Annals of General Psychiatry最新文献

{"title":"Beyond inflammation and cholesterol: atherogenic index of plasma mediates the link between hsCRP/HDL-C ratio and depression in US adults NHANES 2015-2020.","authors":"Jing-Ying Ma, Jue Hu, FaDan Tang, YiLin Meng, Fa Ye, Lin-Lin Hu, Yong-Hua Zhang","doi":"10.1186/s12991-025-00624-3","DOIUrl":"10.1186/s12991-025-00624-3","url":null,"abstract":"<p><strong>Background: </strong>Dyslipidemia and inflammation play key roles in the pathophysiology of depression and are significantly associated with the plasma atherogenic index (AIP). However, a reliable biomarker for diagnosing depression remains elusive. The hsCRP/HDL-C ratio, combining C-reactive protein (hs-CRP) and high-density lipoprotein cholesterol (HDL-C), may serve as a potential composite indicator.</p><p><strong>Objective: </strong>This study aims to explore the relationship between the hsCRP/HDL-C ratio and depression.</p><p><strong>Methods: </strong>NHANES data (2015-2020) from 10,357 participants were analyzed. Depression was assessed using the PHQ-9, and dyslipidemia with AIP. Participants were grouped based on their hsCRP/HDL-C ratio. Statistical methods included Student's t-test, chi-square test, logistic regression, restricted cubic spline (RCS) model, and mediation analysis.</p><p><strong>Results: </strong>RCS regression analysis showed a nonlinear relationship between the hsCRP/HDL-C ratio and depression. The two-piece logistic regression model was used to calculate the threshold effect, and the likelihood ratio test (p < 0.05) indicated that the inflection point for hs-C/H was 11.608. When the hsCRP/HDL-C ratio was below this threshold, a positive correlation with depression was observed (OR: 1.04, 95% CI: 1.01-1.07). When the hsCRP/HDL-C ratio was equal to or greater than the threshold, a negative correlation was found (OR: 0.99, 95% CI: 0.97-1.00). Subgroup analysis showed consistent results, with marital status being the only factor that significantly influenced this relationship. Mediation analysis revealed that AIP partially mediated the relationship between hsCRP/HDL-C ratio and depression, explaining 11.2% of the total effect (95% CI: 2.26%-27.00%).</p><p><strong>Conclusions: </strong>A higher hsCRP/HDL-C ratio is associated with increased depression risk. Interventions targeting CRP levels and lipid abnormalities may help reduce this risk.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":"9"},"PeriodicalIF":3.6,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12905919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017295","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":"Transforming treatment-resistant depression (TRD) care in the Gulf Cooperation Council (GCC) countries: a narrative review of emerging therapies, advancements, and implementation barriers.","authors":"Mohammed A Alhassan","doi":"10.1186/s12991-025-00626-1","DOIUrl":"10.1186/s12991-025-00626-1","url":null,"abstract":"<p><strong>Background: </strong>Treatment-resistant depression (TRD) remains a major clinical challenge worldwide and across the Gulf Cooperation Council (GCC) countries, where the burden of mental health disorders continues to rise. Conventional TRD therapies, including antidepressants, augmentation strategies, and electroconvulsive therapy (ECT), often result in incomplete remission and are associated with significant adverse effects, highlighting the need for innovative therapeutic approaches.</p><p><strong>Objective: </strong>This narrative review explores the mechanisms, clinical evidence, regional adoption, and recent advances of ketamine, esketamine, and rTMS in TRD, while examining barriers to implementation and outlining future directions for care in the GCC.</p><p><strong>Key findings: </strong>Esketamine adoption is increasing in the GCC, with the United Arab Emirates (UAE) and Qatar leading implementation efforts. In both countries, esketamine and related treatments are currently administered in controlled clinical settings within leading psychiatry clinics. Region-specific governmental strategies, such as Qatar's national mental health initiatives, have further supported the structured introduction of these therapies. rTMS is also being gradually integrated into regional mental health services, with notable expansion through private providers in the UAE and Hamad Medical Corporation (HMC) in Qatar. Despite these advancements, access remains limited due to regulatory challenges, high costs, and infrastructure constraints. Implementation of these therapies may serve as a foundation for future regional mental health policies, although cultural stigma, limited insurance coverage, and workforce shortages continue to pose barriers.</p><p><strong>Conclusions: </strong>Novel therapies for TRD demonstrate clinical efficacy and feasibility in the GCC. Nevertheless, their wider adoption requires addressing accessibility challenges, reducing stigma, and expanding professional training. Strategic investments, policy reforms, and awareness initiatives will be critical to embedding these treatments into mental health systems and transforming TRD care in the region.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":"10"},"PeriodicalIF":3.6,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12905890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017282","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":"Predicting negative symptoms: a novel scale for assessing anticipatory cognitive mechanisms in psychosis.","authors":"Celia Ceballos-Munuera, Juan Francisco Rodríguez-Testal","doi":"10.1186/s12991-026-00631-y","DOIUrl":"10.1186/s12991-026-00631-y","url":null,"abstract":"<p><strong>Introdcution: </strong>Negative symptoms are a central feature of the schizophrenia spectrum and also appear subclinically in healthy individuals, being associated with poor functional outcomes. Although clinician-rated measures remain the gold standard, self-report tools offer efficiency and a direct insight into subjective experiences.</p><p><strong>Objective: </strong>This study presents the development and validation of the Negative Symptoms Anticipation Scale (NSAS), a novel self-report instrument designed to assess anticipatory cognitions related to negative symptoms.</p><p><strong>Method: </strong>In a pilot study, an initial 28-item version was refined to a final 16-item version organized into three factors: [Kirkpatrick B, Fenton WS, Carpenter WT, Marder SR 1;32(2):214-9:2006] Anticipation of Social Difficulties [Sicras-Mainar A, Maurino J, Ruiz-Beato E, Navarro-Artieda R 14(1):225:2014], Anticipation of Relationship Difficulties, and [Stahl SM, Buckley PF 115(1):4-11:2007] Anticipation of Low Energy in Daily Activities.</p><p><strong>Results: </strong>In a community sample (N = 3,237), the NSAS demonstrated excellent internal consistency (α = 0.927; ω = 0.926; α ordinal = 0.949) and test-retest reliability, as well as a robust factor structure confirmed via confirmatory exploratory analysis (CFI ≥ 0.997; RMSEA ≤ 0.025). Factorial invariance was established across gender and age, and ROC curve analysis indicated outstanding predictive ability for identifying individuals at risk for transitioning to psychosis (AUC = 0.905). Convergent validity was supported by moderate to high correlations with established measures of negative symptoms and negative schizotypy. Hierarchical linear regression showed that, when controlling for social anhedonia and depression, the anticipatory component contributed approximately 7-25% of the variance in negative symptoms.</p><p><strong>Conclusions: </strong>These findings support the validity of the NSAS and suggest that its application could facilitate early detection and intervention in psychosis.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":"8"},"PeriodicalIF":5.8,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12903480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146008731","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 mediating role of insulin resistance in depression driving phenotypic age acceleration.","authors":"Li Zhang, QianKun Yang, Jie Yu, Yue Hu","doi":"10.1186/s12991-026-00629-6","DOIUrl":"10.1186/s12991-026-00629-6","url":null,"abstract":"<p><strong>Background: </strong>Depression, characterized by significant psychological and physiological alterations, has been proved to tightly associate with insulin resistance (IR) and hallmarks of biological aging. Phenotypic Age Acceleration (PhenoAgeAccel), which quantifies the discrepancy between biological and chronological age, serves as a robust indicator of accelerated aging. However, the interplay between depression, IR, and accelerated aging remains unclear. This study aims to explore the relationship between depression and PhenoAgeAccel, and the potential mediating role of IR in this association.</p><p><strong>Methods: </strong>A total of 4,555 adults participants from the National Health and Nutrition Examination Survey (NHANES) database with complete data on depression, PhenoAgeAccel, and other essential covariates were included in this study. Depression severity was assessed by the nine-item Patient Health Questionnaire (PHQ-9), with a PHQ-9 score ≥ 10 used to define depression. Four indicators, including triglyceride-glucose index (TyG), TyG-body mass index (TyG-BMI), TyG-waist height ratio (TyG-WHTR), and metabolic score for insulin resistance (METS-IR), were used to assess IR. Weighted multivariable linear regression analyses were performed to identify the association of depression/PHQ-9 score with PhenoAgeAccel. Moreover, subgroup analyses, interaction tests, and adjusted restricted cubic spline (RCS) analyses were employed to explore the robustness, stability, and potential nonlinearity of the associations between PHQ-9/depression and PhenoAgeAccel. Additionally, mediation analysis was conducted to investigate the mediating role of IR biomarkers in the association between PHQ-9 score and PhenoAgeAccel.</p><p><strong>Results: </strong>In the fully-adjusted model, being depressive and one-unit increment in PHQ-9 score were associated with a 1.93-year (95% CI: 0.95-2.92) and 0.14-year (95% CI: 0.07-0.21) increase in PhenoAgeAccel, respectively. A positive linear dose-response relationship between PHQ-9 score and PhenoAgeAccel was identified via RCS analysis (P for overall = 0.001, P_{non-linearity}=0.867). Subgroup analyses and interaction tests revealed a more pronounced association between depression/PHQ-9 and PhenoAgeAccel in subgroups with diabetes, moderate-to-heavy alcohol consumption, and higher education levels (all P_interaction<0.05). IR biomarkers were observed to mediated 3.6-8.4% of the total effect, with METS-IR showing the highest mediation (8.4%, 95% CI: 0.024-0.222).</p><p><strong>Conclusions: </strong>Depression was associated with accelerated PhenoAgeAccel, with insulin resistance acting as a partial mediator. In depression management, interventions targeting metabolic issues like insulin resistance should also be considered to mitigate depression-associated aging.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":"6"},"PeriodicalIF":3.6,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12895949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994173","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":"Global prevalence of different levels of anxiety and stress symptoms in healthcare students: A meta-analysis and meta-regression.","authors":"Ying Xuan Loh, Ying Lau, Wen Wei Ang, Shean Ern Shannen Lee, Siew Tiang Lau","doi":"10.1186/s12991-025-00618-1","DOIUrl":"10.1186/s12991-025-00618-1","url":null,"abstract":"<p><strong>Background: </strong>There are limited reviews to report the different levels of anxiety and stress symptoms among students studying nursing, pharmacy, and allied health.</p><p><strong>Objective: </strong>To calculate the global prevalence of different levels of anxiety and stress symptoms among healthcare students and examine the factors that affect the different levels of prevalence estimates.</p><p><strong>Methods: </strong>A three-step comprehensive search of 10 databases was conducted. Meta-analysis, subgroup analyses, and meta-regression were performed using the meta package in R software. The Newcastle-Ottawa Scale and Grading of Recommendations Assessments, Development and Evaluation criteria were utilised for the quality appraisal of included studies and the certainty of the evidence, respectively.</p><p><strong>Results: </strong>A total of 112 studies with 42,331 healthcare students across 43 countries were selected. The prevalences of unspecified, mild, moderate, severe, and extremely severe anxiety symptoms were 41% (95% CI: 33-50), 15% (95% CI: 12-19), 22% (95% CI: 19-26), 10% (95% CI: 8-13), 14% (95% CI: 11-17), respectively. The prevalences of unspecified, mild, moderate, severe, and extremely severe stress symptoms were 36% (95% CI: 25-47), 15% (95% CI: 12-18), 32% (95% CI: 25-40), 11% (95% CI: 8-15), 4% (95% CI: 2-5), respectively. A series of subgroup and meta-regression analyses identified geographic region, use of an instrument, type of healthcare students, sample size and study quality were significantly impacted prevalence estimates.</p><p><strong>Conclusion: </strong>Findings can contribute as evidence to raising awareness about different levels of anxiety and stress symptoms. Early screening and tailored preventive interventions can help eliminate the prevalence in healthcare students.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":"4"},"PeriodicalIF":3.6,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12870317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145896122","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":"Managing schizophrenia with affective, sexual, metabolic and substance-use comorbidities: pharmacological considerations from an expert consensus.","authors":"Eduard Vieta, Ángel L Montejo, Toby Pillinger, Bernardo M Dell'Osso, Maria Dimitraka, Saeed Farooq, Gustavo Jesus, Carlos Parro Torres, Thomas Wobrock, Sofia Pappa","doi":"10.1186/s12991-025-00620-7","DOIUrl":"10.1186/s12991-025-00620-7","url":null,"abstract":"<p><strong>Background: </strong>Schizophrenia is a complex psychiatric disorder frequently complicated by comorbidities that contribute to functional impairment, poor treatment adherence, and elevated mortality. Among the most prevalent and burdensome are affective symptoms, sexual dysfunction, metabolic disturbances, and substance use disorders, which remain underrecognized and insufficiently addressed in routine care.</p><p><strong>Objectives: </strong>This expert consensus aimed to develop comorbidity-informed pharmacological strategies for schizophrenia, grounded in real-world challenges and individualized treatment needs.</p><p><strong>Methods: </strong>A multidisciplinary panel of 10 European psychiatrists convened for an in-person meeting. Four expert-led presentations, each addressing a key comorbidity, were followed by open discussion. A modified two-round Delphi process was subsequently used to validate the consensus statements, which were thematically synthesized into actionable recommendations.</p><p><strong>Results: </strong>Consensus-based recommendations were developed across four comorbidity domains, integrating current evidence with real-world clinical expertise. The panel emphasized the importance of individualized, patient-centered pharmacological strategies that balance efficacy, tolerability, and long-term functional outcomes. Partial dopamine agonists and other metabolically or hormonally favorable agents were identified as clinically useful across several comorbid profiles. Recommendations also addressed the optimization of antipsychotic selection, management of treatment-emergent side effects, and coordinated care for patients with dual diagnosis (also referred to as co-occurring disorders). Measurement-based monitoring and integrated service models were consistently highlighted as essential for improving outcomes.</p><p><strong>Conclusions: </strong>Effective management of schizophrenia requires a shift toward comorbidity-informed, recovery-oriented pharmacological care. These expert recommendations provide practical strategies to support individualized treatment planning in real-world clinical settings.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":"3"},"PeriodicalIF":5.8,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12859896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145853135","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":"Too much of a good thing: OTC calcium carbonate overdose causing milk-alkali syndrome in a psychiatric patient.","authors":"Alexandra She, Sangay Bhutia, Francis E Jenney","doi":"10.1186/s12991-025-00615-4","DOIUrl":"10.1186/s12991-025-00615-4","url":null,"abstract":"<p><strong>Background: </strong>In the United States, milk-alkali syndrome or calcium-alkali syndrome is the third most common cause of hypercalcemia, after primary hyperparathyroidism and malignancy. Clinically, patients present with a triad of hypercalcemia, acute kidney injury, and metabolic alkalosis. Classically, it has been associated with excessive intake of calcium and absorbable alkali, and recently it has become more common in postmenopausal females who ingest calcium supplements for osteoporosis.</p><p><strong>Case presentation: </strong>Here, we present the case of a 72-year-old Caucasian female with a longstanding diagnosis of bipolar I disorder who presented to the Emergency Department (ED) with a sudden onset of generalized weakness, multiple falls, and altered mental status over the course of several days. On admission, she had elevated serum calcium, acute kidney injury, and metabolic alkalosis.</p><p><strong>Conclusions: </strong>This case underscores the importance of thorough medical and psychiatric assessment in patients presenting with altered mental status, particularly in those with a history of overdosing. It also highlights the need for close collaboration between psychiatry and internal medicine in the management of metabolic disturbances that may mimic or exacerbate psychiatric symptoms. A stepwise approach to the diagnosis and treatment of hypercalcemia is reviewed, with particular attention to considerations unique to psychiatric populations.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":"24 1","pages":"75"},"PeriodicalIF":3.6,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12729112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145826872","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":"Structural equation modeling of associated factors and regional variations in major depressive disorders and generalized anxiety disorders among reproductive-age Bangladeshi women: a nationally representative study.","authors":"Passakorn Suanrueang, Karl Peltzer","doi":"10.1186/s12991-025-00619-0","DOIUrl":"10.1186/s12991-025-00619-0","url":null,"abstract":"<p><strong>Background: </strong>The study's objective was to (1) assess the prevalence among women and associated factors of major depressive disorder (MDD) and generalized anxiety disorder (GAD); (2) identify associated factors and regional variations in the relationship between GAD-7 and PHQ-9 scores; and (3) yield insights to support and strengthen mental health policy and service delivery in Bangladesh.</p><p><strong>Methods: </strong>Data from 19,987 women (aged 15-49 years) who participated in the 2022 Bangladesh Demographic and Health Survey and completed the mental health module were analyzed. Descriptive statistics assessed MDD/GAD prevalence. SEM analyzed factors associated with psychological distress, and regional variations were examined via linear regression.</p><p><strong>Results: </strong>Among 2388 Bangladeshi women aged 15-49 who had MDD and/or GAD, who provided complete responses for all related variables, sociodemographic factors, resource-related determinants, and negative life events were significantly associated with higher levels of depression and anxiety. The path analysis model indicated that sociodemographic factors (β = 0.69), resource-related factors (β = 0.19), and negative life events (β = 0.05) contributed to depression (PHQ score: β = 0.81, p < 0.001) and anxiety (GAD score: β = 0.84, p < 0.001). Age (β = 0.21, p < 0.001) and marital status (β = 0.20, p < 0.001) were the strongest sociodemographic factors associated with psychological distress, while education (β = 0.41, p < 0.001) and wealth status (β = 0.41, p < 0.001) were the most important resource-related factors. The model demonstrated an acceptable to good fit (Chi-square = 240.67, df = 63, RMSEA = 0.050, GFI = 0.967, AGFI = 0.952, and CFI = 0.826). Regionally, Sylhet City indicated the strongest relationship between GAD and MDD (R² = 0.567), followed by Khulna (R² = 0.543) and Rajshahi (R² = 0.508). An R² Value of 0.567 indicated that approximately 57% of the variability in MDD score in Sylhet can be explained by GAD score.</p><p><strong>Conclusion: </strong>Path analysis highlighted a multidimensional approach to understanding psychological distress. Sociodemographic, resource factors, and negative life events as determinants collectively serve as associated factors of psychological distress among Bangladeshi females, highlighting the need for culturally tailored interventions with early anxiety screening and coping skills training to improve mental health outcomes.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":"2"},"PeriodicalIF":5.8,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12797580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145706957","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":"Acceptability of active and sham home-based transcranial direct current stimulation in major depression: mixed methods qualitative analysis in a randomised controlled trial.","authors":"Peter J Lagerberg, Rachel D Woodham, Sudhakar Selvaraj, Nahed Lajmi, Harriet Hobday, Gabrielle Sheehan, Ali-Reza Ghazi-Noori, Maheen Rizvi, Sarah S Kwon, Paulette Orhii, Rodrigo Machado-Vieira, Jair C Soares, Allan H Young, António R Fidalgo, Hakimeh Rezaei, Cynthia H Y Fu","doi":"10.1186/s12991-025-00607-4","DOIUrl":"10.1186/s12991-025-00607-4","url":null,"abstract":"<p><strong>Purpose: </strong>Transcranial direct current stimulation (tDCS) is a novel non-invasive brain stimulation therapy that is a potential treatment for major depressive disorder (MDD). Acceptability impacts patient preference, treatment adherence and outcomes, however, it has typically been assessed through measures of attrition, self-reported satisfaction levels, or adverse events. We sought to explore participant acceptability using structured questionnaires and individual interviews.</p><p><strong>Methods: </strong>Acceptability was assessed in a fully remote, multisite, double-blind, placebo-controlled, randomized superiority trial of a 10-week course of home-based tDCS for MDD. Questionnaires were conducted at baseline and at the 10-week end of treatment. Participants were 174 adults (120 women) with MDD in a current depressive episode of at least moderate severity. Active or sham tDCS was self-administered over 10 weeks with remote supervision at regular intervals. A thematic analysis was conducted.</p><p><strong>Results: </strong>Four themes were revealed: acceptability, ease of use, side effects, and trial participation. The themes indicated generally high acceptability of tDCS as a treatment of MDD in both the active and sham treatment groups. Some participants noted concerns about the technical functionality of the device and the impact of side effects.</p><p><strong>Conclusions: </strong>The first three themes are central to understanding participant perspectives of tDCS and its feasibility as a treatment option. In addition, the theme of trial participation highlights the value of participant support when introducing a new treatment, which may underscore treatment options in general. Furthermore, acceptability is a dynamic concept as participant views changed during treatment.</p><p><strong>Trial registration: </strong>NCT05202119, registered on 9th January 2022.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":" ","pages":"1"},"PeriodicalIF":3.6,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12781599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145676362","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":"Mental health of children in high-altitude regions: a bibliometric study and visualization analysis from 1979 to 2024.","authors":"Pujue Huang, Xue Deng, Jiao Tang, Yang Zhai, Tao Wang","doi":"10.1186/s12991-025-00616-3","DOIUrl":"10.1186/s12991-025-00616-3","url":null,"abstract":"<p><strong>Background: </strong>Children's mental health in high-altitude areas is influenced by various environmental, socioeconomic, and biological factors. This study aims to explore the knowledge framework and key research areas in this domain, using bibliometric methods to analyze trends, collaboration patterns, and essential themes related to children's mental health at high altitudes.</p><p><strong>Methods: </strong>A bibliometric analysis was conducted on publications from 1979 to 2024 retrieved from the Web of Science Core Collection database. The R package \"Bibliometrix,\" VOSviewer, and CiteSpace were used to analyze publication trends, collaboration patterns, and research themes.</p><p><strong>Results: </strong>A total of 520 English-language articles were included. The United States was the most prolific country (226 articles), and Duke University was the leading institution (66 articles). The Journal of the American Academy of Child and Adolescent Psychiatry was the most influential journal. E. Jane Costello was the most prolific author (50 publications). Co-occurrence network analysis identified four major clusters: possible mechanisms, outcomes, psychopathology, and management of mental health issues. Academic research in very high HDI countries focuses more on quality-of-life and mental health issues, whereas low and medium HDI countries prioritize fundamental public health and common disease prevention.</p><p><strong>Conclusions: </strong>This study provides a bibliometric foundation for quantitatively assessing research trends on mental health among children in high-altitude regions. Current research primarily focuses on underlying mechanisms, outcomes, mental health conditions, and management strategies. For countries at different development levels, research should be tailored to their specific social development stages and health challenges.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":"24 1","pages":"74"},"PeriodicalIF":3.6,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12676785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145666788","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}