Psychological Medicine最新文献

{"title":"Child maltreatment and resilience in adulthood: a systematic review and meta-analysis.","authors":"Natalia E Fares-Otero, Julia Carranza-Neira, Jacqueline S Womersley, Aniko Stegemann, Inga Schalinski, Eduard Vieta, Georgina Spies, Soraya Seedat","doi":"10.1017/S0033291725001205","DOIUrl":"10.1017/S0033291725001205","url":null,"abstract":"<p><p>We conducted a systematic review and meta-analysis to quantify associations between overall and subtypes of CM, global/trait resilience, and five resilience domains (coping, self-esteem, emotion regulation, self-efficacy, and well-being) in adults, and to examine moderators and mediators of these associations. A systematic search was undertaken on 12 June 2024 to identify published peer-reviewed articles in five databases (PROSPERO-CRD42023394120). Of 15,262 records, 203 studies were included, comprising 145,317 adults (M <i>_age</i> = 29.62 years; 34.96% males); 183 studies and 557 effect sizes were pooled in random-effect meta-analyses. Overall CM and its subtypes were negatively associated with global/trait resilience and its domains (<i>r</i> = -0.081 to -0.330). Emotional abuse/neglect showed the largest magnitude of effect (<i>r</i> = -0.213 to -0.321). There was no meta-analytic evidence for an association between sexual abuse and coping, and physical abuse/neglect and self-esteem. Meta-regressions identified age, sample size, and study quality as moderators. Subgroup analyses found that associations between emotional abuse and emotion regulation were stronger, while associations between emotional abuse and self-esteem were weaker, in western <i>versus</i> non-western countries. No differences were found in associations between CM and resilience in clinical <i>versus</i> non-clinical samples. Narrative synthesis identified several mediators. Associations were of small magnitude and there were a limited number of studies, especially studies assessing CM subtypes, such as physical neglect, bullying, or domestic violence, and resilience domains, such as coping or self-efficacy, in males, and clinical samples. CM exposure negatively impacts resilience in adults, an effect observed across multiple maltreatment types and resilience domains. Interventions focused on resilience in adults with CM histories are needed to improve health and psychosocial outcomes.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e163"},"PeriodicalIF":5.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cumulative exposure to childhood adversity and risk of adult psychosis: a dose-response meta-analysis.","authors":"Aidan Flinn, Rebecca Hefferman-Clarke, Sophie Parker, Kate Allsopp, Lan Zhou, Marieke Begemann, Richard Bentall, Filippo Varese","doi":"10.1017/S0033291725001138","DOIUrl":"10.1017/S0033291725001138","url":null,"abstract":"<p><strong>Background: </strong>Past meta-analyses have confirmed robust associations between childhood traumatic experiences and the risk of psychosis. However, the dose-response relationship between cumulative adversity exposure and psychosis risk observed in some, but not all, previous studies in this area has not been specifically scrutinized or substantiated via recommended meta-analytic methods. This meta-analysis aimed to synthesize the available evidence on dose-response effects between childhood trauma and psychosis outcomes.</p><p><strong>Methods: </strong>PsycINFO, PubMed, EMBASE, Web of Science, CNKI, and WANFANG were searched from inception to July 2024 to identify observational studies reporting odds ratios for psychosis outcomes across multiple levels of childhood trauma exposure. Dose-response effects were extracted from eligible studies and synthesized via robust error meta-regression analyses.</p><p><strong>Results: </strong>Twenty-one studies comprising 59,975 participants were included in the meta-analysis. A significant nonlinear relationship was observed between the number of childhood adversities and the risk of future psychosis experiences (<i>p</i> for nonlinearity = .021). The pooled odds ratio for psychosis increased from 1.76 (95% confidence interval [CI]: 1.39-2.22) for 1 exposure to 6.46 (95% CI: 4.37-9.53) for 5+ exposures compared to no traumatic experience.</p><p><strong>Conclusions: </strong>This meta-analysis provides robust evidence for a dose-response relationship between cumulative childhood adversity and psychosis risk, with nonlinear patterns suggestive of an accelerating, more pronounced, risk at higher levels of trauma exposure. These findings underscore the importance of considering childhood traumatic experiences as a putative and potentially causative risk factor for psychotic experiences, as well as early prevention and intervention efforts targeting childhood adversity to reduce the risk of psychosis.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e162"},"PeriodicalIF":5.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating causal discovery and clinically-relevant insights to explore directional relationships between autistic features, sex at birth, and cognitive abilities - ERRATUM.","authors":"Angela Tseng, Sunday M Francis, Eric Rawls, Christine Conelea, Nicola M Grissom, Erich Kummerfeld, Sisi Ma, Suma Jacob","doi":"10.1017/S0033291725001114","DOIUrl":"10.1017/S0033291725001114","url":null,"abstract":"","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e161"},"PeriodicalIF":5.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between disordered eating and psychosis in clinical and non-clinical populations: a systematic review and meta-analysis.","authors":"Georgia Drymonitou, Amy McCulloch, Sarah Parry, Rhia Gough, Rodrigo Moreira Cruz, Mia Mostoufi, Mariam Jawad, Charlotte Newman, Duncan Harding, Gonzalo Salazar de Pablo, Tom Jewell","doi":"10.1017/S003329172500114X","DOIUrl":"10.1017/S003329172500114X","url":null,"abstract":"<p><strong>Background: </strong>Eating disorders and psychotic disorders represent two of the most serious psychiatric conditions. Emerging lines of evidence from genetic and epidemiological studies suggest that these disorders may commonly co-occur. This systematic review investigated the association between these disorders across community and clinical populations.</p><p><strong>Method: </strong>A systematic review was preregistered (CRD42021231771) and conducted according to PRISMA guidelines. Web of Science, PsycINFO and Medline were searched for articles on the association and comorbidity between psychosis and eating disorders up to the 26th February 2024. A random effects meta-analysis was conducted for studies reporting comorbidity of eating disorders and psychotic disorders based on clinical diagnosis or interview measures, to estimate prevalence of the comorbidity between these disorders. A narrative synthesis was conducted for all other studies and grouped by sample (general population, eating disorders or psychotic disorders).</p><p><strong>Results: </strong>In total 43 studies met inclusion criteria for the systematic review and 16 were included in the meta-analysis. Findings suggest substantial comorbidity between eating disorders and psychotic disorders, with a pooled comorbidity prevalence of 8% (CI: 3, 14) based on clinical diagnosis or interview measures. Studies using self-report questionnaires also highlight the association between eating disorders and psychosis across clinical and community populations.</p><p><strong>Conclusions: </strong>Eating disorders and psychotic disorders frequently co-occur. Further research should investigate the temporal order of symptom development and consider the need for novel interventions targeted at overlapping psychotic and eating disorder symptoms and associated phenomena.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e160"},"PeriodicalIF":5.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PTSD subtypes and their underlying neural biomarkers: a systematic review.","authors":"Chen Zhang, Shilat Haim-Nachum, Neal Prasad, Benjamin Suarez-Jimenez, Sigal Zilcha-Mano, Amit Lazarov, Yuval Neria, Xi Zhu","doi":"10.1017/S0033291725001229","DOIUrl":"10.1017/S0033291725001229","url":null,"abstract":"<p><p>Posttraumatic stress disorder (PTSD) is a heterogenous disorder with frequent diagnostic comorbidity. Research has deciphered this heterogeneity by identifying PTSD subtypes and their neural biomarkers. This review summarizes current approaches, symptom-based group-level and data-driven approaches, for generating PTSD subtypes, providing an overview of current PTSD subtypes and their neural correlates. Additionally, we systematically assessed studies to evaluate the influence of comorbidity on PTSD subtypes and the predictive utility of biotypes for treatment outcomes. Following the PRISMA guidelines, a systematic search was conducted to identify studies employing brain imaging techniques, including functional magnetic resonance imaging (fMRI), structural MRI, diffusion-weighted imaging (DWI), and electroencephalogram (EEG), to identify biomarkers of PTSD subtypes. Study quality was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. We included 53 studies, with 44 studies using a symptom-based group-level approach, and nine studies using a data-driven approach. Findings suggest biomarkers across the default-mode network (DMN) and the salience network (SN) throughout multiple subtypes. However, only six studies considered comorbidity, and four studies tested the utility of biotypes in predicting treatment outcomes. These findings highlight the complexity of PTSD's heterogeneity. Although symptom-based and data-driven methods have advanced our understanding of PTSD subtypes, challenges remain in addressing the impact of comorbidities and the limited validation of biotypes. Future studies with larger sample sizes, brain-based data-driven approaches, careful account for comorbidity, and rigorous validation strategies are needed to advance biologically grounded biotypes across mental disorders.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e153"},"PeriodicalIF":5.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12115270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The clinical efficacy of psychological interventions for bipolar depression: a systematic review and individual patient data (IPD) meta-analysis.","authors":"Sakir Yilmaz, Anna Huguet, Steve Kisely, Sanjay Rao, JianLi Wang, Molly Price, Richard Morriss, Maree Inder, Tania Perich, Kim Wright","doi":"10.1017/S0033291725001023","DOIUrl":"10.1017/S0033291725001023","url":null,"abstract":"<p><p>Unlike conventional meta-analyses, individual patient data (IPD) meta-analysis assesses moderator variables at the level of each participant, which generates more precise and biased estimates. The objective of this study was to investigate whether psychological therapy reduces depression symptoms in people with Bipolar I and II disorders and examine whether baseline depression has a moderating effect on treatment outcomes. Through the use of several electronic databases, a systematic search was conducted. Eligible studies were randomized controlled trials evaluating a psychological intervention for adults diagnosed with Bipolar I or II disorder. Titles and abstracts were screened, followed by full texts. The authors of the included studies were asked to provide IPD from their trials. A multilevel model approach was used to analyze the data. From the 7552 studies found by our searches, six studies with 668 study participants were eligible. Intervention significantly reduced depression scores. There was a significant association between baseline depression and post treatment depression scores. There was no statistically significant interaction between condition allocation and baseline depression score. When IPD from the two most comparable studies were analyzed, CBT had reduced depression scores relative to the comparator condition. The study included patient data from only six studies which were heterogeneous in terms of intervention type, outcome measure, and comparators. Overall, the psychological interventions tested significantly reduced bipolar depression scores. There was no evidence of moderation by baseline depression scores.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e154"},"PeriodicalIF":5.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12115277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of 28-day simvastatin administration on emotional processing, reward learning, working memory, and salivary cortisol in healthy participants at-risk for depression: OxSTEP, an online experimental medicine trial.","authors":"Riccardo De Giorgi, Shona Waters, Amy L Gillespie, Alice M G Quinton, Michael J Colwell, Susannah E Murphy, Philip J Cowen, Catherine J Harmer","doi":"10.1017/S0033291725001187","DOIUrl":"10.1017/S0033291725001187","url":null,"abstract":"<p><strong>Background: </strong>Statins are among the most prescribed medications worldwide. Both beneficial (e.g. antidepressant and pro-cognitive) and adverse (e.g. depressogenic and cognitive-impairing) mental health outcomes have been described in clinical studies. The underlying neuropsychological mechanisms, whether positive or negative, are, however, not established. Clarifying such activities has implications for the safe prescribing and repurposing potential of these drugs, especially in people with depression.</p><p><strong>Methods: </strong>In this double-blind, randomized, placebo-controlled experimental medicine study, we investigated the effects of simvastatin on emotional processing, reward learning, working memory, and waking salivary cortisol (WSC) in 101 people at-risk for depression due to reported high loneliness scores (mean 7.3 ± 1.2 on the UCLA scale). This trial was largely conducted during periods of social distancing due to the COVID-19 pandemic (July 2021-February 2023), and we employed a fully remote design within a UK-wide sample.</p><p><strong>Results: </strong>High retention rates, minimal outlier data, and typical main effects of task condition (e.g. emotion) were seen in all cognitive tasks, indicating this approach was comparable to in-person testing. After 28 days, we found no statistically significant differences (F's < 3.0, p's > 0.20) for any of the measures of emotional processing, reward learning, working memory, and WSC.</p><p><strong>Conclusions: </strong>Study results do not substantiate concerns regarding adverse neuropsychiatric events due to statins and support the safety of their prescribing in at-risk populations. Although other unmeasured cognitive processes may be involved, our null findings are also in line with more recent clinical evidence suggesting statins do not show antidepressant or pro-cognitive efficacy.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e155"},"PeriodicalIF":5.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12115272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between subjective cognitive concerns and objective neurocognitive performance in primary medical versus primary psychiatric populations.","authors":"Matthew S Phillips, George Whitman Kent, Hajar Ismail, Justyna Piszczor, Briana N Galindo, Greg Shapiro, Lisette Gonzalez, Brian M Cerny, Jason R Soble","doi":"10.1017/S0033291725001084","DOIUrl":"10.1017/S0033291725001084","url":null,"abstract":"<p><strong>Background: </strong>Subjective cognitive concerns (SCCs) refer to individuals' self-identified cognitive limitations, irrespective of objective neurocognitive performance. Previous literature has overwhelmingly found that psychiatric factors, not neurocognitive dysfunction, are a primary correlate of elevated SCCs across a wide range of clinical populations. However, the relationship between SCCs and objective neurocognitive performance is complex and may further be influenced by underlying mechanisms of various impairments or etiologies. Moreover, much of the extant literature has under-utilized performance validity tests (PVTs) when analyzing objective neuropsychological outcomes.</p><p><strong>Methods: </strong>As such, this study examined the associations between SCCs, performance validity, neurocognitive performance, and psychiatric distress among adult clinical patients with primary medical/neurologic (n = 127) and psychiatric (n = 106) etiologies.</p><p><strong>Results: </strong>Results showed that elevated SCCs are associated with greater degrees of performance invalidity and psychiatric distress, but not neurocognitive performance, among both groups.</p><p><strong>Conclusions: </strong>Findings support the utility of PVTs in clinical research and further highlight the impact of psychiatric factors on SCCs, regardless of medical/neurologic or psychiatric etiology.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e156"},"PeriodicalIF":5.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12115266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse childhood experiences and their differential relationships with transdiagnostic mental health outcomes in young adults.","authors":"Yufan Chen, Zoe Aitken, Dylan Hammond, Andrew Thompson, Steven Marwaha, Chris Davey, Michael Berk, Patrick McGorry, Andrew Chanen, Barnaby Nelson, Aswin Ratheesh","doi":"10.1017/S0033291725000893","DOIUrl":"10.1017/S0033291725000893","url":null,"abstract":"<p><p>Adverse childhood experiences (ACEs) are associated with poor mental health outcomes, which are increasingly conceptualized from a transdiagnostic perspective. We examined the impact of ACEs on transdiagnostic mental health outcomes in young adulthood and explored potential effect modification. We included participants from the Avon Longitudinal Study of Parents and Children with prospectively measured data on ACEs from infancy till age 16 as well as mental health outcomes at ages 18 and 24. Exposures included emotional neglect, bullying, and physical, sexual or emotional abuse. The outcome was a pooled transdiagnostic Stage of 1b (subthreshold but clinically significant symptoms) or greater level (Stage 1b+) of depression, anxiety, or psychosis - a clinical stage typically associated with first need for mental health care. We conducted multivariable logistic regressions, with multiple imputation for missing data. We explored effect modification by sex at birth, first-degree family history of mental disorder, childhood neurocognition, and adolescent personality traits. Stage 1b + outcome was associated with any ACE (OR = 2.66, 95% CI = 1.68-4.22), any abuse (OR = 2.08, 95% CI = 1.38-3.14), bullying (OR = 2.15, 95% CI = 1.43-3.24), and emotional neglect (OR = 1.68, 95% CI = 1.06-2.67). Emotional neglect had a weaker association with the outcome among females (OR = 1.14, 95% CI = 0.61-2.14) than males (OR = 3.49, 95% CI = 1.64-7.42) and among those with higher extraversion (OR = 0.91, 95% CI = 0.85-0.97), in unweighted (<i>n</i> = 2,126) and weighted analyses (<i>n</i> = 7,815), with an openness-neglect interaction observed in the unweighted sample. Sex at birth, openness, and extraversion could modify the effects of adverse experiences, particularly emotional neglect, on the development of poorer transdiagnostic mental health outcomes.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e147"},"PeriodicalIF":5.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12115273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating brain imaging features and genomic profiles for the subtyping of major depression.","authors":"Liangying Yin, Yuping Lin, Jinghong Qiu, Yong Xiang, Ming Li, Xiao Xiao, Simon Sai-Yu Lui, Hon-Cheong So","doi":"10.1017/S0033291725001096","DOIUrl":"10.1017/S0033291725001096","url":null,"abstract":"<p><strong>Background: </strong>Precise stratification of patients into homogeneous disease subgroups could address the heterogeneity of phenotypes and enhance understanding of the pathophysiology underlying specific subtypes. Existing literature on subtyping patients with major depressive disorder (MDD) mainly utilized clinical features only. Genomic and imaging data may improve subtyping, but advanced methods are required due to the high dimensionality of features.</p><p><strong>Methods: </strong>We propose a novel disease subtyping framework for MDD by integrating brain structural features, genotype-predicted expression levels in brain tissues, and clinical features. Using a multi-view biclustering approach, we classify patients into clinically and biologically homogeneous subgroups. Additionally, we propose approaches to identify causally relevant genes for clustering.</p><p><strong>Results: </strong>We verified the reliability of the subtyping model by internal and external validation. High prediction strengths (PS) (average PS: 0.896, minimum: 0.854), a measure of generalizability of the derived clusters in independent datasets, support the validity of our approach. External validation using patient outcome variables (treatment response and hospitalization risks) confirmed the clinical relevance of the identified subgroups. Furthermore, subtype-defining genes overlapped with known susceptibility genes for MDD and were involved in relevant biological pathways. In addition, drug repositioning analysis based on these genes prioritized promising candidates for subtype-specific treatments.</p><p><strong>Conclusions: </strong>Our approach successfully stratified MDD patients into subgroups with distinct clinical prognoses. The identification of biologically and clinically meaningful subtypes may enable more personalized treatment strategies. This study also provides a framework for disease subtyping that can be extended to other complex disorders.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e158"},"PeriodicalIF":5.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12115278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}