Nature mental health最新文献

{"title":"Genetic susceptibility to schizophrenia through neuroinflammatory pathways associated with retinal thinness","authors":"Finn Rabe, Lukasz Smigielski, Foivos Georgiadis, Nils Kallen, Wolfgang Omlor, Victoria Edkins, Matthias Kirschner, Flurin Cathomas, Edna Grünblatt, Steven Silverstein, Brittany Blose, Daniel Barthelmes, Karen Schaal, Jose Rubio, Todd Lencz, Philipp Homan","doi":"10.1038/s44220-025-00414-6","DOIUrl":"10.1038/s44220-025-00414-6","url":null,"abstract":"Schizophrenia is associated with structural and functional changes in the central nervous system, including the most distal part of it, the retina. However, the question of whether retinal atrophy is present before individuals develop schizophrenia or is a secondary consequence of the disorder remains unanswered. Here we address this question by examining the association between polygenic risk scores for schizophrenia and retinal morphologies in individuals without a schizophrenia diagnosis. We used population data for 34,939 white British and Irish individuals from the UK Biobank. Our robust regression results show that higher polygenic risk scores for schizophrenia were associated with thinner overall maculae, while controlling for confounding factors (b = −0.17, P = 0.018). Similarly, we found that greater polygenic risk scores for schizophrenia specific to neuroinflammation gene sets were associated with thinner ganglion cell inner plexiform layers (b = −0.10, self-contained P = 0.014, competitive P = 0.02). These results provide new evidence for genetic factors that could predispose individuals to heightened neuroinflammatory responses. Over time, these responses could contribute to neurodegenerative processes such as retinal thinning. This study explores the relationship between the genetic risk for schizophrenia and retinal thickness, demonstrating that neuroinflammatory pathways are linked to retinal thinning, with C-reactive protein partially mediating this effect. These findings suggest that retinal changes may serve as a potential noninvasive biomarker for schizophrenia risk.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"3 5","pages":"538-547"},"PeriodicalIF":8.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043705","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":"Transcranial direct current stimulation enhances exposure–response prevention for contamination-related OCD: a randomized clinical trial","authors":"Jian Gao, Wenjun Jia, Puzhe Li, Hui zhao, Liangjun Lin, Meiling Chen, Rui Gao, Xitong Liu, Tianran Zhang, Wenqing Zhao, Lian Gu, Jiejing Yu, Mu-Ming Poo, Dan J. Stein, Jianfeng Luo, Jian Jiang, Zhen Wang","doi":"10.1038/s44220-025-00410-w","DOIUrl":"10.1038/s44220-025-00410-w","url":null,"abstract":"In this randomized, double-blind, controlled trial, we examined whether combining transcranial direct current stimulation (tDCS) with exposure–response prevention (ERP) (tDCS + ERP) enhances obsessive–compulsive disorder (OCD) treatment efficacy compared to ERP alone. Fifty-three patients with OCD with contamination-related symptoms were enrolled and randomly assigned to receive either active or sham anodal tDCS targeting the prefrontal cortex during ERP treatment, with the intervention comprising ten sessions over an eight-week primary endpoint. An electroencephalogram (EEG) was administered at baseline and after tDCS + ERP treatments 1 and 8, and magnetic resonance imaging was conducted at baseline. The primary outcome was the percent reduction in Yale–Brown Obsessive–Compulsive Scale (Y-BOCS) scores. We found a significantly larger percent reduction in Y-BOCS scores in the active group compared with the sham group after tDCS + ERP treatment 4 (active, 25.3 ± 2.2%; sham, 18.0 ± 2.2%, 95% confidence interval (CI), 1.1–13.5%, F = 5.681, Bonferroni-corrected P = 0.021) and treatment 8 (active, 38.1 ± 3.0%; sham, 28.2 ± 3.0%, 95% CI, 1.3–18.4%, F = 5.406, Bonferroni-corrected P = 0.024). The secondary outcome measure was the response rate, defined as a reduction of ≥35% in the Y-BOCS score, which was 16/26 for patients treated with active tDCS and 8/27 for sham tDCS (active versus sham: 61.5% versus 29.6%, χ2 = 5.443, P = 0.020). No moderate or severe adverse effects were reported. An exploratory analysis of EEG-based brain state showed a marginally significant correlation (false discovery rate-corrected P = 0.08) between the final treatment outcome and tDCS-induced changes in microstate class A occurrence after the first active tDCS session. Concurrent tDCS could significantly enhance ERP’s therapeutic efficacy for contamination-related OCD. ClinicalTrials.gov registration: NCT04527302 . In this randomized double-blind controlled trial, the authors examine whether the combination of transcranial direct current stimulation and exposure–response prevention (ERP) is more effective than ERP alone at improving OCD symptoms.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"3 5","pages":"507-516"},"PeriodicalIF":8.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145123270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosis — symptoms, states and stages","authors":"","doi":"10.1038/s44220-025-00420-8","DOIUrl":"10.1038/s44220-025-00420-8","url":null,"abstract":"The term ‘psychosis’ has evolved over time to describe a mental state that is characterized by a disconnect from reality, which can present as a range of symptoms including hallucinations, delusions or disturbed cognition. It is also a symptom for the diagnosis of related disorders. Although there is variability in conceptualizing the construct, identifying risk factors for developing psychosis and early intervention are clear mental health and public health priorities.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"3 4","pages":"387-388"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44220-025-00420-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143801931","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":"Creating a supportive academic culture by preventing and responding to transgressive behavior","authors":"Tim Van Den Bossche, Dries H. Bostyn, Femke De Backere, Sean Bex","doi":"10.1038/s44220-025-00409-3","DOIUrl":"10.1038/s44220-025-00409-3","url":null,"abstract":"","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"3 5","pages":"481-482"},"PeriodicalIF":8.7,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145123274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The paradox of clozapine in Black people with treatment-resistant schizophrenia","authors":"Eromona Whiskey, Christian Bachmann, Olubanke Dzahini, David Taylor, Ebenezer Oloyede","doi":"10.1038/s44220-025-00411-9","DOIUrl":"10.1038/s44220-025-00411-9","url":null,"abstract":"Clozapine is currently the only licensed medication for treatment-resistant schizophrenia (TRS). Ethnic inequalities in treatment with clozapine have been described extensively, particularly regarding the effect on Black ethnic groups. Here we explore the reasons for clozapine underuse in this population, identifying potential misconceptions and providing suggestions to address these barriers. Whiskey et al. discuss the reasons for the underuse of clozapine among Black individuals with treatment-resistant schizophrenia and propose changes to enhance clinicians’ confidence in prescribing it to this population.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"3 4","pages":"402-407"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143801938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effectiveness of long-acting injectable versus oral antipsychotic medication after a first episode of psychosis","authors":"Alejandro G. Szmulewicz, Gonzalo Martínez-Alés, Roger Logan, Ridha Joober, Maria Ferrara, Christian Kelly, Diane Fredrikson, Lorna E. Thorpe, Sarah Conderino, Covadonga M. Díaz-Caneja, Vinod Srihari, Lakshmi N. Yatham, Deepak K. Sarpal, Ann K. Shinn, Celso Arango, Jai L. Shah, Dost Öngür, Miguel A. Hernán, on behalf of the FEP-CAUSAL Collaboration","doi":"10.1038/s44220-025-00407-5","DOIUrl":"10.1038/s44220-025-00407-5","url":null,"abstract":"Switching to long-acting injectable (LAI) antipsychotic therapy as compared with continuation of oral therapy after a first episode of psychosis (FEP) may reduce the risk of relapse and hospitalization, as reported in some randomized trials. However, other trials and network meta-analyses reported no risk reduction. We emulated two target trials using data from the FEP-CAUSAL Collaboration, an international consortium of observational cohorts of people with FEP. The first target trial was designed to ask a similar question as the European Long-Acting Antipsychotics in Schizophrenia Trial (EULAST) trial, which compared the 18-month hospitalization risk between patients assigned to LAI therapy (aripiprazole, risperidone or paliperidone) and those on continuation of oral therapy. We benchmarked the observational estimates to those from the actual trial. The second target trial extended the first to examine the 3-year risks of psychotic relapses and in subgroups (prior relapses, non-adherence, substance use disorder). Of 2,228 individuals with FEP, 1,067 were eligible for the benchmarking analyses. Both our target trial emulation and EULAST showed little effect of LAI therapy initiation on the 18-month hospitalization risk. In the extended analysis (1,193 individuals), the 3-year risk difference of psychotic relapse comparing LAI therapy initiation with oral continuation was –7.0% (95% CI: –12.1, –0.7). The risk difference was substantially lower in subgroups with a prior relapse (–15.5%, 95%CI: –24.1, –5.5) or prior non-adherence (–21.9, 95% CI: –41.9, –2.0). We estimated that, compared with oral therapy continuation, LAI therapy initiation reduced psychotic relapses over 3 years. LAI therapy initiation may be particularly beneficial in vulnerable subgroups. This study reveals that in people with first episode of psychosis receiving oral antipsychotic medication, switching to long-acting injectable antipsychotic therapy may reduce psychotic relapses, especially in vulnerable subgroups, such as those with prior relapses or non-adherence to antipsychotic medication.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"3 4","pages":"421-428"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143801937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving mental health diagnostic quality through cognitively tractable definitions","authors":"Philip Millroth, August Collsiöö","doi":"10.1038/s44220-025-00404-8","DOIUrl":"10.1038/s44220-025-00404-8","url":null,"abstract":"Arriving at a clinical diagnosis using diagnostic criteria is fundamental to mental health practice. Here we argue that high diagnostic quality can only be achieved by aligning diagnostic frameworks with the cognitive capabilities of clinicians, which may require redefining not only the diagnostic procedures but also the criteria themselves.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"3 4","pages":"393-395"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143801906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Over-the-counter hearing aids reduce depression symptoms in older adults with hearing loss: a randomized controlled trial","authors":"Fan Jiang, Alimu Dayimu, Qiuyue Dong, Qi Jing, Peipei Fu, Xiaofei Li, Chengchao Zhou, Haibo Wang, Lei Xu","doi":"10.1038/s44220-025-00408-4","DOIUrl":"10.1038/s44220-025-00408-4","url":null,"abstract":"Previous studies have shown that hearing loss doubles the risk of depression in older adults, and this parallel, randomized, controlled, open-label trial aims to assess the effectiveness of community health worker-delivered over-the-counter (OTC) hearing aids on depression symptoms in this population. The primary outcome is the change in depression symptoms at 6 months from baseline. Secondary outcomes include communication function, loneliness and social isolation. Older adults aged 60 years or older with mild to moderately severe hearing loss were randomized 1/1 to the OTC hearing aid intervention (n = 109) or a wait-list control group (n = 112) between 1 April and 5 July 2023. Depression symptoms, as measured by the short Geriatric Depression Scale (GDS-15), improved in the intervention group at 6 months (mean difference –1.65; 95% confidence interval 1.18, 1.58; P < 0.001). Similar improvements were seen in communication function, social isolation and loneliness. Approximately 80% of participants maintained >4 hours of hearing aid use per day. No adverse events were reported in this trial. The study demonstrated that community health worker-delivered OTC hearing aids are effective in reducing depression symptoms in older adults with hearing loss. Trial registration: ChiCTR2300069838 . In this randomized controlled trial, the authors investigate the benefits of over-the-counter hearing aids on depression symptoms in older adults with mild–moderate hearing loss.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"3 5","pages":"498-506"},"PeriodicalIF":8.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145123282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal neuroplasticity and mental health during the transition to motherhood","authors":"Natalia Chechko, Susanne Nehls","doi":"10.1038/s44220-025-00399-2","DOIUrl":"10.1038/s44220-025-00399-2","url":null,"abstract":"The first 6 weeks postpartum are characterized by major changes in the bodies of cisgender women and an increased vulnerability to psychiatric disorders such as postpartum depression (PPD). This Perspective addresses the debate over the onset of PPD in the first 6 weeks postpartum and its probable relationship to physiological adaptation processes. Fluctuations in hormone levels during pregnancy and childbirth trigger simultaneous changes in brain structure and function, which are particularly dynamic in the first 6 weeks postpartum. At the same time, rapid hormone withdrawal coincides with mood disorders such as ‘baby blues’ or PPD. Understanding the covariance between the temporal trajectories of hormonal adaptations, time-dependent neuroplasticity and the onset of mood disorders may shed valuable light on the highly sensitive time frame of the first 6 weeks postpartum, which, in addition to being a critical period of transition, may prove to be crucial for the onset of PPD. In this Perspective, the authors highlight the importance of the first 6 weeks after birth for postpartum neuroplasticity, and discuss multiple occurring processes that may contribute to the onset of postpartum depression.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"3 4","pages":"396-401"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143801903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Embracing complexity in resilience research","authors":"Sarah R. Lowe","doi":"10.1038/s44220-025-00403-9","DOIUrl":"10.1038/s44220-025-00403-9","url":null,"abstract":"Resilience, defined as the recovery or maintenance of positive functioning after a negative event, is a dynamic and multisystemic process. To reflect this complexity and promote wellbeing, research should consider diverse methodologies, precise terminology, acknowledgement of limitations, and careful communication of findings.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"3 4","pages":"391-392"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143801939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}