Annals of General Psychiatry最新文献

{"title":"Brief pharmacist-led intervention using a structured questionnaire to improve attitudes toward medication adherence in patients on antipsychotics: a single-site before-after study.","authors":"Masaki Maehara, Masayasu Sugiyama, Daisuke Kobayashi, Junpei Mutoh, Kanta Noguchi, Mitsuhiro Wada","doi":"10.1186/s12991-026-00636-7","DOIUrl":"10.1186/s12991-026-00636-7","url":null,"abstract":"<p><strong>Background: </strong>Medication adherence among patients with psychiatric disorders is a significant challenge that often leads to poor clinical outcomes. Although pharmacist-led interventions have demonstrated the potential to improve medication adherence, evidence remains limited, particularly in patients treated with antipsychotics. This study aimed to evaluate the effectiveness of a brief pharmacist-led intervention in enhancing medication adherence among outpatients receiving antipsychotic therapy.</p><p><strong>Methods: </strong>This exploratory, prospective, single-arm study was conducted at a community pharmacy in Japan. Fifty outpatients prescribed antipsychotic medications participated in the study. A brief pharmacist-led intervention was delivered focusing on identifying and addressing barriers to adherence. The primary outcomes were changes in Drug Attitude Inventory-10 (DAI-10) scores and the proportion of participants with unused medications.</p><p><strong>Results: </strong>Participants taking preexisting medications exhibited a significant improvement in DAI-10 scores (mean increase, + 2.05 points; from 5.81 ± 4.00 to 7.86 ± 2.90, p = 0.00619). The proportion of participants who reported non-adherence to medication regimens decreased significantly from 42% to 24% (p= 0.0159).</p><p><strong>Conclusions: </strong>The brief pharmacist-led intervention was effective in improving attitudes toward medication and behavioral adherence among patients receiving antipsychotic treatment in our study group. These findings underscore the importance of active pharmacist engagement for supporting medication adherence.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13063625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343380","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":"A novel sex-specific role for 27-hydroxycholesterol in early-onset schizophrenia.","authors":"Zuoli Sun, Mingxia Liu, Junjuan Yan, Yuanzhen Wu, Haixia Wang, Yuhong Li, Yilang Tang, Yi Zheng, Rena Li","doi":"10.1186/s12991-026-00642-9","DOIUrl":"10.1186/s12991-026-00642-9","url":null,"abstract":"<p><strong>Background: </strong>Although Schizophrenia is a serious mental illness which more common in adults, it can also manifest in childhood with disease onset before age 18 as \"early-onset schizophrenia\" (EOS). While our previous research identified circulating oxysterols-24(S)-hydroxycholesterol (24 S-OHC) and 27-hydroxycholesterol (27-OHC)-as potential biomarkers in adult schizophrenia, their role in EOS remains unknown. This study aimed to characterize the developmental trajectories of these oxysterols during early life and evaluate their clinical relevance in EOS, with particular emphasis on sex-specific effects.</p><p><strong>Methods: </strong>We recruited 142 healthy individuals (aged 1 to 41 years) to define age-related oxysterol patterns and 71 EOS patients (aged 4 to 18 years) to identify disease-associated changes. Plasma concentrations of 24 S-OHC and 27-OHC were measured using liquid chromatography-tandem mass spectrometry.</p><p><strong>Results: </strong>Healthy participants exhibited significant age-dependent variations, with younger individuals showing higher 24 S-OHC and lower 27-OHC levels. While EOS patients showed no overall differences in oxysterol levels compared to age-matched healthy controls, a striking sex-based divergence emerged: male patients exhibited significantly elevated levels of 27-OHC compared to females. Additionally, the 24 S-OHC/27-OHC ratio showed a positive correlation with negative symptom severity, which did not survive correction for multiple comparisons but may still indicate a potential relationship. Notably, sex-stratified analysis revealed opposing correlations between 27-OHC levels and PANSS scores, most prominently for positive symptoms.</p><p><strong>Conclusions: </strong>This study represents the first evidence of sexually dimorphic oxysterol regulation in EOS and highlights 27-OHC as a sex-sensitive factor linked to clinical symptom expression, even in the absence of group-level oxysterol alterations.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13063885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147347285","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":"Psychiatry in transition: an assessment in the context of societal change.","authors":"Fabian Max Wedmann, Francesco Albasini, Robert Davidson, Adele Mayr, Andreas Conca","doi":"10.1186/s12991-026-00637-6","DOIUrl":"10.1186/s12991-026-00637-6","url":null,"abstract":"<p><strong>Aims: </strong>To explore how global challenges such as climate change, artificial intelligence (AI), and migration intersect with generational change among psychiatric trainees and reshape specialist training.</p><p><strong>Methods: </strong>An integrative review drawing on symposium contributions and a comprehensive literature review to assess the evolving priorities and challenges in psychiatric training.</p><p><strong>Results: </strong>Younger psychiatrists increasingly prioritize work-life balance, sustainability, and participatory learning environments. However, gaps remain in integrating climate-related knowledge, transcultural competence, AI literacy and neurodevelopmental disorders within psychiatric curricula. Generational tensions and traditional hierarchical structures further complicate training.</p><p><strong>Conclusions: </strong>A new training model is needed that fosters mutual understanding between generations, encourages reflective dialogue, and supports collaborative learning. Preparing psychiatrists for the future requires updated content and a commitment to relational transformation and co-created educational practices.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13041367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147300795","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":"Depression and apathy: examining an overlooked dimension.","authors":"Elvira Anna Carbone, Renato de Filippis, Alessia Scalzo, Emanuela Calabretta, Stefano Lodari, Marianna Rania, Giulia Menculini, Alfonso Antonio Vincenzo Tortorella, Cristina Segura-Garcia, Pasquale De Fazio","doi":"10.1186/s12991-026-00641-w","DOIUrl":"10.1186/s12991-026-00641-w","url":null,"abstract":"<p><p>BACKGROUND: Apathy is a significant yet frequently overlooked aspect of Major Depressive Disorder (MDD), often confused with anhedonia, and with the potential to influence clinical outcomes and quality of life regardless of the severity of depressive symptoms. Despite its importance, the relationship between apathy and depression remains underrepresented in current research. This study aims to assess the prevalence of apathy in a sample of outpatients affected by MDD and to explore its clinical, cognitive, and functional correlates. METHODS: Outpatients with MDD (n = 154) during a clinical stability phase have been assessed using the Apathy Evaluation Scale-Clinician version (AES-C), Dimensional Apathy Scale (I-DAS), MADRS, BDI-II, MMSE, PANSS, EQ-5D-3 L, and CGI-S. Patients were categorized into two groups according to the presence/absence of apathy (AES-C score ≥ 42). Groups comparison and a stepwise logistic regression were run to identify clinical differences between groups and the predictors of apathy. RESULTS: Apathy was detected in 48% of the sample. Patients with apathy scored higher on depression scales, had lower cognitive performance, more negative and general psychopathology, greater clinical severity, and reduced quality of life. Significant differences emerged in initiation and executive apathy. Logistic regression identified MADRS item 8 “inability to feel” and BDI-II item 12 “loss of interest” as the factors showing the strongest association with apathy. CONCLUSION: Apathy is a prevalent and clinically relevant feature in MDD, associated with greater psychopathology and functional impairment. Findings support the need to routinely assess apathy in clinical setting, even during symptomatic stability phases. Specific symptoms may serve as key markers for its identification. </p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13041180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282076","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":"The bidirectional effects of hemorrhoids, depression, and anxiety: a prospective cohort study in the UK Biobank.","authors":"Zhiguang Huang, Xinyao Yi, Xinchang Liu, Yan He, Jian Huang, Shaolin Liang, Wai-Kit Ming","doi":"10.1186/s12991-026-00634-9","DOIUrl":"10.1186/s12991-026-00634-9","url":null,"abstract":"<p><strong>Background: </strong>This study examines the bidirectional association between hemorrhoidal disease and mental health conditions, specifically depression and anxiety. While a plausible connection exists, research on their interplay is limited.</p><p><strong>Methods: </strong>Using data from the UK Biobank (until March 2024), this prospective study analyzed two cohorts: 48,620 participants in the hemorrhoids-to-mental disorder cohort and 87,310 in the mental disorder-to-hemorrhoids cohort. Analyses were adjusted for multiple sociodemographic, lifestyle, and clinical covariates, including age, sex, ethnicity, BMI, smoking status, alcohol consumption, socioeconomic indicators, and comorbidities. We employed time-varying Cox proportional hazards models in conjunction with propensity score matching to estimate associations, assessing risk within 5 years, within 10 years, and over long-term follow-up.</p><p><strong>Results: </strong>Fully adjusted models revealed significant associations between hemorrhoidal disease and mental disorders. A diagnosis of hemorrhoidal disease was associated with a higher risk of subsequent depression (HR, 1.56 [95% CI, 1.46-1.66]) and anxiety (HR, 1.55 [95% CI, 1.46-1.66]). Conversely, a diagnosis of depression was associated with an increased risk of subsequent hemorrhoidal disease (HR, 1.14 [95% CI, 1.09-1.19]), as was a diagnosis of anxiety (HR, 1.46 [95% CI, 1.38-1.54]).</p><p><strong>Conclusion: </strong>This study identifies a significant bidirectional association between hemorrhoidal disease and mental health conditions. Notably, the interaction between smoking and anxiety highlights a subgroup at elevated risk that may benefit from closer clinical attention. These findings support an integrated care perspective that considers both gastrointestinal and mental health conditions, while acknowledging that causal inferences cannot be definitively established from observational data.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12961811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257125","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":"Associations between immigration background, adverse childhood experiences, and depressive symptoms in adulthood in immigrants and descendants of immigrants in France: a mediation analysis.","authors":"Kasra Zarei, Pamela J Surkan, Judith van der Waerden, Emmanuel Wiernik, Siddartha Aradhya, Anna-Clara Hollander, Kelvin Choi, Maria Melchior","doi":"10.1186/s12991-025-00612-7","DOIUrl":"10.1186/s12991-025-00612-7","url":null,"abstract":"","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146211982","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":"Understanding suicide risk in mild cognitive impairment: a systematic review of suicide epidemiology in older adults.","authors":"Nicole Bungaro, Rossella Mattea Quinto, Lorenzo Scoma, Laura Dattilo, Claudio Imperatori, Marco Innamorati, Federica Genova, Michela Balsamo, Leonardo Carlucci","doi":"10.1186/s12991-026-00639-4","DOIUrl":"10.1186/s12991-026-00639-4","url":null,"abstract":"<p><p>BACKGROUND: Late-life suicide represents a major public health issue, with older adults showing the highest lethality and completion rates. Mild Cognitive Impairment (MCI), a critical stage of increased psychological vulnerability, may represent an acute phase of suicide vulnerability. This systematic review aimed to synthesize existing evidence on suicide risk among older adults with MCI, examining the prevalence of suicide ideation and behaviors, as well as associated factors and therapeutic outcomes. METHODS: Following PRISMA guidelines, four databases (PubMed, Scopus, MEDLINE, PsycINFO) were searched. Eligible studies included participants aged ≥ 65 years, presence of MCI, and an assessment of suicide risk. Methodological quality was appraised using JBI Critical Appraisal Checklists. RESULTS: Seventeen records published between 2002 and 2024 met inclusion criteria. Across studies, individuals with MCI consistently reported higher rates of suicide ideation compared both with cognitively intact controls and older adults showing more severe cognitive impairment. Prevalence estimates ranged from 0.5% in a large community sample to as high as 84% in a clinical cohort. Depressive symptoms, particularly late-life depression, emerged as the strongest correlate, along with social isolation, female gender, younger age, being single, and multimorbidity. Across three randomized controlled trials, psychotherapeutic interventions and supportive care conditions were associated with reductions in suicide ideation, likely mediated by improvements in emotional regulation and depression. CONCLUSION: MCI may represent a particularly vulnerable stage of cognitive decline, marked by preserved insight, loss of autonomy, and heightened existential distress. Standardizing diagnostic criteria and suicidality measures, and implementing tailored psychotherapeutic approaches, are essential steps toward prevention and early interventions in this high-risk population. </p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13014771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146206417","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":"Altered subgenual anterior cingulate cortex connectivity in psoriasis patients with depression: a resting-state fMRI case-control study.","authors":"Ni Liu, Xiaoxu Wang, Yanan Zhang, Xue Han, Fan Yi, Jianwei Huo, Tai Chang","doi":"10.1186/s12991-026-00638-5","DOIUrl":"10.1186/s12991-026-00638-5","url":null,"abstract":"<p><strong>Background: </strong>Psoriasis is a chronic inflammatory skin disease frequently comorbid with depression, yet the underlying neurobiological mechanisms remain unclear. This study investigated functional connectivity (FC) alterations of emotion-regulation circuits and their association with inflammatory markers in psoriasis patients with depression.</p><p><strong>Methods: </strong>Seventeen psoriasis patients with depression and 17 matched controls underwent resting-state functional magnetic resonance imaging (rs-fMRI) examination. Seed-based FC analysis was performed to examine connectivity abnormalities of the subgenual anterior cingulate cortex (sgACC), a key emotional regulation region, with the following statistical thresholds: voxel-level p < 0.001 (uncorrected) with cluster-level false discovery rate (FDR) correction at p < 0.05 for multiple comparisons. Correlation analyses were conducted to evaluate relationships between sgACC connectivity patterns and depression severity (Self-rating Depression Scale, SDS), pruritus intensity (Visual Analog Scale, VAS), and serum levels of IL-6 and IL-17 in a subgroup of participants (n = 7).</p><p><strong>Results: </strong>Psoriasis patients with depression showed increased sgACC connectivity with DMN nodes (posterior cingulate cortex(PCC), angular gyrus(AG)) and executive network regions (superior frontal gyrus (SFG), middle frontal gyrus (MFG)) versus controls. FC between sgACC-AG correlated with SDS scores (r = 0.598, p = 0.011), while sgACC with right SFG (r = 0.893, p = 0.007) and left MFG (r = 0.929, p = 0.003) connectivity positively associated with IL-17 levels.</p><p><strong>Conclusions: </strong>The findings reveal a \"dual-circuit\" dysfunction pattern in psoriatic depression: sgACC-DMN hyperconnectivity linked to depressive symptoms, and sgACC-dlPFC (dorsolateral prefrontal cortex) alterations associated with IL-17 elevation. These results establish the sgACC as a neural hub bridging inflammation and mood dysregulation, supporting the \"skin-brain axis\" hypothesis. The identified FC patterns may serve as biomarkers for targeted interventions in inflammation-related depression.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13011298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146206372","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":"Lurasidone continuation in real-world clinical cases in Japan: retrospective study of factors associated with six-month persistence.","authors":"Kohei Fujita, Yuko Sugimoto, Ryosuke Aratake, Takaaki Yoshimoto, Mihoko Kawai, Takahide Fukatsu, Yasuhiro Mori, Makoto Nishihara, Jun Miyata","doi":"10.1186/s12991-026-00640-x","DOIUrl":"10.1186/s12991-026-00640-x","url":null,"abstract":"<p><strong>Background: </strong>Treatment discontinuation remains a major challenge for patients with schizophrenia, often resulting in relapse and subsequent rehospitalization. While treatment persistence is a practical marker of real-world effectiveness, findings related to lurasidone continuation in clinical settings in Japan are limited.</p><p><strong>Methods: </strong>For this retrospective observational study, the records of 62 patients with schizophrenia who had lurasidone treatment initiated at Aichi Medical University Hospital between June 2020 and December 2024 were analyzed. Treatment persistence was defined as continuation of lurasidone for ≥ 180 days. Associations of baseline characteristics, including illness duration, prior antipsychotic class (serotonin-dopamine antagonist, SDA; dopamine partial agonist, DPA; multi-acting receptor-targeted antipsychotic, MARTA), and other clinical variables, with six-month persistence were analyzed using Kaplan-Meier survival analysis and log-rank testing.</p><p><strong>Results: </strong>The six-month treatment persistence rate was 54.8%. Patients with illness duration < 5 years showed a significantly greater rate of persistence (71.4%) as compared to those with a longer duration (46.3%) (P = 0.046). Persistence also varied based on prior antipsychotic class, with the rate 76.5% for SDA, 50.0% for DPA, and 35.0% for MARTA (P = 0.045). No statistically significant differences in six-month persistence were observed across sex, treatment setting, or lurasidone dose range.</p><p><strong>Conclusions: </strong>This is the first known study to evaluate real-world lurasidone persistence in patients in Japan. The findings indicate that both pharmacodynamic compatibility and early-phase treatment can enhance persistence. The insights obtained underscore the importance of individualized treatment planning, though require further validation by use of prospective, multi-center studies.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13011661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146199831","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":"Mechanisms and clinical potential of combined tDCS and virtual reality in psychiatric disorders: a systematic review.","authors":"Xuanru Guo, Huiqing Jiang, Ziming Zheng, Junhang Zhang, Liyu Cao, Haiteng Jiang","doi":"10.1186/s12991-025-00621-6","DOIUrl":"10.1186/s12991-025-00621-6","url":null,"abstract":"<p><strong>Background: </strong>Transcranial direct current stimulation (tDCS) and virtual reality (VR) have emerged as promising non-invasive interventions in treating psychiatric disorders. Despite their individual efficacy in improving symptoms of various psychiatric conditions, the understanding of the combined use of tDCS and VR is limited. This review aims to evaluate the clinical effects and mechanisms of combined tDCS and VR in treating psychiatric disorders.</p><p><strong>Methods: </strong>We conducted a PRISMA 2020-compliant systematic review, searching major databases (PubMed, Web of Science, Scopus, PsycINFO, ScienceDirect, Cochrane Library, Google Scholar, medRxiv and ClinicalTrials.gov) for studies from January 2000 to July 2025 that evaluated combined tDCS-VR in psychiatric populations. Eligible clinical trials were screened, with tDCS/VR parameters and clinical outcomes extracted, and randomized controlled trials appraised using the Cochrane Risk of Bias 2 tool.</p><p><strong>Results: </strong>Fourteen studies met inclusion criteria: seven reviews and seven empirical trials (five randomized controlled trials, two pilot/feasibility studies) using mainly 1-2 mA prefrontal tDCS paired with disorder-congruent VR. In post-traumatic stress disorder (PTSD) and specific phobias showed short-term symptom reductions, with some PTSD benefits maintained up to 12 months. Evidence for social anxiety and mild cognitive impairment-related depression was limited to single small RCTs with transient or inconsistent improvements. Overall confidence in the evidence is limited by small sample sizes, variable protocols, and risk‑of‑bias concerns.</p><p><strong>Conclusion: </strong>Although seven small, heterogeneous studies indicate that combined tDCS-VR is feasible and shows preliminary therapeutic promise-most consistently in PTSD and, to a lesser extent, in specific phobias-the overall evidence base remains limited. Mechanistic findings suggesting modulation of medial and ventromedial prefrontal-amygdala circuits are still exploratory. Given substantial methodological heterogeneity, small sample sizes, and risk of bias, tDCS-VR should be regarded as experimental. The larger, well‑designed, disorder‑tailored randomized controlled trials using standardized stimulation/VR protocols, mechanistic outcome measures, and efforts to identify predictors of response are required before routine clinical implementation.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":"13"},"PeriodicalIF":5.8,"publicationDate":"2026-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197266","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}