Annals of General Psychiatry最新文献

{"title":"Diagnostic accuracy of machine learning approaches for suicide‑related outcomes: a meta‑analysis.","authors":"Parisa Kohnepoushi, Maryam Afraie, Hamza Rahmani, Seyedeh Asrin Seyedoshohadaei, Babak Ghadirzadeh, Yousef Moradi","doi":"10.1186/s12991-026-00671-4","DOIUrl":"https://doi.org/10.1186/s12991-026-00671-4","url":null,"abstract":"<p><strong>Objective: </strong>This diagnostic test accuracy meta-analysis aimed to provide clinically interpretable estimates (sensitivity, specificity, likelihood ratios (LR), predictive value (PV) and post‑test probabilities) for machine‑learning (ML) models predicting suicide‑related outcomes.</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase, PsycINFO, and Web of Science identified studies published between January 2010 and December 2024. Eligible studies used a single-gate design (cross-sectional or longitudinal), included at least 100 participants, and reported diagnostic performance metrics (e.g., sensitivity, specificity, area under the receiver operating curve (AUC)) for ML algorithms. Models examined included Support Vector Machines (SVM), Logistic Regression, Random Forest, XGBoost, Artificial Neural Networks (ANN), Gradient Boosting, and Ensemble approaches. Two reviewers independently extracted data. Pooled estimates of sensitivity, specificity, PPV, NPV, and AUC were calculated using a bivariate random-effects model. Risk of bias was assessed using QUADAS-2.</p><p><strong>Results: </strong>Of 500 screened records, 22 studies met inclusion criteria. Ensemble models demonstrated the highest pooled AUC (0.95; 95% CI, 0.92-0.96), with specificity of 0.97 (95% CI, 0.95-0.98) and sensitivity of 0.50 (95% CI, 0.29-0.71). Gradient-boosting and ensemble approaches showed strong discriminative performance overall; model-specific estimates are reported in the Results. At a pre-test probability of 25%, post-test probabilities for a positive result ranged from 64% (Logistic Regression) to 88% (Ensemble Models).</p><p><strong>Conclusion: </strong>Machine-learning approaches demonstrated promising diagnostic accuracy for suicide-related outcomes in heterogeneous clinical populations. However, because primary studies rarely reported diagnosis- or outcome-specific performance, these findings should not be assumed to generalize across specific disorders or to suicide mortality. Future research should incorporate diagnosis-stratified and outcome-resolved validation to clarify clinical applicability.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Normative modeling reveals functional connectivity heterogeneity in internet gaming disorder.","authors":"Zixiao Wang, Yong Xie, Yidan Wang, Lingxiao Wang, Guang-Heng Dong","doi":"10.1186/s12991-026-00664-3","DOIUrl":"https://doi.org/10.1186/s12991-026-00664-3","url":null,"abstract":"<p><strong>Background: </strong>Internet gaming disorder (IGD) is associated with abnormal functional connectivity (FC) in brain networks. However, findings from resting-state functional magnetic resonance imaging studies are highly inconsistent, likely due to individual heterogeneity in IGD-related neural alterations-a feature commonly observed in other psychiatric disorders but understudied in IGD.</p><p><strong>Methods: </strong>We applied normative modeling to nucleus accumbens (NAcc) seed-to-voxel resting-state FC to derive individualized deviation (Z) maps for 173 IGD participants relative to age- and sex-adjusted normative ranges from 232 healthy controls. We then performed exploratory unsupervised clustering of network-level deviation features across three sample data, three atlas templates, and two clustering algorithms, selecting the optimal number of clusters using the silhouette criterion.</p><p><strong>Results: </strong>IGD showed marked heterogeneity in FC deviations: voxel-level deviations were largely idiosyncratic in both spatial distribution and direction. When deviations were summarized at the network level, clustering consistently selected a two-cluster solution across data, atlases, and algorithms, separating a majority \"low-deviation\" stratum from a smaller \"high-deviation\" stratum.</p><p><strong>Conclusions: </strong>IGD is characterized by pronounced individual variability in FC deviations. Network-level deviations yield a robust higher- vs. lower-deviation stratification, although the present findings do not support interpreting this pattern as evidence for discrete subtypes. The present study highlights the utility of individualized deviation mapping beyond conventional case-control analyses for characterizing heterogeneity in IGD.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147809672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient perspectives on the challenges, obstacles, and opportunities in discussing and managing anhedonia in major depressive disorder (MDD): a focus group study.","authors":"Rebecca Portela, Teri Brister, Gregory Mattingly, Tiina Drissen, Hannah E Bowrey","doi":"10.1186/s12991-026-00662-5","DOIUrl":"https://doi.org/10.1186/s12991-026-00662-5","url":null,"abstract":"","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can art help us confront the health inequities faced by Europe's largest minority?","authors":"Philippe Courtet, Hala Kerbage","doi":"10.1186/s12991-026-00663-4","DOIUrl":"https://doi.org/10.1186/s12991-026-00663-4","url":null,"abstract":"","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":"25 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-/pro and synbiotics on anxiety and depression symptoms: a GRADE assessed systematic review and meta-analysis of randomized controlled trials.","authors":"Juan Lian, Wang Yu, Gao Feng, Dan Miao","doi":"10.1186/s12991-026-00661-6","DOIUrl":"https://doi.org/10.1186/s12991-026-00661-6","url":null,"abstract":"","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antidepressant prescribing patterns and patient-reported adverse effects: a cross-sectional study from Pakistan.","authors":"Sohail Riaz, Fazli Khuda, Abuzar Khan, Asif Jan, Samir Ibenmoussa, Ghallab Alotaibi, Syed Shaukat Ali, Basmah Abdulaziz Albabtain","doi":"10.1186/s12991-026-00644-7","DOIUrl":"https://doi.org/10.1186/s12991-026-00644-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Antidepressant prescribing practices and Adverse-effect profiles are poorly characterised in Pakistan, highlighting the need for systematic evaluation. This study aimed to assess prescribing patterns, validate the Urdu version of the Antidepressant Side-Effect Checklist (U-ASEC), and document patient-reported adverse effects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A cross-sectional questionnaire-based study was conducted at two psychiatry clinics in Lahore and Rawalpindi. All adult patients diagnosed with MDD according to the DSM-5-TR were invited to participate. Sampling was done through a convenient method. The Urdu-translated Antidepressant Side-Effect Checklist (U-ASEC) was developed through forward-back translation, expert panel review and pilot testing, and its psychometric properties such as internal consistency, construct validity were examined. Descriptive statistics were used to summarize demographic and clinical characteristics. Differences in adverse-effect scores across demographic and clinical groups were assessed with Kruskal-Wallis tests followed by Dunn's test with Bonferroni adjustment. Multivariable logistic regression models were fitted for each adverse-effect item to explore associations with antidepressant classes, adjusting for age, sex, tobacco use, comorbidity and duration of MDD. Multicollinearity was checked using variance inflation factors (VIF) (&lt; 3 for all variables), and false discovery rate (FDR) control was used to account for multiple testing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the 457 participants, 54.9% were male and 60% of participants were married. Escitalopram was the most frequently prescribed single agent (12.9%), and Selective serotonin reuptake inhibitors as a class accounted for 32.1% of monotherapy prescriptions. Combination therapy was used by 26.7% of participants; typical pairs included mirtazapine + escitalopram (12.2%) and mirtazapine + fluoxetine (5.5%). The U-ASEC demonstrated good internal consistency (Cronbach's alpha = 0.78). Factor analysis identified three clusters of adverse effects: autonomic dysfunction, Central Nervous System effects, and metabolic effects. Dry mouth and insomnia were the most frequently reported adverse effects of SSRIs. Adverse effects varied by class: TCAs had higher rates of nausea/vomiting (41.3%); SNRIs were associated with a higher prevalence of urinary difficulties (32.4%); atypicals reduced dry mouth (18.8%) but increased dizziness (10.4%); and dual therapy showed more metabolic effects, including weight gain (29.5%) and increased body temperature (20.5%). Significant associations were identified for dry mouth (p = 0.0059), nausea and vomiting (p = 0.0202), problem with urination (p = 0.0248), feeling like the room is spinning (p = 0.041), and Tremor (p = 0.0382). Multivariable analysis showed TCAs increased odds of nausea (OR 3.96, 95% CI 1.72-9.03, p = 0.001), urination problems (OR 2.77, 1.10-6.63, p = 0.025), orthostatic symptoms","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147687323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unraveling links between lifestyle behaviors and depressive symptoms: a network analysis using NHANES 2007-2018 data.","authors":"Fuhua Yang, Lu Liu, Ying Zhang, Dejun Cheng, Rui Yu, Jiaci Lin","doi":"10.1186/s12991-026-00656-3","DOIUrl":"https://doi.org/10.1186/s12991-026-00656-3","url":null,"abstract":"<p><strong>Objective: </strong>Implementing effective interventions targeting specific depressive symptoms is essential for reducing the overall burden of depression. Our study employed network analysis to explore the complex interrelationships between multiple lifestyle behaviors and depressive symptoms, and to compare network differences across different age groups.</p><p><strong>Methods: </strong>Using data from the National Health and Nutrition Examination Survey (NHANES), we analyzed 4,040 participants between the ages of 20 and 80 from the 2007-2018 survey cycles. Depressive symptoms were assessed using the 9-item Patient Health Questionnaire (PHQ-9), and data on five lifestyle behaviors-healthy diet, alcohol consumption, screen time, smoking, and physical activity-were collected. Network models were estimated using R version 4.4.3 to calculate strength, bridge strength, and age-related differences.</p><p><strong>Results: </strong>The network analysis revealed that smoking (bridge expected influence; BEI = 2.59), alcohol use (BEI = 2.19), and screen time (BEI = 2.17) were the most prominent bridging nodes linking lifestyle behaviors and depressive symptoms. In addition, healthy diet (LB1) was negatively associated with appetite problems (PHQ5; edge weight = -0.02), and psychomotor agitation or retardation (PHQ8; edge weight = -0.02); screen time (LB3) was positively linked to trouble sleeping (PHQ3; edge weight = 0.04), and appetite problems (PHQ5; edge weight = 0.03); smoking (LB4) was associated with appetite problems (PHQ5; edge weight = 0.04) and depressed mood (PHQ2; edge weight = 0.03); physical activity (LB5) was negatively related to fatigue (PHQ4; edge weight = -0.05). Finally, global network strength differed significantly across age groups, with a clear age-related decline in overall connectivity: the Youth group exhibited the highest global strength (4.56), followed by the Middle-aged group (4.07) and the Older group (3.45).</p><p><strong>Conclusions: </strong>These findings contribute to the development of more nuanced and effective public health strategies for the prevention and treatment of depression.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alexithymia and self-harm in depressed adolescents: the mediating role of resting-state functional connectivity of the ventral hippocampal-fusiform gyrus.","authors":"Ying Ma, Yongjie Zhou, Huihang Fu, Xiaoyi Lin, Mengxin Huang, Yi Zhang, Yahan Li, Yu Liu, Weiju Zhou, Ruoling Chen, Yaojing Chen, Jieling Wu, Jie Tang","doi":"10.1186/s12991-026-00655-4","DOIUrl":"https://doi.org/10.1186/s12991-026-00655-4","url":null,"abstract":"","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147643808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex differences in prevalence and clinical correlates for psychotic symptoms in first-episode drug-naïve patients with bipolar disorder: a cross-sectional study.","authors":"Yehong Chen, Yujia Zhai, Hao Chen, Xuebing Liu","doi":"10.1186/s12991-026-00654-5","DOIUrl":"https://doi.org/10.1186/s12991-026-00654-5","url":null,"abstract":"<p><strong>Background: </strong>Psychotic symptoms, which affect a significant proportion of patients with bipolar disorder (BD), are associated with adverse prognostic outcomes. Currently, sex-specific patterns of psychotic symptoms remain inadequately characterized in BD. This study seeks to investigate sex-based differences in psychotic symptoms among first-episode drug-naïve (FEDN) BD patients among Han Chinese population.</p><p><strong>Methods: </strong>A total of 577 FEDN BD patients, comprising 271 males and 306 females, were recruited in this study. Demographic characteristics were collected using a specialized questionnaire. The positive subscale of the Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Scale, Young Mania Rating Scale, and Clinical Global Impression Scale-Severity of Illness were used to evaluate clinical symptoms. Moreover, fasting blood glucose, prolactin, lipids, and thyroid hormone levels, alongside metabolic syndrome (MetS) were assessed.</p><p><strong>Results: </strong>The prevalence of psychotic symptoms showed no significant sex differences in the FEDN BD cohort (p = 0.968). Nevertheless, multiple linear regression revealed that MetS score (p = 0.001) was significantly associated with the PANSS Positive subscale score (PANSS-P) among males, whereas thyroid-stimulating hormone (TSH) levels (p < 0.001) and high-density lipoprotein cholesterol (HDL-C) levels (p < 0.001) were significantly associated with PANSS-P among females. Binary logistic regression revealed that MetS score (p = 0.002) was a significant correlate of the prevalence of psychotic symptoms among males only, whereas TSH levels (p < 0.001) significantly correlated with the prevalence of psychotic symptoms among females only.</p><p><strong>Conclusions: </strong>Among Han Chinese FEDN BD patients, our study revealed the following: (1) No significant sex difference was observed in the prevalence of psychotic symptoms; (2) HDL-C functions as a meaningful protective factor against the prevalence of psychotic symptoms in both males and females, while its association with symptom severity is observed exclusively in females; (3) Sex-specific indicators correlate with psychotic symptoms, specifically MetS dominates in males, while TSH in females. Our results call for sex-informed clinical protocols that integrate metabolic-endocrine monitoring and targeted interventions to reduce psychosis risk in BD.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of screen time and chronotype with depression and anxiety symptoms among Chinese adolescents.","authors":"Ye Xu, Yi-Fan Lin, Liuxun Li, Yanzhi Li, Liwen Yang, Herui Wu, Caixia Zhang, Wenyu Zhou, Lei Yang, Ciyong Lu","doi":"10.1186/s12991-026-00659-0","DOIUrl":"https://doi.org/10.1186/s12991-026-00659-0","url":null,"abstract":"<p><strong>Background: </strong>Depression and anxiety symptoms among adolescents have increased in recent years, making the identification of modifiable risk factors important. Prolonged screen time (ST) and later chronotype may be independently and jointly associated with adolescent mental health. This study aimed to examine the independent and joint associations of ST and chronotype with depression and anxiety symptoms among adolescents.</p><p><strong>Methods: </strong>Data were drawn from the China Adolescent Health Screening Program (CAHSP), a large school-based health screening program conducted in Shenzhen, southern China, using a multistage cluster sampling design, including 10,083 adolescents (mean age: 13.7 [SD: 1. 6] years). ST was assessed using structured self-report items, while chronotype was measured using the Morningness-Eveningness Questionnaire-5 (MEQ-5). Depression and anxiety symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7), respectively. Logistic regression models adjusted for relevant covariates were employed to examine independent and joint associations of ST and chronotype with depression and anxiety symptoms.</p><p><strong>Results: </strong>Excessive ST and later chronotype were significantly associated with depression and anxiety symptoms. Significant interaction indicated that the association between excessive ST and mental health symptoms differed across chronotype groups. Stratified analyses confirmed that within each chronotype group, adolescents with excessive ST had higher odds of depression and anxiety, with the strongest associations observed in evening chronotype (E-type) adolescents (depression: aOR = 2.54, 95% CI: 2.01-3.22; anxiety: aOR = 2.49, 95% CI: 1.98-3.13). Joint analyses further confirmed that E-type adolescents with excessive ST showed the highest odds of screening positive for depression and anxiety symptoms (depression: aOR = 5.55, 95% CI: 4.38-7.02; anxiety: aOR = 4.71, 95% CI: 3.73-5.93) compared with the non-excessive ST and M-type group.</p><p><strong>Conclusion: </strong>Higher levels of ST and later chronotype were associated with higher odds of screening positive for depression and anxiety symptoms among adolescents. Public health strategies to promote adolescents' mental well-being should focus on encouraging healthy screen behaviors and promoting sleep hygiene, particularly for E-type adolescents.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}