American Journal of Psychiatry最新文献

{"title":"Reduced Threat-Related Neural Efficiency: A Possible Biomarker for Pediatric Anxiety Disorders.","authors":"Julia O Linke,Reut Naim,Simona P Haller,Parmis Khosravi,Beck Scheinberg,Meghan E Byrne,Anita Harrewijn,Ellen Leibenluft,Melissa A Brotman,Anderson M Winkler,Daniel S Pine","doi":"10.1176/appi.ajp.20241043","DOIUrl":"https://doi.org/10.1176/appi.ajp.20241043","url":null,"abstract":"OBJECTIVEPediatric anxiety disorders are common and predict adult psychopathology, yet current treatments, such as cognitive-behavioral therapy (CBT), produce lasting remission in less than 50% of affected youths. To support the search for improved, mechanistically grounded interventions, this study evaluated neural efficiency, defined as similarity in functional connectivity between a threat task and rest, as a potential biomarker. The study evaluated neural efficiency in relation to anxiety diagnosis and treatment response.METHODSThe authors compared 103 youths with an anxiety disorder diagnosis (mean age, 12.5 years [SD=2.91], 62% female) to 103 youths with no psychiatric diagnosis (mean age, 13.4 years [SD=2.58], 53% female). Participants completed functional MRI while resting and during a dot-probe task with threatening faces. Neural efficiency was calculated as partial correlations between intrinsic and task-related functional connectivity patterns across the whole brain. Four-month test-retest reliability as well as relationships with anxiety and response to exposure-based CBT were examined.RESULTSNeural efficiency demonstrated satisfactory test-retest reliability (intraclass correlation coefficient=0.65) in healthy youths over a period of 11 to 18 weeks. Neural efficiency was significantly negatively related to anxiety as both a diagnostic category (t=2.62, d=0.29) and a symptom dimension (r=-0.18). Although it did not change after CBT, lower neural efficiency at baseline was significantly associated with poorer treatment response in a subset of 80 anxious youths who underwent CBT (β=-11.88, χ2=9.20).CONCLUSIONSNeural efficiency, measured as network reconfiguration between rest and task, holds promise as a biomarker in pediatric anxiety. Its association with CBT response suggests that it might aid in patient stratification and offer a target for interventions aimed at enhancing CBT efficacy.","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"1 1","pages":"appiajp20241043"},"PeriodicalIF":17.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145241036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relapse in Schizophrenia: A Systematic Review of Criteria for Clinical Studies and International Consensus Guidelines to Improve Them.","authors":"Oliver D Howes,Bernard R Bukala,Eric Y H Chen,Christoph U Correll,Alkomiet Hasan,William G Honer,John M Kane,Stefan Leucht,Spyridon Siafis,Ofer Agid,Dickens Akena,Celso Arango,Lukoye Atwoli,Thomas R E Barnes,Michael L Birnbaum,Istvan Bitter,Alan Breier,Robert W Buchanan,Leslie Citrome,David R Cotter,Nicolas Crossley,Michael Davidson,Andrea de Bartolomeis,Lynn E DeLisi,Sonia Dollfus,Serdar M Dursun,Bjørn H Ebdrup,Helio Elkis,Robin Emsley,Peter Falkai,Emilio Fernández-Egea,Wolfgang Fleischhacker,Oliver Freudenreich,Ary Gadelha,Wolfgang Gaebel,Ariel Graff-Guerrero,Ad Gridley,Jaime E C Hallak,Philipp Homan,René S Kahn,Stefan Kaiser,Maria Kapi,James L Kennedy,Euitae Kim,Bruce J Kinon,Jun Soo Kwon,Stephen M Lawrie,Jimmy Lee,F Markus Leweke,Tao Li,Jan Libiger,Stephen R Marder,Ingrid Melle,Herbert Meltzer,Armida Mucci,Dieter Naber,Shinchiro Nakajima,Jimmi Nielsen,Oisín O'Brien,Akin Ojagbemi,Wolfgang Omlor,Christos Pantelis,Jozef Peuskens,Thomas J Raedler,Mao-Sheng Ran,Tiago Reis Marques,Gary Remington,Susan Rossell,Jose M Rubio,Gabriele Sachs,James Scott,Tianmei Si,Dan Siskind,Cynthia O Siu,Iris E Sommer,Takefumi Suzuki,Hiroyoshi Takeuchi,Rajiv Tandon,David Taylor,Solomon Teferra,Neil Thomas,Jari Tiihonen,Hiroyoki Uchida,Alp Ucok,Daniel Umbricht,Ganesan Venkatasubramanian,Elias Wagner,James T R Walters,Chuanyue Wang,Mark Weiser,Charlie Wright,Xin Yu,Robert A McCutcheon","doi":"10.1176/appi.ajp.20241040","DOIUrl":"https://doi.org/10.1176/appi.ajp.20241040","url":null,"abstract":"OBJECTIVERelapse prevention is a major goal of schizophrenia treatment. However, there is no standard definition of relapse. To address this, the authors reviewed recent approaches and developed consensus criteria to operationally define relapse.METHODSTo evaluate current criteria, a systematic review was performed of randomized controlled trials of relapse conducted from 2012 to 2024. To develop consensus criteria, the authors used a multiphase Delphi approach involving over 100 experts from 37 countries, including people with lived experience of relapse.RESULTSThe review showed only two pairs of studies that used the same criteria. Clinical judgment alone was sufficient to define relapse in 85% of studies, and 58% used relative symptom change. The recommended criteria cover the pre-baseline, baseline, and relapse components with optimum and minimum criteria and provide a reporting checklist. The recommendations include using standardized, validated measures that can be applied across settings, and using absolute symptom change. The authors also identify criteria that should not be used and make reporting recommendations, including for specific symptom domains (positive, negative, or cognitive) and across symptom domains, hospitalization, home treatment, and risky, violent, or suicidal behavior.CONCLUSIONSThere are limitations and heterogeneity in current definitions of relapse, which limit study comparisons, potentially bias meta-analyses, and question the validity of some studies. Adopting the consensus recommendations for a standardized approach should improve the validity and reliability of study outcomes, facilitate cross-study comparisons, and also standardize research into risk factors for relapse.","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"108 1","pages":"appiajp20241040"},"PeriodicalIF":17.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145241035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adolescent Suicidality and Depression, Premenstrual Dysphoric Disorder, and Safety Issues Related to Ketamine and Esketamine Treatment.","authors":"Ned H Kalin","doi":"10.1176/appi.ajp.20250862","DOIUrl":"https://doi.org/10.1176/appi.ajp.20250862","url":null,"abstract":"","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"9 1","pages":"889-891"},"PeriodicalIF":17.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Esketamine 5 Years After Approval: Welcome New Data With Continuing Questions.","authors":"Alan F Schatzberg,Konstantinos N Fountoulakis","doi":"10.1176/appi.ajp.20250745","DOIUrl":"https://doi.org/10.1176/appi.ajp.20250745","url":null,"abstract":"","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"69 1","pages":"892-893"},"PeriodicalIF":17.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward Precision Reproductive Psychiatry: A Call for Targeted, Transdiagnostic Approaches to Premenstrual Disorders.","authors":"Tory A Eisenlohr-Moul","doi":"10.1176/appi.ajp.20250781","DOIUrl":"https://doi.org/10.1176/appi.ajp.20250781","url":null,"abstract":"","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"34 1","pages":"894-897"},"PeriodicalIF":17.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neural Predictors of Risk for Developing a Depressive Disorder: Specificity, Generalizability, and Developmental Timing.","authors":"Deanna M Barch","doi":"10.1176/appi.ajp.20250836","DOIUrl":"https://doi.org/10.1176/appi.ajp.20250836","url":null,"abstract":"","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"1 1","pages":"898-900"},"PeriodicalIF":17.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intranasal Esketamine: The Baby in the Bathwater.","authors":"Maxwell Zachary Price,Richard Louis Price","doi":"10.1176/appi.ajp.20250168","DOIUrl":"https://doi.org/10.1176/appi.ajp.20250168","url":null,"abstract":"","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"17 1","pages":"950-951"},"PeriodicalIF":17.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What's Behind the Increased Risk of Suicidal Behavior in Black Girls?","authors":"Nadine M Melhem","doi":"10.1176/appi.ajp.20250790","DOIUrl":"https://doi.org/10.1176/appi.ajp.20250790","url":null,"abstract":"","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"44 1","pages":"901-902"},"PeriodicalIF":17.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Esketamine Treatment for Depression in Adults: Response to Price et al. and Canuso et al.","authors":"Konstantinos N Fountoulakis,Athanasios Saitis,Alan F Schatzberg","doi":"10.1176/appi.ajp.20250551","DOIUrl":"https://doi.org/10.1176/appi.ajp.20250551","url":null,"abstract":"","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"18 1","pages":"954-956"},"PeriodicalIF":17.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on Esketamine Treatment for Depression in Adults: A PRISMA Systematic Review and Meta-Analysis.","authors":"Carla M Canuso,Cynthia Bossie,Dong-Jing Fu,Rosanne Lane,Teodora Doherty,Arunas Lignugaris,Andrea Fagiolini,Pierre-Michel Llorca,Roger S McIntyre,Andreas Reif,Gerard Sanacora,Richard C Shelton,Eduard Vieta,Allan H Young,Wayne C Drevets","doi":"10.1176/appi.ajp.20250250","DOIUrl":"https://doi.org/10.1176/appi.ajp.20250250","url":null,"abstract":"","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"141 1","pages":"951-954"},"PeriodicalIF":17.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}