Annals of General Psychiatry最新文献

{"title":"Efficacy of acupuncture for generalized anxiety disorder: a systematic review.","authors":"Jingling Lai, Yikun Wang, Xiaoyan Yao, Jinna Yu, Siyan Lu, Jianxin Lu, Jun Liu","doi":"10.1186/s12991-025-00614-5","DOIUrl":"10.1186/s12991-025-00614-5","url":null,"abstract":"<p><strong>Background: </strong>This systematic review aimed to assess the efficacy and safety of acupuncture for generalized anxiety disorder (GAD), with a particular focus on acupuncture alone and acupuncture combined with medication, compared with medication or sham acupuncture.</p><p><strong>Methods: </strong>We searched MEDLINE/PubMed, Web of Science, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP Database for Chinese Technical Periodicals, Chinese Biomedical Literature Database (CBM), and ClinicalTrials.gov up to August 31, 2025. Randomized controlled trials (RCTs) of acupuncture for GAD were independently screened and extracted by two reviewers following strict quality assessment. Risk of bias was evaluated using the RoB 2.0 tool, evidence certainty was assessed with the GRADE approach, and meta-analyses were conducted with RevMan 5.3. Subgroup analyses were performed according to comparator type and acupuncture parameters (treatment modality, duration, frequency, and sessions).</p><p><strong>Results: </strong>A total of 41 RCTs involving 3,209 participants were included. Meta-analysis showed that acupuncture alone (MD -1.79, 95% CI -2.69 to -0.88; 19 studies) and acupuncture combined with medication (MD -2.26, 95% CI -3.05 to -1.48; 20 studies) were superior to medication alone in reducing Hamilton Anxiety Rating Scale (HAMA) scores. Acupuncture also outperformed sham acupuncture (MD -3.46, 95% CI -4.76 to -2.16; 3 studies). Significant improvements were also observed in total effective rate, Self-Rating Anxiety Scale (SAS) scores, and Clinical Global Impression-Efficacy Index (CGI-EI), with lower rates of adverse events in the acupuncture groups. Subgroup analyses suggested that a treatment duration of 4-6 weeks was associated with better outcomes; for stand-alone acupuncture, a frequency of seven sessions per week was more effective than medication, while for combined therapy, a frequency of 2-4 sessions per week was more effective than medication.</p><p><strong>Discussions: </strong>This meta-analysis indicates that acupuncture, either as a monotherapy or in combination with medication, may provide superior efficacy to medication and sham acupuncture, with fewer adverse events. However, most included studies were rated as having \"some concerns\" in risk of bias by RoB 2.0, and GRADE assessment suggested low or very low certainty of evidence for the primary outcome (HAMA). Egger's test indicated no significant publication bias in HAMA. Further high-quality, large-scale RCTs are required to confirm these findings.</p><p><strong>Registration: </strong>The protocol of the review was registered in PROSPERO (CRD42015016033).</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":"24 1","pages":"73"},"PeriodicalIF":3.6,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12664193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145627720","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":"Anomalous self-experience in substance-induced and primary psychotic disorders: a cross-sectional comparative study using the EASE interview.","authors":"Luisa De Risio, Alessio Mosca, Arianna Pasino, Enrico Pompili, Giuseppe Nicolò, Mauro Pettorruso, Giovanni Martinotti","doi":"10.1186/s12991-025-00608-3","DOIUrl":"10.1186/s12991-025-00608-3","url":null,"abstract":"<p><strong>Background: </strong>Disturbances of the minimal self, or anomalous self-experiences (ASEs), are increasingly regarded as a core feature of primary psychotic disorders (PPDs). However, it remains unclear whether similar self-disorders are present in substance-induced psychosis (SIP), a condition that often mimics PPDs in its early stages.</p><p><strong>Objective: </strong>The study aims to compare ASEs between PPD and SIP using the EASE interview, to evaluate the diagnostic specificity of ASEs and determine whether these disturbances are exclusive to primary psychoses or also present in SIP.</p><p><strong>Methods: </strong>A total of 54 clinically stable patients were recruited from psychiatric centers in Italy (27 with schizophrenia spectrum disorders (SSD), mean age ≈ 27 years; 27 with substance-induced psychosis, mean age ≈ 28 years).. Diagnoses were established according to DSM-5 criteria. ASEs were assessed using the Examination of Anomalous Self-Experience (EASE) interview, and scores were compared across five experiential domains. Non-parametric statistics and logistic regression were employed to identify domain-specific differences and their diagnostic utility.</p><p><strong>Results: </strong>While total EASE scores did not differ significantly between groups, Domain 4 (Demarcation/Transitivism) was significantly higher in the SIP group (p < .0001, r = .72), contrary to classical phenomenological models that typically associate self-world boundary disturbances with schizophrenia spectrum disorders. In contrast, Domain 2 (Self-awareness and Presence) trended higher in the PPD group (p = .049, r = .27) and Domain 5 (Existential Reorientation) showed a similar trend (p = .098, r = .22)., aligning with classical phenomenological models of schizophrenia. Logistic regression confirmed the predictive value of these domains for group classification.</p><p><strong>Conclusion: </strong>ASEs are not exclusive to PPDs and may also manifest in SIP, particularly in the domain of \"self-world boundary\" disturbances. These findings challenge the assumption that self-disorders are unique to endogenous psychosis and highlight the need for refined phenomenological assessment in early diagnostic work. Longitudinal studies are needed to clarify whether ASEs in SIP represent transient phenomena or prodromal markers of schizophrenia.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":"24 1","pages":"72"},"PeriodicalIF":3.6,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12648912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145602003","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":"Pro-inflammatory cytokines level in depressed patients with suicidal behaviour: a systematic review and meta-analysis.","authors":"Reza Moshfeghinia, Mahla Ghahramani, Ramtin Naderian, Sara Mostafavi, Ali Arman, Hoorad Mohagheghzadeh, Erfan Haghighifard, Safa Tahmasebi, Zahra Kanannejad, Arash Javanbakht, Jamshid Ahmadi","doi":"10.1186/s12991-025-00609-2","DOIUrl":"10.1186/s12991-025-00609-2","url":null,"abstract":"<p><strong>Introduction: </strong>The study assesses proinflammatory factors in major depressive disorder (MDD) patients with and without suicidal behaviors, and healthy controls, to identify potential biomarkers for suicidal behaviors and prevention strategies.</p><p><strong>Methods: </strong>We conducted a systematic review, which we have registered in Prospero (#CRD42024547764), and searched through five databases until March 2024. We included observational studies in English that reported on depressed patients with and without suicidal behaviors, as well as healthy controls, and measured the levels of pro-inflammatory cytokines. The Newcastle- Ottawa Scale was used for quality evaluation of the studies and the main analysis was performed using Stata 17.</p><p><strong>Results: </strong>One systematic review resulted in 4,369 articles but only 24 were selected for the review. The meta-analysis showed depressed patients with suicidal behaviors had significantly higher interleukin (IL)-6 levels compared to the control group with a standardized mean difference (SMD) of 1.26 [0.07, 2.45]; I² = 98.81%. There was no significant difference noted between the depressed patients suffering from suicidal behaviors and those not suffering (SMD 0.42 [-0.58, 1.42]; I² = 98.50%). There is no significant difference between the groups in the levels of tumor necrosis factor-alpha (TNF-α) and IL-10. Further analysis of IL-4, IL-2, IL-1β, IF-γ, and TGF-β1 also indicated no significant group differences.</p><p><strong>Conclusion: </strong>The review found no significant cytokine differences (including IFN-γ, IL-1β, IL-2, IL-4, IL-8, IL-10, TGF-β1, TNF-α) between depressed individuals with or without suicidal ideation and controls. Variations likely reflect methodological differences, highlighting the need for standardized, longitudinal research.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":"24 1","pages":"71"},"PeriodicalIF":3.6,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12639735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145572682","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":"Smoking status and the onset of suicidal ideation among adults in Japan during the COVID-19 pandemic.","authors":"Andrew Stickley, Aya Shirama, Tomiki Sumiyoshi","doi":"10.1186/s12991-025-00610-9","DOIUrl":"10.1186/s12991-025-00610-9","url":null,"abstract":"<p><strong>Purpose: </strong>As previous research has linked smoking to suicidal behavior, it is possible that smoking may have played a role in suicidality during the COVID-19 pandemic. However, relatively little research has examined this association. To address this gap, the present study examined the relationship between smoking status and the onset of suicidal ideation in Japan during the pandemic.</p><p><strong>Methods: </strong>Data were analyzed from 3,164 adults from the Japanese general population who participated in an online survey in early 2023. Information was collected on smoking status and incident suicidal ideation during the COVID-19 pandemic. Logistic regression was conducted to examine associations.</p><p><strong>Results: </strong>In a fully adjusted analysis, current smoking was associated with significantly higher odds of the onset of suicidal ideation in the total sample (OR: 2.31, 95%CI: 1.37, 3.90). In a sex-stratified analysis, both former (OR: 4.49, 95%CI: 1.75, 11.50) and current smoking (OR: 6.12, 95%CI: 2.67, 14.01) were associated with the onset of suicidal ideation in men, whereas no such association was observed in women.</p><p><strong>Conclusion: </strong>Smoking was associated with the onset of suicidal ideation among adults in Japan during the COVID-19 pandemic, with the association observed in men but not women.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":"24 1","pages":"70"},"PeriodicalIF":3.6,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12639973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145572676","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":"Vortioxetine effectiveness in the treated major depressive disorder patients in Saudi Arabia.","authors":"Ali Garatli, Sherif Saad, Rafat Alowesei, Francis Xavier, Mohammed Zeina, Wael Lofty, Mohammad Khalid, Nawaf Alharthi, Tamer Talaat, Samar Ali Asiri","doi":"10.1186/s12991-025-00585-7","DOIUrl":"10.1186/s12991-025-00585-7","url":null,"abstract":"<p><strong>Background: </strong>Major Depressive Disorder (MDD) is a prevalent mental health condition characterized by persistent feelings of sadness, loss of interest or pleasure, and a range of physical and cognitive symptoms. Despite the availability of various treatment options, many MDD patients continue to experience significant impairment in their daily lives.</p><p><strong>Purpose: </strong>This multicenter study aimed to evaluate the therapeutic benefits of vortioxetine in routine clinical practice for patients with MDD in Saudi Arabia.</p><p><strong>Methods: </strong>A total of 499 eligible patients participated in the study. This is a Phase IV study that included 30 psychiatric sites across Saudi Arabia. Data collection occurred at baseline and routine visits. Patients treated with vortioxetine experienced a significant reduction in depressive symptom severity, as indicated by the PHQ-9 total score, throughout the study period (p < 0.001).</p><p><strong>Results: </strong>Significant improvements were also observed in various areas of functioning and cognitive depression symptoms, and safety. Results demonstrated a significant reduction in depressive symptoms, and sexual well-being, indicating vortioxetine as an effective treatment option for MDD in the Middle East and Africa (MEA) region.</p><p><strong>Conclusions: </strong>These findings support the real-world effectiveness of vortioxetine as a promising treatment option for MDD patients in the MEA region, highlighting its potential to reduce depressive symptoms.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":"24 1","pages":"69"},"PeriodicalIF":3.6,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12625635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145547876","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 association between sleep onset time and depression among U.S. adults: a cross-sectional study from NHANES 2015-2020.","authors":"Kunming Bao, Dongjun Bao, Xiaoming Li, Run Xie, Yu Zhang, Jianrong Jiang, Zhiqing Li, Zhidong Huang, Liling Chen, Wenjun Gu, Kaihong Chen","doi":"10.1186/s12991-025-00613-6","DOIUrl":"10.1186/s12991-025-00613-6","url":null,"abstract":"<p><strong>Background: </strong>The link between sleep onset time and depression is not well understood. We aimed to investigate the association of sleep onset time with depression.</p><p><strong>Methods: </strong>Data from the 2015 to March 2020 National Health and Nutrition Examination Survey were analyzed. Sleep onset time was categorized into five intervals: [22:00-23:00), [23:00-00:00), [00:00-01:00), [01:00-20:00), and [20:00-22:00). Depression was assessed using the Patient Health Questionnaire. Multivariate logistic regression and generalized linear regression analyses were conducted to evaluate the association of sleep onset time with depression.</p><p><strong>Results: </strong>The study sample consisted of 6991 adults (weighted mean age 45.6 years [SE, 0.5]; 49.5% female). Depression prevalence varied by sleep onset time intervals: 4.12% for [00:00-01:00), 5.94% for [01:00-20:00), 3.89% for [20:00-22:00), 1.98% for [22:00-23:00), and 3.26% for [23:00-00:00). After adjusting for sleep duration and other covariates, the odds ratios (ORs) for depressive symptoms were significantly greater at sleep onset time during [01:00-20:00) (OR, 2.39; 95% CI 1.20-4.74) and marginally higher at [20:00-22:00) (OR, 1.78; 95% CI 0.99-3.20) compared to the sleep onset time during [22:00-23:00). Higher PHQ-9 scores were associated with sleep onset time outside [22:00-23:00).</p><p><strong>Conclusion: </strong>Sleep onset time between [22:00-23:00) was associated with the lowest odds of depression. This suggests new directions for depression research and interventions, emphasizing the importance of considering sleep onset time in mental health strategies.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":"24 1","pages":"67"},"PeriodicalIF":3.6,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12625249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145547816","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 burden of anxiety, depression, and substance use disorders attributable to childhood maltreatment among adolescents in Africa: insights from the global burden of disease study 2021.","authors":"Louisa Esi Mackay, Blen Dereje Shiferaw, Yunjiao Luo, Na Yan, Yuhao Wang, Yingxue Wang, Yihan Wang, Xinyi Hu, SuSu Tian, Jiayi Tian, Huihang Lan, Yuxuan Liu, Wei Wang","doi":"10.1186/s12991-025-00611-8","DOIUrl":"10.1186/s12991-025-00611-8","url":null,"abstract":"<p><strong>Background: </strong>Childhood maltreatment is a major risk factor for mental and substance use disorders particularly among adolescents however, there's no comprehensive report of its attributable burden on anxiety, depression, and substance use disorder in Africa. This research sort to delineate the Disability-adjusted life years (DALYs) trend and age-period-cohort effects on these disorders attributable to childhood maltreatment among 10-24-year-olds in Africa.</p><p><strong>Methods: </strong>DALY estimates and 95% uncertainty intervals for anxiety, depression, and substance use disorder attributable to childhood maltreatment among adolescents in Africa were extracted from the Global Burden of Disease Study (GBD) 2021. Trends between 1990 and 2021 were analyzed using Joinpoint regression analysis. The Age-Period-Cohort model was used to determine the effect of age, period, and cohort on these disorders.</p><p><strong>Results: </strong>In 2021, the DALY rate for anxiety was 95.41 (37.32-185.13), 117.57 (54.31-209.16) for depression, and 3.82 (0.63-10.38) for substance use disorder per 100,000 population among adolescents in Africa. Trend analysis showed an increase in anxiety [AAPC: 0.88 (0.84-0.91)] and depressive disorders [AAPC: 0.71(0.68-0.74)]. Niger recorded the highest growth in average annual percentage change (AAPC): 3.17 [95% CI 3.08-3.27] for anxiety, Burkina Faso recorded the highest rise in AAPC: 1.96 [95% CI 1.85-2.08] for depression, and Uganda recorded the highest incline in AAPC: 0.65 [95% CI 0.59-0.72] for substance use disorder. Higher age effects were noted in all disorders, particularly in the 15-19-year group. Period effects were higher for anxiety and depressive disorders and lower for substance use disorders. A higher cohort effect was observed in all disorders during the study period.</p><p><strong>Conclusions: </strong>Anxiety and depressive disorders due to childhood maltreatment have been on the rise for 3 decades in Africa. Given the implications of the early onset and lifetime burden of mental and substance use disorders, a comprehensive policy framework that facilitates increased access to specialists in childhood maltreatment-related mental disorder services is essential.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":"24 1","pages":"68"},"PeriodicalIF":3.6,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12625208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145547759","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":"Pet ownership and risk of depression: a systematic review and meta-analysis.","authors":"Reza Moshfeghinia, Salma Rostamipourfard, Mohammadsadegh Kamran, Sara Mostafavi, Fahimeh Golabi, Getinet Ayano, Jamshid Ahmadi","doi":"10.1186/s12991-025-00600-x","DOIUrl":"10.1186/s12991-025-00600-x","url":null,"abstract":"<p><strong>Background: </strong>Pet ownership is often believed to confer psychological benefits, such as reducing loneliness and providing emotional support. However, evidence on its relationship with depression is mixed, and no clear consensus currently exists. This systematic review and meta-analysis aimed to evaluate the association between pet ownership and the risk of depression.</p><p><strong>Methods: </strong>A comprehensive systematic review and meta-analysis were performed following PRISMA guidelines. Three electronic databases (PubMed, Scopus, Web of Science) were searched for observational studies assessing the impact of pet ownership on depression. Two independent reviewers screened and extracted data, and study quality was evaluated using the Newcastle-Ottawa Scale. Random-effects models were used to compute pooled odds ratios (ORs) and 95% confidence intervals (CIs) using STATA-17.</p><p><strong>Results: </strong>A total of 21 studies involving 159,322 participants were included. Overall, pet ownership was not associated with a significant change in depression risk compared to non-ownership (OR: 1.03; 95% CI: 0.995-1.07). However, sensitivity analyses by pet type revealed that cat ownership was associated with a modestly increased risk of depression (OR: 1.06; 95% CI: 1.02-1.09), whereas dog ownership showed no significant association (OR: 0.93; 95% CI: 0.789-1.10).</p><p><strong>Conclusion: </strong>This study reveals a complex relationship between pet ownership and depression. Cat ownership is linked to a higher risk, while dog ownership shows mixed results. Overall, pet ownership isn't significantly associated with depression, highlighting the need for further research into its psychosocial dynamics and mental health implications.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":"24 1","pages":"66"},"PeriodicalIF":3.6,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12590595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145450548","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":"Exploring physicians' emotional reactions to suicidal patients: the impact of physician- and patient-related issues.","authors":"Dimitrios Kiakos, Céline Bourquin-Sachse, Stéphane Richard-Devantoy, Friedrich Stiefel, Laurent Michaud","doi":"10.1186/s12991-025-00602-9","DOIUrl":"10.1186/s12991-025-00602-9","url":null,"abstract":"<p><strong>Background: </strong>The physician-patient relationship is essential in the care of suicidal patients, yet factors shaping this relationship remain insufficiently explored. This study aimed to explore physicians' emotional reactions to suicidal patients and how both physician- and patient-related issues influence these responses.</p><p><strong>Methods: </strong>Interviews were conducted with six physicians from the Douglas Mental Health University Institute in Montreal. A thematic analysis was performed using Hayes' structural model of countertransference as the analytical framework.</p><p><strong>Results: </strong>Three primary emotional reactions emerged: emotional connection/avoidance, confidence/doubts, and powerlessness attributed to own limitations/to the patient. Clinicians' core needs-the need to help, need for security, and need for efficacy-were found to be pivotal in shaping these emotional responses. Similarly, patient-related factors, notably life experiences, disease, suicidality, and attitudes significantly influenced these reactions. Patterns linking physicians' emotional responses to their underlying needs and patient-related factors were analyzed, leading to the development of a conceptual framework.</p><p><strong>Conclusions: </strong>This framework offers implications for research, clinical supervision, and medical training, fostering deeper insight into the physician-patient relationship in the context of suicidality.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":"24 1","pages":"65"},"PeriodicalIF":5.8,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12553232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145367436","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":"Mitochondrial dysfunction, a new marker warning of neuropsychiatric disorder risk: evidence from genetics and epidemiology.","authors":"Qingan Fu, Jizhen Li, Huangxin Zhu, Qingyun Yu, Tianzhou Shen, Zhekang Liu, Yue Liu, Wei Zhou","doi":"10.1186/s12991-025-00604-7","DOIUrl":"10.1186/s12991-025-00604-7","url":null,"abstract":"<p><strong>Background: </strong>Mitochondrial dysfunction has been implicated in the pathogenesis of a variety of neuropsychiatric disorders, but its causal role remains unclear. Mitochondrial DNA copy number (mtDNA-CN) and methylmalonic acid (MMA) are well-recognized biomarkers of mitochondrial function, but their association with psychiatric disorders has not yet been fully assessed.</p><p><strong>Methods: </strong>We performed two-step two-sample Mendelian randomization (MR) analyses using genome-wide association study (GWAS) data to assess causal associations between mtDNA-CN and 13 major neuropsychiatric disorders. In addition, we conducted a cross-sectional analysis using National Health and Nutrition Examination Survey (NHANES) data 2011-2014 to examine the association between serum MMA levels and cognitive impairment and depressive symptoms to further validate the correctness and robustness of the results of the MR analysis.</p><p><strong>Results: </strong>MR analysis showed a significant negative causal effect of mtDNA-CN on bipolar disorder, Alzheimer's disease, dementia, depressive symptoms, and autism spectrum disorders (OR ranged from 0.15 to 0.84, all p < 0.05). Reverse MR analysis showed that only depressive symptoms had a significant causal effect on reducing mtDNA-CN. NHANES analysis further showed that higher MMA levels were significantly associated with an increased risk of cognitive impairment (OR = 1.56, p = 0.036) and depression (OR = 1.53, p = 0.020), suggesting that mitochondrial dysfunction and neuropsychiatric disorders have a close association.</p><p><strong>Conclusion: </strong>The mitochondrial function biomarkers mtDNA-CN and MMA are expected to be potential therapeutic targets for depression and cognitive dysfunction, emphasizing the need for mitochondrial function monitoring and interventions in future therapies targeting neuropsychiatric disorders.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":"24 1","pages":"64"},"PeriodicalIF":3.6,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12542384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145342924","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}