Psychological Medicine最新文献

{"title":"From risk to chronicity: genetic and neuroimaging insights into the evolving patterns of spontaneous brain activity in schizophrenia.","authors":"Yijing Zhang, He Wang, Mengjing Cai, Wei Wang, Jin Qiao, Xinyu Wang, Yue Wu, Qian Wu, Zhihui Zhang, Minghuan Lei, Qi An, Wenjie Cai, Haolin Wang, Fengtan Li, Yingying Xie, Feng Liu, Lining Guo","doi":"10.1017/S0033291725102006","DOIUrl":"https://doi.org/10.1017/S0033291725102006","url":null,"abstract":"<p><strong>Background: </strong>Schizophrenia progresses through high-risk, first-episode, and chronic stages, each associated with altered spontaneous brain activity. Resting state functional MRI studies highlight these changes, but inconsistencies persist, and the genetic basis remains unclear.</p><p><strong>Methods: </strong>A neuroimaging meta-analysis was conducted to assess spontaneous brain activity alterations in each schizophrenia stage. The largest available genome-wide association study (GWAS) summary statistics for schizophrenia (<i>N</i> = 53,386 cases, 77,258 controls) were used, followed by Hi-C-coupled multimarker analysis of genomic annotation (H-MAGMA) to identify schizophrenia-associated genes. Transcriptome-neuroimaging association and gene prioritization analyses were performed to identify genes consistently linked to brain activity alterations. Biological relevance was explored by functional enrichment.</p><p><strong>Results: </strong>Fifty-two studies met the inclusion criteria, covering the high-risk (<i>N</i>_high-risk = 409, <i>N</i>_control = 475), first-episode (<i>N</i>_case = 1842, <i>N</i>_control = 1735), and chronic (<i>N</i>_case = 1242, <i>N</i>_control = 1300) stages. High-risk stage showed reduced brain activity in the right median cingulate and paracingulate gyri. First-episode stage revealed increased activity in the right putamen and decreased activity in the left gyrus rectus and right postcentral gyrus. Chronic stage showed heightened activity in the right inferior frontal gyrus and reduced activity in the superior occipital gyrus and right postcentral gyrus. Across all stages, 199 genes were consistently linked to brain activity changes, involved in biological processes such as nervous system development, synaptic transmission, and synaptic plasticity.</p><p><strong>Conclusions: </strong>Brain activity alterations across schizophrenia stages and genes consistently associated with these changes highlight their potential as universal biomarkers and therapeutic targets for schizophrenia.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e306"},"PeriodicalIF":5.5,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reward-related activation of fronto-striatal regions scaled negatively with C-reactive protein.","authors":"Athina R Aruldass, Manfred Kitzbichler, Tsen Vei Lim, Jonathan Cavanagh, Philip Cowen, Carmine Pariante, Edward Bullmore, Neil Harrison","doi":"10.1017/S0033291725102031","DOIUrl":"https://doi.org/10.1017/S0033291725102031","url":null,"abstract":"<p><strong>Background: </strong>Depression is characterized by divergent changes in positive and negative affect. Emerging roles of inflammation in depression portend avenues for novel immunomodulator-based monotherapy, targeting mechanistically distinct symptoms such as anhedonia and pessimism.</p><p><strong>Methods: </strong>To investigate links between these divergent affective components and inflammation, we used a probabilistic reinforcement-learning fMRI paradigm, testing for evidence of hyposensitivity to reward, and hypersensitivity to punishment in low-inflammation depression cases (loCRP depression; CRP ≤ 3 mg/L; <i>N</i> = 48), high-inflammation depression cases (hiCRP depression; CRP > 3 mg/L; <i>N</i> = 31), and healthy controls (HC; CRP ≤ 3 mg/L; <i>N</i> = 45). We aimed to (i) determine whether depression cases with high and low inflammation showed aberrant neural activation to monetary gains and losses compared to controls, and (ii) examine if these alterations correlated with a continuous measure of C-reactive protein (CRP) in depression, as well as indices of anhedonia and pessimism derived from behavioral instruments in depression.</p><p><strong>Results: </strong>Voxel-wise activation was observed in key brain regions sensitive to monetary reward (ventromedial prefrontal cortex, vmPFC; nucleus accumbens, NAc) and punishment (insula) outcomes across all three groups. However, there was no significant difference in activation between groups. Within depression cases, increasing CRP scaled negatively with activation in the right vmPFC and left NAc but not insula cortex. However, there was no significant association between regional activation and severity of anhedonia or pessimism.</p><p><strong>Conclusions: </strong>Our results support the previously reported association between CRP and striatal reward reactivity in depression but do not extend this to processing of negatively valenced information.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e308"},"PeriodicalIF":5.5,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"False reassurances based on inadequate data not helpful.","authors":"Mark A Horowitz, Michael P Hengartner, Martin Plöderl, Joanna Moncrieff","doi":"10.1017/S0033291725102092","DOIUrl":"https://doi.org/10.1017/S0033291725102092","url":null,"abstract":"","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e309"},"PeriodicalIF":5.5,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Executive function mediates prefrontal excitation-inhibition balance and emotion recognition in euthymic bipolar disorder.","authors":"Cheng Ying Wu, Chih-Yu Chang, Shyh-Yuh Wei, Hui Hua Chang, Ying Tsung Tsai, Tsung-Hua Lu, Ren-Yi Lin, Yen Kuang Yang, Po See Chen, Yu-Lien Huang, Huai-Hsuan Tseng","doi":"10.1017/S0033291725102018","DOIUrl":"https://doi.org/10.1017/S0033291725102018","url":null,"abstract":"<p><strong>Background: </strong>Euthymic bipolar disorder (euBD) patients exhibit deficits in neurocognitive and social cognitive functioning compared to healthy controls (HCs). Our prior research has shown that the excitatory/inhibitory (<i>E</i>/<i>I</i>) imbalance in the default mode network (DMN) is linked to executive function in euBD. Neurocognitive impairments are associated with social cognition deficits in individuals with mental disorders. Given this connection, this study posits <i>E</i>/<i>I</i> imbalance within the DMN is associated with social cognition, with executive function as a mediator.</p><p><strong>Methods: </strong>Seventy-five HCs and 49 euBD individuals were recruited. Using the emotion recognition task, Diagnostic Analysis of Nonverbal Accuracy 2-Taiwan version (DANVA-2-TW) and cognitive flexibility task, Wisconsin Card Sorting Test (WCST), we assessed emotion recognition and prefrontal function. Proton magnetic resonance spectroscopy (¹H-MRS) measured metabolites in the posterior cingulate cortex (PCC) and medial prefrontal cortex/anterior cingulate cortex (mPFC/ACC), quantifying excitatory glutamate+glutamine (Glx) and inhibitory GABA to calculate the E/I ratio.</p><p><strong>Results: </strong>euBD patients showed poorer emotion recognition (<i>p</i> = 0.020) and poorer cognitive flexibility (fewer WCST categories completed, <i>p</i> = 0.002). A negative association was found between emotion recognition and the E/I ratio in the mPFC/ACC of the BD patients (<i>r</i> = -0.30, <i>p</i> = 0.034), which was significantly mediated by cognitive flexibility (<i>Z</i> = -2.657, <i>p</i> = 0.007).</p><p><strong>Conclusion: </strong>The BD patients demonstrate deficits in emotion recognition, linked to an altered E/I balance in the prefrontal cortex, and the cognitive flexibility, a key aspect of executive function, mediates the impact of the E/I ratio on emotion recognition accuracy in euBD patients.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e307"},"PeriodicalIF":5.5,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A computational approach to understanding effort-based decision-making in depression.","authors":"Vincent Valton, Anahit Mkrtchian, Madeleine Moses-Payne, Alan Gray, Karel Kieslich, Samantha VanUrk, Veronika Samborska, Don Chamith Halahakoon, Sanjay G Manohar, Peter Dayan, Masud Husain, Jonathan P Roiser","doi":"10.1017/S0033291725101967","DOIUrl":"https://doi.org/10.1017/S0033291725101967","url":null,"abstract":"<p><strong>Background: </strong>Motivational dysfunction is a core feature of depression and can have debilitating effects on everyday function. However, it is unclear which cognitive processes underlie impaired motivation and whether impairments persist following remission. Decision-making concerning exerting effort to obtain rewards offers a promising framework for understanding motivation, especially when examined with computational tools.</p><p><strong>Methods: </strong>Effort-based decision-making was assessed using the Apple Gathering Task, where participants decide whether to exert effort via a grip-force device to obtain varying levels of reward; effort levels were individually calibrated and varied parametrically. We present a comprehensive computational analysis of decision-making, initially validating our model in healthy volunteers (<i>N</i> = 67), before applying it in a case-control study including current (<i>N</i> = 41) and remitted (<i>N</i> = 46) unmedicated depressed individuals and healthy volunteers with (<i>N</i> = 36) and without (<i>N</i> = 57) a family history of depression.</p><p><strong>Results: </strong>Four fundamental computational mechanisms that drive patterns of effort-based decisions, which replicated across samples, were identified: overall bias to accept effort challenges; reward sensitivity; and linear and quadratic effort sensitivity. Traditional model-agnostic analyses showed that both depressed groups showed lower willingness to exert effort. In contrast with previous findings, computational analysis revealed that this difference was primarily driven by lower effort-acceptance bias, but not altered effort or reward sensitivity.</p><p><strong>Conclusions: </strong>This work provides insight into the computational mechanisms underlying motivational dysfunction in depression. Lower willingness to exert effort could represent a trait-like factor contributing to symptoms and a fruitful target for treatment and prevention.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e302"},"PeriodicalIF":5.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abnormal functional network connectivity mediates the relationship between depressive symptoms and cognitive decline in late-onset depression.","authors":"Zhidai Xiao, Ben Chen, Mingfeng Yang, Qiang Wang, Danyan Xu, Gaohong Lin, Pengbo Gao, Shuang Liang, Qin Liu, Jiafu Li, Xiaomin Zheng, Xiaomei Zhong, Yuping Ning","doi":"10.1017/S0033291725100706","DOIUrl":"https://doi.org/10.1017/S0033291725100706","url":null,"abstract":"<p><strong>Background: </strong>Late-onset depression (LOD) is featured by disrupted cognitive performance, which is refractory to conventional treatments and increases the risk of dementia. Aberrant functional connectivity among various brain regions has been reported in LOD, but their abnormal patterns of functional network connectivity remain unclear in LOD.</p><p><strong>Methods: </strong>A total of 82 LOD and 101 healthy older adults (HOA) accepted functional magnetic resonance imaging scanning and a battery of neuropsychological tests. Static functional network connectivity (sFNC) and dynamic functional network connectivity (dFNC) were analyzed using independent component analysis, with dFNC assessed via a sliding window approach. Both sFNC and dFNC contributions were classified using a support vector machine.</p><p><strong>Results: </strong>LOD exhibited decreased sFNC among the default mode network (DMN), salience network (SN), sensorimotor network (SMN), and language network (LAN), along with reduced dFNC of DMN-SN and SN-SMN. The sFNC of SMN-LAN and dFNC of DMN-SN contributed the most in differentiating LOD and HOA by support vector machine. Additionally, abnormal sFNC of DMN-SN and DMN-SMN both correlated with working memory, with DMN-SMN mediating the relationship between depression and working memory. The dFNC of SN-SMN was associated with depressive severity and multiple domains of cognition, and mediated the impact of depression on memory and semantic function.</p><p><strong>Conclusions: </strong>This study displayed the abnormal connectivity among DMN, SN, and SMN that involved the relationship between depression and cognition in LOD, which might reveal mutual biomarkers between depression and cognitive decline in LOD.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e227"},"PeriodicalIF":5.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of rTMS on self-reported quality of life in younger and older adults with major depressive disorder.","authors":"Katharina Göke, Jonathan Downar, Fidel Vila-Rodriguez, Zafiris J Daskalakis, Tarek K Rajji, Benoit H Mulsant, Daniel M Blumberger","doi":"10.1017/S0033291725102079","DOIUrl":"https://doi.org/10.1017/S0033291725102079","url":null,"abstract":"<p><strong>Background: </strong>Repetitive transcranial magnetic stimulation (rTMS) is a well-established intervention for treatment-resistant depression. However, its effects on patient-reported outcomes, such as quality of life (QoL), have not been fully characterized, especially among older adults. This study compares the impact of rTMS on QoL in younger (<60 years) versus older (≥60 years) adults with major depressive disorder.</p><p><strong>Methods: </strong>We analyzed data from 531 participants with depression (ages 18-89 years) from two randomized clinical trials (THREE-D and FOUR-D). All participants received either unilateral or bilateral rTMS or theta burst stimulation. QoL was assessed using the Quality of Life Enjoyment and Satisfaction Questionnaire - Short Form at baseline, end of treatment, and 12-week follow-up, and compared between younger adults (age < 60 years; <i>n</i> = 360) and older adults (age ≥ 60 years, <i>n</i> = 171). The clinical relevance of the changes was evaluated through effect sizes, using a predefined threshold of 12 points as the minimal clinically important difference, and comparisons with community norms.</p><p><strong>Results: </strong>After rTMS treatment, both younger and older adults experienced statistically significant improvements in QoL, with medium to large effect sizes. The effect was sustained over 12 weeks of follow-up. At baseline, only 0.3% of younger adults and 2.3% of older adults reported normal QoL, which significantly increased to, respectively, 19.8 and 19.4% by the end of treatment, and 23.7 and 26.8% at the 12-week follow-up.</p><p><strong>Conclusions: </strong>rTMS yielded acute and sustained clinically meaningful improvements in QoL, with similar effects among younger and older adults with depression. The magnitude of improvement was comparable to, or exceeded, that reported in antidepressant trials.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e303"},"PeriodicalIF":5.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Normative amygdala fMRI response during emotional processing as a trait of depressive symptoms in the UK Biobank.","authors":"Jerke J van den Berg, Henricus G Ruhé, Henk A Marquering, Liesbeth Reneman, Matthan W A Caan","doi":"10.1017/S0033291725101797","DOIUrl":"https://doi.org/10.1017/S0033291725101797","url":null,"abstract":"<p><strong>Background: </strong>Heightened reactivity in the amygdala measured by functional magnetic resonance imaging during emotional processing is considered a potential biomarker for clinical depression. Still, it is unknown whether this is also true for depressive symptoms in the general population, and - when in remission after recurrent depressive episodes - it is associated with future episodes.</p><p><strong>Methods: </strong>Using the UK Biobank population study (<i>n</i> = 11,334), we investigated the association of amygdala reactivity during negative facial stimuli, focusing on lifetime depression (trait), depressive symptoms (state), and the modulating effect of antidepressant (AD) treatment thereof. We employed normative modeling (NM) to better incorporate population heterogeneity of the amygdala activity.</p><p><strong>Results: </strong>In line with a previous study, depressive symptoms (state) over the last 2 weeks were not associated with the amygdala reactivity signal. Rather, our results indicate a significant positive association (<i>p</i> = 0.03, <i>ω</i>² = 0.001) between amygdala response and the recurrence of depressive episodes (trait). Longitudinal analysis revealed that the group that had experienced a single depressive episode before showed a significantly increased amygdala response after additional episodes (<i>p</i> = 0.03, <i>ω</i>² = 0.017). ADs were not associated with amygdala response directly, but decreased associations within episode recurrence severity.</p><p><strong>Conclusions: </strong>The amygdala response to negative stimuli was associated with an individual's risk of recurrence of depressive episodes, and AD treatment reduced these associations. This study highlights the relevance of amygdala reactivity as a trait, but not a state biomarker for (recurrent) depression. Moreover, it demonstrates the benefit of applying NM in the context of population data.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e304"},"PeriodicalIF":5.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between recreational cannabis use, psychotic-like experiences, and the salience network in adolescent and young adult twins.","authors":"Hande Atmaca-Turan, Didenur Şahin-Çevik, Serenay Çakar, Fulya Gökalp-Yavuz, Martijn van den Heuvel, Fruhling Rijsdijk, Francesca Filbey, Timothea Toulopoulou","doi":"10.1017/S0033291725101773","DOIUrl":"https://doi.org/10.1017/S0033291725101773","url":null,"abstract":"<p><strong>Background: </strong>The use of cannabis in adolescence and early adulthood, critical phases for brain development, is linked to psychotic-like experiences (PLEs). The underlying mechanisms, however, remain unclear. This research examined the relationship between recreational cannabis use and PLEs, emphasizing the connectivity of the salience network (SN), which plays a role in salience processing and psychosis. To determine whether this relationship reflects shared genetic or environmental contributions, twin modeling was used.</p><p><strong>Methods: </strong>We included 232 healthy adolescent Turkish twins who underwent diffusion MRI and psychometric assessment. SN connectivity was quantified using graph theory metrics. Linear mixed models were used to examine the associations among cannabis use, SN factors, and PLEs. Mediation analyses assessed whether SN parameters explained the cannabis-PLEs association. Twin models disentangle genetic and environmental contributions to these traits and their covariation.</p><p><strong>Results: </strong>Cannabis use was significantly associated with higher overall PLE frequency. A specific SN factor predicted both total and positive PLEs. However, SN connectivity did not mediate the cannabis-PLEs relationship. Twin modeling showed that cannabis use and PLEs were mainly influenced by unique environmental factors. No significant phenotypic covariations were found among cannabis use, PLEs, and SN parameters.</p><p><strong>Conclusions: </strong>Recreational cannabis use during adolescence and young adulthood is associated with heightened PLEs, although this association is not mediated by SN connectivity. The environment plays an important role during adolescence in shaping these traits independently. The findings underscore the need for longitudinal and genetically informed studies to clarify the mental health effects of adolescent cannabis use.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e300"},"PeriodicalIF":5.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of intermittent escitalopram treatment on impulsivity and inattention in women with premenstrual irritability and anger.","authors":"Maria Gröndal, Christin Englund, Jakob Näslund, Karl Ask, Elias Eriksson, Stefan Winblad","doi":"10.1017/S0033291725102055","DOIUrl":"https://doi.org/10.1017/S0033291725102055","url":null,"abstract":"<p><strong>Background: </strong>Women diagnosed with premenstrual dysphoric disorder (PMDD) report significant symptom relief when treated with selective serotonin reuptake inhibitors, but few studies have addressed the possibility of capturing this effect in behavioral, laboratory-based tests. This study examined the effects of intermittent treatment with escitalopram (vs. placebo) on a behavioral measure of impulsivity and inattentiveness in women reporting high levels of premenstrual irritability and anger.</p><p><strong>Methods: </strong>Participants (<i>N</i> = 27) rated cardinal PMDD mood symptoms over three menstrual cycles using Visual Analogue Scales. In Cycles 2 and 3, participants displaying cyclicity with respect to the irritability/anger item received escitalopram (20 mg) or placebo in a randomized, single-blind, crossover design. The participants completed the Conners Continuous Performance Test (CPT 3) in the luteal phase of the intervention cycles. Additionally, they filled out the UPPS Impulsive Behavior Scale, once in the luteal phase and once in the follicular phase of the placebo cycle.</p><p><strong>Results: </strong>In line with previous reports, escitalopram caused a significant reduction in self-rated irritability and anger in the luteal phase. When on escitalopram, the participants demonstrated a lower frequency of anticipatory responses and greater consistency in response speed in the CPT 3. With respect to self-reported impulsivity, participants reported higher levels of urgency and lower levels of sensation seeking in the luteal placebo phase versus the follicular phase.</p><p><strong>Conclusions: </strong>The finding that escitalopram impacted the outcome of the CPT 3 test in women with premenstrual irritability highlights the possible role of impulsivity in this condition.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e301"},"PeriodicalIF":5.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}