BMC Psychiatry最新文献

{"title":"Assessment of depression and pain in the general population: a scoping review.","authors":"Kira Schubert, Kathrin Wandscher, Kathrin Jobski, Sonja Sydekum, Carsten Bantel, Falk Hoffmann","doi":"10.1186/s12888-026-08510-2","DOIUrl":"10.1186/s12888-026-08510-2","url":null,"abstract":"<p><strong>Background: </strong>Depression and pain, which often overlap, are highly prevalent in the general population. However, the available evidence synthesis on their comorbidity is limited to specific patients. We aimed to give an overview on the assessment of co-occurring depression and pain in the general population focusing on measurements for both disorders.</p><p><strong>Methods: </strong>This scoping review was registered ( https://doi.org/10.17605/OSF.IO/DCE3Q ) and received no funding. MEDLINE (via PubMed), PsycINFO (via EBSCOhost) and EMBASE (via Elsevier) were searched from inception to 10th of December 2024. Cross-sectional and cohort studies with ≥ 100 participants ≥ 14 years, presenting prevalences and/or effect estimates for both depression and pain were included. Data analysis was performed following the principles of Arksey and O´Malley.</p><p><strong>Results: </strong>We screened 16.916 records and included 60 studies reported in 61 articles, published between 2001 and 2024, of which 42 were cross-sectional and 18 were cohort-studies. Depression was assessed with 19 different measurements, including 17 instruments (most often CES-D, GDS and PHQ), and 2 question based measures. Pain was assessed with 20 different measurements, including 17 instruments (most often VAS, BPI and FPS-R), and 3 question-based measures. The reported comorbid prevalence varied: pain by depression 6.8-87% (median: 50.2%; n = 12) and depression by pain 11-84.5% (median: 46.5%; n = 14).</p><p><strong>Conclusion: </strong>Depression and pain show high mutual comorbidity in the general population (about 50%), but measurements in the literature were heterogenous in terms of versions, cut-offs, definitions or assessed characteristics. In patients with either depression or pain, we propose a standardized initial assessment also considering the multidimensionality of pain.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760058","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":"Psychiatric, anesthetic, and procedural characteristics of modified electroconvulsive therapy courses in adolescents treated in a tertiary child and adolescent psychiatry service: a 15-year retrospective cohort study.","authors":"Alper Alnak, Ceyhan Oflezer","doi":"10.1186/s12888-026-08520-0","DOIUrl":"10.1186/s12888-026-08520-0","url":null,"abstract":"<p><strong>Background: </strong>Evidence on electroconvulsive therapy (ECT) in adolescents is largely retrospective and rarely reports psychiatric outcomes together with anesthetic and procedural characteristics. We characterized modified ECT courses in a tertiary child and adolescent psychiatry service.</p><p><strong>Methods: </strong>This retrospective cohort included adolescents aged 13-18 years treated with modified ECT from 2010 to 2025; the ECT course was the unit of analysis. Illness severity was rated with the Clinical Global Impression-Severity (CGI-S) scale at admission and discharge. The primary outcome was a composite of any documented hemodynamic event, prolonged seizure, or recovery/behavioral event; short or absent seizures were analyzed separately as a technical seizure-adequacy outcome. Logistic models used standard errors clustered by patient.</p><p><strong>Results: </strong>Among 156 ECT courses in 150 adolescents (1,465 sessions), diagnoses were schizophrenia spectrum (46.2%), bipolar spectrum (23.1%), neurodevelopmental (18.6%), and depressive disorders (12.2%). Median CGI-S decreased from 5.0 at admission to 3.0 at discharge, with a study-defined decrease of at least 2 points in 152 courses (97.4%) and a discharge CGI-S of 2 or less in 60 (38.5%). The primary composite event occurred in 63 courses (40.4%), involving one event domain in 49 (31.4%) and two or more in 14 (9.0%). Short or absent seizures occurred in 42 courses (26.9%); theophylline use was associated with higher odds of this outcome, most plausibly reflecting confounding by indication. Estimates for age, bipolar spectrum disorder, and succinylcholine dose were imprecise and hypothesis-generating.</p><p><strong>Conclusions: </strong>In this severe tertiary cohort, ECT-centered inpatient care was associated with substantial within-course global improvement, and acute course-level events were common but usually confined to a single domain. Acute anesthesia- or procedure-related events and technical seizure adequacy should be reported separately, and exploratory dose or medication associations should not be interpreted causally.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126756","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":"Implementing modular competence-oriented psychotherapy in inpatient psychiatry: a three-year analysis of restraint and seclusion.","authors":"Lisa Magdalena Störkel, Johanna Hepp, Yannik Bendel, Michael Franz, Sara Franz","doi":"10.1186/s12888-026-08468-1","DOIUrl":"10.1186/s12888-026-08468-1","url":null,"abstract":"<p><strong>Background: </strong>Coercive measures remain used in psychiatric care, despite ongoing ethical concerns and efforts to minimize their application. Psychotherapeutic or competence-oriented frameworks may contribute to reducing situations that lead to coercion, yet empirical evidence is scarce.</p><p><strong>Objective: </strong>This naturalistic study examined whether the introduction of Modular Competence-Oriented Psychotherapy (MCP) at site A was associated with changes in the frequency and duration of coercive measures (2022-2024), compared to site B providing treatment as usual.</p><p><strong>Methods: </strong>Routinely collected inpatient data from two psychiatric sites in Germany were analyzed retrospectively (n = 15,361 cases). Generalized linear models assessed annual changes in the use of restraint and seclusion. Linear models examined changes in the duration of restraint and seclusion episodes.</p><p><strong>Results: </strong>Overall, the probability of coercive measures was significantly higher at site B than at site (A). At site A, the likelihood and duration of restraint and the duration of seclusion significantly declined over time, while the likelihood of seclusion remained stable. Except for seclusion duration, time trends did not differ significantly between sites. For seclusion duration, site A showed a significantly stronger decline than site (B). Descriptively, assaults decreased at site A but remained stable at site B.</p><p><strong>Conclusions: </strong>Implementation of MCP at site A was associated with reductions in the duration of restraint and seclusion, without indications of increased risk events. Although the naturalistic design and concurrent changes at site B preclude causal conclusions, the findings offer preliminary evidence for the feasibility and potential value of integrating a competence-oriented psychotherapeutic framework in psychiatry.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13445883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148676999","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":"Defining a minimal clinically important difference for the Vanderbilt ADHD Parent Rating Scale in children with Attention-Deficit/Hyperactivity Disorder.","authors":"Shuaishuai Deng, Lili Cai, Qiuhan Cai, Siyuan Hu, Jianting Wu, Yao Zhang","doi":"10.1186/s12888-026-08462-7","DOIUrl":"10.1186/s12888-026-08462-7","url":null,"abstract":"<p><strong>Background: </strong>Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental condition in children and adolescents that poses substantial challenges to health, functioning, and well-being. This study aimed to estimate the minimal clinically important difference (MCID) for the Chinese version of the Vanderbilt ADHD Parent Rating Scale (VAFPRS) and its key score domains using anchor-based and distribution-based methods.</p><p><strong>Methods: </strong>In this multicenter prospective observational study, 99 children aged 4-17 years who were diagnosed with ADHD were recruited from four tertiary hospitals in China. Caregivers completed the VAFPRS at baseline and follow-up and the Clinical Global Impression-Improvement (CGI-I) scale at follow-up. MCID values were estimated using the anchor-based median change method, the receiver operating characteristic (ROC) curve method, and the distribution-based 0.5 standard deviation (SD) method.</p><p><strong>Results: </strong>A total of 81 patients completed the follow-up assessment. CGI-I scores were significantly correlated with changes in the total VAFPRS score, core symptoms, inattention, and hyperactivity/impulsivity (r = 0.38-0.43, all p < 0.01). The corresponding anchor-based median MCID estimates were - 8, -5, - 2, and - 3, respectively. ROC curve analysis yielded lower thresholds for these domains (- 3.5, - 2.5, - 1.5, and - 2.5), with acceptable discrimination (AUC ≥ 0.70) for identifying improvement.</p><p><strong>Conclusion: </strong>This study estimated MCID values for the Chinese VAFPRS in children and adolescents with ADHD. Anchor-based median estimates derived from the minimally improved CGI-I group were - 8 for the total score, - 5 for core symptoms, - 2 for inattention, and - 3 for hyperactivity/impulsivity. ROC-derived thresholds were lower and may provide complementary classification cutoffs for identifying improvement status.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079627","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":"Modeling suicidal thoughts and behaviors in university students: integrating suicide theory with interpretable machine learning.","authors":"Li-Chung Lin, Chih-Han Leng, Grace Yao","doi":"10.1186/s12888-026-08171-1","DOIUrl":"10.1186/s12888-026-08171-1","url":null,"abstract":"<p><p>University students are at risk of suicidal thoughts and behaviors (STB), with prevalence rates higher than those in the general population. Machine learning (ML) enhances the accuracy of STB prediction and provides new possibilities and explanatory frameworks for this issue. This study extends prior research in two ways: (1) by employing, for the first time, a sample of Taiwanese university students and (2) by synthesizing suicide-related theoretical knowledge and empirical findings to identify individual, risk, and protective factors. Based on these elements, a comprehensive ML-based prediction model of STB among university students was developed with four analytic modes to evaluate the relative importance and contributions of three predictor categories. Using data from the NTU Students' Physical and Mental Health Assessment System, a total of 3,901 students were retained in the current study, with 13 self-report assessments administered. Classic logistic regression and five ML classifiers (e.g., bagged LR, RF, LightGBM, linear SVM, and RBF SVM) were utilized. Compared with traditional statistical methods, ML algorithms improved prediction of STB among high‑risk students. RF and LightGBM performed best, with similar results in Mode 2 (risk factor only) and Mode 4 (integrated individual, risk, and protective factors), both outperforming Mode 3 (protective factor only) and Mode 1 (individual factor only). Ultimately, this study enhances the interpretability of ML-based models for predicting STB. Moreover, it provides researchers with deeper insights for developing systematic prediction models and offers a screening tool for identifying university students at high risk of STB.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13439907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148676980","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":"Resting-state fMRI-based machine learning for predicting SSRI treatment response in major depressive disorder.","authors":"Yuxuan Hu, Jinrui Gao, Yaoze Liu, Rui Zhong, Zixuan Wu, Juan Qiao","doi":"10.1186/s12888-026-08336-y","DOIUrl":"10.1186/s12888-026-08336-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Major Depressive Disorder (MDD) is a prevalent mental health condition with significant societal impact. Although prior research has highlighted the brain changes modulated by antidepressant therapy, their efficacy and effectiveness are debated. The low rates of treatment response still existed in the pharmacological therapy of MDD. Exploring an optimal neurological predictor of symptom improvement caused by pharmacotherapy is urgently needed for improving response to treatment. Our purpose is to develop a predictive model for MDD therapy using machine learning techniques based on resting-state fMRI metrics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 116 MDD patients underwent 3.0T resting-state magnetic resonance image scanning. Demographic data and the 24-item Hamilton Depression Rating Scale (HAMD-24) were collected from all participants. An additional independent cohort of 25 MDD patients was included for external model validation. Based on the reduction rate of HAMD-24 scores at different time points, the patients were divided into an early improvement group, an early response group, and a clinical response group: (1) Early improvement group: HAMD-24 reduction rate ≥ 20% after 1 week of treatment; (2) Early response group: HAMD-24 reduction rate ≥ 25% after 2 weeks of treatment; (3) Clinical response group: HAMD-24 reduction rate ≥ 50% after 4 weeks of treatment. For model construction, LASSO regression was applied for feature selection, integrating identified brain regions, HAMD-24 symptom clusters, and clinical variables. Five machine learning models were established based on features screened by the LASSO regression model to predict treatment response in MDD. All models were trained and assessed using 10-fold cross-validation, the most stable logistic regression model was selected for external validation in a temporally independent cohort (n = 25).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;At 1 week, alterations were mainly observed in the frontal and sensorimotor regions. At 2 weeks, differences were found in the opercular, postcentral, orbitofrontal, temporal, and angular areas. At 4 weeks, additional abnormalities appeared in the frontal, occipital, and postcentral cortices. Moreover, right Postcentral gyru was found to be present in the differential brain regions observed at 1 week, 2 weeks, and 4 weeks comparisons. In addition, ten features related to the treatment response were identified using the LASSO regression model, including age, years of education, core depressive symptoms, and several brain region features primarily involving the postcentral gyrus. Among the constructed machine learning models, the Logistic Regression model based on LASSO-selected features (including age, education, core depressive symptoms, and the postcentral gyrus) demonstrated the most stable performance. It achieved an area under the curve (AUC) of 0.801 in the internal validation and maintained robust predictive performance in th","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13439837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673027","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":"Suicide prevention through a SafetyPlan intervention for patients after a suicide attempt or in a suicidal crisis (SAFETY+): a study protocol of a randomised-controlled trial in acute inpatient psychiatric care.","authors":"Mariam Yunusah, Lena Marie Hensel, Tobias Teismann, Peter Brieger, Hermann Spießl, Yekaterina Pashutina, Sarah Sophia Michna, Chiara Spielmann, Marlene Stadler, Johanna Freund, Susanne Menzel, Chaimae El Hammadi, Johannes Hamann","doi":"10.1186/s12888-026-08483-2","DOIUrl":"10.1186/s12888-026-08483-2","url":null,"abstract":"<p><strong>Background: </strong>Individuals undergoing acute inpatient psychiatric treatment or who have recently been discharged face an especially elevated risk of suicide. Nevertheless, suicide-specific interventions are still not routinely implemented in inpatient psychiatric care in Germany. Safety plan interventions (SPIs), which involve developing individualised safety plans, have been shown to be highly effective in reducing the number of suicide attempts. Due to their simplicity and low resource requirements, they may be suitable for broad implementation. However, there is currently a lack of evidence regarding their effectiveness in inpatient psychiatric settings in Germany. This study addresses this critical research gap by investigating whether the SAFETY+ intervention can reduce suicide attempts within twelve months of discharge from a German inpatient psychiatric setting compared to usual care. Additionally, the research project will focus on the implementation of the intervention.</p><p><strong>Method: </strong>This mixed-methods study combines a randomised controlled trial (RCT) with qualitative interviews of participants and professionals involved in treatment and study implementation. In the RCT, 450 patients with acute suicidality will be recruited from three large psychiatric clinics in Bavaria. Participants will be randomly assigned to either the SafetyPlan group (n = 225) or the treatment-as-usual group (n = 225). The intervention includes a manualised SafetyPlan intervention (SPI) session during hospitalisation and telephone follow-up sessions one and four weeks after discharge. Data will be collected at five time points: after consenting to participate (T0a) and shortly before discharge (T0b), as well as at follow-ups six weeks (T1), six months (T2) and twelve months (T3) after discharge.</p><p><strong>Discussion: </strong>The findings of this study can be transferred directly into standard psychiatric practice since the study is embedded in routine clinical care. The study encompasses both urban areas (Munich) and rural areas with limited outpatient resources (e.g., the Bavarian Forest region, a rural area in Eastern Bavaria), thereby enhancing the generalisability of the results to other psychiatric care settings with similar structures across Germany. Should the procedure prove effective, the findings may promote future nationwide implementation efforts.</p><p><strong>Trial registration: </strong>This trial is registered with the German Clinical Trials Register (DRKS), ID: DRKS00037168, registered on 07 July 2025. URL: https://www.drks.de/DRKS00037168 .</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673000","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 transdiagnostic network of childhood trauma, anxiety, and depression in college students: centrality of emotional neglect and the bridging function of emotional abuse.","authors":"Yang He, Jian Yang, Yanjie Duan, Yaru Sun, Jinhui Hu, Ning Chen, Wei Liu","doi":"10.1186/s12888-026-08451-w","DOIUrl":"https://doi.org/10.1186/s12888-026-08451-w","url":null,"abstract":"<p><strong>Background: </strong>College students are highly susceptible to anxiety and depression, for which childhood trauma (CT) is a major risk factor. However, the fine-grained pathways linking specific CT subtypes to these disorders remain unclear, limiting targeted intervention. This study aimed to use network analysis to investigate the associations between CT subtypes and symptoms of anxiety, depression, and their comorbidities among college students.</p><p><strong>Methods: </strong>A cross-sectional online survey was conducted among 2,864 students from nine Chinese universities. Participants completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). Three regularized partial correlation networks (CT-anxiety, CT-depression, and CT-comorbidity) were constructed using the R package. Expected influence (EI) and bridge expected influence (BEI) indices were used to identify central and bridge nodes. Network stability was assessed via case-dropping bootstrapping.</p><p><strong>Results: </strong>Emotional neglect consistently emerged as the most central node across all three networks. In the CT-anxiety network, emotional abuse and \"afraid something will happen\" were key bridging nodes. In the CT-depression network, emotional abuse and \"thoughts of death\" possessed the greatest degree of bridge centrality. Critically, in the CT-comorbidity network, this same pairing again exhibited the strongest bridge centrality, demonstrating its stable role as a transdiagnostic bridge linking CT to both anxiety and depression, even within comorbid presentations.</p><p><strong>Conclusions: </strong>Emotional neglect, emotional abuse, and the key symptoms \"afraid something will happen\" and \"thoughts of death\" emerge as the central and bridge nodes linking CT to anxiety, depression, and their comorbidity. These nodes represent precise targets for early intervention to reduce the mental health burden among college students.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13483618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787823","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":"Metabolic bridge between sleep disturbances and depression: mediating effects of insulin resistance and clinical implications.","authors":"Fan Zhang, Wenjian Li","doi":"10.1186/s12888-026-08464-5","DOIUrl":"https://doi.org/10.1186/s12888-026-08464-5","url":null,"abstract":"<p><strong>Background: </strong>This study's objective was to investigate the mediating role of insulin resistance (IR) in the association between sleep disturbances and depression and reveal its underlying biological mechanisms and clinical implications.</p><p><strong>Methods: </strong>The present study's sample population was derived from data collected during the period of 2005 to 2014 as part of the National Health and Nutrition Examination Survey. The total sample size comprised 20,510 adults. The utilization of multidimensional sleep assessment (sleep duration, trouble sleeping, and sleep disorders), the PHQ-9 depression scale, and clinically validated IR indicators (METS-IR, TyG, and TyG-BMI) was undertaken to parse associations between variables and quantify mediating effects. This was accomplished by constructing multivariable adjusted modeling, restricted cubic spline modeling, causal-mediation analytic frameworks, and using multiple imputation techniques to address missing data.</p><p><strong>Results: </strong>The results of the study indicated a significant association between sleep disturbances and depression. Sleep disturbances were defined as trouble sleeping, sleep disorders, and poor sleep patterns. Additionally, there was a significant positive association between IR indicators and depression. Following the implementation of confounder adjustment, a unit increase in METS-IR was associated with a 2% increase in the prevalence of depression (OR = 1.02, 95% CI: 1.01-1.02). The ORs for TyG and TyG-BMI were 1.36 (95% CI: 1.26-1.45) and 1.01 (95% CI: 1.01-1.01), respectively. The relationship between sleep disturbances and depression was partially mediated by IR, with mediation ratios ranging from 1.94% to 7.34%. The most substantial mediating effect (7.34%) was observed for TyG-BMI. Furthermore, it was observed that individuals with poorer sleep quality exhibited an elevated prevalence of IR and depression (P for trend < 0.001). The mediating effect of IR indicators remained significant after multiple imputations were used to address missing variables.</p><p><strong>Conclusion: </strong>IR constitutes a significant biological mechanism that links sleep disturbances to depression. The enhancement of sleep quality and the regulation of IR may be pivotal in preventing and managing depression. Future studies should further validate the causality and mechanism of this relationship and explore effective interventions.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149285100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transdiagnostic child mental health trajectories in Japan: protocol for a nationwide web‑based open cohort study.","authors":"Takashi Yamada, Kohei Kurita, Tomoko Nishimura, Makoto Fujii, Arika Yoshizaki, Tomoka Yamamoto, Yoshiko Iwatani, Ikuko Hirata, Eiko Honaga, Ryo Kimura, Masaya Tachibana, Ikuko Mohri, Ryo Kawasaki, Masayuki Endo, Nagahide Takahashi, Taiichi Katayama, Kenji J Tsuchiya, Kuriko Kagitani-Shimono","doi":"10.1186/s12888-026-08463-6","DOIUrl":"10.1186/s12888-026-08463-6","url":null,"abstract":"<p><strong>Background: </strong>Preventive psychiatry requires longitudinal, transdiagnostic data from before adolescence, yet such data are scarce. We propose a nationwide, digital, open cohort in Japan to track mental health trajectories from birth to late adolescence using multi-informant assessments (caregivers and adolescents) within a transdiagnostic, biopsychosocial framework. Diagnosis-open recruitment will combine community-facing dissemination with clinically linked neurodevelopmental enrichment (e.g. autism spectrum disorder and attention-deficit/hyperactivity disorder), addressing underrepresentation of neurodivergent children and adolescents alongside neurotypical peers. An optional saliva sub-cohort will support genetic and epigenetic analyses. This design will characterize risk and protective factors and their developmental timing to inform stage-specific prevention and early intervention.</p><p><strong>Methods: </strong>From February 2026, approximately 7,000 children and caregivers (up to ~14,000 individuals) will be recruited nationwide from community and clinical settings into a longitudinal online cohort. Eligible participants are caregivers aged ≥ 18 years of children and adolescents aged 0-18 years; adolescents aged 13-18 years will also complete self-reports. Enrollment and annual follow-ups will use a secure web platform integrated with LINE, a widely used communication app in Japan. Validated questionnaires will annually assess mental health and development: caregivers report on all children, and adolescents provide self-reports. The principal repeated transdiagnostic outcome is the caregiver-reported Strengths and Difficulties Questionnaire (SDQ) Total Difficulties score across ages 2-18 years. Adolescent self-reported scores will be analyzed as complementary informant-specific secondary outcomes. Longitudinal mixed-effects models will examine developmental changes and associations with risk and protective factors, with exploratory genetic and epigenetic analyses.</p><p><strong>Discussion: </strong>This large longitudinal cohort will generate insights into child and adolescent mental health trajectories in Japan. Following participants from infancy through adolescence will help identify early risk and resilience indicators across traditional diagnoses. Integrating multi-informant surveys with genetic and epigenetic data will clarify how biological, psychological, and social factors interact over time. Nationwide digital recruitment aims to broaden geographic reach and reduce burden; representativeness will be empirically evaluated and findings interpreted cautiously. Results will inform the timing and targets of stage-specific preventive and early interventions in community and clinical settings.</p><p><strong>Trial registration: </strong>Japan Registry of Clinical Trials (jRCT), jRCT1050250205. Registered on 26 January 2026.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918415","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}