Neuropsychiatric Disease and Treatment最新文献

{"title":"Application of the Plan-Do-Check-Act Management Model to Violence Risk Management in a Psychiatric Ward: Impact on Patient Safety and Nurse-Patient Relationships.","authors":"Junhua Li, Huiming Niu, Xiaojuan Liu, Zhijie Lei, Hongfang Li, Ying Cheng, Hongjuan Du, Yalan Wang","doi":"10.2147/NDT.S598444","DOIUrl":"10.2147/NDT.S598444","url":null,"abstract":"<p><strong>Background: </strong>Violence in psychiatric wards poses significant risks to patients, staff and the therapeutic environment. Patients with schizophrenia frequently exhibit violent behaviours that compromise safety and disrupt therapeutic relationships. Although reactive crisis management remains the norm, systematic, proactive strategies for violence prevention are scarce. The Plan-Do-Check-Act (PDCA) cycle provides a structured quality improvement framework, yet its effectiveness in psychiatric violence risk management has not been well established.</p><p><strong>Objective: </strong>This study aimed to evaluate the effectiveness of the PDCA cycle management model in reducing violent incidents and improving patient satisfaction with nursing care in inpatients with schizophrenia.</p><p><strong>Methods: </strong>A quasi-experimental study was conducted between April 2021 and April 2022 at Tianshui Third People's Hospital, Gansu Province, China. Four hundred patients with schizophrenia were enrolled and allocated to either a research group (n = 200), receiving PDCA cycle management in addition to standard care, or a control group (n = 200), receiving standard care alone. The Modified Overt Aggression Scale, violence behaviour recording forms and patient satisfaction surveys were used to assess outcomes over an 8-week period.</p><p><strong>Results: </strong>Of the 400 enrolled patients, 331 completed the 8-week study (research group: n = 162; control group: n = 169). After implementing PDCA cycle management, the research group demonstrated significantly lower aggression scale scores (7.54 ± 2.07 vs 10.53 ± 3.99, <i>p</i> < 0.001) and reduced frequencies of verbal aggression, property damage, self-harm and physical assault compared with controls. Patient satisfaction increased significantly in the research group (60.5% \"very satisfied\" vs 51.5% in controls, <i>p</i> = 0.015).</p><p><strong>Conclusion: </strong>The PDCA cycle management model effectively reduces violent behaviour incidence and enhances patient satisfaction in psychiatric wards, offering a systematic approach to violence risk management that strengthens nurse-patient relationships and improves overall care quality.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"598444"},"PeriodicalIF":3.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13590001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012742","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":"Epilepsy: Bridging Epidemiological Landscapes, Molecular Mechanisms, and Emerging Precision Therapeutics.","authors":"Shitao Wang, Shicong Zhao, Yuqian Cao, Hao Wang","doi":"10.2147/NDT.S629134","DOIUrl":"10.2147/NDT.S629134","url":null,"abstract":"<p><p>Epilepsy ranks among the most prevalent neurological disorders worldwide, and recent years have witnessed significant advancements in understanding its epidemiological features, pathophysiological mechanisms, diagnostic methodologies, and therapeutic approaches. This review systematically examines the epidemiology of epilepsy, highlighting pronounced regional and population-based disparities, particularly the substantial treatment gap observed in low-income countries. Regarding pathogenesis, epilepsy development involves aberrant ion channel function, neuroinflammatory processes, dysregulation of the mTOR signaling pathway, and genetic predispositions. Diagnostic innovations, including ultra-high field magnetic resonance imaging, artificial intelligence-enhanced electroencephalogram analysis, and liquid biopsy techniques, have markedly enhanced the precision of epileptogenic focus localization and etiological identification. Genetic investigations have uncovered numerous epilepsy-associated genes, thereby underpinning the advancement of targeted therapies. Therapeutically, novel antiepileptic drugs, neuromodulation modalities such as vagus nerve stimulation and deep brain stimulation, alongside gene therapy, have expanded treatment options for refractory epilepsy. Nonetheless, global epilepsy management continues to confront challenges including limited drug accessibility, social stigma, and pharmacoresistance. The future trajectory emphasizes individualized and precision medicine approaches, integrating genomics, biomarker discovery, and intelligent monitoring technologies to foster comprehensive improvements in epilepsy diagnosis and treatment.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"629134"},"PeriodicalIF":3.2,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13577169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977448","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":"Multimodal MRI Radiomics and Machine Learning Identify Node-Level Structural and Functional Alterations in HIV-Associated Asymptomatic Neurocognitive Impairment.","authors":"Tiantian Tian, Zhongkai Zhou, Qiu Xu, Yanbin Shi, Lingling Zhao, Wei Wang","doi":"10.2147/NDT.S630533","DOIUrl":"10.2147/NDT.S630533","url":null,"abstract":"<p><strong>Objective: </strong>In the era of combination antiretroviral therapy (cART), asymptomatic neurocognitive impairment (ANI) has become a common manifestation of HIV-associated neurocognitive disorders (HAND). Because ANI occurs without overt functional impairment, it may be overlooked in routine clinical practice despite being associated with an increased risk of subsequent symptomatic cognitive decline. This study aimed to develop a classification model for HIV-ANI by integrating node-level radiomic features derived from structural and functional MRI within a machine-learning framework, and to investigate the potential association between abnormalities in core cognitive network nodes and large-scale brain network dysfunction.</p><p><strong>Materials and methods: </strong>A total of 67 individuals with HIV-associated asymptomatic neurocognitive impairment (HIV-ANI) and 70 cognitively intact individuals with HIV (HIV-IC) were included. Core regions of the default mode network (DMN), central executive network (CEN), and salience network (SN) were defined as regions of interest (ROIs). Node-level radiomic features were extracted from 3D T1-weighted imaging, amplitude of low-frequency fluctuation (ALFF), and regional homogeneity (ReHo) maps derived from resting-state fMRI. Unimodal, multimodal, and imaging-clinical fusion models were constructed using ElasticNet-regularized logistic regression after a stratified 7:3 training-test split. SHapley Additive exPlanations (SHAP) and a nomogram were used for model interpretation and individualized risk prediction.</p><p><strong>Results: </strong>The imaging-clinical fusion model achieved the highest AUC in the test set (0.735), with numerically better discriminative performance than the unimodal models. Functional features, particularly ReHo-derived features, contributed substantially to model prediction. SHAP analysis identified the medial prefrontal cortex, anterior and posterior cingulate cortices, and insula as key predictive regions. Clinical factors, including years of education and duration of HIV infection, also contributed to model performance.</p><p><strong>Conclusion: </strong>Structural and functional alterations are detectable within core cognitive network nodes at the HIV-ANI stage. The integration of multimodal MRI radiomic features with clinical factors showed potential for identifying HIV-ANI and provided preliminary evidence that node-level abnormalities may be associated with broader network dysfunction in early HAND. Further validation in larger, independent cohorts is warranted.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"630533"},"PeriodicalIF":3.2,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13577179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977478","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":"Celecoxib Ameliorates Chronic Restraint Stress-Induced Depression-Like Behavior in Sprague-Dawley Rats.","authors":"Yian Ling, Jing Li, Wanbin Liu, Yejun Gao, Lijuan Nie, Cuizhen Zhu, Qingrong Xia","doi":"10.2147/NDT.S616612","DOIUrl":"10.2147/NDT.S616612","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic stress is associated with depressive-like behaviors, dysregulation of the hypothalamic-pituitary-adrenal axis, and changes in inflammatory signaling. Celecoxib is a selective cyclooxygenase-2 inhibitor that has been investigated as a potential adjunctive treatment for depression; however, its effects in a chronic restraint stress model require further characterization.</p><p><strong>Methods: </strong>Male Sprague-Dawley rats were randomly assigned to a control group, chronic restraint stress (CRS) model group, CRS plus celecoxib group, or CRS plus fluoxetine group. The CRS procedure was conducted for 6 weeks, with restraint applied for 4 h per day. Celecoxib was administered by oral gavage at a dose of 20 mg/kg/day, and fluoxetine was administered at 10 mg/kg/day for 2 weeks throughout the CRS procedure. Depression-like and related behavioral changes were evaluated using the open field test, forced swimming test, Y-maze test, and sucrose preference test. Cytokine and corticosterone concentrations were measured in hippocampal homogenates. Hippocampal IBA-1 immunoreactivity and histological changes were evaluated using immunofluorescence, H&E staining, Nissl staining, and transmission electron microscopy.</p><p><strong>Results: </strong>Compared with control rats, CRS-exposed rats showed changes in open-field activity, forced-swimming behavior, Y-maze performance, and sucrose preference. Celecoxib treatment was associated with improved behavioral parameters compared with the CRS model group. Celecoxib was also associated with lower concentrations of IL-1β, IL-6, TNF-α, and corticosterone, reduced hippocampal IBA-1 immunoreactivity, and less pronounced histological and ultrastructural alterations.</p><p><strong>Discussion: </strong>These findings indicate that celecoxib was associated with improved behavioral outcomes and reduced inflammatory, endocrine, histological, and ultrastructural alterations in CRS-exposed rats.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"616612"},"PeriodicalIF":3.2,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906854","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":"Acupuncture Modulation of the Microbiota-Gut-Brain Axis in Major Depressive Disorder: Integrative Mechanisms, Emerging Evidence, and Future Therapeutic Perspectives.","authors":"Jingwen Zhang, Linjing Wang, Shuai Shi, Zhihong Liu, Jiajie Niu, Jingwen Zhao, Chunying Wang","doi":"10.2147/NDT.S625743","DOIUrl":"10.2147/NDT.S625743","url":null,"abstract":"<p><p>Major depressive disorder (MDD) is a prevalent and disabling psychiatric condition. Its pathophysiology extends beyond monoamine deficiency to encompass systemic dysregulation of the gut-brain axis-a bidirectional network integrating neural, immune, endocrine, and microbial signals. Accumulating evidence indicates that MDD patients frequently exhibit gut microbiota dysbiosis, impaired intestinal mucosal barrier integrity, and systemic low-grade inflammation. These gut-derived pathological alterations may collectively contribute to the onset and progression of depression through complex interactions involving microbial metabolites, immune signaling, and neuroendocrine pathways. Although several recent reviews have addressed gut-brain axis dysfunction in depression or the therapeutic effects of acupuncture individually, a systematic synthesis integrating neuroimmune, neuroendocrine, and microbiome mechanisms within a unified framework remains lacking. This review integrates three key regulatory dimensions-neuroimmune regulation, hypothalamic-pituitary-adrenal (HPA) axis homeostasis, and gut microbiota remodeling-through which acupuncture is proposed to modulate the gut-brain axis in MDD. Acupuncture, a core modality of Traditional Chinese Medicine (TCM), offers unique advantages in intervening in this complex system due to its multi-target regulatory properties. Modern studies have linked classical TCM principles to the vagus-adrenal axis, the endocannabinoid system, the HPA axis, and the TLR4/NF-κB pathways. Specifically, preclinical evidence suggests that acupuncture may induce systemic anti-inflammatory responses, suppress NLRP3 inflammasome activation, restore HPA axis negative feedback, and repair the intestinal barrier, while also reshaping gut microbiota composition, promoting short-chain fatty acid synthesis, and regulating tryptophan metabolism. These coordinated actions may generate synergistic multi-system antidepressant effects. Clinical evidence further suggests that acupuncture combined with pharmacotherapy may outperform medication alone, although high-quality clinical trials remain limited. This review critically appraises current evidence and methodological limitations, and proposes future directions including rigorous randomized controlled trials, multi-omics integrative approaches, and microbiome-guided precision acupuncture strategies, aiming to advance individualized acupuncture treatment for MDD.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"625743"},"PeriodicalIF":3.2,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906828","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 Retrospective Chart Review of PTSD Symptoms in Military Servicemembers Participating in an Individually Guided Neuromodulation (Alpha-rTMS) Wellness Program.","authors":"Alexander Balbir, Kayleigh Prowse, Julie Kim","doi":"10.2147/NDT.S612731","DOIUrl":"10.2147/NDT.S612731","url":null,"abstract":"<p><strong>Introduction: </strong>Military members, particularly those who have been exposed to combat, face heightened risks of post-traumatic stress disorder (PTSD), which can significantly impair their overall quality of life. Current treatments are suboptimal, and despite published evidence, they do not provide therapy personalized to individual brain network activity.</p><p><strong>Materials and methods: </strong>This is an uncontrolled open-label retrospective chart review of 94 active duty and retired servicemembers who self-reported symptoms related to PTSD. As part of the Operation Synchrony Program, participants received individually guided neuromodulation (α-rTMS) treatment, which was derived using a decision tree algorithm based on each participant's multivariate endogenous rhythms. The full treatment comprised α-rTMS sessions delivered 5 days a week, 30 minutes each, for a total of four weeks. Side effects and clinical assessments were collected including the PTSD Checklist for DSM-5 (PCL-5), Patient Health Questionnaire (PHQ-9), Rivermead Post-Concussion Symptoms Questionnaire (RPQ-16), and Brief Resilience Scale (BRS), administered at baseline, week-2, and week-4. This chart review protocol was approved under an exemption by WCG (Western IRB and Copernicus Group) IRB Study #1-1763934-1.</p><p><strong>Results: </strong>α-rTMS treatment was well-tolerated by participants, with no serious adverse events recorded. Average PCL-5 scores decreased significantly by a total of 48% from baseline (<i>M</i>=35.9) to week-4 (<i>M</i>=18.8) with 31% of the decrease occurring by week-2 (<i>M</i>=24.7). A similar trend was observed for the other scales such that the average scores significantly decreased from baseline to week-4 by 46% for RPQ-16, 52% for PHQ-9, and 13% for BRS.</p><p><strong>Conclusion: </strong>Significant improvements in clinical symptoms were observed in this study. These results underscore the potential for α-rTMS treatment to address the gap in current treatment options by providing effective, safe, non-pharmacological treatment to reduce PTSD symptoms in military and civilian populations.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"612731"},"PeriodicalIF":3.2,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13550109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between <i>CYP450</i> Polymorphisms and Treatment Outcomes of Escitalopram and Venlafaxine in Patients with Post Stroke Depression.","authors":"Yanyan Wang, Wenzhe Sun, Chensheng Pan, Zhou Zhu, Guo Li, Xin Zhao, Suiqiang Zhu","doi":"10.2147/NDT.S610626","DOIUrl":"10.2147/NDT.S610626","url":null,"abstract":"<p><strong>Background: </strong>Genetic polymorphisms in drug metabolism play an important role in the wide inter-individual variability in antidepressant efficacy. This study aimed to determine whether cytochrome P450 2C19 (<i>CYP2C19</i>) and cytochrome P450 2D6 (<i>CYP2D6</i>) genotypes predict treatment response to escitalopram (ESC) and venlafaxine (VEN), respectively, in patients with post-stroke depression (PSD).</p><p><strong>Methods: </strong>In this single-center prospective observational study, 313 acute stroke patients with PSD were consecutively enrolled and received ESC or VEN for 8 weeks. Efficacy was assessed using the 17-item Hamilton Depression Scale (HAMD-17). The primary outcome was the change in HAMD-17 score from baseline to week 8; secondary outcomes were response (≥50% reduction) and remission (score ≤7). Patients were stratified by <i>CYP2C19</i> and <i>CYP2D6</i> genotypes into fast- and slow-metabolizer subgroups. Subgroup comparisons utilized <i>χ²</i> -tests and Mann-Whitney <i>U</i>-tests.</p><p><strong>Results: </strong>At week 8, among 148 ESC-treated patients, <i>CYP2C19</i> genotypes were distributed as poor/intermediate metabolizers (PM/IM) 82 (55.4%) and normal/rapid metabolizers (NM/RM) 64 (43.2%); among 113 VEN-treated patients, <i>CYP2D6</i> genotypes showed marked imbalance (only 2 IM, 111 NM). No significant difference was found between ESC PM/IM and NM/RM subgroups in HAMD‑17 reduction (median: 10 vs 11, <i>P</i>=0.434), response (61.0% vs 69.7%, <i>P</i>=0.269), or remission (48.8% vs 51.5%, <i>P</i>=0.741). For patients treated with VEN, there was a significant imbalance in the distribution of <i>CYP2D6</i> genotypes, which prevented us from further analyzing the association between <i>CYP2D6</i> gene polymorphisms and the efficacy of VEN.</p><p><strong>Conclusion: </strong>No significant effect of <i>CYP2C19</i> genetic polymorphism on ESC efficacy was observed in this study. These findings underscore the need for further exploration into the clinical utility of pharmacogenetics. Future antidepressant treatment should prioritize cost-effective, pragmatic approaches over costly genetic testing alone.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"610626"},"PeriodicalIF":3.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900953","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":"Effectiveness and Safety of Venlafaxine in Japanese Major Depressive Disorder Patients with or without Anxious Distress (EXPAND Study): A 12-Week Prospective Observational Study.","authors":"Hitoshi Sakurai, Keisuke Nomoto, Tomoki Ito, Yasuyuki Matsumoto, Shingo Higa","doi":"10.2147/NDT.S614460","DOIUrl":"10.2147/NDT.S614460","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated outcomes of venlafaxine treatment in Japanese patients with major depressive disorder (MDD) in routine clinical practice. Since anxiety is a common and clinically relevant feature of MDD, descriptive analyses were conducted based on the presence or absence of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) anxious distress.</p><p><strong>Patients and methods: </strong>This 12-week, multicenter, single-arm, observational study consecutively enrolled adult patients with MDD initiating venlafaxine in Japan. DSM-5 anxious distress was assessed at baseline. The primary endpoint was change in Montgomery-Åsberg Depression Rating Scale (MADRS) total score from baseline to week 12 or discontinuation. Secondary endpoints included MADRS response and remission rates, patient-reported outcomes, and safety. Analyses were descriptive and conducted by anxious distress status.</p><p><strong>Results: </strong>Among enrolled patients, 407 received venlafaxine and comprised the safety analysis set; 198 (48.6%) had anxious distress. MADRS total score decreased from baseline to week 12 or discontinuation in the overall population and in patients with and without anxious distress. Patients with anxious distress had higher baseline symptom severity but showed improvement over time. Similar improvements were seen across secondary patient-reported outcomes in both subgroups. Drug-related adverse events and discontinuations due to adverse events were numerically more frequent in patients with anxious distress. The safety profile was in line with established findings.</p><p><strong>Conclusion: </strong>Venlafaxine treatment in clinical practice improved depressive symptoms, anxiety, functioning, quality of life, and cognitive complaints in patients with MDD. Improvements were seen in patients with and without anxious distress. These results provide descriptive real-world evidence on treatment outcomes; however, they should be interpreted with caution given the non-comparative study design and other limitations. The findings may inform clinical decision-making in patients with heterogeneous presentations encountered in routine psychiatric practice.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"614460"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897645","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":"Prevalence of Generalized Anxiety Disorder in Psychiatric Outpatients (PRADO Study): A Multicenter Cross-Sectional Study in Japan.","authors":"Keisuke Nomoto, Tempei Otsubo, Shingo Higa, Satoshi Matsuyama, Takeshi Inoue","doi":"10.2147/NDT.S607540","DOIUrl":"10.2147/NDT.S607540","url":null,"abstract":"<p><strong>Purpose: </strong>Generalized anxiety disorder (GAD) impairs quality of life (QoL) and daily function; however, it remains under-recognized in Japan due to symptom overlap and a lack of approved treatments. This study estimated GAD prevalence among psychiatric outpatients using the Structured Clinical Interview for DSM (SCID), examined associated demographic and clinical factors, assessed health status and QoL, and evaluated the diagnostic validity of the Generalized Anxiety Disorder 7-item scale (GAD-7) and the Kessler 6-item Psychological Distress scale (K6) versus SCID.</p><p><strong>Methods: </strong>This multicenter, cross-sectional study analyzed 407 patients across 22 sites. Prevalence was determined through SCID-based structured interviews. Demographics were obtained from paper questionnaires and clinical characteristics from medical records. Patient-reported outcomes quantified burden and screening accuracy.</p><p><strong>Results: </strong>Eighty-three of 407 patients (20.4%) met DSM-5 criteria for GAD using SCID. Prevalence was higher in females versus males (68.7% vs 31.3%) and more common among younger individuals. Comorbid depressive disorders were frequent (63.4%), with major depressive disorder being the most prevalent. Patients with GAD were more likely to have lower income, be students, and exhibit higher symptom severity on both the Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR) and the GAD-7. Patients with GAD (n=83) had higher QIDS-SR, GAD-7, and K6 scores than non-GAD patients, indicating greater depressive symptoms, anxiety, and psychological distress. Health-related QoL and functional impairment measured through EuroQol 5 Dimensions 5 Levels and the Sheehan Disability Scale indicated worse outcomes in GAD. GAD-7 and K6 demonstrated moderate diagnostic performance versus SCID.</p><p><strong>Conclusion: </strong>GAD was prevalent among Japanese psychiatric outpatients (20.4%), suggesting the potential under-recognition in clinical practice, with some patients receiving alternative diagnoses. The lack of approved treatments and recognized diagnostic procedures may exacerbate the patient's burden. Developing GAD-specific therapies and improving diagnostic awareness are critical to addressing this unmet need.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"607540"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897648","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":"Heart-Brain Axis Dysregulation in Depression: Mechanisms and Implications for Neuromodulation.","authors":"Yilin Xiong, Ziyu Zhu, Caijie Shen, Wei Deng, Yuqi Cheng","doi":"10.2147/NDT.S623896","DOIUrl":"10.2147/NDT.S623896","url":null,"abstract":"<p><p>Major depressive disorder (MDD) is increasingly recognized as a systemic disorder involving dysregulation of the heart-brain axis (HBA). Mounting evidence links impaired HBA signaling to the pathogenesis of major depressive disorder. Emerging data indicate that neuromodulation-mediated autonomic alterations correlate with depressive symptom remission. Although neuromodulatory therapies are widely deployed clinically, HBA-based biomarkers remain experimental, and no consistent physiological predictors of treatment response have been established to date. This review summarizes HBA dysfunction in depression across neural, biochemical, and mechanical pathways, integrating evidence from preclinical and clinical studies. We critically evaluate recent advances in leveraging these pathways to optimize neuromodulation strategies. Emerging evidence suggests that certain neuromodulation approaches-including transcranial magnetic stimulation (TMS), transcranial electrical stimulation (TES), vagus nerve stimulation (VNS), electroconvulsive therapy (ECT), and deep brain stimulation (DBS)-may modulate heart-brain axis function. It has been hypothesized that such modulation could represent a physiological pathway contributing to mood improvement, providing a rationale for a heart-oriented framework in neuromodulation research. However, the clinical utility of this framework and its underlying biomarkers remain to be established through rigorous long-term investigations. By bridging the conventional conceptual divide between psychiatric and cardiovascular diseases, this review offers a systems-level perspective on neuromodulation efficacy and highlights the potential of HBA-related biomarkers for assessing pathological states and guiding treatment strategies in depression and other psychosomatic conditions.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"623896"},"PeriodicalIF":3.2,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897690","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}