Journal of Clinical Psychiatry最新文献

{"title":"Lumateperone as Adjunctive Therapy in Patients With Major Depressive Disorder and Anxious Distress: Post Hoc Analysis of a Phase 3, Randomized, Double-Blind Trial.","authors":"Gary S Sachs, Suresh Durgam, Willie R Earley, Susan G Kozauer, Changzheng Chen, Prakash Masand","doi":"10.4088/JCP.26m16409","DOIUrl":"10.4088/JCP.26m16409","url":null,"abstract":"<p><p><b>Objective:</b> Anxious distress is associated with poor outcomes in the treatment of major depressive disorder (MDD). This exploratory post hoc analysis utilized data from a phase 3 study to investigate adjunctive lumateperone 42 mg efficacy in patients with MDD with inadequate antidepressant therapy (ADT) response and anxious distress.</p><p><p><b>Methods:</b> Outpatients (18-65 y) had <i>DSM-5</i>-defined MDD with inadequate response to 1-2 ADTs in the current depressive episode, Montgomery-Åsberg Depression Rating Scale (MADRS) Total score ≥24, and Clinical Global Impression-Severity (CGI-S) score ≥4 (July 2021-February 2024). Patients were randomized to 6-week oral lumateperone 42 mg+ADT (n=239) or placebo+ADT (n=242). Efficacy was assessed in patients with or without <i>DSM-5</i>-defined anxious distress.</p><p><p><b>Results:</b> Of 481 patients, 43% met criteria for anxious distress. Lumateperone+ADT significantly improved MADRS Total score from baseline to Day 43 versus placebo+ADT in patients with anxious distress (least squares mean difference vs placebo [LSMD]= -6.8; 95% CI=-9.00 to -4.51; effect size [ES]=0.85; <i>P</i><.0001) or without (LSMD=-3.5; 95% CI=-5.47 to -1.58; ES=0.44; <i>P</i> <.001). MADRS response and remission rates at Day 43 were significantly greater with lumateperone+ADT in both subgroups (<i>P</i><.05). At Day 43, lumateperone+ADT significantly improved CGI-S score (<i>P</i><.0001), MADRS inner tension item (<i>P</i><.001), and Quick Inventory of Depressive Symptomatology-Self Report-16 item Total score (<i>P</i><.05) in both subgroups. Generalized Anxiety Disorder-7 item Total score significantly improved at Day 43 with lumateperone+ADT in patients with anxious distress (<i>P</i> <.0001) but did not reach statistical significance in those without anxious distress (<i>P</i>=.379).</p><p><p><b>Conclusion:</b> Adjunctive lumateperone 42 mg significantly improved depression and anxiety symptoms in patients with MDD with inadequate ADT response and anxious distress.</p><p><p><b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT04985942.</p>","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"87 3","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Voice of the Patient.","authors":"Mark Opler","doi":"10.4088/JCP.26com16630","DOIUrl":"https://doi.org/10.4088/JCP.26com16630","url":null,"abstract":"","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"87 4","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Speech to Develop Multivariable Prediction Models for Major Depressive Disorder and Generalized Anxiety Disorder During Pregnancy.","authors":"Hamideh Bayrampour, Joana Amorim, Joao Pimentel, Sukhpreet K Tamana, Patricia Janssen, Alixandra Bacon, Frank Rudzicz","doi":"10.4088/JCP.26m16487","DOIUrl":"https://doi.org/10.4088/JCP.26m16487","url":null,"abstract":"<p><p></p><p><p><b>Objective:</b> Depression and anxiety are common during pregnancy yet remain underdetected. In this project, we examined the usefulness of speech for predicting major depressive disorder (MDD) and generalized anxiety disorder (GAD) during pregnancy.</p><p><p><b>Methods:</b> We conducted a Prediction Model Development and Evaluation Study using data collected from July 2019 to May 2020 in British Columbia, Canada. MDD and GAD diagnoses were ascertained using the Structured Clinical Interview for <i>DSM-5</i>. We extracted speech features from recorded interviews that contained the voices of both patient and the interviewer (full interview), as well as from manually verified speech segments (VS) of patients. We trained several machine learning models and compared the predictive performance of speech-based models with combined models-consisting of pregnancy/sociodemographic characteristics and speech features-in multivariate analyses.</p><p><p><b>Results:</b> The total sample included 146 participants: 19 with MDD, 28 with GAD (3 had comorbid MDD and GAD), and 102 controls (no current/past known psychiatric disorders). Speech models based on the full interviews showed consistent patterns of good performance for MDD (F1-scores between 74%-77%) and GAD (F1-scores between 76%-80%). Models based on VS showed poor performance for MDD (F1-scores between 42%-45%) and acceptable performance for GAD (F1-scores between 51%-65%). Adding pregnancy/sociodemographic characteristics to the best speech models did not improve the performance of GAD models (best F1-score 78.00%±19.86) and slightly reduced that of MDD models (best F1-score 76.00%±11.45).</p><p><p><b>Conclusion:</b> The most influential speech features for prediction of MDD and GAD during pregnancy aligned with those reported among the general population.</p>","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"87 4","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilizing a Smartphone Application for Perinatal Depression Screening and Care Linkages: A Cross-Sectional Cohort Study.","authors":"Kay Roussos-Ross, Rhea Parimoo, Nayana A Sojin, Jungjun Bae, Deepthi S Varma, Raisa Zarin, Lauren A Agliano, Megan Deichen Hansen, Tony Wen, Amie J Goodin","doi":"10.4088/JCP.26m16429","DOIUrl":"https://doi.org/10.4088/JCP.26m16429","url":null,"abstract":"<p><p></p><p><p><b>Objective:</b> To evaluate the feasibility of a smartphone app in the identification of perinatal depression (PND) symptoms and provision of subsequent follow-up care/service linkages to postpartum participants.</p><p><p><b>Methods:</b> Recruitment occurred from November 2021 to June 2024 for this cross-sectional study. Postpartum patients delivering a liveborn infant at a quaternary care academic hospital were offered participation if they were ≥18 years old, English-speaking, used a smartphone, and agreed to downloading the study app. Participants were asked to complete at least 1 in-app mental health assessment per week over the 6-week study period; assessments included the Edinburgh Postpartum Depression Scale (EPDS). Participants identified as at risk of PND received a follow-up call from a study nurse. Process and outcome measure analysis was conducted and reported as proportions.</p><p><p><b>Results:</b> We identified 13.6% (n=202) of participants with actively monitored pregnancies as having symptoms of PND through positive screening on the EPDS, while 115 participants received nurse follow-up due to participant requests or nonresponsiveness to app prompts. These interactions resulted in 475 nurse telephone calls to 317 participants, with some participants receiving multiple calls. Most participants contacted by the study nurses (17.2%, n=254) preferred to continue with in-app monitoring over seeking care in a traditional clinical setting. The prescreening mood item showed a sensitivity of 65.7% and specificity of 92.6% against the EPDS as the reference standard, supporting its role as a triage tool rather than a replacement for validated screening.</p><p><p><b>Conclusion:</b> The prevalence of probable PND in our cohort is comparable to that observed in US women, demonstrating the app's ability to identify PND in postpartum individuals. Mobile health apps can assist clinicians in identification and management of patients with depression.</p>","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"87 4","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment-Resistant Depression as a Dynamic Continuum: A Consensus Panel Report on Mechanism-Informed Pharmacologic Sequencing.","authors":"Anita H Clayton, Michael Asbach, Patricia Cabrera, Cristina Cusin, Jay Fawver, Jordan F Karp, Laura Leahy","doi":"10.4088/JCP.htrdachi2508","DOIUrl":"https://doi.org/10.4088/JCP.htrdachi2508","url":null,"abstract":"<p><p>Treatment-resistant depression (TRD) affects a substantial proportion of patients with major depressive disorder and is associated with significant functional impairment, elevated suicide risk, and increased treatment complexity. In December 2025, a multidisciplinary expert consensus panel convened in Boston, Massachusetts, to address contemporary challenges in the identification and pharmacologic management of TRD. The panel concluded that TRD is best understood as a dynamic continuum reflecting the interaction between illness biology, patient complexity, and cumulative treatment history-not a categorical end point defined only by a fixed number of prior failures. Early identification of inadequate antidepressant response through measurement-based care, diagnostic reassessment, and active comorbidity management is essential to preventing entrenched resistance and functional decline. Pharmacologic sequencing should prioritize mechanistic diversity, with nonresponse prompting a mechanism switch and partial response prompting augmentation; as resistance arises, timely referral and consideration of therapies targeting glutamatergic signaling and potentially related neuroplasticity are warranted. Special populations-including patients with suicidality, comorbid anxiety or trauma, and unrecognized bipolarity-require faster escalation and closer monitoring. To support clinical implementation, the panel developed a 4-stage framework-spanning initial detection through high-acuity interventions-that operationalizes these recommendations across levels of care. These consensus recommendations are intended to help clinicians act earlier, sequence treatments more strategically, and match pharmacologic choices to the biology underlying each patient's resistance.</p><p><p><i>J Clin Psychiatry</i> <i>2026;87(3):htrdachi2508</i>.</p>","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"87 3","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Sexual Function With Adjunctive Lumateperone in Patients With Major Depressive Disorder.","authors":"Anita H Clayton, Willie R Earley, Susan G Kozauer, Yifan Mo, John B Edwards, Suresh Durgam","doi":"10.4088/JCP.26m16387","DOIUrl":"10.4088/JCP.26m16387","url":null,"abstract":"<p><p><b>Objective:</b> Lumateperone is an atypical antipsychotic to treat schizophrenia, bipolar I or II depression, and major depressive disorder (MDD). Randomized phase 3 Study 502 (NCT05061706) investigated the impact of adjunctive lumateperone 42 mg/day on sexual functioning, per Changes in Sexual Functioning Questionnaire 14-item version (CSFQ-14).</p><p><p><b>Methods:</b> Adults meeting <i>DSM-5</i> criteria for MDD with inadequate response to 1-2 antidepressant therapies (ADTs) in the current depressive episode, Montgomery-Åsberg Depression Rating Scale Total score ≥24, Clinical Global Impression Scale-Severity score ≥4, and Quick Inventory of Depressive Symptomatology-Self Report-16-item score ≥14 were randomized to 6-week lumateperone 42 mg+ADT or placebo+ADT. Sexual function was assessed by CSFQ-14 Total and domain scores in the intent-to-treat (ITT) population and subgroups.</p><p><p><b>Results:</b> Of 480 patients in the ITT population, 82.5% had sexual dysfunction at baseline (women=284; men=112). Lumateperone+ADT significantly improved CSFQ-14 Total score at Day 43 vs placebo+ADT (least squares mean difference [LSMD]=2.7; effect size [ES]=0.38; <i>P</i><.0001). Significantly greater improvements were observed in patients with baseline sexual dysfunction (LSMD=3.1; ES=0.42; <i>P</i><.0001), with no change in those without. Improvements were observed in women (LSMD=3.5; ES=0.47; <i>P</i><.0001) and in men (LSMD=1.9; ES=0.33; <i>P</i>=.08). Significant improvements in CSFQ-14 Total score at Day 43 were observed across age groups and CSFQ domain scores, with both sexes having significant improvements in pleasure and desire/interest. Improvements in depressive symptoms may be linked to improvement in sexual functioning.</p><p><p><b>Conclusions:</b> Adjunctive lumateperone 42 mg did not worsen sexual functioning and was not associated with treatment-related sexual dysfunction in patients with MDD with inadequate response to ADT.</p><p><p><b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT05061706.</p>","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"87 3","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacotherapies for Co-Occurring Stimulant Use Disorder and Attention-Deficit/Hyperactivity Disorder: A Network Meta-Analysis.","authors":"Henrique N P Oliva, Alejandra Pulido-Saavedra, Alisson M Paredes Naveda, Emerson Forselius, Marc N Potenza, Oluwole O Jegede, Gustavo A Angarita","doi":"10.4088/JCP.26r16478","DOIUrl":"10.4088/JCP.26r16478","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the benefit of pharmacotherapies for adults with co-occurring stimulant use disorder (StUD) and attention-deficit/hyperactivity disorder (ADHD) using network meta-analysis.</p><p><p><b>Data Sources:</b> Searches were conducted of PubMed, Embase, Scopus, Web of Science, and ClinicalTrials.gov from inception to February 2026, without language restrictions.</p><p><p><b>Study Selection:</b> Of 4,152 studies retrieved, 6 were included. These evaluated pharmacologic treatments in co-occurring StUD and ADHD, reporting stimulant use parameters and ADHD symptom-related outcomes. We excluded studies not including both disorders, reviews, and abstracts.</p><p><p><b>Data Extraction:</b> Data extracted included continuous abstinence from stimulants, negative urine toxicologies, and ADHD severity. Pharmacotherapies included methylphenidate (MPH), mixed amphetamine salt (MAS), and bupropion. Standardized mean differences (SMDs) or odds ratios (ORs) were calculated; treatment ranking probabilities were assessed using P-scores.</p><p><p><b>Results:</b> Higher-dose MPH and MAS were associated with superior outcomes. For continuous abstinence, MAS produced the greatest benefit versus placebo (OR=8.45; 95% CI, 2.55-27.98; <i>P</i>=.0005), with the 80-mg dose ranking highest in the network analysis (P-score=0.846). Similarly, pharmacotherapy increased the odds of negative urine tests (OR=1.65; 95% CI, 1.01-2.71; <i>P</i>=.05), and the highest MAS dose again ranked first (P-score=0.890). Regarding improvement in ADHD symptom severity (SMD=-0.59; 95% CI, -0.94 to -0.23; <i>P</i>=.001), the greatest reduction was observed with MPH 180 mg (P-score=0.899). Safety profiles for pharmacotherapies were comparable with placebo.</p><p><p><b>Conclusions:</b> Stimulant-based pharmacotherapies, particularly higher-dose MPH and MAS, were associated with superior outcomes for both stimulant-use indicators and ADHD symptoms. These findings support consideration of optimized stimulant dosing when treating co-occurring StUD and ADHD, though further trials are warranted to refine clinical recommendations.</p>","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"87 4","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electroconvulsive Therapy and All-Cause Mortality, Nonsuicide Mortality, and Suicide Mortality.","authors":"Chittaranjan Andrade","doi":"10.4088/JCP.26f16659","DOIUrl":"10.4088/JCP.26f16659","url":null,"abstract":"<p><p>Electroconvulsive therapy (ECT) is associated with early benefits and with high response and remission rates in patients with depression; recovery from depression may, in turn, carry short- and long-term benefits. This article examines observational data on short- and long-term all-cause mortality, nonsuicide mortality, and suicide mortality following treatment of depression with ECT. To frame the subject in its proper context, a very large meta-analysis found that, relative to nondepressed or general population controls, depression was associated with a doubled risk of all-cause mortality, a tenfold risk of suicide mortality, and an increased risk of mortality in the presence of a wide range of medical comorbidities. All-cause mortality risks were also higher in psychotic depression relative to nonpsychotic depression and in treatment-resistant depression relative to depression that was not treatment-resistant. Three meta-analyses on mortality risks following ECT were published in 2025; these had partially, but not fully, overlapping datasets. The overall impression from these meta-analyses was that ECT-treated depressed cohorts were at lower risk of all-cause mortality, nonsuicide mortality, and natural cause mortality relative to comparison cohorts receiving treatments other than ECT. The all-cause mortality benefit was evident early as well as during long-term follow up. ECT-treated cohorts were also at lower risk of suicide mortality, though this finding appeared to be limited to the initial months posttreatment. Possible explanations for the findings are considered. Confounding by indication and confounding by severity of indication may also play a role, though more against ECT than in favor of ECT. Although cause-effect relationships cannot be asserted from observational studies, these findings encourage the use of ECT in depressed subjects for whom ECT is indicated. However, these findings cannot be extrapolated to all depressed samples.</p>","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"87 4","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obstetric Risk Associated With Stimulant Versus Nonstimulant Treatment During Pregnancy.","authors":"Dara E Babinski, Wen-Jan Tuan","doi":"10.4088/JCP.26m16372","DOIUrl":"https://doi.org/10.4088/JCP.26m16372","url":null,"abstract":"<p><p></p><p><p><b>Objective:</b> To evaluate and compare the obstetric risks associated with stimulant and nonstimulant medication use during pregnancy.</p><p><p><b>Methods:</b> This retrospective cohort study used TriNetX electronic health records from 894,986 pregnancies recorded between 2010 and 2023. Women aged 18-45 years were grouped by attention-deficit/hyperactivity disorder (ADHD) medication exposure during pregnancy: stimulant (n=3,465), nonstimulant (n=575), or no ADHD medication (n=890,946). Propensity score-based inverse probability of treatment weighting balanced demographic, substance use, medical, and mental health factors, including ADHD. Weighted logistic regression compared adverse pregnancy outcomes across groups.</p><p><p><b>Results:</b> Stimulant and nonstimulant use during pregnancy were both associated with increased risk for several obstetric complications compared to no medication, with increased-risk odds ratios ranging from 1.21 to 1.85 for stimulants and 1.12 to 5.70 for nonstimulants. Compared with nonstimulants, stimulants were associated with higher odds of placenta previa and large for gestational age but lower odds of gestational diabetes, placental abruption, intrauterine growth restriction, and preterm delivery.</p><p><p><b>Conclusion:</b> Stimulant and nonstimulant use during pregnancy were associated with increased obstetric risk. Given the observational electronic health record design, lack of an ADHD-unmedicated comparison group, and lack of adjustment for concomitant medication exposures, findings should be interpreted as potential safety signals rather than definitive causal estimates. Findings support individualized risk-benefit assessment and further research on ADHD treatment during pregnancy.</p>","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"87 3","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ADHD Medication Safety in Pregnancy: Precise Estimates, Uncertain Causal Inference.","authors":"Jacqueline M Cohen","doi":"10.4088/JCP.26com16606","DOIUrl":"https://doi.org/10.4088/JCP.26com16606","url":null,"abstract":"","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"87 3","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}