Psychiatry and Clinical Neurosciences最新文献

{"title":"Exploring the neuropathological basis of lateral ventricular enlargement in elderly patients with schizophrenia.","authors":"Youta Torii, Hirotaka Sekiguchi, Chikako Habuchi, Ayako Miwa, Shusei Arafuka, Kazuhiro Takeda, Hiroshige Fujishiro, Mari Yoshida, Yasushi Iwasaki, Shuji Iritani, Masashi Ikeda","doi":"10.1111/pcn.70079","DOIUrl":"10.1111/pcn.70079","url":null,"abstract":"<p><strong>Aim: </strong>Lateral ventricular enlargement is a robust morphological finding in schizophrenia. However, its characteristics and neuropathological basis in elderly patients remain poorly understood. We aimed to clarify the impact of neuropathologically confirmed neurodegenerative pathologies on lateral ventricular size in elderly patients with schizophrenia and explore other clinical factors potentially influencing ventricular morphology.</p><p><strong>Methods: </strong>We examined 31 postmortem brains from patients with schizophrenia with an onset age of <40 years. The ventricular-brain ratio (VBR) was measured using computed tomography within 3 years before death. Neuropathological evaluations of various neurodegenerative pathologies were performed according to the current diagnostic criteria, and the relationship between these pathologies, clinical factors, and VBR was examined.</p><p><strong>Results: </strong>Although Alzheimer's disease (AD) pathology increased with age, VBR did not differ significantly according to the severity of AD pathology in elderly patients with schizophrenia. Meanwhile, patients with aging-related tau astrogliopathy (ARTAG) in the medial temporal lobe exhibited a significantly higher VBR than those without. In elderly schizophrenia patients without neurodegenerative diseases, VBR was significantly correlated with illness duration but not with age at computed tomography scanning.</p><p><strong>Conclusion: </strong>Lateral ventricular enlargement may occur in elderly patients with schizophrenia regardless of conventional neurodegenerative pathologies, such as AD pathology. This enlargement may be related not only to ARTAG but also to illness duration, suggesting a progressive process intrinsic to schizophrenia. This finding warrants further studies with a detailed histological assessment beyond conventional neurodegenerative pathologies to clarify the basis of ventricular enlargement in schizophrenia.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":"682-693"},"PeriodicalIF":5.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13447128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148056417","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":"Network-level disconnectivity tracks poststroke depressive symptom improvement.","authors":"Aleksi J Sihvonen, Sonia L E Brownsett, David A Copland, Alistair Walsh, Stephen M Davis, Geoffrey A Donnan, Leeanne M Carey","doi":"10.1111/pcn.70075","DOIUrl":"10.1111/pcn.70075","url":null,"abstract":"<p><strong>Aims: </strong>Poststroke depression is the most common psychological condition following a stroke and can severely impact outcome. However, the neurobiological biomarkers associated with recovery of poststroke depression remain unclear. In this longitudinal observational study, we set out to investigate the effect of lesion-induced focal damage and network-level disconnectivity, and longitudinal structural connectivity on poststroke depression and its recovery.</p><p><strong>Methods: </strong>Sixty-two participants underwent a psychological assessment utilizing the Montgomery-Asberg Depression Rating Scale (MADRS-SIGMA) at 3 and 12 months post first-ever stroke. First, we evaluated the relationship between lesions and MADRS scores at the 3 months using voxel-based lesion-symptom mapping and lesion network mapping. Next, we assessed the longitudinal relationship between structural connectivity and MADRS scores (change from 3 to 12 months) using multi-shell diffusion-weighted MRI data (n = 29) collected at both timepoints.</p><p><strong>Results: </strong>Patient lesions mapped to a connected brain network centered on the left dorsolateral prefrontal cortex (P_FDR <0.05). Longitudinal diffusion MRI analysis revealed that increased quantitative anisotropy in the identified structural network was associated with improved depressive symptoms longitudinally (P = 0.014), independent of demographic and clinical covariates. Significant associations between the lesions and focal brain structures were not identified.</p><p><strong>Conclusions: </strong>Depressive symptoms and their improvement mapped to a specific structural brain network. Knowledge of the integrity of this network could prove useful for predicting poststroke depression.</p><p><strong>Clinical trial registration: </strong>START-PrePARE Australian New Zealand Clinical Trials, www.anzctr.org.au, Registry number: ACTRN12610000987066. EXTEND ClinicalTrial.gov identifier: NCT00887328.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":"676-681"},"PeriodicalIF":5.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13447115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147942902","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":"Hypnotic discontinuation is not synonymous with successful deprescribing: A Taiwan perspective.","authors":"Lien-Chung Wei, Ding-Lieh Liao","doi":"10.1111/pcn.70110","DOIUrl":"https://doi.org/10.1111/pcn.70110","url":null,"abstract":"<p><p>This article relates to Higher discontinuation with dual orexin receptor antagonists than with benzodiazepines: A Japanese claims cohort study.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592892","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":"Circular inference in visual cortical hierarchies in schizophrenia.","authors":"Shuhei Hara, Keita Suzuki, Akio Murakami, Kei Majima, Mohamed Abdelhack, Fan L Cheng, Kenji Doya, Hidehiko Takahashi","doi":"10.1111/pcn.70104","DOIUrl":"https://doi.org/10.1111/pcn.70104","url":null,"abstract":"<p><strong>Aim: </strong>In schizophrenia, disrupted perceptual processes contribute to positive symptoms. However, it remains unclear how top-down priors and bottom-up likelihoods are represented across the hierarchy of visual cortices. To identify these processes within cortical hierarchies, the circular inference model offers a framework to account for the biased integration of priors and likelihoods that may underlie hallucinations and delusions.</p><p><strong>Methods: </strong>Twenty-one participants, including 10 schizophrenia patients and 11 healthy controls, conducted a perceptual decision-making task while undergoing functional MRI (fMRI) scanning. Participants first received probabilistic hints about forthcoming objects, then viewed a blurred image, and finally answered the object identity and confidence using a slider. Subjects' performances were analyzed based on Bayesian perception models, and the variables representing top-down prior and bottom-up likelihood were used for fMRI data analysis.</p><p><strong>Results: </strong>Region of interest analysis revealed significantly enhanced top-down-related activity throughout the visual cortex in schizophrenia, compared with healthy controls (F(1,133) = 8.82, p = 0.003, <math> <semantics> <mrow><msup><mi>η</mi> <mn>2</mn></msup> </mrow> <annotation>$$ {eta}^2 $$</annotation></semantics> </math>  = 0.059). In addition, exploratory ROI analyses found increased bottom-up-related activity in the early visual areas in individuals with higher delusion scores (V1: r = 0.41, p = 0.059, V2: r = 0.47, p = 0.030).</p><p><strong>Conclusions: </strong>Using model-based fMRI analysis, these findings provide evidence for enhanced top-down activity across the visual hierarchy in schizophrenia. Exploratory analyses also suggested a potential association between bottom-up hypersensitivity and delusional ideation; however, this association did not survive multiple-comparison correction. Our results are consistent with altered circular information flow in the visual cortex and highlight the value of model-based neuroimaging for uncovering latent abnormalities in perceptual processing.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449106","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":"Interpreting particulate matter-depression trajectory findings: Baseline adjustment, mixtures, and mediation.","authors":"Yi-Fang Kuo, Lien-Chung Wei","doi":"10.1111/pcn.70105","DOIUrl":"https://doi.org/10.1111/pcn.70105","url":null,"abstract":"<p><p>This article relates to Interpreting particulate matter-depression trajectory findings: Baseline adjustment, mixtures, and mediation.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431094","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":"Model choice in meta-analysis should not be driven by Cochran's Q test.","authors":"Yuki Matsuda, Yuta Suzuki, Aran Tajika, Taro Kishi","doi":"10.1111/pcn.70103","DOIUrl":"https://doi.org/10.1111/pcn.70103","url":null,"abstract":"<p><p>This article relates to Model choice in meta-analysis should not be driven by Cochran's Q test.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412740","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":"Effects of particulate matter exposures on depressive symptom trajectories: Evidence from a national longitudinal survey in China.","authors":"Hengchang Wang, Yiling Lou, Yulin Xie, Yan Guo, Linlin Wang, Chiyu Chen, Furong Wang, Qingqing Jiang, Shiyi Cao","doi":"10.1111/pcn.70058","DOIUrl":"10.1111/pcn.70058","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to assess the associations between particulate matter (PM) exposures and depressive symptom trajectories, as well as the potential contributing role of loneliness in these associations.</p><p><strong>Methods: </strong>The analysis included 11,758 participants (≥45 years), with depressive symptoms and covariate data from the China Health and Retirement Longitudinal Study (2011-2020) and PM data from the ChinaHighAirPollutants dataset. Depressive symptom trajectories were identified using group-based trajectory modeling. Individual and combined effects of PM on depressive symptom trajectories were assessed using multivariable logistic regression and weighted quantile sum (WQS) regression, with results reported as odds ratio (OR) and 95% confidence interval (CI). A serial multiple mediator model was used to evaluate the contributing role of loneliness.</p><p><strong>Results: </strong>Five depressive symptom trajectories were identified: stable-low, stable-moderate, stable-high, decreasing, and increasing. PM exposures were positively associated with more severe depressive symptom trajectory groups (stable-high [PM₁₀: OR = 1.10, 95% CI 1.04-1.16; WQS: OR = 1.41, 95% CI 1.09-1.82] and increasing [PM_1.0: OR = 1.44, 95% CI 1.06-1.98; PM_2.5: OR = 1.10, 95% CI 1.02-1.19; PM₁₀: OR = 1.10, 95% CI 1.06-1.13; WQS: OR = 1.21, 95% CI 1.01-1.45]) compared to the stable-low symptoms trajectory. Loneliness contributed to 26.73%-29.73% of the associations between PM exposure and depressive symptom trajectories.</p><p><strong>Conclusion: </strong>Exposures to individual and mixed PM pollutants increase the risk of severe depressive symptom trajectory groups, and reducing loneliness alleviates these effects. The findings underscore the need for further coordinated control of PM pollutants and alleviating loneliness to prevent depressive symptoms.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":"585-594"},"PeriodicalIF":5.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147609341","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":"Immune dysregulation in mania: A proof-of-concept platelet proteomics study.","authors":"Paola Magioncalda, Matteo Martino, Nhi Thao Ngoc Le, Wen-Yin Chen, Ming-Chyi Huang, David Blum, Thierry Burnouf","doi":"10.1111/pcn.70055","DOIUrl":"10.1111/pcn.70055","url":null,"abstract":"<p><strong>Aims: </strong>Bipolar disorder (BD) is a major psychiatric condition with a multifaceted and largely unknown pathophysiology. Mania, the defining feature of BD, remains underinvestigated. Proteomics offers a powerful, data-driven, unbiased approach to uncover biological alterations. Blood platelets provide a stable and comprehensive reflection of the body's internal milieu. This proof-of-concept study explores platelet proteomic alterations in mania.</p><p><strong>Methods: </strong>High-resolution proteomic profiling was performed on platelet samples from hospitalized patients with severe mania (n = 11) and 1:1 age- and sex-matched healthy controls (n = 11) using liquid chromatography-tandem mass spectrometry. Platelet proteins were quantified, differentially expressed proteins identified, and functional enrichment analyses conducted to characterize associated biological pathways. Key proteomic predictions were validated by enzyme-linked immunosorbent assay (ELISA) in platelet and plasma samples.</p><p><strong>Results: </strong>Proteomic analysis revealed that mania is associated with proteins primarily enriched in immune activation while lacking those enriched in cell homeostasis. Among shared proteins, mania exhibited a prominent cluster of downregulated proteins, primarily converging on immune-related pathways. The most robust alteration involved deficits in MHC Class I-mediated antigen processing. Key immune regulatory hubs - transforming growth factor (TGF)-β and interleukin-4 (IL-4) - were identified, with the association of increased TGF-β levels with mania validated by ELISA.</p><p><strong>Conclusions: </strong>This study highlights platelet proteomics as a valuable tool for investigating biological alterations in psychiatric disorders. Our findings indicate deficits in MHC Class I-related pathways and immune alterations consistent with chronic low-grade inflammation, suggesting potential roles for latent viral and autoimmune-related mechanisms in BD. These results support and refine the concept of immune dysregulation in mania and BD.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":"575-584"},"PeriodicalIF":5.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13332576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147619065","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":"Genetics of bipolar disorder: Translating discoveries to biological insights and clinical decision support.","authors":"Guy Hindley, Elise M Koch, Nadine Parker, Alexey A Shadrin, Olav Bjerkehagen Smeland, Oleksandr Frei, Kevin S O'Connell, Ole A Andreassen","doi":"10.1111/pcn.70067","DOIUrl":"10.1111/pcn.70067","url":null,"abstract":"<p><p>Bipolar disorder (BD) is a clinically heterogenous mental disorder with a diversity in clinical trajectories and treatment response. Twin studies have shown that BD is highly heritable, with estimates ranging from 60% to 90%. However, our understanding of this genetic component has yet to be translated into clinical interventions or prediction tools. In this review, we summarize findings from large-scale international collaborations, with the latest and largest study finding 298 genome-wide significant loci and 36 credible mapped genes associated with BD, alongside the first genes with an increased burden of rare genetic variants. We next highlight key biological insights from these findings, including widespread genetic overlap but distinct patterns of genetic correlation with other mental disorders and related traits; enrichment of gene expression within both brain-specific tissues and cell types and non-brain tissues, including pancreatic and large intestinal tissues; and the identification of novel drug targets and repurposing candidates, including calcium channel blockers. While these insights may take several years before they impact clinical practice, the potential for genetic advances to impact patient care through more accurate nosology and the development of clinically relevant prediction and stratification tools is more imminently achievable. We go on to summarize the most prominent methods for genetic prediction, including artificial intelligence-based methods, before discussing promising use-cases and key challenges to implementation. Looking to the future, cross-disciplinary collaboration, access to real-world data for robust validation, and pragmatic solutions that facilitate implementation across diverse healthcare systems will be crucial to achieving material advances in clinical care and improving outcomes for people with BD.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":"536-545"},"PeriodicalIF":5.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842003","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":"Durability of zuranolone in postpartum depression versus major depressive disorder.","authors":"Itsuki Terao","doi":"10.1111/pcn.70011","DOIUrl":"10.1111/pcn.70011","url":null,"abstract":"<p><p>The antidepressant effect of zuranolone appears to be sustained beyond the treatment period in postpartum depression, whereas in major depressive disorder it may not persist after treatment discontinuation.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":"630"},"PeriodicalIF":5.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805170","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}