Asian journal of psychiatry最新文献

{"title":"Ketamine's mechanisms of action in major depressive disorder and treatment-resistant depression: Is brain topological change a candidate convergent systems-level pathway?","authors":"Gia Han Le, Sabrina Wong, Simryn Selby, Roger S McIntyre","doi":"10.1016/j.ajp.2026.105178","DOIUrl":"https://doi.org/10.1016/j.ajp.2026.105178","url":null,"abstract":"<p><p>Ketamine is a rapid-acting antidepressant with demonstrated efficacy in major depressive disorder and treatment-resistant depression, yet the mechanisms by which its molecular actions translate into sustained clinical improvement remain incompletely understood. Prevailing models have emphasized N-methyl-D-aspartate receptor antagonism and downstream glutamatergic signaling; however, convergent evidence indicates that ketamine engages a broader hierarchy of biological processes spanning synaptic plasticity, circuit dynamics, and large-scale brain network organization. This narrative review integrates molecular, cellular, circuit-level, neuroimaging, and electrophysiological findings to evaluate whether normalization of pathological brain topology represents a convergent systems-level pathway mediating ketamine's antidepressant effects. Across modalities, depressive disorders are characterized by disrupted network integration and segregation, stability of maladaptive configurations, and impaired flexibility of large-scale neural systems. Evidence from functional magnetic resonance imaging and electroencephalography indicates that ketamine rapidly modulates these abnormalities, increasing global connectivity, reducing rigid network organization, and enhancing neural signal diversity and network dynamics. These effects emerge within hours, are associated with clinical improvement, and show temporal and mechanistic distinctions from those observed with monoaminergic antidepressants, neuromodulation, psychotherapy, and serotonergic psychedelics. Integrating these findings, this review proposes that ketamine's molecular and circuit-level actions are necessary but not sufficient, with antidepressant efficacy shaped by how these processes are instantiated within large-scale network topology. Conceptualizing brain topology as an integrative systems-level framework may help reconcile diverse mechanistic observations, clarify sources of treatment resistance, and inform testable hypotheses for topology-based biomarkers and novel rapid-acting antidepressant strategies.</p>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"125 ","pages":"105178"},"PeriodicalIF":4.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nanodispersible cannabidiol (150 mg/mL) for generalized anxiety disorder: Comparative emerging clinical evidence with first-line anxiolytics and mechanistic insights from network pharmacology and pharmacogenomics.","authors":"Prasad Rao Gundugurti, Prasanna Latha Komaravalli, Amrita Chatterjee, Bharath Harohalli Byregowda, Chandrashekhar Kocherlakota, Kumar Sd Kothapalli","doi":"10.1016/j.ajp.2026.105182","DOIUrl":"https://doi.org/10.1016/j.ajp.2026.105182","url":null,"abstract":"","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"125 ","pages":"105182"},"PeriodicalIF":4.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic and artificial intelligence applications in neuropsychiatric disorders: Intervention, diagnosis, and use beyond the clinic.","authors":"Wei Wang, Anna Cavallini, Roger Andre Søraa, Federico Manzi","doi":"10.1016/j.ajp.2026.105172","DOIUrl":"https://doi.org/10.1016/j.ajp.2026.105172","url":null,"abstract":"","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":" ","pages":"105172"},"PeriodicalIF":4.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When ECT is not readily available: Pharmacological management of catatonia in a correctional medical facility in Japan","authors":"Ryo Mitoma,&nbsp;Takahiro Sawada","doi":"10.1016/j.ajp.2026.104890","DOIUrl":"10.1016/j.ajp.2026.104890","url":null,"abstract":"","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"118 ","pages":"Article 104890"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146147417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perinatal depression policies in China: A three-dimensional analysis with implications for low- and middle-income countries health systems","authors":"Hongjuan Wang ,&nbsp;Huiqing Li ,&nbsp;Siyuan Tang ,&nbsp;Mei Sun","doi":"10.1016/j.ajp.2026.104894","DOIUrl":"10.1016/j.ajp.2026.104894","url":null,"abstract":"<div><h3>Objective</h3><div>To map China’s perinatal depression (PND) policy architecture across three dimensions (policy instruments, policy objectives, and implementers), and to synthesize key themes, thereby identifying structural gaps and implementation-relevant design weaknesses.</div></div><div><h3>Methods</h3><div>National and subnational policy documents issued in China (2009–2025) were systematically retrieved from official government websites using predefined search terms. Policies were mapped using a three-dimensional framework (policy instruments, objectives, and implementers). We conducted content analysis to quantify the distribution and configurations of policy instruments across dimensions, followed by a thematic synthesis of policy texts using a hybrid deductive–inductive coding approach in NVivo 12.0.</div></div><div><h3>Results</h3><div>Fifty-one policies were included. Supply-oriented instruments predominated; management was the most frequent objective, and maternal and child health (MCH) agencies were the principal implementers. Thematic synthesis indicated that supply-oriented measures prioritized service integration, network development, and workforce capacity-building; demand-oriented measures targeted financial barriers and service uptake; and environment-oriented measures emphasized strategic planning and public education.</div></div><div><h3>Conclusions</h3><div>China’s PND policy mix is supply-oriented, management-centered, and primarily delivered through MCH institutions. To strengthen system performance and equity, policies should diversify demand- and environment-oriented instruments, institutionalize cross-sector coordination, expand service coverage, and standardize early detection and multidisciplinary care pathways. This three-dimensional mapping provides transferable lessons for Low- and Middle-Income Countries aiming to build more integrated and evidence-informed PND policy frameworks.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"118 ","pages":"Article 104894"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146187456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of expanding the PACE clinic: Closing the gap by including complex presentations in youth mental health","authors":"Kevin O’Byrne ,&nbsp;Gabriele Lo Buglio ,&nbsp;Paolo Girardi ,&nbsp;Tommaso Boldrini ,&nbsp;Donna Gee ,&nbsp;Ashlee Hancock ,&nbsp;Patrick McGorry ,&nbsp;Barnaby Nelson ,&nbsp;John Stratford ,&nbsp;Andrew Thompson ,&nbsp;Alison Yung ,&nbsp;Suzie Lavoie ,&nbsp;Andrea Polari","doi":"10.1016/j.ajp.2026.104886","DOIUrl":"10.1016/j.ajp.2026.104886","url":null,"abstract":"<div><h3>Objective</h3><div>This paper evaluated the impact of expanding the intake criteria at the Personal Assessment and Crisis Evaluation (PACE) clinic, a Melbourne based specialized early psychosis service, on its clinical governance, by including young people with complex mental health presentations.</div></div><div><h3>Methods</h3><div>Electronic medical records of 80 consecutive individuals aged 15–25 enrolled at PACE in 2020 were audited. A typical episode of care at PACE lasts six months. Service users were classified into three groups: At-Risk Mental State (ARMS), First Episode Psychosis (FEP), and Complex Presentations (CP). Demographic, clinical, and treatment characteristics were compared. Outcomes included clinical characteristics, comorbidities, length of care, and transition to psychosis during clinical care.</div></div><div><h3>Results</h3><div>Of 80 people, 56 % met ARMS criteria, 14 % FEP, and 31 % CP at Youth Access Team assessment, the port of entry of Orygen Specialist Program. Among the Complex group, 40 % later met ARMS criteria at entry into PACE. 12-month psychosis transition rate for ARMS was 20 % whilst none in the CP transitioned. Despite not meeting threshold for psychosis, 91 % of the CP had an episodes of care of more than 12 months. There were high rates of comorbidity including major depression (39 %), autism spectrum disorder (21 %), and substance use (39 %).</div></div><div><h3>Conclusions</h3><div>Expanding PACE’s intake criteria to include CP allowed for the engagement of young people with substantial unmet care needs. Importantly, 40 % of individuals with CP also met criteria for ARMS. Furthermore, over 90 % of those with CP required treatment for more than one year, highlighting a persistent need for long-term care. The study also highlighted challenges in applying evidence-based evaluation tools to systematically identify young people presenting with an at-risk syndrome, impacting the provision of stage-based care. Inclusion of CP in an ARMS clinic increased heterogeneity in an already diverse ARMS population and potentially undermined the consistency of the ARMS construct. Therefore, ARMS clinics should focus primarily on assessing and supporting people with ARMS only. There remains an ongoing need for professional development to maintain standards of care in early intervention, and consistent efforts should be made to successfully integrate evidence into clinical practice.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"118 ","pages":"Article 104886"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146177721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of a social robot-assisted training for socio-cognitive and cognitive functions in Parkinson’s disease: A comparison with an active control group.","authors":"G. Figliano ,&nbsp;L. Miraglia ,&nbsp;F. Manzi ,&nbsp;T. Romanelli ,&nbsp;M. Nazzario ,&nbsp;I. Borgini ,&nbsp;M. Donini ,&nbsp;L. Scarcia ,&nbsp;C. Di Dio ,&nbsp;A. Marchetti ,&nbsp;D. Massaro","doi":"10.1016/j.ajp.2026.104885","DOIUrl":"10.1016/j.ajp.2026.104885","url":null,"abstract":"<div><div>This study evaluated the efficacy of 12-week of Socially Assistive Robot (SAR) training program on socio-cognitive and cognitive functions in 11 individuals with early-stage Parkinson’s disease (PD) and 9 healthy older adults. Both groups underwent the same intervention with the Pepper robot. Pre- and post-assessments were analyzed using mixed-design repeated-measures ANOVAs. Results showed high adherence (90 %) and a significant main effect of <em>Time</em> on several outcomes, including global cognition, executive functions, and Theory of Mind (ToM) tasks (all <em>p</em> &lt; .05), suggesting that both groups demonstrated significant improvements. These findings also suggest that a SAR-based intervention is feasible and effective. The main result of the study was the improvement in the skills trained during the intervention, observed in both groups. This pattern also indicate that SAR-based interventions may be beneficial not only for individuals with early-stage PD but also for healthy older adults, highlighting the potential preventive value of SAR-based training in supporting healthy cognitive and social aging.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"118 ","pages":"Article 104885"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146187455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of key hubs and aberrant connectivity patterns in depression associated with white matter hyperintensity","authors":"Shuo Zhang ,&nbsp;Yikun Lu ,&nbsp;Zhongjian Tan ,&nbsp;Ying Zhou ,&nbsp;Xiao Han ,&nbsp;Lifang Ma ,&nbsp;Fangyuan Cui","doi":"10.1016/j.ajp.2026.104891","DOIUrl":"10.1016/j.ajp.2026.104891","url":null,"abstract":"<div><h3>Background</h3><div>There is a significant association between white matter hyperintensities (WMH) and the onset of depression. This study aimed to elucidate the underlying pathological mechanism underpinning WMH-related vulnerability to depression through multimodal neuroimaging analyses of brain structural and functional network alterations.</div></div><div><h3>Methods</h3><div>We recruited 48 WMH patients with depressive symptoms (WMH-D), 47 WMH patients without depressive symptoms (WMH-ND), and 50 demographically matched healthy controls (HC). We first compared global functional connectivity (FC) derived from the amplitude of low-frequency fluctuations (ALFF) and whole-brain voxel-based morphometry (VBM) analyses across groups. Subsequent correlation analyses were performed to examine the relationships between neuroimaging findings and clinical characteristics.</div></div><div><h3>Results</h3><div>WMH-D patients exhibited significantly reduced FC between the central executive network (CEN) and default mode network (DMN), coupled with enhanced CEN-salience network (SN) connectivity, suggesting a characteristic triple-network dysregulation pattern. Additionally, concurrent functional and structural alterations in the right superior temporal gyrus (STG) demonstrated positive correlations with both depressive severity (r = 0.371, <em>p</em> &lt; 0.009) and disease duration (r = 0.302, <em>p</em> = 0.037).</div></div><div><h3>Conclusions</h3><div>The study identifies a triple-network (DMN-SN-CEN) functional connectivity signature in WMH-related depression, suggesting potential neuroimaging biomarkers for clinical diagnosis. The identified STG abnormalities, manifesting as concurrent structural-functional deficits, may constitute the neural substrate linking cerebrovascular pathology to depressive symptomatology. These overlapping alterations provide a promising therapeutic target for early intervention strategies.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"118 ","pages":"Article 104891"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146187457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on The nature and correlates of childhood trauma in individuals at clinical-high risk (CHR) for psychosis: A cross-country study in Brazil, China and Turkey","authors":"Feng Qiao,&nbsp;Mengjie Sun,&nbsp;Wenlong Hua","doi":"10.1016/j.ajp.2026.104893","DOIUrl":"10.1016/j.ajp.2026.104893","url":null,"abstract":"","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"118 ","pages":"Article 104893"},"PeriodicalIF":4.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146187458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A culturally embedded digital–community paradigm for mental health in the Middle East: A conceptual letter toward system-level transformation","authors":"Mahdi Naeim,&nbsp;Mohammad Narimani","doi":"10.1016/j.ajp.2026.104841","DOIUrl":"10.1016/j.ajp.2026.104841","url":null,"abstract":"","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"117 ","pages":"Article 104841"},"PeriodicalIF":4.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145923869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}