Psychological Medicine最新文献

{"title":"Continuation electroconvulsive therapy combined with pharmacotherapy for depression relapse prevention: A systematic review and meta-analysis.","authors":"Ana Jelovac, Richard Braithwaite, Charles H Kellner, Declan M McLoughlin","doi":"10.1017/S0033291725101608","DOIUrl":"10.1017/S0033291725101608","url":null,"abstract":"<p><p>Relapse following electroconvulsive therapy (ECT) remains a significant clinical challenge despite continuation of pharmacotherapy. We performed a systematic review and meta-analysis (PROSPERO CRD420251000113) of the efficacy and acceptability of continuation ECT (cECT) combined with pharmacotherapy compared to pharmacotherapy alone for relapse prevention following an acute course of ECT for depression. We searched PubMed, Embase, Web of Science, and CENTRAL databases for randomized controlled trials enrolling adults diagnosed with a unipolar or bipolar major depressive episode, who met remission or response criteria after an acute course of ECT and who were subsequently randomized to cECT with pharmacotherapy versus pharmacotherapy alone. The efficacy outcome was the cumulative relapse rate at 6-month follow-up. Data were synthesized using random-effects meta-analyses with effect sizes expressed as relative risks (RRs) with 95% confidence intervals (CIs). Four trials (<i>n</i> = 254) met the inclusion criteria. cECT combined with pharmacotherapy significantly reduced relapse compared to pharmacotherapy alone (RR = 0.57, 95% CI = 0.37-0.88; <i>I</i>² = 0%; number needed to treat = 7). Sensitivity analyses consistently supported the superiority of cECT under all examined dropout scenarios and analytic approaches. Acceptability, measured by all-cause dropout, was similar between the groups (RR = 1.12; 95% CI = 0.48-2.62; <i>I</i>² = 0%). cECT combined with pharmacotherapy significantly reduces the RR of relapse by 43% compared to pharmacotherapy alone without compromising acceptability. These findings reinforce the role of cECT as a valuable relapse prevention strategy following successful acute ECT and highlight the need for larger, multicenter trials to further optimize post-ECT prophylaxis.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e251"},"PeriodicalIF":5.5,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966723","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":"Adapting evidence-based psychological treatments for inpatient care: Commentary on Rudd (2025).","authors":"Mariah T Hawes, Stephanie Marcello, Evan M Kleiman","doi":"10.1017/S0033291725101621","DOIUrl":"https://doi.org/10.1017/S0033291725101621","url":null,"abstract":"<p><p>Rudd (2025) submitted a comment on our recent editorial, which highlights the widespread lack of access to evidence-based psychological treatment (EBT) in psychiatric inpatient care and encourages increased efforts to study adaptations of existing EBTs for this setting (Hawes, Marcello, & Kleiman, 2025). In our editorial, we specifically call for investment in inpatient group therapy, as this is the dominant mode of psychological treatment in psychiatric hospitals due to limited staff availability coupled with a lack of reimbursement incentives for individual therapy. Rudd offers a compelling case for the consideration of problem-specific and strategic treatment add-ons adapted from existing EBTs for inpatient care, such as his adaptation of brief cognitive behavioral therapy (CBT) for suicide prevention for inpatient care (BCBT-I). BCBT-I is an abbreviated version of a one-on-one outpatient EBT that produced comparable reductions in posttreatment suicide risk to the full protocol (Diefenbach et al., 2024). We agree that existing EBTs that can serve as efficient add-ons to traditional care, such as BCBT-I, can offer a compelling avenue for improving inpatient care. We view adaptations of EBTs for group therapy and strategic add-on formats as complementary and overlapping strategies that together address the ongoing crisis in inpatient care. In this article, we elaborate on the challenges in adapting EBTs for acute settings and how nontraditional treatment models, like strategic treatment add-ons and open, stand-alone single-session groups, can address these challenges.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e250"},"PeriodicalIF":5.5,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966712","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":"Causal structural covariance network identifies progressive gray matter atrophy in adolescents with major depressive disorder.","authors":"Jiahui Chen, Xinjuan Jin, Junqi Gao, Yihao Zhang, Yixin Zhang, Changlin Bai, Feiyu Xu, Yuan Yao, Wenxin Zhang, Ying Yang, Xingxing Zhu, Kangcheng Wang","doi":"10.1017/S0033291725101542","DOIUrl":"10.1017/S0033291725101542","url":null,"abstract":"<p><strong>Background: </strong>Adolescence is a period marked by high vulnerability to onset of depression. Neuroimaging studies have revealed considerableatrophy of brain structure in patients with major depressive disorder (MDD). However, the causal structural networks underpinning gray matter atrophies in depressed adolescents remain unclear. This study aimed to examine the initial gray matter alterations in MDD adolescents and investigate their causal relationships of abnormalities within brain structural networks.</p><p><strong>Methods: </strong>First-episode adolescent patients with MDD (<i>n</i> = 80, age = 15.57 ± 1.78) and age- and sex-matched healthy controls (<i>n</i> = 82, age = 16.11 ± 2.76) were included. We analyzed T1-weighted structural images using voxel-based morphometry to identify gray matter alterations in patients and the disease stage-specific abnormalities. Granger causality analysis was then conducted to construct causal structural covariance networks. We also identified potential pathways between the causal source and target.</p><p><strong>Results: </strong>Compared to controls, MDD patients with shorter illness duration showed gray matter atrophy in localized brain regions such as ventral medial prefrontal cortex (vmPFC), anterior cingulate cortex, and insula. With a prolonged course of MDD, gray matter atrophy extended to widespread brain areas. Causal network results demonstrated that early abnormalities had positive effects on the default mode, frontoparietal networks, and reward circuits. Moreover, vmPFC demonstrated the highest out-degree value, possibly representing the initial source of brain abnormality in adolescent depression.</p><p><strong>Conclusions: </strong>These findings revealed the progression of gray matter atrophy in adolescent depression and demonstrated the directional influences between initial localized alterations and subsequent deterioration in widespread brain networks.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e249"},"PeriodicalIF":5.5,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966649","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":"Successful antipsychotic dose tapering leading to better cognition in patients with remitted psychosis: Results of Guided Antipsychotic Reduction to Reach Minimum Effective Dose (GARMED) trial.","authors":"Chun-I Liu, Chih-Min Liu, Ming H Hsieh, Yi-Ting Lin, Yi-Ling Chien, Tzung-Jeng Hwang, Ko Yen, Chen-Chung Liu","doi":"10.1017/S0033291725101591","DOIUrl":"10.1017/S0033291725101591","url":null,"abstract":"<p><strong>Background: </strong>In patients with remitted psychosis, the dosage of antipsychotics can be lowered without increased risk of relapse. Whether dose tapering can lead to improved cognition is unclear. We compared changes in cognitive performance between patients undergoing dose tapering and those receiving a fixed maintenance dose.</p><p><strong>Methods: </strong>A 2-year prospective trial of patients with stable schizophrenia-related psychotic disorders was conducted: one group received guided dose reduction (GDR) and one group received maintenance treatment. Cognitive function was assessed using the Wechsler Adult Intelligence Scale-Third Edition, Mandarin Chinese version, at baseline, 1, and 2 years. The relations between the ratio of reduced dose and the extent of cognitive improvement were examined by Spearman's correlation coefficient. We also examined cognitive performance between aripiprazole (ARI) users and non-ARI users.</p><p><strong>Results: </strong>GDR patients exhibited significantly greater improvements in total intellectual quotient (IQ), particularly working memory, and information and arithmetic subtest scores, with no significant difference in relapse rates between groups. Statistically significant dose-response correlations were found between the degree of dose reduction and improvements in total IQ (<i>n</i> = 72, <i>r</i> = 0.242, <i>p</i> = 0.041), Working Memory Index (<i>n</i> = 72, <i>r</i> = 0.284, <i>p</i> = 0.016), and Arithmetic subtest (<i>n</i> = 72, <i>r</i> = 0.295, <i>p</i> = 0.012). There were no differences in cognitive changes between ARI users and non-users.</p><p><strong>Conclusions: </strong>Lowering antipsychotic dosage may ameliorate patient performance in several cognitive domains. This finding is worthy of consideration while evaluating the risk-to-benefit ratio of tapering antipsychotics in patients with remitted psychosis.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e247"},"PeriodicalIF":5.5,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966500","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":"Neural mechanisms underlying implicit emotion regulation deficit in relational and nonrelational trauma PTSD: Insights from the Nested Hierarchical Model of Self.","authors":"Yunxiao Guo, Qian Xiong, Yafei Tan, Junrong Zhao, Sijun Liu, Jiaojiao Jia, Zhihui Zhang, Yuyi Zhang, Zhihong Ren","doi":"10.1017/S0033291725101505","DOIUrl":"10.1017/S0033291725101505","url":null,"abstract":"<p><strong>Background: </strong>Posttraumatic stress disorder (PTSD) exhibits marked heterogeneity, with relational (R; interpersonal) and nonrelational (NR; environmental) trauma subtypes demonstrating distinct psychopathological trajectories. Despite clinical recognition of these differences, their neurobiological underpinnings of emotion processing remain poorly understood. Guided by the Nested Hierarchical Model of Self (NHMS) - which posits trauma-type-specific disruptions in hierarchical self-processing systems - this study investigated neural mechanisms differentiating among PTSD subtypes during implicit emotion regulation.</p><p><strong>Methods: </strong>A sample of 122 participants, including patients with PTSD (R: <i>n</i> = 51; NR: <i>n</i> = 29) and trauma-exposed controls matched by trauma type (R: <i>n</i> = 22; NR: <i>n</i> = 20), underwent functional magnetic resonance imaging while performing the Shifted Attention Emotion Appraisal Task. Behavioral assessments and trauma typology coding were complemented by regions of interest (ROI)-based and whole-brain analyses.</p><p><strong>Results: </strong>Results revealed that PTSD-R showed hypoactivation in right superior frontal gyrus (during implicit emotion regulation; BA9; <i>p</i> = 0.049, ηp² = 0.033), whereas PTSD-NR exhibited hyperactivation in fusiform (during emotion modulation by attention shifting; <i>p</i> = 0.036, ηp² = 0.037). Symptom severity inversely correlated with social support (<i>r</i> = -0.353 to -0.417, <i>p</i> < 0.01), with relational PTSD reporting the lowest support (<i>p</i> < 0.001). Across conditions, dorsolateral prefrontal clusters (BA8/9) demonstrated anticorrelations with default-mode regions (<i>r</i> = -0.272 to -0.549, <i>p</i> < 0.01) aligning with NHMS' predictive coding framework.</p><p><strong>Conclusions: </strong>These findings validate trauma-type-specific neural hierarchies, suggesting relational trauma disrupts top-down self-identity schemas, while NR trauma amplifies bottom-up threat detection. The study advances precision psychiatry by linking implicit regulation biomarkers to targeted interventions - cognitive restructuring for PTSD-R and interoceptive recalibration for PTSD-NR.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e248"},"PeriodicalIF":5.5,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966464","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":"Unlocking mental health insights with UK Biobank data: Past use and future opportunities.","authors":"Katrina A S Davis, Luwaiza Mirza, Scott R Clark, Jonathan R I Coleman, Aliyah S Kassam, Natalie T Mills, Amy Zadow, Andrew M McIntosh, Matthew Hotopf","doi":"10.1017/S0033291725101359","DOIUrl":"10.1017/S0033291725101359","url":null,"abstract":"<p><p>UK Biobank (UKB) is a large-scale, prospective resource offering significant opportunities for mental health research. Data include genetic and biological data, healthcare linkage, and mental health enhancements. Challenges arise from incomplete linkage of some sources and the incomplete coverage for enhancements, which also occur at different times post-baseline. We searched for publications using UKB for mental health research from 2016 to 2023 to describe and inspire future use. Papers were classified by mental health topic, 'additional' aspects, and the data used to define the mental health topic. We identified 480 papers, with 338 focusing on mental health disorder topics (affective, anxiety, psychotic, multiple, and transdiagnostic). The most commonly studied disorder was depression (41%). The most common single method of ascertaining mental disorder status was the Mental Health Questionnaire (26%), with genetic risk, for example, using polygenic risk scores, also frequent (21%). Common additional aspects included brain imaging, gene-environment interaction, and the relationship with physical health. The review demonstrates the value of UKB to mental health research. We explore the strengths and weaknesses, producing resources informed by the review. A strength is the flexibility: conventional epidemiological studies are present, but also genomics, imaging, and other tools for understanding mental health. A major weakness is selection effects. UKB continues to hold potential, especially with additional data continuing to become available.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e244"},"PeriodicalIF":5.5,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966505","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":"Affective dynamics and emotional reactivity in social anxiety disorder.","authors":"Beth Foote, Femke Lamers, Mike Xiao, Lihong Cui, Vadim Zipunnikov, Mathilde M Husky, Kathleen R Merikangas","doi":"10.1017/S0033291725000121","DOIUrl":"10.1017/S0033291725000121","url":null,"abstract":"<p><strong>Background: </strong>Although heightened anxiety associated with social interaction or evaluation is the core diagnostic criterion for social anxiety disorder (SAD), there is growing evidence that SAD is characterized by more pervasive reactivity beyond social situations. We employed Ecological Momentary Assessment (EMA) to describe the affective dynamics and emotional reactivity to daily events in a community-based sample of adults with SAD compared with other anxiety disorders, and controls without anxiety or mood disorders.</p><p><strong>Methods: </strong>A sample of 236 adults with a lifetime diagnosis of SAD (n = 53), other anxiety disorders (n = 120), and no mood or anxiety disorder (n = 63) based on comprehensive diagnostic interviews answered brief electronic interviews that assessed daily life events and mood and anxiety symptoms four times a day for two weeks. Linear mixed models were used to quantify reactivity to daily life events.</p><p><strong>Results: </strong>Persons with SAD had higher average levels of sad and anxious mood than those with other anxiety disorders or controls. Irrespective of comorbid mood disorders, people with SAD also demonstrated significantly greater decreases in both sad and anxious mood following positive events, and a greater increase in anxious mood following negative, particularly non-social events.</p><p><strong>Conclusions: </strong>Our findings regarding pervasive reactivity beyond the social context in people with SAD confirm the need for broader conceptualization of this disorder as well as expansion of interventions beyond the social context. This work also demonstrates the utility of EMA as a powerful tool to track individual variability and reactivity in daily life that can inform etiology, treatment and prevention.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e242"},"PeriodicalIF":5.5,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966654","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":"Cannabis use is associated with changes in psychological and functional well-being during young adulthood: evidence from self-reports and hair analyses.","authors":"Lydia Johnson-Ferguson, Michelle Loher, Laura Bechtiger, Clarissa Janousch, Markus R Baumgartner, Tina M Binz, Denis Ribeaud, Manuel Eisner, Boris B Quednow, Lilly Shanahan","doi":"10.1017/S003329172510144X","DOIUrl":"10.1017/S003329172510144X","url":null,"abstract":"<p><strong>Background: </strong>Cannabis use in young adulthood is common, yet few studies have explored how it predicts <i>changes</i> in psychopathology and functional well-being in community samples. We assessed these links using both self-reported frequency of cannabis use and hair THC concentrations.</p><p><strong>Methods: </strong>Data came from a community sample of young adults (<i>N</i> = 863) who reported cannabis use (weekly-to-daily use: <i>n</i> = 150) and provided hair samples at age 20 (cannabis detected: <i>n</i> = 110). Liquid chromatography-tandem mass spectrometry quantified delta-9-tetrahydrocannabinol (THC) and cannabinol (CBN) concentrations in hair. At ages 20 and 24, participants reported psychopathology (psychotic-like experiences, problematic substance use, internalizing symptoms, and aggression) and functional wellbeing (general well-being, delinquency, and not being in employment, education, or training). Multiple linear and logit regression models tested associations between six different continuous and dichotomous operationalizations of self-reported and objective cannabis exposure at age 20 and psychological and functional well-being at age 24, adjusting for sex, sociodemographic characteristics, and the outcomes measured at age 20.</p><p><strong>Results: </strong>Both self-reported frequency of cannabis use and hair THC concentrations predicted increases in psychotic-like experiences and internalizing symptoms, increased aggression, decreased general well-being, higher odds of not being in employment, training, or education, and more problematic substance use from age 20 to 24, with small effect sizes. Composite exposure scores derived from self-reports and hair data were not more informative than either source alone.</p><p><strong>Conclusions: </strong>Frequent cannabis use predicted adverse changes in psychopathological outcomes from ages 20 to 24, regardless of how it was assessed.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e246"},"PeriodicalIF":5.5,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966700","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":"Validation of the Imperial Psychedelic Predictor Scale - CORRIGENDUM.","authors":"Michael Angyus, Sarah Osborn, Eline Haijen, David Erritzoe, Joseph Peill, Taylor Lyons, Hannes Kettner, Robin Carhart-Harris","doi":"10.1017/S0033291725101219","DOIUrl":"10.1017/S0033291725101219","url":null,"abstract":"","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e243"},"PeriodicalIF":5.5,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966528","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 difference in the effect of methadone and protracted abstinence on the coupling among key large-scale brain networks of individuals with heroin use disorder: A resting-state fMRI study.","authors":"Jiajie Chen, Ning Wu, Long Jin, Jia Zhu, Yongbin Li, Zhidong Wang, Fan Wang, Wei Wang, Wei Li, Qiang Li","doi":"10.1017/S0033291725101451","DOIUrl":"10.1017/S0033291725101451","url":null,"abstract":"<p><strong>Background: </strong>Methadone maintenance treatment (MMT) and protracted abstinence (PA) effectively reduce the craving for heroin among individuals with heroin use disorder (HUD). However, the difference in their effects on brain function, especially the coupling among the large-scale brain networks (default mode [DMN], salience [SN], and executive control [ECN] networks), remains unclear. This study analyzed the effects of the MMT and PA on these networks and the predictive value of the bilateral resource allocation index (RAI) for craving for heroin.</p><p><strong>Methods: </strong>Twenty-five individuals undergoing the MMT, 22 undergoing the PA, and 51 healthy controls underwent resting-state functional magnetic resonance imaging (rs-fMRI). Independent component analysis identified the ECN, DMN, and SN. The SN-ECN and SN-DMN connectivity and the bilateral RAI were evaluated. The relationships between network coupling and clinical and psychological characteristics were analyzed. The multiple linear regression model identified significant variables for predicting craving scores.</p><p><strong>Results: </strong>The MMT group showed significantly stronger SN-left ECN (lECN) coupling and left RAI than the PA group. In the MMT group, SN-lECN connectivity and bilateral RAI were positively correlated with the total methadone dose. In both treatment groups, SN-right ECN (rECN) connectivity and right RAI were negatively correlated with craving. The models revealed that the bilateral RAI and the MMT and PA were associated with the craving.</p><p><strong>Conclusions: </strong>The MMT enhances SN-lECN coupling and the left RAI more than the PA, possibly due to higher control modulation. The RAI could help predict heroin craving in individuals with HUD undergoing either treatment program.</p>","PeriodicalId":20891,"journal":{"name":"Psychological Medicine","volume":"55 ","pages":"e245"},"PeriodicalIF":5.5,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966460","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}