Frontiers in Psychiatry最新文献

{"title":"Case report: Twice-daily 15mA transcranial alternating current stimulation for adolescent major depressive disorder with suicidal ideation.","authors":"Dan-Dan Cheng, Yi-Lin Yang, Zi-Yi Yuan, Su Hong, Li Kuang","doi":"10.3389/fpsyt.2025.1669966","DOIUrl":"10.3389/fpsyt.2025.1669966","url":null,"abstract":"<p><strong>Background: </strong>Adolescent major depressive disorder with suicidal ideation (MDD-SI) poses significant treatment challenges and carries substantial mortality risk, while existing interventions often demonstrate limited acute efficacy for suicidal ideation (SI).</p><p><strong>Methods: </strong>This two-week prospective case series investigated the feasibility and preliminary therapeutic effects of high-frequency transcranial alternating current stimulation (tACS) administered twice daily. Seven adolescents with MDD-SI underwent 40-minute tACS sessions (77.5 Hz, 15 mA) twice-daily over a two weeks for a total of 20 sessions, in conjunction with stable pharmacotherapy.</p><p><strong>Results: </strong>The accelerated tACS protocol was well-tolerated with no adverse events. It demonstrated significant reductions in both depressive symptoms and SI within two weeks (all <i>P</i> < 0.05), predominantly in the first week. Treatment response varied based on psychiatric and medical comorbidities, indicating potential moderators.</p><p><strong>Conclusion: </strong>These preliminary findings suggest the potential of accelerated high-frequency tACS as a potential crisis intervention for adolescent MDD-SI, while highlighting the need for controlled clinical trials to establish efficacy and optimize stimulation parameters.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"16 ","pages":"1669966"},"PeriodicalIF":3.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250592","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 case report of seizure worsening after perampanel add-on to oxcarbazepine: possible role of metabolic interaction and pharmacogenetics.","authors":"Xin Fang, Menglu Zhu, Lijiang Wang","doi":"10.3389/fpsyt.2025.1621598","DOIUrl":"10.3389/fpsyt.2025.1621598","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the factors contributing to increased seizure frequency in patients treated with a combination of oxcarbazepine (OXC) and perampanel.</p><p><strong>Methods: </strong>The influence of the combined use of perampanel and oxcarbazepine on pharmacokinetics was analyzed, and the results were further confirmed by scoring the Naranjo Adverse Reaction Scale. The influence of race on antiseizure medications (ASMs) was also analyzed.</p><p><strong>Results: </strong>The concomitant use of perampanel and oxcarbazepine increased the plasma concentration of oxcarbazepine. Scoring with the Naranjo adverse reaction scale indicated that the deterioration of seizures in patients following the addition of perampanel may be associated with the interaction of the two drugs.</p><p><strong>Conclusion: </strong>The exacerbation of epilepsy in patients may be attributed to the increased blood concentration of oxcarbazepine resulting from its combination with perampanel, which potentially triggers a worsening of seizures. Variations in gene mutations related to Asian factors, as well as differences in drug metabolism enzymes and transporters, may also contribute to alterations in the concentration of ASMs.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"16 ","pages":"1621598"},"PeriodicalIF":3.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12500544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250594","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":"Exploring lived experiences in home-based psychiatric care: a qualitative study of service users, families, and professionals in Spain.","authors":"Ana María Besoaín-Cornejo, Montserrat Gil-Girbau, Mariam Alouali-Moussakhkhar, Luisa Baladón Higueras, Josefina Sáez, Maria Rubio-Valera","doi":"10.3389/fpsyt.2025.1670470","DOIUrl":"10.3389/fpsyt.2025.1670470","url":null,"abstract":"<p><strong>Introduction: </strong>Psychiatric home care provides a wide range of multidisciplinary, user-centered, high-intensity psychiatric interventions to manage mental health crises. Previous studies have found high satisfaction with care, but only assessed user and nurse perspectives. This study aimed to understand the experience of a psychiatric home hospitalization program in Spain from the perspective of all involved (users, families and healthcare professionals).</p><p><strong>Materials and methods: </strong>A qualitative study with a phenomenological approach was conducted to assess \"Crisis Resolution and Home Treatment\" (CRHT), a psychiatric home care program. Semi-structured individual and group interviews were held between 2021 and 2022. The final sample size was determined by saturation and data were analyzed thematically. Analyses were performed by a multidisciplinary team and externally reviewed by a mental health user and an experienced CRHT manager.</p><p><strong>Results: </strong>Four main themes summarizing CRHT experiences emerged: (1) Organizing and operating CRHT programs; (2) Receiving care at home; (3) Caregiver and family involvement and (4) Consequences of the home-based care model. CRHT allows individualized and contextualized treatment. Users and families valued home care and felt safe, although unprepared for the post-discharge situation, especially as care intensity decreases. While home care strengthens family bonds, some caregivers may need additional support to manage a crisis. Along with personalized care, CRHT allows for the development of a comprehensive lifelong treatment plan, although the care burden (for oneself and others) must be considered.</p><p><strong>Conclusion: </strong>CRHT was rated positively as a flexible intervention, facilitating person-centered care and strengthening trust between users, their families, and the CRHT team. It offers personalized treatment and connects individuals to further support, enabling better treatment experiences and strengthening family relationships.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"16 ","pages":"1670470"},"PeriodicalIF":3.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12500623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250581","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":"Case Report: Substance fixation in autism spectrum disorder with resultant anorexia nervosa.","authors":"Lucas Arney, Raymond Uymatiao, Justin White","doi":"10.3389/fpsyt.2025.1630528","DOIUrl":"10.3389/fpsyt.2025.1630528","url":null,"abstract":"<p><p>Autism spectrum disorder (ASD) has a long-standing history of being strongly associated with multiple psychiatric comorbidities, including substance use disorders (SUDs) and eating disorders (EDs) like anorexia nervosa (AN). ASD-specific features, including repetitive behaviors, constricted interests, cognitive rigidity, and obsessive fixations, are believed to make patients with ASD vulnerable to SUD and ED development. However, little research attempts to understand the interconnection between ASD and these comorbidities. We present a case of a 26-year-old man with a long-standing diagnosis of ASD who developed SUD and restrictive food intake, culminating in the patient meeting the AN criteria. This patient voluntarily admitted himself to the inpatient psychiatric unit with worsening depression and suicidal ideation following a car accident resulting from sleep deprivation and acute cannabis intoxication. Further investigation revealed a problematic, obsessive pattern of initial alcohol use associated with weight gain, followed by profound food restriction and subsequent transition to daily, near-constant cannabis use. On presentation, he appeared anxious with overt signs of sleep deprivation and malnutrition from substantial weight loss with a body mass index (BMI) decline from 23.6 to 16.98 over the last year. A urine drug screen was positive for cannabinoids, and imaging was unremarkable. Over an 11-day hospitalization, a multidisciplinary team initiated anxiolytics, antidepressants, sleep aids, and cannabis-withdrawal management combined with nutritional rehabilitation under dietitian supervision until acute suicidality was resolved with an improved BMI to 18.75. At discharge, the patient reported eagerness to engage with outpatient psychotherapy, ongoing psychiatric follow-up, and ASD-adapted cognitive behavioral therapy. This case underscores the diagnostic and management implications associated with co-occurring ASD, SUD, and ED. Obsessive fixation and rigidity potentiate maladaptive coping, which, if unaddressed in therapy, may increase the risk of future SUD and ED relapse. Though rapid inpatient stabilization is possible, gaps in both specialty care and ASD-adapted programs may compound relapse risk, especially in underserved regions. Additionally, this case necessitates a comprehensive assessment of patients with neurodevelopmental disorders for more informed and integrated therapeutic intervention. The nuanced interplay between ASD, SUD, and ED has synergistic effects on caloric restriction, requiring multidisciplinary treatment strategies to achieve sustained recovery and reduce morbidity in a vulnerable population.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"16 ","pages":"1630528"},"PeriodicalIF":3.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250578","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":"Examining the relationship between perceived social support and prenatal distress in pregnant women.","authors":"Somayae Abdollahi Sabet, Samira Ahmadi, Zahra Pakian, Azam Maleki","doi":"10.3389/fpsyt.2025.1514249","DOIUrl":"10.3389/fpsyt.2025.1514249","url":null,"abstract":"<p><strong>Background: </strong>Understanding the link between perceived social support and prenatal distress is vital for improving maternal mental health during pregnancy.</p><p><strong>Objective: </strong>To examine the relationship between perceived social support and prenatal distress among pregnant women.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on 220 pregnant women at Ayatollah Mousavi Hospital in Zanjan City in 2023. Participants were selected through a convenience sampling method, and data were collected using the Prenatal Distress and social support questionnaires. The analysis involved Spearman's rank correlation, the Mann-Whitney U test, the Kruskal-Wallis test, and backward conditional logistic regression with median cut-off points, all at a 95% confidence level.</p><p><strong>Results: </strong>The average perinatal distress score was 39.38 (SD = 6.04), and the average social support score was 45.66 (SD = 10.91). Total social support was negatively correlated with overall prenatal distress (r = -0.355), childbirth and the baby-related distress (r =-0.472), and emotional/relational issues(r = -0.119), but not with body image-related distress (r = 0.090, p = 0.35). Younger, higher-educated women with more children reported lower distress. Additionally, women aged 18-25, with more children, low income, who were housewives, or had a gestational age of 29-42 weeks, had higher social support scores (p < 0.01).</p><p><strong>Conclusion: </strong>Both perinatal distress and perceived social support were observed at moderate levels among the study population. Parity emerged as the only independent predictor for both prenatal distress and social support, with primiparous women exhibiting higher distress levels, while multiparous women reported higher perceived social support. These findings underscore the importance of developing tailored interventions that address the distinct needs of women according to their parity status.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"16 ","pages":"1514249"},"PeriodicalIF":3.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244155","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":"Functional near-infrared spectroscopy as a diagnostic aid for stable schizophrenia.","authors":"Suzhen Zhang, Ting Li, Liangliang Chen, Tongkuai Cong, Xinping Kuai, Yonggang Mu","doi":"10.3389/fpsyt.2025.1635854","DOIUrl":"10.3389/fpsyt.2025.1635854","url":null,"abstract":"<p><strong>Objective: </strong>Cognitive impairment in schizophrenia (SCZ) is common, but the mechanism remains unclear. This study aimed to investigate whether brain activation during the functional near-infrared spectroscopy (fNIRS) verbal fluency test (VFT) task is associated with cognitive deficits and to evaluate the reliability of fNIRS as a clinical tool for diagnosing stable SCZ.</p><p><strong>Methods: </strong>A total of 45 stable SCZ patients and 30 healthy controls (HC) were included. Demographic information, Positive and Negative Symptom Scale (PANSS), and MATRICS Consensus Cognitive Battery (MCCB) were assessed. During VFT, hemodynamic responses in the frontotemporal cortex were monitored with fNIRS.</p><p><strong>Results: </strong>During VFT, individuals with SCZ demonstrated a reduced number of valid words, lower β value in channel 8, 25-26, 35-36 and 47-48, and decreased integral value (IV) in both the prefrontal lobe and bilateral temporal lobes. IV of the temporal lobes and the β value of channel 48 demonstrated sensitivity for diagnosis of SCZ, with an area under the receiver operating characteristic curve of 0.781 (95% CI: 0.667-0.896), and 0.762 (95% CI: 0.655-0.869), respectively. Moreover, IV of the temporal lobes correlated positively with multi-domain of cognition, including speed of processing, attention/vigilance, social cognition and MCCB total scores. The β value of channel 48 correlated positively with speed of processing.</p><p><strong>Conclusion: </strong>Our findings suggest that fNIRS may serve as a valuable clinical measure of cognition assessment, and IV of bilateral temporal lobes and β value of channel 48 can be used as candidate biomarkers to differentiate individuals with schizophrenia.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"16 ","pages":"1635854"},"PeriodicalIF":3.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244246","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":"Population pharmacokinetics modelling to predict DDI from zopiclone on clozapine in schizophrenia patients.","authors":"Huan-Huan Han, Yue Zhang, Jie Wang, Xue Tian, Ye Li, Su-Mei He, Cun Zhang, Xiao Chen, Dong-Dong Wang","doi":"10.3389/fpsyt.2025.1664678","DOIUrl":"10.3389/fpsyt.2025.1664678","url":null,"abstract":"<p><strong>Introduction: </strong>Clozapine, as a core drug for the treatment of schizophrenia, is widely used in the drug treatment of schizophrenia patients. However, when multiple drugs are used in combination, it is not clear whether there are drug-drug interactions (DDI) of clozapine in patients with schizophrenia. This study aims to use population pharmacokinetics (PPK) modelling to predict DDI and individualized therapy of clozapine in schizophrenia patients.</p><p><strong>Methods: </strong>We collected 81 patients with schizophrenia and included their physiological data, biochemical data, treatment plans and information on combined medication during the clinical treatment process. Next, PPK modelling was used to analyze drugs with potential DDI when clozapine was used in schizophrenia patients, and dosage adjustments were recommended.</p><p><strong>Results: </strong>Final analysis revealed that weight and coadministration of zopiclone affected clozapine clearance, and there was DDI with clozapine when zopiclone was used concurrently in schizophrenia patients. Further, for schizophrenia patients without zopiclone, 10 mg/kg/day, 9 mg/kg/day, 8 mg/kg/day and 7 mg/kg/day clozapine were recommended for 40-50 kg, 50-67 kg, 67-88 kg, and 88-120 kg patients, respectively. For schizophrenia patients with zopiclone, 6 mg/kg/day and 5 mg/kg/day clozapine were recommended for 40-70 kg and 70-120 kg patients, respectively. This study was the first to systematically analyze DDI when clozapine was used in schizophrenia patients and found DDI when zopiclone and clozapine were taken concurrently.</p><p><strong>Conclusion: </strong>When zopiclone was taken concurrently, clozapine dosage need to be reduced. Based on this, schizophrenia patients individualized dosage adjustment was recommended.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"16 ","pages":"1664678"},"PeriodicalIF":3.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244310","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 clinical protocol for group-based ketamine-assisted therapy in a community of practice: the Roots To Thrive model.","authors":"Shannon Dames, Pamela Kryskow, Vivian W L Tsang, Elena Argento","doi":"10.3389/fpsyt.2025.1568017","DOIUrl":"10.3389/fpsyt.2025.1568017","url":null,"abstract":"<p><strong>Background: </strong>Ketamine-assisted therapy (KaT) has demonstrated therapeutic potential in treating depression, anxiety, and PTSD, driving interest in group-based models of care. Yet, few published protocols offer the comprehensive structure required for safe, scalable application in real-world clinical settings. The RTT-KaT model offers a resilience-informed, community-anchored framework that integrates trauma-aware care with a respectful and intentional weaving of Western and Indigenous knowledge systems. Initially launched as a quality improvement initiative through a partnership between a Canadian university and a regional health authority, RTT-KaT has since evolved into a non-profit clinical program. To date, it has supported over 750 participants through more than 2,000 KaT sessions and 700 Community of Practice groups. RTT-KaT is a culturally informed, resilience-focused model of group-based psychedelic-assisted therapy developed and refined since 2018. The model is rooted in the intentional weaving of Western clinical frameworks and Indigenous knowledge systems, grounded in principles of relational accountability, cultural humility, and trauma-informed care.</p><p><strong>Methods: </strong>This methods protocol describes the RTT-KaT model, including its medical, operational, and ceremonial components. Delivered over 12 weeks, the program embeds three intramuscular or sublingual ketamine sessions within a structured Community of Practice. Weekly large- and small-group sessions are grounded in somatic, relational, and culturally responsive principles. The program is co-facilitated by a multidisciplinary-and often multicultural-team including healthcare providers, therapists, and somatic energy practitioners. A structured, psychology- and resilience-informed curriculum cultivates core resilience factors-such as congruence and sense of coherence-through practices that foster awareness, meaning-making, somatic regulation, and alignment with one's values and purpose.</p><p><strong>Results: </strong>Ketamine is positioned as an amplifier, not the primary driver of change. Ceremonial framing, intentional group process, and a relationally anchored curriculum serve as central mechanisms supporting meaningful change. Supplementary materials detail protocols for screening, dosing, consent, medical monitoring, and integration. While early outcome data have been published elsewhere, this article presents the methodology and protocol to support replication, adaptation, and ongoing evaluation.</p><p><strong>Discussion: </strong>RTT-KaT offers a structured, scalable, evidence-informed, and culturally responsive model that bridges clinical safety with both Western and Indigenous knowledge systems. A longitudinal follow-up study is currently underway to evaluate long-term impact and guide future implementations.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"16 ","pages":"1568017"},"PeriodicalIF":3.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244113","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":"Associations between Cloninger's temperament and character traits and light preference.","authors":"Hirofumi Hirakawa, Takeshi Terao, Kentaro Kohno, Akari Sakai, Nobuko Kawano","doi":"10.3389/fpsyt.2025.1605581","DOIUrl":"10.3389/fpsyt.2025.1605581","url":null,"abstract":"<p><strong>Background: </strong>It is unknown whether light preference (brightness or darkness) is associated with Cloninger's temperament and character traits. This study examined the association between Cloninger's temperament, character, and light preference in healthy individuals. The aim of the present study was to investigate the hypotheses that self-transcendence but not self-directedness may be associated with brightness preference, whereas harm avoidance may be associated with darkness preference.</p><p><strong>Methods: </strong>Data from 130 healthy participants were analyzed in an opt-out study. First, the data distribution of temperament and character scores was investigated by Shapiro-Wilk test. If the distribution was not normal, we used non-parametric test to compare temperament and character scores based on light preference (brightness or darkness), morning light exposure (yes or no), and bedtime mobile phone use (yes or no). Second, binomial logistic regression analyses were performed for each temperament and character scores as dependent variables in which the subjects were divided into two groups using median as a cut-off point (less than median = 0, equal to or more than median = 1), with age, sex, light preference, morning light exposure, and bedtime mobile phone use as independent variables.</p><p><strong>Results: </strong>Self-directedness was significantly associated with brightness preference and no bedtime mobile phone use. Our hypotheses were not supported.</p><p><strong>Conclusions: </strong>The present findings suggest that self-directedness may be associated with brightness preference and no bedtime mobile phone use. Further studies are required to determine the causal relationships.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"16 ","pages":"1605581"},"PeriodicalIF":3.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244058","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":"Exercise interventions for depressive, manic, and anxiety symptoms in bipolar disorder: a systematic review and meta-analysis.","authors":"Xinmo Li, Feike Liu, Feng Ding, Xiaochen Ma, Yongguo Zhu","doi":"10.3389/fpsyt.2025.1648008","DOIUrl":"10.3389/fpsyt.2025.1648008","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the efficacy of exercise interventions on depressive, manic, and anxiety symptoms in patients with bipolar disorder (BD) through a systematic review and meta-analysis, and to explore the impact of different exercise parameters (session duration, frequency, etc.) on these symptoms.</p><p><strong>Methods: </strong>We comprehensively searched Embase, Web of Science, PubMed, The Cochrane Library, Wan fang, Weipu Database(VIP), and China National Knowledge Infrastructure (CNKI) databases for randomized controlled trials (RCTs) published until May 2025. Included studies met the following criteria (1): participants aged ≥18 years with BD diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) or International Classification of Diseases, 11th Revision (ICD-11) criteria (2); exercise as the primary intervention (3); control groups receiving standard rehabilitation treatment. Study quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. Meta-analyses were performed using Stata 18.0, and evidence quality was evaluated with Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology.</p><p><strong>Results: </strong>A total of 7 RCTs n=576 were included. Meta-analysis demonstrated that exercise significantly improved depressive symptoms (SMD =-0.63, 95%CI: -1.11 to -0.14, P=0.01) and anxiety symptoms (SMD =-0.70, 95%CI: -1.26 to -0.15, P<0.05) in BD patients, but showed no significant effect on manic symptoms (SMD =-0.23, 95%CI: -0.67 to 0.21, P>0.05). Subgroup analyses revealed that exercise protocols featuring session duration ≤1 hour/session (SMD= -0.86, P=0.02), frequency >5 sessions/week (SMD = -0.76, P<0.01), and intervention period ≤12 weeks (SMD = -0.79, P=0.02) produced more pronounced improvements in depressive symptoms. The GRADE approach rated the quality of evidence as low for all outcomes (depression, anxiety, mania), with downgrading factors including substantial heterogeneity, imprecision, and risk of bias.</p><p><strong>Conclusion: </strong>Current low-quality evidence suggests that exercise may alleviate depressive and anxiety symptoms in BD patients (particularly with high-frequency, prolonged-duration, short-term protocols), while its effect on manic symptoms remains inconclusive. These findings should be interpreted cautiously due to methodological limitations of included studies.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/prospero/, identifier CRD420251041926.</p>","PeriodicalId":12605,"journal":{"name":"Frontiers in Psychiatry","volume":"16 ","pages":"1648008"},"PeriodicalIF":3.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244150","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}