Clinical Neuropsychiatry最新文献

{"title":"The Relationship Between Academic Stress and Student Suicide: A Systematic Review and Meta-Analysis.","authors":"Manish Tyagi, Vinod Kumar Singh, Hare Krishna, Ajay Kumar","doi":"10.36131/cnfioritieditore20260205","DOIUrl":"https://doi.org/10.36131/cnfioritieditore20260205","url":null,"abstract":"<p><strong>Objective: </strong>Academic stress has been increasingly identified as a possible risk factor for suicidal behavior among students at all levels of education and in international settings. This systematic review and meta-analysis was conducted to synthesize the existing evidence for the association between academic stress and suicidal ideation and behavior.</p><p><strong>Method: </strong>A systematic search was performed across six databases, viz., PubMed, Scopus, PsycINFO, Web of Science, CINAHL, and the Cochrane Library, from inception until May 2025. The criteria for study inclusion necessitated them to quantitatively measure academic stress and suicide-related outcomes, viz., suicidal ideation and suicide attempts, among adolescent or young adult student groups. Data extraction involved demographic details, measurement tools for stress and suicidality, statistical findings, and covariate adjustments. The AXIS tool was applied to evaluate the risk of bias. Meta-analysis was carried out using RevMan 5.4.1, employing a random-effects model to estimate pooled mean differences (MD) for continuous outcomes and odds ratios (OR) for dichotomous outcomes.</p><p><strong>Results: </strong>10 cross-sectional studies were included in the review. Academic stress was measured with a range of instruments, mostly self-report questionnaires. Most studies reported suicidal ideation as the main outcome, and fewer used suicide attempts or probability estimates. There were distinct methodological variations in stress severity classification, psychologic or academic confounder adjustment, and psychometric properties reporting. Pooled mean difference between females and males in academic stress was nonsignificant (MD=10.38; 95% CI: -6.34 to 27.09; p=0.22), as was between suicidal ideation (MD=14.43; 95% CI: -22.16 to 51.02; p=0.44). Overall continuous outcomes were also nonsignificant (MD=12.38; 95% CI: -3.70 to 28.47; p=0.13). The pooled odds ratios for suicidal ideation and suicide attempts, however, were statistically significant (OR=0.01; 95% CI: 0.01 to 0.02 and OR=0.00; 95% CI: 0.00 to 0.02 respectively; both p<0.0001) indicating a correlation with increased academic stress. Additionally, there was extremely large heterogeneity in most of the pooled analyses (I²> 98%).</p><p><strong>Conclusions: </strong>The prevalence of academic stress had a strong association with suicidal ideation and suicide attempts in dichotomous outcome models. However, continuous outcomes did not yield significant differences in the two genders. Associations that were found were confounded by measurement instrument variability, not making proper adjustments for psychiatric and academic confounders, and methodological differences in studies.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"23 2","pages":"165-181"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784855","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":"Association Between Serum Adropin Levels and Cognitive Impairment in the Elderly: A Cross-Sectional Study.","authors":"Safinaz Abousamra, Mohammed M El Arman, Hossam Arafa Ghazi, Heba Shereif El-Sobky, E Hatata","doi":"10.36131/cnfioritieditore20260203","DOIUrl":"https://doi.org/10.36131/cnfioritieditore20260203","url":null,"abstract":"<p><strong>Objective: </strong>Despite promising data from rodent models demonstrating a link between adropin deficiency and cognitive dysfunction, in-depth examinations of such an association in humans are lacking. Accordingly, the present study investigated the relationship between serum adropin levels and cognitive function in a sample of elderly individuals.</p><p><strong>Method: </strong>This cross-sectional study included 90 elderly (≥ 65 years of age) participants from geriatric outpatient clinics at Mansoura University (Mansoura City, Egypt), who were classified with normal cognition, mild neurocognitive disorder/mild cognitive impairment, or major neurocognitive disorder/dementia according to criteria from the Diagnostic and Statistical Manual of Psychiatric Disorders, Fifth Edition. Assessments included a comprehensive geriatric evaluation, cognitive testing, and measurement of serum adropin levels and metabolic parameters.</p><p><strong>Results: </strong>Multivariate regression (R²= 0.464) revealed that serum adropin (β = 3.09, p < 0.001), education ≥ 4 years (β = 1.47, p = 0.040), and total cholesterol level (β = -0.02, p = 0.004) were independently associated with Mini-Mental State Examination scores. Adropin levels ≤ 1.9 ng/mL yielded 90.2% sensitivity and 95.9% specificity for discriminating cognitive impairment (mild cognitive impairment and dementia), and ≤ 1.6 ng/mL specifically for dementia, with 83.3% sensitivity and 93.1% specificity.</p><p><strong>Conclusions: </strong>Lower serum adropin levels were significantly associated with cognitive impairment in elderly individuals, with strong diagnostic discriminative ability (area under the receiver operating characteristic curve, 0.993). However, larger-scale longitudinal studies are required to establish causality and validate these findings.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"23 2","pages":"144-153"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785253","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":"Sex Differences and Psychological Assessments in Chronic Pain: A Systematic Review and Meta-Analysis.","authors":"Harvey Sudharta, Marson Putra, Ika Suswanti, Kevin Kristian, Isadora Gracia Sahusilawane, Jimmy Fransisco Abadinta Barus","doi":"10.36131/cnfioritieditore20260207","DOIUrl":"https://doi.org/10.36131/cnfioritieditore20260207","url":null,"abstract":"<p><strong>Objective: </strong>Mental illnesses often coexist with pain, forming a vicious cycle that exacerbate disabilities. Existing sex biases and conflicting study results remain contentious. The primary outcome of this systematic review and meta-analysis is to compare different psychological assessment scores across sexes in chronic pain populations.</p><p><strong>Method: </strong>We performed a systematic review of the association of mental health outcomes among different sexes in the chronic pain population based on a comprehensive search of PubMed, ScienceDirect, ProQuest, and EBSCOhost. A meta-analysis was conducted based on available data to clarify the association between psychological test results and sex differences. Joanna Briggs Institute (JBI tool) was used to verify the quality of the evidence. The Standardized Mean Differences (SMD) with a confidence interval (CI) of 95% were used to determine the association.</p><p><strong>Results: </strong>Nine cross-sectional studies were included in the meta-analysis (3,003 participants), comprising four anxiety and eight depression assessments. The JBI tool rated all studies as high quality. The analysis showed that females had significantly lower anxiety scores (SMD - 0.10; p = 0.03) with chronic pain. The depression scores did not differ between sexes (SMD 0.13; p = 0.20).</p><p><strong>Conclusions: </strong>This study demonstrated that females had significantly lower anxiety scores than males in chronic pain populations, with no differences in depression. Therefore, care should unbiasedly address the pain experience and mental health in males, which is often underrecognized among chronic pain sufferers.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"23 2","pages":"193-204"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784947","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":"Informal Caregivers As True Partners In Mental Health Recovery: Is It Time For A Complete Rewrite?","authors":"Shyhrete Rexhaj, Jocelyn Deloyer, Philippe Golay, Laurence Fond-Harmant, Jérôme Favrod, Charles Bonsack, Yasser Khazaal, Camille Gaglio, Alexandra Nguyen, Krzysztof Skuza, Margarita Maraitou, Hélène Wilquin, Romain Rey, Spyridon Zormpas, Christian Burr, Aurélie Clement-Perritaz, Romuald Droczinski, Monique Corbaz, Christian Pfister, André Decreane, Donatella Marazziti","doi":"10.36131/cnfioritieditore20260201","DOIUrl":"https://doi.org/10.36131/cnfioritieditore20260201","url":null,"abstract":"<p><p>This viewpoint highlights the indispensable role of informal caregivers in mental health recovery. The authors note that mental disorders affect around one in eight people worldwide, with major impacts on family quality of life and substantial health system costs. Informal caregivers are advocated not as peripheral supporters, but as key partners in care pathways, to be recognized in public policies and clinical practice. Scientific evidence shows their involvement reduces relapses, isolation, and hospitalization rates. This viewpoint identifies significant psychosocial risks facing informal caregivers and stresses the need for tailored support measures. The authors underscore the need for comprehensive support measures, clearer institutional recognition, ethically balanced information-sharing practices, structured educational initiatives, and more rigorous research and evaluation frameworks. Five priority areas are proposed for transforming care models: recognition, support, ethics, education, and research. Neglecting informal caregivers weakens mental health systems, whereas including them helps build more humane, effective, and resilient approaches.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"23 2","pages":"131-135"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785324","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":"How Psychological Trauma Affects Cognitive Functions: A Systematic Review and Meta-Analysis.","authors":"Patrizia Velotti, Guyonne Rogier, Francesca Favieri, Giuseppe Forte, Sara Beomonte Zobel, Stefania Cataudella, Claudia Civilla, Anna Velotti, Margherita Balladori, Andrea Capone, Emanuela Salati, Martina Salzillo, Micaela Sepe Monti, Marco Toccaceli Blasi, Marco Canevelli, Maria Casagrande, Giuseppe Bruno","doi":"10.36131/cnfioritieditore20260208","DOIUrl":"https://doi.org/10.36131/cnfioritieditore20260208","url":null,"abstract":"<p><strong>Objective: </strong>Promising research has investigated the relationships between psychological trauma and cognitive impairments, resulting in deficits of information processing, attention or memory. From a clinical point of view, investigations regarding the potential associations between cognitive outcomes and trauma appear useful to draw informed clinical indications for practitioners. However, the current lack of systematization of the existing literature makes difficult to frame in a comprehensive perspective the results brought by empirical research.</p><p><strong>Method: </strong>PRISMA principles were used to perform a systematic search on MEDLINE, PubMed, PsycINFO, PsycARTICLES, Scopus and Web of Science databases. Studies were screened and selected using inclusion/exclusion criteria defined in a PICOS format.</p><p><strong>Results: </strong>The initial search identified 75.245 records and led to the final inclusion of 29 independent contributions assessing between-group differences considering differences according to trauma exposure or posttraumatic stress disorder diagnosis. After the extraction and codification of information and the computation of effect sizes, a series of meta-analyses were performed using a random effects model. Data confirm a significant impact of psychological trauma on cognitive domains, indicating that individuals who experienced traumas show worse cognitive functioning, particularly in the attention and executive functions domains. Moreover, meta-analyses reported that in the case of posttraumatic stress disorder, there are more cognitive domains impaired, including memory, processing speed, visuospatial processing, and global cognitive functioning.</p><p><strong>Conclusions: </strong>The study confirms a direct association between trauma and cognitive functioning, suggesting the importance of further studies examining the characteristics of the traumatic experience to provide clear clinical guidelines.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"23 2","pages":"205-224"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785330","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":"Intellectual Profiles in Children with Unilateral and Bilateral Cerebral Palsy: A Multilevel Analysis of the Wisc-Iv Scale.","authors":"Maria Chiara Di Lieto, Costanza Rufini, Elisa Matteucci, Benedetta Del Lucchese, Elena Beani, Veronica Barzacchi, Antea Scrocco, Chiara Pecini, Giuseppina Sgandurra","doi":"10.36131/cnfioritieditore20260204","DOIUrl":"https://doi.org/10.36131/cnfioritieditore20260204","url":null,"abstract":"<p><strong>Objective: </strong>Cerebral palsy (CP) is a neurodevelopmental disorder primarily affecting motor functioning and often accompanied by cognitive impairments. Although intellectual profiles in children with CP are known to be heterogeneous, standard intelligence assessments often rely on a single global IQ score, which may obscure important intra-individual differences and limit clinical usefulness. This study aimed to explore intellectual functioning in children with unilateral and bilateral spastic cerebral palsy using a detailed multi-level analysis to examine how motor impairments may influence performance on WISC-IV indices and subtests.</p><p><strong>Method: </strong>A cross-sectional study was conducted on 48 children aged 6-15 years with spastic cerebral palsy (24 unilateral, 24 bilateral). Inclusion required at least one WISC-IV index score above 80. Intellectual functioning was assessed through Full Scale IQ, four cognitive indices (verbal comprehension, perceptual reasoning, working memory, processing speed), and individual subtests. Participants were classified by cerebral palsy type and gross motor function level. Descriptive and comparative statistics identified significant group differences.</p><p><strong>Results: </strong>Intellectual profiles showed marked heterogeneity. Over half of the children showed marked discrepancies among WISC-IV index scores, making the Full Scale IQ difficult to interpret as a representation of their overall cognitive functioning. Working Memory and Processing Speed were the most frequently impaired indices. Processing Speed deficits were consistent across CP types and motor levels, while Working Memory impairments were more pronounced in children with bilateral CP. Perceptual and verbal reasoning differences were more evident in bilateral cases. Greater motor impairment correlated with lower Perceptual Reasoning and Processing Speed scores, highlighting the influence of motor functioning on performance.</p><p><strong>Conclusions: </strong>Detailed, multi-level assessments of WISC-IV performance provides a clearer understanding of cognitive functioning in children with CP. Considering indices and subtests in relation to motor constraints helps distinguish true cognitive abilities from motor-related limitations, supporting accurate diagnosis and targeted interventions.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"23 2","pages":"154-164"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785333","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":"Investigating the Pleiotropic Role of KIF21B in Schizophrenia and Multiple Sclerosis: A Bioinformatics Analysis.","authors":"Ela Doruk Korkmaz, Elif Everest","doi":"10.36131/cnfioritieditore20260202","DOIUrl":"https://doi.org/10.36131/cnfioritieditore20260202","url":null,"abstract":"<p><strong>Objective: </strong>Genome-wide association studies have identified shared genetic risk loci between schizophrenia (SCZ) and multiple sclerosis (MS), suggesting overlapping biological mechanisms despite distinct clinical presentations. Here, we aimed to characterize the biological plausibility of <i>KIF21B</i> as a shared genetic risk gene for SCZ and MS, two disorders with overlapping genetic risk loci despite distinct clinical presentations.</p><p><strong>Method: </strong>We performed bioinformatics analyses of <i>KIF21B</i> using publicly available data from GTEx, STRING, and the GWAS Catalog, including tissue-specific expression profiling, protein interaction network analysis, transcriptome-wide co-expression analysis, and phenome-wide association analysis.</p><p><strong>Results: </strong><i>KIF21B</i> expression was significantly enriched in both brain and immune tissues compared to other tissue types. Protein interaction network analysis demonstrated that <i>KIF21B</i> functions within microtubule-based transport machinery essential for axonal function. Co-expression analysis identified significant correlation with immune-related genes, including the established MS susceptibility gene <i>ANKRD55</i>, with pathway enrichment for T cell activation and lymphocyte diferentiation. Phenome-wide association analysis confirmed <i>KIF21B</i> pleiotropy across multiple autoimmune and psychiatric conditions.</p><p><strong>Conclusions: </strong>These findings support <i>KIF21B</i> as a biologically plausible shared risk gene whose dual neural and immune functions may contribute to susceptibility for both neuropsychiatric and autoimmune diseases of the central nervous system.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"23 2","pages":"136-143"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784912","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":"A Multi-Method Meta-Analysis of Neuro-Behavioral Motor Inhibition Outcomes Across Substance-Use Problems and Related Developmental Psychopathological Conditions: A Self-Regulation Approach.","authors":"Marco Cavicchioli, Sara Masoumi, Cesare Maffei, Simona Scaini, Federica Galli, Andrea Scalabrini","doi":"10.36131/cnfioritieditore20260206","DOIUrl":"https://doi.org/10.36131/cnfioritieditore20260206","url":null,"abstract":"<p><strong>Objectives: </strong>Alterations in motor inhibition (MI) may be involved in the homotypic and heterotypic developmental pathways of substance use disorders (SUDs) and related conditions (e.g., binge drinking). However, no studies have clarified the neuro-behavioral correlates of MI across the various conditions (e.g., ADHD and major depressive disorder in childhood/adolescence) constituting developmental trajectories of SUDs and related problems, especially within a self-regulation conceptual framework.</p><p><strong>Method: </strong>A multi-method meta-analysis (i.e., voxel-based, network, and multilevel) of MI tasks (i.e., Go/No-Go; Stop Signal) was conducted. Neuroimaging (fMRI) and event-related potential (ERP) data were analyzed. The study included children and adolescents with ADHD, adolescents with major depressive disorder, and subjects with SUDs and related conditions.</p><p><strong>Results: </strong>Sixty-eight studies (fMRI: 42; ERPs: 26) were included. The analysis showed a shared increased responsiveness of the rostral anterior cingulate cortex among conditions of interest during \"No-Go\" trials compared to healthy controls (HCs). Reduced N200/P300 waves, together with increased reaction times in response to MI task experimental conditions, were found among conditions of interest compared to HCs. Network meta-analysis results showed that distinct patterns of neural activity linked to different self-regulation domains differentiated these clinical conditions from one another.</p><p><strong>Conclusions: </strong>Common and distinct patterns of neuro-behavioral responses associated with self-regulation mechanisms, especially regarding MI, should be considered key latent dimensions involved in the homotypic and heterotypic developmental pathways of SUDs and related problems.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"23 2","pages":"182-192"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785316","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":"Sleep Quality And Its Associated Factors In Patients With Systemic Lupus Erythematosus.","authors":"Lai Thuy Duong, Nguyen Thi Phuong Thuy, Duong Minh Tam, Tran Thi Thu Ha, Pham Thi Minh Nham, Cao Thi Trinh, Nguyen Hoang Thanh","doi":"10.36131/cnfioritieditore20260105","DOIUrl":"https://doi.org/10.36131/cnfioritieditore20260105","url":null,"abstract":"<p><strong>Objective: </strong>To assess the prevalence of poor sleep quality and identify associated factors among patients with systemic lupus erythematosus (SLE).</p><p><strong>Method: </strong>A cross-sectional study was conducted at Bach Mai Hospital, Vietnam, from January 2024 to December 2024. Adult SLE patients meeting the ACR/EULAR 2019 classification criteria were consecutively enrolled. Data were collected on sociodemographic, clinical, behavioral, and psychological characteristics. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), with a global score >5 indicating poor sleep. Depression and anxiety were measured using the Beck Depression Inventory-II (BDI-II) and Hamilton Anxiety Rating Scale (HAM-A), respectively. Multivariate logistic and Tobit regression analyses were performed to identify factors associated with poor sleep quality and PSQI score.</p><p><strong>Results: </strong>A total of 453 SLE patients participated, of whom 66.7% exhibited poor sleep quality. In multivariate regression, poor sleep quality was independently associated with older age (OR: 1.05, 95% CI: 1.02-1.07), higher disease activity (SLEDAI; OR: 1.04, 95% CI: 1.01-1.06), greater organ damage (SLICC/ACR index; OR: 1.17, 95% CI: 1.02-1.34), and higher anxiety severity (mild: OR 2.51, moderate: OR 3.53). Alcohol use (OR: 0.24, 95% CI: 0.07-0.90) and opioid use (OR: 0.08, 95% CI: 0.01-0.99) were associated with lower odds of poor sleep quality. For PSQI score, worse sleep quality was significantly associated with older age (Coef.: 0.09, 95% CI: 0.06-0.11), more frequent lupus flares (2 episodes: Coef. 1.14; ≥3 episodes: Coef. 1.76), and higher anxiety severity (mild: 1.82; moderate: 2.34; severe: 3.99).</p><p><strong>Conclusions: </strong>Multidisciplinary approaches targeting psychological well-being, disease control, and healthy lifestyle behaviors are essential to improve sleep and quality of life in this population.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"23 1","pages":"56-62"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12937497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327560","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":"Why The Polyvagal Theory Is Untenable: An international expert evaluation of the polyvagal theory and commentary upon Porges, S.W. (2025). Polyvagal theory: current status, clinical applications, and future directions. Clin. Neuropsychiatry, 22(3), 169-184.","authors":"Paul Grossman, Gareth L Ackland, Andrew M Allen, Gary G Berntson Berntson, Lindsea C Booth, Gordon M Burghardt, Julie Buron, Vladimir Dinets, J Sean Doody, Mathias Dutschmann, David G S Farmer, James P Fisher, Alexander V Gourine, Michael J Joyner, John M Karemaker, Sahib S Khalsa, Edward G Lakatta, Cleo A C Leite, Vaughan G Macefield, Benedito H Machado, Robin M Machado, Clément Menuet, David Mendelowitz, Davi J A Moraes, Winfried Neuhuber, Matteo M Ottaviani, David J Paterson, Julian F Paton Paton, Peter R Pellegrino, Rohit Ramchandra, Julia Shanks, James S Schwaber, Kalyanam Shivkumar, K Michael Spyer, Edwin W Taylor, J Andrew Taylor, Tobias Wang, Song T Yao, Irving H Zucker","doi":"10.36131/cnfioritieditore20260110","DOIUrl":"https://doi.org/10.36131/cnfioritieditore20260110","url":null,"abstract":"<p><p>Thirty-nine highly acknowledged experts in the areas of the physiology and the evolution of the vagus nerve and of vertebrate social behavior (many whose works have been cited in the polyvagal theory [PVT] literature as supporting the theory) were invited by the first author to participate as co-authors of this article. They were asked to evaluate the PVT and comment upon an overview of the theory written by its author (Porges, 2025a). All those invited, save one, accepted and co-authored the paper. The dissenting scholar was \"unfamiliar with the PVT.\" This article specifically appraises--based upon the current state of knowledge of autonomic function and vertebrate evolution--several major elements of the PVT, as described in Porges (2025a) and elsewhere. These include: 1) the validity of PVT assumptions that respiratory sinus arrhythmia is a direct measure of the extent of central vagal drive to the heart; 2) PVT characterizations regarding the neuroanatomy and functions of two major brainstem vagal nuclei, the ventrally situated Nucleus Ambiguus and the Dorsal Motor Nucleus of the vagus nerve; 3) PVT assertions regarding the evolution of the vagus nerve; 4) PVT claims about the specificity of mammalian social behavior in relation to nonmammalian vertebrates, and 5) PVT interpretations of earlier seminal physiological literature. All co-authors agree that major tenets of the PVT are not supported by past or current knowledge and, in several instances, are inconsistent with the broader evidence base. Since the topics addressed constitute fundamental premises of the PVT, we conclude that the PVT is untenable, because it is not defensible based on existing neurophysiological and evolutionary evidence. The psychological elements composing the superstructure of the PVT are primarily derived from earlier psychological literature and are neither clarified nor strengthened by PVT constructs that lack evidence. This article does not intend to address alternative explanations about relations between vagal function and psychological processes, although such explanations do exist.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"23 1","pages":"100-112"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12937499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327624","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}