Psychiatry and Clinical Neurosciences最新文献

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The longitudinal patterns of depression subtypes and stressors in depression severity in the Canadian longitudinal study on aging (CLSA). 加拿大老龄化纵向研究(CLSA)中抑郁亚型和抑郁严重程度压力因素的纵向模式。
IF 5 3区 医学
Psychiatry and Clinical Neurosciences Pub Date : 2024-09-02 DOI: 10.1111/pcn.13728
Yingying Su, Muzi Li, Norbert Schmitz, Xiangfei Meng
{"title":"The longitudinal patterns of depression subtypes and stressors in depression severity in the Canadian longitudinal study on aging (CLSA).","authors":"Yingying Su, Muzi Li, Norbert Schmitz, Xiangfei Meng","doi":"10.1111/pcn.13728","DOIUrl":"https://doi.org/10.1111/pcn.13728","url":null,"abstract":"<p><strong>Aim: </strong>The current study aims to characterize the longitudinal patterns of depression subtypes and investigate the associations among the stability of depression subtypes, COVID-19-related stressors, and depression severity.</p><p><strong>Methods: </strong>The study utilized data from the Canadian Longitudinal Study on Aging, which is a national, long-term study of Canadian adults aged 45 and older (n = 12,957). Latent profile analysis was used to identify latent depression subtypes. Latent transition analysis was then applied to assess the stability of these subtypes over time. Hierarchical multivariate linear regression was used to explore the relationships among these identified depression subtypes, COVID-19-related stressors, and depression severity among males and females, respectively.</p><p><strong>Results: </strong>Distinct depression subtypes were identified. Except for atypical depression, other depression subtypes showed greater stability over time. We also found that melancholic depression (B = 9.432) and typical depression (B = 6.677) were strongly associated with depression severity during the pandemic. Health-related stressors (B = 0.840), conflict (B = 3.639), difficulties accessing resources (B = 0.927), separation from family (B = 0.840), and caregiving experience (B = 0.764), were significantly associated with increased depression severity. Sex-specific analyses also revealed differences in the associations between stressors and depression severity between males and females.</p><p><strong>Conclusions: </strong>This study contributes valuable insights into the latent clustering of depression subtypes and their stability. Stressors were associated with increased depression severity, with distinct associations observed among males and females. These findings have implications for targeted early interventions and integrated clinical management strategies by providing the evidence base for tailored mental health care during and after the pandemic.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142111423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A double-blind trial of decoded neurofeedback intervention for specific phobias. 针对特定恐惧症的解码神经反馈干预双盲试验。
IF 5 3区 医学
Psychiatry and Clinical Neurosciences Pub Date : 2024-09-02 DOI: 10.1111/pcn.13726
Cody A Cushing, Hakwan Lau, Mitsuo Kawato, Michelle G Craske, Vincent Taschereau-Dumouchel
{"title":"A double-blind trial of decoded neurofeedback intervention for specific phobias.","authors":"Cody A Cushing, Hakwan Lau, Mitsuo Kawato, Michelle G Craske, Vincent Taschereau-Dumouchel","doi":"10.1111/pcn.13726","DOIUrl":"https://doi.org/10.1111/pcn.13726","url":null,"abstract":"<p><strong>Aim: </strong>A new closed-loop functional magnetic resonance imaging method called multivoxel neuroreinforcement has the potential to alleviate the subjective aversiveness of exposure-based interventions by directly inducing phobic representations in the brain, outside of conscious awareness. The current study seeks to test this method as an intervention for specific phobia.</p><p><strong>Methods: </strong>In a randomized, double-blind, controlled single-university trial, individuals diagnosed with at least two (one target, one control) animal subtype-specific phobias were randomly assigned (1:1:1) to receive one, three, or five sessions of multivoxel neuroreinforcement in which they were rewarded for implicit activation of a target animal representation. Amygdala response to phobic stimuli was assessed by study staff blind to target and control animal assignments. Pretreatment to posttreatment differences were analyzed with a two-way repeated-measures anova.</p><p><strong>Results: </strong>A total of 23 participants (69.6% female) were randomized to receive one (n = 8), three (n = 7), or five (n = 7) sessions of multivoxel neuroreinforcement. Eighteen (n = 6 each group) participants were analyzed for our primary outcome. After neuroreinforcement, we observed an interaction indicating a significant decrease in amygdala response for the target phobia but not the control phobia. No adverse events or dropouts were reported as a result of the intervention.</p><p><strong>Conclusion: </strong>Results suggest that multivoxel neuroreinforcement can specifically reduce threat signatures in specific phobia. Consequently, this intervention may complement conventional psychotherapy approaches with a nondistressing experience for patients seeking treatment. This trial sets the stage for a larger randomized clinical trial to replicate these results and examine the effects on real-life exposure.</p><p><strong>Clinical trial registration: </strong>The now-closed trial was prospectively registered at ClinicalTrials.gov with ID NCT03655262.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142111419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Arachidonic acid-derived dihydroxy fatty acids in neonatal cord blood relate symptoms of autism spectrum disorders and social adaptive functioning: Hamamatsu Birth Cohort for Mothers and Children (HBC Study). 新生儿脐带血中花生四烯酸衍生二羟基脂肪酸与自闭症谱系障碍症状和社会适应功能的关系:滨松母子出生队列研究》(Hamamatsu Birth Cohort for Mothers and Children, HBC Study)。
IF 5 3区 医学
Psychiatry and Clinical Neurosciences Pub Date : 2024-09-01 Epub Date: 2024-07-23 DOI: 10.1111/pcn.13710
Takaharu Hirai, Naoko Umeda, Taeko Harada, Akemi Okumura, Chikako Nakayasu, Takayo Ohto-Nakanishi, Kenji J Tsuchiya, Tomoko Nishimura, Hideo Matsuzaki
{"title":"Arachidonic acid-derived dihydroxy fatty acids in neonatal cord blood relate symptoms of autism spectrum disorders and social adaptive functioning: Hamamatsu Birth Cohort for Mothers and Children (HBC Study).","authors":"Takaharu Hirai, Naoko Umeda, Taeko Harada, Akemi Okumura, Chikako Nakayasu, Takayo Ohto-Nakanishi, Kenji J Tsuchiya, Tomoko Nishimura, Hideo Matsuzaki","doi":"10.1111/pcn.13710","DOIUrl":"10.1111/pcn.13710","url":null,"abstract":"<p><strong>Aim: </strong>Autism spectrum disorder (ASD) is associated with abnormal lipid metabolism, such as a high total ratio of omega-6 to omega-3 in polyunsaturated fatty acids (PUFAs). PUFAs are metabolized to epoxy fatty acids by cytochrome P450 (CYP); then, dihydroxy fatty acid is produced by soluble epoxide hydrolase. This study examined the association between PUFA metabolites in the cord blood and ASD symptoms and adaptive functioning in children.</p><p><strong>Methods: </strong>This prospective cohort study utilized cord blood to quantify PUFA metabolites of the CYP pathway. The Autism Diagnostic Observation Schedule (ADOS-2) and Vineland Adaptive Behaviors Scales, Second Edition (VABS-II) were used to assess subsequent ASD symptoms and adaptive functioning in children at 6 years. The analysis included 200 children and their mothers.</p><p><strong>Results: </strong>Arachidonic acid-derived diols, 11,12-diHETrE was found to impact ASD symptom severity on the ADOS-2-calibrated severity scores and impairment in the socialization domain as assessed by the VABS-II (P = 0.0003; P = 0.004, respectively). High levels of 11,12-diHETrE impact social affect in ASD symptoms (P = 0.002), while low levels of 8,9-diHETrE impact repetitive/restrictive behavior (P = 0.003). Notably, there was specificity in the association between diHETrE and ASD symptoms, especially in girls.</p><p><strong>Conclusion: </strong>These findings suggest that the dynamics of diHETrE during the fetal period is important in the developmental trajectory of children after birth. Given that the role of diol metabolites in neurodevelopment in vivo is completely uncharacterized, the results of this study provide important insight into the role of diHETrE and ASD pathophysiology.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dementia treatment and prevention in the era of 60 million patients: advancing disease-modifying therapies faster, wider, and deeper. 6000 万患者时代的痴呆症治疗和预防:更快、更广、更深地推进疾病改变疗法。
IF 5 3区 医学
Psychiatry and Clinical Neurosciences Pub Date : 2024-09-01 DOI: 10.1111/pcn.13713
Masaru Mimura
{"title":"Dementia treatment and prevention in the era of 60 million patients: advancing disease-modifying therapies faster, wider, and deeper.","authors":"Masaru Mimura","doi":"10.1111/pcn.13713","DOIUrl":"https://doi.org/10.1111/pcn.13713","url":null,"abstract":"","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Connecting mechanistic biomarkers to psychotic symptoms. 将机制生物标志物与精神病症状联系起来。
IF 5 3区 医学
Psychiatry and Clinical Neurosciences Pub Date : 2024-09-01 DOI: 10.1111/pcn.13708
Xiongfei Wang, Yunzhe Liu
{"title":"Connecting mechanistic biomarkers to psychotic symptoms.","authors":"Xiongfei Wang, Yunzhe Liu","doi":"10.1111/pcn.13708","DOIUrl":"https://doi.org/10.1111/pcn.13708","url":null,"abstract":"","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tetrabenazine-induced acute dystonic reaction during the treatment of comorbid tics in a young woman with autism spectrum disorder. 一名患有自闭症谱系障碍的年轻女性在治疗合并抽搐症期间因四苯巴嗪诱发急性肌张力障碍反应。
IF 5 3区 医学
Psychiatry and Clinical Neurosciences Pub Date : 2024-09-01 Epub Date: 2024-06-28 DOI: 10.1111/pcn.13705
Marcelo D Mendonça, J Bernardo Barahona-Corrêa
{"title":"Tetrabenazine-induced acute dystonic reaction during the treatment of comorbid tics in a young woman with autism spectrum disorder.","authors":"Marcelo D Mendonça, J Bernardo Barahona-Corrêa","doi":"10.1111/pcn.13705","DOIUrl":"10.1111/pcn.13705","url":null,"abstract":"","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141470488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Identification of schizophrenia by applying interpretable radiomics modeling with structural magnetic resonance imaging of the cerebellum. 通过小脑结构性磁共振成像应用可解释的放射组学模型识别精神分裂症。
IF 5 3区 医学
Psychiatry and Clinical Neurosciences Pub Date : 2024-09-01 Epub Date: 2024-07-02 DOI: 10.1111/pcn.13707
Minji Bang, Kisung Park, Seoung-Ho Choi, Sung Soo Ahn, Jinna Kim, Seung-Koo Lee, Yae Won Park, Sang-Hyuk Lee
{"title":"Identification of schizophrenia by applying interpretable radiomics modeling with structural magnetic resonance imaging of the cerebellum.","authors":"Minji Bang, Kisung Park, Seoung-Ho Choi, Sung Soo Ahn, Jinna Kim, Seung-Koo Lee, Yae Won Park, Sang-Hyuk Lee","doi":"10.1111/pcn.13707","DOIUrl":"10.1111/pcn.13707","url":null,"abstract":"<p><strong>Aims: </strong>The cerebellum is involved in higher-order mental processing as well as sensorimotor functions. Although structural abnormalities in the cerebellum have been demonstrated in schizophrenia, neuroimaging techniques are not yet applicable to identify them given the lack of biomarkers. We aimed to develop a robust diagnostic model for schizophrenia using radiomic features from T1-weighted magnetic resonance imaging (T1-MRI) of the cerebellum.</p><p><strong>Methods: </strong>A total of 336 participants (174 schizophrenia; 162 healthy controls [HCs]) were allocated to training (122 schizophrenia; 115 HCs) and test (52 schizophrenia; 47 HCs) cohorts. We obtained 2568 radiomic features from T1-MRI of the cerebellar subregions. After feature selection, a light gradient boosting machine classifier was trained. The discrimination and calibration of the model were evaluated. SHapley Additive exPlanations (SHAP) was applied to determine model interpretability.</p><p><strong>Results: </strong>We identified 17 radiomic features to differentiate participants with schizophrenia from HCs. In the test cohort, the radiomics model had an area under the curve, accuracy, sensitivity, and specificity of 0.89 (95% confidence interval: 0.82-0.95), 78.8%, 88.5%, and 75.4%, respectively. The model explanation by SHAP suggested that the second-order size zone non-uniformity feature from the right lobule IX and first-order energy feature from the right lobules V and VI were highly associated with the risk of schizophrenia.</p><p><strong>Conclusion: </strong>The radiomics model focused on the cerebellum demonstrates robustness in diagnosing schizophrenia. Our results suggest that microcircuit disruption in the posterior cerebellum is a disease-defining feature of schizophrenia, and radiomics modeling has potential for supporting biomarker-based decision-making in clinical practice.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Multivariate sharp-wave ripples in schizophrenia during awake state. 清醒状态下精神分裂症的多变量尖波涟漪。
IF 5 3区 医学
Psychiatry and Clinical Neurosciences Pub Date : 2024-09-01 Epub Date: 2024-06-24 DOI: 10.1111/pcn.13702
Takefumi Ohki, Zenas C Chao, Yuichi Takei, Yutaka Kato, Masakazu Sunaga, Tomohiro Suto, Minami Tagawa, Masato Fukuda
{"title":"Multivariate sharp-wave ripples in schizophrenia during awake state.","authors":"Takefumi Ohki, Zenas C Chao, Yuichi Takei, Yutaka Kato, Masakazu Sunaga, Tomohiro Suto, Minami Tagawa, Masato Fukuda","doi":"10.1111/pcn.13702","DOIUrl":"10.1111/pcn.13702","url":null,"abstract":"<p><strong>Aims: </strong>Schizophrenia (SZ) is a brain disorder characterized by psychotic symptoms and cognitive dysfunction. Recently, irregularities in sharp-wave ripples (SPW-Rs) have been reported in SZ. As SPW-Rs play a critical role in memory, their irregularities can cause psychotic symptoms and cognitive dysfunction in patients with SZ. In this study, we investigated the SPW-Rs in human SZ.</p><p><strong>Methods: </strong>We measured whole-brain activity using magnetoencephalography (MEG) in patients with SZ (n = 20) and sex- and age-matched healthy participants (n = 20) during open-eye rest. We identified SPW-Rs and analyzed their occurrence and time-frequency traits. Furthermore, we developed a novel multivariate analysis method, termed \"ripple-gedMEG\" to extract the global features of SPW-Rs. We also examined the association between SPW-Rs and brain state transitions. The outcomes of these analyses were modeled to predict the positive and negative syndrome scale (PANSS) scores of SZ.</p><p><strong>Results: </strong>We found that SPW-Rs in the SZ (1) occurred more frequently, (2) the delay of the coupling phase (3) appeared in different brain areas, (4) consisted of a less organized spatiotemporal pattern, and (5) were less involved in brain state transitions. Finally, some of the neural features associated with the SPW-Rs were found to be PANSS-positive, a pathological indicator of SZ. These results suggest that widespread but disorganized SPW-Rs underlies the symptoms of SZ.</p><p><strong>Conclusion: </strong>We identified irregularities in SPW-Rs in SZ and confirmed that their alternations were strongly associated with SZ neuropathology. These results suggest a new direction for human SZ research.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141458970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Arginine vasopressin in mood disorders: A potential biomarker of disease pathology and a target for pharmacologic intervention. 情绪障碍中的精氨酸加压素:疾病病理的潜在生物标志物和药物干预的目标。
IF 5 3区 医学
Psychiatry and Clinical Neurosciences Pub Date : 2024-09-01 Epub Date: 2024-06-25 DOI: 10.1111/pcn.13703
Hiroe Hu, Carlos A Zarate, Joseph Verbalis
{"title":"Arginine vasopressin in mood disorders: A potential biomarker of disease pathology and a target for pharmacologic intervention.","authors":"Hiroe Hu, Carlos A Zarate, Joseph Verbalis","doi":"10.1111/pcn.13703","DOIUrl":"10.1111/pcn.13703","url":null,"abstract":"<p><p>Vasopressin or arginine-vasopressin (AVP) is a neuropeptide molecule known for its antidiuretic effects and serves to regulate plasma osmolality and blood pressure. The existing literature suggests that AVP plays a multifaceted-though less well-known-role in the central nervous system (CNS), particularly in relation to the pathophysiology and treatment of mood disorders. Animal models have demonstrated that AVP is implicated in regulating social cognition, affiliative and prosocial behaviors, and aggression, often in conjunction with oxytocin. In humans, AVP is implicated in mood disorders through its effects on the hypothalamic-pituitary-adrenal (HPA) axis as well as on the serotoninergic and glutamatergic systems. Measuring plasma AVP has yielded interesting but mixed results in mood and stress-related disorders. Recent advances have led to the development of copeptin as a stable and reliable surrogate biomarker for AVP. Another interesting but relatively unexplored issue is the interaction between the osmoregulatory system and mood disorder pathophysiology, given that psychotropic medications often cause dysregulation of AVP receptor expression or signaling that can subsequently lead to clinical syndromes like syndrome of inappropriate diuresis and diabetes insipidus. Finally, pharmaceutical trials of agents that act on V1a and V1b receptor antagonists are still underway. This narrative review summarizes: (1) the neurobiology of the vasopressinergic system in the CNS; (2) the interaction between AVP and the monoaminergic and glutamatergic pathways in the pathophysiology and treatment of mood disorders; (3) the iatrogenic AVP dysregulation caused by psychotropic medications; and (4) the pharmaceutical development of AVP receptor antagonists for the treatment of mood disorders.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11371531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141458968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Vortioxetine for depression in adults: A systematic review and dose-response meta-analysis of randomized controlled trials. 治疗成人抑郁症的伏替西汀:随机对照试验的系统回顾和剂量反应荟萃分析。
IF 5 3区 医学
Psychiatry and Clinical Neurosciences Pub Date : 2024-09-01 Epub Date: 2024-07-03 DOI: 10.1111/pcn.13709
Xin Yang, Shuping Fang, Wenqi Lyu, Yongbo Hu, Huifang Xu, Xiao Jiang, Yurou Zhao, Yuwei Zhang, Jin Li, Weihong Kuang
{"title":"Vortioxetine for depression in adults: A systematic review and dose-response meta-analysis of randomized controlled trials.","authors":"Xin Yang, Shuping Fang, Wenqi Lyu, Yongbo Hu, Huifang Xu, Xiao Jiang, Yurou Zhao, Yuwei Zhang, Jin Li, Weihong Kuang","doi":"10.1111/pcn.13709","DOIUrl":"10.1111/pcn.13709","url":null,"abstract":"<p><strong>Aim: </strong>Major depressive disorder (MDD) is a prevalent psychiatric condition and vortioxetine offers promising antidepressant effects due to its unique pharmacological profile. However, the dose-response relationships of vortioxetine for MDD is not well established. We aimed to conduct dose-response meta-analyses to fill this gap.</p><p><strong>Methods: </strong>We systematically searched multiple electronic databases for randomized controlled trials of vortioxetine for MDD, with the last search conducted on 08 February, 2024. The dose-response relationship was evaluated using a one-stage random-effects dose-response meta-analysis with restricted cubic spline model. The primary outcome was efficacy (mean change in depression scale score), with secondary outcomes including response, dropout for any reasons (acceptability), dropout for adverse events (tolerability), and any adverse events (safety).</p><p><strong>Results: </strong>The dose-response meta-analysis comprised 16 studies, with 4,294 participants allocated to the vortioxetine group and 2,299 participants allocated to the placebo group. The estimated 50% effective dose was 4.37 mg/day, and the near-maximal effective dose (95% effective dose) was 17.93 mg/day. Visual inspection of the dose-efficacy curve suggests that a plateau possibly had not been reached yet at 20 mg/day. Acceptability, tolerability and safety decreased as the dose increased. Subgroup analysis indicated that no significant differences were observed in acceptability, tolerability and safety among the dosage groups.</p><p><strong>Conclusions: </strong>Vortioxetine may potentially provide additional therapeutic benefits when exceeding the current licensed dosage without significantly impacting safety. Conducting clinical trials exceeding the current approved dosage appears necessary to fully comprehend its efficacy and risk.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":null,"pages":null},"PeriodicalIF":5.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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