BMC Psychiatry最新文献

{"title":"Effectiveness of amisulpride augmentation versus other antipsychotics in clozapine-treated adolescents: a real-world retrospective study.","authors":"Binay Kayan Ocakoglu, Ayşegül Tonyalı, Uğur Karabağ, Zeynep Gültekin Taş, Damla Kasap Üstündağ, Gül Karaçetin","doi":"10.1186/s12888-026-08548-2","DOIUrl":"10.1186/s12888-026-08548-2","url":null,"abstract":"<p><strong>Background: </strong>In this study, we compared the clinical response to clozapine-amisulpride augmentation versus clozapine augmentation with other antipsychotics among children and adolescents with schizophrenia spectrum disorders in clinical practice. Crucially, the comparative efficacy of specific augmentation strategies in this vulnerable, early-onset population remains a largely unanswered question in current literature.</p><p><strong>Methods: </strong>Seventy-six inpatients who were treated with clozapine between 2013 and 2023 years at a tertiary care psychiatric university teaching hospital in Turkey were included in this retrospective study. Patients were divided into clozapine+amisulpride (n = 22) and clozapine+others (n = 54) groups according to their treatment regimen. Clinical response was assessed by comparing baseline and discharge Positive and Negative Syndrome Scale (PANSS) scores and response rates defined as ≥20% and ≥30% improvement. The effect of group assignment on clinical response was examined by multiple linear regression analysis while controlling for clozapine dose, baseline PANSS scores, and adjunctive antipsychotic load standardized via the Defined Daily Dose (DDD) method.</p><p><strong>Results: </strong>Mean age of the patients was 15.9 ± 2.3 years. Baseline PANSS total scores were similar between groups (p = 0.977). Mean changes in PANSS total scores (-25.1±34.7 vs. -25.5±32.1; p = 0.968) and subscale scores were not significantly different between groups at discharge. Response rates according to 30% and 20% thresholds were similar between groups (38.1% vs. 51.1%; p = 0.324, p = 0.954). In the multiple linear regression analysis, clozapine dose (p = 0.026) and baseline PANSS score (p < 0.001) were significant predictors of change in PANSS total score. In the negative subscale model, higher clozapine doses predicted greater symptom reduction (p = 0.028), whereas higher standardized doses of adjunctive antipsychotics predicted poorer improvement (p = 0.031).</p><p><strong>Conclusions: </strong>Clozapine augmentation with amisulpride was not superior to augmentation with other antipsychotics in our sample. Treatment response appears to be driven more by clozapine dose and baseline severity. In addition, high standardized doses of adjunctive agents may counterproductively limit negative symptom recovery, perhaps due to secondary negative symptoms caused by excessive D2 receptor blockade.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation and real-world effectiveness of a weighted blanket intervention and standard melatonin treatment for children with ADHD and sleep problems: protocol for a pragmatic longitudinal cohort study.","authors":"Ingrid Larsson, Petra Svedberg, Håkan Jarbin, Jens Nygren, Annelie Lindholm, Katarina Aili, Julia S Malmborg","doi":"10.1186/s12888-026-08538-4","DOIUrl":"10.1186/s12888-026-08538-4","url":null,"abstract":"<p><strong>Background: </strong>Sleep problems are common in children with attention-deficit/hyperactivity disorder (ADHD), yet the real-world use, implementation, and long-term outcomes of weighted blankets and standard melatonin treatment remain understudied. This study protocol describes a research project evaluating the real-world effectiveness and implementation of a weighted blanket intervention and standard melatonin treatment for children with ADHD and sleep problems in routine clinical practice. The project focuses on (1) changes over time in sleep, health-related outcomes, and resource utilization within and across treatment arms, and (2) barriers and facilitators to implementation in routine clinical practice.</p><p><strong>Methods: </strong>The research project uses: (1) a pragmatic longitudinal cohort design to investigate real-world changes over time in sleep, health-related outcomes, and healthcare resource utilization among children receiving either a weighted blanket intervention or standard melatonin treatment, and (2) a process evaluation design to evaluate implementation in routine clinical practice. Approximately 150 child-parent dyads will be included in each treatment arm. Children aged 6-14 years and one of their parents will each complete questionnaires at baseline, before treatment starts, at 1, 3, 6, and 12 months, and then annually for an additional nine years. The questionnaires assess sleep problems using the Children's Sleep Habits Questionnaire (CSHQ) total score as the primary sleep outcome, treatment adherence and treatment changes, additional sleep-related measures, everyday function, lifestyle habits, worry and anxiety, ADHD-related symptoms, health-related quality of life, pain, resource utilization, and treatment use and implementation. Child-parent dyads and clinical staff members will be interviewed at 6 and 12 months. Appropriate parametric and non-parametric statistical tests will be performed. Interviews will be analyzed using qualitative content analysis. The implementation process will be analyzed using a convergent parallel mixed methods approach.</p><p><strong>Discussion: </strong>The project has the potential to inform clinical guidelines and decision-making frameworks for personalized care for children with ADHD. By evaluating patterns of treatment use and treatment change, real-world outcomes, and implementation in routine clinical practice, the project may contribute knowledge about the role of weighted blankets as a non-pharmacological treatment option alongside standard melatonin treatment.</p><p><strong>Trial registration: </strong>http://ClinicalTrials.gov , NCT06808425; registered 29 January 2025.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13508435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Encounters between people with mental health and/or substance use problems and ambulance clinicians: a qualitative interview study in Norway.","authors":"Lin Eik Ulvøy, Jorun Rugkåsa, Trine Møgster Jørgensen, Solveig H H Kjus, Kristin Häikiö","doi":"10.1186/s12888-026-08546-4","DOIUrl":"10.1186/s12888-026-08546-4","url":null,"abstract":"<p><strong>Background: </strong>Interactions between ambulance clinicians and people with mental health and/or substance use problems are frequent, and international studies show that these encounters are often shaped by stigma, power dynamics and challenges to patient autonomy. However, there is limited research exploring patients' experiences of ambulance services in the Norwegian context. This study addresses this knowledge gap.</p><p><strong>Methods: </strong>This qualitative study was based on in-depth, semi-structured interviews with 23 people with mental health and/or substance use problems recruited from primary and specialized healthcare services and service user organizations. The data were analyzed using reflexive thematic analysis, with input from a multidisciplinary stakeholder group throughout the research process.</p><p><strong>Results: </strong>Participants reported varied experiences in their encounters with ambulance clinicians. Prior interactions with other healthcare services strongly shaped their expectations of, and willingness to seek, emergency care. While some described professional and reassuring care, others experienced patronizing attitudes toward conditions perceived as self‑inflicted. Several participants also reported inadequate physical health assessments and treatment, and many felt excluded from decision‑making processes due to limited information, involvement, and respect. These experiences influenced their sense of safety, autonomy, and trust in emergency services.</p><p><strong>Conclusions: </strong>In Norway, people with mental health and/or substance use problems described several challenges in their encounters with ambulance services, including stigma, patronizing attitudes, inadequate physical healthcare, and limited patient involvement. These findings highlight the need for improved competence in mental health and substance use and clearer communication practices to promote more equitable and respectful ambulance care.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The severity of dissociation and dissociative phenomena in non-affective psychosis: a systematic review and meta-analyses.","authors":"Adam O'Neill, Gillian Haddock, Kate Stalker, Kim Barnett, Amelia Pearson, Dawn Edge, Omar Laftah, Leah Millard-Brewer, Lee D Mulligan","doi":"10.1186/s12888-026-08424-z","DOIUrl":"10.1186/s12888-026-08424-z","url":null,"abstract":"<p><strong>Background: </strong>Non-affective psychosis is associated with elevated risk of suicide, self-harm, and reduced life expectancy. Symptoms of dissociation are common in non-affective psychosis, and dissociative experiences are known to be linked to multiple markers of elevated clinical risk, including sleep disturbance and negative affect. The present review represents the first comprehensive quantification of dissociative phenomena severity across multiple instruments in non-affective psychosis.</p><p><strong>Methods: </strong>Six databases (Embase, MEDLINE, PsycINFO, PubMed, Scopus, Web of Science) were searched from inception and systematically screened. Eligibility was established against ICD/DSM criteria or service-defined categorisation, including first-episode psychosis, brief limited intermittent psychotic symptoms, and at-risk of psychosis mental states. In total, data were extracted for 22 measures. Four random effects meta-analyses were conducted for measures with three or more independent datasets: the Dissociative Experiences Scale (DES) (k = 51; n = 3,878); the Cambridge Depersonalization Scale (CDS) (k = 6; n = 351); the Examination of Anomalous Self Experience scale, using the dichotomous scoring method (EASE-D) (k = 11; n = 340); and the Examination of Anomalous Self Experience scale, using the continuous scoring method (EASE-C) (k = 6; n = 235).</p><p><strong>Results: </strong>DES data yielded a pooled mean of 21.28 (95% CI 19.19-23.38), consistent with moderately elevated dissociation. CDS data yielded a pooled mean of 36.38 (95% CI 26.89-45.87), also raised relative to community norms. EASE-D pooled means (M = 17.76 95% CI 15.29-20.24) and EASE-C pooled means (M = 74.86 95% CI 52.36-97.35) both indicated high and clinically relevant loads of basic self-disturbance. High heterogeneity (I² > 85%) across measures highlights considerable variability in dissociative severity across samples, suggesting that levels of dissociation and dissociative experiences are not uniform in populations who experience non-affective psychosis.</p><p><strong>Conclusions: </strong>The present findings emphasise the importance of assessing dissociation in non-affective psychosis, and where necessary, intervening clinically. Nonetheless, the development of trauma-informed, dissociation-targeted clinical interventions is required to optimise approaches to support. Throughout the literature, there is a pressing need for more harmonised measurement efforts and further mechanistic research.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatal neurological complications in anorexia nervosa: a case report of osmotic demyelination syndrome in the binge-eating/purging subtype.","authors":"Xin Zhao, Ge Tan, Hongru Zhu, Xiuli Li, Lan Zhang","doi":"10.1186/s12888-026-08366-6","DOIUrl":"https://doi.org/10.1186/s12888-026-08366-6","url":null,"abstract":"<p><strong>Background: </strong>Anorexia nervosa (AN) is associated with high mortality due to severe complications. Osmotic demyelination syndrome (ODS), although rare, is a severe neurological complication that has been associated with rapid correction of chronic hyponatremia. The occurrence of ODS in patients with AN, particularly the binge-eating/purging subtype (AN-BP), remains poorly recognized despite their increased susceptibility arising from chronic malnutrition and multiple electrolyte disturbances.</p><p><strong>Case presentation: </strong>A 33-year-old woman was treated in the intensive care unit of an outside hospital on July 7, 2025, for severe hyponatremia, with a serum sodium level of 103.52 mmol/L. Her serum sodium increased from 103.52 mmol/L to 123.34 mmol/L over approximately 20.5 h, corresponding to a correction rate of 23.2 mmol/L per 24 h. When she presented to the emergency department of our hospital on July 10, 2025, she exhibited marked psychiatric and behavioral abnormalities. After psychiatric consultation, supplementary history obtained from her family revealed a 10 month history of untreated anorexia nervosa.Serial brain MRI examinations demonstrated both central pontine myelinolysis (CPM) and extrapontine myelinolysis (EPM), with lesions involving the pons, basal ganglia, and cerebellum. During hospitalization at our institution, she received corticosteroid therapy in combination with multidisciplinary supportive care. At the 1-month post-discharge follow-up(September 2025), she remained dependent on others for activities of daily living. With sustained participation in rehabilitation training, her condition markedly improved, at a 7 month telephone follow up (March 2026), her Functional Independence Measure (FIM) total score was 126, and she had resumed normal work and daily life.</p><p><strong>Conclusions: </strong>This case describes ODS occurring after correction of severe hyponatremia in a patient with previously unrecognized AN-BP and multiple electrolyte abnormalities. Although causality cannot be established from a single case, the temporal association highlights the importance of cautious electrolyte correction, close neurological monitoring, and early MRI evaluation when new neuropsychiatric symptoms emerge. Further studies are needed to clarify the factors contributing to ODS risk in patients with eating disorders.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Event-related potential correlates of ESS-C-defined relapse-risk status in clinically stable patients with schizophrenia: a cross-sectional study.","authors":"Yang Feng, Junhui Dong, Minle Lu, Na Zhang, Huizhen Huang, Shuxin Zhang, Dandan Mao, Yuqiu Zhou","doi":"10.1186/s12888-026-08532-w","DOIUrl":"10.1186/s12888-026-08532-w","url":null,"abstract":"<p><strong>Background: </strong>Schizophrenia (SCZ) is associated with a high relapse rate, but objective electrophysiological correlates of relapse-related clinical vulnerability remain insufficiently understood. Event-related potential (ERP) components, such as P3 and N2, have been widely investigated as markers of cognitive dysfunction in SCZ. However, relatively few studies have examined ERP characteristics in clinically stable patients stratified according to early warning signs of relapse. The present study investigated ERP characteristics in clinically stable patients with SCZ classified according to the Early Signs Scale-Chinese version (ESS-C), aiming to explore whether ERP components are associated with ESS-C-defined relapse-risk status.</p><p><strong>Methods: </strong>A cross-sectional study design was adopted. A total of 70 patients with SCZ and 35 healthy controls (HCs) were initially recruited. After electroencephalography (EEG) preprocessing, 90 participants were included in the final analysis, comprising 30 HCs, 30 patients in the non-relapse-risk group (NR), and 30 patients in the relapse-risk group (RR). Patients with SCZ were classified into the NR and RR groups according to the ESS-C cutoff. ERP data were recorded using a three-stimulus visual oddball paradigm. The amplitudes and latencies of N2 at Cz and P3 at CPz were extracted, and their associations with negative symptoms were analyzed.</p><p><strong>Results: </strong>A significant overall group effect was observed for P3 amplitude (F = 9.914, P < 0.001), with Bonferroni-corrected post hoc comparisons showing significantly higher P3 amplitude in the RR group than in the HC group (P < 0.001), while the NR group showed intermediate values. Sensitivity analysis restricted to patients with SCZ showed that ESS-C-defined relapse-risk status was significantly associated with P3 amplitude after adjustment for available clinical variables. N2 amplitude was positively correlated with negative symptom severity (r = 0.278, P < 0.05).</p><p><strong>Conclusions: </strong>Clinically stable patients with SCZ still exhibit abnormal neural information processing. P3 amplitude may be associated with ESS-C-defined relapse-risk status in clinically stable SCZ, whereas N2 may be related to negative symptom severity. These findings provide preliminary evidence that ERP components may be associated with relapse-risk status in clinically stable SCZ.</p><p><strong>Clinical trial number: </strong>NA.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The silent struggle after childbirth - barriers and facilitators to help-seeking for postpartum depression and anxiety.","authors":"Anna Luisa Büssow, Lara Seefeld, Julia Schellong, Susan Garthus-Niegel","doi":"10.1186/s12888-026-08509-9","DOIUrl":"10.1186/s12888-026-08509-9","url":null,"abstract":"<p><strong>Background: </strong>The postpartum period makes mothers particularly vulnerable to mental health disorders such as postpartum depression and anxiety. Despite the high prevalence of these disorders, help-seeking for them remains critically low, leaving many women without adequate support. Therefore, the aim of this study was to examine the extent to which different factors are associated with help-seeking intentions and actual help-seeking behaviors for mental health disorders among postpartum women. We also examined how these factors differed between groups of women with symptoms of postpartum depression, postpartum anxiety, symptoms of both disorders, and women without clinical symptoms.</p><p><strong>Methods: </strong>We used data from a cross-sectional study in Dresden, Germany, with data from N = 4,624 women collected via telephone interviews between 2021 and 2024. Multiple linear regression models were used to examine predictors of help-seeking intention (n = 4,554) in all the groups, while logistic regression models (n = 778) were used to investigate predictors of actual help-seeking behavior among women with symptoms of postpartum depression and/or anxiety.</p><p><strong>Results: </strong>For the different factors, results varied between help-seeking intention and actual help-seeking behavior. Negative health beliefs were found to have the most negative effect on help-seeking intention for all groups. Help-seeking intentions were lower among women with a migrant background who had symptoms of either postpartum depression or anxiety, among women with lower knowledge of services who were not clinically affected, and lower among women with symptoms of postpartum depression who had not used mental health services before. Recognition of a mental disorder was by far the most important factor associated with higher actual help-seeking behavior for all groups. Higher income and older age were factors associated with higher actual help-seeking behavior among women with symptoms of postpartum depression.</p><p><strong>Conclusions: </strong>This study identified factors associated with help-seeking for postpartum depression and anxiety. The findings suggest that routine screening for postpartum depression and anxiety to address the lack of recognition of mental disorders, as well as targeted awareness campaigns to support positive health beliefs, are needed and can improve help-seeking. Tailored interventions for at-risk groups, such as low-income or migrant women, could improve postpartum mental health care.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurophysiological and autonomic effects of Cognitive Remediation Therapy in schizophrenia: a randomized controlled EEG-GSR study.","authors":"Metin Çınaroğlu, Eda Yılmazer, Selami Varol Ülker, Gökben Hızlı Sayar","doi":"10.1186/s12888-026-08491-2","DOIUrl":"10.1186/s12888-026-08491-2","url":null,"abstract":"<p><strong>Background: </strong>Cognitive impairment and emotion dysregulation are core features of schizophrenia and remain insufficiently addressed by pharmacological treatment. Cognitive Remediation Therapy (CRT) has demonstrated efficacy in improving neurocognitive performance; however, evidence linking behavioral improvements to neurophysiological and autonomic mechanisms remains limited. The present randomized controlled trial examined the effects of CRT on electrophysiological, autonomic, cognitive, and clinical outcomes in clinically stable individuals with schizophrenia.</p><p><strong>Methods: </strong>Fifty-seven outpatients with schizophrenia were randomized to a 12-week CRT program (24 sessions) or control condition. Forty-eight participants completed the protocol (CRT: n = 26; control: n = 22). Primary outcome was change in P300 amplitude during a visual oddball task. Secondary outcomes included N200 amplitude, frontal midline theta power during a 2-back task, skin conductance responses (SCR) to negative emotional stimuli, working memory performance, emotion recognition, symptom severity (PANSS), global cognition (MoCA, BACS), emotion regulation (Difficulties in Emotion Regulation Scale (DERS)), and quality of life (QLS). Repeated-measures ANOVA tested Group × Time interactions.</p><p><strong>Results: </strong>CRT produced a significant increase in P300 amplitude relative to control (F(1,46) = 18.72, p < .001, η²p = .29). Significant Group × Time interactions were also observed for N200 amplitude (η²p = .18) and frontal midline theta power (η²p = .26). SCR to negative stimuli decreased in the CRT group (η²p = .16), whereas tonic baseline arousal showed no significant interaction. Behavioral improvements were observed in 2-back accuracy (η²p = .24) and backward digit span (η²p = .19), alongside gains in facial emotion recognition. Psychometric analyses revealed significant improvements in PANSS total and subscales, MoCA, BACS composite, DERS, and QLS scores. Correlation analyses demonstrated that increases in P300 and theta power were associated with improvements in working memory and global cognition, while reductions in SCR were associated with improvements in emotion regulation.</p><p><strong>Conclusions: </strong>CRT induced convergent improvements across neural, cognitive, autonomic, and clinical domains. Enhanced P300 amplitude and frontal midline theta power suggest strengthened attentional allocation and executive control mechanisms, while reduced stimulus-evoked autonomic reactivity indicates improved emotional regulation. These findings support CRT as a mechanistically informed intervention capable of modifying core cognitive-control processes and promoting functional recovery in schizophrenia.</p><p><strong>Trial registration: </strong>This randomized controlled trial was prospectively registered at ClinicalTrials.gov (Identifier: NCT06936397; registration date: 20.04.2025).</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IL-1α and CRP as key inflammatory mediators linking neuropathic pain, anxiety, and depression in major depressive disorder.","authors":"Cuizhen Zhu, Lin Cheng, Jian Cheng, Qingrong Xia, Junwei Yan, Chao Li, Mingming Zheng, Jingyue Yang, Jianliang Gao, Loufeng Zhang, Peijun Ju, Hua Gao","doi":"10.1186/s12888-026-08351-z","DOIUrl":"https://doi.org/10.1186/s12888-026-08351-z","url":null,"abstract":"<p><strong>Background: </strong>It's common comorbidity for Major Depressive Disorder (MDD), anxiety, and pain, underpinned by shared chronic inflammatory processes, this study aimed to identify etiological inflammatory biomarkers, focusing on MDD individuals with anxiety and pain symptoms.</p><p><strong>Methods: </strong>Initially, 218 participants underwent screening for this cross-sectional study. Ultimately, 75 first-episode drug-naive patients with MDD and 40 healthy controls met the inclusion criteria. Depression and anxiety symptoms were assessed by Hamilton Depression Rating Scale-24 (HAMD-24), Hamilton Anxiety Rating Scale-14 (HAMA-14), Beck Depression Inventory-II (BDI-II) and Beck Anxiety Inventory (BAI), respectively. Short-Form McGill Pain Questionnaire-2 (SF-MPQ-2) and Prospective and Retrospective Memory Questionnaire (PRMQ) were to evaluate the pain feature and memory function respectively. Meso Scale Discovery was used to measure the amounts of eighteen cytokines and chemokines in peripheral blood. We use the sequential path model (model 6) and the moderated path model (model 59) in the PROCESS to examine the relationship between variables. A Gaussian Graphical Model (GGM), Gradient Boosted Regression (GBR) algorithm, SHapley Additive exPlanations (SHAP) values and Partial Dependence Plots (PDP) were used to visualize the primary features on model predictions.</p><p><strong>Results: </strong>MDD patients displayed significantly higher IL-1α levels, lower CRP levels, greater pain sensitivity, and more cognitive impairment compared to controls. Multivariate regression confirmed a significant positive link between IL-1α and neuropathic pain (β = 0.25, p = 0.014). A sequential path model and a moderated path model revealed a crucial indirect pathway: IL-1α did not directly cause depressive symptoms but acted sequentially: IL-1α → neuropathic pain → subjective anxiety → depressive symptoms. High CRP levels exacerbated the relationship between anxiety and neuropathic pain. GBR analysis confirmed IL-1α as the most significant feature predicting pain.</p><p><strong>Conclusions: </strong>The findings highlight IL-1α and CRP as key inflammatory markers associated with the relationship between pain, anxiety, and depressive symptoms. These results suggest the potential relevance of inflammation-related pathways in the clinical assessment of pain within the context of MDD.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of the Chinese healthy eating index and dietary diversity score with depressive and anxious symptoms among older adults.","authors":"Xinyan Ma, Hanqing Zhao, Yuhong Zhao, Chao Huang, Hao Ai, Minghui Sun","doi":"10.1186/s12888-026-08517-9","DOIUrl":"10.1186/s12888-026-08517-9","url":null,"abstract":"<p><strong>Background: </strong>Depression and anxiety significantly contribute to the mental health disease burden. Although healthy dietary patterns may mitigate mental distress, evidence regarding the associations of dietary quality and dietary diversity with mental health remains limited. This study aimed to investigate the independent and joint associations of the Chinese Healthy Eating Index (CHEI) and Dietary Diversity Score (DDS) with depression, anxiety, and their co-occurrence among Chinese older adults.</p><p><strong>Methods: </strong>We utilized cross-sectional data from the 2018 Chinese Longitudinal Healthy Longevity Survey, which included a total of 9,455 participants aged 65 years and older. The CHEI and DDS were applied to evaluate dietary quality and dietary diversity, respectively. We employed logistic regression models to examine these associations.</p><p><strong>Results: </strong>In the fully adjusted model, higher CHEI was associated with lower odds of depression (OR [odds ratio] _{tertile [T] 3 vs. T1}= 0.63, 95% CI [confidence interval]: 0.53, 0.75), anxiety (OR _{T3 vs. T1}= 0.61, 95% CI: 0.51, 0.74), and their co-occurrence (OR _{T3 vs. T1}= 0.66, 95% CI: 0.51, 0.84). A 10-unit increment in CHEI was associated with 33% lower odds of depression, 32% lower odds of anxiety, and 32% lower odds of their co-occurrence. Similarly, a higher DDS was inversely associated with the odds of depression (OR _{T3 vs. T1}= 0.59, 95% CI: 0.50, 0.70), anxiety (OR _{T3 vs. T1}= 0.56, 95% CI: 0.47, 0.67), and their co-occurrence (OR _{T3 vs. T1}= 0.60, 95% CI: 0.47, 0.76). Each one-unit increase in DDS was correlated with a 12% lower odds of depression, anxiety, and their co-occurrence. Moreover, compared to the group with low CHEI and low DDS, the group with high CHEI and high DDS showed significantly lower odds of depression, anxiety, and their co-occurrence.</p><p><strong>Conclusions: </strong>The study revealed that higher CHEI and DDS scores were inversely associated with depressive symptoms, anxious symptoms, and their co-occurrence among Chinese older adults. Additional longitudinal research is required to confirm our findings.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148954917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}