Alpha psychiatry最新文献

{"title":"Comparative Trends in the Burden of Depressive Disorders in China and Globally, 1990-2021: Evidence From the Global Burden of Disease 2021.","authors":"Rui Li, Jiawen Huo, Junjiao Ping, Jing Wan, Xuan Ren, Shuyi Zhu, Aoxiang Luo, Tingyun Jiang","doi":"10.31083/AP48228","DOIUrl":"10.31083/AP48228","url":null,"abstract":"<p><strong>Background: </strong>Depressive disorders are among the leading causes of global disability, with steadily increasing incidence and prevalence posing serious challenges to public health systems. As one of the most populous countries worldwide, China's disease burden trajectory holds significant implications for global mental health trends. However, few studies have systematically compared China's long-term trends with global patterns. This study aimed to evaluate the disease burden of depressive disorders in China from 1990 to 2021 using Global Burden of Disease Study 2021 (GBD 2021) data and to systematically compare these trends with global trajectories, with additional analysis across age and sex subgroups.</p><p><strong>Methods: </strong>We extracted data on the number of incident cases, prevalent cases, and disability-adjusted life years (DALYs) for depressive disorders, along with their corresponding age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), and age-standardized DALY rate (ASDR) from the GBD 2021 database. Joinpoint regression was used to estimate the estimated annual percentage change (EAPC) and the average annual percentage change (AAPC). The statistical significance of temporal trends was assessed based on 95% confidence intervals and two-sided <i>p</i> values (<0.05), with stratified analyses by age group and sex.</p><p><strong>Results: </strong>From 1990 to 2021, the number of depressive disorder cases in China showed an overall increasing trend, whereas ASIR, ASPR, and ASDR exhibited a gradual overall decline; in contrast, these age-standardized indicators showed a slight overall increase at the global level. Age-stratified analyses showed that ASIR, ASPR, and ASDR increased rapidly among individuals aged 10-24 years in both China and globally. From age 25 onward, the global burden of depressive disorders was mainly concentrated in the 25-49-year age group and declined with increasing age; in China, however, the disease burden remained at relatively high levels among middle-aged and older adults, with ASPR and ASDR peaking in the 40-69-year age group and then declining gradually. Sex-stratified analyses showed that, in both China and globally, females had higher overall disease burden levels than males in terms of incident cases, prevalent cases, DALYs, and corresponding age-standardized indicators.</p><p><strong>Conclusions: </strong>Despite China's declining standardized burden, depressive disorders remain a major public health concern. The observed differences in age distribution and sex-specific burden, as well as divergent trends between China and global levels, underscore the need for targeted mental health interventions focused on adolescents, older adults, and women. These findings contribute to the evidence base for formulating population-specific mental health policies through a global comparative lens.</p>","PeriodicalId":72151,"journal":{"name":"Alpha psychiatry","volume":"27 3","pages":"48228"},"PeriodicalIF":2.9,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13339878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406944","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":"Thalamic Subregion Alterations and Short-Chain Fatty Acids in Schizophrenia and Ultra-High-Risk Individuals: A Cross-Sectional Study.","authors":"Huiqing Peng, Xiaogang Chen, Ying He, Shuting Chen, Zongchang Li, Chunwang Li, Ke Jin, Liu Yuan, Xiaoqian Ma","doi":"10.31083/AP49150","DOIUrl":"10.31083/AP49150","url":null,"abstract":"<p><strong>Background: </strong>Thalamic abnormalities have been implicated in schizophrenia, but their early role remains unclear. This study investigated structural and functional alterations of thalamic subregions in drug-naïve first-episode schizophrenia (FES) patients and ultra-high-risk (UHR) individuals, and explored their associations with serum short-chain fatty acids (SCFAs).</p><p><strong>Methods: </strong>This cross-sectional study included 102 FES patients, 72 UHR individuals, and 69 healthy controls (HCs). Structural magnetic resonance imaging (MRI) data were available for all participants, and functional MRI and SCFA measurements were conducted in subgroups (functional MRI (fMRI): 76 FES, 63 UHR, 61 HC; SCFA: 59 FES, 51 UHR, 40 HC).</p><p><strong>Results: </strong>Thalamic volume was smaller in FES compared to HCs, with atrophy present specifically at the psychotic stage, particularly affecting the right thalamus and nuclei including the mediodorsal medial magnocellular (MDm), ventromedial (VM), and ventral posterolateral (VPL). Functional connectivity (FC) disruptions were observed in the left sensory thalamus with cortico-striatal-thalamic circuits and in the right occipital thalamus with fronto-temporal regions. Thalamic volumetric deficits correlated with negative and disorganized symptoms in both clinical groups. Serum SCFAs showed several significant associations: in the UHR group, FC between the right occipital thalamus and the left medial frontal cortex was negatively associated with acetic acid and total SCFA levels; in FES patients, centromedian nucleus volume was positively correlated with acetic acid; and in HCs, butyric acid was inversely correlated with the volume of the mediodorsal (MD) lateral nucleus.</p><p><strong>Conclusions: </strong>These findings highlight early thalamic subregional alterations in psychosis risk and co-occurring changes in gut-derived metabolites. Whether and how these changes are related remains a question for future research.</p>","PeriodicalId":72151,"journal":{"name":"Alpha psychiatry","volume":"27 3","pages":"49150"},"PeriodicalIF":2.9,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13339799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407113","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":"Cognition-Modulated EEG Signatures and Clinical Features in Major Depressive Disorder: A Machine Learning-Based Exploratory Study.","authors":"Cheng-Ta Li, Chih-An Lai, Jia-Shyun Jeng, Chih-Ming Cheng, Ya-Mei Bai, Chung-Ping Chen","doi":"10.31083/AP50791","DOIUrl":"10.31083/AP50791","url":null,"abstract":"<p><strong>Background: </strong>Major depressive disorder (MDD) includes heterogeneous clinical dimensions, including depressive symptom severity, treatment refractoriness, and suicidality, which are commonly assessed using subjective rating scales and retrospective clinical histories. Dysfunction of frontal and anterior cingulate cortex (ACC) networks has been implicated in MDD, suggesting that electroencephalography (EEG)-based approaches combined with machine learning (ML) may help with objective characterization of clinical heterogeneity.</p><p><strong>Methods: </strong>Resting-state and cognition-modulated EEG data were analyzed from 209 patients with MDD. A rostral ACC-engaging cognitive task (RECT) was used to probe frontal-ACC circuitry. Linear and non-linear EEG features extracted from frontal electrodes across multiple frequency bands were integrated with several ML classifiers to perform exploratory classification of suicidality, depressive symptom severity, and treatment refractoriness. Class imbalance in suicidality was addressed using synthetic oversampling applied to the training data only.</p><p><strong>Results: </strong>ML models, particularly Random Forest (RF), outperformed support vector machines across all outcomes. RF achieved classification accuracies of around 83% (area under curve (AUC) = 0.83) for depression severity and 87% (AUC = 0.87) for treatment refractoriness. Suicidality categorization performance improved following data balancing. Feature importance studies found consistent patterns across outcomes, with useful predictors primarily obtained from frontal electrodes and nonlinear EEG complexity measures.</p><p><strong>Conclusions: </strong>The combination of cognition-engaging frontal modulation and ensemble-based ML applied to EEG data suggests the feasibility of an exploratory, unified EEG-based approach for identifying important characteristics of MDD. These findings highlight the importance of frontal network dysfunction across the severity spectrum of MDD and the need for further validation in larger and longitudinal cohorts.</p>","PeriodicalId":72151,"journal":{"name":"Alpha psychiatry","volume":"27 3","pages":"50791"},"PeriodicalIF":2.9,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13339876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406883","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":"Potential Targets for Scalp Acupuncture and Brain Stimulation in Mental Disorders: Evidence From Large-Scale Meta-Analyses.","authors":"Yuanyuan Li, Yuan Feng, Yuefeng Wu, Qiao Kong, Binlong Zhang, Yu Liu, Siyi Yu, Jiao Liu, Jin Cao, Pauline Jeong, Fangyuan Cui, Jian Kong","doi":"10.31083/AP45940","DOIUrl":"10.31083/AP45940","url":null,"abstract":"<p><strong>Background: </strong>Scalp acupuncture and brain stimulation techniques, such as transcranial electrical stimulation, have shown promise in the management of mental disorders. However, the identification of precise stimulation targets remains a critical bottleneck. Pinpointing brain regions associated with mental disorders is essential for optimizing the efficacy of these scalp-based therapies.</p><p><strong>Methods: </strong>Using Neurosynth Compose, we performed large-scale coordinate-based meta-analyses to identify potential targets for nine mental disorders: schizophrenia, bipolar disorder, major depressive disorder, anxiety disorders, obsessive-compulsive disorder, post-traumatic stress disorder, insomnia, autism spectrum disorder, and attention deficit hyperactivity disorder. The identified brain clusters were projected onto the scalp surface and spatially integrated with standard acupoints, and the electroencephalography (EEG) 10-20 system to define accessible intervention sites.</p><p><strong>Results: </strong>The analyses successfully delineated scalp targets for each of the nine investigated disorders. These findings largely corroborated existing clinical protocols while also suggesting novel regions as potential therapeutic targets. The results revealed both disorder-specific targets and cortical areas implicated across multiple psychiatric conditions. Notably, the dorsolateral and ventrolateral prefrontal cortices, middle temporal gyrus, and inferior parietal lobule emerged as critical overlapping targets, offering potential avenues for scalp acupuncture and brain stimulation in comorbid mental disorders.</p><p><strong>Conclusions: </strong>We propose refined, evidence-based protocols for scalp acupuncture and brain stimulation. These findings may advance precision-targeted neuromodulation strategies and support the development of novel therapeutic approaches in psychiatric care.</p>","PeriodicalId":72151,"journal":{"name":"Alpha psychiatry","volume":"27 3","pages":"45940"},"PeriodicalIF":2.9,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13339880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407001","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":"Victim Selection Patterns in Sexual Offenders With Severe Mental Illness: An Exploratory Forensic Evaluation Study.","authors":"Chia-Heng Lin, Wen-Ching Hsieh, Li-Ting Lin, Chia-Hsiang Chan","doi":"10.31083/AP50083","DOIUrl":"10.31083/AP50083","url":null,"abstract":"<p><strong>Background: </strong>Sexual offenders with severe mental illness (SMI) remain underexamined, particularly regarding victim-selection patterns that may inform risk assessment and management. This study compared victim-related and selected clinical characteristics between sexual offenders with and without SMI in a court-referred forensic psychiatric evaluation sample.</p><p><strong>Methods: </strong>This retrospective study included 86 male sexual offenders referred for forensic psychiatric evaluation between 2009 and 2022. Participants were categorized into an SMI group (n = 21; schizophrenia-spectrum/other psychotic disorders or bipolar-related disorders) and a non-SMI group (n = 65). Group comparisons were conducted using bivariate analyses, and exploratory logistic regression examined victim-related correlates of SMI status.</p><p><strong>Results: </strong>Compared with non-SMI offenders, offenders with SMI were more likely to have adult victims and stranger victims. In the final model, adult victim (odds ratio (OR) = 4.40, 95% confidence interval (CI) 1.30-14.91) and stranger victim (OR = 3.81, 95% CI 1.16-12.46) remained associated with SMI status. Substance use disorder was more common in the non-SMI group.</p><p><strong>Conclusions: </strong>In this exploratory forensic sample, sexual offenders with SMI showed distinct victim-selection patterns. Because the SMI subgroup was small and consisted predominantly of schizophrenia-spectrum disorders, these findings should be interpreted cautiously and regarded as preliminary.</p>","PeriodicalId":72151,"journal":{"name":"Alpha psychiatry","volume":"27 3","pages":"50083"},"PeriodicalIF":2.9,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13339779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407094","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":"Healthy Lifestyle and Time to Depression Onset in Individuals With and Without Incident Stroke: A Longitudinal Analysis Using UK Biobank Data.","authors":"Chengguang Zou, Guo Li","doi":"10.31083/AP49487","DOIUrl":"10.31083/AP49487","url":null,"abstract":"<p><strong>Background: </strong>Depression and stroke are leading causes of the global health burden. Adherence to a healthy lifestyle can reduce the risk of both conditions. However, the quantitative effect of a healthy lifestyle on the timing of depression onset remains unclear, as does whether the association between lifestyle and depression differs according to the occurrence of stroke. We therefore examined whether the association between a healthy lifestyle and depression differed between individuals who did and did not experience an incident stroke.</p><p><strong>Methods: </strong>Using data from the UK Biobank, we assessed the associations between lifestyle factors and time to depression using accelerated-failure-time models. Subgroup analyses were conducted to examine whether the association between lifestyle factors and time to depression differed according to the occurrence of incident stroke.</p><p><strong>Results: </strong>A total of 165,941 participants were included in the study. During follow-up, 5507 individuals developed depression, among whom 103 had previously developed stroke. Participants with 6-7 healthy lifestyle behaviors exhibited an 81% longer time to depression onset than did those with 0-2 healthy lifestyle behaviors after adjusting for covariates. Each one-point increase in the healthy lifestyle score (HLS) was associated with approximately 16.2% prolongation in time to depression. The association between HLS and time to depression onset was observed both in participants with and without incident stroke, although effect estimates were attenuated among those with incident stroke.</p><p><strong>Conclusions: </strong>The protective association between HLS and delayed depression onset was consistently observed in individuals both with and without incident stroke. Although the association was weaker among those who experienced stroke, lifestyle factors remained strongly associated with depression risk, underscoring the importance of lifestyle modification for mental health prevention irrespective of stroke status.</p>","PeriodicalId":72151,"journal":{"name":"Alpha psychiatry","volume":"27 3","pages":"49487"},"PeriodicalIF":2.9,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13339789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407077","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":"Resilience and Grief-Related Functional Impairment in Paraguayan Adults With Recent Significant Loss: A Cross-Sectional Study.","authors":"Julio Torales, Juliana Bae, Melissa Medina, Fiorella Velázquez, Maia Leguizamón, Eva Giménez-Legal, Marcelo O Higgins, Tomás Caycho-Rodríguez, João Mauricio Castaldelli-Maia, Antonio Ventriglio, Iván Barrios","doi":"10.31083/AP51829","DOIUrl":"10.31083/AP51829","url":null,"abstract":"<p><strong>Background: </strong>Bereavement is a common life experience that can lead to diverse psychological outcomes, ranging from adaptive coping to significant functional impairment. While resilience has been identified as a key factor in psychological adaptation after loss, the relationship between resilience and grief-related functional impairment remains insufficiently explored in many cultural contexts, particularly in Latin America. This study examined the association between resilience and grief-related functional impairment in Paraguayan adults who had experienced a recent significant loss.</p><p><strong>Methods: </strong>A cross-sectional study was conducted using a non-probabilistic convenience sample of 215 Paraguayan adults aged 18-40 years. Data were collected through an online questionnaire including sociodemographic variables and the Connor-Davidson Resilience Scale (CD-RISC-25). Participants who reported the loss of a significant person during the previous two years additionally completed the Grief Impairment Scale and contextual questions related to the loss. Descriptive, bivariate, and multivariable analyses were performed using RStudio.</p><p><strong>Results: </strong>Overall, 59.5% of participants reported having experienced a significant loss within the previous two years. Mean resilience scores did not differ significantly between individuals with and without recent loss (<i>p</i> = 0.773). Within the bereaved subsample (n = 128), resilience was significantly associated with educational level (<i>p</i> = 0.020) and religiosity (<i>p</i> = 0.027). Grief-related functional impairment was associated with sex (<i>p</i> = 0.048), type of relationship with the deceased (<i>p</i> = 0.035), time since loss (<i>p</i> = 0.023), perceived social support (<i>p</i> = 0.049), and psychotropic medication use (<i>p</i> = 0.016). Multivariable models confirmed educational level and religiosity as predictors of resilience.</p><p><strong>Conclusions: </strong>Resilience scores did not differ significantly between individuals with and without recent bereavement at the time of assessment, even among individuals experiencing functional difficulties related to grief. Contextual factors such as religiosity and social support appear to play an important role in shaping bereavement outcomes. These findings highlight the importance of assessing both adaptive psychological resources and functional impairment in the evaluation of grief.</p>","PeriodicalId":72151,"journal":{"name":"Alpha psychiatry","volume":"27 3","pages":"51829"},"PeriodicalIF":2.9,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13339782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407030","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":"EEG Neurofeedback for Major Depressive Disorder: A Scoping Review.","authors":"Dan Cătălin Oprea, Jonathan Rabinowitz, Bogdan Gireadă, Bogdan-Ionel Tamba, Romeo-Petru Dobrin, Eliza-Mihaela Cămănaru, Vlad Teodor Iacob, Ana Caterina Cristofor, Alexandra Boloș, Roxana Chiriță","doi":"10.31083/AP50633","DOIUrl":"10.31083/AP50633","url":null,"abstract":"<p><p>Neurofeedback (NF) is an emerging treatment for Major Depressive Disorder (MDD). NF is a training approach that enables individuals to self-regulate brain activity patterns associated with emotional and cognitive dysfunction. While interest is increasing, research results vary, and clinical implementation does not follow standardized protocols. This scoping review aimed to map and synthesize the existing peer-reviewed evidence on electroencephalography (EEG)-based neurofeedback interventions for MDD, with a focus on training protocols, neurophysiological targets, reported clinical outcomes, and methodological limitations. A systematic scoping review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines (OSF registration): https://doi.org/10.17605/OSF.IO/NQ3BW. Electronic searches were performed across Embase, PubMed, Web of Science, and ClinicalTrials.gov. Studies were included if they evaluated EEG-based neurofeedback interventions in adults with MDD and reported clinical or neurophysiological outcomes. Of 1299 records identified, 11 studies met the inclusion criteria, encompassing outcome data from 175 patients who received active EEG-NF. The studies observed a reduction in depressive symptoms following neurofeedback, most commonly using frontal alpha asymmetry protocols (k = 5). Potential improvements in cognitive performance were reported in 4 studies, particularly those incorporating upper-alpha or beta/theta modulation. Connectivity-based approaches using low-resolution electromagnetic tomography Z-score neurofeedback (low-resolution electromagnetic tomography (LORETA); k = 2) suggested possible effects on deep brain networks involved in emotional regulation, though replication remains limited. This scoping review outlines the existing evidence on EEG-based neurofeedback in major depressive disorder, highlighting the diversity of protocols, targets, and reported outcomes. While preliminary findings suggest potential clinical relevance, substantial methodological limitations and heterogeneity remain. These observations emphasize the need for more rigorous, standardized, and longitudinal research to better define the role of EEG-based neurofeedback in the treatment of MDD.</p>","PeriodicalId":72151,"journal":{"name":"Alpha psychiatry","volume":"27 3","pages":"50633"},"PeriodicalIF":2.9,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13339797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407007","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":"Disrupted Functional Brain Network Topology in Etomidate Misuse.","authors":"Ying Tang, Xingmin Wang, Juan Le, Qiuping Huang, Hao Chen, Xinxin Chen, Xuhao Wang, Yunde Tang, Lishun Zhao, Lin Zhao, Hongxian Shen, Zhenjiang Liao","doi":"10.31083/AP49872","DOIUrl":"10.31083/AP49872","url":null,"abstract":"<p><strong>Background: </strong>Etomidate misuse (EM) has recently become an increasing public health concern in East and Southeast Asia, but its neurobiological mechanisms are still not well understood. Although substance use disorders (SUDs) are commonly associated with disruptions in large-scale brain network organization, the effects of EM on brain network topology remain largely unexplored.</p><p><strong>Methods: </strong>Resting-state functional magnetic resonance imaging (rs-fMRI) data were acquired from individuals with EM and healthy controls (HC). Graph theoretical analyses were employed to and characterize global and nodal topological properties of functional brain networks. Clinical assessments captured substance use characteristics, craving, impulsivity, and addiction severity. Partial correlation analyses were conducted to examine associations between network metrics and substance use characteristics. Additonally, a support vector machine (SVM) classifier was implemented to discriminate individuals with EM from HC based on network features.</p><p><strong>Results: </strong>A total of 103 individuals with EM and 57 HC were included in the final analysis. Global topological organization that appeared was largely preserved in the EM group, with the exception of a significantly reduced clustering coefficient. At the nodal level, individuals with EM exhibited significant alterations in degree centrality, betweenness centrality, and nodal efficiency across regions predominantly distributed within the default mode, attention, and sensorimotor networks. Correlation analyses revealed no significant associations between network metrics and substance use characteristics following correction for multiple comparisons. Furthermore, the SVM model achieved moderate classification performance (accuracy = 66.7%) with an area under the curve (AUC) of 0.711.</p><p><strong>Conclusions: </strong>This study provides the first systematic investigation of the brain network topology in EM. The findings indicate widespread alterations in nodal network properties alongside relatively preserved global topological organization. While these results may offer preliminary indicators related to EM, their clinical relevance requires further in future research.</p>","PeriodicalId":72151,"journal":{"name":"Alpha psychiatry","volume":"27 3","pages":"49872"},"PeriodicalIF":2.9,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13339792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407004","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":"Ascorbic Acid for Major Depressive Disorder Treated With Modified Electroconvulsive Therapy: A Randomized Controlled Trial Protocol.","authors":"Li Zhao, Yuxuan Yang, Binyang Cai, Kongyan Wu, Yuhuan Gong, Qibin Chen, Xiao Li, Jie Luo","doi":"10.31083/AP49803","DOIUrl":"10.31083/AP49803","url":null,"abstract":"<p><strong>Background: </strong>Major depressive disorder is marked by high prevalence and elevated suicide risk. Modified electroconvulsive therapy (MECT) is a well-established, effective, and fast-acting method for treating major depressive disorder with acute suicide control, though its application is constrained by adverse effects. Enhancing the therapeutic effectiveness and/or reducing the adverse effects of MECT holds clinical practical value. Ascorbic acid (AA) can enhance the effectiveness of some antidepressants, yet its effects on depressed patients undergoing MECT lack clinical evidence. This study investigates whether AA augments the antidepressant effects of MECT in patients with major depressive disorder.</p><p><strong>Methods and analysis: </strong>This is a prospective, randomized, double-blind, placebo-controlled trial. We will enroll 240 patients with major depressive disorder scheduled for MECT. Participants will be treated either with intravenous AA (500 mg, n = 120) or with intravenous normal saline (n = 120), administered immediately before each MECT session, just prior to induction of general anesthesia. The primary outcome is the treatment response rate, defined as the proportion of patients with a ≥50% reduction in the 24-item Hamilton Depression Rating Scale (HAMD-24) score. Secondary outcomes include remission rate, presence of psychotic symptoms, cognition, and adverse effects. This study is expected to provide an evidence based, safe, and cost effective strategy for optimizing MECT protocols, as well as potential directions for future mechanistic investigations.</p><p><strong>Ethics and dissemination: </strong>The study will adhere to the principles of the Declaration of Helsinki. It received approval from the Institutional Review Board of the First Affiliated Hospital of Chongqing Medical University, China (Approval No. 2024-235-01). Written informed consent will be obtained from all participants. Results will be disseminated through peer reviewed publications and conference presentations. This study will offer the first clinical evidence of the effects of AA on patients diagnosed with major depressive disorder undergoing MECT. The findings may indicate the potential of AA for refining MECT based therapeutic strategies, optimizing depression treatment protocols, and improving clinical prognosis.</p><p><strong>Clinical trial registration: </strong>The study has been registered on https://www.chictr.org.cn/index.html (registration number: ChiCTR2500095678; registration link: https://www.chictr.org.cn/showproj.html?proj=248072).</p>","PeriodicalId":72151,"journal":{"name":"Alpha psychiatry","volume":"27 3","pages":"49803"},"PeriodicalIF":2.9,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13339794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407064","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}