Psychiatry and Clinical Neurosciences最新文献

{"title":"Chain of Risks Evaluation (CORE): A framework for safer large language models in public mental health.","authors":"Lingyu Li, Shuqi Kong, Haiquan Zhao, Chunbo Li, Yan Teng, Yingchun Wang","doi":"10.1111/pcn.13781","DOIUrl":"10.1111/pcn.13781","url":null,"abstract":"<p><p>Large language models (LLMs) have gained significant attention for their capabilities in natural language understanding and generation. However, their widespread adoption potentially raises public mental health concerns, including issues related to inequity, stigma, dependence, medical risks, and security threats. This review aims to offer a perspective within the actor-network framework, exploring the technical architectures, linguistic dynamics, and psychological effects underlying human-LLMs interactions. Based on this theoretical foundation, we propose four categories of risks, presenting increasing challenges in identification and mitigation: universal, context-specific, user-specific, and user-context-specific risks. Correspondingly, we introduce CORE: Chain of Risk Evaluation, a structured conceptual framework for assessing and mitigating the risks associated with LLMs in public mental health contexts. Our approach suggests viewing the development of responsible LLMs as a continuum from technical to public efforts. We summarize technical approaches and potential contributions from mental health practitioners that could help evaluate and regulate risks in human-LLMs interactions. We propose that mental health practitioners could play a crucial role in this emerging field by collaborating with LLMs developers, conducting empirical studies to better understand the psychological impacts on human-LLMs interactions, developing guidelines for LLMs use in mental health contexts, and engaging in public education.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":"299-305"},"PeriodicalIF":5.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034098","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":"Medication equivalent dose program in R.","authors":"Shinsuke Koike, Yoji Hirano, Shinichiro Nakajima, Kentaro Morita","doi":"10.1111/pcn.13817","DOIUrl":"10.1111/pcn.13817","url":null,"abstract":"","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":"356-357"},"PeriodicalIF":5.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753361","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":"Sodium benzoate, a D-amino acid oxidase inhibitor, improved short-term memory in patients with mild cognitive impairment in a randomized, double-blind, placebo-controlled clinical trial.","authors":"Chieh-Hsin Lin, Shi-Heng Wang, Hsien-Yuan Lane","doi":"10.1111/pcn.13841","DOIUrl":"https://doi.org/10.1111/pcn.13841","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have found that sodium benzoate (the pivotal D-amino acid oxidase [DAO] inhibitor) improved cognitive function in patients with mild Alzheimer disease; however, its efficacy for mild cognitive impairment (MCI) (especially its core feature, impaired short-term memory) remains uncertain. The aim of this study was to evaluate the efficacy and safety of sodium benzoate in treating amnestic MCI (aMCI).</p><p><strong>Methods: </strong>This study was a randomized, double-blind, placebo-controlled clinical trial conducted in a major medical center in Taiwan. Eighty-two patients with aMCI were recruited for 24-week treatment of 250 to 1500 mg/day of sodium benzoate or placebo. Overall, cognitive function was measured by Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-cog), and short-term memory was evaluated by the 'recall of test instructions' item in the ADAS-cog. The generalized estimating equation was applied to compare the two groups in efficacy.</p><p><strong>Results: </strong>Compared with placebo, sodium benzoate therapy, displayed a trend, albeit statistically insignificant, in improving overall cognitive function (P = 0.082), and significantly improved short-term memory (P = 0.044). Both benzoate and placebo were well tolerated and benzoate therapy produced no additional side effect.</p><p><strong>Conclusions: </strong>With the moderate sample size of the current study, treatment using sodium benzoate, a DAO inhibitor, showed promise in improving cognition, especially short-term memory, in patients with aMCI. Of note, while the ADAS-cog total score has been regarded as insensitive in measuring aMCI, its 'recall of test instructions' item may be a more sensitive and clinically feasible tool. Further larger studies are warranted to confirm the preliminary finding.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier. NCT04736355.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128504","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":"Effect of lisdexamfetamine on difficulty waking.","authors":"Hiroyuki Sasaki, Shuken Boku, Minoru Takebayashi","doi":"10.1111/pcn.13840","DOIUrl":"https://doi.org/10.1111/pcn.13840","url":null,"abstract":"","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111847","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":"Hikikomori Diagnostic Evaluation-Screening Form (HiDE-S): A validation study.","authors":"Salvatore Reina, Taisei Kubo, Laura Orsolini, Toshio Matsushima, Sota Kyuragi, Keitaro Matsuo, Tomohiro Nakao, Umberto Volpe, Takahiro A Kato","doi":"10.1111/pcn.13837","DOIUrl":"https://doi.org/10.1111/pcn.13837","url":null,"abstract":"","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014690","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":"Association of objective body shape and perceived body image with depressive symptoms in men and women.","authors":"Seong-Uk Baek, Jin-Ha Yoon","doi":"10.1111/pcn.13836","DOIUrl":"https://doi.org/10.1111/pcn.13836","url":null,"abstract":"<p><strong>Aims: </strong>Mental health issues related to negative body image are growing concerns. We explored the association between objectively and subjectively measured body shape and depressive symptoms.</p><p><strong>Method: </strong>A nationwide sample of 26,204 Korean adults was analyzed. Objective body shape was measured using the A Body Shape Index (ABSI), where a higher score indicates greater central obesity. ABSI scores were categorized into three groups: low, medium, and high. Perceived body image was classified into five categories: (i) very thin, (ii) slightly thin, (iii) normal, (iv) slightly fat, and (v) very fat. Depressive symptoms were assessed using the Patient Health Questionnaire-9. Logistic regressions were employed to calculate odds ratios (ORs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>An increase in ABSI score was positively associated with depressive symptoms in men (OR = 1.27; 95% CI = 1.09-1.49) but not in women. Among men, those who perceived their body shape as very thin or very fat had 2.62-fold (95% CI = 1.70-4.05) and 2.34-fold (95% CI = 1.57-3.47) higher odds of having depressive symptoms, respectively, compared with those who perceived their body shape as normal. Among women, those who perceived their body shape as very thin or very fat had 2.73-fold (95% CI = 1.92-3.86) and 2.48-fold (95% CI = 1.97-3.14) increased odds of having depressive symptoms, respectively. The association between perceived body image and depressive symptoms manifested differently depending on ABSI group and gender.</p><p><strong>Conclusion: </strong>Negative body image was associated with depressive symptoms, and this relation was differently observed across genders and different categories of actual body shape.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008912","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":"Comment on: Is clozapine use a risk of hematological malignancies? Insights from a meta-analysis \"Clozapine and Malignancy Risk\".","authors":"Kazuki Nishida, Basile Chrétien","doi":"10.1111/pcn.13839","DOIUrl":"https://doi.org/10.1111/pcn.13839","url":null,"abstract":"","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045154","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":"Efficacy and safety of SDT-001, a dual-task digital device, in managing attention-deficit/hyperactivity disorder symptoms in children and adolescents: a phase 3, randomized, standard treatment-controlled study.","authors":"Katsunaka Mikami, Tasuku Miyajima, Ryo Nishino, Naohiro Kawazoe, Yousuke Kinoshita, Takashi Okada, Hiroki Fukuju","doi":"10.1111/pcn.13833","DOIUrl":"https://doi.org/10.1111/pcn.13833","url":null,"abstract":"<p><strong>Aim: </strong>This phase 3, multicenter, open-label study aimed to evaluate the efficacy and safety of SDT-001, a dual-task digital device, compared to standard treatment (environmental and/or psychosocial treatment: treatment as usual; TAU) in the comparison part and to evaluate the safety, tolerability, and long-term efficacy of SDT-001 in the repetition part in Japanese children and adolescents with attention-deficit/hyperactivity disorder (ADHD).</p><p><strong>Methods: </strong>In the comparison part, participants on standard treatment were randomized (2:1) to SDT-001 (n = 109; 25 min/day for 6 weeks, with a 4-week follow-up) or TAU (n = 55) groups. Participants (n = 126) from the comparison part transitioned to a single-arm repetition part with SDT-001 (6 weeks and followed for 12 weeks). Primary endpoint in the comparison part was changed from baseline to 6 weeks in ADHD rating scale IV (ADHD-RS-IV) inattention scores.</p><p><strong>Results: </strong>In the comparison part, SDT-001 demonstrated superiority to TAU, with significantly greater improvements from baseline to week 6 in ADHD-RS-IV inattention (adjusted mean difference [95% confidence interval], -2.97 [-4.38, -1.56]; P < 0.0001), total (-4.56 [-6.75, -2.38]; P < 0.0001), and hyperactivity-impulsivity (-1.55 [-2.64, -0.46]; P = 0.0056) scores. Additionally, other secondary endpoints showed improvements in symptoms in the SDT-001 group. In the repetition part, SDT-001 showed sustained reductions in ADHD-RS-IV scores till 12 weeks after completion of the 6-week treatment. No new severe adverse events or safety concerns were reported.</p><p><strong>Conclusion: </strong>SDT-001 demonstrated superior efficacy at week 6 in ADHD-RS-IV compared to TAU, and reductions in scores were maintained up to the following 12 weeks, indicating its potential as a novel digital therapeutic option for ADHD management.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041893","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":"Predicting social anxiety disorder based on communication logs and social network data from a massively multiplayer online game: Using a graph neural network.","authors":"Kenji Yokotani, Masanori Takano, Nobuhito Abe, Takahiro A Kato","doi":"10.1111/pcn.13804","DOIUrl":"10.1111/pcn.13804","url":null,"abstract":"<p><strong>Aim: </strong>Social anxiety disorder (SAD) is a mental disorder that requires early detection and treatment. However, some individuals with SAD avoid face-to-face evaluations, which leads to delayed detection. We aim to predict individuals with SAD based on their communication logs and social network data from a massively multiplayer online game (MMOG).</p><p><strong>Method: </strong>The study included 819 users of Pigg Party, a popular MMOG in Japan. Participants completed the Japanese version of the Liebowitz Social Anxiety Scale (LSAS-J) and a social withdrawal scale (hikikomori) questionnaire. Participants scoring ≥60 on the LSAS-J were classified as having SAD, while those scoring <60 were classified as not having SAD (non-SAD). A total of 142,147 users' communication logs and 613,618 social edges from Pigg Party were used as input to predict whether participants had SAD or non-SAD. Graph sample and aggregated embeddings (Graph SAGE) was utilized as a graph neural network model.</p><p><strong>Results: </strong>Individuals with SAD were more likely to be socially withdrawn in the physical community (hikikomori), had fewer friends, spent less time in other users' virtual houses, and showed lower entropy in their visitation times in MMOG. Based on their social network data, the Graph SAGE model predicted SAD, with an F1 score of 0.717.</p><p><strong>Conclusion: </strong>The communication logs and social network data in an MMOG include indicators of interpersonal avoidance behaviors, which is typical of individuals with SAD; this suggests their potential use as digital biomarkers for the early detection of SAD.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":"274-281"},"PeriodicalIF":5.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12047062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143503844","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":"Brain iron load and neuroaxonal vulnerability in adult attention-deficit hyperactivity disorder.","authors":"Jatta Berberat, Sonja M Kagerer, Claudia Späni, Jun Hua, Francesco Bavato, Philipp Gruber, Peter Cm van Zijl, Nader Perroud, Xu Li, Philipp Stämpfli, Erich Seifritz, Karl-Olof Lövblad, Boris B Quednow, Paul G Unschuld","doi":"10.1111/pcn.13806","DOIUrl":"10.1111/pcn.13806","url":null,"abstract":"<p><strong>Aim: </strong>Adult attention deficit hyperactivity disorder (ADHD) may be associated with an increased risk of dementia in old age. Here, we investigated the liability for neurodegenerative brain disease in adult ADHD, possibly reflected by increased brain iron content and associated neuroaxonal vulnerability.</p><p><strong>Methods: </strong>Thirty-two adults with ADHD (35 ± 10 years) and 29 age- and sex-matched controls (32 ± 12 years) underwent magnetic resonance imaging (MRI), standardized psychometric testing and assessment of lifestyle factors. Quantitative susceptibility mapping (QSM) was used to assess magnetic abnormalities indicating local alterations of iron deposition in the brain. By calculating QSM-maps, local iron deposition was tested for statistically significant differences between ADHD and healthy controls. Plasma neurofilament light chain (NfL) levels were measured as an indicator of neuroaxonal integrity by using a fourth-generation ELLA immunoassay.</p><p><strong>Results: </strong>Brain iron content differed in persons with ADHD, with strongest effects observable in the right precentral cortex (healthy controls: 0.0033 ± 0.0017ppm; ADHD: 0.0048 ± 0.0016ppm; t(59) = 3.56, P < 0.001). Moreover, right precentral cortex iron in persons with ADHD was associated with increased blood NfL levels (F(1.57) = 13.2, P = 0.001, r² = 0.19).</p><p><strong>Conclusion: </strong>Our results indicate altered regional iron content in the brains of adults with ADHD. The observed association between increased precentral magnetic susceptibility and increased NfL suggests a connection between local excess of brain iron and neuroaxonal damage in ADHD. Given the limited sample size of the current study and the naturalistic medication plan, further longitudinal studies are needed to establish whether altered brain iron distribution in adults with ADHD may be associated with an increased risk of dementia at old age.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":"282-289"},"PeriodicalIF":5.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12047069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516539","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}