Purpose:Depression is one of the leading causes of avoidable suffering worldwide, and over 50% of patients do not respond to their first antidepressant treatment, which underscores the need for more effective alternatives. This clinical predicament urgently requires an effective solution. The core objective of this study is to clarify the clinical efficacy and application value of the triple reuptake inhibitor toludesvenlafaxine in patients with poor response to the first antidepressant therapy, providing a new basis for treatment options for this refractory group. Methods:This multicenter study included 61 patients meeting Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) criteria for depression. All patients still had a Montgomery Depression Rating Scale (MADRS) score of ≥24 after 4 weeks of treatment with an adequate single initial antidepressant, and were clearly classified as an ineffective or partially effective initial antidepressant treatment. Patients were switched to toludesvenlafaxine for an 8-week treatment period. The primary outcome measure was the change in MADRS score from baseline to 8 weeks. The secondary outcome measures included the changes in the scores of the Hamilton Anxiety Scale (HAMA), the Dimensional Anhedonia Rating Scale (DARS), the Quality of Life Enjoyment and Satisfaction Questionnaire, Short Form (Q-LES-Q-SF), and the Clinical Global Impression of Severity Scale (CGI-S) from baseline to 8 weeks. Results:For such patients that did not respond to the first treatment, significant and rapid efficacy was demonstrated after switching to toludesvenlafaxine. At 8 weeks of treatment, the average MADRS score of the patients decreased by 15.5 points compared with the baseline (95% CI, -17.7 to -13.3; p < 0.0001; Cohen's d = 2.35). Forty-three percent of them met the clinical remission, and 67% achieved a clinical response. More clinically significant is that the therapeutic effect emerged at an early stage-2 weeks (95% CI, -9.4 to -6.4; p < 0.0001; Cohen's d = 1.52) and 4 weeks (95% CI, -13.3 to -9.8; p < 0.0001; Cohen's d = 2.11). After 2 weeks of treatment, there were statistically significant differences in the HAMA, Q-LES-Q-SF, and CGI-S scores at each time point compared with the baseline. The improvement in the DARS score was statistically significant from 4 weeks. In terms of safety, the most common adverse reactions were palpitations, constipation, nausea, vomiting, hypoesthesia, and dizziness, which are mostly mild to moderate and controllable. In particular, the drug significantly improved sexual dysfunction (95% CI, -4.3 to -0.7; p = 0.0071), which is crucial for improving treatment compliance. Conclusion:This study confirmed that toludesvenlafaxine not only has significant clinical efficacy (including early onset, high remission, and response) for patients with depression who did not respond to the first antidepressant treatment, but also has good safety and can improve sexual dysfunction that affects compliance. This result highlights the significant position of toludesvenlafaxine in addressing the key clinical challenge of first treatment failure, providing a highly valuable new option for the subsequent treatment of such patients.

Disordered eating (DE) is prevalent among adolescents and often linked to parenting dimensions. Proximal psychological factors such as self-esteem, depression, anxiety, and sleep quality are associated with DE. However, the interplay between parenting dimensions and these psychological factors remains unclear. This study used a network approach to examine how parenting dimensions are associated with proximal psychological factors in relation to DE in Chinese adolescents, and to explore potential gender differences. A total of 5148 adolescents aged 12–20 were included in the analysis. Network analysis was employed to construct basic networks of parenting dimensions and DE, and extended networks incorporating proximal psychological factors. Bridge strength indices were calculated to identify bridge nodes. Network comparison tests were used to explore gender differences in network structure and strength. In the basic networks, maternal rejection showed the strongest association with DE symptom “self-induced vomiting”. Gender differences were observed in the basic network, with boys’ DE symptoms linked to both maternal and paternal parenting dimensions, while girls’ DE symptoms were more associated with maternal parenting dimensions. When psychological factors were included, self-esteem and sleep quality emerged as key bridge variables connecting parenting dimensions and DE. Gender-specific patterns were observed: in boys, self-esteem was the primary bridge node, whereas in girls, sleep quality was the strongest bridge node. No significant global differences were found between gender networks, but several edge variations revealed distinct gender-specific associations. Parenting dimensions are closely linked to adolescents’ disordered eating through psychological factors such as self-esteem and sleep quality. Gender-specific associations suggest that prevention efforts should focus on both parental influences and self-esteem for boys, and maternal influences and sleep quality for girls. Disordered eating is common in teenagers and may be influenced by parenting and mental wellbeing. This study used network analysis to explore how parenting dimensions are linked to disordered eating in Chinese adolescents, and whether psychological factors such as self-esteem help explain this link. 5148 adolescents aged 12–20 participanted in the study. In the direct association, maternal rejection was most consistently associated with disordered eating across all groups. Self-esteem and sleep quality were identified as important bridge nodes in connecting parenting with disordered eating. Some differences were found between girls and boys: self-esteem was a key factor connecting parenting to disordered eating, while for girls, sleep quality played a more prominent role in this connection. These findings suggest that support and prevention should consider parenting dimension, self-esteem, and sleep quality.

Previous studies have yielded conflicting findings regarding the relationship between the use of sleep-related drugs (SRDU) and suicidal behaviors. This population-based study aimed to analyze the associations between SRDU and suicidal behaviors. Additionally, we examined the associations between SRDU and specific conditional suicidal behaviors, providing insights into the impact of SRDU on the progression of suicidal behaviors. The study was conducted among community residents aged 18 and older using a cross-sectional design, analyzing 21,376 participants. Data on SRDU, suicidal ideation, plans, and attempts were collected. Participants were categorized into general individuals without suicidal behaviors (GNS), suicidal ideators without a plan or attempt (SINPA), suicidal ideators with a plan but no attempt (SIP), and individuals who attempted suicide (SA). Insomnia, sleep apnea, rapid eye movement sleep behavior disorder (RBD), and narcolepsy were assessed using the Athens Insomnia Scale, Berlin Questionnaire, Rapid Eye Movement Sleep Behavior Disorder Questionnaire, and Ullanlinna Narcolepsy Scale, respectively. After adjusting for sociodemographic variables, insomnia, sleep apnea, RBD, and narcolepsy, SRDU showed a positive association with suicidal ideation (OR = 3.02), plans (OR = 4.78), and attempts (OR = 6.40; all p < 0.001). Compared to GNS, and after controlling for the same variables, SRDU was associated with SINPA (OR = 2.46), SIP (OR = 5.11), and SA (OR = 6.93; all p < 0.001) respectively. However, no significant differences in SRDU were found between SINPA, SIP, and SA (all p > 0.05). This population-based study confirms that SRDU is positively associated with suicidal ideation, plans, and attempts, even after accounting for the risk factors of insomnia, sleep apnea, RBD, and narcolepsy. Nonetheless, SRDU does not appear to influence the progression from suicidal ideation to attempt.

Background:Adjunctive therapy with a second-generation antipsychotic (SGA) represents a treatment option for major depressive disorder (MDD) patients with inadequate response to antidepressants. Evidence suggests that early initiation of adjunctive SGA treatment may yield greater benefits. This study aimed to investigate the efficacy, safety, and tolerability of adjunctive therapy with perospirone initiated after 4 weeks of antidepressant treatment in MDD patients with inadequate response. Methods:This phase IV, multi-center, randomized, double-blind, placebo-controlled trial assessed the efficacy, safety and tolerability of perospirone as an adjunct to serotonin norepinephrine reuptake inhibitors (SNRIs) or selective serotonin reuptake inhibitors (SSRIs) in patients with MDD who showed inadequate response to SSRIs/SNRIs. Patients with moderate-to-severe depression (defined as a baseline Montgomery-Åsberg Depression Rating Scale [MADRS] score of ≥20) who exhibited a reduction of <50% in the total score of MADRS after receiving at least one antidepressant at an adequate dose for at least four weeks during the current episode were included in the study. The primary intervention timepoint was set at week 4, with treatment initiation permitted up to week 8. Eligible patients were randomized 1:1 to the perospirone group (perospirone + SSRIs/SNRIs) or the placebo group (placebo + SSRIs/SNRIs) and received treatment for 8 weeks. Perospirone was administered once or twice daily at an initial dose of 4-8 mg/day and a maintenance dose of 12-48 mg/day, based on symptom severity and patient tolerance. The study, conducted across 10 Chinese hospitals between December 16, 2021 and June 19, 2024, evaluated the primary efficacy endpoints of response (≥50% reduction in the MADRS score) and remission (MADRS score ≤10) rates at the end of the 8-week treatment. The study was registered at www.chictr.org.cn (ChiCTR2200063354). Findings:A total of 210 participants were randomized into the two groups (108 were assigned to the perospirone group and 102 to the placebo group). Compared to the placebo group, more patients in the perospirone group achieved remission at week 8 (55.2% vs. 38.9%, odds ratio [OR] = 1.944, 95% confidence interval [CI]: 1.060-3.564, p = 0.032), and the proportions of participants with clinical response were comparable between the two groups (67.8% vs. 60.0%, OR = 1.406, 95% CI: 0.759-2.605, p = 0.28). Most common adverse events (AEs) were mild arousal-related symptoms, autonomic dysfunction, and extrapyramidal symptoms. Treatment discontinuation rates due to AEs were low and comparable in both groups, with no significant safety concerns. Interpretation:Early adjunctive treatment with perospirone for 8 weeks may confer potential benefits, particularly in MDD patients who exhibit inadequate response to SSRIs/SNRIs and present with more severe symptoms requiring rapid improvement. While the treatment demonstrated acceptable tolerability and safety profiles, the observed efficacy should be interpreted with caution and regarded as hypothesis-generating due to the lack of multiplicity adjustment. Further confirmatory randomized controlled trials are warranted to validate these findings. Funding:The study was supported by the STI2030-Major Projects (grant 2021ZD0202000), National Natural Science Foundation of China (grant 82201693 and 82471555), Hunan Provincial Natural Science Outstanding Youth Foundation (grant 2025JJ20093), Science and Technology Innovation Program of Hunan Province (grant 2024RC3057), Sanming Project of Medicine in Shenzhen (grant SZSM202311025), and Reboscience (Zhuhai) Pharmaceutical Research Co., Ltd., and sponsored by Livzon Pharmaceutical Group Inc.

Aromatic amino acids (AAAs) play a critical role in neurotransmitter synthesis and are implicated in the pathogenesis of depression. However, their trace concentrations in biological samples pose significant challenges for detection. In this study, we present a novel approach for the sensitive and precise detection of AAAs in human urine. A composite material, GO-MONs-NH2, was synthesized by in situ growing amino-functionalized microporous organic networks (MONs-NH2) on the surface of graphene oxide (GO) via a solvothermal method. The resulting GO-MONs-NH2 material, with a hierarchical porous structure, combines the mechanical stability of GO and the high adsorption capacity of MONs-NH2. It efficiently extracts AAAs through multiple adsorption mechanisms, including hydrogen bonding, π-π interactions, and electrostatic forces, exhibiting rapid mass transfer and high affinity for tyrosine, phenylalanine, and tryptophan. The GO-MONs-NH2 solid-phase extraction (SPE) technique, coupled with high-performance liquid chromatography-diode array detection (HPLC-DAD), enables simultaneous detection of the three AAAs in urine samples without the need for mass spectrometry. The developed method demonstrates a wide linear range (0.05-50 μg/mL), low limits of detection (3.96-7.13 ng/mL), high accuracy (recoveries: 90.8 %-107.5 %), and good precision (RSDs ≤ 6.4 %). This method offers a reliable, cost-effective, and non-invasive tool for early screening and monitoring of depression.

A reduction in the hedonic capacity, that is, anhedonia, is closely associated with the onset of depression, which negatively affects mental health and life satisfaction. However, simple and comprehensive tools to assess hedonic capacity in community-dwelling adults are lacking. An online survey was conducted from March to April 2023, recruiting 678 community-dwelling adults. We assessed the psychometric properties of the Chinese version of the Dimensional Anhedonia Rating Scale (DARS) and used multivariate linear regression to examine gender differences in hedonic capacity and its contributing factors. The Chinese version of the DARS demonstrated excellent reliability and validity in the non-clinical sample. Higher education levels and being female were associated with better hedonic capacity, while sleep disturbances and living alone were linked to lower hedonic capacity. Additionally, gender differences were found in the factors affecting hedonic capacity: for males, living alone and sleep disturbances had a negative impact, whereas for females, higher education levels were positively associated with hedonic capacity. There was a lack of structured diagnoses among community samples. The Chinese version of the DARS is an effective tool for assessing hedonic capacity, i.e. screening for depression in community-dwelling populations. The observed gender differences in hedonic capacity imply that future mental health services could be more effective if adapted based on gender.

Binge-eating disorder(BED)is a type of eating disorder characterized by recurrent episodes of binge eating.Patients with BED have recurrent impulsive and out-of-controlled binge eating behavior,which can lead to gastrointestinal disorders,obesity,and the resulting metabolic and functional disorders of various systems and other physical problems;and it is also often co-morbid with affective disorder,anxiety disorders,substance use disorders,and other mental disorders,which need to be taken seriously.However,the recognition of BED in China was late,and it is difficult to achieve early identification and diagnosis,resulting in a prolonged course of disease.Therefore,under the organization of the Eating Disorders Coordination Group of the Psychosomatic Medicine Society of the Chinese Medical Association,together with the Eating Disorders Research Collaboration Group of the Psychiatric Medicine Society of the Chinese Medical Association,an expert group composed of 15 psychiatrists and evidence-based medicine experts,and 2 internal medicine experts,formulated this expert consensus based on evidence-based medical evidence,domestic and foreign guidelines and expert consensus,and expert experiences.The aim of this study is to improve the recognition,diagnosis and treatment of BED by psychiatrists,internists and general practitioners in China.

BACKGROUND Blonanserin (BNS) is a well-tolerated and effective drug for treating schizophrenia. AIM To investigate which types of patients would obtain the most benefit from BNS treatment. METHODS A total of 3306 participants were evaluated in a 12-week, prospective, multicenter, open-label post-marketing surveillance study of BNS. Brief psychiatric rating scale (BPRS) scores were calculated to evaluate the effectiveness of BNS, and its safety was assessed with the incidence of adverse drug reactions. Linear regression was used to screen the influencing factors for the reduction of BPRS total score, and logistic regression was used to identify patients with a better response to BNS. RESULTS The baseline BPRS total score (48.8 ± 15.03) decreased to 27.7 ± 10.08 at 12 weeks (P < 0.001). Extrapyramidal symptoms (14.6%) were found to be the most frequent adverse drug reactions. The acute phase, baseline BPRS total score, current episode duration, number of previous episodes, dose of concomitant antipsychotics, and number of types of sedative-hypnotic agents were found to be independent factors affecting the reduction of BPRS total score after treatment initiation. Specifically, patients in the acute phase with baseline BPRS total score ≥ 45, current episode duration < 3 months, and ≤ 3 previous episodes derived greater benefit from 12-week treatment with BNS. CONCLUSION Patients in the acute phase with more severe symptoms, shorter current episode duration, fewer previous episodes, and a lower psychotropic drug load derived the greatest benefit from treatment with BNS.

Background: Total white blood cell count (TWBCc), an index of chronic and low-grade inflammation, is associated with clinical symptoms and metabolic alterations in patients with schizophrenia. The effect of antipsychotics on TWBCc, predictive values of TWBCc for drug response, and role of metabolic alterations require further study. Methods: Patients with schizophrenia were randomized to monotherapy with risperidone, olanzapine, quetiapine, aripiprazole, ziprasidone, perphenazine or haloperidol in a 6-week pharmacological trial. We repeatedly measured clinical symptoms, TWBCc, and metabolic measures (body mass index, blood pressure, waist circumference, fasting blood lipids and glucose). We used mixed-effect linear regression models to test whether TWBCc can predict drug response. Mediation analysis to investigate metabolic alteration effects on drug response. Results: At baseline, TWBCc was higher among patients previously medicated. After treatment with risperidone, olanzapine, quetiapine, perphenazine, and haloperidol, TWBCc decreased significantly (p < 0.05). Lower baseline TWBCc predicted greater reductions in Positive and Negative Syndrome Scale (PANSS) total and negative scores over time (p < 0.05). We found significant mediation of TWBCc for effects of waist circumference, fasting low-density lipoprotein cholesterol, and glucose on reductions in PANSS total scores and PANSS negative subscale scores (p < 0.05). Conclusion: TWBCc is affected by certain antipsychotics among patients with schizophrenia, with decreases observed following short-term, but increases following long-term treatment. TWBCc is predictive of drug response, with lower TWBCc predicting better responses to antipsychotics. It also mediates the effects of certain metabolic measures on improvement of negative symptoms. This indicates that the metabolic state may affect clinical manifestations through inflammation.

Purpose:Depressive disorder is a mental health disorder with complicated etiopathogenesis. Environmental stress and neurodevelopment combined with other factors contribute to the occurrence of depression. Especially for the depressive disorder with chronic negative stress, it has characteristics of recurrence and poor curative effect because of unclear mechanism. Here, we investigated the hippocampal structures and functional connectivity (FC) according to resting-state functional magnetic resonance imaging in patients with depression who underwent chronic negative stress.Patients and Methods:A total of 65 patients with depression (34 underwent chronic negative stress and 31 non-underwent chronic negative stress) and 30 healthy controls who did not undergo chronic negative stress were included in the study. The volumes of hippocampal subfields, seed-based FCs between hippocampus and the whole brain voxels, and ROI-wise-based FC between hippocampal subfields were compared among the three groups.Results:In the patients with depression who underwent chronic negative stress, the volumes of right_GC-ML-DG-head, right_CA4-head and right_CA3-head increased, FCs between Temporal_Mid_R, Precuneus_R, Frontal_Sup_R, Temporal_Sup_R, Angular_L, Frontal_Inf_Tri_R, Supp_Motor_Area_R, Precentral_L and hippocampus increased, and FCs between parasubiculum and CA3, and presubiculum and CA1 decreased. When compared to the patients who did not undergo chronic negative stress, the patients who underwent chronic negative stress had larger volumes of right_GC-ML-DG-head and right_CA3-head, higher FCs between Frontal_Sup_R, Frontal_Inf_Tri_R and hippocampus, and lower FCs between presubiculum and CA1.Conclusion:The depression underwent chronic negative stress may experience disrupted hippocampal structures and functional connectivity. It may be one of potential depressive disorder subtypes.

Objective: To study the clinical effect of group cognitive behavioral therapy to one-onone treatment on patients with early-onset schizophrenia. Methods: Totally, 133 patients with early-onset schizophrenia admitted to the Department of Psychiatry of our hospital from September 2020 to September 2023 were selected and divided into a control group and an observation group according to whether group behavioral cognitive therapy was performed. The general demographic data of the patients were collected, and the propensity score matching method was used to balance the baseline data of the 2 groups. The Positive and negative syndrome scale, Personal and Social Performance Scale, severity of illness (SI), and efficacy index (EI) were compared between the 2 groups after matching. Results: After matching, 72 patients were included in our study. Compared to the control group, observation group PANSS score were decreased including after intervention (P P > .05). Both groups showed a decrease between before and after treatments. Positive and Negative Syndrome Scale reduction rate after treatment and total response rate were increased in the observation group (P P <.001). Personal and Social Performance Scale of the Clinical Global Impression (CGI) scores were higher than those of the control group. In the CGI scores, there is a significant difference that SI scores were lower in the observation group (P P = .002), while EI scores were higher (P P <.001). Conclusion: Group cognitive behavioral therapy is beneficial to the improvement of mental symptoms and disease severity, social function, and curative effect, which is advocated and popularized.

In clinical practice, accurately identifying self-injurious behavior among adolescents with major depressive disorder (MDD) is crucial for individualized treatment. This study aimed to examine the differences in prefrontal cortex activation using the functional near-infrared spectroscopy (fNIRS) during the verbal fluency task (VFT) assessment of adolescents with MDD and self-harm (SH) compared with those without SH. A total of 60 eligible patients were included for final analysis, with the SH group containing 36 participants, and the Non-SH group containing 24 participants. We found that right middle frontal gyrus (rMFG) was more activated in the SH group than that in the Non-SH group during the VFT assessments (z = -3.591, p = 0.004, FDR correction). The z-scores of beta values of rMFG exhibited a good discriminatory power with the area under the curve (AUC) in distinguishing the two groups (AUC = 0.775, p < 0.001). These findings reveal that the fNIRS-VFT paradigm may be a useful tool for discovering neurobiological differences among adolescents with MDD.

BACKGROUND:As clinical practices with lithium salts for patients diagnosed with bipolar disorder (BD) are poorly documented in Asia, we studied the prevalence and clinical correlates of lithium use there to support international comparisons.METHODS:We conducted a cross-sectional study of use and dosing of lithium salts for BD patients across 13 Asian sites and evaluated bivariate relationships of lithium treatment with clinical correlates followed by multivariate logistic regression modeling.RESULTS:In a total of 2139 BD participants (52.3% women) of mean age 42.4 years, lithium salts were prescribed in 27.3% of cases overall, varying among regions from 3.20% to 59.5%. Associated with lithium treatment were male sex, presence of euthymia or mild depression, and a history of seasonal mood change. Other mood stabilizers usually were given with lithium, often at relatively high doses. Lithium use was associated with newly emerging and dose-dependent risk of tremors as well as risk of hypothyroidism. We found no significant differences in rates of clinical remission or of suicidal behavior if treatment included lithium or not.CONCLUSIONS:Study findings clarify current prevalence, dosing, and clinical correlates of lithium treatment for BD in Asia. This information should support clinical decision-making regarding treatment of BD patients and international comparisons of therapeutic practices.

Anorexia nervosa(AN)is a type of eating disorders characterized by self-starvation,significant loss of body mass,and malnutrition.AN has the highest mortality rate among all psychiatric disorders,leading to severe psychopathologic symptoms and life-threatening medical complications.However,AN cannot be recognized and diagnosed early in China,resulting in a prolonged course of the disease.Therefore,under the organization of the Eating Disorders Coordination Group of the Psychosomatic Medicine Society of the Chinese Medical Association,together with the Eating Disorders Research Collaboration Group of the Psychiatric Medicine Society of the Chinese Medical Association,this expert consensus was formulated by 16 medical experts based on evidence-based medical evidence,domestic and international guidelines and expert consensus,expert experience,etc.,in order to improve the recognition,diagnosis and treatment of AN among domestic professionals.

BACKGROUND:Research in functional asymmetry of Major Depressive Disorder (MDD) under different tasks is crucial for clinical diagnose. METHODS:Fifty individuals with MDD and twenty healthy controls (HCS) were recruited for hemodynamic data collection under four fNIRS tasks (Emotional picture, Verbal fluency, Fingering and Negative emotional picture description task). Integral values and functional connectivity strength were employed to probe neural activation and functional connectivity in frontal and temporal lobes in MDD. Following, asymmetry characteristic of the frontal cortex between MDD and HCS under four tasks were carefully analyzed and compared. RESULTS:Individuals with MDD demonstrated heightened connectivity between the frontal and right temporal lobes and reduced connectivity between the frontal and left temporal lobes compared to HCS in all tasks. Additionally, MDD exhibited attenuated activation in the left frontal lobes and exaggerated activation in the right frontal lobes, diverging from HCS. Furthermore, the disparities in left-right asymmetry characteristic of frontal cortex activation between MDD and HCS were more pronounced during the combined task. LIMITATIONS:Further research is required to grasp the neurophysiological mechanisms governing left-right asymmetry across various tasks and the influence of task-induced brain fatigue on cerebral cortex hemodynamics in MDD. CONCLUSION:The left-right asymmetry feature provides valuable neurophysiological insights for diagnosing MDD clinically. Variations in activation patterns and functional connectivity features between MDD and HCS are closely tied to the task chosen. Thus, in clinical practice, carefully selecting appropriate fNIRS tasks and relevant features can significantly improve the diagnostic accuracy of MDD.

BackgroundAlthough several studies have explored the association between breakfast consumption and suicidal behaviors among children and adolescents, such associations have been less frequently reported among adults and seniors.MethodThis population-based cross-sectional study was conducted in Hebei Province, China. A total of 21, 376 community residents aged 18 years and older were interviewed. This study evaluated the breakfast frequency per week (BFF), full breakfast frequency (FBF), suicidal ideation, suicide plans, and suicide attempts of the participants. Sociodemographic variables, living alone, and sleep quality were also measured.ResultsThe prevalence of suicidal ideation, plans, and attempts were 1.4, 0.3, and 0.2%, respectively. Compared to ≥6 days/week BFF, 2–3 days/week BFF was positively associated with suicidal ideation (OR = 1.93, p < 0.01), suicide plan (OR = 2.73, p < 0.05), and suicide attempts (OR = 3.46, p < 0.05). In addition, participants with 2–3 days/week FBF was also at higher risk of suicidal ideation (OR = 2.06, p < 0.001), comparing with never FBF.ConclusionThe reported prevalence of suicidal ideation, plans, and attempts were lower compared to other countries. Lower breakfast frequency was positively associated with suicidal behaviors, and participants with 2–3 days/week of full breakfast consumption were also at a higher risk of suicidal ideation.

Objective: Suicidal behavior is strongly correlated with depressive symptoms and the degree of suicidal ideation. Cognitive impairment may have varying degrees of influence on suicidal ideation (SI) and suicidal attempts (SA). The aim of this study was to identify the cognitive biomarkers that distinguish suicidal ideation from suicidal attempts in adolescents. Methods: The cross-sectional sample comprised 54 adolescents with major depressive disorder (MDD) and 32 healthy controls (HC). The THINC-it was utilized to assess cognitive function of all the samples. Suicidal ideation was examined by the Positive and Negative Suicide Ideation Scale (PANSI). Based on the type of data, one-way ANOVA or Kruskal-Wallis was performed to investigate group differences. Bonferroni post-hoc analysis was employed for regulating type I error for pairwise comparisons. Network analysis was used to compare the networks associated with suicidal ideation, depression symptoms, and cognitive function between SA and SI. Results: The depression symptoms (HAMD-17) (F=72.515, P<0.001) and suicidal ideation (PANSI) (F=267.952, P<0.001) in the SA were higher than those in the SI. Analysis of between-group differences showed SA performed worse in THINC-it, especially in "Spotter (SP)" (P=0.033), "Objective cognition score (OS)" (P=0.027) and "Composite score (CS)" (P=0.017). Compared with SI, network analysis revealed that SA had a unique network of cognitive function, depressive symptoms, and suicidal ideation. Nevertheless, both networks exhibit comparable performance concerning the node strength of cognitive function. Within their separate networks, the aspects of CS, OS, and SP have emerged as the three most crucial elements. Conclusion: Adolescents with SI or SA exhibit a broad spectrum of cognitive impairments. Attention impairment can be beneficial in discerning between SI and SA. Future interventions for adolescent suicide can center on attention and the comprehensive cognitive ability that it represents.

目的 了解2012-2022年精神康复领域的研究热点及发展趋势.方法 系统检索Web of Science数据库2012-2022年收录的精神康复领域研究文献.运用CiteSpace软件对精神康复研究文献的作者、机构、关键词进行可视化分析.结果 共纳入3 045篇文献.国际精神康复领域研究热点集中于以患者为中心的精神康复模式探索,如社区康复、职业康复及解决污名化问题等.结论 为了促进中国精神康复领域研究发展,未来学者可以在借鉴国际研究热点、研究前沿的基础上,加强创新研究思路和方法,开拓精神康复研究的新领域.

Abstract Background Ziprasidone mesylate injection is an atypical antipsychotic drug which is recently approved in China. In combination with its oral formulation, sequential therapy with ziprasidone brings new interventions to patients with agitation in the acute phase of schizophrenia. The purpose of this 7-day multicenter study conducted in China was to evaluate the efficacy and safety of ziprasidone sequential treatment through intramuscular/oral routes in agitated patients with schizophrenia. Methods A total of 95 patients were enrolled from three centers in this study. The study duration was 7 days. In the first 3 days, subjects were administered an intramuscular injection of ziprasidone 10–40 mg daily and started sequentially with oral ziprasidone 40–80 mg at dinner (or lunch) from the day of the last intramuscular injection. In the following 4 days, according to the severity of the symptoms and the drug response, 120–160 mg of ziprasidone was orally administered daily. In total, six visits were scheduled to assess the Positive and Negative Syndrome Scale (PANSS), the Behavioral Activity Rating Scale (BARS), the Clinical Global Impression of Severity (CGI-S), and Improvement (CGI-I) scores throughout the procedure. Lastly, adverse events were recorded during treatment. Results Out of the 95 patients that were enrolled, 83 cases were effectively completed. Visits 3, 4, 6, PANSS, and PANSS-excited component (PANSS-EC) subscale points, and Visit 2–Visit 6 viewpoints, BARS scale points, and baseline scores denote a progressive downward trend (P < 0.001). In this study, 62 adverse events were reported. The most common adverse events were extrapyramidal symptoms (EPS) (23 cases) and excessive sedation(10 cases), and 13 cases of prolonged QTc interval were reported. Conclusions Ziprasidone IM demonstrated significant and rapid reduction in agitation, and sequential oral formulation keep stability and continuation of the treatment can further ensure efficacy. Ziprasidone sequential therapy may provide a new approach to acute agitation in schizophrenic patients. Trial registration The Chinese Clinical Trials Registry; URL: https://www.chictr.org.cn : ChiCTR-OIC-16007970.