Asian journal of psychiatry最新文献

{"title":"Boosting and maintaining the response to transcranial direct current stimulation (tDCS) in schizophrenia with persistent hallucinations: A retrospective exploratory study from a naturalistic clinical cohort","authors":"Rujuta Parlikar ,&nbsp;Priyavarshini Boopathy ,&nbsp;Harsh Pathak ,&nbsp;Dinakaran Damodaran ,&nbsp;Sowmya Selvaraj ,&nbsp;Harleen Chhabra ,&nbsp;Swarna Buddha Nayok ,&nbsp;Vani Holebasavanahalli Thimmashetty ,&nbsp;Anushree Bose ,&nbsp;Sri Mahavir Agarwal ,&nbsp;Venkataram Shivakumar ,&nbsp;Vanteemar S. Sreeraj ,&nbsp;Janardhanan C. Narayanaswamy ,&nbsp;Ganesan Venkatasubramanian","doi":"10.1016/j.ajp.2025.104457","DOIUrl":"10.1016/j.ajp.2025.104457","url":null,"abstract":"<div><h3>Background</h3><div>Transcranial direct current stimulation (tDCS) may help to alleviate persistent auditory hallucinations (AH) in schizophrenia, though its effects vary. This study examines the effectiveness, replicability and tolerance of booster and maintenance tDCS courses administered to patients with schizophrenia in a naturalistic clinical setting after an initial tDCS course.</div></div><div><h3>Methods</h3><div>Thirty-three patients received booster course(s) (after symptom relapse) and/or maintenance courses (to prevent relapse) following an initial course of 2–15 days. Linear mixed-effect (LME) model and intra-class correlation (ICC) evaluated the differences and consistency of percentage improvement in AH across the initial and booster courses. The duration between the initial and the first booster course served as a proxy for time to relapse, with its relationship to clinical and demographic measures analyzed using Pearson’s correlation.</div></div><div><h3>Results</h3><div>The booster course was safely administered in 33 patients, 22 weeks after the initial course. AH improved significantly in 20 patients. The improvement percentages for the initial (43.6 %) and the booster courses (29.3 %) had an ICC of 0.711 (95 %CI:0.372–0.868, p &lt; 0.001), suggesting moderate replicability of effects. The LME model revealed that course type and number of tDCS sessions significantly influenced improvement. Maintenance tDCS was administered in 5 patients at 1–4 week intervals, with 2 maintaining improvement.</div></div><div><h3>Conclusion</h3><div>This study offers insights into the likely duration of initial tDCS effects and highlights the utility of booster courses for individuals who responded to the initial treatment. The study suggests the possibility of using maintenance tDCS in patients who have responded to the initial or booster treatments.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"107 ","pages":"Article 104457"},"PeriodicalIF":3.8,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705277","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":"Temporal transition patterns and predictors of depressive symptoms during pregnancy: A latent transition analysis","authors":"Zina Fan ,&nbsp;Jiayi Wang ,&nbsp;Xinyue Liu ,&nbsp;Ke Peng ,&nbsp;Ying Zhou ,&nbsp;Xiaoxv Yin ,&nbsp;Yanhong Gong","doi":"10.1016/j.ajp.2025.104453","DOIUrl":"10.1016/j.ajp.2025.104453","url":null,"abstract":"<div><h3>Background</h3><div>Antenatal depression is a critical factor affecting maternal health. However, the heterogeneous profiles of antenatal depression across pregnancy, the evolving patterns of profile transitions over time, and their predictors remain unclear. This study aims to identify the latent profiles of antenatal depressive symptoms in pregnant women, analyze the developmental patterns of risk type transitions over time, and explore key predictors of the probabilities of profile transitions during pregnancy.</div></div><div><h3>Methods</h3><div>A longitudinal follow-up study was conducted in two cities in China, involving 856 pregnant women who met the inclusion criteria and completed surveys during early, mid, and late pregnancy. Data were analyzed using Latent Profile Analysis (LPA) and Latent Transition Analysis (LTA). LPA was employed to identify latent profiles of antenatal depression, while LTA was used to explore longitudinal patterns of profile transitions from early to late pregnancy. Regression mixture models and logistic regression analyses were applied to examine the associations between demographic characteristics, family functioning, and the distinct latent profiles of antenatal depression as well as their developmental transitions. The Harman single-factor test was used to assess common method bias.</div></div><div><h3>Results</h3><div>Antenatal depression demonstrates developmental heterogeneity across pregnancy and can be categorized into four distinct subgroups. Latent Transition Analysis (LTA) revealed that pregnant women in the low depressive symptom group were more likely to remain stable over time, with a stability probability of 86 %. In contrast, those in the high depressive symptoms group showed a higher likelihood of transitioning (20 %), with probabilities of shifting to the moderate anhedonia group and the low anhedonia group both at 32 %. Educational attainment, physical activity, and family functioning were identified as significant predictors of antenatal depression profiles (P &lt; 0.01). Furthermore, age, educational level, residence, employment status, physical activity, and family functioning were significant predictors of the transition probabilities between antenatal depression profiles over time (P &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>The latent profiles of antenatal depressive symptoms exhibit relatively stable transition patterns throughout pregnancy. Education level, physical activity, and family functioning are significant predictors of these profiles and their transition probabilities over time. The impact of prenatal depression on maternal and offspring health poses not only short-term threats but also long-term multidimensional health burdens. Comprehensive early screening for depressive symptoms, combined with continuous and personalized intervention strategies tailored to prenatal depression profiles, should be integrated into standard prenatal care.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"107 ","pages":"Article 104453"},"PeriodicalIF":3.8,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696642","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":"Internet-based behavioural parent training intervention for children with attention-deficit/hyperactivity disorder: A randomized clinical trial","authors":"Hong Fan ,&nbsp;Weiwei Yang ,&nbsp;Xvfang Wu ,&nbsp;Qianhui Chen ,&nbsp;Haoxue Wang ,&nbsp;Kaiheng Zhu ,&nbsp;Shuai Zhao ,&nbsp;Rundong Liu ,&nbsp;Zhen Xiang ,&nbsp;Zhike Wang ,&nbsp;Tianchun Wang ,&nbsp;Jun Tang ,&nbsp;Ranran Song","doi":"10.1016/j.ajp.2025.104459","DOIUrl":"10.1016/j.ajp.2025.104459","url":null,"abstract":"<div><h3>Background</h3><div>Behavioral parent training (BPT) is recognized as a significant non-pharmacological treatment for attention-deficit/hyperactivity disorder (ADHD). However, there is limited empirical evidence of its effectiveness within the Chinese context, particularly for online BPT. This study evaluates the efficacy of an 8-session internet-based BPT (I-BPT) program in improving ADHD symptoms and mental health outcomes for children and parents, compared to routine clinical care (RCC).</div></div><div><h3>Methods</h3><div>Participants included 120 children with ADHD and their parents, recruited from the Wuhan Mental Health Centre between March and September 2023. They were randomly assigned to either the I-BPT+RCC (N = 60) or RCC (N = 60) group, with assessments conducted at baseline and after two months. Child-related outcomes measured were ADHD symptoms, depressive symptoms, anxiety symptoms and functional impairment. Parent-related outcomes included depressive symptoms, anxiety symptoms and parental stress. Analyses of covariance (ANCOVA) were used to compare the efficacy of I-BPT+RCC with the RCC alone.</div></div><div><h3>Results</h3><div>The I-BPT+RCC group showed significant improvements in total ADHD symptoms (<em>F</em>=6.84, <em>P</em> = 0.010), inattention (<em>F</em>=4.82, <em>P</em> = 0.030), hyperactivity/impulsivity (<em>F</em>=4.83, <em>P</em> = 0.030), and child depressive symptoms (<em>F</em>=8.56, <em>P</em> = 0.004) compared to the RCC group. Parental stress also significantly decreased in the I-BPT+RCC group (<em>F</em>=5.95, <em>P</em> = 0.016).</div></div><div><h3>Conclusions</h3><div>Overall, the I-BPT significantly enhanced health outcomes for children with ADHD and their parents. These findings highlight the potential of I-BPT as an effective and accessible treatment option for a broader patient population.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"107 ","pages":"Article 104459"},"PeriodicalIF":3.8,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724440","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":"An interpretable deep-learning approach to detect biomarkers in anxious-depressed symptoms from prefrontal fNIRS signals during an autobiographical memory test","authors":"Yan Zhang ,&nbsp;Yawen Xu ,&nbsp;Yihang Cheng ,&nbsp;Yihong Zhao ,&nbsp;Marc N. Potenza ,&nbsp;Hui Shi","doi":"10.1016/j.ajp.2025.104451","DOIUrl":"10.1016/j.ajp.2025.104451","url":null,"abstract":"<div><h3>Background</h3><div>Individuals with anxious-depressed (AD) symptoms have more severe mood disorders and cognitive impairment than those with non-anxious depression (NAD) symptoms. Therefore, it is important to clarify the underlying neurophysiology of these two symptom groups to optimize treatment.</div></div><div><h3>Methods</h3><div>We developed an interpretable deep-learning framework based on two convolutional neural networks (CNN) to diagnose depression from functional near-infrared spectroscopy (fNIRS) neuroimaging data recorded during an autobiographical memory test (AMT) from 824 participants. This system was designed to discriminate between individuals with depressed symptoms (<em>N</em> = 127) and healthy controls (<em>N</em> = 697) and identify AD (<em>N</em> = 72) and NAD (<em>N</em> = 55). Besides, we employed the SHapley Additive exPlanations (SHAP) method to discover discriminative biomarkers for AD symptoms.</div></div><div><h3>Results</h3><div>Positive episode recall features effectively distinguished depressed symptoms with the highest accuracy of 0.89, sensitivity of 0.84, specificity of 0.90, and area under the receiver operator characteristic curve (AUC) of 0.84. Conversely, negative episode recall features achieved the highest accuracy of 0.91, sensitivity of 0.80, specificity of 0.85, and an AUC of 0.91 for identifying AD symptoms. These performances were based on a five-fold cross-validation procedure. Based on the SHAP-derived analyses, the most influential channels contributing to AD symptom prediction were located within the right hemisphere.</div></div><div><h3>Conclusion</h3><div>This study revealed that the hemodynamic hypo-activation of negative emotional valence in the right frontal pole area (rFPA) may contribute to AD symptom prediction.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"107 ","pages":"Article 104451"},"PeriodicalIF":3.8,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724442","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":"Exploring the associations between psychiatric symptoms and cognitive functions in first-episode schizophrenia: A network analysis","authors":"Peng Cheng,&nbsp;Zhening Liu,&nbsp;Feiwen Wang,&nbsp;Jun Yang,&nbsp;Jie Yang","doi":"10.1016/j.ajp.2025.104454","DOIUrl":"10.1016/j.ajp.2025.104454","url":null,"abstract":"<div><h3>Background</h3><div>First-episode schizophrenia represents a critical period for intervention in the treatment of schizophrenia. Understanding the intricate relationships between psychiatric symptoms and cognitive functions is vital for early precise intervention and predicting illness outcomes. Previous research has largely overlooked this issue, and traditional analytical methods based on pre-established theoretical assumptions are insufficient. This study aims to address this gap by utilizing graph theory-based network analysis.</div></div><div><h3>Methods</h3><div>The study employed the Positive and Negative Syndrome Scale (PANSS) to assess psychiatric symptoms. Cognitive functions were evaluated using the Digit Symbol and Information subtests from the Wechsler Adult Intelligence Scale (WAIS), which measure information processing efficiency and general knowledge, respectively. A network of psychiatric symptoms and cognitive functions was constructed based on these assessments.</div></div><div><h3>Results</h3><div>The network analysis revealed that negative symptom nodes were central. Notably, node N1 (Blunted affect) showed a negative correlation with the Digit Symbol node, being the only psychiatric symptom node linked to cognitive functions. Community detection analysis indicated that cognitive, positive symptom, and negative symptom nodes tended to cluster within their respective categories, while general psychopathology nodes showed a tendency to cluster with various types of nodes. Some general psychopathology nodes were isolated, reflecting the concealed nature of certain psychiatric symptoms in first-episode schizophrenia patients.</div></div><div><h3>Conclusion</h3><div>This study innovatively applies network analysis to explore the characteristics of the psychiatric symptom-cognitive function network in Chinese patients with first-episode schizophrenia. The findings provide valuable theoretical insights for targeted symptom-based interventions and for predicting disease outcomes in first-episode schizophrenia.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"107 ","pages":"Article 104454"},"PeriodicalIF":3.8,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705276","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":"Budget impact analysis of long-acting injections for the treatment of Schizophrenia in Japan","authors":"Mami Kasahara-Kiritani ,&nbsp;Chu-chu Sheng ,&nbsp;Nan Li ,&nbsp;Akihide Wakamatsu ,&nbsp;Sonja Sorensen ,&nbsp;Rameet Sachdev ,&nbsp;Sayooj Sunil Raj ,&nbsp;Ataru Inagaki","doi":"10.1016/j.ajp.2025.104455","DOIUrl":"10.1016/j.ajp.2025.104455","url":null,"abstract":"<div><h3>Background</h3><div>Following policy changes implemented in April 2020 in Japan, long-acting injectable antipsychotics (LAI-As) have been reimbursed as a part of a government initiative for community-oriented mental health care. This study assessed the financial impact of increased LAI-A usage compared to the current LAI-A and oral antipsychotic (OA) usage for the treatment of adult patients with schizophrenia.</div></div><div><h3>Methods</h3><div>A budget impact (BI) model was developed to estimate the BI of increased LAI-A usage from the Japanese healthcare payor perspective over five years. The inputs were informed by the most recent available data reflecting the current reimbursement structure and treatment practices. The model considered drug acquisition, administration visit, psychotherapy, and hospitalization costs. Scenario and sensitivity analyses were conducted.</div></div><div><h3>Results</h3><div>Increasing LAI-A uptake by 10 % from current usage each year resulted in a BI of ¥886,001,060 (0.09 % increase) over five years. Hospitalization and drug acquisition costs constituted 84.1 % and 9.4 % of the total cost, respectively. Variation in the hospitalization inputs for patients on OAs and LAI-As had the greatest impact on the net budget, ranging from being cost saving to resulting in a small positive BI.</div></div><div><h3>Conclusion</h3><div>Increased utilization of LAI-As for schizophrenia treatment in Japan has a minimal BI. Despite the increased drug acquisition and administration visit costs, the decreased hospitalization costs offset the overall impact. Altogether, these findings support the continued reimbursement and usage of LAI-As aligned with the recent policy changes.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"107 ","pages":"Article 104455"},"PeriodicalIF":3.8,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interlinked causes: To what extent is our mental well-being affected by the growing catastrophes within one health spectrum?","authors":"KM Surapaneni,&nbsp;RF D’Souza,&nbsp;Rajiv Tandon","doi":"10.1016/j.ajp.2025.104450","DOIUrl":"10.1016/j.ajp.2025.104450","url":null,"abstract":"","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"106 ","pages":"Article 104450"},"PeriodicalIF":3.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143678965","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 AI-driven sentiment analysis on patient outcomes in psychiatric care: A narrative review","authors":"Chou-Yi Hsu ,&nbsp;Sayed M. Ismail ,&nbsp;Irfan Ahmad ,&nbsp;Nasser Said Gomaa Abdelrasheed ,&nbsp;Suhas Ballal ,&nbsp;Rishiv Kalia ,&nbsp;A. Sabarivani ,&nbsp;Samir Sahoo ,&nbsp;KDV Prasad ,&nbsp;Mohsen Khosravi","doi":"10.1016/j.ajp.2025.104443","DOIUrl":"10.1016/j.ajp.2025.104443","url":null,"abstract":"<div><div>This article addresses the pressing question of how advanced analytical tools, specifically artificial intelligence (AI)-driven sentiment analysis, can be effectively integrated into psychiatric care to enhance patient outcomes. Utilizing specific search phrases like “AI-driven sentiment analysis,” “psychiatric care,” and “patient outcomes,” a comprehensive survey of English-language publications from the years 2014–2024 was performed. This examination encompassed multiple databases such as PubMed, PsycINFO, Google Scholar, and IEEE Xplore. Through a comprehensive analysis of qualitative case studies and quantitative metrics, the study uncovered that the implementation of sentiment analysis significantly improves clinicians’ ability to monitor and respond to patient emotions, leading to more tailored treatment plans and increased patient engagement. Key findings indicated that sentiment analysis improves early mood disorder detection, personalizes treatments, enhances patient-provider communication, and boosts treatment adherence, leading to better mental health outcomes. The significance of these findings lies in their potential to revolutionize psychiatric care by providing healthcare professionals with real-time insights into patient feelings and responses, thereby facilitating more proactive and empathetic care strategies. Furthermore, this study highlights the broader implications for healthcare systems, suggesting that the incorporation of sentiment analysis can lead to a paradigm shift in how mental health services are delivered, ultimately enhancing the efficacy and quality of care. By addressing barriers to new technology adoption and demonstrating its practical benefits, this research contributes vital knowledge to the ongoing discourse on optimizing healthcare delivery through innovative solutions in psychiatric settings.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"107 ","pages":"Article 104443"},"PeriodicalIF":3.8,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681082","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":"Neuroscience in pictures: Functional neurological disorder","authors":"Christiana Westlin ,&nbsp;Matcheri S. Keshavan ,&nbsp;David L. Perez","doi":"10.1016/j.ajp.2025.104449","DOIUrl":"10.1016/j.ajp.2025.104449","url":null,"abstract":"<div><div>Functional neurological disorder (FND) is a biopsychosocially-complex, prevalent, and potentially disabling neuropsychiatric condition. In this pictorial review, we explore the complexity of FND, from its diagnosis and conceptualization to current mechanistic understandings. We highlight advances in neuroimaging research that have revealed structural and functional brain alterations in FND and discuss a variety of factors that may serve as predisposing vulnerabilities for the development of this condition and/or perpetuate symptoms. This overview is designed as an initial teaching resource to educate trainees, clinicians, and researchers, highlighting core concepts in the literature on FND. Given that mechanistic research in FND is at a relatively early stage and is rapidly evolving, the interested reader should aim to continue updating their mechanistic understanding of FND as research further advances in this area.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"106 ","pages":"Article 104449"},"PeriodicalIF":3.8,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668946","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":"Neuroscience in Pictures: 4. Depression","authors":"Matcheri S. Keshavan ,&nbsp;Seo Ho Song ,&nbsp;Carl Salzman","doi":"10.1016/j.ajp.2025.104448","DOIUrl":"10.1016/j.ajp.2025.104448","url":null,"abstract":"<div><div>Major depressive disorder represents a complex heterogeneous syndrome with significant public health impact. This pictorial review explores the multifaceted pathophysiology of depression through the case of an individual suffering from depression. Genetic vulnerability and environmental etiological factors, including early life adversity, and their interactions create a biological diathesis through alterations in stress response systems and neural circuitry. We review current evidence for several interconnected pathophysiological mechanisms underlying depression, including monoamine neurotransmission, hypothalamic-pituitary-adrenal axis dysfunction, chronic inflammation, and reduced neuroplasticity. Using the Research Domain Criteria framework, we connect these mechanisms across multiple levels of analysis—from genes, circuits to behavior. Neuroimaging findings highlight disruptions in key networks including the default mode, salience, and executive control circuits. The effectiveness of pharmacological, psychotherapeutic and other non-pharmacological interventions in depression underscores the importance of targeting multiple biological systems. This review emphasizes depression’s complex etiology involving dynamic interactions between genetic predisposition, environmental stressors, and neurobiological alterations, suggesting the need for personalized, multimodal therapeutic approaches.</div></div>","PeriodicalId":8543,"journal":{"name":"Asian journal of psychiatry","volume":"107 ","pages":"Article 104448"},"PeriodicalIF":3.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681307","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}