Therapeutic Advances in Psychopharmacology最新文献

{"title":"Drug utilization in geriatric psychiatric patients in the emergency department-a cohort study under real-world conditions.","authors":"Martin Schulze Westhoff, Sophie Bannasch, Johannes Heck, Stefan Bleich, Sebastian Schröder, Adrian Groh","doi":"10.1177/20451253251339373","DOIUrl":"10.1177/20451253251339373","url":null,"abstract":"<p><strong>Background: </strong>Psychiatric emergencies include agitation, substance-related (e.g., withdrawal) symptoms, and suicidal as well as self-harming behavior and require interdisciplinary management. Drug treatment of geriatric patients in emergency situations may be complicated by adverse drug reactions (ADRs).</p><p><strong>Objectives: </strong>This study aimed to investigate prescriptions of potentially inappropriate medications (PIMs) and potential drug-drug interactions (DDIs) in the context of geriatric psychiatric emergencies in the emergency department (ED).</p><p><strong>Design: </strong>Retrospective single-center study.</p><p><strong>Methods: </strong>The medication lists of 87 consecutively acquired geriatric patient cases receiving pharmacological treatment between January 2018 and December 2022 in a psychiatric emergency department were analyzed. Herein, utilizing the PRISCUS 2.0 list and the Fit fOR The Aged (FORTA) classification, prescriptions of PIMs were assessed, and DDIs were classified with the aid of the drug interaction program AiDKlinik® (Arzneimittel-Informations-Dienste, Dosing GmbH, Heidelberg, Germany).</p><p><strong>Results: </strong>A total of 94 drugs were administered during treatment in the ED. The total number of drugs per patient was on average 5.9 1 (median: 5; interquartile range: 4) hereafter. 77.7% of the newly prescribed drugs were PIMs according to the PRISCUS 2.0 list, while 18.1% were designated as therapeutic alternatives to PIMs. 70.2% and 22.3% of the newly recommended drugs were FORTA category C and D drugs, respectively. An average of 0.8 (median: 0; interquartile range: 1) potential DDIs existed before psychiatric ED treatment, and 0.9 (median: 0; interquartile range: 2) potential DDIs thereafter (<i>p</i> = 0.002). Coercive measures-such as administration of medication against the patient's will-were rarely required in the study population.</p><p><strong>Conclusion: </strong>The majority of all drug prescriptions for the treatment of geriatric psychiatric emergencies were categorized as PIMs according to the PRISCUS 2.0 list and the FORTA classification. However, it should be noted that these PIM classification systems were not specifically designed for geriatric psychiatric settings. The number of potential DDIs was significantly higher after drug administration in the ED than before, which should prompt the monitoring of certain clinical parameters in the further course of treatment.</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":"15 ","pages":"20451253251339373"},"PeriodicalIF":3.4,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094947","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 missing link? Pharmacists' perspectives on discontinuation of long-term antidepressants: a qualitative study.","authors":"Ellen Van Leeuwen, Els Mehuys, Chris F Johnson, An-Sofie De Keyzer, Koen Boussery, Thierry Christiaens","doi":"10.1177/20451253251333977","DOIUrl":"https://doi.org/10.1177/20451253251333977","url":null,"abstract":"<p><strong>Background: </strong>Long-term use of antidepressant drugs is widespread despite guidelines recommending limited duration. General practitioners (GPs) play a central role in reviewing and discontinuing antidepressants, although they hesitate to initiate a discussion about the long-term use. The potential role of pharmacists in this process is underexplored, despite their pharmaceutical expertise and accessibility.</p><p><strong>Objectives: </strong>To explore community pharmacists' perspectives on the discontinuation of long-term use of antidepressants, and the barriers and facilitators to their involvement in this process.</p><p><strong>Design: </strong>Qualitative study.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with 14 Belgian community pharmacists until data saturation. Interviews were recorded, transcribed, and thematically analyzed.</p><p><strong>Results: </strong>Four themes emerged. (1) \"Antidepressants at the pharmacy: a persistent taboo\" showed pharmacists' hesitancy to initiate discontinuation discussions due to societal stigma and fear of being perceived as nosy. (2) \"Balancing risks vs benefits\" highlights that pharmacists were primarily concerned about relapse in stable patients but recognized that a patient request from a patient experiencing side effects may facilitate discontinuation. (3) \"Is this my role?,\" pharmacists viewed GPs as the primary decision-makers in discontinuation, limiting their role to supporting GP treatment decisions. Key facilitators for discontinuation included a GP's decision to stop and a motivated patient. Regular reviews by the pharmacist could also facilitate the discontinuation process. (4) Optimizing pharmacists' role' with a strong need for GP collaboration, and acknowledging a need to optimize knowledge and skills to support antidepressant discontinuation.</p><p><strong>Conclusion: </strong>Our study reveals that pharmacists viewed GPs as pivotal in the discontinuation process, as they make the decisions, while they see their role as supportive, following the doctor's decision. However, they faced significant barriers to discontinuing long-term antidepressants, including fear of relapse, societal taboo, and unclear responsibilities. More education, confidence building, and better collaboration with GPs could empower pharmacists to play a proactive role, improving the antidepressant discontinuation process.</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":"15 ","pages":"20451253251333977"},"PeriodicalIF":3.4,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047357","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":"Reasons for discontinuing and restarting lithium multiple times: a case-register study based on the South London and Maudsley NHS Foundation Trust Clinical Record Interactive Search system.","authors":"Petra Truedson, Kalliopi Vallianatou, Michael Ott, Martin Maripuu, Krister Lindmark, David M Taylor, Ursula Werneke","doi":"10.1177/20451253251332275","DOIUrl":"https://doi.org/10.1177/20451253251332275","url":null,"abstract":"<p><strong>Background: </strong>Despite the therapeutic benefits, non-adherence to lithium is common. One recent study showed that most patients discontinue lithium due to adverse effects. Little is known about individuals starting and discontinuing lithium repeatedly.</p><p><strong>Objectives: </strong>We aimed to determine reasons for discontinuing and restarting lithium multiple times in patients with bipolar or schizoaffective disorder.</p><p><strong>Design: </strong>Retrospective cohort study based on psychiatric case records of the SLaM Biomedical Research Centre Case Register (SLaM BRC case register).</p><p><strong>Method: </strong>Anonymised clinical data were extracted via the Clinical Record Interactive Search (CRIS) application. Patients with at least three events of lithium discontinuation between 2012 and 2022 were included.</p><p><strong>Results: </strong>Of 2888 eligible patients, 123 patients had discontinued lithium on at least three occasions. Psychiatric reasons, such as suspected lack of insight, feeling subjectively well or disagreeing with diagnosis, were the most common reasons for lithium discontinuations. They accounted for 77.2% of cases in the first event of discontinuation, 73.2% in the second and 72.3% in the third event. Adverse physical effects accounted for 19.5% of cases in the first event of discontinuation, 25.2% in the second and 26.0% in the third event. Relapse into the underlying affective disorder accounted for 83.7% each of reinstatements in the first and second events and 82.1% in the third event.</p><p><strong>Discussion: </strong>In our sample, lithium was discontinued due to adverse effects in only a minority of patients. In most cases, the reasons for lithium discontinuation were considered psychiatric. Lithium was mainly restarted due to relapse. This warrants a better understanding of the reasons for repeatedly discontinuing lithium and the best way to promote lithium adherence to prevent a perpetual cycle of remitting when on lithium and relapsing when off lithium.</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":"15 ","pages":"20451253251332275"},"PeriodicalIF":3.4,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049582","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":"Investigation on the factors associated with maintenance of paliperidone long-acting injection in the real-world treatment of patients with schizophrenia.","authors":"Nuree Kang, Ae Jeong Jo, Sung Woo Joo, Jung Sun Lee, Kyu Young Lee, Yong Sik Kim, Jae Hoon Jeong, Jeong Hoon Lee, Joongyub Lee, Se Hyun Kim","doi":"10.1177/20451253251333987","DOIUrl":"https://doi.org/10.1177/20451253251333987","url":null,"abstract":"<p><strong>Background: </strong>Long-acting injectable (LAI) antipsychotics have been shown to improve adherence and clinical outcomes in schizophrenia treatment. However, issues with compliance and early discontinuation of LAIs remain a significant challenge in real-world settings. Understanding the factors influencing successful initiation and maintenance is essential to maximize their clinical benefits.</p><p><strong>Objectives: </strong>This study aimed to investigate factors associated with the maintenance of paliperidone LAI (PLAI) during the first year of treatment in a real-world clinical setting, focusing on initiation practices and baseline clinical factors.</p><p><strong>Design: </strong>This was a non-interventional, retrospective observational study conducted at three hospitals in South Korea. Data were collected from electronic medical records from January 2010 to January 2023.</p><p><strong>Methods: </strong>This study included 664 patients who initiated PLAI treatment. Kaplan-Meier survival analysis and multivariate Cox proportional hazards models were used to evaluate clinical and demographic factors influencing the 1-year discontinuation rate.</p><p><strong>Results: </strong>The 1-year discontinuation rate was 51.5% (342/664), with most discontinuations occurring in the early phase of treatment. Factors significantly associated with a lower risk of discontinuation included initiating PLAI with the standard starting dose of 150 mg (hazards ratio (HR) 0.766, <i>p</i> = 0.021), concurrent use of antipsychotics at baseline (HR 0.630, <i>p</i> = 0.019), a higher dose of concurrent antipsychotics (HR 0.985, <i>p</i> = 0.005), and outpatient initiation (HR 0.671, <i>p</i> < 0.001). Baseline clozapine use was associated with a lower risk of treatment discontinuation (HR 0.755, <i>p</i> = 0.096). A predictive model incorporating these factors demonstrated moderate ability to predict 1-year discontinuation (area under the curve (AUC) = 0.61).</p><p><strong>Conclusion: </strong>The findings highlight the importance of adhering to the standard dosing regimen for PLAI initiation and its potential as an augmentation agent in combination with other antipsychotics. Initiating PLAI in an outpatient setting and addressing adherence challenges early in treatment may enhance long-term treatment continuity in patients with schizophrenia.</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":"15 ","pages":"20451253251333987"},"PeriodicalIF":3.4,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983000","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":"Relationship between resilience and mental health among COVID-19 bereaved people: the mediating role of dual process coping.","authors":"Liping Wu, Siying Chen, Suqin Tang","doi":"10.1177/20451253251328607","DOIUrl":"10.1177/20451253251328607","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;People bereaved due to COVID-19 may face mental health challenges and posttraumatic growth opportunities. Resilience, as an inherent trait or ability, may protect the bereaved from developing mental health problems and facilitate growth. The Dual Process Model (DPM) is an important framework for understanding adaptation after bereavement. However, little is known about whether resilience could help with adjusting to COVID-19 bereavement and whether dual process coping plays a part in the relationship between resilience and mental health among COVID-19 bereaved individuals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We aim to examine the relationship between resilience and symptoms of prolonged grief, posttraumatic stress, anxiety, depression, and posttraumatic growth following COVID-19 bereavement, and to investigate the role of dual process coping, which includes loss-oriented (LO) coping, restoration-oriented (RO) coping, and oscillation between LO coping and RO coping in this relationship.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;This is an online cross-sectional survey.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;A total of 408 Chinese participants who lost a close person due to COVID-19 participated in the study from September to October 2020. Demographic and loss-related information was collected. Resilience, dual process coping, symptoms of prolonged grief, posttraumatic stress, anxiety, depression, and posttraumatic growth were measured. Correlation analyses and mediation analyses were conducted to analyze the data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Resilience was negatively correlated with anxiety and depressive symptoms and positively correlated with posttraumatic growth. In the relationship between LO coping, RO coping, oscillation, and mental health, LO coping was positively associated with prolonged grief, posttraumatic stress, anxiety, and depressive symptoms, as well as posttraumatic growth; RO coping was negatively associated with prolonged grief symptoms and posttraumatic growth, and positively associated with anxiety and depressive symptoms; oscillation was negatively associated with prolonged grief, posttraumatic stress, anxiety, and depressive symptoms. In addition, mediation analysis showed that oscillation mediated the relationship between resilience and anxiety and depressive symptoms, and RO coping mediated the relationship between resilience and depressive symptoms and posttraumatic growth.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our findings indicate that among individuals who have experienced bereavement due to COVID-19, RO coping serves a protective role in the relationship between resilience and depressive symptoms and a facilitative role in the relationship between resilience and posttraumatic growth. Additionally, oscillation plays a protective role in the association between resilience and symptoms of anxiety and depression. Professionals should consider the bereaved individuals' resilience, LO coping, RO coping, and osci","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":"15 ","pages":"20451253251328607"},"PeriodicalIF":3.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796196","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":"Decreased citalopram concentration caused by enzyme induction effect of rifampin: a case report.","authors":"Jiajia Liu, Jinmeng Li, Ren Zheng, Ruoying Zhang","doi":"10.1177/20451253251328582","DOIUrl":"10.1177/20451253251328582","url":null,"abstract":"<p><p>Citalopram is a selective serotonin reuptake inhibitor used to treat depression and various anxiety disorders, which is mainly metabolized by the P450 (CYP) enzyme. Rifampin is a rifamycin with bactericidal activity against <i>Mycobacterium tuberculosis</i>. Rifampin significantly induces the P450 (CYP) enzyme system, which makes it susceptible to potential drug interactions with other medications. However, there have been few reports on the possible interaction between rifampin and citalopram. We report a 76-year-old patient who had been taking citalopram 20 mg daily for long-term treatment of depression. After 2 months of rifampin treatment for tuberculosis, the patient presented with intractable depressive symptoms, insomnia, and a profound sense of hopelessness. The trough plasma concentration of citalopram was monitored, which was 8.19 ng/mL, and failed to reach the guideline-recommended effective therapeutic range (50-110 ng/mL). Based on the therapeutic drug monitoring results of citalopram, the dosage of citalopram was adjusted to 40 mg daily, resulting in a significant improvement in depressive symptoms. This case provides further evidence of a clinically significant interaction that may occur between rifampin and citalopram.</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":"15 ","pages":"20451253251328582"},"PeriodicalIF":3.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11946286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731742","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 evolution of long-acting antipsychotic treatments.","authors":"Sofia Pappa, Robin Emsley","doi":"10.1177/20451253241305610","DOIUrl":"10.1177/20451253241305610","url":null,"abstract":"","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":"14 ","pages":"20451253241305610"},"PeriodicalIF":3.4,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847939","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":"Clozapine/norclozapine plasma level ratio and cognitive functioning in patients with schizophrenia spectrum disorders: a systematic review.","authors":"Timo T Moscou, Selene R T Veerman","doi":"10.1177/20451253241302603","DOIUrl":"10.1177/20451253241302603","url":null,"abstract":"<p><strong>Background: </strong>Extant research on cognitive functioning in treatment-resistant schizophrenia (TRS) is limited and of poor quality. Cognitive impairments in patients with schizophrenia spectrum disorders (SSD) significantly influence quality of life. In patients with TRS, clozapine (CLO) is not consistently associated with improved cognitive functioning. The active metabolite n-desmethylclozapine (norclozapine (NCLO)) potentially exerts procognitive effects due to cholinergic and glutamatergic activity. Unfortunately, research on CLO/NCLO ratio and cognitive functioning is even more scarce.</p><p><strong>Objectives: </strong>To review the literature on the effect of the CLO/NCLO ratio on cognitive functioning in patients with SSD.</p><p><strong>Design: </strong>This is a systematic review.</p><p><strong>Data sources and methods: </strong>A search was carried out in the electronic databases Embase, PsycINFO, PubMed, Cochrane and the Cochrane Controlled Register of Trials with no restrictions in language or publication year.</p><p><strong>Results: </strong>We identified 15 relevant studies (longitudinal, <i>k</i> = 4; cross-sectional, <i>k</i> = 11). The study population consisted of adult clozapine users (<i>n</i> = 953) with varying degrees of treatment resistance. Specific cognitive domains and overall cognitive functioning were assessed using various neuropsychological tests and a composite score, respectively. Eleven studies were considered of fair quality (longitudinal: <i>k</i> = 2, cross-sectional: <i>k</i> = 9). In one longitudinal study, a negative causal relationship was found between the CLO/NCLO ratio and attention/vigilance and a negative correlation between social cognition and the composite score (<i>n</i> = 11). No significant correlations were found between the CLO/NCLO ratio and the cognitive domains processing speed, reasoning/problem solving, or for working memory (<i>k</i> = 1, <i>n</i> = 11), verbal learning (<i>k</i> = 1, <i>n</i> = 43) or visual learning (<i>k</i> = 2, <i>n</i> = 54). Study designs and populations were heterogeneous, and the analysis of confounding factors was limited and inconsistent.</p><p><strong>Conclusion: </strong>Clinical evidence is too scarce to support the hypothesis of a procognitive effect of NCLO. Personalised CLO treatment by modulating the CLO/NCLO ratio remains a distant prospect. Recommendations for future CLO research and anticipated limitations are discussed.</p><p><strong>Trial registration: </strong>This systematic review was preregistered with PROSPERO (CRD42023385244).</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":"14 ","pages":"20451253241302603"},"PeriodicalIF":3.4,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802319","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":"Altered orbitofrontal and pars opercularis cortical thickness in betel quid dependence chewers.","authors":"Li Li Fu, Hui Juan Chen, Wei Yuan Huang, Yi Hao Guo, Li Ting Liu, Qing Qing Fu, Hao Dong Qin, Tao Liu, Feng Chen","doi":"10.1177/20451253241304219","DOIUrl":"10.1177/20451253241304219","url":null,"abstract":"<p><strong>Background: </strong>Altered cerebral cortex's structural organization has been found in individuals with betel quid dependence (BQD). However, the neurological underpinnings of the BQD-related abnormalities in cortical thickness and brain circuitry deficit are largely unknown.</p><p><strong>Objective: </strong>This study aimed to investigate potential abnormalities of brain circuitry in the cortical thickness of BQD individuals by applying the surface-based morphometry (SBM) method.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>High spatial resolution, three-dimensional T1-weighted structural imaging data were collected from 53 individuals with BQD and 37 healthy controls (HCs) who were similar to the BQD group in terms of age, sex, and educational level. The SBM method was applied to analyze the cortical thickness alterations in BQD-related areas. Independent-samples <i>t</i>-test was used to assess the cortical thickness difference between the two groups. Pearson correlation analysis was used to investigate the correlation between cortical thickness changes and clinical characteristics, including BQD scale scores and duration of BQD.</p><p><strong>Results: </strong>The BQD group had a higher cortical thickness than the HC group at the lateral orbitofrontal (<i>t</i> = 4.703, <i>p</i> = 0.0028) and pars opercularis (<i>t</i> = 3.602, <i>p</i> = 0.0403) clusters in the right cerebral hemisphere, with age, sex, and education duration as covariates (<i>p</i> < 0.05, Monte Carlo). There were no significant differences in age, sex, or education duration-adjusted cortical thickness of the left cerebral hemisphere between BQD chewers and HCs (<i>p</i> <i>></i> 0.05, Monte Carlo). Correlation analysis revealed that the cortical thickness of the right pars opercularis was negatively correlated with the BQD duration (<i>r</i> = -0.274, <i>p</i> = 0.047). The cortical thickness of the right lateral orbitofrontal cluster was not significantly correlated with Betel Quid Dependence Scale (BQDS) or BQD duration (<i>p</i> > 0.05).</p><p><strong>Conclusion: </strong>This study demonstrated that BQD might be associated with changes in the orbitofrontal and pars opercularis cortical thickness, which may be related to the neurobiological basis of BQD.</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":"14 ","pages":"20451253241304219"},"PeriodicalIF":3.4,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802285","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":"Disrupted emotion regulation and spontaneous neural activity in panic disorder: a resting-state fMRI study.","authors":"Hai-Yang Wang, Bei-Yan Guan, Shi-Yao Wang, Ming-Fei Ni, Yan-Wei Miao, Feng Tian, Yumin Chen, Meng-Li Wu, Rui Li, Bing-Wei Zhang","doi":"10.1177/20451253241298871","DOIUrl":"10.1177/20451253241298871","url":null,"abstract":"<p><strong>Background: </strong>Emotional dysregulation, particularly unconscious catastrophic cognitions, plays a pivotal role in the genesis of panic disorder (PD). However, no studies have yet applied the percentage of amplitude fluctuation (PerAF) metric in resting-state functional magnetic resonance imaging to examine spontaneous neural functioning and its relation to catastrophic cognitions in PD.</p><p><strong>Objectives: </strong>To explore the interplay between resting-state neural activity, functional connectivity (FC), and unconscious emotion regulation in individuals with PD.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>The study encompassed 51 participants, including 26 PD patients and 25 healthy individuals. The PerAF algorithm was employed to explore the local spontaneous neural activity in PD. Regions exhibiting aberrant spontaneous neural activity were used as seed points for whole-brain FC analysis. Correlations were utilized to examine associations between local neural activity patterns and neurocognitive assessments in PD.</p><p><strong>Results: </strong>The study revealed that compared to healthy individuals, PD patients exhibited elevated PerAF values in key emotion-regulation-related brain regions, including the ventromedial prefrontal cortex (vmPFC), striatum, amygdala, dorsomedial prefrontal cortex (dmPFC), and cerebellum. In addition, the resting-state FC between vmPFC and precuneus, as well as between the cerebellum and precuneus, was weakened in PD patients. Furthermore, positive associations were noted between PerAF measurements of vmPFC and amygdala and catastrophizing scores.</p><p><strong>Conclusion: </strong>PD involves regional and network-level alterations in resting-state brain activity. The fronto-striatal-limbic circuits play a critical role in catastrophic-style emotion regulation in PD patients. Reduced FC within the default mode network and cerebellum-default mode network may signify a coordination anomaly in introspection and cognitive activities in PD. These findings complement the model of implicit emotion regulation in PD and suggest potential intervention targets.</p>","PeriodicalId":23127,"journal":{"name":"Therapeutic Advances in Psychopharmacology","volume":"14 ","pages":"20451253241298871"},"PeriodicalIF":3.4,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648750","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}