Neuropsychiatric Disease and Treatment最新文献

{"title":"Doomscrolling: Its Relationships with Fear of Missing Out, Netlessphobia, Internet Addiction, and Psychological Distress in University Students.","authors":"Mahboubeh Dadfar, Yahya Turan, Alireza Ghorbani, David Lester, Mehmet Sinan Tam","doi":"10.2147/NDT.S628415","DOIUrl":"10.2147/NDT.S628415","url":null,"abstract":"<p><strong>Introduction: </strong>This study explores the structural associations connecting digital anxieties (fear of missing out [FoMo] and netlessphobia) to psychological distress through intermediate digital behaviors (doomscrolling and Internet addiction) within an integrated Interaction-Person-Affect-Cognition-Execution (I-PACE) and cognitive-behavioral framework.</p><p><strong>Methods: </strong>Utilizing a cross-sectional online design, a convenience sample of 608 Iranian university students completed validated Farsi versions of the Doomscrolling Scale (DS), Fear of Missing Out Scale (FoMOs), Fırat Netlessphobia Scale (F-NPS), Internet Addiction Test (IAT), and Patient Health Questionnaire-4 (PHQ-4) via Google Forms. Structural Equation Modeling (SEM) with Maximum Likelihood estimation and 5000 bias-corrected bootstrap resamples was conducted to evaluate direct and indirect pathways.</p><p><strong>Results: </strong>The structural model exhibited acceptable fit. Direct paths from netlessphobia and FoMo to psychological distress were statistically non-significant, supporting a full indirect association pattern. Netlessphobia demonstrated a strong positive indirect association with psychological distress, predominantly operating via Internet addiction and secondarily through doomscrolling. Conversely, FoMo was indirectly associated with psychological distress exclusively through Internet addiction, as its indirect pathway via doomscrolling was statistically non-significant. The model explained 43.6% of the total variance in psychological distress.</p><p><strong>Discussion: </strong>Digital fears serve as distal correlates of student psychological distress, primarily operating through generalized Internet addiction rather than negative content monitoring alone. Interventions should prioritize addressing compulsive technology use and disconnection anxieties.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"628415"},"PeriodicalIF":3.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137630","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":"Plasma Sphingomyelin and Ceramide Profiles as Potential Biomarkers in Young Adults with Bipolar Depression: A Lipidomics Study.","authors":"Yanhua Chen, Shan Zhang, Zhitong Zhang, Yan Yao","doi":"10.2147/NDT.S636080","DOIUrl":"https://doi.org/10.2147/NDT.S636080","url":null,"abstract":"<p><strong>Background: </strong>Bipolar depression (BPD) lacks reliable peripheral biomarkers for early diagnosis. Sphingomyelin (SM) and ceramide (Cer) are bioactive lipids implicated in neuronal membrane signaling, yet their diagnostic utility in young adults with BPD remains unclear.</p><p><strong>Patients and methods: </strong>We conducted a single-center exploratory untargeted lipidomics study focusing on SM and Cer species in plasma from 26 young adults (18-26 years) with BPD at baseline and after three weeks of quetiapine and magnesium valproate treatment (BPD3w), alongside 27 sex- and age-matched healthy controls (HC). Group comparisons of total SM, total Cer, and SM/Cer ratio were performed; ROC curves assessed discriminative ability. A Venn diagram approach, followed by LASSO regression with bootstrap averaging, identified a refined candidate biomarker panel from 140 SM/Cer species.</p><p><strong>Results: </strong>Both BPD and BPD3w groups exhibited elevated total SM and Cer relative to HC, whereas the SM/Cer ratio was significantly reduced. Paired analysis revealed that total SM and the SM/Cer ratio decreased after treatment (both P < 0.05), while total Cer remained unchanged. Intersection analysis yielded 14 candidate lipids, which were further refined via LASSO regression (λ = 100) with bootstrap averaging to a 4-species panel: Cer(t20:1/24:3), Cer(d19:1/25:3), SM(t18:0/22:0), and Cer(t17:0/22:0), with an AUC of 0.975 (95% CI: 0.917-1.000), representing an unvalidated internally derived estimate pending further validation. Correlation analysis revealed that Cer(d19:1/25:3), Cer(t17:0/22:0), and SM(t18:0/22:0) were positively correlated with depressive, anxiety, and manic symptom severity (HAMD, HAMA, and YMRS). Cer(t20:1/24:3) showed a modest negatively correlation with HAMD, but not with HAMA or YMRS. Additionally, Cer(t20:1/24:3) and SM(t18:0/22:0) exhibited sex-dependent differences.</p><p><strong>Conclusion: </strong>Plasma SM and Cer profiles are altered in young adults with BPD and show a partial trend toward normalization following short-term treatment. A refined 4-species panel showed promising but internally derived discriminative performance in this exploratory study. While peripheral sphingolipid signatures may serve as potential biomarkers for BPD, these findings require validation in independent cohorts before any clinical application.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"636080"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112902","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":"Kaempferide Promotes Neuroprotection and Functional Recovery After Spinal Cord Injury and is Associated with Differential Regulation of ARG1, CA4, CYP1B1, and OAT.","authors":"Zhichao Meng, Wenchong Yu, Ao Ma, Xuzhou Liu, Sibei Li, Yeungyeung Liu","doi":"10.2147/NDT.S628411","DOIUrl":"https://doi.org/10.2147/NDT.S628411","url":null,"abstract":"<p><strong>Introduction: </strong>Spinal cord injury (SCI) is a severe neurological disorder that often causes long-term motor dysfunction, and effective neuroprotective treatments remain limited. Kaempferide has anti-inflammatory and neuroprotective activities, but its effects and associated targets in SCI remain unclear.</p><p><strong>Methods: </strong>Kaempferide-related targets were intersected with differentially expressed genes and SCI-associated modules from GSE151371. Three machine-learning algorithms identified candidate genes, which were evaluated in GSE151371 and GSE226238. Immune cell deconvolution analysis, gene set enrichment analysis, and molecular docking were performed. The effects of kaempferide were evaluated in glutamate-injured HT22 cells and primary cortical neurons and in a mouse spinal cord hemisection model. CYP1B1 overexpression and siRNA-ARG1 knockdown were used for functional evaluation.</p><p><strong>Results: </strong>Four candidate hub genes-ARG1, CA4, CYP1B1, and OAT-were identified. In GSE151371, their areas under the receiver operating characteristic curves (AUCs) were 0.946, 0.892, 0.926, and 0.913, respectively. In GSE226238, the corresponding AUCs were 0.733, 0.745, 0.871, and 0.823. Molecular docking predicted docking scores of -7.1, -7.7, -10.6, and -8.2 kcal/mol for ARG1, CA4, CYP1B1, and OAT, respectively. Kaempferide increased neurite length and branching in glutamate-injured primary cortical neurons and reduced intracellular ROS accumulation in glutamate-injured HT22 cells. CYP1B1 overexpression and ARG1 knockdown each attenuated kaempferide-enhanced neurite outgrowth. In SCI mice, kaempferide treatment was associated with improved locomotor function, less histological tissue disorganization, and greater NeuN immunoreactivity at the lesion site. Western blotting showed further upregulation of ARG1 and downregulation of CA4, CYP1B1, and OAT after kaempferide treatment.</p><p><strong>Conclusion: </strong>Kaempferide showed neuroprotective effects in cellular and mouse SCI models. CYP1B1 overexpression and ARG1 knockdown experiments supported their potential involvement in kaempferide-enhanced neurite outgrowth, whereas the causal roles of CA4 and OAT remain to be established.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"628411"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112899","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":"Home-Based Transcranial Direct Current Stimulation for Depression: From Feasibility to Clinical Implementation.","authors":"Giuseppina Pilloni, Andre R Brunoni, Leigh Charvet","doi":"10.2147/NDT.S618006","DOIUrl":"https://doi.org/10.2147/NDT.S618006","url":null,"abstract":"<p><p>Home-based transcranial direct current stimulation (tDCS) for major depressive disorder (MDD) has progressed from early feasibility studies to an approved clinical treatment, highlighted by the US Food and Drug Administration's 2025 premarket approval of the Flow FL-100 device. This milestone shifts the field from asking whether home-based tDCS can be delivered safely and effectively to defining how it should be implemented in routine clinical practice. This review synthesizes the current evidence on treatment outcomes, adherence, and safety, with an emphasis on factors that determine successful real-world implementation. Randomized controlled trials support the efficacy of home-based tDCS when delivered using adequate cumulative dosing, structured treatment protocols, and appropriate supervision or adherence monitoring. In contrast, shorter-duration and fully unsupervised protocols have generally shown less favorable outcomes, although the independent contributions of dose, treatment duration, and supervision remain difficult to disentangle. High adherence has been reported with user-centered device design, standardized training, remote monitoring, and scalable supervision models that maintain treatment fidelity while supporting broad clinical deployment. Home-based tDCS has demonstrated an excellent safety profile when delivered using standardized equipment, structured protocols, and active monitoring, exemplified by more than 30,000 supervised home-based sessions delivered through a large academic clinical program without reported skin lesions or serious adverse events attributable to tDCS. Remaining priorities include optimizing acute and maintenance dosing strategies, identifying predictors and biomarkers of response, defining the role of paired behavioral interventions, personalizing treatment for special populations - including perinatal patients, older adults, and adolescents - and integrating home-based tDCS within interventional psychiatry care pathways. The evidence supports a transition from proof-of-concept to clinical implementation, with future research focused on optimizing delivery, personalizing treatment, and expanding access to evidence-based neuromodulation for depression.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"618006"},"PeriodicalIF":3.2,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112764","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":"Determinants of ADHD Health Literacy and Public Awareness of Child-Friendly City Policies in Wenzhou: A Cross-Sectional Survey.","authors":"Jingwei Ye, Yuan Wen, Tianyun Zhang, Yihao Zeng, Xiaxin Jin, Jingyan Lin, Shenghui Du, Xiaolan Yang, Jingyang Zhan, Khaing Wut Yi Hla, Xianghan Shu, Dan Wang","doi":"10.2147/NDT.S639923","DOIUrl":"https://doi.org/10.2147/NDT.S639923","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate adult Attention Deficit Hyperactivity Disorder (ADHD)-related health literacy, its determinants, and public awareness of local Child-Friendly City (CFC) policies in Wenzhou.</p><p><strong>Methods: </strong>This study adopted a mixed-methods design. The quantitative cross-sectional survey recruited 1792 adults (≥18 years), applying a validated 9-item ADHD knowledge scale to gauge ADHD health literacy. Independent <i>t</i>-tests, one-way Analysis of Variance (ANOVA) and chi-square tests, factorial ANOVA, and Poisson regression respectively analyzed univariate group disparities, multivariate interactions, and independent predictors of literacy outcomes. For the qualitative strand, independent semi-structured interviews with 300 participants (including minors) were conducted to explore public perceptions and awareness of local CFC policies. Thematic analysis was adopted to synthesize interview narratives about policy understanding and dissemination.</p><p><strong>Results: </strong>Single-factor analysis initially revealed potential associations between educational level, occupation, attitudes toward ADHD, and having relatives or friends with ADHD were significant influencing factors in both regions (all P<0.05), with significant interactions (eg interaction of parental status, age, and educational level; all P<0.05). Yet these associations reversed after adjustment for confounders. Poisson regression, confirmed educational level (β = 0.0624), positive attitude (β = 0.0758) and do not know having relatives or friends with ADHD (β = 0.1002) as positive predictors (β = 0.1002) (all P<0.05). Regarding policy awareness, Dongtou District showed superior understanding overall compared to the Wenzhou Urban Area (all P<0.05), and professional groups (healthcare- and education-related practitioners) exhibited significantly higher awareness levels than the general public.</p><p><strong>Conclusions: </strong>Wenzhou adults have moderately low ADHD health literacy with regional and social disparities. Higher educational level, positive attitude, and do not know having relatives or friends with ADHD predicted superior literacy, while female gender, urban residence, and professional identities correlate with lower levels. CFC policy awareness is inadequate. Targeted dissemination for high-priority groups and region-adapted support systems are needed.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"639923"},"PeriodicalIF":3.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112780","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":"Experimental Study on Anxiolytic and Antidepressant Effects of Zhi-Chi-Jie-Yu Granules in CUMS Mice and Prediction of Underlying Molecular Mechanisms.","authors":"Yanqi Luo, Xinyu Gao, Wenxin Shi, Xixi Cheng, Yujing Zhou, Ruijiao Wang, Yunzhong Chen","doi":"10.2147/NDT.S641398","DOIUrl":"https://doi.org/10.2147/NDT.S641398","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the in‑vivo pharmacological effects of Zhi-Chi-Jie-Yu Granules(ZCK) on CUMS‑induced anxiety‑ and depression‑like behaviors in mice. Post‑hoc exploratory analyses including network pharmacology and molecular docking were further performed to generate potential mechanistic hypotheses for its anti‑depressant action.</p><p><strong>Methods: </strong>An anxiety‑depression model was established in ICR mice via chronic unpredictable mild stress (CUMS) combined with solitary housing. Mice were divided into six groups (n=10): blank control, model, fluoxetine, and ZCK low‑, medium‑, and high‑dose groups. Behavioral changes were assessed by secondary‑auxiliary (SPT), together with FST, TST, OFT and EPM. Serum inflammatory cytokines and hippocampal neurotransmitters (5‑HT, NE) were measured by ELISA, and hippocampal pathological damage was observed by HE staining. UPLC‑Q‑TOF‑MS was used to characterize the chemical profile of ZCK. Non‑targeted serum metabolomics, network pharmacology, and molecular docking were integrated to predict targets and pathways.</p><p><strong>Results: </strong>ZCK significantly alleviated CUMS‑induced depressive‑ and anxiety‑like behaviors (P < 0.05 or P < 0.01). It downregulated serum pro‑inflammatory cytokines (IL‑6, TNF‑α), increased hippocampal 5‑HT and NE levels, and attenuated neuronal damage. UPLC‑Q‑TOF‑MS identified 39 core components. Metabolomics revealed 56 differential metabolites, mainly enriched in alanine‑aspartate‑glutamate and arachidonic acid metabolism. Network pharmacology predicted 410 overlapping targets, and the top‑10 core targets contained TP53, AKT1, STAT3, SRC, TNF and others. Considering our experimental findings on neuroinflammation, inflammatory‑related key targets (SRC, TNF, IL-6, NF‑κB and IL-1B) were selected for subsequent molecular‑docking verification. Molecular‑docking simulations suggested potential binding interactions between core components and key targets (binding energies <-5.0 kcal/mol).</p><p><strong>Conclusion: </strong>ZCK exerts anti‑anxiety and antidepressant effects in CUMS mice, accompanied by reduced peripheral neuroinflammation and improved hippocampal neurotransmitter levels. Multi‑omics and network‑pharmacology analyses further predict potential multi‑dimensional regulatory candidates, including neuroinflammation‑related signaling, neurotransmitter homeostasis and metabolic perturbation. These computational hypotheses require further protein‑level experimental validation. This study provides preliminary in‑vivo evidence for ZCK and an integrated methodological reference for TCM compound research.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"641398"},"PeriodicalIF":3.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112753","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":"Putative Neuroimmune Mechanisms and Candidate Biomarkers of rTMS Efficacy in Improving Negative Symptoms of Schizophrenia: Evidence Boundaries and Translational Pathways.","authors":"Yuxu Zou, Yingying Zhang, Hongbo He, Wenxia Jiang, Xinxin Li, Tianhao Bao, Changqing Gao","doi":"10.2147/NDT.S641230","DOIUrl":"10.2147/NDT.S641230","url":null,"abstract":"<p><p>Negative symptoms in schizophrenia often persist for prolonged periods, severely impairing patients' social functioning, while the therapeutic benefits of existing pharmacological treatments remain limited. Recent meta-analyses suggest that high-frequency stimulation of the left dorsolateral prefrontal cortex (L-DLPFC) provides short-term adjunctive benefits for negative symptoms, with effects ranging from small to moderate. However, treatment response is influenced by the stimulation parameters, target localization, and patient characteristics; thus, overall therapeutic efficacy remains heterogeneous. In patients with schizophrenia, peripheral immune-inflammatory abnormalities may occur, and some inflammatory markers are associated with disease stage, cognitive function, and negative symptom severity. Repetitive transcranial magnetic stimulation (rTMS) can modulate the prefrontal cortex and related brain networks, but its effects on immune-inflammatory processes, neuroendocrine-autonomic function, and neuroplasticity remain to be further elucidated. This review summarizes the immune-inflammatory mechanisms underlying negative symptoms, the clinical efficacy of rTMS, and the biological link between them, and discusses the potential of inflammatory markers for patient stratification and treatment-response prediction. In the future, standardized symptom assessment, stimulation parameters, and target localization are warranted, alongside repeated biological sample collection, prespecified stratified analyses, and external validation. Until inflammatory markers have been sufficiently validated with respect to predictive performance, reproducibility, and clinical net benefit, they should not be used alone to determine rTMS treatment eligibility, select stimulation parameters, or guide stratification decisions.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"641230"},"PeriodicalIF":3.2,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13618574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075532","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 Thalamic Gray Matter Volume and Psychomotor Symptoms in Major Depressive Disorder: A Voxel-Based Morphometry Study.","authors":"Yanxi Gu, Xinlin Wang, Fei Liu, Jiaxin Wu, Qiong Zhang, Haonan Ma, Jingyi Bai, Xiangyun Long, Zheng Lu","doi":"10.2147/NDT.S636580","DOIUrl":"10.2147/NDT.S636580","url":null,"abstract":"<p><strong>Background: </strong>Major depressive disorder (MDD) is a heterogeneous disorder with diverse symptom profiles and treatment responses. Psychomotor retardation and agitation represent clinically relevant dimensions of MDD heterogeneity, but their neurobiological basis remains unclear. Given the role of the thalamus in motor regulation and affective processing, this study examined thalamic gray matter volume (GMV) differences among patients with MDD with predominant psychomotor retardation (MDD-R), patients with MDD with predominant psychomotor agitation (MDD-A), and healthy controls (HCs).</p><p><strong>Methods: </strong>Structural MRI data from the REST-meta-MDD consortium included 54 patients with MDD-A, 123 with MDD-R, and 122 HCs. Total, hemispheric, and 30 subregional thalamic GMV measures were extracted using voxel-based morphometry and the AAL3v1 atlas. ComBat harmonization was applied before analysis. Group differences were tested with analysis of covariance controlling for sex, age, education, and total gray matter volume. Exploratory partial Spearman correlations examined associations with psychomotor symptoms, HAMD(adj), and anxiety symptoms.</p><p><strong>Results: </strong>After FDR correction, significant group effects were limited to the bilateral ventral anterior nucleus (VA). Patients with MDD-R had greater bilateral VA GMV than HCs, whereas MDD-A did not differ from HCs. No direct MDD-A vs MDD-R difference survived FDR correction; only the left inferior pulvinar showed a nominal difference. Exploratory correlations linked several thalamic nuclei, including the reuniens nucleus, ventral posterolateral nucleus, lateral geniculate nucleus, and anteroventral nucleus, to psychomotor, depressive, or anxiety symptoms.</p><p><strong>Conclusion: </strong>MDD-R was associated with selective bilateral VA structural differences rather than widespread thalamic abnormalities. No direct thalamic GMV difference between MDD-A and MDD-R survived FDR correction. The exploratory symptom associations suggest that thalamic structure may relate to multidimensional clinical heterogeneity in MDD. These findings require replication given the cross-sectional design, unequal subgroup sizes, and incomplete medication data.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"636580"},"PeriodicalIF":3.2,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13618326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075542","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":"Risk-Stratified Tiered Intervention Among Chinese Clinical High-Risk for Psychosis Patients and Attenuated Negative Symptoms as a Predictor of 1-Year Psychosis Conversion: A Retrospective Propensity-Matched Real-World Cohort Study.","authors":"Jing Zhang, Jiangnan Deng, Xianzhu Tu, Wenling Chen","doi":"10.2147/NDT.S634996","DOIUrl":"10.2147/NDT.S634996","url":null,"abstract":"<p><strong>Objective: </strong>This retrospective propensity-score-matched real-world cohort study aimed to evaluate the clinical efficacy of risk stratification combined with tiered intervention in young Chinese patients at clinical high-risk (CHR) for psychosis, and to explore whether attenuated negative symptoms could independently predict 1-year conversion to overt psychosis.</p><p><strong>Methods: </strong>A total of 150 CHR patients receiving risk-stratified tiered management were enrolled as the intervention group, and 75 CHR patients receiving conventional routine care were matched as the control group via propensity-score matching (PSM). All participants completed standardized two-stage clinical screening, cranial MRI to exclude organic brain lesions, and systematic symptom and functional assessments. Logistic regression and receiver-operating-characteristic (ROC) curve analyses were performed to identify independent predictors of psychosis conversion, with a specific focus on attenuated negative symptoms. Primary outcomes included 1-year psychosis conversion rate, changes in global functioning, and treatment adherence.</p><p><strong>Results: </strong>After 1-year follow-up, the intervention group showed a significantly lower psychosis conversion rate (9.3% vs 20.0%, <i>P</i>=0.021), greater improvement in global functioning (mean Δ = 9.8 vs 4.0, <i>P</i> < 0.001), and higher treatment adherence (78% vs 40%, <i>P</i> < 0.001) relative to the PSM-matched control group. Multivariate logistic regression identified severe attenuated negative symptoms as an independent risk-associated factor for 1-year psychosis conversion (OR = 2.71, 95% CI: 1.43-5.14, <i>P</i> < 0.01). The ROC-AUC of attenuated negative symptoms for predicting psychosis conversion was 0.79, indicating acceptable predictive performance.</p><p><strong>Conclusion: </strong>Risk stratification paired with tiered intervention reduced the risk of psychosis transition, improved global social functioning, and enhanced treatment adherence among Chinese CHR patients within this real-world cohort. Attenuated negative symptoms represent a reliable independent predictor of 1-year psychosis conversion and may be integrated into routine clinical risk assessment to support targeted early-intervention strategies for CHR populations.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"634996"},"PeriodicalIF":3.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149063197","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":"Physical Therapy for Treatment-Resistant Depression A Comprehensive Review of Efficacy, Safety, and Evidence Grading.","authors":"Wenxia Jiang, Haoran Xing, Yuncheng Bai, Normala Ibrahim, Yuntian Xiao, Xinxin Li, Yuxu Zou, Yingying Zhang, Xiaolina Zhang, Xiaolei Liu, Changqing Gao, Tianhao Bao","doi":"10.2147/NDT.S623902","DOIUrl":"10.2147/NDT.S623902","url":null,"abstract":"<p><p>Major depressive disorder (MDD) is a common psychiatric illness that is primarily treated with antidepressant medications in clinical practice. Depression that responds poorly to antidepressant therapy is referred to as treatment-resistant depression (TRD). However, the definition and pathogenesis of TRD are unclear, which may contribute to delayed diagnosis and management for some patients, ultimately affecting their prognosis. Although antidepressant drug therapy remains the first-line treatment for MDD, a growing body of evidence suggests that physical therapies may offer advantages over pharmacological treatments in improving depressive symptoms in selected patients. This review summarizes and comparatively analyzes recommendations from major international guidelines, including CANMAT, RANZCP, WFSBP, APA, and NICE, regarding the definition of TRD and physical treatment strategies. Widely used physical therapies for TRD are evaluated with respect to efficacy, safety and tolerability, clinical positioning, target populations, and regulatory status. Current evidence supports ECT and rTMS as the principal established treatment options for TRD. VNS may be considered for highly refractory TRD characterized by chronicity, recurrent episodes, and failure of multiple treatments, although it is generally positioned as a later-line intervention. Acupuncture and Neurofeedback may serve as adjunctive interventions with limited supporting evidence. Emerging techniques, including tACS, DBS, MST, EpCS, and FUS, lack sufficient high-quality evidence and standardized treatment protocols and should currently be conducted primarily in specialized centers or research settings. In addition, this review also highlights novel physical approaches and combination strategies with potential therapeutic value for TRD, provides scientific evidence and treatment references for clinical practice.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"623902"},"PeriodicalIF":3.2,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13604013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039960","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}