Neuropsychiatric Disease and Treatment最新文献

{"title":"Electroacupuncture Attenuates Neuroinflammation in PCPA-Induced Insomnia Rats by Suppressing the TLR4/MyD88/NF-κB p65 Pathway and M1 Microglial Activation.","authors":"Meng Zhang, Lian Liu, Tian Tan, Lijuan He, Bingqing Hu, Sixian Li, Mengya Jiang, Peng Deng, Qingjia Ren","doi":"10.2147/NDT.S608945","DOIUrl":"10.2147/NDT.S608945","url":null,"abstract":"<p><strong>Background: </strong>Insomnia is closely associated with neuroinflammation, yet the therapeutic mechanism of electroacupuncture (EA) remains unclear. This animal study investigated whether EA attenuates hypothalamic neuroinflammation in para-chlorophenylalanine (PCPA)-induced insomnia rats by suppressing the TLR4/MyD88/NF-κB p65 pathway and M1 microglial activation, using TAK-242 (HY-11109), a selective TLR4 inhibitor, as a positive control.</p><p><strong>Methods: </strong>Forty Sprague-Dawley rats (20 male, 20 female, sex-balanced across groups) were randomly allocated to Control, Model, EA, and TAK-242 groups (n=10 per group). Insomnia was induced in the model, EA, and TAK-242 groups by intraperitoneal injection of PCPA (500mg/kg) for 2 consecutive days. The TAK-242 group received daily intraperitoneal injection of TAK-242 (3 mg/kg). The EA group received acupuncture at Baihui (GV20), bilateral Benshen (GB13), Shenmen (HT7) and Sanyinjiao (SP6), with ipsilateral Shenmen (HT7) and Sanyinjiao (SP6) connected to an electroacupuncture device using a 2 Hz continuous wavefor 20 minutes daily over 7 days. Sleep latency and total sleep duration were recorded via the pentobarbital sodium righting reflex test. Serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels were assessed via the enzyme-linked immunosorbent assay (ELISA); Hypothalamic microglial M1 polarization was assessed by Iba-1/CD86 immunofluorescence co-localization. Protein and mRNA levels of TLR4, MyD88, NF-κB p65, TNF-α, and IL-6 were quantified by Western blot and RT-qPCR, respectively. All outcome assessments were performed by investigators blinded to group allocation.</p><p><strong>Results: </strong>Compared with the model group, both electroacupuncture and TAK-242 significantly shortened sleep latency and prolonged total sleep time (P < 0.01), and reduced serum levels of TNF-α and IL-6 (P < 0.01). Both interventions also attenuated CD86 fluorescence intensity (P < 0.01) and Iba-1/CD86 co-expression (P < 0.05), and down-regulated the protein and mRNA expression of TNF-α, IL-6, TLR4, MyD88, and NF-κB p65 in the hypothalamus (P < 0.01). The effects of electroacupuncture and TAK-242 on sleep parameters, CD86 fluorescence intensity, and Iba-1/CD86 co-expression were comparable, whereas TAK-242 exerted a more pronounced inhibitory effect than electroacupuncture on the expression of inflammatory cytokines and pathway-related proteins in the serum and hypothalamus (P < 0.05, P < 0.01).</p><p><strong>Conclusion: </strong>Electroacupuncture effectively improved sleep disturbances in PCPA-induced insomnia rats. The underlying mechanism may be associated with inhibition of the TLR4/MyD88/NF-κB p65 signaling pathway, suppression of M1 microglial activation, and downregulation of pro-inflammatory cytokines, thereby partly alleviating hypothalamic neuroinflammation.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"608945"},"PeriodicalIF":3.2,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888149","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":"Quality of Life Measurement Tools in Interventions for Anxiety and Depressive Disorders: A Systematic Literature Review in Global Settings.","authors":"Fredrick Dermawan Purba, Farah Fadilah Hasyim, Hari Setyowibowo, Ralph De Vries","doi":"10.2147/NDT.S614122","DOIUrl":"10.2147/NDT.S614122","url":null,"abstract":"<p><p>Anxiety and depression Disorders play a crucial role in the global disease burden and impose significant effects. Depression markedly impacts psychosocial functioning and quality of life. Nevertheless, the effectiveness of mental health interventions is generally assessed through symptom reduction, the use of QoL as a patient-centered outcome is still not standardized. This systematic review aims to identify QoL instruments used in anxiety and depression interventions and analyze variations in their application in various global contexts. A systematic literature review was conducted in accordance with PRISMA 2020 guidelines and prospectively registered in PROSPERO (CRD420251109799). Literature searches were performed in PubMed, Embase.com, Scopus, and APA PsycInfo. Following screening and eligibility assessment, 17 studies were included in the final review. Interventions included psychotherapy, mindfulness, and body-based therapy, digital interventions, pharmacotherapy, and combined approaches. The most frequently used QoL instruments were SF-36/SF-12, EQ-5D, and WHOQOL-BREF. In general, interventions showed that physical activity has a positive impact on QoL, particularly in the psychological and social domains. However, instrument heterogeneity, the dominance of self-reports, and cultural context limitations were major challenges. Standardization of culturally sensitive QoL measurements is needed to improve the validity and comparability of global findings.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"614122"},"PeriodicalIF":3.2,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888145","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":"Serum Lithium Monitoring, Short-Term Outcomes, and Treatment Barriers in Bipolar Disorder: A Real-World Study.","authors":"Xin Xin, Guangyu Zhou","doi":"10.2147/NDT.S625299","DOIUrl":"10.2147/NDT.S625299","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize serum lithium monitoring, clinician-recorded short-term outcomes, and treatment barriers in a clinically selected outpatient cohort of patients with bipolar disorder that was enriched for suicide risk.</p><p><strong>Patients and methods: </strong>We retrospectively reviewed consecutive routine-care records from a specialist mood-disorders clinic between January 2024 and March 2025. The monitoring dataset comprised 188 patients and 562 valid serum lithium measurements. The outcome dataset comprised 124 patient-level records from initial or follow-up encounters, and a separate implementation dataset contained 13 patients with documented discontinuation or non-initiation. The serum lithium value closest to the clinical outcome assessment was used in exploratory analyses.</p><p><strong>Results: </strong>Among monitored patients, 124/188 (66.0%) had at least two measurements. Median serum lithium concentration was 0.62 mmol/L (interquartile range 0.50-0.84), and 18/562 measurements (3.2%) were >1.2 mmol/L. Clinician-recorded remission was documented in 72/124 outcome records (58.1%) and any improvement in 114/124 (91.9%). Any improvement was 90.0%, 96.1%, and 81.5% in the <0.4, 0.4-<0.8, and ≥0.8 mmol/L groups, respectively (exploratory unadjusted P=0.053). Remission did not differ across groups (P=0.952), and the continuous serum lithium value was not associated with remission (odds ratio per 0.1 mmol/L, 1.01; 95% confidence interval 0.86-1.18). Documented barriers included adverse effects, testing or logistical burden, toxicity concerns, and poor palatability.</p><p><strong>Conclusion: </strong>A single routine-care serum lithium concentration recorded near a clinical assessment was not associated with clinician-recorded remission. The analysis did not evaluate longitudinal exposure or confirmed steady-state trough concentrations, and improvement during comprehensive care cannot be attributed to lithium alone. These findings support an integrated lithium-care pathway that combines interpretable monitoring, accessible testing, early management of adverse effects, clear toxicity education, and suicide-specific safety planning.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"625299"},"PeriodicalIF":3.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866195","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 Therapies and Neuromodulation for Treatment-Resistant Schizophrenia: A Review of Potential Mechanisms, Efficacy, and Safety.","authors":"Haiqiang Zhao, Yu Ding, Haoran Xing, Yingying Zhang, Mier Li, Luanmei Ding, Wanyong Ye, Lei Geng, Hong Ye, Tianhao Bao","doi":"10.2147/NDT.S621364","DOIUrl":"10.2147/NDT.S621364","url":null,"abstract":"<p><p>Antipsychotic medications remain the conventional treatment for treatment-resistant schizophrenia (TRS), yet some patients exhibit poor responses. Due to the limitations of pharmacological interventions, physical therapies are increasingly recognized as essential supplements in managing TRS. This article systematically examines the current clinical applications and research advances of physical therapeutic techniques for TRS. Existing evidence suggests that electroconvulsive therapy (ECT), particularly when administered as an adjunct to antipsychotic medication, may improve positive symptoms and overall clinical outcomes in a subset of patients with TRS. However, its potential cognitive adverse effects and related ethical considerations warrant careful evaluation. As a non-invasive neuromodulatory technique, transcranial magnetic stimulation (TMS) may exert therapeutic effects by modulating frontotemporal cortical excitability and activity within associated neural circuits, thereby contributing to improvements in auditory hallucinations, negative symptoms, and cognitive function. Transcranial electrical stimulation (tES), including transcranial direct current stimulation (tDCS), is characterized by procedural simplicity, favorable safety, and good tolerability. Its clinical effects may be mediated through modulation of cortical excitability, synaptic plasticity, and functional connectivity. However, current studies remain highly heterogeneous with respect to sample size, stimulation parameters, treatment duration, outcome measures, and follow-up periods. Moreover, no physical therapy has yet been approved by the US. Food and Drug Administration (FDA) for the treatment of TRS. This article aims to synthesize the therapeutic efficacy of various physical interventions for TRS and summarize the current clinical evidence, thereby broadening the range of potential treatment options for patients with TRS and promoting a more comprehensive clinical understanding and management of this condition.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"621364"},"PeriodicalIF":3.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857508","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 Anxiety and Depression Among Patients in a Palliative Care Setting During the COVID-19 Pandemic: A Mixed-Methods Cross-Sectional Study.","authors":"Doreen Birungi Agasha, Germanus Natuhwera, Eve Namisango, Hanif Kasozi, Elizabeth Mbabazi, Stanley Wilson Acuda","doi":"10.2147/NDT.S575211","DOIUrl":"10.2147/NDT.S575211","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 is a new disease with high transmission and mortality rates and can cause or exacerbate a myriad of psychological sequelae, particularly in patients with underlying serious illness. Palliative care patients' experiences have been widely studied, but research on their experiences during COVID-19 pandemic is scanty.</p><p><strong>Aim: </strong>To determine the prevalence of and factors associated with anxiety and depression among palliative care patients and explore palliative care patients' experiences during the COVID-19 pandemic.</p><p><strong>Materials and methods: </strong>This cross-sectional mixed-methods study used the Hospital Anxiety and Depression Scale (HADS) and face-to-face audio-recorded interviews to collect data from participants between April and May, 2022. Quantitative data were analysed using STATA v.17. Chi-square test and multivariate logistic regression were performed to examine factors associated with depression and anxiety. Qualitative data were analysed using thematic analysis.</p><p><strong>Results: </strong>Of the 96 participants, 74% (n=71) were female. Patients who earned ≥100,000 Ugandan shillings (OR=0.18, p=0.026, CI 0.040-0.818) had lower odds of depression compared to patients who earned less, while patients who missed clinic appointment sometimes (OR=26.02, P=0.025, CI 1.503-450.226) and those who reported change in sleep pattern (OR=15.91, p=001, CI 3.030-83.567) had higher odds of depression. Male participants had lower odds of anxiety (OR=7.93, p=0.003, CI 2.004-31.370) while those who missed medicines very often (OR=6.79, p=0.024, CI 1.288-35.852) and those who reported change in sleep pattern (OR=10.21, p=0.000, CI 2.790-37.393) showed higher odds of anxiety. Three main themes emerged from the qualitative interviews: (1) Navigating multidimensional suffering before and during a pandemic, (2) the healthcare system as a precipitant of suffering, and (3) finding hope and meaning amidst uncertainty and suffering.</p><p><strong>Conclusion: </strong>Mental health morbidities were great in this cohort, occurring in a multifaceted manner, with disruptions to the psychological, social, financial, and physical dimensions of patients' quality of life. Palliative care continuity and mental health, psychosocial and spiritual support services should be integrated into humanitarian emergency health care package in future outbreaks.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"575211"},"PeriodicalIF":3.2,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13499549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796137","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":"Does the Microbiota-Gut-Brain Axis Mediate the Antidepressant Effects of Acupuncture? A Structured Review of Preclinical and Clinical Evidence.","authors":"Ling Wang, Ruping Shang, Chunping Zhang, Shengchun Wang, Jin Xian","doi":"10.2147/NDT.S625958","DOIUrl":"https://doi.org/10.2147/NDT.S625958","url":null,"abstract":"<p><strong>Background: </strong>Acupuncture is used for depressive disorders, but the extent to which its effects are mediated by the microbiota-gut-brain axis (MGBA) remains uncertain.</p><p><strong>Objective: </strong>To determine whether current preclinical and clinical evidence supports gut microbiota as a mediator, amplifier, or biomarker of acupuncture-related antidepressant effects.</p><p><strong>Methods: </strong>Eight databases were searched from inception to 6 July 2026 for peer-reviewed studies of acupuncture in depressive disorders or validated depressive-like phenotypes that reported gut microbiota or microbiota-derived metabolite outcomes.</p><p><strong>Results: </strong>Twenty-six independent studies were included: 22 preclinical and 4 clinical studies. Animal experiments consistently showed acupuncture-induced behavioral improvements accompanied by shifts in gut microbial composition, with several studies also documenting changes in intestinal barrier function, inflammatory signaling, microbial metabolites, neuroendocrine indicators, and synaptic plasticity. However, reported alterations at the phylum and taxon levels were inconsistent, and most work merely identified parallel changes instead of establishing microbiota mediation. One electroacupuncture donor fecal microbiota transplantation study offered the strongest evidence that acupuncture-remodeled microbiota can transfer behavioral benefits, while a second bidirectional transplantation confirmed microbiota participation in the disease model but could not establish acupuncture-specific microbiota mediation. Clinical evidence was limited to postpartum and post-stroke depression and was constrained by nonrandomized allocation, add-on designs, incomplete longitudinal microbiota sampling, and confounding.</p><p><strong>Conclusion: </strong>Current evidence supports a host-mediated ecological framework whereby acupuncture remodels the intestinal niche and modulates MGBA signaling. Nonetheless, microbiota-mediated effects have not been verified across most preclinical models and remain unconfirmed in clinical settings.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"625958"},"PeriodicalIF":3.2,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13489047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796202","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":"Role of NRF2 in Electroacupuncture's Effects on Postoperative Cognitive Impairment in Rats.","authors":"Zhi-Gang Wang, Dong-Ran Cui, Yi Gao, Jin-Ge Yuan, Qiu-Jun Wang, Yong-Xue Chen","doi":"10.2147/NDT.S612783","DOIUrl":"https://doi.org/10.2147/NDT.S612783","url":null,"abstract":"<p><strong>Objective: </strong>Postoperative cognitive dysfunction (POCD), characterized by cognitive and memory decline following anesthesia and surgery, is a common complication in elderly patients. Nuclear factor erythroid-derived 2-like 2 (NRF2), a key regulator of cellular redox balance, has been implicated in cognitive processes in various neurological disorders. Electroacupuncture (EA), with its controllable stimulation parameters, has shown preventive effects against cognitive dysfunction. This study aimed to investigate whether NRF2 mediates the beneficial effects of EA on cognitive function in POCD.</p><p><strong>Methods: </strong>A POCD model was established in 20-month-old male Sprague-Dawley rats undergoing tibial fracture surgery. Beginning on postoperative day 24, EA was administered at the Hegu (LI4), Neiguan (PC6), and Zusanli (ST36) acupoints once daily for five consecutive days. The specific NRF2 antagonist ML385 (30 mg/kg) was intraperitoneally administered 2 hours before each EA session over the same period. Behavioral tests, including the T-maze test, fear conditioning (FC), and novel object recognition (NOR), were conducted on postoperative day 30. Immunofluorescence staining was used to assess neuronal count, apoptosis, microglial activation, and the percentage of NRF2-positive microglia. Electrophysiological recordings of brain activity were also performed.</p><p><strong>Results: </strong>EA treatment significantly improved cognitive and memory performance in POCD rats. Immunofluorescence analysis revealed reduced neuronal apoptosis, increased synaptic density, suppressed microglial activation, and enhanced nuclear translocation of NRF2, indicating attenuated neuroinflammation and oxidative stress. Furthermore, EA strengthened the phase-amplitude coupling between theta and gamma oscillations. Notably, all these neuroprotective and cognitive-enhancing effects of EA were abolished by ML385.</p><p><strong>Conclusion: </strong>In a POCD rat model, our findings demonstrate that EA ameliorates cognitive impairment, and this effect is potentially mediated through NRF2 pathway activation.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"612783"},"PeriodicalIF":3.2,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796177","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":"Resting-State EEG Functional Connectivity and Independent Correlates of Cognitive Impairment in Patients with Atrial Fibrillation.","authors":"Min-Qiang Bao, Dan Xiao, Xiang-Shun She, An-Feng Yin, Xiao-Ning Sheng, Shuang-Shuang Chen, Dandan Chu, Guo-Liang Gao, Yi-Nong Chen, Yu Wang","doi":"10.2147/NDT.S607557","DOIUrl":"https://doi.org/10.2147/NDT.S607557","url":null,"abstract":"<p><strong>Objective: </strong>To investigate alterations in resting-state electroencephalography (rsEEG) functional connectivity (FC) in patients with atrial fibrillation (AF) and cognitive impairment, examine its independent association with cognitive dysfunction, and evaluate the potential neurophysiological biomarker value of rsEEG FC in AF-related cognitive impairment.</p><p><strong>Methods: </strong>A total of 141 participants were divided into three groups: controls without AF or cognitive impairment (HC, n = 41), patients with AF without cognitive impairment (PT-WoCI, n = 37), and patients with AF and cognitive impairment (PT-CI, n = 63). All participants underwent rsEEG and cognitive assessment using the Montreal Cognitive Assessment. EEG metrics, including power spectral density (PSD), FC, phase-amplitude coupling (PAC), and sample entropy (EnSA), were derived from rsEEG data. Candidate EEG features were further screened using LASSO regression. Multivariable logistic regression models were constructed to assess independent associations between rsEEG metrics and cognitive impairment. Receiver operating characteristic (ROC) curves were used to evaluate model discriminatory performance.</p><p><strong>Results: </strong>Compared with HC and PT-WoCI groups, the PT-CI group showed significantly reduced alpha-band FC. In multivariable logistic regression analysis, alpha-band wPLI remained independently associated with cognitive impairment in patients with AF (OR = 0.44, 95% CI: 0.24-0.72, P = 0.002). The model incorporating clinical variables and alpha-band wPLI showed good discriminatory ability (area under the ROC curve: 0.814 [95% CI: 0.729-0.900]).</p><p><strong>Conclusion: </strong>Impaired alpha-band FC is associated with cognitive impairment in patients with AF. Alpha-band wPLI showed an independent association with cognitive status, supporting the potential clinical utility of rsEEG FC as an objective marker of AF-related cognitive impairment.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"607557"},"PeriodicalIF":3.2,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761243","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":"Optimizing Benzodiazepine Use for Chronic Insomnia: Insights from a Delphi Expert Consensus Study.","authors":"Matteo Di Vincenzo, Umberto Albert, Bernardo Dell'Osso, Giovanni Martinotti, Maurizio Pompili, Andrea Fiorillo","doi":"10.2147/NDT.S621541","DOIUrl":"https://doi.org/10.2147/NDT.S621541","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic insomnia is the most prevalent sleep-wake disorder, affecting more than 16% of the general population. Benzodiazepines (BDZs) represent a therapeutic option for this condition, given their rapid action and sleep-maintenance effects. BDZ use remains valid and widespread, even if, in some cases, it has been associated with misuse and tolerance when treatment is protracted. We carried out a Delphi study to reach an expert consensus on the appropriate use of BDZs and potential unclear aspects regarding their management of chronic insomnia, including special populations.</p><p><strong>Methods: </strong>A panel of 33 experts was asked to answer a questionnaire consisting of 35 questions, prepared by a Steering Committee. Items which did not reach a consensus (namely, agreement of more than 66% of responders) in the first in-person round were re-answered by experts in an online second round.</p><p><strong>Results: </strong>Experts emphasized the importance of half-life, formulation, and usage patterns in guiding appropriate prescribing of BDZs. \"As‑needed\" administration was deemed preferable for specific populations-elderly and individuals with relevant physical comorbidities. However, consensus was not reached regarding the appropriateness of BDZ use for chronic insomnia in women during the first trimester of pregnancy or breastfeeding. The panel also highlighted the need to strengthen clinicians' training and improve patients' education.</p><p><strong>Conclusion: </strong>A thorough clinical characterization of each patient with chronic insomnia should remain the cornerstone for guiding BDZ treatment decisions. Enhancing physicians' training and strengthening patients' education are essential steps toward optimizing BDZ use.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"621541"},"PeriodicalIF":3.2,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13478234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796172","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":"Cross-Sectional Associations of Insomnia, Social Dysfunction, Suicidality, and Depressive Symptoms in Rural Adults with Schizophrenia: A Sex-Stratified Analysis.","authors":"Yuting Wang, Zhaoyang Cheng, Xiaoping Yuan, Yanling Liao, Su-Qi Song, Huanzhong Liu, Kai Zhang","doi":"10.2147/NDT.S617984","DOIUrl":"https://doi.org/10.2147/NDT.S617984","url":null,"abstract":"<p><strong>Background: </strong>Insomnia, social dysfunction, suicidality, and depressive symptoms commonly co-occur in schizophrenia. Their joint cross-sectional associations and potential sex differences among rural adults with schizophrenia remain unclear.</p><p><strong>Methods: </strong>This multicenter cross-sectional study included 931 rural adults with schizophrenia in Chaohu, China. Depressive symptoms, insomnia severity, social dysfunction, and suicidality were assessed using the Patient Health Questionnaire-9, Insomnia Severity Index, Social Disability Screening Schedule, and a composite suicidality score, respectively. Sex-stratified logistic regression and exploratory indirect-association analyses with 5,000 bootstrap resamples were conducted. A sensitivity analysis used a non-overlapping Patient Health Questionnaire-7 score excluding the sleep and suicidality items.</p><p><strong>Results: </strong>Of 931 participants, 457 were male and 474 were female. Female participants had higher depressive-symptom, insomnia, suicidality, and social-dysfunction scores than male participants (all P≤0.005). In both sex-stratified models, higher insomnia, suicidality, and social-dysfunction scores were associated with greater odds of at least mild depressive symptoms. In the exploratory model, insomnia severity was directly associated with depressive-symptom score (b=0.388, 95% bootstrap confidence interval [CI], 0.345-0.431). Indirect associations via social dysfunction (0.042, 95% CI, 0.028-0.057) and suicidality (0.038, 95% CI, 0.021-0.058) were supported, whereas the serial indirect association was not (0.002, 95% CI, -0.0001 to 0.005). Sex did not moderate the indirect associations.</p><p><strong>Conclusion: </strong>Women reported higher symptom and social-dysfunction scores than men, but sex did not moderate the estimated indirect associations. Insomnia, social dysfunction, suicidality, and depressive symptoms formed a clinically relevant cross-sectional pattern; however, temporal ordering and causality cannot be inferred. Longitudinal studies with non-overlapping measures and broader clinical covariates are needed.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"617984"},"PeriodicalIF":3.2,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761250","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}