Journal of Clinical Psychiatry最新文献

{"title":"Effect of Nature Videos on the Burden of Caregivers of Patients With Dementia.","authors":"Kritta Supanimitamorn, Gobhathai Sittironnarit, Kankamol Jaisin, Naratip Sa-Nguanpanich, Kitikan Thana-Udom","doi":"10.4088/JCP.25m15817","DOIUrl":"10.4088/JCP.25m15817","url":null,"abstract":"<p><p></p><p><p><b>Objective:</b> Caregivers of people with dementia (PWD) often face burdens, but engaging in traditional mindfulness practices and spending time in nature can enhance positive emotions. This study aimed to assess the effectiveness and feasibility of nature videos in reducing burden, anxiety, and depression among caregivers of PWD in Thailand. As caregivers are often time poor, a brief 10-minute online mindfulness session was designed to make participation more feasible.</p><p><p><b>Methods:</b> This randomized controlled trial assigned 47 eligible individuals to 2 groups. The experimental group received dailynature videos for 4 weeks, while the control group received daily self-care guidance. The 12-item Zarit Burden Interview (12-item ZBI), the Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder-7 (GAD-7), and the Connor Davidson Resilience Scale (CD-RISC) were used to assess caregivers' burden at baseline and the 4-week follow-up. Recruitment occurred from March 2023 to February 2024.</p><p><p><b>Results:</b> The mean age was 50.59 years. On average, participants watched videos for 11.49 minutes per day, and the duration was 23 days. Both groups showed a significant decrease in burden at follow-up, but the between-group changes of 12-item ZBI were not significantly different. Brief mindfulness interventions reduced PHQ-9 scores by 4.14 points (<i>P</i><.001) and increased CD-RISC scores by 5.68 points (<i>P</i>=.001). GAD-7 and PHQ-9 were significantly positively correlated with the 12-item ZBI (<i>r</i>=0.55, <i>P</i><.001, and <i>r</i>=0.42, <i>P</i>=.005, respectively).</p><p><p><b>Conclusion:</b> Brief mindfulness interventions through nature videos and receiving self-care advice can reduce the burden among caregivers of PWD and reduce levels of depression.</p><p><p><b>Trial Registration:</b> Dataset from study at Thaiclinicaltrials.org identifier: TCTR20230216001.</p>","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"86 3","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790613","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":"Early Change in Depressive Symptom Severity With Naltrexone-Bupropion Combination and Its Association With Reduction in Methamphetamine Use in ADAPT-2 Trial.","authors":"Manish K Jha, Udi E Ghitza, Steve Shoptaw, Abu Minhajuddin, Snoben Kuruvila, Sidarth Wakhlu, Edward V Nunes, Joy Schmitz, Phillip O Coffin, Gavin Bart, Thomas Carmody, Madhukar H Trivedi","doi":"10.4088/JCP.25m15825","DOIUrl":"10.4088/JCP.25m15825","url":null,"abstract":"<p><p><b>Objective:</b> This study evaluated whether depressive symptom severity improved early with extended-release naltrexone and bupropion combination (naltrexone bupropion) compared to a placebo in individuals with moderate/severe methamphetamine use disorder and predicted subsequent use of methamphetamine.</p><p><p><b>Methods:</b> This secondary analysis from the Accelerated Development of Additive Pharmacotherapy Treatment for Methamphetamine Use Disorder (ADAPT-2) trial, which was conducted from May 23, 2017-July 25, 2019, included 326 individuals with a 9-item Patient Health Questionnaire (PHQ-9) score ≥5 at baseline. Repeated-measures mixed model analyses evaluated early (baseline-to-week-4) changes in depressive symptom severity with naltrexone-bupropion versus placebo and provided slope estimates for PHQ-9 change. Additional depression outcomes included response (≥50% reduction in PHQ-9 from baseline) and remission (PHQ-9 ≤4). Methamphetamine treatment response was ascribed if 3 out of 4 urine drug screens were negative during weeks 5 and 6. Logistic regression analyses evaluated whether changes in depression predicted methamphetamine treatment response. Covariates included age, sex, race, ethnicity, and baseline PHQ-9.</p><p><p><b>Results:</b> There was a greater reduction in PHQ-9 scores at week 4 with naltrexone-bupropion versus placebo (estimate = -2.52; standard error = 0.81). At week 4, depression response (odds ratio [OR] = 2.54; 95% confidence limit [CL], 1.42-4.55) and remission (OR = 3.04; 95% CL, 1.57-5.87) were more likely with naltrexone-bupropion versus placebo. Greater baseline-to-week 4 reduction in PHQ-9 was associated with a higher likelihood of methamphetamine treatment response (OR = 3.74, 95% CL, 1.28-10.93) and explained 24.8% (95% CI, 6.7%-60.3%) of the effect of naltrexone-bupropion on methamphetamine treatment response.</p><p><p><b>Conclusion:</b> Use of naltrexone bupropion was associated with early reduction in depressive symptom severity compared to a placebo, which was associated with a higher likelihood of reduction in subsequent methamphetamine use.</p><p><p><b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT03078075.</p>","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"86 3","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790611","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":"Suicide Risk Among Patients with Bipolar Disorder: The Role of Sleep Disruption Versus Benzodiazepine Use.","authors":"Andrew S Tubbs, Fabian-Xosé Fernandez","doi":"10.4088/JCP.25lr15890","DOIUrl":"https://doi.org/10.4088/JCP.25lr15890","url":null,"abstract":"","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"86 3","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790619","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":"Early Response to Ketamine for Suicidal Crisis Reduces Suicidal Events at 3 Months.","authors":"Martin Pastre, Raphael Chancel, Manon Malestroit, Philippe Courtet, Emilie Olié","doi":"10.4088/JCP.25m15829","DOIUrl":"10.4088/JCP.25m15829","url":null,"abstract":"<p><p><b>Background:</b> Intravenous (IV) ketamine has demonstrated rapid reduction of suicidal ideation (SI), but its impact on suicidal attempts remains unclear. This study investigates the effect of IV ketamine on SI at 7 days and suicidal events (suicide attempt or hospitalizations for SI) at 3 months in a real-world clinical setting.</p><p><p><b>Methods:</b> We conducted an observational retrospective study including 100 adult French patients who received 1 or 2 IV ketamine infusions (0.5 mg/kg) within 1 week for a suicidal crisis between June 2022 and June 2024. Depressive symptoms (Montgomery-Asberg Depression Rating Scale) and SI severity (Columbia-Suicide Severity Rating Scale [C-SSRS]) were assessed at baseline and 7 days postinfusion. Suicidal events were collected from clinical records at 3 months.</p><p><p><b>Results:</b> Ketamine significantly reduced depressive symptoms (β = -11; <i>P</i> < .001) and SI severity (β = -2.0; <i>P</i> < .001) at 7 days after controlling for age, sex, and number of infusions. A direct (β = -0.78; <i>P</i> < .001) and indirect effect (β = -0.29; <i>P</i> = .007) on SI through depression reduction was observed. Sixty-one percent of patients were SI responders (≥50% reduction in C-SSRS severity). SI responders at 7 days had 75% lower odds of experiencing suicidal events at 3 months (OR =0.25; <i>P</i> = .009).</p><p><p><b>Conclusion:</b> This is the first study demonstrating that early SI response to IV ketamine is associated with a reduced risk of suicidal events at 3 months. These findings support ketamine's unique antisuicidal properties beyond its antidepressant effects, highlighting its potential role in suicide prevention.</p><p><p><b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT06806475.</p>","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"86 3","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790612","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":"Efficiency and Extent of Niacin-Induced Skin Flushing Patterns in Early Stages of Psychosis.","authors":"TianHong Zhang, LiHua Xu, YanYan Wei, XiaoChen Tang, RanPiao Gan, Dan Zhang, ZhengHui Yi, XiaoHua Liu, HaiChun Liu, ZiXuan Wang, Tao Chen, Jin Gao, Qiang Hu, LingYun Zeng, ChunBo Li, JiJun Wang","doi":"10.4088/JCP.24m15559","DOIUrl":"https://doi.org/10.4088/JCP.24m15559","url":null,"abstract":"<p><p><b>Objective:</b> Niacin-induced skin flushing response (NSFR) attenuation is a well documented biomarker for psychosis and has also been used in studies of bipolar affective disorder. It appears not only in later stages but also in first episodes and in clinical high-risk (CHR) stages.</p><p><p><b>Methods:</b> NSFR tests were conducted on healthy controls (HC), CHR individuals, and first-episode psychosis (FEP) patients from January 2019 to March 2024. The tests involved applying niacin patches at different concentrations and recording skin responses at multiple time points. A newly introduced slope variable was used to evaluate response efficiency. CHR participants were followed for 3 years to assess the predictive value of NSFR efficiency and attenuation degree for psychosis onset.</p><p><p><b>Results:</b> This study included 98 CHR individuals (mean age: 18.4 years, 42.9% male), 54 FEP patients (24.7 years, 50% male), and 61 HC (25.8 years, 54.1% male). Over the 3-year follow-up, 23 (23.5%) CHR individuals converted to psychosis. CHR individuals showed NSFR attenuation levels between those of FEP patients and HC. Lower response efficiency was associated with a higher risk of developing psychosis, specifically at 10^-4 M and 10^-2 M concentrations (<i>P</i> = .001 and <i>P</i> = .039, respectively). The area under the curve for predicting psychosis onset using slope values at 10^-2 M was 0.645 (<i>P</i> = .034). For discriminating CHR from HC, significant factors included slope at 10^-3 M concentration (<i>P</i> = .006), total scores at 5 minutes (<i>P</i> = .001) and 15 minutes (<i>P</i> = .005), and total scores at 10^-3 M (<i>P</i> = .002) and 10^-2 M (<i>P</i> = .001). For discriminating FEP from HC, significant factors were the slope at 10^-4 M concentration (<i>P</i> = .023), total score at 5 minutes (<i>P</i> = .003), and total score at 10^-3 M concentration (<i>P</i> = .040).</p><p><p><b>Conclusions:</b> NSFR efficiency is a sensitive marker for early psychosis risk, highlighting the need for precise and comprehensive detection methods.</p>","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"86 3","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790614","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":"Klotho and Matrix Metalloproteinase-9 Levels and Their Association With Inhibitory Dyscontrol in Adolescents With First-Episode Major Affective Disorders.","authors":"Li-Chi Chen, Ya-Mei Bai, Shih-Jen Tsai, Ju-Wei Hsu, Mu-Hong Chen","doi":"10.4088/JCP.24m15696","DOIUrl":"https://doi.org/10.4088/JCP.24m15696","url":null,"abstract":"<p><p><b>Background:</b> The roles of Klotho and matrix metalloproteinase (MMP)-9 in the pathomechanisms underlying first episode major affective disorders as well as their impact on related inhibitory control function remain unclear.</p><p><p><b>Methods:</b> This study included 44 adolescents with first-episode bipolar disorder, 60 with first-episode major depressive disorder, and 46 age matched healthy controls between January 1, 2021, and August 31, 2024. <i>DSM-5</i> criteria were used to make the diagnoses of 2 major affective disorders. All the participants were assessed for levels of Klotho and MMP-9 and completed the go/no-go task. Generalized linear models (GLMs) were employed to compare Klotho and MMP 9 levels, along with inhibitory control function, between groups.</p><p><p><b>Results:</b> After adjustments for demographic characteristics, clinical symptoms, and psychotropic medication use, the GLMs indicated that adolescents with bipolar disorder and those with major depressive disorder exhibited significantly lower Klotho levels compared with the control group (<i>P</i> = .007). Additionally, adolescents with bipolar disorder had the highest MMP-9 levels (<i>P</i> = .002), followed by those with major depressive disorder (<i>P</i> = .031), compared with healthy controls. Furthermore, lower Klotho levels and higher MMP-9 levels were associated with inhibitory control deficits.</p><p><p><b>Conclusions:</b> Adolescents experiencing first-episode bipolar disorder and major depressive disorder exhibited decreased Klotho levels and increased MMP-9 levels, both of which were associated with deficits in inhibitory control function. Additional studies are warranted to clarify the specific pathomechanisms underlying the complex associations between major affective disorders, Klotho and MMP-9 dysregulation, and deficits in inhibitory control function.</p>","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"86 3","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651029","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":"How Do We Get Ketamine Safety Right? Three Questions From a Clinical Service.","authors":"Benjamin D Brody, Dennis M Popeo, Roy W Smetana, Dora Kanellopoulos","doi":"10.4088/JCP.25com15946","DOIUrl":"https://doi.org/10.4088/JCP.25com15946","url":null,"abstract":"","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"86 3","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651028","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":"Actigraphy-Measured Sleep/Wake Characteristics Associated With Suicidal Ideation in Older Adults Who Have Depression and High Suicide Risk.","authors":"Stephen F Smagula, Gehui Zhang, Sara Albert, Sarah Lim, Allison G Harvey, Michael R Irwin, William Vaughn McCall, Charles F Reynolds, Daniel J Buysse, Robert T Krafty","doi":"10.4088/JCP.24m15522","DOIUrl":"10.4088/JCP.24m15522","url":null,"abstract":"<p><p><b>Objective:</b> The aim of this study was to identify sleep/wake characteristics associated with suicidal ideation (SI) severity among older adults who are at risk for suicide.</p><p><p><b>Methods:</b> This 6-week observational study examined associations between weekly actigraphy-derived sleep/wake measures and SI severity (Beck Scale for Suicidal Ideation [SSI]). The sample (n = 30; 83% female; average age = 62 years), enrolled April 2021 through March 2023, self reported a physician diagnosis of <i>DSM-5</i> major depressive disorder with an episode in the last 6 months and also had either recent active SI or a past suicide attempt. Weekly sleep/wake measures included sleep duration, fragmentation, and 2 rhythm variables (interdaily stability and relative amplitude). Primary analyses used age- and sex-adjusted repeated-measure linear mixed models, 1 model per sleep/wake variable, to assess associations between weekly sleep/ wake and SI reported at week's end. We examined if associations of sleep/wake factors with SI were independent of depression severity (Patient Health Questionnaire-8 scores).</p><p><p><b>Results:</b> Longer sleep duration, greater interdaily stability, and higher relative amplitude were associated with lower SI (eg, for each standard deviation higher interdaily stability, SSI scores were an estimated 1.4 points lower [<i>P</i> = .005]). After adjusting for depression severity, both sleep/wake rhythm variables remained significantly associated with SI, whereas the association between sleep duration and SI severity was attenuated by >80%.</p><p><p><b>Conclusion:</b> In this sample, sleep/wake rhythm disruption (but not sleep duration or fragmentation) related to SI independent of depression severity. Targeting disruptions in sleep/wake rhythms may be an important avenue for future trials of sleep medicine approaches to reduce SI in older adults.</p>","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"86 3","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651027","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":"Prognostic and Prescriptive Predictors of Treatment Response to Adjunctive VNS Therapy in Major Depressive Disorder: A RECOVER Trial Report.","authors":"Scott T Aaronson, Charles R Conway, Charles Gordon, Ying-Chieh Lisa Lee, Mark S George, John Zajecka, Patricio Riva-Posse, David L Dunner, Matthew Macaluso, Peter B Rosenquist, Brian J Mickey, Yvette I Sheline, Vasilis C Hristidis, Hunter Brown, Christopher L Kriedt, Quyen Tran, Mark T Bunker, Harold A Sackeim, A John Rush","doi":"10.4088/JCP.25m15850","DOIUrl":"10.4088/JCP.25m15850","url":null,"abstract":"<p><p><b>Objective:</b> Vagus nerve stimulation (VNS) therapy is a long-term intervention for treatment-resistant major depression (TRD) adjunctive to treatment as usual (TAU). To enhance clinical decision- making, we identified subgroups that respond especially well or poorly with active VNS vs no stimulation sham VNS (prognostic predictors) and subgroups that specifically benefit from active VNS vs sham VNS (prescriptive predictors).</p><p><p><b>Methods:</b> In the RECOVER trial, patients with marked TRD (N=493) were randomized to either active VNS (N=249) or sham VNS (N=244); both groups continued TAU. Baseline demographic, clinical, and treatment history characteristics were evaluated as potential prognostic and/or prescriptive outcome predictors. Outcome assessment was based on a tripartite measure that combined depressive symptoms (Quick Inventory of Depressive Symptomatology-Clinician), psychosocial function (Work Productivity and Activity Impairment Questionnaire item 6), and quality of life (Mini-Quality of Life Enjoyment and Satisfaction Questionnaire). Generalized linear mixed models were employed to identify both prognostic and prescriptive predictors of tripartite outcomes.</p><p><p><b>Results:</b> Several baseline features predicted outcomes across the entire sample and within the sham VNS group (prognostic prediction). History of treatment with electroconvulsive therapy (ECT; lifetime and current episode) or transcranial magnetic stimulation (TMS; current episode) was associated with poorer prognosis. However, these same features were associated with greater benefit from active VNS vs sham VNS. The presence of comorbid anxiety disorders was predictive of a better prognosis overall, but smaller benefit from active VNS vs sham VNS.</p><p><p><b>Conclusions:</b> Marked TRD patients with a history of ECT or TMS had especially poorer outcomes when receiving sham VNS plus TAU for 1 year than those without this history. These same subgroups showed significant differential benefit with active VNS than with sham VNS (positive prescriptive effect). The absence of a comorbid anxiety disorder was linked to superior benefit from active VNS vs sham VNS. These predictors may inform clinical decision-making when considering VNS.</p><p><p><b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT03887715.</p>","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"86 3","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651030","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":"Exploring Vascular Endothelial Growth Factor and Other Blood-Brain Barrier Biomarkers in Cognition of First-Episode Psychosis: An Observational Study.","authors":"Alejandro Ballesteros, María Flores-Lopez, Ana M Sánchez-Torres, Gustavo J Gil-Berrozpe, Lucía Moreno-Izco, Ana Gavito, Antonia Serrano, Fernando Rodríguez de Fonseca, Manuel J Cuesta","doi":"10.4088/JCP.24m15486","DOIUrl":"10.4088/JCP.24m15486","url":null,"abstract":"<p><p><b>Background:</b> Cognitive deficits are a core feature of early stages of schizophrenia. However, according to neurodevelopmental models, the extent to which chemokines and growth factors are involved in cognitive function remains debatable. We aimed to investigate whether homeostatic/inflammatory chemokines and growth factors are associated with cognitive impairment in patients with first-episode psychosis (FEP) in remission.</p><p><p><b>Methods:</b> Fifty patients, 21 healthy siblings, and 24 controls participated in the study. The primary outcomes were associations between cognition and growth factors (brain-derived neurotrophic factor [BDNF] and vascular endothelial growth factor [VEGF]), homeostatic markers (CXCL12), and inflammatory chemokines (CCL2, CCL3, CX3CL1, and CCL11) using a whole-blood immunoassay procedure. Differences between the FEP group, siblings, and controls were also examined to understand distinct group profiles.</p><p><p><b>Results:</b> The VEGF levels were significantly higher in the FEP group than in the control group. High VEGF levels are significantly associated with lower social cognition scores. Moreover, a post hoc hierarchical regression model explained 34.5% of the variance in social cognition (<i>F</i>_{11, 32}=1.533, <i>P</i>=.168), with inflammatory variables explaining 13.5% and VEGF showing statistical significance (β=-1.936, <i>P</i>=.022). No additional significant results were found for the other inflammatory biomarkers.</p><p><p><b>Conclusions:</b> Our preliminary results suggest that an increase in VEGF might help preserve social cognition after first- episode psychosis. These findings might suggest that a compensatory mechanism could outweigh other VEGF- related hypotheses, such as blood-brain barrier opening and chronic neuroinflammation. However, this hypothesis requires further investigation to address the methodological challenges of determining chemokine levels and controlling for confounding variables.</p>","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"86 3","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602086","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}