Psychological Medicine最新文献

{"title":"Differences between persistent and episodic depression in processing novel positive information.","authors":"Tobias Kube, Edith Rapo, Mimi Houben, Thomas Gärtner, Eva-Lotta Brakemeier, Julia Anna Glombiewski, Winfried Rief","doi":"10.1017/S0033291725101530","DOIUrl":"https://doi.org/10.1017/S0033291725101530","url":null,"abstract":"<p><strong>Background: </strong>Research has pointed to important psychopathological differences between persistent and episodic depressive disorders. Here, we tested the hypothesis that people with persistent rather than episodic depression have difficulty revising established expectations in response to novel positive information. In terms of underlying mechanisms, we predicted that these differences between the two subtypes would be related to the engagement in cognitive immunization (i.e. devaluing expectation-disconfirming positive information).</p><p><strong>Methods: </strong>Prior to their psychotherapeutic treatment, 54 outpatients with persistent depressive disorder and 102 outpatients with episodic major depressive disorder completed an experimental task. In this task, participants watched other patients' reports of positive effects of psychotherapy. Our primary outcome was change in treatment expectations from before to after watching the positive reports.</p><p><strong>Results: </strong>Overall, people with persistent depression had lower treatment expectations than people with episodic depression. In addition, they changed their treatment expectations less in response to other patients' positive reports. This effect was greater for psychotherapy outcome expectations than for role expectations. The lack of expectation change in persistent depression relative to episodic depression was particularly pronounced in a cognitive immunization-promoting experimental condition.</p><p><strong>Conclusions: </strong>The results indicate that people with persistent depression have difficulty adjusting their treatment expectations in response to positive information on psychotherapy. This may be a risk factor for poor treatment outcome. The results regarding cognitive immunization suggest that for people with persistent depression, slight doubts about the value of information on the positive effects of psychotherapy may be sufficient to prevent them from integrating this information.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e261"},"PeriodicalIF":5.5,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993366","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":"Impaired emotional memory dissipation in insomnia disorder.","authors":"Shengzi Zeng, Hao Fong Sit, Xiao Li, Ryan Bottary, Edward F Pace-Schott, Tony J Cunningham, Shirley Xin Li, Xiaoqing Hu","doi":"10.1017/S0033291725101566","DOIUrl":"https://doi.org/10.1017/S0033291725101566","url":null,"abstract":"<p><strong>Background: </strong>Insomnia disorder, characterized by chronic sleep disruption, often co-occurs with maladaptive emotional memory processing. However, much remains unknown regarding the evolution of emotional memories and their neural representations over time among individuals with insomnia disorder.</p><p><strong>Method: </strong>We examined the electroencephalographic (EEG) activities during emotional memory encoding, post-encoding sleep, and multiple retrieval phases - including immediate post-encoding, post-sleep, and a 7-day delayed retrieval - among 34 participants with insomnia disorder and 35 healthy control participants.</p><p><strong>Results: </strong>Healthy controls exhibited adaptive dissipation of emotional memory: memory declined over time, accompanied by reduced subjective feelings toward negative memories. In contrast, participants with insomnia exhibited impaired dissipation: they retained both the emotional content and affective tone of the memories, with diminished time-dependent declines in memory and affect. Beyond behavioral performance, only participants with insomnia maintained stable neural representations of emotion over time, a pattern absent in healthy controls. Additionally, during the post-encoding sleep, slow-wave sleep (SWS), and rapid eye movement (REM) sleep durations predicted the adaptive dissipation of emotional memory over time, but only among healthy participants.</p><p><strong>Conclusion: </strong>These findings highlight abnormalities in emotional memory processing among individuals with insomnia disorder and underscore the important function of SWS and REM sleep in facilitating adaptive emotional memory processing.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e260"},"PeriodicalIF":5.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966512","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":"Two subtypes of major depressive disorder are identified from individualized gray matter morphological abnormalities in a large multi-site dataset.","authors":"Keke Fang, Baohong Wen, Liang Liu, Ya Tian, Huiting Yang, Shaoqiang Han, Xianfu Sun, Lianjie Niu","doi":"10.1017/S0033291725101499","DOIUrl":"10.1017/S0033291725101499","url":null,"abstract":"<p><strong>Background: </strong>Neuroimaging studies provide compelling evidence that major depressive disorder (MDD) is associated with widespread gray matter morphological abnormalities. However, significant interindividual variability complicates the interpretation of group-level findings, highlighting the need for investigating potential MDD subtypes.</p><p><strong>Methods: </strong>In this study, we aimed to identify subtypes of MDD based on individualized deviations from normative gray matter volumes (GMVs), as estimated using a normative model derived from healthy controls (HCs). We leveraged a large, multi-site dataset of high-resolution structural MRI scans, comprising 1,276 MDD patients and 1,104 matched HCs. To explore the transcriptional and molecular mechanisms underlying the observed structural abnormalities, we examined the relationships between GMV deviations, transcriptomic similarities (as measured by the correlated gene expression [CGE] connectome), and the distribution of neurotransmitter receptors/transporters.</p><p><strong>Results: </strong>Our results revealed two reproducible MDD subtypes, each exhibiting distinct patterns of GMV abnormalities across study sites. Subtype 1 displayed increased GMVs in cerebral regions and decreased GMVs in cerebellar regions, whereas subtype 2 showed the opposite pattern, with decreased GMVs in cerebral regions and increased GMVs in cerebellar areas. The identified GMV abnormalities were differentially associated with neurotransmitter receptor/transporter distributions. Furthermore, these abnormalities were linked to transcriptionally connected gene networks, suggesting genetic underpinnings for both subtypes. Notably, the two subtypes exhibited distinct CGE-informed disease epicenters.</p><p><strong>Conclusions: </strong>This study identifies two robust MDD subtypes, providing new insights into the neurobiological and genetic bases of MDD and offering a potential advancement in the nosology of the disorder.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e257"},"PeriodicalIF":5.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966467","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":"Shared and distinct alterations of thalamic subregional functional connectivity in early- and late-onset obsessive-compulsive disorder.","authors":"Qianmei Yu, Yao Liu, Xiang Wang, Feng Gao, Chuman Xiao, Zhiyan Wang, Yan Han, Qinzu Kong, Qian Liu, Jie Fan, Xiongzhao Zhu","doi":"10.1017/S0033291725100548","DOIUrl":"https://doi.org/10.1017/S0033291725100548","url":null,"abstract":"<p><strong>Background: </strong>Studies highlight the thalamus as a key region distinguishing early- from late-onset obsessive-compulsive disorder (OCD). While structural thalamic correlates with OCD onset age are well-studied, resting-state functional connectivity (rsFC) remains largely unexplored. This study examines thalamic subregional rsFC to elucidate pathophysiological differences in OCD based on different onset times.</p><p><strong>Methods: </strong>The study comprised 85 early-onset OCD (EO-OCD) patients, 94 late-onset OCD (LO-OCD) patients, and 94 age- and sex-matched healthy controls (HCs). rsFC analysis was conducted to assess thalamic connectivity across seven subdivisions among the groups.</p><p><strong>Results: </strong>Both EO-OCD and LO-OCD patients exhibited increased rsFC between the primary motor thalamus and the posterior central gyrus and between the thalamic premotor and the supplementary motor areas. EO-OCD patients showed significantly stronger rsFC between the prefrontal thalamus (Ptha) and the middle frontal gyrus (MFG) compared to both LO-OCD patients and HCs. In contrast, LO-OCD patients demonstrated reduced rsFC between the Ptha and the inferior parietal lobule (IPL) compared to EO-OCD patients and HCs. Additionally, the rsFC between the Ptha and both the MFG and IPL was negatively correlated with age of onset, with earlier onset linked to stronger connectivity.</p><p><strong>Conclusion: </strong>These findings reveal both shared and distinct thalamic connectivity patterns in EO-OCD and LO-OCD patients. Sensory-motor networks exhibiting thalamic hyperconnectivity are critical for the manifestation of OCD, regardless of age of onset. The frontal-parietal network and thalamic hyperconnectivity may present a compensatory mechanism in EO-OCD patients, while hypoconnectivity with the frontoparietal network may reflect a neural mechanism underlying LO-OCD.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e258"},"PeriodicalIF":5.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966490","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":"Letter to the editor: Early adversity and inflammation at midlife: the moderating role of internalizing psychopathology.","authors":"Hisao Toyoshima, Masayoshi Koinuma, Tomohide Akase","doi":"10.1017/S0033291725101554","DOIUrl":"https://doi.org/10.1017/S0033291725101554","url":null,"abstract":"","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e259"},"PeriodicalIF":5.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966510","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":"Validity and reliability of the Mini International Neuropsychiatric Interview in Sub-Saharan Africa: a cross-country comparison study.","authors":"Kristina J Korte, Kimberly Hook, Rocky Stroud, Amantia Ametaj, Manasi Sharma, Hayden Mountcastle, Biruh Alemayehu, Beakal Amare, Azeb Asaminew Alemu, Ribka Birhanu, Engida Girma, Barkot Milkias, Mahlet Yared, Florence Jaguga, Jackline Mmochi, Felitcita Omari, Edgar Guma, Hillary Kutessa, Claire Kwagala, Harriet Nakuya, Molly Naisanga, Dickens Akena, Lukoye Atwoli, Symon Kariuki, Charles R J C Newton, Zukiswa Zingela, Dan J Stein, Teferra Solomon, Karestan C Koenen, Bizu Gelaye","doi":"10.1017/S0033291725100573","DOIUrl":"10.1017/S0033291725100573","url":null,"abstract":"<p><strong>Background: </strong>Diagnostic tools, such as the Mini International Neuropsychiatric Interview (MINI) 7.0.2 and the Structured Clinical Interview for the DSM-5 (SCID), aim to increase the validity and reliability of diagnostic assessment. However, these tools were created in high-income countries (HICs) with limited investigation of the psychometrics of these tools when used in low- and middle-income countries (LMICs). Thus, there is a need to examine the psychometric properties of these measures in LMICs. The present investigation aimed to examine the use of the MINI in Ethiopia, Kenya, and Uganda.</p><p><strong>Methods: </strong>A multicountry comparison of the validity and reliability of the MINI was conducted in a study of 954 participants (<i>n</i> = 667 cases; <i>n</i> = 287 controls) with and without a psychotic spectrum disorder, defined as any psychotic or bipolar spectrum disorder for the NeuroGAP - Psychosis study. Test-retest reliability of the MINI was examined in a subset of 303 participants (<i>n</i> = 164 cases; <i>n</i> = 139 controls) from the overall sample.</p><p><strong>Results: </strong>Results revealed the MINI and SCID provided excellent diagnostic accuracy with area under the curve (AUC) values of .91 (<i>SE</i> = .01) for the MINI and .95 (<i>SE</i> = .01) for the SCID. Positive predictive values (PPV) were the highest for the SCID (93.8%) and slightly lower for the MINI (88.7%). Reliability analyses revealed substantial agreement for psychotic and bipolar diagnostic groups.</p><p><strong>Conclusions: </strong>Similar patterns of results were observed at the country level with a few notable differences. Limitations and future directions are discussed.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e254"},"PeriodicalIF":5.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966453","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":"Identifying key brain pathology in bipolar and unipolar depression using a region-specific brain aging trajectories approach: Insights from the Taiwan Aging and Mental Illness Cohort.","authors":"Jun-Ding Zhu, I-Jou Chi, Hui-Yun Hsu, Shih-Jen Tsai, Albert C Yang","doi":"10.1017/S0033291725101517","DOIUrl":"https://doi.org/10.1017/S0033291725101517","url":null,"abstract":"<p><strong>Background: </strong>Identifying key areas of brain dysfunction in mental illness is critical for developing precision diagnosis and treatment. This study aimed to develop region-specific brain aging trajectory prediction models using multimodal magnetic resonance imaging (MRI) to identify similarities and differences in abnormal aging between bipolar disorder (BD) and major depressive disorder (MDD) and pinpoint key brain regions of structural and functional change specific to each disorder.</p><p><strong>Methods: </strong>Neuroimaging data from 340 healthy controls, 110 BD participants, and 68 MDD participants were included from the Taiwan Aging and Mental Illness cohort. We constructed 228 models using T1-weighted MRI, resting-state functional MRI, and diffusion tensor imaging data. Gaussian process regression was used to train models for estimating brain aging trajectories using structural and functional maps across various brain regions.</p><p><strong>Results: </strong>Our models demonstrated robust performance, revealing accelerated aging in 66 gray matter regions in BD and 67 in MDD, with 13 regions common to both disorders. The BD group showed accelerated aging in 17 regions on functional maps, whereas no such regions were found in MDD. Fractional anisotropy analysis identified 43 aging white matter tracts in BD and 39 in MDD, with 16 tracts common to both disorders. Importantly, there were also unique brain regions with accelerated aging specific to each disorder.</p><p><strong>Conclusions: </strong>These findings highlight the potential of brain aging trajectories as biomarkers for BD and MDD, offering insights into distinct and overlapping neuroanatomical changes. Incorporating region-specific changes in brain structure and function over time could enhance the understanding and treatment of mental illness.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e253"},"PeriodicalIF":5.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966479","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":"Alterations of plasma neural-derived extracellular vesicles microRNAs in patients with bipolar disorder.","authors":"Han Jiang, Bin Ren, Yamin Zhang, Yuqiang Zhou, Jianming Wu, Xueli Yu, Hua Yu, Peiyan Ni, Yan Xu, Wei Deng, Wanjun Guo, Xun Hu, Xueyu Qi, Tao Li","doi":"10.1017/S0033291725000741","DOIUrl":"https://doi.org/10.1017/S0033291725000741","url":null,"abstract":"<p><strong>Background: </strong>MicroRNAs (miRNAs) alterations in patients with bipolar disorder (BD) are pivotal to the disease's pathogenesis. Since obtaining brain tissue is challenging, most research has shifted to analyzing miRNAs in peripheral blood. One innovative solution is sequencing miRNAs in plasma extracellular vesicles (EVs), particularly those neural-derived EVs emanating from the brain.</p><p><strong>Methods: </strong>We isolated plasma neural-derived EVs from 85 patients with BD and 39 healthy controls (HC) using biotinylated antibodies targeting a neural tissue marker, followed by miRNA sequencing and expression analysis. Furthermore, we conducted bioinformatic analyses and functional experiments to delve deeper into the underlying pathological mechanisms of BD.</p><p><strong>Results: </strong>Out of the 2,656 neural-derived miRNAs in EVs identified, 14 were differentially expressed between BD patients and HC. Moreover, the target genes of miR-143-3p displayed distinct expression patterns in the prefrontal cortex of BD patients versus HC, as sourced from the PsychENCODE database. The functional experiments demonstrated that the abnormal expression of miR-143-3p promoted the proliferation and activation of microglia and upregulated the expression of proinflammatory factors, including IL-1β, IL-6, and NLRP3. Through weighted gene co-expression network analysis, a module linking to the clinical symptoms of BD patients was discerned. Enrichment analyses unveiled these miRNAs' role in modulating the axon guidance, the Ras signaling pathway, and ErbB signaling pathway.</p><p><strong>Conclusions: </strong>Our findings provide the first evidence of dysregulated plasma miRNAs within neural-derived EVs in BD patients and suggest that neural-derived EVs might be involved in the pathophysiology of BD through related biological pathways, such as neurogenesis and neuroinflammation.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e256"},"PeriodicalIF":5.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966710","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":"Progressive gray matter reduction in schizophrenia patients with persistent auditory hallucinations by causal structural covariance network analysis.","authors":"Xu Shao, Honghong Ren, Lulin Dai, Jingqi He, Jinguang Li, Ying He, Xiangzhen Kong, Xiaogang Chen, Jinsong Tang","doi":"10.1017/S0033291725101438","DOIUrl":"https://doi.org/10.1017/S0033291725101438","url":null,"abstract":"<p><strong>Background: </strong>Schizophrenia patients with auditory hallucinations have distinct morphological abnormalities, but whether this population have a progressive gray matter atrophy pattern and specific transmission chain of causal effects remains unclear. This study was designed to construct a causal structural covariance network in schizophrenia patients with persistent auditory hallucinations.</p><p><strong>Methods: </strong>T1-weighted MRI images were acquired from 90 schizophrenia patients with persistent auditory hallucinations (pAH group) and 83 healthy controls (HC group). Stage-specific independent <i>t</i> tests of gray matter volume (GMV) comparisons between the two groups were used to depict the GMV atrophic pattern and locate the atrophic origin. In the pAH group, the causal structural covariance network (CaSCN) was constructed to map causal effects between the atrophic origin and other regions as the auditory hallucination severity increased.</p><p><strong>Results: </strong>With the ascending of hallucinatory severity, GMV reductions began from the thalamus, bilateral medial frontal gyri, left Rolandic operculum, and left calcarine, and expanded to other frontal and temporal regions, hippocampal complex, insula, anterior cingulate gyri, fusiform, and cerebellum. Using the peak region (thalamus) as the causal origin in the network, transitional nodes including the right opercular part of the inferior frontal gyrus, bilateral postcentral gyri, left thalamus, and right middle frontal gyrus received the casual information and projected to target nodes from the frontal, temporal, parietal, and occipital cortices, limbic system, and cerebellum.</p><p><strong>Conclusions: </strong>Our study revealed causal effects from the thalamus and a specific transmission pattern of causal information within the network, indicating a thalamic-cortical-cerebellar circuitry dysfunction related to auditory hallucinations.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e255"},"PeriodicalIF":5.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966448","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":"Relapse rates in stable obsessive-compulsive disorder after antidepressant discontinuation versus maintenance: A systematic review and meta-analysis.","authors":"Taro Kishi, Kenji Sakuma, Masakazu Hatano, Shun Hamanaka, Yasufumi Nishii, Nakao Iwata","doi":"10.1017/S0033291725101578","DOIUrl":"https://doi.org/10.1017/S0033291725101578","url":null,"abstract":"<p><strong>Background: </strong>The optimal duration for maintaining antidepressant treatment in individuals with obsessive-compulsive disorder (OCD) who achieve symptom stabilization remains unclear.</p><p><strong>Methods: </strong>This systematic review and pairwise meta-analysis of double-blind randomized placebo-controlled trials (DBRPCTs) compared antidepressant maintenance and antidepressant discontinuation groups in terms of relapse rate at each DBRPCT study endpoint (primary outcome), OCD symptom improvement, all-cause discontinuation, and adverse event-related discontinuation. Furthermore, relapse rates at 4, 8, 12, 16, 20, and 24 weeks were compared between the groups. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated. The absolute risk reduction (ARR) and number needed to treat to benefit (NNTB) for relapse rates were also estimated.</p><p><strong>Results: </strong>Nine trials (n = 1084; mean age: 32.8 years; proportion of males: 53.3%) were included. The antidepressant maintenance group had lower relapse rates at each DBRPCT study endpoint (RR [95% CI] = 0.53 [0.42-0.68]; ARR = 21.0%; NNTB = 5) and lower all-cause and adverse event-related discontinuation rates than the antidepressant discontinuation group. The maintenance group also exhibited lower relapse rates at 4 weeks (RR [95% CI] = 0.47 [0.31-0.70]; ARR: not significant; NNTB: not significant), 8 weeks (0.42 [0.31-0.57]; 12.0%; 8), 12 weeks (0.43 [0.32-0.56]; 18.0%; 6), 16 weeks (0.41 [0.32-0.52]; 25.0%; 4), 20 weeks (0.43 [0.34-0.53]; 26.0%; 4), and 24 weeks (0.42 [0.33-0.52]; 27.0%; 4) than the discontinuation group. Moreover, the maintenance group outperformed the discontinuation group regarding OCD symptom improvement.</p><p><strong>Conclusions: </strong>Individuals with OCD may benefit from continued antidepressant treatment, provided that it is well tolerated.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e252"},"PeriodicalIF":5.5,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966522","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}