Psychiatry and Clinical Neurosciences最新文献

{"title":"Psychometrics of BE-PSD-V2.0 and its correspondence with PANSS and CGI-S.","authors":"Hiroyoshi Takeuchi, Naoki Hashimoto, Yoshiteru Takekita, Maeri Yamamoto, Jun Miyata, Kazutaka Ohi, Hiroyuki Muraoka, Michihiko Koeda, Itaru Miura, Kazuto Oya, Yasushi Kawamata, Yuta Yoshino, Yoji Hirano, Hikaru Hori, Genichi Sugihara, Junya Matsumoto, Satsuki Ito, Ryo Sawagashira, Atsuhito Toyomaki, Hayato Watanabe, Yosuke Koshikawa, Toshiya Funatsuki, Yuki Tanaka, Shinichiro Nakajima, Saki Homma, Yuka Kaneko, Yutaro Shimomura, Keita Kawai, Chikako Kawai, Manabu Kubota, Hiroyuki Igarashi, Sadao Otsuka, Daisuke Fujikane, Yuhei Suzuki, Yuri Kobayashi, Yuki Matsuda, Tomoko Kitajima, Shinichiro Ochi, Hideaki Yasuda, Ryota Hashimoto","doi":"10.1111/pcn.70043","DOIUrl":"10.1111/pcn.70043","url":null,"abstract":"<p><strong>Aim: </strong>We aimed to examine the psychometric properties of the second version of the Brief Evaluation of Psychosis Symptom Domains (BE-PSD-V2.0) and its correspondence with the Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression-Severity scale (CGI-S) scores.</p><p><strong>Methods: </strong>This cross-sectional study was conducted at 18 institutes in Japan. We performed correlational analyses to test the convergent and divergent validity of the BE-PSD-V2.0. Inter-rater reliability was assessed using intraclass correlation coefficients (ICCs). The equipercentile equating method was employed to examine the linking of the BE-PSD-V2.0 with the PANSS and the CGI-S.</p><p><strong>Results: </strong>A total of 353 patients with schizophrenia spectrum disorders were included. Spearman's rank correlation coefficients between the BE-PSD-V2.0 item scores and their corresponding PANSS factor scores ranged from 0.64 to 0.86, indicating sufficient convergent validity. These specific correlation coefficients were consistently the highest among all item-to-factor comparisons, indicating sufficient divergent validity. In 34 patients, ICCs for the BE-PSD-V2.0 item and total scores ranged from 0.60 to 0.94, showing sufficient inter-rater reliability. Conversion tables were established between the BE-PSD-V2.0 total score and the PANSS total score, between the BE-PSD-V2.0 total score and the CGI-S score, and between the BE-PSD-V2.0 item scores and their corresponding PANSS factor scores. A correspondence between symptomatic remission criteria using the PANSS and BE-PSD-V2.0 was confirmed.</p><p><strong>Conclusions: </strong>The BE-PSD-V2.0 possesses sufficient psychometric properties and corresponds to the PANSS and CGI-S. It is a sound and reliable brief rating scale for assessing symptoms in schizophrenia spectrum disorders, and its established conversion correspondences facilitate score interpretation within existing clinical paradigms for both clinical practice and research.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":"417-422"},"PeriodicalIF":6.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147434969","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}

{"title":"Intact delay discounting but more optimal reward-based decisions in anorexia nervosa during an experiential task.","authors":"Fabio Bernardoni, Joseph A King, Maria Seidel, Martin Schoemann, Nina Kasaeva, Katrin Gramatke, Kerstin Weidner, Veit Roessner, Stefan Scherbaum, Stefan Ehrlich","doi":"10.1111/pcn.70041","DOIUrl":"10.1111/pcn.70041","url":null,"abstract":"<p><strong>Aims: </strong>Individuals with anorexia nervosa (AN) have an apparent increased capacity to delay gratification and forgo immediate food rewards in their long-term pursuit of thinness. Prior research probed this capacity using delay discounting tasks that assess how rapidly the subjective value of rewards decreases as a function of time until receipt. However, significant effects in AN were mostly subtle or absent using traditional tasks. Here, we tested whether altered delay discounting might be revealed in AN during an experiential gamified task.</p><p><strong>Methods: </strong>Eighty acutely underweight females with AN and pairwise age-matched female healthy controls (HC) made binary choices moving an avatar to collect rewards of varying magnitudes and distances. The presence of an overall time limit rendered one choice optimal (i.e. higher cost-benefit ratio) in each trial. We tested group differences in delay/distance discounting and used signal detection theory to determine whether decision patterns were due to inherent preferences (e.g. for immediate rewards) or acuity to detect optimal choices.</p><p><strong>Results: </strong>No group differences in delay discounting parameters were found, but participants with AN favored smaller, closer rewards when this was the optimal strategy. This was neither related to an a priori bias toward immediate/delayed rewards nor enhanced choice acuity.</p><p><strong>Conclusion: </strong>Even in a more realistic experiential task, individuals with AN did not exhibit reduced delay discounting. Instead, because choosing the closer option more frequently required more decisions overall, our findings may reflect increased task engagement and align with the notion of greater willingness to exert effort for reward in AN.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":"409-416"},"PeriodicalIF":6.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146213842","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}

{"title":"The development of positron emission tomography (PET) tracer for glutamate AMPA receptors and its application to human biology and clinics.","authors":"Mai Hatano, Hiroki Abe, Takuya Takahashi","doi":"10.1111/pcn.70040","DOIUrl":"10.1111/pcn.70040","url":null,"abstract":"<p><p>Psychiatric and neurological disorders severely compromised patients' quality of life. Despite their urgent needs, the development of diagnostics and therapeutics based on the biological basis has made only little progress. This is due to limited evidence on the biological basis of these disorders in humans. Synapses are fundamental structural units of neurotransmission, and neuropsychiatric disorders are considered as 'synapse diseases'. Thus, a translational approach based on synaptic physiology is important to understand these disorders. Excitatory glutamatergic synapses play principal roles in neuronal functions. Glutamate α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor (AMPAR) is a fundamental molecule of glutamatergic neurotransmission and therefore is considered to be a promising translational target. Here we review the limitations of current diagnostics and therapeutics of psychiatric disorders and claim the essential need for the promotion of translational medicine based on the synaptic physiology of AMPAR. Further, we introduce our recent translational challenge to tackle these diseases by targeting AMPARs.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":"367-373"},"PeriodicalIF":6.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146181992","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}

{"title":"Polygenic score for schizophrenia worsens the effect of bipolar disorder course on neuronal metabolism and white matter microstructure.","authors":"Marco Paolini, Andrea Grifoni, Laura Raffaelli, Beatrice Bravi, Mario Crespi, Lidia Fortaner-Uyà, Sara Spadini, Cristina Lorenzi, Cristina Colombo, Raffaella Zanardi, Alessandro Serretti, Francesco Benedetti, Sara Poletti","doi":"10.1111/pcn.70037","DOIUrl":"10.1111/pcn.70037","url":null,"abstract":"<p><strong>Aim: </strong>Bipolar disorder (BD) and schizophrenia (SCZ) share many clinical and neurobiological features, and a continuum between the two has been postulated. Bipolar patients leaning toward the SCZ pole of the continuum may have a higher risk of neuroprogression. Here we investigated the relationships between illness course, white matter integrity, levels of N-acetylaspartate (NAA), and polygenic score (PRS) of SCZ.</p><p><strong>Methods: </strong>A sample of 103 depressed bipolar inpatients underwent magnetic resonance imaging (MRI) acquisition to perform diffusion tensor imaging (DTI) analysis and magnetic resonance spectroscopy to assess NAA. Genotyping and PRS calculation were also performed in a subsample of 75 patients. Associations between illness course, NAA, and white matter microstructure were explored; indirect effects were investigated through mediation models; further, a possible moderating effect of SCZ-PRS was tested.</p><p><strong>Results: </strong>Negative associations emerged between number of affective episodes and NAA. Manic episodes were also negatively associated with white matter integrity, and NAA significantly mediated the effect of manic episodes on DTI metrics. SCZ-PRS moderated the relation between illness duration and NAA. Moderated mediation analyses showed that only at high SCZ-PRS, illness duration negatively affected NAA, which in turn was linked to reduced fractional anisotropy.</p><p><strong>Conclusion: </strong>Our results support the concept of neuroprogression in BD, suggesting a deleterious effect of acute episodes, particularly manic ones, on neurochemical and white matter alterations. Further, patients with a higher SCZ-PRS seem to show detrimental effects related to illness duration, possibly suggesting a longitudinal course closer to SCZ.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":"381-389"},"PeriodicalIF":6.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143275","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}

{"title":"The use of virtual reality in forensic-correctional psychiatric settings: A systematic review.","authors":"Michael Y Wang, Eric Yu, Rida Tauqir, Maya Mckeown, Shahnawaz Towheed, Mark M Kaggwa, John M Bradford, Gary A Chaimowitz, Andrew T Olagunju","doi":"10.1111/pcn.70068","DOIUrl":"https://doi.org/10.1111/pcn.70068","url":null,"abstract":"<p><p>Virtual reality (VR) is increasingly being used as an innovative technology for assessment, treatment, and training within psychiatric settings. However, little work has been done to synthesize existing literature on the use and benefits of VR in forensic-correctional settings. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Protocol is available at Open Science Framework (https://osf.io/3m6p2). A total of 1317 articles were screened, and 32 reports were included in the final review. VR interventions were identified as effective in forensic-correctional settings for assessment of patients with pedophilic disorders, reducing aggression and stress, increasing empathy in intimate partner violence (IPV) offenders, enhancing community reintegration through education and vocational readiness, and improving patient engagement. Furthermore, VR allows innovative incorporation of biophysiological measures to support objective and quantifiable measures of risk within forensic-correctional populations. Barriers to VR use and implementation included cybersickness in users, the knowledge and technical burden to utilize interventions, and the demand for resources. The quality of the included studies was assessed as predominantly moderate. Overall, the findings in this review highlight the promising benefits of VR as an innovative tool for assessments and care in forensic-correctional settings. There is need for stakeholders' support, standardization of VR uses, and promotion of evidence-based guidelines for successful implementation and effective integration into care. As the integration of technologies into healthcare continues to advance, VR has the capacity to reshape mental health care within forensic-correctional settings and future research is needed to guide effective use.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779635","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}

{"title":"Acute prefrontal hemodynamic responses to intermittent theta burst stimulation correlate with current depression and episode recurrence: A cross-sectional study.","authors":"Minxia Jin, Adam W L Xia, Wanda M W Chau, Nancy M X Y Shi, Penny P Qin, Bella B B Zhang, Rebecca L D Kan, Alvin H P Tang, Tim T Z Lin, Sharie X Wang, Dicky W S Chung, Frank Padberg, Georg S Kranz","doi":"10.1111/pcn.70066","DOIUrl":"https://doi.org/10.1111/pcn.70066","url":null,"abstract":"<p><strong>Background: </strong>Mounting evidence has indicated that multiple major depressive disorder (MDD) episodes are correlated with brain morphometric changes that confer an increased recurrence risk. Functional abnormalities underlying this recurrent vulnerability remain underexplored. Acute neuroplastic responses to repetitive transcranial magnetic stimulation hold promise to identify such functional alterations.</p><p><strong>Methods: </strong>This study involved 121 adults, including 39 individuals with current MDD, 41 individuals with MDD in remission, and 41 healthy controls. Cross-sectional changes in hemodynamic responses and functional connectivity induced by a single session of intermittent theta burst stimulation over the left dorsolateral prefrontal cortex (dlPFC) were measured using simultaneous functional near-infrared spectroscopy and analyzed with linear mixed models. Hierarchical regression examined the relationships between the number of prior depressive episodes and observed functional changes in patient cohorts.</p><p><strong>Results: </strong>Stimulation instantly elevated deoxyhemoglobin levels in the stimulated dlPFC across all participants, with greater increases in patient cohorts versus controls, demonstrating a persistent disease effect regardless of prior episodes or remitted state. Poststimulation increases in oxyhemoglobin concentration were current depression-dependent and associated with multiple episodes in remitted patients. Prefrontal networks were characterized by a transient reduction in global node degree during stimulation in all groups.</p><p><strong>Conclusions: </strong>Our findings align with clinical and preclinical evidence linking disrupted neurovascular function in the prefrontal cortex to depression pathophysiology. Poststimulation responses in the stimulated dlPFC, reflecting the current state and multiple prior episodes, show potential for aiding in differential diagnosis and indicating depression vulnerability. Longitudinal studies are needed to determine whether such neurological dysfunctions represent disease progression or a vulnerability biomarker.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691856","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}

{"title":"Integrated transcriptomic and clinical analysis of autism spectrum disorder reveals structured heterogeneity and links Methyl-CpG Binding Domain Protein 2 expression with symptom severity.","authors":"Wasana Yuwattana, Chayanit Poolcharoen, Thanit Saeliw, Marlieke Lisanne van Erp, Songphon Kanlayaprasit, Natchaya Vanwong, Valerie W Hu, Pon Trairatvorakul, Weerasak Chonchaiya, Kim-Anh Lê Cao, Tewarit Sarachana","doi":"10.1111/pcn.70065","DOIUrl":"https://doi.org/10.1111/pcn.70065","url":null,"abstract":"<p><strong>Aim: </strong>Autism spectrum disorder (ASD) remains underexplored in Southeast Asia, with limited characterization of its molecular underpinnings and clinical heterogeneity. This study investigated transcriptomic variation and its relationship to clinical diversity in Thai children with ASD using integrated molecular and phenotypic analyses.</p><p><strong>Method: </strong>Peripheral blood transcriptomic profiling was performed in 150 ASD and 70 typically developing (TD) children to identify differentially expressed transcripts (DETs), followed by pathway enrichment, unsupervised molecular clustering, and integrative multiomics modeling. Clinical data from 200 ASD and 110 TD participants were analyzed in parallel to evaluate screening performance and derive phenotype-based subgroups.</p><p><strong>Results: </strong>Differential expression analysis identified 1,407 DETs with significant enrichment of autism-associated genes. Pathway analysis consistently implicated dysregulation of protein-synthesis machinery. Unsupervised transcriptome-based clustering revealed three molecular subgroups characterized by translational, innate-immune, and interferon-associated signatures, which did not directly correspond to clinical severity, age, or cognitive level, indicating structured biological heterogeneity beyond symptom-based classification. Integration of transcriptomic and phenotypic data demonstrated moderate cross-domain correspondence. Among recurrent molecular signals, MBD2 showed consistent upregulation across subgroups and strong associations with social-interaction measures (r = 0.74). In parallel, clinical machine-learning models showed high within-cohort screening performance, while a refined 17-transcript panel achieved robust discriminative accuracy, supporting the complementary role of molecular features in ASD stratification.</p><p><strong>Conclusion: </strong>Transcriptomic stratification reveals biologically structured heterogeneity in ASD that is only partially reflected in clinical presentation, supporting a multilayered framework integrating molecular and phenotypic dimensions.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147676406","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}

{"title":"Time-dependent risk of falls associated with hypnotic use in hospitalized patients.","authors":"Kazuhiro Shishida, Yutaro Shimomura, Masayuki Murayama, Kimio Yoshimura, Hiroyuki Uchida, Masaru Mimura, Hiroyoshi Takeuchi","doi":"10.1111/pcn.70057","DOIUrl":"https://doi.org/10.1111/pcn.70057","url":null,"abstract":"<p><strong>Aim: </strong>Falls are a common and serious problem among hospitalized patients. While hypnotics are a known risk factor, it remains unclear whether fall risk varies by time of day. This study examined the time-dependent risk of falls associated with different classes of hypnotics.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of patients aged ≥20 years who had their first admission to our hospital and were discharged between April 2016 and March 2018. Time-to-fall was analyzed using stepwise Cox proportional hazards models across four time periods (0:00-5:59, 6:00-11:59, 12:00-17:59, 18:00-23:59). Covariates included hypnotic use (Z-drugs, short-acting benzodiazepines, long-acting benzodiazepines, ramelteon, suvorexant, trazodone), age, sex, body mass index (BMI), length of stay, activities of daily living score, emergency admission, and surgery.</p><p><strong>Results: </strong>Among the 22,458 patients included in the study, 268 falls occurred, with 73, 65, 56, and 74 in each time period, respectively. Association between hypnotic use and fall risk varied by time. Z-drugs were associated with falls during 18:00-23:59 (adjusted hazard ratio [aHR] 2.65, 95% confidence interval [CI] 1.29-5.45). Short-acting benzodiazepines were associated with falls during 00:00-05:59 (aHR 2.06, 95% CI 1.07-3.97). Long-acting benzodiazepines were associated with falls during 06:00-11:59 (aHR 3.37, 95% CI 1.20-9.26). No significant associations were observed for ramelteon, suvorexant, or trazodone.</p><p><strong>Conclusions: </strong>Fall risk associated with hypnotic use is not uniform throughout the day. Short-acting benzodiazepines were linked to evening and nighttime falls, while long-acting benzodiazepines increased morning fall risk. These findings highlighted the need to consider time-specific fall risks when prescribing hypnotics.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633875","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}

{"title":"Adverse outcomes between VMAT2 and anticholinergics in tardive dyskinesia: A target trial emulation.","authors":"Tien-Wei Hsu, Chih-Wei Hsu, Ping-Tao Tseng, Yi-Ya Fang, Chuo-Yu Lee, Yu-Hsuan Lin, Brendon Stubbs, Trevor Thompson, Andre F Carvalho, Yu-Chen Kao, Jen-Ping Chen, Fu-Chi Yang, Chia-Kuang Tsai, Chih-Sung Liang","doi":"10.1111/pcn.70056","DOIUrl":"https://doi.org/10.1111/pcn.70056","url":null,"abstract":"<p><strong>Aim: </strong>Vesicular monoamine transporter 2 (VMAT2) inhibitors have been approved for the treatment of tardive dyskinesia (TD), whereas anticholinergic agents are still widely used for this condition. This study aimed to compare the risk of major clinical adverse outcomes among patients with TD treated with VMAT2 inhibitors versus anticholinergic agents.</p><p><strong>Methods: </strong>This retrospective cohort study used the TriNetX collaborative network, which aggregates de-identified electronic health records (EHRs) across the United States. Adults aged≧18 years with TD who initiated anticholinergic agents or VMAT2 inhibitors for the first time between 2019 and 2025 were included. We applied a target trial emulation framework under the intention-to-treat principle. 1:1 propensity score matching was applied. Cox hazard regression was used to assess the primary outcomes: incident fall, injury, fracture, and mortality, and secondary outcomes: incident delirium, dementia, and arrythmia.</p><p><strong>Results: </strong>After propensity score matching, 2749 patients (mean age: 59 years; 34% male) were included in each treatment group with well-balanced demographics. Compared with anticholinergic therapy, VMAT2 inhibitors were associated with significantly lower risks of fall (HR = 0.83, 95% CI = 0.73-0.93), injury (HR = 0.77, 95% CI = 0.71-0.85), fracture (HR = 0.82, 95 % CI = 0.72-0.94), and mortality (HR = 0.71, 95% CI = 0.58-0.87). Secondary outcomes also favored VMAT2 inhibitors, with reduced risks of delirium (HR = 0.39, 95% CI = 0.29-0.52), dementia (HR = 0.55, 95 % CI = 0.45-0.69), and arrhythmia (HR = 0.72, 95% CI = 0.60-0.85).</p><p><strong>Conclusion: </strong>This real-world study suggests that VMAT2 inhibitors may offer a safer therapeutic option than anticholinergic agents for TD management, supporting their potential clinical advantage and the need for further long-term validation.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633891","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}

{"title":"Predictive neuroimaging biomarkers of major depressive disorder treatment response: An umbrella review.","authors":"Yasmin Esmaeilian, Ahmadreza Samimi, Sajjad Mousavi, Iman Kiani, Giulia Cattarinussi, Hossein Sanjari Moghaddam","doi":"10.1111/pcn.70053","DOIUrl":"https://doi.org/10.1111/pcn.70053","url":null,"abstract":"<p><p>Major depressive disorder (MDD) is a heterogeneous condition with varied responses to pharmacological, psychotherapeutic, and neuromodulation interventions. Identifying neuroimaging biomarkers predictive of treatment response could facilitate personalized treatment selection. This umbrella review synthesized findings from systematic reviews and meta-analyses evaluating neuroimaging biomarkers predictive of treatment response in MDD. A comprehensive search was conducted across PubMed, Scopus, Web of Science, and Embase. Fourteen systematic reviews and meta-analyses, encompassing 17,855 individuals with MDD, were included. Imaging modalities assessed included structural MRI, functional MRI (resting-state and task-based), diffusion tensor imaging, PET, MEG, and fNIRS. Methodological quality was evaluated using the Measurement Tool to Assess Systematic Reviews (AMSTAR 2 tool). The most consistently predictive biomarkers were increased volume and activity in the anterior cingulate cortex (ACC) and hippocampus and altered functional connectivity in the default mode network (DMN) and fronto-limbic circuits. Predictive patterns varied by treatment modality: for example, larger hippocampal volume predicted pharmacotherapy response, while smaller hippocampal volume was associated with better outcomes in ECT. Machine learning models integrating multimodal data achieved high predictive accuracy (AUC >0.85), though most lacked external validation. Evidence quality was low to very low among the included studies due to methodological heterogeneity. Neuroimaging biomarkers, particularly involving ACC, hippocampus, and large-scale functional networks, hold promise for guiding treatment selection in MDD. Integration of multimodal imaging and computational approaches may enhance predictive accuracy. However, standardization and prospective validation in clinical settings are needed for translation into practice.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623519","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}