AIMS:Alcohol use disorder (AUD) is a public health concern in China. Psychosocial interventions are a key component of comprehensive treatment. We conducted the first systematic review and meta-analysis of Chinese studies evaluating the effectiveness of psychosocial interventions on AUD, and depressive and anxiety symptoms. METHODS:A systematic search was conducted across both English and Chinese databases, covering records from inception to June 10, 2025. The primary outcome was relapse rate; secondary outcomes included anxiety and depressive symptoms, assessed using HAMA and HAMD, respectively. Quality assessment was performed using the Cochrane Risk of Bias tool. Meta-analyses were conducted using RevMan 5.3. Forty-eight studies were included (44 in Chinese and 4 in English), involving 4592 patients (2317 in the intervention and 2275 in the control groups). OUTCOMES:Psychosocial interventions significantly reduced relapse compared to control groups [40 studies, n = 3819, OR = 0.28, 95% CI (0.24, 0.32), P < 0.001]. Psychosocial treatments also improved anxiety [13 studies，n = 1249, SMD = -1.85, 95% CI (-2.46, -1.23), P < 0.001] and depression [16 studies, n = 1694; SMD = -1.62, 95% CI (-2.13, -1.11), P < 0.001]. Funnel plots suggested a high risk of publication bias. CONCLUSIONS:Evidence from studies in Chinese patients indicates that structured or standardized psychosocial interventions are more effective than routine care alone in reducing relapse and improving mood symptoms in patients with AUD. The findings support their broader integration into treatment in China, though publication bias must be considered.

China's mental health service system is transitioning from an expansion-oriented stage focused primarily on addressing resource shortages and improving access to care toward a more mature stage that places greater emphasis on service quality， operational efficiency， patients' rights， and long-term outcomes. The principal challenge is no longer merely an insufficient overall supply of mental health resources， but rather inadequate alignment among service goals， the structure of service provision， payment incentives， allocation of responsibilities， and professional capacity. Recent incidents involving inappropriate psychiatric admissions and misuse of medical insurance funds in a small number of institutions， although not representative of the mental health sector as a whole， have exposed several structural risks within an inpatient-dominated service model. These include misalignment between inpatient services and medical insurance payment incentives， expansion of institutions and beds outpacing the development of professional capacity and quality governance， excessive concentration of social-risk management responsibilities in medical institutions， and inadequate continuity of care across hospitals， communities， and families. In practice， psychiatric hospitalization may simultaneously serve the multiple functions of clinical treatment， institutional financing， and the management of social risks. When the boundaries among these functions are unclear， and outpatient care， day services， community-based rehabilitation， and social support lack stable institutional and financial support， hospitalization may become systematically overused. The next stage of reform should shift mental health services from a hospital- and inpatient-dominated model toward a stratified and continuous system centered on patients' needs； establish medical insurance payment and evaluation mechanisms that balance costs， quality， functional outcomes， and long-term value； clarify the responsibilities of medical institutions， communities， families， and relevant government sectors； and make professional competence， ethical standards， patients' rights， and institutional governance the foundations of quality improvement. The key to the high-quality development of mental health services in China lies neither in simply increasing or reducing the number of psychiatric beds nor solely in strengthening post hoc regulation， but in aligning institutional incentives with patients' interests and promoting symptom improvement， functional recovery， and social participation.

Serum albumin, a reverse acute-phase protein, tends to decrease in response to acute clinical conditions. We hypothesized that albumin levels would exhibit state-dependent dynamics, with distinct patterns between acute episodes and remission states in schizophrenia. To test this, we conducted a retrospective longitudinal study to investigate the dynamic serum albumin levels in 148 schizophrenia patients, starting from their first episode through remission and subsequent relapse. A matched general population sample served as the control group. Classification models were developed using albumin levels (Albumin current) and changes (ΔAlbumin1 = Albumin current-Albumin previous remission, and ΔAlbumin2 = Albumin current-Albumin previous acute episode) to distinguish clinical states. Model performance was evaluated using the area under the receiver operating characteristic (ROC) curve (AUC). Serum albumin levels were significantly lower during acute episodes (first episode: 45·6, standard deviation (SD) 4·0 g/L; relapse: 44·9, SD 4·0 g/L) compared to remission (48·6, SD 2·9 g/L) and matched controls (48·6, SD 3·4 g/L). Patients in remission showed albumin levels comparable to controls. These findings remained consistent after adjustment for potential confounders using mixed-effects model and in sex-stratified analyses. The classification model incorporating ΔAlbumin1 and ΔAlbumin2 achieved an AUC of 0·88 (95% CI: 0·84, 0·92) in distinguishing acute episodes from remission. These findings highlight serum albumin's potential as a clinically useful biomarker of illness activity/state and mental stress in schizophrenia, with utility in differentiating between acute and remitted states.

The rapid proliferation of synthetic opioids, particularly fentanyl and its analogues, has intensified the opioid crisis, highlighted the limitations of fragmented approaches to opioid use disorder (OUD), and heightened tensions between the United States and China. This narrative review compares public health policy responses in the United States and China across four key domains: demand reduction, harm reduction, supply control, and governance coordination, to evaluate how integrated governance can improve outcomes. In the United States, there has been substantial progress in expanding opioid agonist treatment, naloxone distribution, and low-threshold services. However, persistent fragmentation across healthcare, public health, criminal justice, and social services continues to limit long-term recovery. In China, sustained declines in registered drug users over seven consecutive years and improvements in community-based rehabilitation reflect a more coordinated system linking treatment, rehabilitation, and social reintegration, although new challenges have emerged from the rising non-medical use of prescription medicines, veterinary anesthetics, and new psychoactive substances. Regulatory control of supply chains, upstream targeted interdiction,expanded treatment access, and harm reduction strategies may contribute collectively to recent reductions in drug overdose deaths in the United States. An effective response to synthetic opioids requires aligning demand reduction, harm reduction, and supply control strategies within a unified public health framework. Public health can serve as a practical bridge across differing policy systems and provide a foundation for sustained international cooperation in the synthetic opioid era.

BACKGROUND AND AIM:Alcohol consumption in China poses significant public health challenges. Between 2005 and 2010, alcohol production and by implication, consumption, surged, leading to increased alcohol-related harms due to weak regulatory frameworks. This study examined recent patterns of alcohol consumption in China using public production data as a proxy. METHOD:Statistical analysis was conducted using data from the National Bureau of Statistics of China on the production of beer, wine, and liquor, from the years 2009 to 2023. RESULTS:The production of liquor and wine in China increased from 7.1 and 0.96 million tons in 2009 to 13.6 and 1.14 million tons in 2016, respectively. Inferred alcohol per capita consumption (APC) rose from 4.38 L in 2009 to 6.45 L in 2016, representing a 47% increase. However, from 2016 onwards, alcohol production declined to 4.5 and 0.14 million tons for liquor and wine in 2023, respectively. Consequently, inferred APC decreased from 6.45 L to 2.85 L, an overall reduction of 55.8%. CONCLUSIONS:Alcohol production and inferred consumption in China appear to have substantially declined since 2016. Potential factors contributing to this decline include stricter government policies, stricter market regulation and tax enforcement, public health campaigns, and demographic and cultural shifts. However, many global measures such as higher taxes, price controls, advertising restrictions, and a legal drinking age, have not been (adequately) implemented in China.

Opioid dependence is a serious, life-threatening condition with severe social impacts. Naltrexone (NTX) can weaken the effect of opioids and effectively reduce opioid self-administration, discrimination, and opioid-induced subjective effects, and the oral dosage form has been approved for the treatment of opioid dependence. However, the effectiveness of oral naltrexone as an opioid antagonist has been limited due to poor patient adherence. A long-acting formulation in the form of naltrexone implant (NTX-IMP) with a five-month duration of action may address this issue and improve outcomes. This study (trial registration number: CTR20181954) aimed to evaluate the effect, safety, and pharmacokinetics of NTX-IMP in agonist effects via hydromorphone challenge test, and to determine optimal dosages for future research. Thirty-one former opioid-dependent individuals were randomized to the 0.9g or the 1.5g NTX-IMP group. All subjects exhibited significant antagonistic effects during hydromorphone challenge test. Calculation of slope between VAS score or pupil diameter and hydromorphone dose suggested a stronger antagonistic effect in the 1.5 g group. Pharmacokinetic data suggested that effective plasma naltrexone concentration (≥1ng/ml) was detected from the third day for over 148 days, with higher concentration and longer duration in the 1.5 g group. All subjects tolerated NTX-IMP well. The findings indicate that the NXT-IMP effectively blocks the agonistic effects of hydromorphone in a dose-dependent manner.

PURPOSE:Previous literature suggests that sleep disturbance is linked to Internet addiction, however, there was not sufficient empirical evidence to validate the causal relationships connecting these two variables. Our research intended to investigate these bidirectional associations in an adolescent population. METHODS:In all, 27 260 adolescents were assessed from December 17 to 26, 2021 and again 6 months later from May 17 to June 5, 2022. To evaluate Internet addiction, researchers employed the Revised Chinese Internet Addiction Scale (CIAS-R), while sleep disturbance was assessed through a four-item questionnaire addressing issues such as: difficulty initiating sleep, difficulty maintaining sleep, early morning awakening, and poor sleep quality. RESULTS:Sleep disturbance at baseline was linked to a higher probability of developing Internet addiction within 6 months, even after adjusting for relevant covariates. Similarly, individuals with Internet addiction at baseline exhibited a markedly increased risk of developing new-onset disturbance at the six-month follow-up. CONCLUSION:This study highlights the bidirectional prospective links between sleep disturbance and Internet addiction among adolescents. The findings hold significant educational and clinical value, offering insights for managing Internet addiction alongside addressing sleep-related issues.

IMPORTANCE Cognitive bias modification (CBM) programs have shown promise in treating psychiatric conditions, but they can be perceived as boring and repetitive. Incorporating gamified designs and adaptive algorithms in CBM training may address this issue and enhance engagement and effectiveness. OBJECTIVE To assess the efficacy of an adaptive approach bias modification (A-ApBM) paradigm with gamified designs and dynamic difficulty adjustments in reducing cue-induced craving in individuals with methamphetamine use history. DESIGN: Randomized controlled trial with three study groups: Adaptive ApBM (A-ApBM), Static ApBM (S-ApBM), and control. SETTING Twelve community-based rehabilitation centers in Sichuan, China. PARTICIPANTS Individuals aged 18-50 with methamphetamine dependence were randomized. INTERVENTION A-ApBM and S-ApBM groups engaged in ApBM training using a smartphone application for four weeks. A-ApBM used an adaptive algorithm to dynamically adjust the difficulty level based on individual performance, while S-ApBM had a static difficulty level. MAIN OUTCOMES AND MEASURES Cue-induced craving scores assessed using a visual analog scale at baseline, post-intervention, and at week-16 follow-up. RESULTS The A-ApBM group showed a significant reduction in cue-induced craving scores at post-intervention compared to baseline (p = 0.02). The reduction remained significant at the week-16 follow-up (p = 0.01). No significant changes were observed in the S-ApBM and control groups. CONCLUSION AND RELEVANCE The adaptive ApBM paradigm with gamified designs and dynamic difficulty adjustments may be an effective intervention for reducing cue-induced craving in individuals with methamphetamine use history. This approach improves engagement and personalization, potentially enhancing the effectiveness of CBM programs. Further research is needed to validate these findings and explore the application of adaptive ApBM in other psychiatric conditions. TRIAL REGISTRATION Registered at clinicaltrials.gov (ID NCT05794438 ).

Abstract Background Alcohol use disorder (AUD) is the most common, costly, and lethal substance use disorder worldwide, with a rising prevalence. Case reports and animal studies suggest deep brain stimulation (DBS) may be an effective harm-reduction treatment in AUD. Aims & Objectives The aim of this study is to explore whether deep stimulating the nucleus accumbens (NAc) and anterior limb of internal capsule (ALIC) simultaneously may have a synergistic effect against treatment-resistant AUD. Method Total of 12 subjects from two centers (Shanghai Mental Health Center and The Second Xiangya Hospital of Central South University) who fit inclusion and exclusion criteria are recruited to undergo neurosurgical implantation of dual-target DBS in bilateral NAc and ALIC on a certain date, the DBS system will be turned on for stimulation and parameters adjusted 10-14 days after implantation. Clinical observations will be follow-up during the 9-32 weeks after DBS system has been turned on. The primary outcome is the performance on alcohol use self-report which will be carried out regularly every three days during the study period. Safety assessments will include adverse event reporting, clinical laboratory tests, vital signs, and prior/concomitant medications. Results This study is recruiting subjects now, and all results will be reported after study completion. Discussion & Conclusion The study will provide evidence for the efficacy and safety of dual-target DBS for treatment-resistant AUD. This abstract describes the design and methodology of the study. Trial Registration ClinicalTrials.gov ID NCT05786872 References None.

Methamphetamine use can produce psychotic symptoms almost indistinguishable from schizophrenia (SCZ). Variation in DNA methylation may be closely implicated in the etiology and longitudinal development of psychiatric disorders. However, the relationship between psychotic symptoms, functional disability, and DNA methylation is still unclear. This study consists of three periods: discovery, validation, and follow-up. In the discovery stage, we employed genome-wide DNA methylation profiling (Illumina 450K) in peripheral blood mononuclear cells to test whether DNA methylation associates with psychotic symptoms and function state in representative SCZ and methamphetamine-induced psychotic disorder (MIP) patients. Then, we found seven differentially methylated regions/genes (DMRs, in UBA6, APOL3, KIF17, MLLT3, GRM8, CSNK1E, SETDB1) overlapping with genetic variants reported in previous studies of psychosis. In the validation stage, we compared the above-mentioned seven genes by MethLight qPCR method in Chinese Han males (N = 109 SCZ patients, N = 99 methamphetamine use disorder with MIP patients, N = 150 methamphetamine use disorder without MIP patients, N = 282 normal controls, age range: 18-50 years). GRM8 showed robustly altered methylation, which has passed rigorous filtration in subsequent validation, suggesting a remarkable contribution to SCZ and MIP. In addition, hypermethylation of GRM8 showed a significant association with the total scores of the Positive Negative Syndrome Scale and WHO disability assessment schedule II in both baseline and follow-up periods. Our findings suggest that increased CpG methylation in the promoter of GRM8 is a potential candidate epigenetic biomarker of psychotic symptoms in transdiagnostic samples of SCZ and MIP.

Aim: To assess the thyroid allostasis in drug -free patients with affective disorder. Methods: Patients with major depressive disorder or bipolar disorder as drug -free, defined as those without psychiatric drugs exposure for at least 4 months before admission, from a tertiary hospital were recruited in this cross-sectional study. The primary outcomes were "structure parameters of thyroid homeostasis", which include "thyroid's secretory capacity" (SPINA -GT), "sum step-up activity of deiodinases" (SPINA-GD), the ratio of total to free thyroxine and "thyroid homeostasis central set point" (TSH index and "thyroid feedback quantile-based index" [TFQI]), calculated by TSH and thyroid hormones measured at admission. A healthy population and non -affective psychiatric disorder (schizophrenia) from the same catchment area were recruited as two comparison groups. Results: A total of 1263 cases of major depressive disorder, 1619 cases of bipolar disorder, 1186 cases of schizophrenia, and 162 healthy controls were included in the study. Compared to healthy control, GD and ratio of total to free thyroxine were lower in affective disorders. Bipolar with mania episode had higher GT than bipolar with depressive episode and major depressive disorder (median level at 3.70 vs. 3.04 and 3.03, respectively). Compared with healthy control, schizophrenia had higher TSH index and TFQI, but no increase in these parameters in major depressive disorder and bipolar disorder. Conclusion: Affective disorders have a unique profile of thyroid allostasis with impaired step-up deiodinase activity and reduced serum protein binding of thyroid hormones, but no change in thyroid homeostasis central set point. Mania episode may be associated with higher thyroid secretory capacity.

Building a functional agricultural province is a key measure for Shanxi Province to comprehensively promote high-quality agricultural development.Based on relevant theoretical foundations and research literature, identify the existing development foundations such as the whole industry chain of functional agriculture, regional brand demonstration, integration of scientific research resources, and construction of characteristic production bases, and systematically sort out financial support to help functional agriculture through financial subsidies, tax incentives, and loan support in Shanxi Province.The mechanism of agricultural development and a feasible path for the development of functional agriculture are proposed.Research results show that the development of functional agriculture in Shanxi Province faces development bottlenecks such as insufficient industrial chain coordination and value-added, heterogeneity of agricultural products and ambiguous regional brand positioning, prominent shortcomings in investment in scientific research elements, and lagging follow-up support for characteristic bases.Based on this, it innovatively proposes a package of policy support for the development of functional agriculture, build a value co-creation system between leading enterprises and the whole industry chain, use geographical indication resources to shape regionally featured

BACKGROUND Addictive disorders have gained worldwide attention.The Chinese Association of Drug Abuse Prevention and Treatment,along with the consensus panel on digital therapeutics(DTx)for addictive disorders,has published an expert consensus on DTx for addictive disor-ders.1 This consensus discusses and summarises the current research and application status of DTx for addictive disorders.It identifies its clin-ical value,application directions,research and development principles,and future prospects.As the consensus is published in Chinese,it may not be easily accessible to an international audience.To address this,we present here an overview of the expert consensus on DTx for addictive disorders in China.The recommen-dations from the consensus are summarised in table 1.

BACKGROUND:Esketamine is a version of ketamine that has been approved for treatment-resistant depression, but our previous studies showed a link between non-medical use of ketamine and brain structural and functional alterations, including dorsal prefrontal grey matter reduction among chronic ketamine users. In this study, we sought to determine cortical thickness abnormalities following long-term, non-medical use of ketamine.METHODS:We acquired structural brain images for patients with ketamine use disorder and drug-free healthy controls. We used FreeSurfer software to measure cortical thickness for 68 brain regions. We compared cortical thickness between the 2 groups using analysis of covariance with covariates of age, gender, educational level, smoking, drinking, and whole-brain mean cortical thickness.RESULTS:We included images from 95 patients with ketamine use disorder and 169 controls. Compared with healthy controls, patients with ketamine use disorder had widespread decreased cortical thickness, with the most extensive reductions in the frontal (including the dorsolateral prefrontal cortex) and parietal (including the precuneus) lobes. Increased cortical thickness was not observed among ketamine users relative to comparison participants. Estimated total lifetime ketamine consumption was correlated with reductions in the right inferior parietal and the right rostral middle frontal cortical thickness.LIMITATIONS:We conducted a retrospective cross-sectional study, but longitudinal studies are needed to further validate decreased cortical thickness after nonmedical use of ketamine.CONCLUSION:This study provided evidence that, compared with healthy controls, chronic ketamine users have widespread reductions in cortical thickness. Our study underscores the importance of the long-term effects of ketamine on brain structure and serves as a reference for the antidepressant use of ketamine.

Background Gaming disorder is a new disease, which is included in the disease unit of disorder caused by addiction in the 11th revision of the International Classification of Diseases. This study examined the symptom characteristics of gaming disorders in Chinese adolescents using the latent profile analysis. Methods Totally, 5988 students (including 3285 boys and 2703 girls; aged 12–18 years) from junior high schools and senior high schools were enrolled. The Gaming Disorder Symptom Questionnaire-21 (GDSQ-21) was used to screen gaming disorder. A latent profile analysis was used for classifying the subgroups based on the extent of gaming usage. The relationship between adolescent gamers and demographic variables was analyzed by logistic regression. Results The results of latent profile analysis supported the models of four latent profiles, which were defined as healthy gamers (Profile 1, 56.83%), impaired control gamers (Profile 2, 26.09%), impaired control-game priority gamers (Profile 3, 9.72%) and gamers with disorder (Profile 4, 7.36%), respectively. Logistic regression analysis found that, compared with girls, boys were more likely to be classified into the group dominated by the impaired gamers, the impaired control-game priority gamers, and the gamers with disorder. Conclusions This study highlighted that the latent profile analysis identified four different groups of adolescent gamers, showing a clearer conceptualization of heterogeneous gamers. Gender and average weekly gaming time can predict the latent profile of adolescents. Our findings may facilitate the design of individualized assessment and early intervention programs for adolescent gamer users based on different gaming usage symptoms.

Purpose of review The situation of China drug use has seen dramatic changes in recent years. The aim of this review is to give a perspective of the current situation of drug abuse, the problems associated with it, and the strategy to control it in China. Recent findings The number of registered drug users and newly discovered drug users had declined for 5 consecutive years, Moreover, the scaling down of drug trafficking and drug-related crimes had been seen for recent years. There are four main drug treatment modalities in China. The drug abuse and its related problems in China face new challenges, including the impact of the coronavirus disease 2019 pandemic, the role of compulsory treatment is overemphasized, the voluntary treatment facilities and community treatment cannot meet the requirements of Chinese society, and the coordination among government departments in drug control and treatment in China need to improved. Summary With years of the joint efforts, the overall drug situation kept improving. The drug abuse and its related problems in China still is a problem, and require effective and immediate interventions.

The purpose of this article is to explore the diagnosis of Internet addiction （gaming disorder） and its research hotspot. Gaming disorder is basically an addictive behavior and is reinforced by obtaining positive emotion and alleviating negative experience. By introducing a complex comorbidity clinical case， this article talked about addictive behavior， gaming disorder and other related issues， and discusses the debate of the diagnosis of gaming disorder and its possible future changes， the treatment， the current main problems and research hotspot.

Background: Overwhelming evidence suggests that increasing alcohol taxes is an effective strategy for curbing alcohol consumption. However, research on the effects of such strategies in low- and middle-income nations is limited.Objective: The aim is to explore the temporal effect of alcohol tax policy in China.Methods: We employ interrupted time series analysis to investigate the temporal effects of tax policy changes on alcohol consumption and related consequences in Mainland China from 1961 to 2019. The study population, the total population of mainland region of China, aged more than 15 years.Results: The results show that the volume tax policy, which was announced in 2000 and implemented in 2001,  led to an immediate reduction in the alcohol consumption (coefficient = -0.429, p < .001). Following the implementation of higher alcohol taxes in 1998 and 2001, the prevalence of alcohol use disorders (AUDs) and related years lived with disability (YLDs) gradually decreased. The relaxation of tax policy in 2006 led to a significant increase in alcohol consumption, both immediately (coefficient = 0.406, p < .001) and in the middle term (coefficient = 0.495, p < .001), as well as contribute to an immediate or medium term significant increase in the prevalence of AUDs (coefficient = 0.038, p = .010; coefficient = 0.032, p < .001) and YLDs (coefficient = 4.363, p = .001; coefficient = 4.226, p < .001).Conclusion: This study demonstrates that changes in alcohol consumption and related consequences (increase or decrease) have followed corresponding changes in alcohol tax policies (easing or tightening), indicating that increasing alcohol taxes can be an effective strategy in China for controlling alcohol consumption and related harms.

ObjectiveThe present study opted for the adrenal phaeochromocytoma (PC12) cell line to frame a neuronal injury model induced by alcohol exposure in vitro, aiming to probe whether TAp73 and miR-96-5p are involved in the neuronal injury process induced by alcohol and elucidate the regulatory relationship between miR-96-5p and TAp73.MethodsImmunofluorescence staining was used to observe the structural features of PC12 cells after culturing in medium with nerve growth factor (NGF). After different doses and different durations of alcohol treatment, CCK-8 assay was performed to detect the viability of PC12 cells, flow cytometry assay was carried out to detect the apoptosis rate of PC12 cells, dual-luciferase reporter assay was used to definitude the regulatory relationship between miR-96-5p and Tp73, and western blot was used to detect the protein expression of TAp73.ResultsThe result of immunofluorescence staining demonstrated that PC12 cells abundantly expressed Map2, CCK-8 assay illustrated alcohol exposure significantly downregulated the cell viability of PC12 cells, Treatment with miR-96-5p inhibitor induced apoptosis and upregulated the expression of TAp73 in PC12 cells. Contrastingly, miR-96-5p mimic reversed the above effects and downregulation of TAp73 inhibited the apoptosis of PC12 cells.ConclusionThe present study demonstrated that miR-96-5p participates in alcohol-induced apoptosis in PC12 cells via negatively regulating TAp73.

Background: Chronic ketamine use has been associated with cognitive impairments, while depressive symptoms are commonly observed in individuals using ketamine. However, the influence of depressive symptoms on cognitive impairments in chronic ketamine users remains unclear. This study aimed to examine the impact of depressive symptoms on cognitive function in this population. Methods: A cross-sectional study was conducted with a sample of chronic ketamine users. Participants underwent comprehensive cognitive assessments, including measures of attention, executive function, working memory, verbal and visual memory. Depressive symptoms were assessed using Beck Depression Inventory (BDI) scores. Multivariate analyses were utilized to compare the cognitive performance of individuals who use ketamine, both with and without depressive symptoms, as well as a control group, while controlling for relevant covariates. Results: The results revealed a significant negative impact of depressive symptoms on cognitive impairments, particularly in the domains of memory and executive function, among chronic ketamine users. The analysis of partial correlations revealed that among individuals who use ketamine and have depressive symptoms, those with higher levels of depressive symptoms demonstrated poorer cognitive performance compared to individuals with lower levels of depressive symptoms, controlling for potential confounding factors. Conclusions: The findings suggest that depressive symptoms contribute to cognitive impairments, specifically in memory and executive function, in chronic ketamine users. Therefore, it is crucial to evaluate depressive symptoms when considering cognitive enhancement treatment for this population.