BMC Psychiatry最新文献

{"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}

{"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":"Sex differences in associations between sleep architecture and CBC-derived immune cell indices in MDD with comorbid insomnia.","authors":"Qi Wang, Manli Deng, Yixu Wang, Dongqi Gu, Wei Zhu, Limin Chen, Jun Wang, Peipei Luan","doi":"10.1186/s12888-026-08470-7","DOIUrl":"https://doi.org/10.1186/s12888-026-08470-7","url":null,"abstract":"<p><strong>Background: </strong>Insomnia symptoms and alterations in sleep architecture are core pathophysiological features of Major Depressive Disorder (MDD). While sex differences in MDD prevalence and symptomatology are well documented, the specific interplay between sleep architecture and complete blood count (CBC)-derived immune cell indices, metabolic markers, and thyroid-related parameters remains under-characterized with respect to sex.</p><p><strong>Methods: </strong>This study included 126 patients with MDD and comorbid insomnia (43 males, 83 females). All participants underwent overnight polysomnography (PSG) and fasting blood biochemical analysis. Sex-specific associations between objective sleep parameters and peripheral biomarkers were analyzed using age-adjusted partial Spearman correlation and multiple linear regression models with interaction terms.</p><p><strong>Results: </strong>Female patients had longer REM sleep latency and N2 sleep duration, whereas male patients had a higher apnea-hypopnea index. Females had higher HDL-C levels, while males had higher monocyte counts. In age-adjusted FDR-corrected correlation analyses, significant associations involving CBC-derived immune cell counts were observed primarily in male patients, where lymphocyte count was associated with TST, REM sleep duration, N1%, and N2 sleep duration; no significant CBC-derived immune cell count correlations remained in female patients. In multivariable interaction analyses with FDR correction, sex × lymphocyte interaction terms remained significant for TMA, REM sleep duration, and REM sleep duration relative to TST.</p><p><strong>Conclusion: </strong>These findings suggest that sex may shape both the subjective-objective expression of sleep disturbance and lymphocyte-related sleep regulation in patients with MDD and comorbid insomnia. The pattern of poorer subjective sleep quality despite relatively favorable selected PSG characteristics in females, together with sex-dependent lymphocyte associations involving REM sleep and arousal measures, warrants further validation in larger longitudinal studies.</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":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149294279","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":"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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13715088/pdf/","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":"OA","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13715222/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and associated factors of suicidal ideation, suicide plans, and suicide attempts among nurses: a systematic review and meta-analysis.","authors":"Wen Huang, Bin Wan, Chuanrui Yang, Jiezheng Hu, Qilei Jia","doi":"10.1186/s12888-026-08426-x","DOIUrl":"https://doi.org/10.1186/s12888-026-08426-x","url":null,"abstract":"<p><strong>Background: </strong>Suicide-related outcomes among nurses represent an important occupational mental health concern; however, evidence regarding their prevalence and associated factors remains fragmented. This systematic review and meta-analysis aimed to estimate the pooled prevalence of suicidal ideation (SI) and suicide plans (SP) among nurses, narratively summarize suicide attempts (SA), and synthesize associated factors.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, Scopus, Embase, PsycINFO, Web of Science, the Cochrane Library, and four Chinese databases (CNKI, CBM, VIP, and Wanfang) from inception to November 1, 2025. Random-effects models were used to estimate pooled prevalence, 95% confidence intervals (CIs), and 95% prediction intervals (PIs) for SI and SP. Subgroup analyses and meta-regression were conducted to explore heterogeneity. Publication bias for SI was assessed using a funnel plot and Egger's test. Associated factors were synthesized narratively, and SA-related findings were summarized narratively because of limited available data and substantial heterogeneity.</p><p><strong>Results: </strong>A total of 1,840 records were initially identified, and 55 articles representing 54 independent studies across 18 countries were included. The pooled prevalence was 12.8% (95% CI: 10.1%-15.7%; 95% PI: 3.2%-36.3%; I² = 99.0%) for SI and 5.0% (95% CI: 3.8%-6.4%; 95% PI: 1.6%-17.6%; I² = 70.2%) for SP, indicating substantial heterogeneity for SI and moderate-to-high heterogeneity for SP. In subgroup analyses, SI prevalence varied by country, geographical region, and recall period. By country, SI prevalence ranged from 6.1% in Spain to 15.5% in Ireland. Regionally, Asia showed the highest SI prevalence (15.7%), followed by Europe (10.8%) and North America (8.6%). Across recall periods, SI prevalence was highest for past-week recall (18.1%) and lowest for past-month recall (8.1%). Meta-regression indicated a negative association between mean age and SI prevalence (R² = 25.86%). SA was reported in a limited number of studies and was summarized narratively because of heterogeneity in measurement and populations. Associated factors spanned multiple domains, with psychological and occupational factors most frequently reported.</p><p><strong>Conclusions: </strong>SI and SP are relatively common among nurses, whereas evidence on SA remains limited. The wide prediction intervals suggest that pooled prevalence estimates should be interpreted as summary measures of heterogeneous evidence rather than precise estimates applicable to all nurse populations. Suicide-related outcomes among nurses appear to be influenced by individual psychological factors as well as occupational and contextual conditions, highlighting the need for targeted mental health support and workplace-based preventive strategies.</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":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149294313","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}