Journal of affective disorders最新文献

{"title":"Anxiety symptom trajectories and subsequent suicidal ideation among patients with major depressive disorder: A longitudinal study in China","authors":"Ruiying Chen ,&nbsp;Yan Chen ,&nbsp;Yanzhi Li ,&nbsp;Wenjing Zhou ,&nbsp;Wenjian Lai ,&nbsp;Subinuer Yiming ,&nbsp;Qindan Zhang ,&nbsp;Chengxi Wen ,&nbsp;Yuhua Liao ,&nbsp;Huimin Zhang ,&nbsp;Yifeng Liu ,&nbsp;Wanxin Wang ,&nbsp;Lan Guo ,&nbsp;Ciyong Lu ,&nbsp;Xue Han","doi":"10.1016/j.jad.2025.119704","DOIUrl":"10.1016/j.jad.2025.119704","url":null,"abstract":"<div><h3>Background</h3><div>To examine the longitudinal associations between different anxiety symptom trajectories and subsequent suicidal ideation (SI) among patients with major depressive disorder (MDD).</div></div><div><h3>Methods</h3><div>We used data from patients with MDD in the Depression Cohort in China. At baseline, 4, 8, and 12 weeks, anxiety symptoms were assessed using the Generalized Anxiety Disorder 7-item Scale, and trajectories were identified using latent class trajectory models. At 12, 24, and 48 weeks, SI was assessed using the Beck Scale for Suicide Ideation.</div></div><div><h3>Results</h3><div>We included 718 participants with a median (IQR) age of 26.0 (22.3, 31.0) years, among whom 489 (68.1 %) were female. Five trajectories of anxiety symptoms were identified: persistent mild (25.1 %), rapidly decreasing (30.1 %), persistent moderate (21.7 %), slowly decreasing (10.3 %), and persistent severe (12.8 %). Compared to the persistent mild anxiety symptom trajectory, the rapidly decreasing anxiety symptom trajectory was significantly associated with lower levels of SI (<em>β</em> coefficient, −0.186; 95 % confidence interval [CI], −0.296 to −0.075). Conversely, the persistent moderate anxiety symptom trajectory (<em>β</em> coefficient, 0.126; 95 % CI, 0.03 to 0.249) and persistent severe anxiety symptom trajectory (<em>β</em> coefficient, 0.334; 95 % CI, 0.185 to 0.482) were associated with higher levels of SI. No statistically significant association was found for the slowly decreasing anxiety symptom trajectory (<em>β</em> coefficient, 0.051; 95 % CI, −0.101 to 0.202).</div></div><div><h3>Limitations</h3><div>Reporting bias; Selection bias; Observational design; Generalizability.</div></div><div><h3>Conclusions</h3><div>Among patients with MDD, achieving reductions in anxiety symptoms may mitigate suicidal risk, and attention should be paid to the suicidal risk associated with anxiety symptoms, particularly when symptoms remain severe in the longitudinal follow-up.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"389 ","pages":"Article 119704"},"PeriodicalIF":4.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disentangling nature and nurture: Exploring the genetic background of depressive symptoms in the absence of recent stress exposure using a GWAS approach","authors":"Berta Erdelyi-Hamza ,&nbsp;Dora Torok ,&nbsp;Sandor Krause ,&nbsp;Nora Eszlari ,&nbsp;Gyorgy Bagdy ,&nbsp;Gabriella Juhasz ,&nbsp;Xenia Gonda","doi":"10.1016/j.jad.2025.119731","DOIUrl":"10.1016/j.jad.2025.119731","url":null,"abstract":"<div><h3>Background</h3><div>Depression triggered by stress exposure versus depression appearing independently of it are two distinct subtypes. Analyzing their genetic background separately may bring us closer to decreasing the noise stemming from heterogeneity. We focused on the genetic background of depressive symptoms appearing in the absence of recent stress exposure with a genome-wide analysis approach and to reveal biological connections between genetic background, brain functioning, and tissue specific differences.</div></div><div><h3>Methods</h3><div>We included nearly 200,000 subjects reporting no stressful life events in the past two years with data on current depressive symptom severity. Following genotyping and quality control, 6,076,829 genetic variants were analyzed. GWAS results were evaluated on SNP, gene, and gene-set levels.</div></div><div><h3>Results</h3><div>64 SNPs with suggestive significance were identified, one SNP (rs60939828 <em>p</em> = 5.92 × 10⁻¹¹), located in <em>DCC</em> survived Bonferroni correction. <em>DCC</em> (<em>p</em> = 4.16 × 10⁻¹⁰) was also among three genes significant in gene-level associations. We identified tissue-specific upregulation in relevant brain areas where the more significantly a gene was associated with depressive symptoms, the higher it was expressed in brain areas including the cerebellar hemisphere (<em>p</em> = 4.0131 × 10⁻⁵), cerebellum (<em>p</em> = 1.79 × 10⁻⁵), frontal cortex (<em>p</em> = 2.9 × 10⁻⁴), cortex (<em>p</em> = 3.4 × 10⁻⁴), and anterior cingulate cortex (<em>p</em> = 9 × 10⁻⁴). Heritability estimation analysis revealed a 7.3 % heritability.</div></div><div><h3>Conclusion</h3><div>Our findings contribute to separating subtypes of depression on a genetic level. Future studies need to compare our results to findings in depression developing following exposure to severe stress to see what genetic markers and implicated pathways may separate these fundamentally distinct subtypes of depressive symptoms, paving the way for precision guidelines for diagnosing and treating depression.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"388 ","pages":"Article 119731"},"PeriodicalIF":4.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of embodied sense of self in the relationship of childhood abuse types to distress and fear","authors":"Laura E. Ong,&nbsp;Brandon M. Davis,&nbsp;Ashley M. Horodyski,&nbsp;Travis A. Cole,&nbsp;Holly K. Orcutt","doi":"10.1016/j.jad.2025.119698","DOIUrl":"10.1016/j.jad.2025.119698","url":null,"abstract":"<div><div>Theoretical models suggest that childhood abuse erodes embodied sense of self (ESS), a multidimensional entity that encompasses both subjective embodied experience and narrative identity. However, no studies have evaluated the impacts of childhood abuse types on the minimal and narrative selves simultaneously or examined the role of this integrated sense of self in the relationship of childhood abuse to psychopathology. The present cross-sectional study investigated ESS as a mediator from childhood emotional abuse (CEA), childhood sexual abuse (CSA), and childhood physical abuse (CPA) to fear and distress in a sample of 610 undergraduate students. Indirect paths were estimated through overall ESS, and through the individual domains of ownership, agency, and narrative. Disturbances to ESS mediated the relationship of both CEA and CPA to fear and distress, with particularly robust indirect paths observed for CEA. CEA demonstrated strong effects on all three ESS domains, while more modest paths appeared from CSA to narrative and from CPA to ownership and agency. Significant indirect effects emerged from both CEA and CPA through agency to distress, and from CEA and CSA through narrative to distress and fear. In both models, direct paths remained from CEA and CSA to distress only. These findings suggest that childhood abuse undermines the formation of an integrated sense of self, and that role of ESS in the pathway from childhood abuse to internalizing symptomatology may be restricted to the agency and narrative domains. Additional research should clarify the mechanisms by which childhood abuse types may disrupt ESS.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"389 ","pages":"Article 119698"},"PeriodicalIF":4.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal warmth and depressive symptoms in children: The mediating role of children's responses to positive affect and the moderating role of peer emotion regulation","authors":"Liuhua Ying,&nbsp;Shuang Zhang","doi":"10.1016/j.jad.2025.119713","DOIUrl":"10.1016/j.jad.2025.119713","url":null,"abstract":"<div><div>Although poor negative emotion regulation is a known risk factor for childhood depression, the potential role of positive emotion regulation—particularly in interaction with maternal warmth and peer socialization in Chinese cultural contexts—remains understudied. This study explored whether children's responses to positive affect may mediate the relationship between maternal warmth and depressive symptoms, and whether peer emotion regulation might moderates these pathways. Participants included 489 Chinese children (<em>M</em> age = 11.06 years, <em>SD</em> = 1.22; 51.7 % female) who completed self-report measures of all main variables. Results showed a direct negative association between maternal warmth and child depressive symptoms, with two potential indirect pathways: positive rumination appeared linked to reduced symptoms, while dampening was associated with increased symptoms. Peer emotion regulation seemed to moderate only the positive mediation pathway, with the buffering effect of positive rumination on depressive symptoms appearing stronger when peer regulation was high. In contrast, the direct protective effect of maternal warmth was more pronounced at lower levels of peer regulation. These preliminary findings suggest that both children's responses to positive affect and peer emotional regulation may influence the extent to which maternal warmth is associated with reduced depressive symptoms. The results tentatively support the value of family-based interventions that target maternal warmth and adaptive positive rumination, especially when combined with peer-supported emotion regulation strategies, as a multi-system approach to alleviating childhood depressive symptoms.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"389 ","pages":"Article 119713"},"PeriodicalIF":4.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating and forecasting global burden of mental disorders attributable to childhood sexual abuse or intimate partner violence: An analysis for the Global Burden of Disease Study 2021","authors":"Ke-chen Xu ,&nbsp;Ying Xie ,&nbsp;Fang Chu ,&nbsp;Meng-ting Li ,&nbsp;Ze-qi Hao ,&nbsp;Collins Opoku Antwi ,&nbsp;Peter Darko Adjei ,&nbsp;Zi-yi Li ,&nbsp;Jun Ren","doi":"10.1016/j.jad.2025.119717","DOIUrl":"10.1016/j.jad.2025.119717","url":null,"abstract":"<div><h3>Background</h3><div>As a leading global disease burden, mental disorders require critical assessment of related risk factors through disability-adjusted life years (DALYs) and years lived with disability (YLDs) to understand their public health impact.</div></div><div><h3>Methods</h3><div>With the data available from 2021 Global Burden of Disease (GBD), we mainly focused on the effect of childhood sexual abuse (CSA) and intimate partner violence (IPV) on global burden of mental disorders. We estimated numbers and the age-standardized rate (ASR) of DALYs/YLDs by sex, age, socio-demographic index (SDI), and country, and calculated the estimated annual percentage change (EAPC). Moreover, we forecasted the DALYs/YLDs using the autoregressive integrated moving average (ARIMA) model from 2022 to 2050.</div></div><div><h3>Findings</h3><div>From 1990 to 2021, the ASR of CSA-attributable DALYs/YLDs has declined from 18.25 (95 % uncertainty interval [UI] 9.04–31.13) to 18.08 (95%UI 8.75–30.97) per 100,000 population, while IPV-attributable ASR increased to 33.57 (95%UI 0.11–73.57) during the COVID-19 pandemic. In 2021, the highest DALYs/YLDs rate was observed in the 40–45 age group. Females exhibited a higher number and ASR of DALYs/YLDs attributable to CSA than males, and as the sole victims of IPV, they are projected to experience a decline in both metrics from 2022 to 2050. Low-SDI regions consistently had the highest ASR of DALYs and YLDs. India, China, and the U.S. bear the greatest burden, with the U.S. showing the highest increasing trend (EAPC: 1.54 [95%UI 1.25–1.83]), while China exhibited a decline (EAPC: −1.88 [95%UI -2.14 to −1.61]).</div></div><div><h3>Conclusions</h3><div>CSA and IPV are key risk factors for mental disorders. The burden imposed on women often attracted more attention in the past, but we see a rising trend in CSA in men. Certain countries like Singapore are doing well while others are struggling. Cross-country learning is thus put forward as important in managing CSA and IPV and their attendant mental disorders.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"389 ","pages":"Article 119717"},"PeriodicalIF":4.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CD63 as a critical biomarker associated with immune infiltration in depression through bioinformatics analysis and experimental validation","authors":"Mengyu Liu ,&nbsp;Duohao Wang ,&nbsp;Yun Sun ,&nbsp;Dandan Xu ,&nbsp;Yujia Cao ,&nbsp;Xinyang Qi ,&nbsp;Junjun Sun","doi":"10.1016/j.jad.2025.119724","DOIUrl":"10.1016/j.jad.2025.119724","url":null,"abstract":"<div><h3>Background</h3><div>Major depressive disorder (MDD) exhibits a multifactorial etiopathogenesis, yet current diagnosis still relies on clinician-rated symptom scales and phenomenological interviews, lacking validated biomarkers.</div></div><div><h3>Methods</h3><div>We analyzed human blood datasets from the Gene Expression Omnibus database to identify differentially expressed genes (DEGs) between MDD patients and healthy controls (CON). Key biomarkers were determined through integrated gene topological analysis in Cytoscape and machine learning algorithms. Immune infiltration profiles were assessed using CIBERSORT. Protein-protein interaction (PPI) networks and competing endogenous RNA (ceRNA) networks associated with candidate genes were constructed via multi-database analysis and validated using external datasets. Finally, candidate gene was validated via qPCR and Western blot in MDD patients, mice models, and cells.</div></div><div><h3>Results</h3><div>CD63 was identified as a potential biomarker using PPI network and machine learning algorithms. CIBERSORT analysis revealed immune infiltration differences between MDD and CON, with CD63 interacting with immune checkpoints HLA-DMB/HLA-DOB. Through multi-database analysis and validation in GSE182194/GSE217811, hsa-mir-1224-5p and three long non-coding RNAs (LINC00630, AP000766.1, LINC02487) formed CD63-associated ceRNA networks. Experimental validation in MDD patients and depression model mice, and SH-SY5Y cells confirmed CD63 dysregulation.</div></div><div><h3>Limitations</h3><div>A larger MDD cohort is required to validate the findings' generalizability; further exploration of CD63 expression across brain regions in MDD patients is also needed.</div></div><div><h3>Conclusion</h3><div>Our findings suggest CD63's dual role as a diagnostic biomarker and therapeutic target in MDD, mediated through immune interaction and ceRNA regulatory mechanisms. CD63 may serve as a biomarker in depression and provide a new target for the diagnosis and therapy of depression.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"389 ","pages":"Article 119724"},"PeriodicalIF":4.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benchmarking empirical severity for the Yale-Brown Obsessive Compulsive Scale-Second Edition.","authors":"Caitlin M Pinciotti, Juliana Avery, Chencheng Zhang, Josselyn S Muñoz, Dayan Berrones, Vanessa Zavala Cruz, Andrew D Wiese, Jacey L Anderberg, Renee M Frederick, Tomás Miño, Nuria Lanzagorta, Juan C Restrepo Castro, Marcos E Ochoa-Panaifo, Wayne K Goodman, James J Crowley, Eric A Storch, Matti Cervin","doi":"10.1016/j.jad.2025.119719","DOIUrl":"10.1016/j.jad.2025.119719","url":null,"abstract":"<p><p>The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is considered the primary instrument for assessing the presence and severity of obsessive-compulsive disorder (OCD). Conceptual and empirical critiques inspired the development of an updated version of the instrument, the Yale-Brown Obsessive Compulsive Scale-Second Edition (Y-BOCS-II), with a higher ceiling of OCD severity to better differentiate between severe and the most debilitating OCD presentations, among other revisions. The Y-BOCS-II has demonstrated sound psychometric properties across diverse samples. Empirically derived severity benchmarks have been proposed for the original Y-BOCS, yielding somewhat different ranges than what has been commonly used in clinical and research settings, yet severity benchmarks for the Y-BOCS-II have yet to be established. Using a diverse, pooled sample of 2982 children and adults with OCD or obsessive-compulsive and related concerns across 13 countries, receiver-operating characteristic (ROC) analyses yielded severity benchmarks that largely mirrored the original Y-BOCS at the lower range of scores and extended the previously established benchmarks at the higher range of scores, owing to the increased ceiling of the instrument. The optimal benchmark ranges were determined as: non-/sub-clinical (0-14), mild (15-21), moderate (22-34), severe (35-50). Similar benchmarks were present across sex and age groups, and their accuracy was adequate in both a holdout sample and an independent sample of OCD patients from China (n = 78). Limitations and implications for the use of the Y-BOCS-II in clinical and research settings are discussed.</p>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":" ","pages":"119719"},"PeriodicalIF":4.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Allostatic load partially mediates the association between number of stressful life events and cardiometabolic multimorbidity: A nationally representative cross sectional study from CHARLS","authors":"Lin Liu ,&nbsp;Xiuli Chen ,&nbsp;Yini Wang ,&nbsp;Qingfang Ye ,&nbsp;Ting Han ,&nbsp;Ping Lin","doi":"10.1016/j.jad.2025.119711","DOIUrl":"10.1016/j.jad.2025.119711","url":null,"abstract":"<div><h3>Background</h3><div>Stressful life events are independent psychological risk factor for diabetes and cardiovascular disease, yet studies on cardiometabolic multimorbidity (CMM) are scarce. This study aimed to examine the effects of stressful life events and their accumulation on the prevalence of CMM, as well as the mediating role of allostatic load in the association between accumulated stressful life events and CMM.</div></div><div><h3>Methods</h3><div>A total of 7493 participants from Wave 3 (2015) of the China Health and Retirement Longitudinal Study (CHARLS) were included. Stressful life events were assessed using five simple questions. CMM, defined as having two or more of cardiometabolic diseases, including diabetes, heart disease and stroke, was obtained through self-reports.</div></div><div><h3>Results</h3><div>The prevalence of CMM increased with the number of stressful life events, ranging from 5.73 % for one stressful life event to 6.61 % for two or more. In the fully adjusted model, the odds ratios (95 % confidence interval) for CMM were 1.49 (1.01–2.20) for participants experiencing marital problems and 1.93 (1.45–2.56) for those with functional disability. Compared with no stressful life events, an increasing number of stressful life events was associated with a higher risk of CMM (<em>P</em>-trend &lt;0.001). The mediation analysis results demonstrated that allostatic load was a significant mediator of the association between accumulated stressful life events and CMM, accounting for a mediated proportion of 16.7 %.</div></div><div><h3>Conclusions</h3><div>In the general population, the presence of specific and cumulative stressful life events is associated with an increased prevalence of CMM, and allostatic load plays a crucial mediation effect.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"389 ","pages":"Article 119711"},"PeriodicalIF":4.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and predictors of suicidal ideation in patients with chronic schizophrenia: A large-scale study on the mediating roles of depression, insomnia and aggression","authors":"Guoshuai Luo ,&nbsp;Ke Zhang ,&nbsp;Yuanyuan Liu ,&nbsp;Rui Jiang ,&nbsp;Jianan Zhou ,&nbsp;Xiangyang Zhang","doi":"10.1016/j.jad.2025.119721","DOIUrl":"10.1016/j.jad.2025.119721","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to investigate the prevalence and predictors of suicidal ideation (SI) in patients with chronic schizophrenia, focusing on the mediating roles of depression, insomnia, and aggression.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted with 1271 patients diagnosed with chronic schizophrenia in China. Participants were assessed using the Beck Scale for Suicide Ideation (SSI), Hamilton Depression Rating Scale (HAMD), Insomnia Severity Index (ISI), Modified Overt Aggression Scale (MOAS), and Positive and Negative Syndrome Scale (PANSS). Mediation and serial mediation analyses were performed to examine the relationships among depression, insomnia, aggression, and SI.</div></div><div><h3>Results</h3><div>The prevalence of SI was 16.44 %. Depression exhibited both direct and indirect effects on SI, mediated by insomnia (indirect effect = 0.255, 95 % CI [0.116, 0.426]) and aggression (indirect effect = 0.115, 95 % CI [0.014, 0.260]). Serial mediation analysis revealed a significant pathway: depression → insomnia → aggression → SI (β = 0.038, 95 % CI [0.003, 0.094]). Younger age, family history of mental illness, alcohol consumption, higher PANSS scores, and elevated HAMD and MOAS scores were significant predictors of SI.</div></div><div><h3>Conclusion</h3><div>The findings highlight the high prevalence of SI in chronic schizophrenia and underscore the complex interplay of depression, insomnia, and aggression in increasing suicide risk. Targeted interventions addressing these mediators, particularly insomnia and aggression, may mitigate SI in this population.</div></div><div><h3>Limitations</h3><div>The cross-sectional design precludes causal inferences. The sample was predominantly male and single, limiting generalizability. Self-reported measures may introduce bias, and medication effects were not controlled.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"389 ","pages":"Article 119721"},"PeriodicalIF":4.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing efficacies of different transcranial magnetic stimulation targeting methods for depression: A meta-analysis","authors":"Sirui Wang ,&nbsp;Qingan Weng ,&nbsp;Gai Kong ,&nbsp;Guanfu Wu ,&nbsp;Huiru Cui ,&nbsp;Zhenying Qian ,&nbsp;Lihua Xu ,&nbsp;Junjie Wang ,&nbsp;Jingjing Huang ,&nbsp;Jijun Wang ,&nbsp;Hui Li ,&nbsp;Yingying Tang","doi":"10.1016/j.jad.2025.119712","DOIUrl":"10.1016/j.jad.2025.119712","url":null,"abstract":"<div><h3>Background</h3><div>Transcranial magnetic stimulation over the left dorsolateral prefrontal cortex is widely used to treat patients with major depressive disorder. The left dorsolateral prefrontal cortex is located using the “5 cm”, F3, or neuro-navigational methods. However, whether treatment efficacy differs according to the method used remains unclear.</div></div><div><h3>Methods</h3><div>The Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines were followed. Randomized controlled trials that compared the efficacy of sham with active transcranial magnetic stimulation using at least one of the three targeting methods or compared different targeting methods in active transcranial magnetic stimulation were selected. The data were independently extracted by two authors and discrepancies were resolved by a third author. The primary outcome was the change in the severity of depressive symptoms. The secondary outcomes were acceptability (drop-out rate) and tolerability (incidence of adverse events).</div></div><div><h3>Results</h3><div>Network meta-analysis of 63 randomized controlled trials involving 3080 participants showed that active transcranial magnetic stimulation using the neuro-navigational (standardized mean difference = 1.19, 95 % confidence interval = 0.55–1.84) and “5 cm” methods (standardized mean difference = 1.13, 95 % confidence interval = 0.79–1.47) had greater anti-depressant efficacy than sham transcranial magnetic stimulation. The neuro-navigational method had the highest surface under the cumulative ranking curve score (79.3), followed by the “5 cm” method (73.9) and the F3 method (40.1). Neuro-navigation also exhibited the lowest drop-out rate and the highest incidence of adverse events.</div></div><div><h3>Conclusions</h3><div>Transcranial magnetic stimulation using neuro-navigation was associated with good efficacy, high acceptability, and low tolerability compared with sham transcranial magnetic stimulation.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"389 ","pages":"Article 119712"},"PeriodicalIF":4.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}