BMC Psychiatry最新文献

{"title":"A data-driven methodological framework for representative recruitment in psychiatric research: insights from the DOCUMENT study.","authors":"Benjamin J M Gooddy, Laila Rida, Bryony Goulding Mew, Ana Rita Moura, Timea Szentgyorgyi, Brandi Eiff, Luisa Schalk, Iman Rafiq, Cathy Davies, Daniel Martins, Lilla A Porffy, Christabel Gibson, Caroline Wooldridge, Giorgio Bergamini, Janet R Nicholson, Markus Waser, Elizabeth Tunbridge, Sigurd D Süssmuth, Valdemar Robert Janulczyk, Karla V Allebrandt, Adam Hampshire, Sukhwinder S Shergill, Steve Williams","doi":"10.1186/s12888-026-08442-x","DOIUrl":"10.1186/s12888-026-08442-x","url":null,"abstract":"<p><strong>Background: </strong>Slow participant recruitment is one of the predominant determinants of failure or delay across clinical research. Even when recruitment targets are met, study populations may be unrepresentative due to sampling biases introduced by recruitment pathways. However, the effectiveness and demographic consequences of recruitment strategies are frequently underreported, undermining the generalisability of clinical findings and contributing to research waste. This study provides a data-driven, quantitative evaluation of multimodal recruitment strategies in psychiatric research, leveraging insights from the DOCUMENT study to synthesise a methodological framework for effective and representative participant recruitment.</p><p><strong>Methods: </strong>Between June 2022 and December 2024, the study utilised a multimodal strategy to recruit participants with major depressive disorder (MDD), schizophrenia (SZ), and healthy volunteers (HV) for a two-phase study to investigate cognitive deficits across groups. Recruitment strategies included NHS clinical services, electronic health records, research registries, primary care sites, online and social media advertising, printed material, institutional resources, and word of mouth. For each avenue, yield, proportion of diagnostic group, recruitment rate, eligibility fraction, labour and financial cost, and demographic skew were quantified.</p><p><strong>Results: </strong>Across avenues, 194 participants were recruited (66 HV, 77 MDD and 51 SZ), with high retention (86-97%). Recruitment efficacy varied substantially by diagnostic group, with online advertising and research registries successfully recruiting MDD and HV participants but failing to recruit eligible people with SZ. Instead, SZ participants were primarily enrolled from labour-intensive clinical avenues (94%). Online recruitment showed higher accrual, but lower eligibility fraction compared to clinical pathways, revealing systematic sampling differences. Despite avenue-specific sampling biases, the multimodal approach yielded close demographic alignment to the 2021 UK Census for London in the study population. Data-driven adaptations, such as protocol amendments to eligibility criteria and online self-report triaging, improved study feasibility.</p><p><strong>Conclusions: </strong>No single recruitment avenue was identified as sufficient for both efficient and representative psychiatric recruitment. Instead, multimodal strategies were necessary to dilute avenue sampling biases. Synthesising 30 months of data, we introduce a 10-point framework for enhancing recruitment effectiveness, feasibility, and representativeness. While grounded in UK-based psychiatric research, these principles are likely transferable to broader clinical research contexts to reduce research waste.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103959","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":"Narrative exposure therapy for war-affected Middle Eastern refugees: a scoping review of outcomes, delivery contexts and implementation gaps.","authors":"Nathalie El Tawil, Tania Awad, Yara Rouhana, Nadine Zalaket, Elias Rahme","doi":"10.1186/s12888-026-08487-y","DOIUrl":"https://doi.org/10.1186/s12888-026-08487-y","url":null,"abstract":"<p><strong>Background: </strong>Refugees from the Middle East are exposed to multiple war-related and displacement-related stressors. Narrative Exposure Therapy (NET) and its child-adapted version (KIDNET) have been applied in various settings, but evidence remains scattered.</p><p><strong>Objective: </strong>To map the available evidence on NET/KIDNET among war-affected Middle Eastern refugees, focusing on outcomes, delivery contexts, study designs, and implementation gaps.</p><p><strong>Methods: </strong>Peer-reviewed articles were systematically reviewed by screening three electronic databases: PubMed, ScienceDirect and Scopus. Inclusion criteria included: studies published from 2015 to 2025, in English or French, involving Middle Eastern refugees or war-affected displaced populations, and reporting psychosocial outcomes after NET/KIDNET intervention.</p><p><strong>Results: </strong>A total of 24 studies met the inclusion criteria: 7 primary studies and 17 secondary studies. Most of the included studies highlighted the potential benefits of NET and its applicability among child and adult refugees. Findings showed significant reduction of Post-traumatic Stress Disorder (PTSD), with limited evidence regarding NET's impact on depression and anxiety. The review identified limitations in follow-up processes to assess sustainability of results as well as cultural adaptability of NET.</p><p><strong>Conclusion: </strong>NET may be beneficial, but evidence is heterogeneous and limited by study design, follow-up duration and contextual adaptation.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103974","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":"Neuroscience-guided bilateral thalamic MRI deep learning for obstructive sleep apnea diagnosis: a dual-center translational study.","authors":"Chong Tao, Saiyue Yu, Lin Han, Qiyuan Cai, Lingzi Meng, Yan Jiang, Lin Wang","doi":"10.1186/s12888-026-08472-5","DOIUrl":"10.1186/s12888-026-08472-5","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) remains substantially underdiagnosed, and recurrent intermittent hypoxia (IH) is a key pathophysiological feature of OSA and may affect thalamic function. We aimed to develop a neuroscience-guided MRI-based deep learning model for auxiliary OSA diagnosis.</p><p><strong>Methods: </strong>Male C57BL/6J mice were exposed to IH, and thalamic activation was assessed using immunofluorescence staining and in vivo calcium imaging. Clinical brain MRI and polysomnography (PSG) data were retrospectively collected from 760 adults across two centers. Center 1 was divided into training and validation cohorts, and center 2 served as an independent external test set. Based on the experimental findings, bilateral thalamic regions were segmented, and a dual-branch 3D CNN with Transformer-based feature fusion was developed.</p><p><strong>Results: </strong>IH induced prominent thalamic activation in mice, and central lateral thalamic nucleus (CL) showed the strongest relative response among the examined thalamic subregions. Compared with the control group, the IH group showed a marked increase in c-Fos-positive cells in the CL (62.50 ± 11.67 vs. 9.67 ± 4.89, n = 6, P < 0.0001). Further calcium signal recordings showed that calcium activity in the CL was significantly increased within the 1-minute time window after stimulation. In the human MRI cohort, the bilateral thalamic deep learning model achieved AUCs of 0.944 (95% CI, 0.926-0.960), 0.928 (95% CI, 0.893-0.957), and 0.911 (95% CI, 0.856-0.957) in the training, validation, and external test sets, respectively, outperforming the unilateral models (P < 0.001).</p><p><strong>Conclusions: </strong>IH-induced thalamic activation, with CL serving as a representative highly responsive thalamic subregion, provided experimental support for thalamic ROI selection. The bilateral thalamic MRI model provides a biologically grounded and externally validated imaging-based approach that may assist OSA identification.</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/PMC13560332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918310","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":"Sleep quality, circadian rhythm disruption, functioning, and treatment adherence in major depression: a cross-sectional exploratory study.","authors":"İrem Gedikli, Ece Alagöz","doi":"10.1186/s12888-026-08465-4","DOIUrl":"https://doi.org/10.1186/s12888-026-08465-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Sleep disturbances and circadian rhythm disruption are highly prevalent in major depressive disorder (MDD) and may contribute to poorer functioning and reduced treatment adherence. However, few studies have examined sleep quality, biological rhythm disruption, functioning, and medication adherence concurrently in an outpatient depression sample. This study investigated the relationships among sleep quality, biological rhythm, functional status, medication adherence, and depression severity in patients diagnosed with depression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A descriptive, correlational cross-sectional study was conducted in the Adult Psychiatry Outpatient Clinic of Maltepe University Faculty of Medicine Hospital between 16 December 2024 and 15 March 2025. A total of 110 patients with a confirmed diagnosis of depression were included. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), biological rhythm disruption using the Biological Rhythm Interview of Assessment in Neuropsychiatry (BRIAN), functional status using the Social Functioning Scale (SFS-T), medication adherence using the Medication Adherence Rating Scale (MARS), and depression severity using the Beck Depression Inventory (BDI). Pearson correlation analyses were used to examine associations among variables, and multiple linear regression analyses were conducted to identify independent factors associated with sleep quality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Sleep impairment was common: 46.4% of participants reported moderate sleep quality and 31.8% reported poor sleep quality. Mean PSQI score was 8.31 (SD = 4.21). Poorer sleep quality (higher PSQI scores) was moderately associated with lower social functioning (r = - 0.300, p &lt; 0.01) and lower medication adherence (r = - 0.350, p &lt; 0.01), and strongly associated with greater biological rhythm disruption (r = 0.621, p &lt; 0.01). Sleep quality was also positively correlated with depression severity (r = 0.494, p &lt; 0.01). Sleep impairment was common: 46.4% of participants reported moderate sleep quality and 31.8% reported poor sleep quality. Poorer sleep quality (higher PSQI scores) was moderately associated with lower social functioning (r = - 0.300, p &lt; 0.01) and lower medication adherence (r = - 0.350, p &lt; 0.01), and positively associated with biological rhythm disruption (r = 0.621, p &lt; 0.01) and depressive symptom severity (r = 0.494, p &lt; 0.01). In the multiple linear regression analysis, the overall model was statistically significant (R² = 0.429, p &lt; 0.001), explaining 42.9% of the variance in sleep quality. After adjustment for the other variables, biological rhythm disruption remained the only independent predictor of sleep quality (β = 0.445, p &lt; 0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In this outpatient depression sample, poor sleep quality was significantly associated with circadian rhythm disruption, reduced functioning, lower medication adherence, and greater depressiv","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":"149285056","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":"Alterations in local neural activity and functional connectivity density in first-episode and recurrent major depressive disorder: a resting-state fMRI study.","authors":"Kejing Zhang, Yue Chen, Ce Zhu, Qingli Mu, Yuwei Xu, Dong Cui, Peng Zhang, Shaojia Lu","doi":"10.1186/s12888-026-08456-5","DOIUrl":"10.1186/s12888-026-08456-5","url":null,"abstract":"<p><strong>Background: </strong>Recurrent major depressive disorder (RMDD) is typically associated with more severe symptoms and poorer prognosis compared to first-episode major depressive disorder (FMDD). However, the specific neuropathological differences between these two stages remain unclear. This study aimed to characterize and compare the abnormal intrinsic brain activity patterns in FMDD and RMDD patients to elucidate the mechanisms underlying the recurrence and progression of depression.</p><p><strong>Methods: </strong>This study included a total of 99 participants, consisting of 33 FMDD patients, 20 RMDD patients, and 46 healthy controls (HCs). All participants underwent resting-state functional magnetic resonance imaging scans. Resting-state data were preprocessed and analyzed using DPABI to compute four-dimensional spatial-temporal consistency of local neural activity (FOCA) and functional connectivity density (FCD) metrics. Between-group differences were assessed with an analysis of covariance (ANCOVA) (covarying for age, sex and mean framewise displacement), followed by region-of-interest extraction and correlation analyses with clinical measures.</p><p><strong>Results: </strong>Compared to HCs, both FMDD and RMDD groups showed reduced FOCA in the left superior parietal gyrus (SPG). Notably, the RMDD group exhibited significantly increased FOCA in the right inferior frontal gyrus (IFG), as well as elevated global and local FCD in the left anterior cingulate cortex (ACC) and right parahippocampal gyrus, compared to both FMDD and HCs. Furthermore, the aberrant FCD values in the left ACC were positively correlated with the number of depressive episodes and the Snaith-Hamilton Pleasure Scale (SHAPS) scores.</p><p><strong>Conclusion: </strong>The findings indicated distinct functional alterations in FMDD and RMDD, with enhanced functional connectivity of the left ACC potentially representing a key feature of functional dysregulation in RMDD.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13711862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149262289","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":"Plasma chromogranin a levels and their role in the etiology of anxiety disorders in children and adolescents.","authors":"Çiğdem Tanrıverdi, Bürge Kabukçu Başay, İhsan Kara, Engin Şebin","doi":"10.1186/s12888-026-08457-4","DOIUrl":"10.1186/s12888-026-08457-4","url":null,"abstract":"<p><strong>Background: </strong>Anxiety disorder is a common psychiatric condition in pediatric populations that may become chronic and impair functioning if left untreated. Chromogranin A (CgA) is a polypeptide co-secreted with catecholamines in response to stress and anxiety. The association between CgA and anxiety disorder has been investigated in adult populations; however, data in children and adolescents remain limited. This research sets out to analyze, for the first time, plasma CgA concentrations in medication-naïve children and adolescents diagnosed with anxiety disorders and to contrast these findings with data obtained from a control group.</p><p><strong>Methods: </strong>This cross-sectional study included 37 medication-naïve children and adolescents aged 9-18 years diagnosed with anxiety disorders and 34 controls with similar age and sex distributions. Plasma chromogranin A (CgA) concentrations were measured using an enzyme-linked immunosorbent assay (ELISA) and compared between the groups. The parents of all participants competed the SCARED Parent Form.</p><p><strong>Results: </strong>Total and subscale SCARED scores were significantly higher in the anxiety disorder group compared with controls (all p < 0.001). Plasma CgA levels exhibited no significant intergroup variation between AD and control groups (p > 0,05). Correlation analyses revealed no significant associations between plasma CgA levels and SCARED total or subscale scores (all p > 0.05). Among sociodemographic variables, only family structure differed significantly between the groups (p = 0.012).</p><p><strong>Conclusions: </strong>In pediatric populations, no significant difference in plasma CgA levels was observed between anxiety disorder and control groups, in contrast to findings in adult studies. This discrepancy may be related to developmental factors such as autonomic nervous system maturation and hormonal changes. Further studies are needed to clarify the role of CgA in the pathophysiology of anxiety disorders in children and adolescents.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149163409","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":"Plasma exosomal microRNA profiles associated with agitation symptoms in schizophrenia.","authors":"Yucheng Ling, Yifan Wang, Ruiqiu Zhu, Yilin Tang, Ran Tao, Yantong Li, Yuxiu Sui","doi":"10.1186/s12888-026-08459-2","DOIUrl":"https://doi.org/10.1186/s12888-026-08459-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Inflammatory dysregulation and synaptic dysfunction have been implicated in the pathophysiology of agitation in schizophrenia (SZ), but the underlying molecular mechanisms remain unclear. Plasma exosomal microRNAs (miRNAs) are stable circulating molecules that may reflect disease-related molecular alterations associated with schizophrenia. This study aimed to investigate plasma exosomal miRNA expression profiles and peripheral inflammatory factors in schizophrenia patients with agitation, and to identify potential biomarkers for agitation symptoms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this study, plasma exosomal miRNA expression profiles and peripheral inflammatory factors were compared between schizophrenia patients with agitation assessed within 24 h of hospital admission using PANSS-EC (SZA group, n = 35) and those without agitation (SZN group, n = 29). Differentially expressed plasma exosomal miRNAs were identified and subjected to GO and KEGG enrichment analyses. Peripheral inflammatory factors, including cytokine levels, neutrophil counts, and neutrophil-to-albumin ratio (NAR), were also measured. Partial correlation analyses (adjusting for age, sex, BMI, chlorpromazine equivalent, and diazepam equivalent) with Bonferroni correction were performed. A binary logistic regression (LR) model with forward stepwise selection (fixed covariates: age, sex, BMI, chlorpromazine equivalent, and diazepam equivalent) was constructed to identify discriminating factors, followed by receiver operating characteristic (ROC) curve analysis and five‑fold cross‑validation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 18 differentially expressed plasma exosomal miRNAs (15 upregulated, 3 downregulated) were identified in the SZA group. Target genes of upregulated miRNAs were enriched in MAPK and Ras signaling pathways, as well as cholinergic synapse and efferocytosis. Conversely, target genes of the downregulated miRNAs were specifically enriched in glutamatergic synapse. NAR showed a trend toward elevation in the SZA group (uncorrected p = 0.004, Bonferroni‑adjusted p = 0.088), while no significant differences in cytokine levels were observed. Partial correlation analysis revealed that in the SZA group, IL‑12p70 was positively correlated with miR‑3620‑5p (r = 0.893, adjusted p &lt; 0.001) and miR‑17‑3p (r = 0.768, adjusted p = 0.028). Multivariable logistic regression (including fixed covariates: age, sex, BMI, chlorpromazine equivalent, diazepam equivalent) retained NAR (OR = 3.778, p = 0.006) and miR‑543 (OR = 0.162, p = 0.026). The combined model (NAR + miR‑543 + fixed covariates) achieved an AUC of 0.812, outperforming single‑marker models (NAR AUC = 0.752, miR‑543 AUC = 0.715). Five‑fold cross‑validation yielded a mean AUC of 0.795 (95% CI 0.675-0.916), with sensitivity 80.1 ± 16.5%, specificity 79.5 ± 26.1%, and accuracy 77.8 ± 8.9%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The findings suggest that schizophrenia patients with agitation e","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149285147","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":"Interaction of serum resistin and smoking behavior in predicting depression risk: a sex-sensitive analysis.","authors":"Claudia von Zimmermann, Christian Weinland, Johannes Kornhuber, Bernd Lenz, Christiane Mühle","doi":"10.1186/s12888-026-08419-w","DOIUrl":"10.1186/s12888-026-08419-w","url":null,"abstract":"<p><strong>Background: </strong>Affective disorders often co-occur with behavioral risk factors like smoking, and chronic metabolic disorders like obesity or type 2 diabetes. One possible regulation factor in these comorbidities could be resistin, an adipokine involved in inflammation and insulin resistance. Here, we investigate these factors in depressed patients, in a sex-sensitive approach.</p><p><strong>Methods: </strong>We assessed depression symptoms in a sex-balanced cohort using the Beck Depression Inventory-II and the Male Depression Risk Scale. We further evaluated smoking behavior using self-report and the Fagerström Test for Nicotine Dependence. Resistin levels were measured in blood samples.</p><p><strong>Results: </strong>Higher resistin levels were associated with increased risk of major depressive disorder (MDD) in a sex- and smoking-dependent manner, with the strongest effect observed in female smokers and ex-smokers. No association was found between resistin and depression severity, while alcohol use emerged as the strongest predictor of masculine depression symptoms.</p><p><strong>Conclusion: </strong>This study demonstrates that resistin interacts with smoking and sex to increase MDD risk, particularly in female smokers/ex-smokers, highlighting the importance of preventive strategies targeting depression risk in women with comorbid risk behaviors such as smoking.</p><p><strong>Trial registration: </strong>German Clinical Trials Register ID DRKS00015291, registration date 2020-01-06, retrospectively registered.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13439829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673047","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":"Rapid and robust effects of high-dose intermittent Transcranial Brain Stimulation (iTBS) on depression and suicidal ideation in adolescents with acute major depression: a 10-day randomised, controlled, single-blind trial.","authors":"Yiling Yang, Qian Ye, Zhizhen Peng, Weiyu Cai, Jianzhao Wen, Jie Zhang, Yutao Lan","doi":"10.1186/s12888-026-08452-9","DOIUrl":"10.1186/s12888-026-08452-9","url":null,"abstract":"<p><strong>Background: </strong>Depression is extremely common among adolescents and can significantly increase the risk of suicide when severe. High-dose intermittent theta burst stimulation (iTBS) is a secure and efficacious physical treatment. However, clinical evidence in adolescents remains limited. This research is designed to assess the therapeutic impacts of high-dose iTBS on depressive symptoms, anxiety symptoms, and suicidal ideation in adolescents suffering from acute depression, along with the factors linked to treatment response.</p><p><strong>Methods: </strong>A total of 61 patients were randomly assigned to either the high-dose iTBS group or the sham stimulation group. All participants received 10 daily sessions of high dose iTBS stimulation over a two-week period, targeting the left dorsolateral prefrontal cortex (DLPFC). Outcome measures assessed at baseline, post-intervention, and 1-month follow-up included 24-item Hamilton Depression Rating Scale (HAMD-24) scores, Beck Scale for Suicide Ideation - Chinese Version (BSI-CV), and Hamilton Anxiety Rating Scale (HAMA). Clinical factors influencing iTBS efficacy were further analyzed.</p><p><strong>Result: </strong>At the end of the 10-day intervention, the high-dose iTBS group exhibited significantly lower HAMD-24 (p = 0.008, Cohen`s d = 0.71 [95%CI: 0.188-1.224]) and BSI-CV (p = 0.011, Cohen`s d = 0.67[95%CI: 0.154-1.186]) scores compared with the sham group, and this advantage persisted at the 1-month follow-up (Week 6) (HAMD-24: Cohen`s d = 0.96[ 95%CI: 0.43-1.49]; BSI-CV: Cohen`s d = 0.76[95%CI: 0.24-1.28]). In contrast, between-group differences in HAMA scores were non-significant both post-intervention (Week 2) and at the 1-month follow-up (Week 6) (p > 0.05). Moreover, poorer family functioning within the high-dose iTBS cohort was associated with diminished therapeutic benefit (p < 0.05).</p><p><strong>Conclusion: </strong>Current research indicates that a 10-day course of high-dose iTBS is effective in alleviating depressive symptoms and suicidal ideation in adolescents with depression, and that the therapeutic effects persist for up to one month after the end of treatment. We also found that high-dose iTBS was less effective in patients with poor baseline family functioning.</p><p><strong>Trial registration: </strong>Chinese clinical trial Registry (ChiCTR2500101152), trial registration date: April 21, 2025(retrospectively registered).</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13700522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149262264","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":"Investigating interpretation bias and stress responses as risk factors in children of parents with depression.","authors":"Tonya Frommelt, Leonie Bäumler, Nicolas Rohleder, Anna Bartosch, Lily Schneider, Charlotte Sumpf, Anca Sfärlea, Gerd Schulte-Körne, Belinda Platt","doi":"10.1186/s12888-026-08408-z","DOIUrl":"10.1186/s12888-026-08408-z","url":null,"abstract":"<p><strong>Background: </strong>Children of parents with depression, hereafter referred to as high-risk youth, are at elevated risk for mental illness, yet the mechanisms underlying this vulnerability remain unclear. Biased interpretation of ambiguous information and altered stress responses in this population have been proposed as potential pathways. As no previous study has examined these factors together, we investigated interpretation bias and endocrinological and affective stress responses as potential markers of depression vulnerability in high-risk children. We hypothesised that children of parents with depression would show more negative interpretation bias, altered cortisol stress responses and greater affective reactivity and prolonged recovery compared to children of parents with no mental illness. Across the sample, associations between interpretation bias and stress responses were expected.</p><p><strong>Method: </strong>Participants were 80 high-risk (parental depression) and 77 low-risk (no parental mental illness) youth aged 10 to 14 years. Mental health was assessed using structured clinical interviews. Interpretation bias was measured using the Scrambled Sentences Task, and stress reactivity and recovery were indexed by salivary cortisol and self-reported affect across six time points. Group differences were tested with t-tests and analyses of covariance. Regressions examined the unique contribution of familial risk status beyond other relevant factors, including depression, anxiety, childhood trauma, pubertal status, and sex. Correlations examined associations between interpretation bias and cortisol and affective stress indices.</p><p><strong>Results: </strong>Groups did not differ in interpretation bias, or cortisol or affective stress responses. Children's own symptoms of psychopathology (depression slightly more so than anxiety) positively predicted their interpretation bias but not their cortisol or affective stress responses. Exploratory moderation analyses showed that higher baseline cortisol strengthened the relationship between depression and interpretation bias. Interpretation bias correlated with cortisol reactivity and recovery within the high-risk but not the low-risk group.</p><p><strong>Conclusion: </strong>Contrary to theoretical accounts, high-risk youth did not exhibit cognitive, affective, or endocrinological vulnerabilities relative to low-risk peers. Interpretation bias was found to be a promising target, robustly linked to clinical outcomes and tentatively to cortisol stress responses, though its absence in high-risk youth is in support of a more selective intervention approach.</p><p><strong>Trial registration: </strong>The study was preregistered under the Deutsches Register Klinischer Studien DRKS00028842 on August 19, 2022.</p>","PeriodicalId":9029,"journal":{"name":"BMC Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13419086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618060","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}