BioPsychoSocial Medicine最新文献

{"title":"Detecting effects of yoga therapy on heart rate variability and autonomic nervous system functioning in adults after cancer treatment: results from a study using single-subject experimental methods.","authors":"Jennifer Brunet, Julia Hussien, Anne Pitman, Amanda Wurz, Ellen Conte, Christophe Herry, Nadia Polskaia, Andrew Seely, Dugald Seely","doi":"10.1186/s13030-026-00367-x","DOIUrl":"https://doi.org/10.1186/s13030-026-00367-x","url":null,"abstract":"<p><strong>Background: </strong>Cancer is a source of physiological and psychological stress. Heart rate variability (HRV) is a measure of autonomic reactivity to physiological and psychological stress. For an initial proof-of-concept, we investigated the effects of a yoga therapy (YT) intervention on HRV metrics and self-reported autonomic nervous system (ANS) functioning using single-subject experimental methods.</p><p><strong>Methods: </strong>Data from 20 adults (M_{age (years)} = 55.7 [SD = 8.6], 85% female, M_{years from diagnosis} = 2.8 [SD = 3.5]) were analyzed. Participants received an initial 90-min 1:1 YT session followed by 6 weekly 60-min small group YT sessions. Hexoskin Smart Shirts captured single lead electrocardiographic data suitable for HRV analysis, and questionnaires were used to assess self-reported state and trait ANS functioning. Data collected prior to (weeks - 6, -3, and 0a), during (immediately after the 1:1 YT session [week 0b] and before the first group session [week 1]), and after (weeks 7 and 12) the YT intervention were analyzed. Hierarchical linear modeling (HLM) was used to estimate average baseline levels (intercept), linear slopes (time), YT initiation effect on levels (phase), and YT intervention effect on linear slopes (time-by-phase) for each outcome.</p><p><strong>Results: </strong>HLM yielded mixed results. Significant (p < 0.05) time, phase, and time-by-phase effects for state ANS, coefficient of variation and high frequency power, time-by-phase effect for trait ANS, and time and phase effects for sample entropy were observed. No significant effects were observed for remaining analyzed HRV metrics.</p><p><strong>Conclusions: </strong>Though mixed, results establish an initial proof-of-concept required to justify larger studies investigating the effects of YT on HRV and self-reported ANS functioning in adults after cancer treatment.</p><p><strong>Trial registration name: </strong>ISRCTN registry.</p><p><strong>Registration number: </strong>ISRCTN64763228.</p><p><strong>Date of registration: </strong>December 12, 2021. This study was retrospectively registered. URL OF TRIAL REGISTRY RECORD: https://www.isrctn.com/ISRCTN64763228 .</p>","PeriodicalId":9027,"journal":{"name":"BioPsychoSocial Medicine","volume":"20 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787957","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":"Evaluation of self-efficacy and its limiting factors among children with asthma aged 8-18 years.","authors":"Raheleh Shanazari, Fatemeh Gholamzadeh, Mojgan Safari, Younes Mohammadi, Arash Khalili","doi":"10.1186/s13030-026-00366-y","DOIUrl":"https://doi.org/10.1186/s13030-026-00366-y","url":null,"abstract":"<p><strong>Background and objective: </strong>Asthma is the most prevalent chronic disease in childhood, and self-efficacy is a key determinant of symptom control, treatment adherence, and prevention of exacerbations. Despite advances in pharmacological management, many children continue to experience barriers that hinder effective self-management. This study aimed to assess the level of self-efficacy and identify its limiting factors among children with asthma aged 8-18 years.</p><p><strong>Methods: </strong>This descriptive cross-sectional study was conducted in 2025 at a pediatric specialty clinic affiliated with a teaching hospital. A total of 100 children with asthma were recruited using convenience sampling. Data were collected using A demographic questionnaire, the Asthma Self-Efficacy Scale, and the Limiting Factors of Self-Efficacy Questionnaire were used to collect the data. The instruments demonstrated acceptable content validity and internal consistency. Data analysis was done with descriptive statistics, Spearman's correlation, and multiple linear regression in SPSS version 22, with statistical significance set at p < 0.05.</p><p><strong>Results: </strong>The findings indicated a moderate level of self-efficacy among children with asthma, accompanied by a relatively low-to-moderate level of perceived limiting factors. Spearman's correlation showed a significant positive association between the frequency of asthma attacks and limiting factor scores (r = 0.197, p = 0.049), suggesting that increased exacerbations were associated with greater perceived barriers to disease management. Multiple linear regression analysis revealed that longer disease duration significantly predicted higher self-efficacy, whereas lower paternal educational level was associated with reduced self-efficacy. The most commonly reported barriers included insufficient disease-related knowledge, concerns about medication side effects, and challenges in treatment follow-up, while family support emerged as a key facilitator of self-efficacy.</p><p><strong>Conclusion: </strong>Children with asthma exhibited moderate self-efficacy in disease management, while cognitive, attitudinal, and family-related barriers undermined sustained self-care behaviors. Strengthening family-centered educational interventions, improving parental health literacy, and implementing targeted nursing programs may contribute to improving self-efficacy and reducing perceived barriers.</p>","PeriodicalId":9027,"journal":{"name":"BioPsychoSocial Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418475","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":"Depressive and anxiety symptoms in COPD: associations with diffusion impairment and echocardiographic pulmonary hemodynamic burden.","authors":"Tetsuya Hiramoto, Satoshi Izuno, Kenta Toda, Atsushi Moriwaki, Makoto Yoshida","doi":"10.1186/s13030-026-00364-0","DOIUrl":"https://doi.org/10.1186/s13030-026-00364-0","url":null,"abstract":"<p><strong>Background: </strong>Psychological distress is common yet often underrecognized in chronic obstructive pulmonary disease (COPD). Physiological correlates beyond spirometry may support biopsychosocial assessment in routine care, but their relation to depressive and anxiety symptoms remain insufficiently characterized.</p><p><strong>Methods: </strong>In this single-center cross-sectional study, 56 clinically stable Japanese COPD outpatients (mean age 73 years; 87.5% men) completed the Self-Rating Depression Scale (SDS) and the State-Trait Anxiety Inventory (STAI). Clinical assessments included spirometry, %DLCO/VA, echocardiographic tricuspid regurgitation pressure gradient (TRPG), body mass index (BMI), and blood biomarkers. Associations were examined using Spearman's rank correlation and multivariable linear regression adjusted for age, sex, and BMI; Model 1 included %DLCO/VA and Model 2 included TRPG. Bootstrap resampling was used to assess the stability of key regression coefficients.</p><p><strong>Results: </strong>Depressive symptoms (SDS ≥ 40) were present in 46.5% of the patients (severe 5.4%), and elevated state anxiety in 41.1% (severe 12.5%). SDS scores were correlated with lower %DLCO/VA, higher TRPG, and lower BMI. STAI-state scores were correlated with higher TRPG. In adjusted analyses, lower %DLCO/VA was independently associated with higher SDS scores, whereas higher TRPG was independently associated with higher SDS and STAI-state scores. %FEV1 was not associated with SDS or STAI scores.</p><p><strong>Conclusions: </strong>In this Japanese outpatient COPD cohort, depressive and anxiety symptoms were common. Elevated TRPG showed a more consistent association with psychological symptoms in bootstrap analyses, whereas lower %DLCO/VA was associated with depressive symptoms but showed less stable bootstrap support than the TRPG findings. These findings support an integrated biopsychosocial assessment approach to routine COPD care, incorporating physiological information beyond spirometric airflow measures.</p>","PeriodicalId":9027,"journal":{"name":"BioPsychoSocial Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350540","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":"Clinical characteristics and healthcare utilization of orthostatic dysregulation in Japan: a nationwide descriptive study.","authors":"Kazuma Shinno, Hiroyuki Iijima, Kazue Ishitsuka, Norihiko Inoue, Yuki Hashimoto, Akira Nagai, Isamu Kamimaki, Shinichiro Nagamitsu","doi":"10.1186/s13030-026-00363-1","DOIUrl":"https://doi.org/10.1186/s13030-026-00363-1","url":null,"abstract":"<p><strong>Background: </strong>Orthostatic dysregulation (OD) is a physical disorder characterized by circulatory disturbances due to autonomic nervous system imbalance that predominantly affects children. In Japan, OD is common and closely associated with school non-attendance, and its clinical management has developed from a psychosomatic perspective. However, large-scale data on real-world clinical practices are lacking. This study uses nationwide data to describe the comorbidities, prescribed medications, and medical practices for OD.</p><p><strong>Methods: </strong>This descriptive study utilized the Medical Information Analysis databank, a nationwide administrative database operated by the National Hospital Organization in Japan. We identified 7,213 patients aged 6 to 18 years who were first diagnosed with OD between 2016 and 2023. Descriptive statistics were used to analyze patient demographics, comorbidities, prescribed medications, and medical practices. Subgroup analyses stratified by prescription patterns were conducted.</p><p><strong>Results: </strong>The median age at diagnosis was 13 years, and 55.6% of the patients were female. The most common comorbidity category was mental health/behavioral disorders (23.6%). The most prevalent specific conditions were sleep disorders (10.2%), school non-attendance (9.3%), and autism spectrum disorder/attention-deficit hyperactivity (7.1%). Pharmacotherapy was provided to 44.0% of the patients, with a mean of 1.3 medications per patient. Midodrine was the most prescribed medication (78.3%), followed by amezinium metilsulfate (6.7%), and propranolol (2.8%). Sleep medications were prescribed to 9.4% of treated patients. The most frequent medical practices were blood tests (48.6%), diagnostic imaging (35.9%), and electrocardiograms (24.2%). The subgroup prescribed sleep medications had a higher prevalence of neurodevelopmental disorders, school non-attendance, and depression.</p><p><strong>Conclusions: </strong>This first nationwide descriptive study of OD in Japan provides real-world evidence on clinical characteristics and healthcare utilization. Heterogeneous comorbidity profiles and prescription patterns reveal the clinical diversity of the patient population. Our findings highlight the need for tailored therapeutic strategies to support more effective care.</p>","PeriodicalId":9027,"journal":{"name":"BioPsychoSocial Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148326555","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":"Gaze perception fuels social anxiety in everyday life: a comparison of two ecological momentary assessment models.","authors":"Mao Nanamori, Nozomi Tomita, Ayaka Yanagida, Hiroaki Kumano","doi":"10.1186/s13030-026-00360-4","DOIUrl":"10.1186/s13030-026-00360-4","url":null,"abstract":"<p><strong>Background: </strong>Self-focused attention is a well-established factor in social anxiety disorder. Our previous study found that perceiving oneself as being watched or evaluated in social contexts exacerbates this tendency, but it remains unclear whether the perception of gaze or evaluation serves as the initial trigger for these cognitive processes. This study used ecological momentary assessment to investigate the temporal sequence of these perceptions and their impact on self-focused attention and social anxiety symptoms.</p><p><strong>Methods: </strong>Thirty-eight participants (17 male, 21 female) completed self-reported web assessments three times daily for 10 days. Measures included perceived evaluation, gaze perception, self-focused attention, and anxiety experienced in social situations. A total of 569 data points were collected and analyzed with multilevel structural equation modeling to compare two competing theoretical models.</p><p><strong>Results: </strong>One model posited that perceived evaluation preceded gaze perception, and the other that gaze perception preceded perceived evaluation. The latter received stronger empirical support, indicating that gaze perception elicits the perceived evaluation, which subsequently increases self-focused attention and social anxiety symptoms. However, model fit differences were small, leaving the alternative model where perceived evaluation precedes gaze perception as a plausible explanation.</p><p><strong>Conclusions: </strong>Gaze perception plays a pivotal role in triggering social anxiety symptoms by fostering the perceived evaluation and amplifying self-focused attention. Interventions targeting gaze perception and sensitivity to evaluation may help reduce social anxiety symptoms.</p>","PeriodicalId":9027,"journal":{"name":"BioPsychoSocial Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315467","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":"Validation of the Japanese version of the death and dying distress scale.","authors":"Seraki Miyamoto, Tadahiro Yamazaki, Toshio Matsubara, Hiroshi Yamagata, Saki Harashima, Hiroshi Kobo, Hiroaki Abe, Masahiko Sumitani, Ken Shimizu, Gary Rodin, Kazuhiro Yoshiuchi","doi":"10.1186/s13030-026-00362-2","DOIUrl":"https://doi.org/10.1186/s13030-026-00362-2","url":null,"abstract":"<p><strong>Background: </strong>The Death and Dying Distress Scale (DADDS) is a self-report instrument used to assess distress related to dying and death in patients with advanced cancer. We aimed to test the reliability and validity of the Japanese-translated version of the DADDS (DADDS-J) and evaluate its psychological properties in patients with advanced cancer in Japan.</p><p><strong>Methods: </strong>Japanese participants with advanced cancer (n = 200) completed the DADDS and additional tools measuring depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), quality of life (Functional Assessment of Cancer Therapy-General; Japanese Version of the Quality of Life at the End of Life-Cancer Scale), symptom burden (Japanese Version of the Quality of Life at the End of Life-Cancer Scale), and spirituality (Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being). Exploratory factor analysis (EFA), parallel analysis, and confirmatory factor analyses (CFA) were performed on 15 DADDS items. Internal consistency was assessed using Cronbach's alpha and McDonald's ω, and construct validity was examined by calculating correlations with relevant scales.</p><p><strong>Results: </strong>EFA and parallel analysis identified a three-factor structure in the 14-item DADDS-J after item 3 was excluded, with Cronbach's alpha and McDonald's ω ranging from 0.85 to 0.92. CFA showed an adequate fit for the unique structure. Each subscale was significantly correlated with age, depression, anxiety, symptom burden, and lower quality of life and spirituality, but not with social and family well-being or time since cancer diagnosis.</p><p><strong>Conclusions: </strong>The DADDS-J has a three-factor structure and demonstrates good reliability and validity. Differences between the original and Japanese versions of the scale may be due to cultural factors. This is the first tool that can measure spiritual pain associated with death in patients with advanced cancer in Japan and is suitable for large-scale studies and clinic use. This scale can enhance research and clinical care for patients with advanced cancer in Japan.</p>","PeriodicalId":9027,"journal":{"name":"BioPsychoSocial Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315538","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":"Association between documented mental health disorders and HIV treatment outcomes among adults receiving antiretroviral therapy in rural Zimbabwe.","authors":"Laston Gonah, Jacqueline Nyamadzawo","doi":"10.1186/s13030-026-00361-3","DOIUrl":"10.1186/s13030-026-00361-3","url":null,"abstract":"<p><strong>Background: </strong>Mental health conditions undermine HIV treatment outcomes, yet evidence from routine care settings in rural Zimbabwe remains limited.</p><p><strong>Aim: </strong>To examine the association between documented mental health disorders and retention in care and viral suppression among adults receiving antiretroviral therapy (ART) at a rural hospital in central Zimbabwe.</p><p><strong>Methods: </strong>This retrospective cohort analysis used routinely collected clinical data to examine associations between documented mental health disorders and retention in care and viral suppression among adults living with HIV receiving ART. Sixty-four adults with comorbid HIV and documented mental health disorders were included as cases and matched 1:1 by age (± 1 year), sex, and duration on ART (± 1 year) to 64 adults without documented mental health disorders or other chronic treatment-related conditions, resulting in a total analytic sample of 128 participants. Ficher's exact test and ordered logistic regression models were used to assess associations between mental health disorders and treatment outcomes, adjusting for relevant demographic covariates.</p><p><strong>Results: </strong>The overall prevalence of documented mental health disorders (predominantly psychosis and anxiety) in this study population was low (3.6%), indicating potential underdiagnosis in routine HIV care. Documented mental health disorders were significantly associated with poorer retention in care and lower rates of viral suppression compared with controls (p < 0.05, respectively), with psychosis and suicidality particularly associated with non-retention.</p><p><strong>Conclusion: </strong>The findings highlight the need to strengthen mental health integration within HIV care. Targeted interventions for high-risk groups, systematic mental health screening, improved HIV-mental health data integration, and task-shifting to trained non-specialist health workers may improve clinical decision-making and support adherence, retention in care and viral suppression in similar resource-limited settings.</p>","PeriodicalId":9027,"journal":{"name":"BioPsychoSocial Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980349","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":"The impact of home-based telerehabilitation pranayama on sleep quality and wellbeing in mild to moderate obstructive sleep apnea syndrome. A randomized controlled trial.","authors":"Zeynep Kaçar Akkoç, Rengin Demir, Rüstem Mustafaoğlu, Ömer Önder Önder, Baha Naci, Ersan Atahan","doi":"10.1186/s13030-026-00359-x","DOIUrl":"10.1186/s13030-026-00359-x","url":null,"abstract":"<p><p>BACKGROUND: Obstructive sleep apnea syndrome (OSAS) is a common disorder that causes repeated airway obstruction, disrupted breathing, and fragmented sleep. This study aimed to investigate the effects of Pranayama on sleep quality, daytime sleepiness, quality of life, fatigue, depression, and anxiety in patients with OSAS. METHODS: This study was designed as an open-label, prospective, randomized controlled trial. OSAS patients meeting the inclusion criteria were randomly assigned to either an Intervention group or a Control group. Pranayama training was applied to the Intervention group for 8 weeks, 7 days a week, and 3 times a day for 15 min. In addition, a single 15-minute session, 3 days a week, was conducted online under the supervision of a physiotherapist. The control group did not receive any intervention. Primary outcome was sleep quality (Pittsburgh Sleep Quality Index, PSQI). Secondary outcomes included daytime sleepiness (Epworth Sleepiness Scale, ESS), Fatigue Severity Scale (FSS), Functional Outcomes of Sleep Questionnaire (FOSQ), Nottingham Health Profile (NHP), and Hospital Anxiety and Depression Scale (HADS). All outcome measures were assessed at baseline and reassessed after the 8-week intervention period. RESULTS: Thirty-eight OSAS patients meeting the inclusion criteria were randomly assigned to either an Intervention group (n = 19) or a Control group (n = 19). Four participants (two in each group) were lost to follow-up, leaving the data of 34 participants (17 per group) available for inclusion in the final analysis. In the intervention group, PSQI scores decreased from 9.12 ± 4.71 to 6.88 ± 4.45 (p < 0.001), whereas no improvement was observed in the control group. Regarding the primary outcome, the reduction in PSQI scores was significantly greater in the intervention group than in the control group (p < 0.001). The ESS scores also decreased significantly in the intervention group, from 9.41 ± 6.15 to 7.41 ± 6.18 (p = 0.006, with a significant between-group difference (p < 0.001). Fatigue severity decreased in the intervention group (FSS change: 0.53 ± 0.70; p = 0.006), with a significant between-group difference (p = 0.037). The FOSQ score improved markedly, with significant gains in FOSQ total score (− 0.38 ± 0.25 vs. 0.14 ± 0.22 in controls; p < 0.001) and in activity level and vigilance subdomains (both p < 0.001). The HADS-anxiety scores decreased by 1.94 ± 3.94 (p = 0.059) and depression scores by 3.06 ± 2.05 (p < 0.001) in the intervention group, with significant between-group differences for both anxiety (p = 0.008) and depression (p < 0.001). CONCLUSION: Pranayama was an effective adjunct therapy for these OSAS patients, and incorporating it into treatment strategies may enhance patient outcomes. CLINICAL TRIAL REGISTRATION NUMBER/DATE: NCT04632147/22.10.2020. </p>","PeriodicalId":9027,"journal":{"name":"BioPsychoSocial Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13188614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147697551","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":"The medial prefrontal cortex as an integrative hub in chronic pain: network mechanisms and the enabling role of artificial intelligence.","authors":"Marco Cascella, Mario Montedoro, Alessandro Vittori","doi":"10.1186/s13030-026-00357-z","DOIUrl":"10.1186/s13030-026-00357-z","url":null,"abstract":"<p><p>Chronic pain is recognized as a disorder of distributed brain networks rather than the consequence of persistent nociceptive input. Among these networks, the medial prefrontal cortex (mPFC) is a key integrative hub linking sensory processing with affective, cognitive, and stress-related dimensions of pain. Evidence from neuroimaging, neurochemical, and longitudinal studies indicates that mPFC dysfunction contributes to impaired top-down modulation, altered emotional regulation, and the persistence of pain states. Nevertheless, these findings should be interpreted within a system-level framework, as mPFC activity reflects network reorganization rather than serving as an isolated or validated clinical biomarker. Moreover, the generalizability of mPFC-centered models is limited across patient populations, including children and those with psychiatric comorbidities or cognitive impairment. This editorial critically examines the neurobiological basis of mPFC-centered network dysfunction in chronic pain and discusses its implications for translational research, with a key focus on artificial intelligence (AI). These technologies are framed not as a near-term clinical solution but as enabling and exploratory methods for integrating multimodal data and modeling complex brain–behavior relationships. Emerging generative AI approaches, agent-based models, and digital twins can also be implemented as conceptual tools for hypothesis generation and in silico exploration of individualized network dynamics, rather than as established clinical applications. Although AI-based approaches may accelerate hypothesis generation and the identification of latent network-level patterns, their clinical relevance is currently constrained by key methodological challenges, including limited generalizability, imperfect phenotypic classification, the absence of robust ground truth for pain, and the need for extensive external and longitudinal validation.Trial registration Not applicable.</p>","PeriodicalId":9027,"journal":{"name":"BioPsychoSocial Medicine","volume":"20 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13067708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147653606","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":"Impacts of opioid use, postoperative pain, pain interference, and side effects on postoperative psychological distress: a retrospective study of the PAIN OUT registry in seven Asian regions.","authors":"Yuchang Bao, Chi Wai Cheung, Yulin Huang, Ruth Zaslansky, Winfried Meissner, Hung Chak Ho","doi":"10.1186/s13030-026-00358-y","DOIUrl":"10.1186/s13030-026-00358-y","url":null,"abstract":"<p><p>BACKGROUND: Postoperative psychological distress is highly prevalent in Asian surgical populations, but the relationships among opioid exposure at different perioperative stages, pain characteristics, side effects, and postoperative anxiety and helplessness remain poorly understood. METHODS: A total of 6,105 patients from seven Asian regions in the PAIN OUT registry were included. Opioid use during the preoperative, intraoperative, recovery room, and ward stages was converted to oral morphine equivalents (OMEs). Four dimensions of postoperative outcomes– psychological distress (anxiety, helplessness), pain intensity, pain interference, and side effects– were assessed using the International Pain Outcomes Questionnaire (IPO-Q). Multinomial logistic regressions were used to examine the associations. RESULTS: Moderate-to-severe anxiety and helplessness were reported by 42.6% and 27.9% of patients, respectively. Time spent in severe pain showed the strongest associations with anxiety (moderate phase: OR = 2.711 [2.238, 3.285] for moderate anxiety; OR = 2.295 [1.72, 3.071] for severe anxiety), while maximum pain severity was less predictive. Sleep interference was most strongly associated with helplessness (severe interference: OR = 3.307 [2.317, 4.720] for severe helplessness; OR = 2.738 [1.94, 3.86] for severe anxiety). Common side effects– dizziness (ORs: 1.535–2.643), drowsiness (ORs: 1.426–1.881), and itching (ORs: 1.428–1.917)—were significantly associated with both anxiety and helplessness. For opioid exposure, higher intraoperative and ward OMEs were modestly associated with lower distress (ORs: 0.969–0.982 per 10-mg increment), while preoperative and recovery-room OMEs showed no significant associations. Counterintuitively, moderate-to-severe maximum pain was associated with lower odds of moderate helplessness (ORs: 0.679–0.687). CONCLUSION: In this Asian cohort, pain duration and sleep disruption were more strongly associated with postoperative psychological distress than pain severity. The timing of opioid administration (intraoperative and ward) showed modest associations, suggesting that when opioids are used may be as important as the total dose. Integrated postoperative care should prioritize rapid resolution of prolonged pain episodes, proactive nighttime symptom management, and structured monitoring of common opioid-related side effects to reduce early postoperative distress. </p>","PeriodicalId":9027,"journal":{"name":"BioPsychoSocial Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13162375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147589787","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}