NEUROPSYCHIATRIE最新文献

{"title":"Converging etiopathogenetic pathways and early prevention opportunities for autism and neurodevelopmental disorders in the first 1000 days of life: a brief narrative review.","authors":"Maria Giardino, Virginia Pasquini","doi":"10.1007/s40211-026-00597-z","DOIUrl":"https://doi.org/10.1007/s40211-026-00597-z","url":null,"abstract":"<p><p>Neurodevelopmental disorders, including autism spectrum disorder, result from complex interactions between genetic susceptibility and early-life environmental exposures that shape brain development. Their increasing prevalence represents a major public health challenge, highlighting the need for effective preventive strategies. This brief narrative review synthesizes current evidence on the converging etiopathogenetic pathways-including genetic vulnerability, environmental risk factors, epigenetic regulation, neuroinflammation, and gut microbiome alterations-that operate during the first 1000 days of life and collectively influence neurodevelopmental trajectories. We also discuss early prevention opportunities targeting modifiable risk factors during this critical developmental window, when heightened neuroplasticity may maximize the effectiveness of preventive interventions. Viewing autism spectrum disorder and related neurodevelopmental disorders through the lens of shared biological mechanisms, provides a framework for precision prevention, facilitates earlier identification of at-risk individuals, and supports the development of multidisciplinary strategies aimed at improving lifelong neurodevelopmental health and reducing the long-term burden on affected individuals, families, and healthcare systems.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[From Count Gustav Chorinsky (1868) to King Ludwig II. of Bavaria (1886) : Cyanide, progressive paralysis & \"paranoia\"].","authors":"Hans Förstl","doi":"10.1007/s40211-026-00594-2","DOIUrl":"https://doi.org/10.1007/s40211-026-00594-2","url":null,"abstract":"<p><strong>Background: </strong>In retrospect, expert opinions-such as those in the case of Ludwig II.-are frequently called into question, particularly when the pervasive Zeitgeist of an era is disregarded.</p><p><strong>Objective: </strong>Drawing upon two cases that appear to be entirely unrelated, this study explores the influence of prior personal experience and prevailing contemporary trends on the expert assessment of mental disorders.</p><p><strong>Materials and methods: </strong>Available information from historical media reports, archival records, and scientific literature in the fields of medicine and cultural studies was systematically analysed.</p><p><strong>Results: </strong>In 1867, Julie von Ebergenyi poisoned the wife of her lover, Count Gustav Chorinsky, at his behest. Bernhard Gudden deemed Chorinsky to be criminally responsible, whereas Benedict Augustin Morel diagnosed \"moral insanity\" and predicted the manifestation of general paralysis with rapid deterioration-a prognosis promptly confirmed by further observation. In 1886, Gudden and other experts with similar prior experience were commissioned to assess king Ludwig II.; they described signs indicative of a severe illness and impending deterioration which mirrored those observed in the earlier case. Over a long period of time, new clinical observations and concepts on general paralysis of the insane along with new insights into its aetiology were overshadowed by Morel's predominant doctrine of degeneration; this theory inspired both Naturalism and Decadence and seemed to be empirically verified time and again.</p><p><strong>Conclusions: </strong>An examination of prior experience and the broader cultural context may improve our understanding of historical diagnostic and prognostic assessments.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[From clinical high risk for psychosis to autism spectrum disorder: navigating the challenges of differential diagnosis-A case report].","authors":"Paula Hoppstock, Elisa Foerster, Nicola Schauer, Maximus Berger, Niklas Fiebig, Nilufar Mossaheb, Josef Baumgartner, Fabian Friedrich","doi":"10.1007/s40211-026-00595-1","DOIUrl":"https://doi.org/10.1007/s40211-026-00595-1","url":null,"abstract":"<p><p>In the early detection of psychosis, the differential diagnosis between autism spectrum disorder (ASD) and schizophrenia spectrum disorders (SSD) is clinically challenging due to substantial symptom overlap and potential comorbidity. Camouflaging and masking may further contribute to an underlying ASD remaining unrecognized in individuals at clinical high risk for psychosis. The present case report illustrates the long-term clinical course of a patient whose core autistic features were interpreted as treatment-resistant negative symptoms of schizophrenia for years. Only through ongoing clinical observation in an inpatient setting ASD was confirmed according to current gold standards diagnostic. This case highlights the critical need to consider ASD as a primary differential diagnosis in individuals presenting psychotic and psychotic-like experiences during early detection of psychosis. By raising clinical awareness of autistic phenomenology earlier identification may be facilitated, enable timely and appropriate support, and help affected individuals develop a coherent illness model for further therapeutic progress.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral pulmonary embolism in anti-NMDA receptor encephalitis presenting as acute psychosis.","authors":"Natali Sorajja, Adir Alper, Luca Biavati, Rhea Dhakal, Priyansh Shah, Sudhamsh Desai","doi":"10.1007/s40211-026-00596-0","DOIUrl":"https://doi.org/10.1007/s40211-026-00596-0","url":null,"abstract":"<p><strong>Background: </strong>Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is an autoimmune disorder that frequently presents with prominent psychiatric manifestations, often leading to misdiagnosis as a primary psychiatric illness. Early recognition is critical, as timely immunotherapy significantly improves outcomes.</p><p><strong>Case presentation: </strong>A 26-year-old previously healthy man presented with acute psychosis following significant emotional stress and first-time marijuana use 3 days earlier. Initially diagnosed with brief psychotic disorder, he developed catatonia and fever. Cerebral spinal fluid (CSF) and serum anti-NMDA receptor antibodies confirmed the diagnosis. His course was complicated by bilateral pulmonary emboli and drug-induced liver injury. Treatment with intravenous immunoglobulin (IVIG) and high-dose corticosteroids resulted in marked improvement. Malignancy work-up was negative.</p><p><strong>Conclusion: </strong>This case underscores the importance of considering autoimmune encephalitis in young patients presenting with new-onset psychosis, in the apparent absence of malignancy. A high index of suspicion and early CSF evaluation can prevent diagnostic delay and improve patient outcomes.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of psychiatry- and addiction-related visits in an emergency department before and during the first COVID-19 lockdown: a retrospective study.","authors":"François A M Jean, David S Koivogui, Chloé Saint Dizier, Zeineb Azouz, Antoine Lamer, Clément Wagon, Christina Peres, Clara Dupire, Sébastien Dambry","doi":"10.1007/s40211-026-00593-3","DOIUrl":"https://doi.org/10.1007/s40211-026-00593-3","url":null,"abstract":"<p><strong>Purpose: </strong>The first weeks of the COVID-19 pandemic were a period of stress, uncertainty, and major disruptions due to the lockdown. We aimed to study the variation in psychiatry-related and addiction-related visits to the emergency department during the first COVID-19 lockdown compared with pre-lockdown periods.</p><p><strong>Methods: </strong>We examined psychiatry-related and addiction-related visits to the emergency department of Calais Hospital before and during the lockdown in France. We analyzed the differences between the periods by (1) comparing means and medians, (2) performing modeling using a generalized linear mixed model (GLMM) and an autoregressive integrated moving average model with exogenous variables (ARIMAX), and (3) identifying breakpoints in the time series.</p><p><strong>Results: </strong>For psychiatry-related visits, the mean was higher before the lockdown (4.05) compared to during the lockdown (2.36, p < 0.001). A negative slope of -0.55 (p < 0.001) was found with the GLMM, confirming the decrease. The ARIMAX yielded similar results (slope: -1.74, p < 0.001). There was a breakpoint in the time series 11 days before the lockdown. For addiction-related visits, the mean was lower before the lockdown (0.8) compared to during the lockdown (1.46, p = 0.044). The GLMM found a positive slope of 0.62 (p = 0.005), confirming the increase and the ARIMAX showed similar results (slope: 0.74, p < 0.001).</p><p><strong>Conclusion: </strong>During the first weeks of the COVID-19 pandemic, psychiatry-related visits to the emergency department decreased, while addiction-related visits increased. The decrease in psychiatric visits began before the first COVID-19 lockdown.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early detection and intervention in at-risk mental states: rationale, structure, and clinical experience from a specialized outpatient service.","authors":"Antonia Renner, Joachim Rockenschaub, Maximus Berger, Clemens Mielacher, Fabian Friedrich, Nilufar Mossaheb","doi":"10.1007/s40211-026-00591-5","DOIUrl":"https://doi.org/10.1007/s40211-026-00591-5","url":null,"abstract":"<p><p>Early detection and intervention are important components of contemporary psychiatric care. They aim to identify emerging mental disorders and clinically relevant at-risk states early on so as to provide timely, needs-based support. This article discusses the rationale, structure, and clinical experience of a specialized outpatient service for early detection and intervention at the Medical University of Vienna and presents an analysis of service uptake/patient characteristics. Located within a tertiary psychiatric university hospital, the service offers low-threshold access, structured diagnostic assessments, multidisciplinary care, and longitudinal monitoring. Patient characteristics are presented based on a retrospective descriptive analysis of routine clinical data collected since 2014, illustrating the heterogeneity of help-seeking individuals presenting with at-risk states, including diverse diagnostic profiles and functional needs. Our findings underscore the importance of individualized, stage-specific care that goes beyond transition prediction to focus on current distress, psychosocial functioning, quality of life, and reducing symptom burden. Integrated early detection services may improve access to care, ensure continuity of treatment, and enable timely intervention for individuals at risk for or in the early stages of psychosis.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Diagnostic challenges of Wernicke-Korsakoff syndrome: A case report].","authors":"Paula Hoppstock, Lea Sommer, Mathias Jachs, Clemens Dejaco, Gregor Kasprian, Radheshyam Stepponat, Armin Trojer, Sabine Weber, Stephan Listabarth, Daniel König","doi":"10.1007/s40211-025-00566-y","DOIUrl":"10.1007/s40211-025-00566-y","url":null,"abstract":"<p><p>Korsakoff syndrome (KS) presents an interdisciplinary challenge in diagnosis and care. The frequent lack of distinct clinical symptoms represents a diagnostic challenge and can complicate early diagnosis. This case report describes a 59-year-old patient who initially presented to internal medicine due to symptoms that appeared to be associated with pre-known cardiovascular and metabolic comorbidities. The initial suspected diagnosis of osmotic demyelination syndrome (formerly known as pontine myelinolysis), which can induce a clinical state very similar to KS, could only be ruled out by MRI evidence of atrophy of the mammillary bodies, confirming the diagnosis of KS. High-dose thiamine supplementation, neurorehabilitative measures, and support by a stable social environment, led to an improvement in cognitive performance. This case highlights the need for differential diagnostic efforts regarding KS and interdisciplinary awareness beyond neurological and psychiatric disciplines.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":"152-158"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145764033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of gambling behavior and risk for gambling disorder in Austria.","authors":"Hans Rittmannsberger, Kurosch Yazdi-Zorn, Jan Rosenleitner, Isabella Fuchs-Leitner","doi":"10.1007/s40211-026-00586-2","DOIUrl":"https://doi.org/10.1007/s40211-026-00586-2","url":null,"abstract":"<p><strong>Background: </strong>After gambling disorder (GD) was included as the first behavioral addiction in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), many studies focused on epidemiology and the impact of different risk factors. In this context, online gambling seems to show especially high addictive potential and, additionally, lacks government control and restrictions.</p><p><strong>Methods: </strong>In this study, we aimed to evaluate the prevalence of GD, as well as various aspects of gambling behavior in a representative Austrian sample (N = 3658). An adapted version of a standardized questionnaire was applied, which covered all nine DSM-5 criteria for GD.</p><p><strong>Results: </strong>Results indicate a lifetime prevalence for gambling of 34.9%, with 4.5% of the whole population at high risk for GD. Males engaged in online gambling three times more often than female participants, and prevalence for online gambling was highest in the youngest cohort (16-29 years).</p><p><strong>Conclusion: </strong>Our findings suggest a general increase in gambling behavior, with clear indications for a higher vulnerability of younger participants as well as for males compared to females. Results are discussed in light of clinical relevance, and the need for further restrictions, especially for online gambling, is argued.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Neuropsychological effects of playing violent video games].","authors":"Christoph Czermak","doi":"10.1007/s40211-026-00574-6","DOIUrl":"10.1007/s40211-026-00574-6","url":null,"abstract":"<p><p>In the wake of current events, the question arises as to the possible psychological and biological consequences of playing violent video games. This area of research has grown enormously in recent decades, with several hundred publications examining a total of over 100,000 study participants. Various meta-analyses in recent years have repeatedly demonstrated a statistically significant aggression-promoting effect of playing violent video games. Nevertheless, controversies continue to arise in this field. Studies on possible biologically measurable changes in the brain have produced mixed results. The following review article provides a brief overview of the current state of this research area. The discussion addresses methodological difficulties, further open questions, hypotheses regarding the nature of the aggression-promoting effect, sociopolitical aspects, and possible conclusions.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":"159-164"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146150910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mendel randomization confirmed gastroesophageal reflux disease may increase the risk of mental disorders.","authors":"Yang Wu, Tian Li, Yanan Zhang, Chujiang Wu, Xiaofeng Zheng, Xiaohui Yu, Jiucong Zhang","doi":"10.1007/s40211-025-00546-2","DOIUrl":"10.1007/s40211-025-00546-2","url":null,"abstract":"<p><strong>Background: </strong>The potential causal relationship between gastroesophageal reflux disease (GERD) and mental disorder was analyzed using the mendelian randomization (MR) method.</p><p><strong>Methods: </strong>Data are derived from genome-wide association study (GWAS) summary data, using gastroesophageal reflux disease (GERD) as the exposure factor. Single nucleotide polymorphisms (SNPs) significantly associated with GERD were selected as instrumental variables (IVs), and mental disorders (bipolar disorder, major depression, Alzheimer's disease, anorexia nervosa, anxiety, and obsessive-compulsive disorder) were used as outcome variables. The inverse variance weighted (IVW) method is used as the main analysis method, and MR-Egger regression, weighted median (WM) method, simple mode and weighted mode are used as supplementary methods for Mendelian randomization (MR) analysis. Cochran's Q test and P value are used to quantify heterogeneity, MR-Egger regression was used to evaluate the multilevel effect test of SNPs, and leave-one-out method to determine whether there are potential SNPs, and to evaluate the stability of the results. Odds ratio (OR) and 95% confidence interval (CI) were used as effect indicators to evaluate whether there is a causal relationship between GERD and mental disorders.</p><p><strong>Results: </strong>IVW demonstrated a causal relationship between GERD and bipolar disorder (OR = 1.70, 95%CI = 1.39-2.09, P < 0.05) and anorexia nervosa (OR = 0.71, 95%CI = 0.52-0.99, P < 0.05). Furthermore, there is a weak causal relationship between GERD and major depression (OR = 1.01, 95%CI = 1.01-1.02, P < 0.05) and anxiety (OR = 1.01, 95%CI = 1.01-1.01, P < 0.05). Similarly, there is no evidence of a causal relationship between GERD and Alzheimer's disease (OR = 0.95, 95%CI = 0.87-1.03, P > 0.05) or obsessive-compulsive disorder (OR = 0.95, 95%CI = 0.67-1.36, P > 0.05). Cochran's Q test for heterogeneity shows that there is no significant heterogeneity (P > 0.05) for bipolar disorder, anxiety, and obsessive-compulsive disorder. However, major depression, Alzheimer's disease, and anorexia nervosa have some degree of heterogeneity (P < 0.05). Horizontal pleiotropic analysis showed that the P values for six mental disorders (0.750, 0.296, 0.154, 0.798, 0.893, 0.451) were all greater than 0.05. Leave-one-out analysis and funnel plot showed that MR analysis results can be considered relatively stable. All F are > 10, indicating no weak IVs bias.</p><p><strong>Conclusion: </strong>GERD can obviously increase the risk of bipolar disorder; the increased risk of anxiety disorder is very slight. There is no clear evidence to support the causal relationship between GERD and four other mental disorders, including major depression, Alzheimer's disease, anorexia nervosa, and obsessive-compulsive disorder.</p>","PeriodicalId":44560,"journal":{"name":"NEUROPSYCHIATRIE","volume":" ","pages":"129-140"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}