Dysfunction of the interoceptive system is recognized as an important component of clinical symptoms,including anxiety,depression,psychosis,and other mental disorders.Non-invasive neuromodulation is an emerging clinic...Dysfunction of the interoceptive system is recognized as an important component of clinical symptoms,including anxiety,depression,psychosis,and other mental disorders.Non-invasive neuromodulation is an emerging clinical intervention approach,and over the past decade,research on non-invasive neuromodulation aimed at regulating interoception has rapidly developed.This review first outlines the pathways of interoceptive signals and assessment methods,then summarizes the interoceptive abnormalities in psychiatric disorders and current studies for non-invasive neuromodulation targeting interoception,including intervention modes,target sites,interoceptive measures,and potential neurobiological mechanisms.Finally,we discuss significant research challenges and future directions.展开更多
The inability to access brain tissue has greatly hindered our ability to study and care for individuals suffering from psychiatric and neurological conditions.Critics have questioned efforts to develop peripheral bloo...The inability to access brain tissue has greatly hindered our ability to study and care for individuals suffering from psychiatric and neurological conditions.Critics have questioned efforts to develop peripheral blood biomarkers in neurological and psychiatric disorders based on the assertion that disease pathology is limited to the brain.The discovery that all tissues,including the brain,release extracellular vesicles(Raposo and Stoorvogel,2013)and cell free DNAs(Chan et al.,2013)into various body fluids has provided a potential way to measure activity from inaccessible tissues like the central nervous system(CNS)and has given rise to the term“liquid biopsy.”The development of liquid biopsies that can diagnose and predict the course of psychiatric and neurological disorders would be transformative.The ability to predict episodic events such as mania,depression,and risk for suicide would be particularly useful for psychiatric care as it would enable the development of interventions that prevent mortality and improve outcomes.Additionally,biomarkers that are informative about drug response and aid in treatment decisions would be a significant advance in psychiatric care as it would prevent patients from having to endure multiple courses of ineffective treatments and side effects.展开更多
The extensive spread of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)throughout China in late 2022 has underscored the correlation between this virus and severe psychiatric disorders.However,there remain...The extensive spread of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)throughout China in late 2022 has underscored the correlation between this virus and severe psychiatric disorders.However,there remains a lack of reported clinical and pathological features.Accordingly,we retrospectively reviewed the electronic medical records of psychiatric inpatients for seven days from early January 2023.Twenty-one inpatients who developed first-episode psychiatric disorders within two weeks after SARS-CoV-2 infection were recruited,while 24 uninfected first-episode psychiatric inpatients were selected as controls.Comparative analyses of clinical manifestations,routine laboratory tests,and imaging examinations were performed.Our investigation demonstrated a 330%increase in the incidence of first-episode psychiatric inpatients after SARS-CoV-2 infection in 2023,compared with the preceding year without SARS-CoV-2 infections.Most cases exhibited psychiatric symptoms within one week of SARS-CoV-2 infection,which resolved after approximately two weeks,with no residual symptoms after three months.One-way ANOVA demonstrated a significant difference in the highest fever temperature between inpatients with and without psychotic symptoms.Infected inpatients displayed elevated levels of interleukin-4,interleukin-8,and interferon-α,but decreased levels of eosinophils and basophils.These findings suggest that SARS-CoV-2 may contribute to the development of psychiatric disorders,likely mediated by the virus-induced inflammatory response and neuronal dysfunction in the context of psychological distress.展开更多
Premenstrual and menstrual exacerbation of psychiatric disorders is a significant area of concern in female mental health.Many females experience a worsening of psychiatric symptoms in the premenstrual and menstrual p...Premenstrual and menstrual exacerbation of psychiatric disorders is a significant area of concern in female mental health.Many females experience a worsening of psychiatric symptoms in the premenstrual and menstrual phases of their menstrual cycle,including heightened anxiety,depression,irritability,and mood swings.These exacerbations are most commonly associated with premenstrual syndrome and premenstrual dysphoric disorder that are characterized by severe emotional and physical symptoms that interfere with daily functioning.The hormonal fluctuations during the menstrual cycle,particularly changes in estrogen and progesterone levels,are believed to play a pivotal role in these exacerbations.Psychiatric disorders such as depression,anxiety,bipolar disorder,and schizophrenia may be influenced by these hormonal changes,with many females reporting an increase in symptom severity during specific phases of the cycle.The mechanisms behind this phenomenon remain complex,with both biological and psychosocial factors contributing to the heightened vulnerability.Clinical management includes careful monitoring of symptom patterns in relation to the menstrual cycle,with treatment options ranging from lifestyle modifications and psychotherapy to pharmacological interventions such as antidepressants and hormonal therapies.Understanding the link between menstruation and psychiatric disorders is essential for improving diagnosis and tailoring effective treatment strategies for affected individuals.展开更多
Insulin plays a crucial role in the metabolic priming and proliferation of neural stem cells(NSCs).However,insulin resistance(IR)is associated with impaired NSC proliferation and cognitive dysfunction,which are the ha...Insulin plays a crucial role in the metabolic priming and proliferation of neural stem cells(NSCs).However,insulin resistance(IR)is associated with impaired NSC proliferation and cognitive dysfunction,which are the hallmarks of psychiatric disorders(PDs).In addition to insulin,de novo lipogenesis(DNL)also plays an essential role in NSC proliferation and function as it supplies fatty acids for membrane phospholipid synthesis and cell signaling.However,enhanced DNL is associated with lipid/fatty acid accumulation,IR,and impaired NSC proliferation.Intriguingly,data from lipidomic studies suggest that DNL could be enhanced before the onset of classical symptoms in patients with PDs.Further,evidence suggests that patients with PDs may develop IR during childhood or before adolescence;therefore,DNL could be enhanced preceding the development of IR.Regarding treatment,while most antidepressants and antipsychotic drugs have been shown to further deteriorate IR and stimulate DNL,various adjunctive drugs/therapies,including chemical,physical,and stem cell therapy,which have shown promising success in treating PDs,reduce DNL while enhancing insulin sensitivity,NSC proliferation,and cognitive function in laboratory animals.Preliminary clinical outcomes and future prospects of these adjunctive drugs/therapies,especially stem cell therapy in treating PDs including schizophrenia and depression,are discussed.展开更多
BACKGROUND Brain-computer interface(BCI)technology is rapidly advancing in psychiatry.Informed consent competency(ICC)assessment among psychiatric patients is a pivotal concern in clinical research.AIM To analyze the ...BACKGROUND Brain-computer interface(BCI)technology is rapidly advancing in psychiatry.Informed consent competency(ICC)assessment among psychiatric patients is a pivotal concern in clinical research.AIM To analyze the assessment of ICC and form a framework with multi-dimensional elements involved in ICC of BCI clinical research among psychiatric disorders.METHODS A systematic review of studies regarding ICC assessments of BCI clinical research in patients with six kinds of psychiatric disorders was conducted.A systematic literature search was performed using PubMed,ScienceDirect,and Web of Science.Peer-reviewed articles and full-text studies were included in the analysis.There were no date restrictions,and all studies published up to February 27,2025,were included.RESULTS A total of 103 studies were selected for this review.Fifty-eight studies included ICC factors,and forty-five were classified in ICC related ethical issues of BCI research in six kinds of psychiatric disorders.Executive function impairment is widely recognized as the most significant factor impacting ICC,and processing speed deficits are observed in schizophrenia,mood disorders,and Alzheimer’s disease.Memory dysfunction,particularly episodic and working memory,contributes to compromised ICC.Five core ethical issues in BCI research should be addressed:BCI specificity,vulnerability,autonomy,dynamic ICC,comprehensiveness,and uncertainty.CONCLUSION A Five-Dimensional evaluative framework,including clinical,ethical,sociocultural,legal,and procedural dimensions,is constructed and proposed for future ICC research in BCI clinical research involving psychiatric disorders.展开更多
BACKGROUND Speech and language therapy(ST)might moderate the prognosis in children with attention deficit and hyperactivity disorder(ADHD)comorbid with speech delay.This study investigated whether ST in children with ...BACKGROUND Speech and language therapy(ST)might moderate the prognosis in children with attention deficit and hyperactivity disorder(ADHD)comorbid with speech delay.This study investigated whether ST in children with ADHD is associated with a decreased risk of subsequent psychiatric disorders.AIM To investigate whether ST in children with ADHD is associated with a decreased risk of subsequent psychiatric disorders.METHODS The population-based National Health Insurance Research Database in Taiwan was used.Hazards of subsequent psychiatric disorders were compared between those who received ST and a propensity-score matched comparison group by Cox regression analyses.RESULTS Of 11987 children with ADHD identified from the dataset,2911(24%)had received ST.The adjusted hazard ratio for any subsequent recorded psychiatric disorder was 0.72(95%confidence interval:0.63-0.82)in children who received ST compared to the matched counterparts.This protective association was only statistically significant in the subgroup that received both medication and behavioral interventions.CONCLUSION ST can moderate the effects of integrated early interventions in ADHD children with speech delay.展开更多
BACKGROUND Non-alcoholic fatty liver disease(NAFLD)and alcohol-related liver disease(Ar-LD)constitute the primary forms of chronic liver disease,and their incidence is progressively increasing with changes in lifestyl...BACKGROUND Non-alcoholic fatty liver disease(NAFLD)and alcohol-related liver disease(Ar-LD)constitute the primary forms of chronic liver disease,and their incidence is progressively increasing with changes in lifestyle habits.Earlier studies have do-cumented a correlation between the occurrence and development of prevalent mental disorders and fatty liver.AIM To investigate the correlation between fatty liver and mental disorders,thus ne-cessitating the implementation of a mendelian randomization(MR)study to elu-cidate this association.METHODS Data on NAFLD and ArLD were retrieved from the genome-wide association studies catalog,while information on mental disorders,including Alzheimer's disease,schizophrenia,anxiety disorder,attention deficit hyperactivity disorder(ADHD),bipolar disorder,major depressive disorder,multiple personality dis-order,obsessive-compulsive disorder(OCD),post-traumatic stress disorder(PTSD),and schizophrenia was acquired from the psychiatric genomics consor-tium.A two-sample MR method was applied to investigate mediators in signifi-cant associations.RESULTS After excluding weak instrumental variables,a causal relationship was identified between fatty liver disease and the occurrence and development of some psychia-tric disorders.Specifically,the findings indicated that ArLD was associated with a significantly elevated risk of developing ADHD(OR:5.81,95%CI:5.59-6.03,P<0.01),bipolar disorder(OR:5.73,95%CI:5.42-6.05,P=0.03),OCD(OR:6.42,95%CI:5.60-7.36,P<0.01),and PTSD(OR:5.66,95%CI:5.33-6.01,P<0.01).Meanwhile,NAFLD significantly increased the risk of developing bipolar disorder(OR:55.08,95%CI:3.59-845.51,P<0.01),OCD(OR:61.50,95%CI:6.69-565.45,P<0.01),and PTSD(OR:52.09,95%CI:4.24-639.32,P<0.01).CONCLUSION Associations were found between genetic predisposition to fatty liver disease and an increased risk of a broad range of psychiatric disorders,namely bipolar disorder,OCD,and PTSD,highlighting the significance of preven-tive measures against psychiatric disorders in patients with fatty liver disease.展开更多
Psychiatric disorders and heart abnormality are closely interconnected.Previous knowledge has been well-established that psychiatric disorders can lead to increased cardiovascular morbidity and even sudden cardiac dea...Psychiatric disorders and heart abnormality are closely interconnected.Previous knowledge has been well-established that psychiatric disorders can lead to increased cardiovascular morbidity and even sudden cardiac death.Conversely,whether heart abnormality contributes to psychiatric disorders remains rarely studied.The work by Zhang et al pointed out that chronic heart failure had effects on the anxiety and depression(AD)severity,and indices including left ventricular ejection fraction,N-terminal pro-brain natriuretic peptide and interleukin-6 were independent risk factors for AD severity.In addition to the aforementioned AD,we herein find that heart failure might additionally impact the development of autism spectrum disorder and post-traumatic stress disorder(albeit P>0.05),and significantly protects against the presence of attention deficit hyperactivity disorder(ADHD),[odds ratio(OR)=0.61,P=0.0071]by using a Mendelian randomization analysis.Bradycardia is also a protective factor for ADHD(OR=0.61,P=0.0095),whereas hypertrophic cardiomyopathy is a mild risk factor for schizophrenia(OR=1.02,P=0.032).These data suggest a wide spectrum of psychiatric disorders secondary to heart abnormality,and we highlight more psychiatric care that should be paid to patients with heart abnormality.展开更多
This article revisits the links between psychopathology and functional gastrointestinal disorders such as irritable bowel syndrome （IBS）, discusses the rational use of antidepressants as well as non-pharmacological ...This article revisits the links between psychopathology and functional gastrointestinal disorders such as irritable bowel syndrome （IBS）, discusses the rational use of antidepressants as well as non-pharmacological approaches to the management of IBS, and suggests guidelines for the treatment of IBS based on an interdisciplinary perspective from the present state of knowledge. Relevant published literature on psychiatric disorders, especially somatization disorder, in the context of [BS, and literature providing direction for management is reviewed, and new directions are provided from findings in the literature. IBS is a heterogeneous syndrome with various potential mechanisms responsible for its clinical presentations. IBS is typically complicated with psychiatric issues, unexplained symptoms, and functional syndromes in other organ systems. Most IBS patients have multiple complaints without demonstrated cause, and that these symptoms can involve systems other than the intestine, e.g. bones and joints （fibromyalgia, temporomandibular joint syndrome）, heart （non-cardiac chest pain）, vascular （post-menopausal syndrome）, and brain （anxiety, depression）. Host IBS patients do not have psychiatric illness per se, but a range of psychoform （psychological complaints in the absence of psychiatric disorder） symptoms that accompany their somatoform （physical symptoms in the absence of medical disorder） complaints. It is not correct to label IBS patients as psychiatric patients （except those more difficult patients with true somatization disorder）. One mode of treatment is unlikely to be universally effective or to resolve most symptoms. The techniques of psychotherapy or cognitive-behavioral therapy can allow IBS patients to cope more readily with their illness. Specific episodes of depressive or anxiety disorders can be managed as appropriate for those conditions. Medications designed to improve anxiety or depression are not uniformly useful for psychiatric complaints in IBS, because the psychoform symptoms that sound similar to those seen in psychiatric disorders may not have the same significance in patients with IBS.展开更多
A number of brain research projects have recently been carried out to study the etiology and mechanisms of psychiatric disorders.Although psychiatric disorders are part of the brain sciences,psychiatrists still diagno...A number of brain research projects have recently been carried out to study the etiology and mechanisms of psychiatric disorders.Although psychiatric disorders are part of the brain sciences,psychiatrists still diagnose them based on subjective experience rather than by gaining insights into the pathophysiology of the diseases.Therefore,it is urgent to have a clear understanding of the etiology and pathogenesis of major psychiatric diseases,which can help in the development of effective treatments and interventions.Artificial intelligence(AI)-based applications are being quickly developed for psychiatric research and diagnosis,but there is no systematic review that summarizes their applications.For this reason,this study briefly reviews three main brain observation techniques used to study psychiatric disorders-namely,magnetic resonance imaging(MRI),electroencephalography(EEG),and kinesics-based diagnoses-along with related AI applications and algorithms.Finally,we discuss the challenges,opportunities,and future study directions of AI-based applications.展开更多
Transcranial magnetic stimulation(TMS)has been established as an important and effective treatment for various psychiatric disorders.However,its effectiveness has likely been limited due to the dearth of neuronavigati...Transcranial magnetic stimulation(TMS)has been established as an important and effective treatment for various psychiatric disorders.However,its effectiveness has likely been limited due to the dearth of neuronavigational tools for targeting purposes,unclear ideal stimulation parameters,and a lack of knowledge regarding the physiological response of the brain to TMS in each psychiatric condition.Modern optical imaging modalities,such as functional near-infrared spectroscopy and diffuse optical tomography,are promising tools for the study of TMS optimization and functional targeting in psychiatric disorders.They possess a unique combination of high spatial and temporal resolutions,portability,real-time capability,and relatively low costs.In this mini-review,we discuss the advent of optical imaging techniques and their innovative use in several psychiatric conditions including depression,panic disorder,phobias,and eating disorders.With further investment and research in the development of these optical imaging approaches,their potential will be paramount for the advancement of TMS treatment protocols in psychiatry.展开更多
SLC6A4 （solute carrier family 6, member 4） gene encodes a serotonin transporter （5-hydroxytryptamine transporter, HTT）, which transports synaptic serotonin into presynaptic terminal. SLC6A4 is known to be the targ...SLC6A4 （solute carrier family 6, member 4） gene encodes a serotonin transporter （5-hydroxytryptamine transporter, HTT）, which transports synaptic serotonin into presynaptic terminal. SLC6A4 is known to be the target of antidepressants such as selective serotonin reuptake inhibitors （SSRIs）. Inhibition of HTT increases synaptic serotonin concentration and thereby exerts antidepressant efficacy. A large number of genetic studies suggest the contribution of genetic variations of SLC6A4 to various psychiatric disorders. The most studied genetic variation, HTT-linked polymorphic region （HTTLPR）,展开更多
Background: The purpose of this retrospective study was to examine the clinical outcomes of patients with concomitant lung cancer and psychiatric disorders who underwent pulmonary resection at our institution and deve...Background: The purpose of this retrospective study was to examine the clinical outcomes of patients with concomitant lung cancer and psychiatric disorders who underwent pulmonary resection at our institution and develop a strategy for treating such patients in the future. Methods: We retrospectively reviewed 23 patients with psychiatric disorders who underwent pulmonary resection for lung cancer at our institution between January 1984 and December 2011. Results: The study population comprised 13 men and 10 women with an average age of 67.4 years. The histological types of lung cancer included adenocarcinoma in 14 patients, squamous cell carcinoma in 4, and other types in 5. Fifteen patients were classified as having pathological TNM stage I cancer, four as having stage II, three as having stage III, and one as having stage IV. The coexisting psychiatric disorders were neurosis in eight patients, depression in seven, schizophrenia in five, dementia in two, and oligophrenia in one. Three patients were admitted without a full understanding of the operation. There were no major complications with the exception of delirium, which was seen in eight patients. None of these patients’ coexisting psychiatric disorders worsened. No perioperative death occurred. Conclusions: At our institution, we cooperate closely with psychiatrists to care for surgical patients with psychiatric disorders. There is a possibility that such cooperation will reduce the frequency of previously reported complications.展开更多
Psychedelics,encompassing both classical and non-classical categories,are psychoactive substances known for inducing hallucinations as well as a range of cognitive and emotional effects[1].Archeological studies have d...Psychedelics,encompassing both classical and non-classical categories,are psychoactive substances known for inducing hallucinations as well as a range of cognitive and emotional effects[1].Archeological studies have demonstrated that both classical psychedelics and non-classical psychedelics have been used for medical purposes for centuries.Moreover,accumulating evidence supports the idea that psychedelics can regulate mood disturbances and psychiatric disorders.展开更多
To the Editor, Human herpesvirus 6 (HHV-6) comprises two double-stranded DNA viruses, HHV-6A and HHV-6B, which are distinguished based on antibody reactivity, T-cell clone reactivity, and restriction banding patterns....To the Editor, Human herpesvirus 6 (HHV-6) comprises two double-stranded DNA viruses, HHV-6A and HHV-6B, which are distinguished based on antibody reactivity, T-cell clone reactivity, and restriction banding patterns.[1] The International Committee on Taxonomy of Viruses has recently classified these as two distinct viral species.[2] HHV-6B is the primary causative agent of roseola infantum, while the pathogenic mechanisms of HHV-6A remain less well understood. Serological studies indicate that over 95% of adults are seropositive for one or both HHV-6 variants, which establish latency following primary infection. These viruses persist primarily in T-cells and bone marrow progenitor cells.[3] In vitro studies have demonstrated HHV-6B latency in astrocytes, while HHV-6A has been shown to remain latent in oligodendrocytes.[4] Both viral types are capable of modulating the immune system, promoting immunosuppressive effects and chronic inflammatory pathways.展开更多
Background Epilepsy is a chronic neurological disorder marked by a persistent tendency to generate seizures,leading to substantial cognitive,behavioral,and psychosocial consequences.This study investigated psychiatric...Background Epilepsy is a chronic neurological disorder marked by a persistent tendency to generate seizures,leading to substantial cognitive,behavioral,and psychosocial consequences.This study investigated psychiatric disorder-related adverse events(AEs)associated with antiseizure medications(ASMs)in children using the Food and Drug Administration Adverse Event Reporting System(FAERS)database.Methods This study conducted a comprehensive analysis of FAERS data from 2004 to 2024,focusing on psychiatric AEs in children with epilepsy or seizures treated with ASMs.Signal values were computed using reporting odds ratio(ROR),proportional reporting ratio(PRR),Bayesian Confdence Propagation Neural Network(BCPNN),and Multi-item Gamma Poisson Shrinker(MGPS).Results A total of 2539 preferred terms(PTs)were included,involving 25 system organ classifcations(SOCs).Nervous system,skin and subcutaneous tissue,and psychiatric disorders are the three most common SOCs for ASMs in children.There were 24 ASMs,whose AEs involved psychiatric disorders,totaling 110 PTs and 214 drug-PT relationships.Psychotic symptoms(notably lorazepam and topiramate,n=116 and 109),substance dependence and abuse(notably pregabalin and clonazepam,n=291 and 110),and the other neuropsychiatric symptoms(notably levetiracetam and valproic acid,n=70 and 62)were the common types of psychiatric disorder-related AEs of ASMs in children.A total of nine ASMs(brivaracetam,clonazepam,diazepam,eslicarbazepine,gabapentin,lamotrigine,lorazepam,perampanel,and tiagabine)were associated with suicidal and self-injurious behavior in children.Conclusions This study highlights psychiatric AEs of ASMs in children,ofering critical insights to improve clinical medication practices and enhance treatment safety.Further research with broader clinical data is needed to promote safe and rational medication use.展开更多
A growing interest in the comprehensive pathogenic mechanisms of psychiatric disorders from the perspective of the microbiome has been witnessed in recent decades;the intrinsic link between microbiota and brain functi...A growing interest in the comprehensive pathogenic mechanisms of psychiatric disorders from the perspective of the microbiome has been witnessed in recent decades;the intrinsic link between microbiota and brain function through the microbiota-gut-brain axis or other pathways has gradually been realized.However,little research has focused on viruses–entities characterized by smaller dimensions,simpler structures,greater diversity,and more intricate interactions with their surrounding milieu compared to bacteria.To date,alterations in several populations of bacteriophages and viruses have been documented in both mouse models and patients with psychiatric disorders,including schizophrenia,major depressive disorder,autism spectrum disorder,and Alzheimer’s disease,accompanied by metabolic disruptions that may directly or indirectly impact brain function.In addition,eukaryotic virus infection-mediated brain dysfunction provides insights into the psychiatric pathology involving viruses.Efforts towards virus-based diagnostic and therapeutic approaches have primarily been documented.However,limitations due to the lack of large-scale cohort studies,reliability,clinical applicability,and the unclear role of viruses in microbiota interactions pose a challenge for future studies.Nevertheless,it is conceivable that investigations into viruses herald a new era in the field of precise psychiatry.展开更多
Whether associations between psychiatric disorders and hospitalization for cardiovascular diseases(CVDs)can be modified by disease susceptibility and the temporal pattern of these associated CVDs remain unknown.In our...Whether associations between psychiatric disorders and hospitalization for cardiovascular diseases(CVDs)can be modified by disease susceptibility and the temporal pattern of these associated CVDs remain unknown.In our study,we conducted a matched cohort study of the UK Biobank including 44,430 patients with common psychiatric disorders(anxiety,depression,and stress-related disorders)between 1997 and 2019,together with 222,150 sex-,Townsend deprivation index-,and birth year-individually matched unexposed individuals.The hazard ratios(HRs)for CVD hospitalization associated with a prior psychiatric disorder were derived from Cox models,adjusted for multiple confounders.We then stratified the analyses by self-reported family history of CVD and CVD polygenic risk score(PRS)calculated based on summary statistics of independent genome-wide association studies.We further conducted disease trajectory analysis and visualized the temporal pattern of CVDs after common psychiatric disorders.During a mean follow-up of 12.28 years,we observed an elevated risk of CVD hospitalization among patients with psychiatric disorders,compared with matched unexposed individuals(hazard ratios[HRs]=1.20,95%confidence interval[CI]:1.18–1.23),especially during the first six months of follow-up(1.72[1.55–1.91]).The stratification analyses by family history of CVD and by CVD PRS obtained similar estimates between subgroups with different susceptibilities to CVD.We conducted trajectory analysis to visualize the temporal pattern of CVDs after common psychiatric disorders,identifying primary hypertension,acute myocardial infarction,and stroke as three main intermediate steps leading to further increased risk of other CVDs.In conclusion,the association between common psychiatric disorders and subsequent CVD hospitalization is not modified by predisposition to CVD.Hypertension,acute myocardial infarction,and stroke are three initial CVDs linking psychiatric disorders to other CVD sequelae,highlighting a need of timely interven-tion on these targets to prevent further CVD sequelae among all individuals with common psychiatric disorders.展开更多
The alteration of gene expression is not restricted to transcriptional regulation but includes a variety of posttranscriptional mechanisms;however,the role of the latter in many diseases remains relatively unknown.By ...The alteration of gene expression is not restricted to transcriptional regulation but includes a variety of posttranscriptional mechanisms;however,the role of the latter in many diseases remains relatively unknown.By using an RNA-Seq dataset of 1510 brain samples from individuals with autism spectrum disorder(ASD),bipolar disorder(BD),schizophrenia(SCZ),and controls,we assessed the contribution of post-transcriptional dysregulation and identified top perturbators accountable for transcriptomic alterations in neuropsychiatric disorders.Approximately 30%of the expression variability was attributed to post-transcriptional dysregulation.Interestingly,mature mRNA levels tended to be post-transcriptionally downregulated in SCZ and BD,leading to the inhibition of neurogenesis and neural differentiation,while they were upregulated in ASD,resulting in enhanced activity of apoptosis.These findings imply contrasting pathologies involving RNA metabolism across neuropsychiatric disorders.An RNA-binding protein,ELAVL3,was predicted to be significantly involved in the disruption of post-transcriptional regulation in all three disorders.To validate this,we knocked down its expression in cerebral organoids.Not only did the differentially expressed genes in ELAVL3 knockdown cover a considerable proportion of predicted targets in the three disorders,but we also found that neurogenesis was significantly affected,given the diminished proliferation and consequently reduced size of the organoids.The present study extends the current understanding of the link between post-transcriptional regulation and neuropsychiatric disorders and provides new potential therapeutic targets for early intervention.展开更多
基金supported by grants from the National Natural Science Foundation of China(82101582)the Shanghai Science and Technology Committee(22Y11903600 and 23Y11906000)the Shanghai Municipal Health Commission(202240266).
文摘Dysfunction of the interoceptive system is recognized as an important component of clinical symptoms,including anxiety,depression,psychosis,and other mental disorders.Non-invasive neuromodulation is an emerging clinical intervention approach,and over the past decade,research on non-invasive neuromodulation aimed at regulating interoception has rapidly developed.This review first outlines the pathways of interoceptive signals and assessment methods,then summarizes the interoceptive abnormalities in psychiatric disorders and current studies for non-invasive neuromodulation targeting interoception,including intervention modes,target sites,interoceptive measures,and potential neurobiological mechanisms.Finally,we discuss significant research challenges and future directions.
基金supported by Department of Defense grant HT9425-24-1-0030 a grant from the Stanley Medical Research Institute(to SS).
文摘The inability to access brain tissue has greatly hindered our ability to study and care for individuals suffering from psychiatric and neurological conditions.Critics have questioned efforts to develop peripheral blood biomarkers in neurological and psychiatric disorders based on the assertion that disease pathology is limited to the brain.The discovery that all tissues,including the brain,release extracellular vesicles(Raposo and Stoorvogel,2013)and cell free DNAs(Chan et al.,2013)into various body fluids has provided a potential way to measure activity from inaccessible tissues like the central nervous system(CNS)and has given rise to the term“liquid biopsy.”The development of liquid biopsies that can diagnose and predict the course of psychiatric and neurological disorders would be transformative.The ability to predict episodic events such as mania,depression,and risk for suicide would be particularly useful for psychiatric care as it would enable the development of interventions that prevent mortality and improve outcomes.Additionally,biomarkers that are informative about drug response and aid in treatment decisions would be a significant advance in psychiatric care as it would prevent patients from having to endure multiple courses of ineffective treatments and side effects.
基金supported by the National Natural Science Foundation of China(Grant Nos.81971289 and 81871344)。
文摘The extensive spread of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)throughout China in late 2022 has underscored the correlation between this virus and severe psychiatric disorders.However,there remains a lack of reported clinical and pathological features.Accordingly,we retrospectively reviewed the electronic medical records of psychiatric inpatients for seven days from early January 2023.Twenty-one inpatients who developed first-episode psychiatric disorders within two weeks after SARS-CoV-2 infection were recruited,while 24 uninfected first-episode psychiatric inpatients were selected as controls.Comparative analyses of clinical manifestations,routine laboratory tests,and imaging examinations were performed.Our investigation demonstrated a 330%increase in the incidence of first-episode psychiatric inpatients after SARS-CoV-2 infection in 2023,compared with the preceding year without SARS-CoV-2 infections.Most cases exhibited psychiatric symptoms within one week of SARS-CoV-2 infection,which resolved after approximately two weeks,with no residual symptoms after three months.One-way ANOVA demonstrated a significant difference in the highest fever temperature between inpatients with and without psychotic symptoms.Infected inpatients displayed elevated levels of interleukin-4,interleukin-8,and interferon-α,but decreased levels of eosinophils and basophils.These findings suggest that SARS-CoV-2 may contribute to the development of psychiatric disorders,likely mediated by the virus-induced inflammatory response and neuronal dysfunction in the context of psychological distress.
文摘Premenstrual and menstrual exacerbation of psychiatric disorders is a significant area of concern in female mental health.Many females experience a worsening of psychiatric symptoms in the premenstrual and menstrual phases of their menstrual cycle,including heightened anxiety,depression,irritability,and mood swings.These exacerbations are most commonly associated with premenstrual syndrome and premenstrual dysphoric disorder that are characterized by severe emotional and physical symptoms that interfere with daily functioning.The hormonal fluctuations during the menstrual cycle,particularly changes in estrogen and progesterone levels,are believed to play a pivotal role in these exacerbations.Psychiatric disorders such as depression,anxiety,bipolar disorder,and schizophrenia may be influenced by these hormonal changes,with many females reporting an increase in symptom severity during specific phases of the cycle.The mechanisms behind this phenomenon remain complex,with both biological and psychosocial factors contributing to the heightened vulnerability.Clinical management includes careful monitoring of symptom patterns in relation to the menstrual cycle,with treatment options ranging from lifestyle modifications and psychotherapy to pharmacological interventions such as antidepressants and hormonal therapies.Understanding the link between menstruation and psychiatric disorders is essential for improving diagnosis and tailoring effective treatment strategies for affected individuals.
文摘Insulin plays a crucial role in the metabolic priming and proliferation of neural stem cells(NSCs).However,insulin resistance(IR)is associated with impaired NSC proliferation and cognitive dysfunction,which are the hallmarks of psychiatric disorders(PDs).In addition to insulin,de novo lipogenesis(DNL)also plays an essential role in NSC proliferation and function as it supplies fatty acids for membrane phospholipid synthesis and cell signaling.However,enhanced DNL is associated with lipid/fatty acid accumulation,IR,and impaired NSC proliferation.Intriguingly,data from lipidomic studies suggest that DNL could be enhanced before the onset of classical symptoms in patients with PDs.Further,evidence suggests that patients with PDs may develop IR during childhood or before adolescence;therefore,DNL could be enhanced preceding the development of IR.Regarding treatment,while most antidepressants and antipsychotic drugs have been shown to further deteriorate IR and stimulate DNL,various adjunctive drugs/therapies,including chemical,physical,and stem cell therapy,which have shown promising success in treating PDs,reduce DNL while enhancing insulin sensitivity,NSC proliferation,and cognitive function in laboratory animals.Preliminary clinical outcomes and future prospects of these adjunctive drugs/therapies,especially stem cell therapy in treating PDs including schizophrenia and depression,are discussed.
基金Supported by the Ministry of Science and Technology of the People's Republic of China(2021ZD0201900)Project 5,No.2021ZD0201905Capital’s Funds for Health Improvement and Research,No.CFH 2022-2-4115.
文摘BACKGROUND Brain-computer interface(BCI)technology is rapidly advancing in psychiatry.Informed consent competency(ICC)assessment among psychiatric patients is a pivotal concern in clinical research.AIM To analyze the assessment of ICC and form a framework with multi-dimensional elements involved in ICC of BCI clinical research among psychiatric disorders.METHODS A systematic review of studies regarding ICC assessments of BCI clinical research in patients with six kinds of psychiatric disorders was conducted.A systematic literature search was performed using PubMed,ScienceDirect,and Web of Science.Peer-reviewed articles and full-text studies were included in the analysis.There were no date restrictions,and all studies published up to February 27,2025,were included.RESULTS A total of 103 studies were selected for this review.Fifty-eight studies included ICC factors,and forty-five were classified in ICC related ethical issues of BCI research in six kinds of psychiatric disorders.Executive function impairment is widely recognized as the most significant factor impacting ICC,and processing speed deficits are observed in schizophrenia,mood disorders,and Alzheimer’s disease.Memory dysfunction,particularly episodic and working memory,contributes to compromised ICC.Five core ethical issues in BCI research should be addressed:BCI specificity,vulnerability,autonomy,dynamic ICC,comprehensiveness,and uncertainty.CONCLUSION A Five-Dimensional evaluative framework,including clinical,ethical,sociocultural,legal,and procedural dimensions,is constructed and proposed for future ICC research in BCI clinical research involving psychiatric disorders.
文摘BACKGROUND Speech and language therapy(ST)might moderate the prognosis in children with attention deficit and hyperactivity disorder(ADHD)comorbid with speech delay.This study investigated whether ST in children with ADHD is associated with a decreased risk of subsequent psychiatric disorders.AIM To investigate whether ST in children with ADHD is associated with a decreased risk of subsequent psychiatric disorders.METHODS The population-based National Health Insurance Research Database in Taiwan was used.Hazards of subsequent psychiatric disorders were compared between those who received ST and a propensity-score matched comparison group by Cox regression analyses.RESULTS Of 11987 children with ADHD identified from the dataset,2911(24%)had received ST.The adjusted hazard ratio for any subsequent recorded psychiatric disorder was 0.72(95%confidence interval:0.63-0.82)in children who received ST compared to the matched counterparts.This protective association was only statistically significant in the subgroup that received both medication and behavioral interventions.CONCLUSION ST can moderate the effects of integrated early interventions in ADHD children with speech delay.
文摘BACKGROUND Non-alcoholic fatty liver disease(NAFLD)and alcohol-related liver disease(Ar-LD)constitute the primary forms of chronic liver disease,and their incidence is progressively increasing with changes in lifestyle habits.Earlier studies have do-cumented a correlation between the occurrence and development of prevalent mental disorders and fatty liver.AIM To investigate the correlation between fatty liver and mental disorders,thus ne-cessitating the implementation of a mendelian randomization(MR)study to elu-cidate this association.METHODS Data on NAFLD and ArLD were retrieved from the genome-wide association studies catalog,while information on mental disorders,including Alzheimer's disease,schizophrenia,anxiety disorder,attention deficit hyperactivity disorder(ADHD),bipolar disorder,major depressive disorder,multiple personality dis-order,obsessive-compulsive disorder(OCD),post-traumatic stress disorder(PTSD),and schizophrenia was acquired from the psychiatric genomics consor-tium.A two-sample MR method was applied to investigate mediators in signifi-cant associations.RESULTS After excluding weak instrumental variables,a causal relationship was identified between fatty liver disease and the occurrence and development of some psychia-tric disorders.Specifically,the findings indicated that ArLD was associated with a significantly elevated risk of developing ADHD(OR:5.81,95%CI:5.59-6.03,P<0.01),bipolar disorder(OR:5.73,95%CI:5.42-6.05,P=0.03),OCD(OR:6.42,95%CI:5.60-7.36,P<0.01),and PTSD(OR:5.66,95%CI:5.33-6.01,P<0.01).Meanwhile,NAFLD significantly increased the risk of developing bipolar disorder(OR:55.08,95%CI:3.59-845.51,P<0.01),OCD(OR:61.50,95%CI:6.69-565.45,P<0.01),and PTSD(OR:52.09,95%CI:4.24-639.32,P<0.01).CONCLUSION Associations were found between genetic predisposition to fatty liver disease and an increased risk of a broad range of psychiatric disorders,namely bipolar disorder,OCD,and PTSD,highlighting the significance of preven-tive measures against psychiatric disorders in patients with fatty liver disease.
基金Supported by the National Natural Science Foundation of China,No.82070285,No.82322033 and No.82470265.
文摘Psychiatric disorders and heart abnormality are closely interconnected.Previous knowledge has been well-established that psychiatric disorders can lead to increased cardiovascular morbidity and even sudden cardiac death.Conversely,whether heart abnormality contributes to psychiatric disorders remains rarely studied.The work by Zhang et al pointed out that chronic heart failure had effects on the anxiety and depression(AD)severity,and indices including left ventricular ejection fraction,N-terminal pro-brain natriuretic peptide and interleukin-6 were independent risk factors for AD severity.In addition to the aforementioned AD,we herein find that heart failure might additionally impact the development of autism spectrum disorder and post-traumatic stress disorder(albeit P>0.05),and significantly protects against the presence of attention deficit hyperactivity disorder(ADHD),[odds ratio(OR)=0.61,P=0.0071]by using a Mendelian randomization analysis.Bradycardia is also a protective factor for ADHD(OR=0.61,P=0.0095),whereas hypertrophic cardiomyopathy is a mild risk factor for schizophrenia(OR=1.02,P=0.032).These data suggest a wide spectrum of psychiatric disorders secondary to heart abnormality,and we highlight more psychiatric care that should be paid to patients with heart abnormality.
文摘This article revisits the links between psychopathology and functional gastrointestinal disorders such as irritable bowel syndrome （IBS）, discusses the rational use of antidepressants as well as non-pharmacological approaches to the management of IBS, and suggests guidelines for the treatment of IBS based on an interdisciplinary perspective from the present state of knowledge. Relevant published literature on psychiatric disorders, especially somatization disorder, in the context of [BS, and literature providing direction for management is reviewed, and new directions are provided from findings in the literature. IBS is a heterogeneous syndrome with various potential mechanisms responsible for its clinical presentations. IBS is typically complicated with psychiatric issues, unexplained symptoms, and functional syndromes in other organ systems. Most IBS patients have multiple complaints without demonstrated cause, and that these symptoms can involve systems other than the intestine, e.g. bones and joints （fibromyalgia, temporomandibular joint syndrome）, heart （non-cardiac chest pain）, vascular （post-menopausal syndrome）, and brain （anxiety, depression）. Host IBS patients do not have psychiatric illness per se, but a range of psychoform （psychological complaints in the absence of psychiatric disorder） symptoms that accompany their somatoform （physical symptoms in the absence of medical disorder） complaints. It is not correct to label IBS patients as psychiatric patients （except those more difficult patients with true somatization disorder）. One mode of treatment is unlikely to be universally effective or to resolve most symptoms. The techniques of psychotherapy or cognitive-behavioral therapy can allow IBS patients to cope more readily with their illness. Specific episodes of depressive or anxiety disorders can be managed as appropriate for those conditions. Medications designed to improve anxiety or depression are not uniformly useful for psychiatric complaints in IBS, because the psychoform symptoms that sound similar to those seen in psychiatric disorders may not have the same significance in patients with IBS.
基金supported by the Special Project on Natural Chronic Non-infectious Diseases(2016YFC1307201)the National Natural Science Foundation of China(61372138,81701328,81871061,and 81371484)+3 种基金the National Key Research&Development Program of China(2018ZX10201002 and 2016YFC1307200)the China Postdoctoral Science Foundation(2017M612972)the Postdoctoral Foundation of Sichuan University to Hongru Zhu(2018SCU12042)the Department of Science&Technology of Sichuan Province(2018SZ0131).
文摘A number of brain research projects have recently been carried out to study the etiology and mechanisms of psychiatric disorders.Although psychiatric disorders are part of the brain sciences,psychiatrists still diagnose them based on subjective experience rather than by gaining insights into the pathophysiology of the diseases.Therefore,it is urgent to have a clear understanding of the etiology and pathogenesis of major psychiatric diseases,which can help in the development of effective treatments and interventions.Artificial intelligence(AI)-based applications are being quickly developed for psychiatric research and diagnosis,but there is no systematic review that summarizes their applications.For this reason,this study briefly reviews three main brain observation techniques used to study psychiatric disorders-namely,magnetic resonance imaging(MRI),electroencephalography(EEG),and kinesics-based diagnoses-along with related AI applications and algorithms.Finally,we discuss the challenges,opportunities,and future study directions of AI-based applications.
文摘Transcranial magnetic stimulation(TMS)has been established as an important and effective treatment for various psychiatric disorders.However,its effectiveness has likely been limited due to the dearth of neuronavigational tools for targeting purposes,unclear ideal stimulation parameters,and a lack of knowledge regarding the physiological response of the brain to TMS in each psychiatric condition.Modern optical imaging modalities,such as functional near-infrared spectroscopy and diffuse optical tomography,are promising tools for the study of TMS optimization and functional targeting in psychiatric disorders.They possess a unique combination of high spatial and temporal resolutions,portability,real-time capability,and relatively low costs.In this mini-review,we discuss the advent of optical imaging techniques and their innovative use in several psychiatric conditions including depression,panic disorder,phobias,and eating disorders.With further investment and research in the development of these optical imaging approaches,their potential will be paramount for the advancement of TMS treatment protocols in psychiatry.
文摘SLC6A4 （solute carrier family 6, member 4） gene encodes a serotonin transporter （5-hydroxytryptamine transporter, HTT）, which transports synaptic serotonin into presynaptic terminal. SLC6A4 is known to be the target of antidepressants such as selective serotonin reuptake inhibitors （SSRIs）. Inhibition of HTT increases synaptic serotonin concentration and thereby exerts antidepressant efficacy. A large number of genetic studies suggest the contribution of genetic variations of SLC6A4 to various psychiatric disorders. The most studied genetic variation, HTT-linked polymorphic region （HTTLPR）,
文摘Background: The purpose of this retrospective study was to examine the clinical outcomes of patients with concomitant lung cancer and psychiatric disorders who underwent pulmonary resection at our institution and develop a strategy for treating such patients in the future. Methods: We retrospectively reviewed 23 patients with psychiatric disorders who underwent pulmonary resection for lung cancer at our institution between January 1984 and December 2011. Results: The study population comprised 13 men and 10 women with an average age of 67.4 years. The histological types of lung cancer included adenocarcinoma in 14 patients, squamous cell carcinoma in 4, and other types in 5. Fifteen patients were classified as having pathological TNM stage I cancer, four as having stage II, three as having stage III, and one as having stage IV. The coexisting psychiatric disorders were neurosis in eight patients, depression in seven, schizophrenia in five, dementia in two, and oligophrenia in one. Three patients were admitted without a full understanding of the operation. There were no major complications with the exception of delirium, which was seen in eight patients. None of these patients’ coexisting psychiatric disorders worsened. No perioperative death occurred. Conclusions: At our institution, we cooperate closely with psychiatrists to care for surgical patients with psychiatric disorders. There is a possibility that such cooperation will reduce the frequency of previously reported complications.
基金supported by the National Natural Science Foundation of China(32192410,32192414,32330043,T2350008,82325019,and 32241015)the Science and Technology Commission of Shanghai Municipality(23XD1423000 and 23ZR1480800)+1 种基金Shanghai Municipal Commission of Health(2022JC016)Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support(20181715)。
文摘Psychedelics,encompassing both classical and non-classical categories,are psychoactive substances known for inducing hallucinations as well as a range of cognitive and emotional effects[1].Archeological studies have demonstrated that both classical psychedelics and non-classical psychedelics have been used for medical purposes for centuries.Moreover,accumulating evidence supports the idea that psychedelics can regulate mood disturbances and psychiatric disorders.
文摘To the Editor, Human herpesvirus 6 (HHV-6) comprises two double-stranded DNA viruses, HHV-6A and HHV-6B, which are distinguished based on antibody reactivity, T-cell clone reactivity, and restriction banding patterns.[1] The International Committee on Taxonomy of Viruses has recently classified these as two distinct viral species.[2] HHV-6B is the primary causative agent of roseola infantum, while the pathogenic mechanisms of HHV-6A remain less well understood. Serological studies indicate that over 95% of adults are seropositive for one or both HHV-6 variants, which establish latency following primary infection. These viruses persist primarily in T-cells and bone marrow progenitor cells.[3] In vitro studies have demonstrated HHV-6B latency in astrocytes, while HHV-6A has been shown to remain latent in oligodendrocytes.[4] Both viral types are capable of modulating the immune system, promoting immunosuppressive effects and chronic inflammatory pathways.
基金supported by China Postdoctoral Science Foundation(grant number:2024M760146)。
文摘Background Epilepsy is a chronic neurological disorder marked by a persistent tendency to generate seizures,leading to substantial cognitive,behavioral,and psychosocial consequences.This study investigated psychiatric disorder-related adverse events(AEs)associated with antiseizure medications(ASMs)in children using the Food and Drug Administration Adverse Event Reporting System(FAERS)database.Methods This study conducted a comprehensive analysis of FAERS data from 2004 to 2024,focusing on psychiatric AEs in children with epilepsy or seizures treated with ASMs.Signal values were computed using reporting odds ratio(ROR),proportional reporting ratio(PRR),Bayesian Confdence Propagation Neural Network(BCPNN),and Multi-item Gamma Poisson Shrinker(MGPS).Results A total of 2539 preferred terms(PTs)were included,involving 25 system organ classifcations(SOCs).Nervous system,skin and subcutaneous tissue,and psychiatric disorders are the three most common SOCs for ASMs in children.There were 24 ASMs,whose AEs involved psychiatric disorders,totaling 110 PTs and 214 drug-PT relationships.Psychotic symptoms(notably lorazepam and topiramate,n=116 and 109),substance dependence and abuse(notably pregabalin and clonazepam,n=291 and 110),and the other neuropsychiatric symptoms(notably levetiracetam and valproic acid,n=70 and 62)were the common types of psychiatric disorder-related AEs of ASMs in children.A total of nine ASMs(brivaracetam,clonazepam,diazepam,eslicarbazepine,gabapentin,lamotrigine,lorazepam,perampanel,and tiagabine)were associated with suicidal and self-injurious behavior in children.Conclusions This study highlights psychiatric AEs of ASMs in children,ofering critical insights to improve clinical medication practices and enhance treatment safety.Further research with broader clinical data is needed to promote safe and rational medication use.
基金supported by The Research Project of Jinan Microecological Biomedicine Shandong Laboratory(JNL-2023001B)The National Key Research and Development Program of China(2023YFC2506200)+2 种基金The Zhejiang Provincial Key Research and Development Program(2021C03107)The Leading Talent of Scientific and Technological Innovation-“Ten Thousand Talents Program”of Zhejiang Province(2021R52016)The Fundamental Research Funds for the Central Universities(226-2022-00193,226-2022-00002,2023ZFJH01-01,and 2024ZFJH01-01).
文摘A growing interest in the comprehensive pathogenic mechanisms of psychiatric disorders from the perspective of the microbiome has been witnessed in recent decades;the intrinsic link between microbiota and brain function through the microbiota-gut-brain axis or other pathways has gradually been realized.However,little research has focused on viruses–entities characterized by smaller dimensions,simpler structures,greater diversity,and more intricate interactions with their surrounding milieu compared to bacteria.To date,alterations in several populations of bacteriophages and viruses have been documented in both mouse models and patients with psychiatric disorders,including schizophrenia,major depressive disorder,autism spectrum disorder,and Alzheimer’s disease,accompanied by metabolic disruptions that may directly or indirectly impact brain function.In addition,eukaryotic virus infection-mediated brain dysfunction provides insights into the psychiatric pathology involving viruses.Efforts towards virus-based diagnostic and therapeutic approaches have primarily been documented.However,limitations due to the lack of large-scale cohort studies,reliability,clinical applicability,and the unclear role of viruses in microbiota interactions pose a challenge for future studies.Nevertheless,it is conceivable that investigations into viruses herald a new era in the field of precise psychiatry.
基金supported by the National Natural Science Foundation of China(81971262 to HS)1.3.5 project for disciplines of excellence,West China Hospital,Sichuan University(ZYYC21005 to HS)+1 种基金EU Horizon2020 Research and Innovation Action Grant(847776 to UV and FF)the Fundamental Research Funds for Central Universities(20826041F4144 to XH).
文摘Whether associations between psychiatric disorders and hospitalization for cardiovascular diseases(CVDs)can be modified by disease susceptibility and the temporal pattern of these associated CVDs remain unknown.In our study,we conducted a matched cohort study of the UK Biobank including 44,430 patients with common psychiatric disorders(anxiety,depression,and stress-related disorders)between 1997 and 2019,together with 222,150 sex-,Townsend deprivation index-,and birth year-individually matched unexposed individuals.The hazard ratios(HRs)for CVD hospitalization associated with a prior psychiatric disorder were derived from Cox models,adjusted for multiple confounders.We then stratified the analyses by self-reported family history of CVD and CVD polygenic risk score(PRS)calculated based on summary statistics of independent genome-wide association studies.We further conducted disease trajectory analysis and visualized the temporal pattern of CVDs after common psychiatric disorders.During a mean follow-up of 12.28 years,we observed an elevated risk of CVD hospitalization among patients with psychiatric disorders,compared with matched unexposed individuals(hazard ratios[HRs]=1.20,95%confidence interval[CI]:1.18–1.23),especially during the first six months of follow-up(1.72[1.55–1.91]).The stratification analyses by family history of CVD and by CVD PRS obtained similar estimates between subgroups with different susceptibilities to CVD.We conducted trajectory analysis to visualize the temporal pattern of CVDs after common psychiatric disorders,identifying primary hypertension,acute myocardial infarction,and stroke as three main intermediate steps leading to further increased risk of other CVDs.In conclusion,the association between common psychiatric disorders and subsequent CVD hospitalization is not modified by predisposition to CVD.Hypertension,acute myocardial infarction,and stroke are three initial CVDs linking psychiatric disorders to other CVD sequelae,highlighting a need of timely interven-tion on these targets to prevent further CVD sequelae among all individuals with common psychiatric disorders.
文摘The alteration of gene expression is not restricted to transcriptional regulation but includes a variety of posttranscriptional mechanisms;however,the role of the latter in many diseases remains relatively unknown.By using an RNA-Seq dataset of 1510 brain samples from individuals with autism spectrum disorder(ASD),bipolar disorder(BD),schizophrenia(SCZ),and controls,we assessed the contribution of post-transcriptional dysregulation and identified top perturbators accountable for transcriptomic alterations in neuropsychiatric disorders.Approximately 30%of the expression variability was attributed to post-transcriptional dysregulation.Interestingly,mature mRNA levels tended to be post-transcriptionally downregulated in SCZ and BD,leading to the inhibition of neurogenesis and neural differentiation,while they were upregulated in ASD,resulting in enhanced activity of apoptosis.These findings imply contrasting pathologies involving RNA metabolism across neuropsychiatric disorders.An RNA-binding protein,ELAVL3,was predicted to be significantly involved in the disruption of post-transcriptional regulation in all three disorders.To validate this,we knocked down its expression in cerebral organoids.Not only did the differentially expressed genes in ELAVL3 knockdown cover a considerable proportion of predicted targets in the three disorders,but we also found that neurogenesis was significantly affected,given the diminished proliferation and consequently reduced size of the organoids.The present study extends the current understanding of the link between post-transcriptional regulation and neuropsychiatric disorders and provides new potential therapeutic targets for early intervention.
