion criteria. Pooled analyses demonstrated that EV treatment improved autistic-like behaviors in the self-grooming test, three-chamber social interaction test, and marble burying test, and decreased levels of proinflammatory cytokines IL-6 and IL-1β (all <i>P</i> < 0.05). No notable enhancements were observed for the open field test, Morris Water Maze, TNF-α or IL-10 (all <i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>Stem cell-derived EV therapy may improve repetitive behaviors and social deficits in ASD animal models, with observed associations with reduced IL-6 and IL-1β levels. These preclinical findings suggest promising translational potential of EV-based therapy for ASD.</p><p><strong>Systematic review registration: </strong>https://osf.io/c78xm, identifier 10.17605/OSF.IO/C78XM.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"17 ","pages":"1956214"},"PeriodicalIF":3.8,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265868","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":"Altered cytokine profiles and elevated lactate levels in children with autism spectrum disorder: indications of a dysregulated immune-metabolic network?","authors":"Nicole Beyer, Theresia Volk, Hella Luksch, Melanie Ring, Nora C Vetter, Angela Roesen-Wolff, Min Ae Lee-Kirsch, Veit Roessner","doi":"10.3389/fpsyt.2026.1904470","DOIUrl":"10.3389/fpsyt.2026.1904470","url":null,"abstract":"<p><strong>Introduction: </strong>Autism spectrum disorder (ASD) is a lifelong neurodevelopmental condition characterized by difficulties in social communication and restricted, repetitive behavior. The etiology and pathophysiology of ASD remain largely unknown; however, a complex interplay of genetic and environmental factors is widely assumed. More recently, altered cytokine/chemokine profiles and a potential vulnerability to mitochondrial alterations have been proposed.</p><p><strong>Methods: </strong>We measured blood lactate and pyruvate and quantified a cytokine/chemokine panel including IL-1β, IL-2, IL-6, TNF-α, IL-8, IFN-β, RANTES, MCP-1/CCL2, MIP-1α/CCL3, MIP-1β/CCL4, CCL11/Eotaxin-1 and CXCL10/IP-10 in a group of autistic children in comparison to a non-autistic age-, gender- and IQ-matched control group.</p><p><strong>Results: </strong>We observed elevated lactate levels, lower concentrations of IL-1β and TNF-α in autistic- compared with control children. In addition, lactate, MIP-1β/CCL4 and TNF-α was significantly associated with behavioral measures of autistic behavior. Pyruvate, the lactate/pyruvate ratio and all other analytes did not differ between groups.</p><p><strong>Discussion: </strong>We conclude that the observed cytokine/chemokine profile may reflect a dysregulated immunological network in autistic children. Elevated lactate may point to metabolic abnormalities with possible mitochondrial involvement. However, unchanged pyruvate and lactate/pyruvate ratio do not support overt mitochondrial dysfunction. These findings require replication in larger studies.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"17 ","pages":"1904470"},"PeriodicalIF":3.8,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13697830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265775","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 unequal cognitive consequences of social disconnection: mechanisms, modifiers and opportunities for dementia prevention.","authors":"Xing Xu, Zhaoying Yu, Lei Gao, Yaping Chen, Yu Liu","doi":"10.3389/fpsyt.2026.1949322","DOIUrl":"10.3389/fpsyt.2026.1949322","url":null,"abstract":"<p><p>Social isolation and loneliness are increasingly recognized as important determinants of cognitive decline and dementia risk in older adults. However, the strength and nature of these associations vary substantially across populations, cognitive outcomes, and stages of ageing. This review examines the sources of such heterogeneity by distinguishing objective social isolation from subjective loneliness and exploring their different psychological, behavioural, and biological pathways. Using a systematic multi-database search and thematic synthesis, we integrated evidence from longitudinal studies, neuroimaging research, and intervention trials to identify factors that increase vulnerability and promote resilience. The review highlights how psychosocial, behavioural, neuroendocrine, and neurostructural mechanisms contribute to differences in cognitive outcomes and discusses implications for targeted and context-sensitive interventions. Remaining challenges include measurement heterogeneity, limited causal evidence, and underrepresentation of low- and middle-income countries. Future research should prioritize harmonized assessments, stratified intervention trials, and culturally adapted implementation approaches. Early identification and prevention of social disconnection may provide greater benefits than attempts to reverse established isolation.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"17 ","pages":"1949322"},"PeriodicalIF":3.8,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13697308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265859","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":"Repetitive transcranial magnetic stimulation for treatment-resistant depression in Singapore: a retrospective, naturalistic study.","authors":"Yi Hang Tay, Ern Wei Christabel Thng","doi":"10.3389/fpsyt.2026.1924135","DOIUrl":"10.3389/fpsyt.2026.1924135","url":null,"abstract":"<p><strong>Introduction: </strong>Naturalistic repetitive transcranial magnetic stimulation (rTMS) outcome data for treatment-resistant depression remain limited in Southeast Asia. This retrospective study describes such outcomes from a general hospital in Singapore.</p><p><strong>Method: </strong>28 outpatients received rTMS (10Hz high-frequency or intermittent theta-burst) targeting the left dorsolateral prefrontal cortex (F3 scalp position) between May 2022 and May 2025. Treatment-resistant depression was defined as failing ≥2 antidepressant classes for ≥6 weeks each. The primary outcome was change in the Montgomery-Åsberg Depression Rating Scale (MADRS) score; secondary outcomes included the Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR16), the Depression, Anxiety and Stress Scale-21 (DASS-21), the Quality of Life, Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF), the Clinical Global Impression-Severity (CGI-S), and the Global Assessment of Functioning (GAF).</p><p><strong>Results: </strong>Despite 85.7% of patients having failed ≥3 antidepressant classes, the mean MADRS score decreased by 15.8 (SD 9.1), from 29.6 (SD 7.6) to 13.9 (SD 11.1, p<0.001). This corresponded to a 67.9% response rate and a 57.1% remission rate. All secondary measures (QIDS-SR16, DASS-21, Q-LES-Q-SF, CGI-S, and GAF) showed significant improvements (all p<0.001). Shorter episode duration and higher baseline quality of life were significantly associated with remission.</p><p><strong>Conclusion: </strong>We report favourable response (67.9%) and remission (57.1%) rates within a general hospital cohort in Singapore following standardised rTMS targeting the left dorsolateral prefrontal cortex (approximated by the F3 position), despite extensive prior antidepressant medication failure. These findings contribute real-world data to the limited Southeast Asian literature on standardised rTMS protocols for treatment-resistant depression in general hospital and similar clinical settings.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"17 ","pages":"1924135"},"PeriodicalIF":3.8,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265785","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 the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and post-stroke depression in patients with acute ischemic stroke.","authors":"Yu Yun, Jie Liu, Yaqiang Li","doi":"10.3389/fpsyt.2026.1882234","DOIUrl":"10.3389/fpsyt.2026.1882234","url":null,"abstract":"<p><strong>Objectives: </strong>Post-stroke depression (PSD) is a frequent and debilitating complication of acute ischemic stroke (AIS), yet its underlying biochemical predictors remain insufficiently characterized. The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) has recently emerged as a robust composite metric for assessing the homeostatic imbalance of lipid metabolism and systemic inflammation. This study aimed to evaluate the longitudinal association between admission NHHR levels and the risk of developing PSD at three months post-stroke in patients with AIS.</p><p><strong>Methods: </strong>We consecutively enrolled 408 patients with AIS from the Department of Neurology at Lixin County People's Hospital between February 2023 and January 2026. Admission NHHR was calculated from fasting lipid panels. Depressive symptoms were evaluated at a 3-month follow-up using the 17-item Hamilton Depression Rating Scale (HAMD-17), with PSD diagnosis confirmed via DSM-V criteria. Participants were stratified into tertiles based on admission NHHR (Q1 ≤7.68; Q2 7.69-10.50; Q3 ≥10.52). Multivariate logistic regression and restricted cubic splines (RCS) were employed to analyze the association between NHHR and PSD risk.</p><p><strong>Results: </strong>Among the 408 participants, 93 (22.79%) were diagnosed with PSD. Patients in the PSD group exhibited significantly higher admission NHHR levels compared to the non-PSD group (<i>P</i> < 0.001). The prevalence of PSD increased progressively across NHHR tertiles: 10.75% in Q1, 25.81% in Q2, and 63.44% in Q3. After adjusting for age, sex, vascular risk factors, stroke severity (NIHSS), and functional impairment (mRS), the highest NHHR tertile remained a potent independent predictor of PSD (OR 3.240, 95% CI 1.850-5.680, <i>P</i> < 0.001). The admission NHHR level exhibited a robust predictive capacity for PSD, with an AUC of 0.738 (95% CI: 0.681-0.790, <i>P</i> < 0.001). RCS analysis further revealed a statistically significant non-linear relationship (<i>P</i> for non-linearity < 0.001), identifying a vulnerability window between NHHR values of 10 and 15 where the risk of depression escalated most sharply. This association persisted in various subgroup analyses.</p><p><strong>Conclusions: </strong>Elevated admission NHHR is independently and non-linearly associated with an increased risk of PSD at three months in AIS patients. As an easily accessible biomarker of lipid-driven systemic inflammation, NHHR may serve as a valuable prognostic tool for early risk stratification and targeted psychological intervention in clinical practice.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"17 ","pages":"1882234"},"PeriodicalIF":3.8,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13697312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265804","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":"Rethinking childhood-onset schizophrenia: neurodevelopmental comorbidities shape the psychopathological profile.","authors":"Michelangelo Di Luzio, Maria Pontillo, Barbara D'Aiello, Giulia D'Amario, Ilaria Bertoncini, Roberto Averna, Milena Labonia, Stefano Vicari","doi":"10.3389/fpsyt.2026.1918377","DOIUrl":"10.3389/fpsyt.2026.1918377","url":null,"abstract":"<p><strong>Objectives: </strong>Childhood-onset schizophrenia (COS), defined by the onset of psychotic symptoms before the age of 13 years, is a rare and severe form of schizophrenia. Despite growing interest, little is known about how neurodevelopmental comorbidities shape its clinical presentation. This study aimed to examine whether COS with comorbid neurodevelopmental disorders differs in psychopathological profile from COS with psychiatric comorbidities and from COS without comorbidities.</p><p><strong>Methods: </strong>Sixty-one children diagnosed with COS and evaluated at symptom onset in a specialized early psychosis service were included and classified into three subgroups: COS with neurodevelopmental comorbidities, COS with psychiatric comorbidities, and COS without comorbidities. Psychopathological dimensions were assessed using the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Aged Children - Present and Lifetime Version and the Structured Interview for Psychosis-Risk Syndromes and the Scale of Prodromal Symptoms (SIPS/SOPS). Group differences were examined using MANOVA and mixed-design repeated-measures ANOVA, repeated with IQ as a covariate, with False Discovery Rate correction across all SIPS measures. A secondary analysis separated intellectual disability from autism spectrum disorder and/or attention-deficit/hyperactivity disorder.</p><p><strong>Results: </strong>Children with COS and neurodevelopmental comorbidities showed an earlier age at onset, lower IQ, greater bizarre thinking and less social anhedonia. In contrast, COS with psychiatric comorbidity and COS without comorbidities exhibited largely overlapping profiles, marked by greater severity of negative symptoms and more organized thought processes. Within the neurodevelopmental group, the symptom pattern did not appear to be driven by specific diagnoses.</p><p><strong>Conclusions: </strong>These preliminary findings are consistent with variation in the configuration of psychopathological features within COS along a continuum, and highlight the relevance of neurodevelopmental trajectories in shaping symptom expression. Accounting for neurodevelopmental comorbidities may be crucial for improving early diagnostic characterization and informing targeted therapeutic strategies in pediatric schizophrenia.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"17 ","pages":"1918377"},"PeriodicalIF":3.8,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265851","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":"Music therapy and music-based support for autistic children: a neurodiversity-informed systematic review and meta-analysis.","authors":"Shanshan Lu, Huimin Feng, Zhidan Wang","doi":"10.3389/fpsyt.2026.1806096","DOIUrl":"10.3389/fpsyt.2026.1806096","url":null,"abstract":"<p><strong>Background: </strong>Music-based interventions, including music therapy, are widely used to support autistic children, but reductions on autism-related scales do not fully represent communication, participation, quality of life, or autonomy. We retained clinically interpretable outcomes while using a neurodiversity-informed framework to organize intervention goals and interpretation.</p><p><strong>Methods: </strong>Web of Science, CNKI, Wanfang Data, VIP, PubMed, the Cochrane Library, Embase, Wiley Online Library, EBSCOhost, and Google Scholar were searched from inception to August 5, 2026. Randomized, quasi-randomized, crossover, and controlled studies involving autistic participants younger than 18 years were eligible. Outcomes were grouped as social communication/interaction, language, adaptive function/participation, quality of life/well-being, and autism-related characteristics and support needs. Positive Hedges' g values favored the music-based condition. Random-effects models used restricted maximum likelihood estimation and modified Hartung-Knapp inference. Comparator intensity, technique, duration, and parent involvement were examined as exploratory moderators.</p><p><strong>Results: </strong>Thirty-three independent studies, representing 1,880 participants in the selected quantitative comparisons, were included and contributed at least one outcome. Social communication/interaction showed a significant pooled effect (k = 10, g = 0.64, 95% CI 0.25 to 1.03, p = 0.0046; I² = 59.6%); the primary evidence layer also remained significant (k = 7, g = 0.57, 95% CI 0.02 to 1.12, p = 0.043). Language showed a significant small pooled effect (k = 11, g = 0.32, 95% CI 0.10 to 0.54, p = 0.009; I² = 0%), whereas the primary evidence layer yielded g = 0.19 (95% CI -0.17 to 0.55). Autism-related scale outcomes showed a significant pooled effect (k = 16, g = 1.23, 95% CI 0.93 to 1.53, p < 0.001; I² = 77.0%) and remained significant among studies reporting a reproducible randomization method (k = 6, g = 0.95, 95% CI 0.29 to 1.61). Adaptive function and quality-of-life estimates did not reach statistical significance. No between-group moderator test was significant. Duration was not associated with effect size (β = -0.034 per month, p = 0.552), and Egger's regression did not detect funnel-plot asymmetry (p = 0.591).</p><p><strong>Conclusions: </strong>Music-based support produced favorable average effects on social communication/interaction, language, and autism-related scale outcomes.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"17 ","pages":"1806096"},"PeriodicalIF":3.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13690717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149244274","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 relationship between impulsive behaviors and adult attention-deficit/hyperactivity disorder symptoms in bipolar disorder.","authors":"Tülay Sati Kirkan, Nazan Dolapoglu","doi":"10.3389/fpsyt.2026.1916550","DOIUrl":"https://doi.org/10.3389/fpsyt.2026.1916550","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to examine the relationship between impulsivity and adult Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms in euthymic patients with Bipolar Disorder (BD) Type I.</p><p><strong>Methods: </strong>One hundred and eleven outpatients diagnosed with BD Type I according to DSM-5 criteria, scoring ≤7 on the Hamilton Depression Rating Scale (HAM-D) and ≤5 on the Young Mania Rating Scale (YMRS), and in remission for at least two months were included. Impulsivity was assessed with the Barratt Impulsiveness Scale-11 (BIS-11) and ADHD symptoms with the Adult ADHD Self-Report Scale (ASRS). Associations were evaluated with Spearman correlation analysis with Benjamini-Hochberg false discovery rate (FDR) correction, and hierarchical multivariable linear regression. Sensitivity analyses addressed item-content overlap, influential observations, and medication effects.</p><p><strong>Results: </strong>A strong positive correlation was found between BIS-11 total and ASRS total scores (ρ=0.722; q<0.001); the ASRS Inattention and Hyperactivity-Impulsivity subscales were themselves moderately intercorrelated (ρ=0.600; p<0.001). Only 18.9% of patients scored ≥72 on the BIS-11 (clinically significant range) and 28.8% screened positive on ASRS Part A. In the final regression model, ASRS total score was the strongest independent predictor of BIS-11 total score (B = 0.734; β=0.676; p<0.001), together with Young Mania Rating Scale score (β=0.170; p=0.018; R²=0.573), an association that strengthened after excluding influential observations and after dichotomization (both p<0.01); variance inflation factors (1.04-2.61) indicated no multicollinearity. Both ASRS subscales remained independent predictors in subscale analysis (Hyperactivity-Impulsivity β=0.436; Inattention β=0.317; both p<0.001). The association persisted after removing shared item content (ρ=0.605; p<0.001), excluding influential observations, and adjusting for treatment regimen.</p><p><strong>Conclusion: </strong>In euthymic BD Type I patients, self-reported impulsivity showed a strong, independent association with self-reported adult ADHD symptom burden, particularly the hyperactivity-impulsivity dimension, robust across sensitivity analyses. Because ADHD symptoms were assessed only by self-report screening, without a structured diagnostic interview, and because the design is cross-sectional, these findings reflect a symptom-level, not diagnostic, association and do not establish causality. They nonetheless support considering ADHD symptoms in the routine clinical evaluation of euthymic BD Type I patients.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"17 ","pages":"1916550"},"PeriodicalIF":3.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13693423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149265797","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":"Efficacy of artificial intelligence-driven conversational agents (chatbots) for mental health promotion among university students: a systematic review and meta-analysis.","authors":"Chen Shao, Xiaochen Chen, Shengnan Qiao, Ang Li, Shipeng Liu, Yanglong Chen","doi":"10.3389/fpsyt.2026.1824378","DOIUrl":"10.3389/fpsyt.2026.1824378","url":null,"abstract":"<p><strong>Background: </strong>University students experience substantial mental-health burdens, while access to timely support remains uneven. AI conversational agents may provide low-threshold support, but the evidence base has expanded rapidly and prior reviews have often combined different age groups, intervention types, outcome domains, and comparator conditions.</p><p><strong>Objective: </strong>To evaluate the effects of AI-mediated conversational interventions on depressive and anxiety symptoms in university students, while distinguishing outcome domains, comparator intensity, intervention architecture, and the evidential requirements for standardized post-intervention effect estimation.</p><p><strong>Methods: </strong>We updated the search in PubMed, Embase, PsycINFO, CENTRAL, and Web of Science to the revised search date and rebuilt an auditable cross-database record ledger. The updated workflow included 3,786 exported records, 451 DOI/PMID duplicates, 41 confirmed title/author duplicates, and 3,294 unique records screened. All title/abstract records completed a two-reviewer screening and consensus chain. Forty-six update-search records entered research-level/full-text assessment. Randomized controlled trials were eligible for causal quantitative synthesis; relevant feasibility, acceptability, usability, and non-comparable controlled studies were retained narratively. Standard post-intervention analyses used Hedges g, REML random-effects models, and Hartung-Knapp adjustment, and were restricted to attributable two-group post-intervention data.</p><p><strong>Results: </strong>In the final locked non-active/low-intensity comparator analysis, three depression comparisons favored conversational interventions (k=3; Hedges g=-0.413, 95% CI -0.557 to -0.268; I2 = 0.0%) and four anxiety comparisons also favored them (k=4; Hedges g=-0.435, 95% CI -0.603 to -0.268; I2 = 2.1%). In the separate active conversational-control analysis, two MYLO comparisons did not show a reliable incremental effect for depression (k=2; g=0.165, 95% CI -0.580 to 0.911) or anxiety (k=2; g=0.190, 95% CI -0.556 to 0.937). The evidence base remained small, clinically heterogeneous, and limited by attrition, self-reported outcomes, and uncertainty regarding generalizability.</p><p><strong>Conclusions: </strong>AI conversational interventions may improve depressive and anxiety symptoms relative to non-active or low-intensity comparators in university students, but the certainty of evidence is low and estimates are based on few comparisons. Evidence against active conversational controls is very uncertain. Outcome-domain differences and architecture-related claims should be treated as hypothesis-generating. Secure, consent-based, human-supervised implementation and objective outcome assessment are priorities for future research.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD420261323382, identifier CRD420261323382.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"17 ","pages":"1824378"},"PeriodicalIF":3.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13690801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149244328","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":"Narcissistic traits and emotional dependence on large language models among adolescents.","authors":"Yihang Zhao, Mengyue Xu, Ning Wang, Yang Liu, Hong Wang","doi":"10.3389/fpsyt.2026.1958023","DOIUrl":"10.3389/fpsyt.2026.1958023","url":null,"abstract":"<p><strong>Background: </strong>This study examined associations between narcissistic traits and emotional dependence on large language models (LLMs) among adolescents, focusing on anxiety and physical activity.</p><p><strong>Methods: </strong>A multistage stratified sample of 1622 Chinese junior high school students was surveyed in November 2025. Narcissistic traits, anxiety, LLM emotional dependence, and physical activity were assessed using the FFNI-SF, GAD-2, an adapted five-item LLM emotional dependence measure, and PARS-3, respectively. Pearson correlations and PROCESS Models 4 and 7 with 5,000 bootstrap resamples were conducted, with Johnson-Neyman analysis used to probe the interaction.</p><p><strong>Results: </strong>Narcissistic traits correlated positively with anxiety (r=0.118, P<0.001) and LLM emotional dependence (r=0.301, P<0.001), while anxiety correlated positively with LLM emotional dependence (r=0.146, P<0.001). Physical activity correlated negatively with anxiety (r=-0.119, P<0.001) and LLM emotional dependence (r=-0.075, P = 0.002). Adjusting for grade and left-behind status, anxiety showed a small indirect association between narcissistic traits and LLM emotional dependence (Effect=0.011, 95% CI [0.004, 0.020]). The narcissistic traits × physical activity interaction was significant (β=-0.056, P = 0.015), with the narcissism-anxiety association significant below 0.73 SD of physical activity. The moderated mediation index was not significant (Index=-0.0061, 95% bootstrap CI [-0.0130, 0.0001]).</p><p><strong>Conclusion: </strong>Narcissistic traits were positively associated with adolescent LLM emotional dependence, with a small cross-sectional indirect association through anxiety. Physical activity moderated the narcissism-anxiety association, although overall moderated mediation was not supported.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"17 ","pages":"1958023"},"PeriodicalIF":3.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13690931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149244047","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}