Neuropsychobiology最新文献

{"title":"Repeated Forced-Swim Stress Modulates Neural Structure and Hepatic Gene Expression in the Stressed Mice Model.","authors":"Abeer Asif, Rubab Batool, Shahzadi Arhum, Aqsa Ashraf, Muhammad Zohaib Iqbal, Azra Mehmood, Agnes S Klar, Muhammad Mustafa","doi":"10.1159/000550173","DOIUrl":"10.1159/000550173","url":null,"abstract":"<p><strong>Introduction: </strong>Throughout time, there has always been a trend connecting stress and tangible damage to one's physical well-being. However, there's a lack of research that elucidates the physical and molecular traits of this stress on organ integrity. Chronic stress disrupts homeostasis, causing oxidative stress, mitochondrial dysfunction, inflammatory markers, and histological damage.</p><p><strong>Methods: </strong>In this study, a repeated forced-swim stress was used to induce stress in the C57BL/6 mice model, and its effects on the brain and liver were analyzed at behavioral, biochemical, histological, and genetic marker levels.</p><p><strong>Results: </strong>Behavioral analysis showed reduced mobility duration in experimental mice. This was further supplemented by histopathological data, which revealed mild brain deterioration and moderate liver damage. Biochemical analysis revealed upregulated levels of aminotransferase and alkaline phosphatase (ALP) and decreased levels of mean corpuscular hemoglobin, pointing toward the existence of liver dysfunctionality due to stress. Moreover, we reported the gene expression analysis of stress biomarkers (Bdnf, Fkbp5, Npy, Comt, Ppm1f, Adra2b, and Slc6a4), with a particular focus on Fkbp5, which is associated with depression and cognitive impairment. Similarly, we also studied the expressions of Crp, Cyp2e1, and Irs-2 to gauge liver damage. Results revealed significantly upregulated expression of Npy, Fkbp5, and Ppm1f in stressed mice.</p><p><strong>Conclusion: </strong>Our study identifies that chronic stress shows physical and molecular realizations. Additionally, this offers further incentive to look closely at Fkbp5, Npy, and Ppm1f under similar conditions and highlights their possible roles as markers of stress-induced damage.</p>","PeriodicalId":19239,"journal":{"name":"Neuropsychobiology","volume":" ","pages":"39-49"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145810709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a Mindful Self-Compassion Intervention on Emotion Regulation in Psychiatric Rehabilitation: A Randomized Controlled Trial.","authors":"Andrea Andorfer, Michaela Hiebler, Hugo Senra, Johannes Peter, Sabina Kraler, Paul Kaufmann, Ewald Pollheimer, Christoph Spah, Adelheid Kresse, Hans-Peter Kapfhammer, Human-Friedrich Unterrainer","doi":"10.1159/000548902","DOIUrl":"10.1159/000548902","url":null,"abstract":"<p><p><p>Introduction: Emotion regulation (ER) is essential for psychological functioning and daily life. Deficits in ER are associated with various psychiatric disorders and are important targets for therapeutic interventions. Self-compassion, the practice of responding to one's own suffering with kindness, has been proposed to support adaptive ER. This study examined changes during a 6-week psychiatric inpatient rehabilitation program to evaluate the effects of a mindfulness- and self-compassion-based intervention on ER.</p><p><strong>Methods: </strong>In a randomized controlled trial, 168 psychiatric inpatients were allocated to either a Mindful Self-Compassion (MSC) intervention group (n = 95) or an active control group receiving Progressive Muscle Relaxation (PMR; n = 73). Participants completed assessments at baseline and post-treatment, including the Self-Compassion Scale (SCS), the Emotion Regulation Questionnaire (ERQ), and the Positive and Negative Affect Schedule (PANAS). At post-treatment, the Reappraisal Inventiveness Test (RIT) was additionally administered. Data were analyzed using mixed-design ANOVAs and independent t tests.</p><p><strong>Results: </strong>Both MSC and PMR groups showed significant increases in self-compassion, positive affect, and self-reported cognitive reappraisal. No significant changes were observed in expressive suppression, and no between-group differences were found for reappraisal inventiveness as measured by the RIT.</p><p><strong>Conclusions: </strong>Participation in either intervention was associated with enhanced use of cognitive reappraisal, suggesting that both MSC and PMR may foster adaptive ER in psychiatric rehabilitation. Further research is warranted to clarify the specific mechanisms and potential long-term benefits of mindful self-compassion interventions in clinical populations. </p>.</p>","PeriodicalId":19239,"journal":{"name":"Neuropsychobiology","volume":" ","pages":"12-21"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12707897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circadian and Sleep-Related Polygenic Scores in Relation to Lithium Treatment Response in Bipolar Disorder.","authors":"Marina Zafrilla-López, Daniel Herrera-Escartín, Maria Guardiola-Ripoll, Arnau García-Fernández, Miriam Acosta-Díez, Anna Giménez-Palomo, Pilar A Saiz, Maria Paz García-Portilla, Esther Jiménez, Sergi Papiol, Lourdes Fañanás, Victoria Ruiz, Patricia Gavín, Leticia González-Blanco, Eduard Vieta, Thomas G Schulze, Mar Fatjó-Vilas, Antoni Benabarre, Marina Mitjans, Bárbara Arias","doi":"10.1159/000551565","DOIUrl":"10.1159/000551565","url":null,"abstract":"<p><p><p>Introduction: Circadian rhythms are reflected through sleep-wake patterns and chronotype. Patients with bipolar disorder (BD) frequently exhibit disrupted sleep patterns and a tendency for evening chronotype. Also, genetic risk factors for BD partially overlap with those influencing sleep traits. Lithium (Li), the first-line therapy for BD, stabilizes circadian rhythms and promotes morningness in responders (Rp). This study aimed to evaluate whether the polygenic burden of sleep-related traits is associated with Li response in BD patients.</p><p><strong>Methods: </strong>A total of 114 European ancestry BD patients were categorized as Li Rp (N = 79) or non-responders (N = 35), based on the reduction of 50% of the episodes. Polygenic scores (PGS) for chronotype, daytime dozing, ease of getting up, insomnia, morningness, napping, sleep duration, and snoring were calculated using PRS-CS. Associations between each PGS and Li response were tested using logistic regression models. Comparisons were made between the extreme quartiles of each PGS.</p><p><strong>Results: </strong>The PGS for ease of getting up was significantly associated with Li response, explaining 9.989% of the variance based on Nagelkerke's pseudo-R2 (FDR-adjusted p value = 0.046). Additionally, individuals with a higher genetic predisposition for ease of getting up had increased odds of a good response (FDR-adjusted p value = 0.039; OR = 5.143; 95% CI = 1.537-17.209).</p><p><strong>Conclusion: </strong>The study suggests that a higher genetic predisposition for ease of getting up in the morning may increase the likelihood of responding to Li treatment in BD patients. Our study aligns with previous evidence, highlighting the importance of sleep and chronotype patterns in response to Li in BD patients. </p>.</p>","PeriodicalId":19239,"journal":{"name":"Neuropsychobiology","volume":" ","pages":"245-254"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13275051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Long-Term Course of Adolescent-Onset Major Depressive Disorder in Females: A 10-Year Cohort Study on Recurrence, Suicide Risk, and Service Use.","authors":"Hazal Yağmur Yılancıoğlu, Tezan Bildik, Sebnem Pırıldar, Zeki Yüncü, Umut Kırlı, Birsen Şentürk Pilan, Çiğdem Yektaş, Arkun Tatar, İpek İnal Kaleli, Nurhak Doğan","doi":"10.1159/000552126","DOIUrl":"10.1159/000552126","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescent-onset major depressive disorder (MDD) is associated with high morbidity, recurrence, and suicide risk. However, few studies have prospectively examined its long-term course into emerging adulthood.</p><p><strong>Methods: </strong>Ninety-four female adolescents (aged 15-17 years) diagnosed with MDD between January and August 2012 were enrolled. After 10 years, 54 participants were reassessed. Psychiatric diagnoses were established using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) at baseline and the Structured Clinical Interview for DSM-5 Disorders (SCID-5) at follow-up. Global functioning was rated using the Global Assessment of Functioning (GAF). At both time points, participants completed the Beck Depression Inventory (BDI), Emotional Autonomy Scale (EAS), Parent Adolescent Relationship Questionnaire (PARQ), and Identity Development Assessment Tool (IDAT).</p><p><strong>Results: </strong>Nearly, all participants (94.4%) experienced recurrent depressive episodes, and 79.6% met criteria for at least one current psychiatric disorder at the follow-up assessment. The most common current diagnoses were MDD and attention-deficit/hyperactivity disorder (each 35.2%). The mean GAF score at follow-up was 64.2 ± 8.1, indicating moderate functional impairment. Lifetime suicide attempts were reported by 32 participants (59.3%). Runaway behaviour was a significant risk factor for suicidal behaviour (odds ratio [OR] = 5.91, 95% confidence interval [CI]: [1.27-27.54], p = 0.024), while earlier psychiatric contact (OR = 0.40, 95% CI: [0.18-0.88], p = 0.027) served as a protective factor. Despite the ongoing need, one-fifth of individuals (n = 11) was receiving psychiatric care in emerging adulthood.</p><p><strong>Conclusion: </strong>Adolescent-onset major depressive disorder is highly recurrent and carries a significant long-term risk for further psychiatric issues and suicide. However, the rigid transition from child to adult services at age 18 appears to disrupt care continuity. Runaway behaviour should be considered a marker of suicide risk, whereas earlier psychiatric contact may be protective. Youth psychiatry programs are needed to bridge the child-adult service gap for adolescents with depression.</p>","PeriodicalId":19239,"journal":{"name":"Neuropsychobiology","volume":" ","pages":"271-284"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147988462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Heavy Metals as a Biomarker in the Pathogenesis of Dyslexia and Specific Learning Disabilities: A Systematic Review.","authors":"Matine Ebadi, Mohammad Narimani, Seyfollah Aghajani, Sanaz Eyni, Ghasem Fattah Zade Ardalani","doi":"10.1159/000548323","DOIUrl":"10.1159/000548323","url":null,"abstract":"<p><strong>Introduction: </strong>Among the possible risk factors for dyslexia and specific learning disabilities (SLD) in children, being exposed to heavy metals in the environment has been considered a significant one, serving as a biological marker. The precise mechanisms by which heavy metals affect cognitive functions were discussed. However, their shared affinity for NMDA receptors or the Na+/K+ ATPase pump can disrupt the balance between reactive oxygen species and antioxidants. Several studies have scrutinized the effect of heavy and toxic metals on dyslexia. Consequently, this research aimed to systematically assess the most recent evidence of the effects of heavy metals on SLD and dyslexia.</p><p><strong>Methods: </strong>Four databases (i.e., Scopus, Web of Science, Google Scholar, and PubMed/Medline) were searched; 450 studies published up to 2024 were found. After applying inclusion/exclusion criteria, five studies were selected, and data regarding the participants' age, measurement instruments, the year of the studies, and the outcomes were extracted and analyzed.</p><p><strong>Results: </strong>Generally, the total sample size in the five studies was 1,909 individuals. These studies examined 25 heavy metals, with selenium (Se), copper (Cu), lead (Pb), zinc (Zn), and nickel (Ni) showing consistent associations with dyslexia and SLD. Metals such as aluminum (Al), arsenic (As), antimony (Sb), cadmium (Cd), cobalt (Co), mercury (Hg), iron (Fe), and manganese (Mn) were cited only once. Notably, heavy metals such as Pb, Al, Sb, and Cd had a definitive role in the neuropathogenesis of SLD.</p><p><strong>Conclusion: </strong>These findings highlighted the importance of implementing environmental control measures to minimize children's exposure to toxic heavy metals.</p>","PeriodicalId":19239,"journal":{"name":"Neuropsychobiology","volume":" ","pages":"50-58"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic Effects and Safety of Mirtazapine for Insomnia in Major Depressive Disorder: Findings from a 6-Week Open-Label Pre- and Post-Intervention Study.","authors":"Mohammad Tariqul Alam, Ahsan Aziz Sarkar, Muhammad Zillur Rahman Khan, Helal Uddin Ahmed, Abdullah Al Mamun, Mahbub Hasan, Rubina Hossain, Taiyeb Ibna Zahangir, Nadia Afroz, Afroza Rahman Lopa, Nayem Akhter Abbassi, Syed Reazur Rahman, Mahfuza Yasmin, Tayabur Rahman, Abul Kashem Md Khaleequzzaman, Dipesh Sonawane, Kalpesh Joshi, Sameer Eknath Rao, Suyog Mehta","doi":"10.1159/000547983","DOIUrl":"10.1159/000547983","url":null,"abstract":"<p><strong>Introduction: </strong>Insomnia is one of the most common symptoms of depression, estimated to occur in approximately 75% of adult patients with depression, and it may persist even after remission from depressive episodes. Our objectives were to evaluate the efficacy of mirtazapine in reducing insomnia and depression symptom severity, assess side effects, and compare quality of life (QoL) before and after intervention in major depressive disorder (MDD) patients with insomnia.</p><p><strong>Methods: </strong>This was a single-center, prospective, open-label, quasi-experimental pre-post-intervention trial of 6 weeks. The Hamilton Depression Rating Scale (HDRS), Insomnia Severity Index (ISI), Antidepressant Side-Effect Checklist (ASEC), and World Health Organization Quality of Life (WHOQOL-BREF) tools were used during the assessment.</p><p><strong>Results: </strong>Out of the 135 recruited patients, 109 (80.7%) completed the trial. On day 14, with a mean dose of 18.9 mg/day, 24.8% of patients experienced remission for insomnia, while 7.3% showed remission for depression. By day 42, with a mean dose of 18.7 mg/day, these figures increased to 62.4% for insomnia and 41.3% for depression. The reduction in the ISI score (mean ± SD) from baseline to day 14 and day 42 was 8.74 ± 6.16 and 13.55 ± 5.32, respectively. Similarly, the reduction in the HDRS score from baseline on day 14 and 42 was 10.30 ± 6.89 and 17.78 ± 6.26, respectively. The most commonly reported adverse effects (>10%) included increased appetite, drowsiness, weight gain, dry mouth, headache, and constipation. Regarding QoL, the differences were significant for all four domains with the highest improvement observed in the physical (mean difference 25.67 ± 13.95) and psychological domains (mean difference 26.35 ± 16.42) of QoL.</p><p><strong>Conclusion: </strong>Mirtazapine treatment was associated with significant improvements in depression, insomnia, and all QoL parameters, with increased appetite and weight gain being the most common adverse effects. Further randomized controlled comparator studies will be beneficial for healthcare providers to improve the clinical care of MDD patients with insomnia.</p>","PeriodicalId":19239,"journal":{"name":"Neuropsychobiology","volume":" ","pages":"1-11"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144962910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fifty Years of Lithium in Obsessive-Compulsive Disorder and Related Disorders: A Systematic Review of Clinical Evidence Challenging a Theoretical Assumption.","authors":"Murilo Branco, Verônica Hühne, Ligia M Fonseca, Inês M Salles-Fonseca, Maria E Moreira-de-Oliveira, Gabriela B de Menezes, Leonardo F Fontenelle","doi":"10.1159/000548947","DOIUrl":"10.1159/000548947","url":null,"abstract":"<p><strong>Introduction: </strong>Obsessive-compulsive disorder (OCD) and related disorders (OCRDs) represent a group of conditions in which lack of response to first-line treatments, such as serotonin reuptake inhibitors (SRIs), is common. Therefore, exploring alternative strategies is necessary. We conducted a systematic review of the use of lithium in OCRDs.</p><p><strong>Methods: </strong>This systematic review was conducted in accordance with PRISMA guidelines. We included studies evaluating the use of lithium for OCRDs in adults. Eligible designs included case reports, case series, observational studies, and clinical trials. Four databases (PubMed, PsycInfo, Web of Science, and <ext-link ext-link-type=\"uri\" xlink:href=\"http://ClinicalTrials.gov\" xmlns:xlink=\"http://www.w3.org/1999/xlink\">ClinicalTrials.gov</ext-link>) were searched on January 21, 2025. Response to lithium was defined by improvement on validated scales or, when unavailable, based on clinical descriptions.</p><p><strong>Results: </strong>Twenty-nine studies met inclusion criteria, including 25 case reports or case series and four clinical trials. Most studies focused on OCD (n = 20), followed by trichotillomania (n = 5), tic disorders (n = 3), and body dysmorphic disorder (n = 1). Across the full sample (n = 97), 38.1% of the subjects showed \"clinical improvement,\" although only 54.6% were assessed using validated instruments. Among case reports and case series (n = 37), 89.2% reported \"improvement.\" However, three crossover RCTs found no consistent benefit of lithium, and the only placebo-controlled trial did not detect significant differences between groups in the final pooled analysis. Analysis of individual data showed response to lithium to be more common among younger individuals (p = 0.02), those with comorbid bipolar disorder (p = 0.005), individuals receiving lithium as monotherapy (p < 0.018), and those without prior exposure to SRIs (p < 0.001). Additionally, responders were less likely to have been assessed using standardized instruments (p < 0.001).</p><p><strong>Conclusion: </strong>This is the first systematic review to evaluate lithium as a treatment strategy for OCRDs. While some reports suggest potential benefits, current evidence - largely based on low-quality studies without standardized assessments - does not support its use. Findings from randomized trials remain inconclusive, and further high-quality research is needed.</p>","PeriodicalId":19239,"journal":{"name":"Neuropsychobiology","volume":" ","pages":"59-72"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145459380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"XPO6 mRNA as a Potential Biomarker for Major Depressive Disorder: Associations with Disease State and Treatment Response.","authors":"Tien-Wei Hsu, Tiao-Lai Huang","doi":"10.1159/000550656","DOIUrl":"10.1159/000550656","url":null,"abstract":"<p><strong>Introduction: </strong>Exportin-6 (XPO6) regulates nuclear export of actin and related proteins, processes essential for cytoskeletal integrity and synaptic function. Given the importance of these mechanisms in mood regulation, XPO6 dysregulation may contribute to the pathophysiology of major depressive disorder (MDD), yet its role remains largely unknown.</p><p><strong>Method: </strong>XPO6 mRNA was measured in the peripheral blood of participants with MDD in an acute depressive episode (acute MDD group), MDD in remission, and healthy controls (screened using Chinese health questionnaire-12 and semi-structured interviews to exclude current or past psychiatric disorders) at baseline. XPO6 mRNA levels were measured after 4 weeks of antidepressant treatment in the acute MDD group. The 17-item Hamilton Depression Rating Scale was used to assess depression severity. XPO6 mRNA levels were quantified by quantitative reverse transcription polymerase chain reaction (RT-qPCR).</p><p><strong>Results: </strong>We recruited 90 participants in the acute MDD group, 60 in the MDD in remission group, and 70 healthy controls. After adjusting for demographics, a significant difference in baseline XPO6 mRNA levels was found among the three groups (F = 4.34, p = 0.014). In the post hoc analysis, a stepwise pattern in XPO6 mRNA levels was observed (acute MDD group > MDD in remission group > healthy controls). After antidepressant treatment in the acute MDD group, XPO6 mRNA levels significantly decreased (2.23 ± 2.39 vs. 1.82 ± 1.96, p = 0.016).</p><p><strong>Conclusion: </strong>XPO6 mRNA levels could be a potential biomarker for MDD, which is also associated with depression disease state and treatment response to antidepressants. Larger sample sizes are needed to confirm these results in the future.</p>","PeriodicalId":19239,"journal":{"name":"Neuropsychobiology","volume":" ","pages":"95-103"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146053084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Randomised Controlled Trial on the Efficacy of Ketamine versus Electroconvulsive Therapy in Severe Depression with Suicidal Ideation.","authors":"Lavanya Seth, Jitendriya Biswal, Surjeet Sahoo, Riya Shetty, Jamuna Das","doi":"10.1159/000550863","DOIUrl":"10.1159/000550863","url":null,"abstract":"<p><p><p>Introduction: Severe depressive episodes with suicidal ideation present major therapeutic challenges and often require interventions beyond standard antidepressant therapy. Electroconvulsive therapy (ECT) remains a cornerstone treatment for refractory depression, while ketamine, an N-methyl-D-aspartate receptor antagonist, has emerged as a rapid-acting antidepressant with potential benefits in reducing suicidal ideation. This study compares the efficacy, onset of action, and tolerability of intravenous ketamine and ECT as adjunctive treatments in severe major depressive disorder with active suicidal ideation.</p><p><strong>Methods: </strong>A randomised controlled trial was conducted at a tertiary care psychiatry department in India, enrolling 64 patients aged 18-60 years with severe depression (HAM-D ≥19, SSI ≥4). Participants were randomly assigned to receive either intravenous ketamine (n = 31) or ECT (n = 33), alongside ongoing oral antidepressants. Both groups underwent six treatment sessions over 2 weeks. Outcomes were assessed at baseline, post-treatment, and 4 weeks after completion. Primary endpoints included changes in depression severity (HAM-D) and suicidal ideation (SSI), while secondary outcomes included response and remission rates, as well as safety and tolerability profiles.</p><p><strong>Results: </strong>Both ECT and ketamine significantly reduced depressive symptoms and suicidal ideation (p < 0.001). HAM-D scores declined from 27 to 1 in the ECT group and from 26 to 2 in the ketamine group by the 4-week follow-up. SSI scores showed parallel improvement, from 12.1 to 1.2 with ECT and 12.6 to 2.0 with ketamine. Ketamine demonstrated a faster onset of clinical improvement, while ECT showed slightly greater durability of response. Side effects were mild in both groups, though ECT was associated with transient cognitive impairment, whereas ketamine produced minor dissociative and urinary symptoms.</p><p><strong>Conclusion: </strong>Ketamine offers a faster reduction in suicidal ideation than ECT, making it a promising acute intervention. Both are effective, safe adjunctive therapies, with treatment choice guided by patient profile and tolerability. </p>.</p>","PeriodicalId":19239,"journal":{"name":"Neuropsychobiology","volume":" ","pages":"156-167"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13046308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acknowledgement to Reviewers.","authors":"","doi":"10.1159/000549199","DOIUrl":"10.1159/000549199","url":null,"abstract":"","PeriodicalId":19239,"journal":{"name":"Neuropsychobiology","volume":" ","pages":"291-292"},"PeriodicalIF":3.1,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145550266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}