World Journal of Psychiatry最新文献

{"title":"Epigenetics and immunology: Under-recognized aspects of suicidality.","authors":"Katarina Kouter, Julija Šmon, Alja Videtič Paska","doi":"10.5498/wjp.v15.i9.107726","DOIUrl":"10.5498/wjp.v15.i9.107726","url":null,"abstract":"<p><p>Suicidality is a complex phenomenon influenced by genetic, environmental, and epigenetic factors. Current tools to estimate suicide risk are insufficient, and there is an increasing need for reliable biomarkers to complement clinical approaches. Growing evidence suggests that immune system dysregulation contributes to the pathophysiology of psychiatric disorders and suicidal behavior. Epigenetic mechanisms, including DNA methylation, histone modifications, and non-coding RNAs, regulate gene expression and may act as a bridge between environmental stressors and (neuro)inflammatory responses. In this review, we examine the evidence of peripheral and central inflammation in suicide completers and individuals with suicidal behavior. Next, we review current knowledge from various studies on suicide-associated epigenetic alterations. Furthermore, we evaluate the mechanisms by which early life adversity and chronic stress contribute to suicide diathesis, focusing on their association with epigenetic modifications and inflammatory pathways. We also examine future prospects and limitations of immunology-related biomarkers and the possibilities of therapeutic interventions targeting the immune system and epigenetic regulation. While challenging, research on epigenetic and immune alterations in suicidality shows promise for identifying suicide risk subtypes and advancing personalized psychiatry.</p>","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":"15 9","pages":"107726"},"PeriodicalIF":3.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disease duration-stratified associations of thyroid hormone levels with psychopathology in hospitalized patients with schizophrenia: A cross-sectional study.","authors":"Xiu-Ping Lei, De-Xin Liao, Guo-Ying Wu, Dan Shuai, Hong-Li Zhang, Bin-You Wang, Yi-Lin Wang","doi":"10.5498/wjp.v15.i9.109858","DOIUrl":"10.5498/wjp.v15.i9.109858","url":null,"abstract":"<p><strong>Background: </strong>Neuroendocrine dysfunction, especially involving the hypothalamic-pituitary-thyroid axis, plays a critical role in the onset and progression of schizophrenia. Alterations in thyroid stimulating hormone (TSH), triiodothyronine (T3), free T3 (FT3), thyroxine (T4), and free T4 have been implicated in this process. Although previous studies have established an association between thyroid function and psychiatric symptoms, how thyroid hormone levels vary with disease duration remains underexplored.</p><p><strong>Aim: </strong>To investigate duration stage-specific associations between thyroid hormones and psychotic symptoms among inpatients with stable schizophrenia.</p><p><strong>Methods: </strong>This cross-sectional study was conducted at Zigong Mental Health Center, China, and included 237 hospitalized patients with stable schizophrenia. Participants were stratified into three groups based on disease duration: 0-10 years, 10.1-20 years, and over 20 years. Peripheral blood samples were collected to measure serum thyroid hormone levels. Psychotic symptoms were assessed using the Positive and Negative Syndrome Scale. Covariate-adjusted linear regression analyses were performed to assess the relationships between thyroid hormone levels and Positive and Negative Syndrome Scale sub-scale scores.</p><p><strong>Results: </strong>The relationship between thyroid hormones and psychotic symptoms varied by disease duration. In patients with a disease course of 0-10 years, T4 [β = -0.848; 95% confidence interval (CI): -1.564 to -0.133; <i>P</i> = 0.021] and FT3 (β = -2.483; 95%CI: -4.693 to -0.273; <i>P</i> = 0.028) levels were significantly inversely associated with general psychopathology scores. Among those with 10.1-20 years of disease, only TSH showed a significant negative correlation with general psychopathology (β = -1.429; 95%CI: -2.348 to -0.509; <i>P</i> = 0.003). No significant correlations were found in the > 20 years group.</p><p><strong>Conclusion: </strong>The associations between thyroid hormones and psychotic symptoms vary according to the duration of schizophrenia (T4/FT3 early; TSH mid), enabling the development of stage-adapted models and management.</p>","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":"15 9","pages":"109858"},"PeriodicalIF":3.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in transcranial magnetic stimulation for psychological symptom management in Parkinson's disease.","authors":"Xiao-Li Zhou, Yan Li, Wan Xia, Ying-Ying Zheng, Ai-Ping Wu","doi":"10.5498/wjp.v15.i9.108497","DOIUrl":"10.5498/wjp.v15.i9.108497","url":null,"abstract":"<p><p>Parkinson's disease patients, in addition to typical motor symptoms, often experience various psychological symptoms, including depression, anxiety, cognitive impairment, impulse control disorders, and psychotic symptoms. These symptoms severely affect patients' quality of life and may even cause a greater disease burden than motor symptoms. This review focuses on the application progress of transcranial magnetic stimulation (TMS) as a non-invasive neuromodulation technique in the treatment of psychological symptoms in Parkinson's disease. Studies have shown that repetitive TMS (rTMS) has significant improvement effects on Parkinson's disease-related depressive symptoms, with mechanisms possibly related to the regulation of the prefrontal-striatal dopamine pathway and the promotion of neuroplasticity. For anxiety symptoms, continuous theta burst stimulation has shown potential in indirect regulation of the amygdala and hippocampal regions. For cognitive impairment, high-frequency rTMS applied to the dorsolateral prefrontal cortex can improve executive function deficits, while bilateral coordinated stimulation protocols help enhance attention and memory functions. For impulse control disorders in Parkinson's disease patients, inhibitory stimulation applied to the orbitofrontal cortex can alleviate pathological gambling and compulsive behaviors. In terms of sleep disorders, TMS has also shown potential efficacy in regulating circadian rhythms and improving rapid eye movement sleep behavior disorder. However, current research still has limitations such as small sample sizes, non-standardized stimulation protocols, and insufficient evaluation of long-term efficacy. Future research directions should focus on optimizing stimulation parameters, exploring individualized treatment protocols, integrating multimodal imaging assessments, and conducting large-sample randomized controlled trials to clarify the clinical application value of TMS in the rehabilitation of psychological symptoms in Parkinson's disease, providing new approaches for the comprehensive management of this common neurodegenerative disease.</p>","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":"15 9","pages":"108497"},"PeriodicalIF":3.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral blood biomarkers and mild behavioral impairment in mild cognitive impairment: Clinical correlations and mechanistic insights.","authors":"Wen-Yong Qiao, Qing-Mei Guo, Xu-Hao Li","doi":"10.5498/wjp.v15.i9.108910","DOIUrl":"10.5498/wjp.v15.i9.108910","url":null,"abstract":"<p><p>In the context of global aging, mild behavioral impairment (MBI) is present in 48.9% of patients with mild cognitive impairment (MCI). MBI, a neurobehavioral syndrome in the elderly, is an independent risk factor for cognitive decline and is closely related to peripheral blood biomarkers associated with Alzheimer's disease, offering new diagnostic and interventional avenues for early MCI. To summarize evidence on peripheral blood biomarkers related to MBI and their underlying mechanisms involving neuroinflammation, tau pathology, and oxidative stress, a systematic review of studies published between 2015 and 2024 was conducted. MBI is closely associated with peripheral blood biomarker changes. Neuroinflammatory markers like glial fibrillary acidic protein and neurofilament light indicate astrocyte activation and neural circuit disruption, with glial fibrillary acidic protein levels correlating with impulse dyscontrol scores. Chitinase-3-like protein 1, a marker of blood-brain barrier integrity, exacerbates neuroinflammation and is linked to depressive symptoms and hippocampal atrophy. Elevated phosphorylated tau proteins in blood correlate with brain tau deposition, increasing the risk of MBI and impairing cognition. Oxidative stress markers damage neurons and disrupt neurotransmission, and concurrent alterations in malondialdehyde and superoxide dismutase levels significantly elevate the risk of MBI. The correlation between MBI and biomarkers offers new diagnostic and interventional directions for early MCI. Future research should standardize MBI assessment, conduct longitudinal studies, explore biomarker-MBI relationships, investigate psychosocial impacts, and develop advanced detection methods.</p>","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":"15 9","pages":"108910"},"PeriodicalIF":3.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability and validity of the preparatory grief scale for use with hemodialysis patients.","authors":"Yue-Juan Li, Xue Li, Mei-Juan Li, Yu-Lin Gao","doi":"10.5498/wjp.v15.i9.107672","DOIUrl":"10.5498/wjp.v15.i9.107672","url":null,"abstract":"<p><strong>Background: </strong>During the gradual decline of physical and social functioning associated with end-stage renal disease, patients might experience a premonition of impending death, resulting in a series of pre-mourning grief responses called preparatory grief. The preparatory grief in advanced cancer patients (PGAC) scale is the most widely used preparatory grief scale for patients on hemodialysis in China.</p><p><strong>Aim: </strong>To verify the reliability and validity of the PGAC scale in patients on hemodialysis.</p><p><strong>Methods: </strong>In total, 327 patients undergoing regular hemodialysis in the blood purification center of three grade-A tertiary hospitals in Guangdong and Guizhou provinces were selected by convenience sampling. The assessment was administered using the general information questionnaire and the Chinese version of PGAC. SPSS 25.0 and Amos 24.0 were used for item analysis, confirmatory factor analysis (CFA), convergent validity, and internal consistency reliability estimation.</p><p><strong>Results: </strong>In the modified Chinese version of PGAC, 7 dimensions covering 27 total items were retained. CFA revealed a good fit of the factor model (chi-square degree of freedom = 2.056, standardized root mean square residual = 0.0479, root mean square error of approximation = 0.0570<i>, GFI</i> = 0.872, <i>AGFI</i> = 0.841, <i>IFI</i> = 0.931, <i>CFI</i> = 0.930, <i>TLI</i> = 0.919). The factor loadings of the items ranged 0.503-0.884. The composite reliability ranged 0.664-0.914, and the average variance extracted ranged 0.366-0.747. Cronbach's α of the scale was 0.945, and Cronbach's α for various dimensions ranged 0.662-0.914.</p><p><strong>Conclusion: </strong>The modified PGAC has good reliability and validity, and it can effectively measure preparatory grief in patients on hemodialysis.</p>","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":"15 9","pages":"107672"},"PeriodicalIF":3.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anxiety and depression in recurrent implantation failure after frozen-thawed embryo transfer and efficacy of endometrial receptivity testing.","authors":"Ya-Bin Guo, Bin Tang, Ling Zhang, Xue Wu, Zhi-Hua Huang","doi":"10.5498/wjp.v15.i9.109175","DOIUrl":"10.5498/wjp.v15.i9.109175","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Despite advances in the use of &lt;i&gt;in vitro&lt;/i&gt; fertilization-embryo transfer (ET) in couples with infertility, recurrent implantation failure (RIF) after ET is still a major problem affecting women, with great psychological and economic burdens for the patient and his/her family.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To investigate the psychological burden (anxiety and depression) and evaluate the clinical benefits of endometrial receptivity testing (ERT) in patients experiencing RIF following frozen-thawed ET.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective cohort study analyzed 371 patients experiencing RIF after assisted reproductive treatment at the First People's Hospital of Changde City between January 2021 and June 2024. Demographic and clinical data were systematically collected through standardized questionnaires. Psychological assessment utilized validated instruments: The Self-Rating Depression Scale for depression evaluation and the Self-Rating Anxiety Scale for anxiety assessment. Participants were stratified by psychological status (anxiety/non-anxiety and depression/non-depression) to analyze influencing factors for anxiety and depression. The cohort was further categorized into the ERT and non-ERT groups based on ERT implementation to comparatively analyze their clinical outcomes. Additionally, they were divided into clinical and nonclinical pregnancy groups to identify factors affecting clinical pregnancy using univariate and multivariate logistic regression models. Compared with the non-ERT group, the 226 patients who underwent ERT-guided ET achieved a higher clinical pregnancy rate, thicker endometrium on transfer day, fewer embryos transferred, and a lower miscarriage rate.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study identified a substantial psychological burden, with anxiety prevalence at 55.0% (mean Self-Rating Anxiety Scale score, 50.89 ± 9.34) and depression at 61.2% (mean Self-Rating Depression Scale score, 55.55 ± 9.48). Multivariate analysis identified annual household income &gt; 100000 yuan as protective factors against both anxiety and depression, whereas advanced maternal age (&gt; 35 years) and multiple implantation failures (≥ 3) served as risk factors. Additionally, anxiety-specific risk factors included prolonged infertility treatment (&gt; 5 years) and the spouse's status as an only child. As to depression-specific risks, chronic infertility (&gt; 3 years) and higher educational attainment (college/bachelor's degree or higher) were key determinants, whereas urban residence was a protective factor. Age &gt; 35 years was a risk factor for clinical pregnancy in patients experiencing RIF, whereas blastocyst-stage ET, a higher number of embryos transferred, and thicker endometrium were protective factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Patients experiencing RIF are particularly susceptible to anxiety and depression, and advanced maternal age and multiple implantation failures represent salient risk factors.","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":"15 9","pages":"109175"},"PeriodicalIF":3.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polyphenols: A top-down approach to nutrition and depression.","authors":"Nataša R Mijailović, Maja Milojević-Rakić, Katarina Mihajlović","doi":"10.5498/wjp.v15.i9.107828","DOIUrl":"10.5498/wjp.v15.i9.107828","url":null,"abstract":"<p><p>Depression is a common psychiatric condition with a considerable influence on global health. Although current pharmacotherapeutic choices are of indisputable relevance, there is sustained interest in natural medicines for treating depressive symptoms. Polyphenols, a class of plant-derived natural compounds, have received attention due to their possible neuroprotective and anti-depressive properties. In this review, we aimed to present the intricate mechanisms through which polyphenols modulate inflammation, neurogenesis, oxidative stress, and the gut microbiota. Consumption of polyphenol-rich diets is emerging as a non-invasive, natural, and cost-effective approach to supporting brain health, with potential influence on depressive symptoms. While there have been promising results, more research is needed to draw solid conclusions regarding the medicinal potential of polyphenols.</p>","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":"15 9","pages":"107828"},"PeriodicalIF":3.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of theta-transcranial alternating current stimulation on working memory performance among healthy adults: A systematic review and meta-analysis.","authors":"Tian-Ya Hou, Xiao-Fei Mao, Rui-Ke Zhang","doi":"10.5498/wjp.v15.i9.107754","DOIUrl":"10.5498/wjp.v15.i9.107754","url":null,"abstract":"<p><strong>Background: </strong>Working memory serves as a fundamental cognitive function that substantially impacts performance in various cognitive tasks. Extensive neurophysiological research has established that theta oscillations (4-8 Hz) play an essential role in supporting working memory operations. Theta-band transcranial alternating current stimulation (tACS) offers a potential mechanism for working memory enhancement through direct modulation of these fundamental neural oscillations. Nevertheless, current empirical evidence shows substantial variability in the observed effects of theta-tACS across studies.</p><p><strong>Aim: </strong>To conduct a systematic review and meta-analysis evaluating the effects of theta-tACS on working memory performance in healthy adults.</p><p><strong>Methods: </strong>A systematic literature search was performed on PubMed, EMBASE, and Web of Science up to March 10, 2025. Effect sizes were computed using Hedges' <i>g</i> with 95% confidence intervals (CIs), with separate meta-analyses for all included studies and for distinct working memory paradigms [n-back and delayed match-to-sample (DMTS) tasks] to examine potential task-specific effects. Subgroup analyses and meta-regression were performed to evaluate the influence of key moderating variables.</p><p><strong>Results: </strong>The systematic review included 21 studies (67 effect sizes). Initial meta-analysis showed theta-tACS moderately improved working memory (Hedges' <i>g</i> = 0.405, 95%CI: 0.212-0.598). However, this effect became nonsignificant after correcting for publication bias (trim-and-fill adjusted Hedges' <i>g</i> = 0.082, 95%CI: -0.052 to 0.217). Task-specific analyses revealed significant benefits in n-back tasks (Hedges' <i>g</i> = 0.463, 95%CI: 0.193-0.733) but not in DMTS tasks (Hedges' <i>g</i> = 0.257, 95%CI: -0.186 to 0.553). Moderator analyses showed that performance in n-back tasks was influenced by stimulation frequency (<i>P</i> = 0.001), concurrent status (<i>P</i> = 0.014), task modality (<i>P</i> = 0.005), and duration (<i>P</i> = 0.013), whereas only the region of targeted stimulation (<i>P</i> = 0.012) moderated DMTS tasks.</p><p><strong>Conclusion: </strong>Theta-tACS enhances working memory in healthy adults, with effects modulated by the task type and protocol parameters, offering dual implications for cognitive enhancement and clinical interventions.</p>","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":"15 9","pages":"107754"},"PeriodicalIF":3.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anxiety and depression status in geriatric patients undergoing total hip arthroplasty: Correlation with postoperative pain and risk factors.","authors":"Zheng Li, Jing Liu, Wen Lei, Li-Bo Wang, Zhi-Wei Yang","doi":"10.5498/wjp.v15.i9.108010","DOIUrl":"10.5498/wjp.v15.i9.108010","url":null,"abstract":"<p><strong>Background: </strong>Anxiety, depression, and postoperative pain are common in patients with hip joint disorders and are associated with compromised functional outcomes and delayed recovery.</p><p><strong>Aim: </strong>To investigate the prevalence of anxiety and depression among geriatric patients who underwent total hip arthroplasty (THA), explored their association with postoperative pain, and identified contributing risk factors.</p><p><strong>Methods: </strong>A total of 111 geriatric patients who underwent THA between January 2021 and January 2024 were included. Standardized psychological assessment tools-including the Zung Self-Rating Anxiety Scale (SAS) and the Zung Self-Rating Depression Scale (SDS)-and the Numeric Rating Scale (NRS) for pain quantification were systematically administered. Pearson correlation analysis was utilized to explore the relationships among SAS, SDS, and NRS scores. Univariate and multivariate binary logistic regression analyses were conducted to identify risk factors for anxiety and depression in these patients.</p><p><strong>Results: </strong>The cohort exhibited moderate anxiety (SAS: 44.23 ± 9.03), mild depression (SDS: 46.98 ± 9.15), and moderate postoperative pain (NRS: 4.93 ± 2.37). Patients with anxiety or depression reported significantly higher NRS scores than those without these conditions. Significant positive correlations were observed between SAS and SDS scores, as well as between each of these and NRS scores. Univariate analysis revealed that gender, age, disease duration, alcohol use, diabetes history, and NRS scores were significantly associated with anxiety and depression. Multivariate analysis further identified female gender, disease duration ≥ 2 years, alcohol use, and NRS scores ≥ 5 as independent predictors of postoperative psychological distress.</p><p><strong>Conclusion: </strong>Anxiety and depression are closely linked with postoperative pain in geriatric patients post-THA recovery. Early psychological screening and multimodal pain management strategies are recommended-particularly for individuals with a disease duration of ≥ 2 years, a history of alcohol consumption, or an NRS score of ≥ 5, as well as female patients-to effectively mitigate their negative emotional states and improve postoperative recovery.</p>","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":"15 9","pages":"108010"},"PeriodicalIF":3.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modulating nuclear factor erythroid 2-related factor 2 and heme oxygenase-1 in liver-brain axis disorders.","authors":"Yi-Ming Zhang, Zhi-Gang Zhang","doi":"10.5498/wjp.v15.i9.108382","DOIUrl":"10.5498/wjp.v15.i9.108382","url":null,"abstract":"<p><p>A broad spectrum of liver disorders and their associated complications most notably hepatic encephalopathy impact millions of individuals worldwide, including conditions such as non-alcoholic fatty liver disease, alcoholic liver injury, viral hepatitis, hepatic fibrosis, cirrhosis, and hepatocellular carcinoma. The underlying pathogenic mechanisms are multifactorial, encompassing oxidative stress, inflammatory cascades, mitochondrial impairment, and disturbances in immune homeostasis. Hepatic encephalopathy patients experience cognitive impairment, mood disturbances, and psychomotor dysfunction, significantly reducing quality of life through mechanisms including oxidative stress, neuroinflammation, and neurotransmitter imbalances. The nuclear factor erythroid 2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1) signaling pathway serves as a critical antioxidative defense mechanism in these conditions. Nrf2 regulates the expression of protective enzymes, while HO-1 exerts anti-inflammatory, anti-apoptotic, and antifibrotic effects through heme degradation products. Natural herbal monomers as Nrf2 activators offer advantages of low toxicity, multi-target actions, and extensive traditional use. Various herbal monomers demonstrate specific effects against different liver diseases: In fatty liver, baicalin alleviates lipid accumulation and inflammation; In alcoholic liver disease, curcumin enhances Nrf2 activity reducing oxidative damage; In drug-induced liver injury, dihydromyricetin mitigates oxidative stress; In viral hepatitis, andrographolide inhibits hepatitis C virus replication; In liver fibrosis, multiple compounds inhibit stellate cell activation. These natural compounds simultaneously alleviate hepatic dysfunction and neuropsychiatric symptoms by modulating the Nrf2/HO-1 pathway, though clinical application still faces challenges such as low bioavailability, requiring further research.</p>","PeriodicalId":23896,"journal":{"name":"World Journal of Psychiatry","volume":"15 9","pages":"108382"},"PeriodicalIF":3.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}