Objective:Using surface-based morphometry (SBM), this study longitudinally tracks dynamic changes in whole-brain cortical morphological parameters in depression patients before and after vortioxetine treatment. Through three-dimensional topological characterization, we investigate the neuroanatomical correlations between cortical structural reorganization and improvements in affective symptoms and cognitive functions.Methods:Prospectively collected clinical data from 22 outpatients with depression (10 males and 12 females, aged 18-50 years, mean age 28.1±9.1) who attended Beijing Huilongguan Hospital clinic from October 2018 to December 2019. An age-matched healthy control group ( n=21; 10 males and 11 females, aged 22-44 years, mean age 30.8±6.6) was recruited concurrently. The Hamilton Rating Scale for Anxiety (HAMA), the 17-item Hamilton Depression Scale (HAMD 17), and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) were used to evaluate the severity of depressive symptoms and cognitive function in patients. Structural magnetic resonance imaging (sMRI) was performed to assess brain structural indices in depression patients before and after vortioxetine treatment, as well as in healthy controls. Whole-brain cortical structure measurements were calculated for all subjects using CAT12 software. Paired-sample t-tests were used to compare changes in cortical structure and clinical scale scores in depression patients before and after treatment, and two-sample t-tests were conducted to compare whole-brain cortical structure differences between patients (pre-and post-treatment) and healthy controls. Multiple regression analysis in SPM 12 was applied to examine the correlation between post-treatment cortical structural indices and clinical and cognitive scale scores in patients. Spearman correlation analysis was used to evaluate the correlation between changes in whole-brain cortical structure and cognitive function before and after vortioxetine treatment. Results:After vortioxetine treatment, patients with depression exhibited significant reductions in HAMA and HAMD 17 scores, along with significant increases in immediate memory, delayed memory, and total RBANS scores, with statistically significant differences observed ( t=8.43, 12.28, -4.71, -2.41, -3.86 respectively; all P<0.05), while there were no significant changes in visual span, language function, or attention ( P>0.05). Compared to healthy controls, depression patients showed a significantly reduced gyrification index in the right insula/superior temporal gyrus before treatment (28.74±1.20 vs 27.44±1.17; t=4.47, P<0.001), but no significant differences in whole-brain cortical structure were observed before and after treatment or between post-treatment patients and healthy controls ( P>0.05). Correlation analysis indicated that fractal dimension was negatively correlated with HAMA and HAMD 17 scores after treatment, while gyrification index was positively correlated with HAMD 17 ( rpartial=-0.79, -0.83, 0.72; P<0.05). Visual span was positively correlated with fractal dimension ( rpartial=0.78) and negatively correlated with gyrification index ( rpartial=-0.73, P<0.05). Sulcal depth was negatively correlated with attention and RBANS total scores ( rpartial=-0.77, -0.75; P<0.05). Additionally, changes in gyrification index in the left fusiform gyrus were positively correlated with changes in attention ( r=0.51), changes in gyrification index in the left posterior cingulate gyrus were positively correlated with changes in immediate memory ( r=0.58), and changes in sulcal depth in the left superior frontal gyrus were negatively correlated with changes in language ability ( r=-0.79) (both P<0.05). Conclusion:Vortioxetine treatment can improve anxiety and depressive symptoms in depression patients, as well as enhance certain cognitive functions, while also affecting cortical structure in the specific cortical area. Changes in cortical structure after vortioxetine treatment are closely related to clinical symptom improvement and cognitive function changes.

Objective:This study aims to analyze the disease burden trends of schizophrenia and bipolar disorder from 1990 to 2021 in China, and to predict the trends of these two disorders over the next 20 years.Methods:This study was conducted between September and October 2024. The data on incidence, prevalence, and disease burden of schizophrenia and bipolar disorder in China were retrieved from the database of the Global Burden of Disease Study 2021 (GBD2021). Temporal trends were quantified via the annual percentage change, average annual percentage change (AAPC), and their corresponding P-values, which were calculated using the empirical quantile method with the Joinpoint software. The autoregressive integrated moving average (ARIMA) model was constructed using data on the incidence, prevalence, and disease burden of schizophrenia and bipolar disorder from 1990 to 2021 to predict the trends in prevalence and disease burden of these two diseases from 2022 to 2041. Results:In China, during the period from 1990 to 2021, the age-standardized incidence rate (ASIR), age-standardized prevalence rates (ASPR), and age-standardized disability-adjusted life year (DALY) rate (ASDR) of schizophrenia all showed a fluctuating upward trend. By 2021, the AAPC of these rates was 3.83% ( P<0.001), 12.99% ( P<0.001), and 14.11% ( P<0.001), respectively, indicating a significant increase. Regarding bipolar disorder, the annual average ASIR in China significantly increased (AAPC=1.25%, P<0.001), while the annual average ASPR significantly decreased (AAPC=-1.03%, P<0.001), and the annual average ASDR showed no significant change (AAPC=-0.08%, P=0.342). The incidence of schizophrenia was mainly concentrated in the 15-34 age group. The prevalence and DALY rates of schizophrenia were on the rise across all age groups. For bipolar disorder, the peak incidence occurred between the ages of 10 and 19, with higher incidence, prevalence, and DALY rates in females compared to males. Looking ahead from 2022 to 2041, the overall ASIR, ASIR for both females and males, and ASPR for males with schizophrenia are projected to gradually increase, while the ASPR and ASDR of bipolar disorder are expected to remain stable, with females continuing to bear a higher disease burden than males. Conclusion:In China, the disease burden of schizophrenia and bipolar disorder substantially changed from 1990 to 2021, with distinct differences across gender and age-groups. The disease burden of schizophrenia is projected to keep rising in the next 20 years. It is imperative to develop targeted and precise prevention and control strategies for different populations.

Objective:To explore the differences in the whole-brain functional connectivity characteristics of magnetoencephalography gamma sub-band in resting state between patients with depression with high and low suicidal ideation.Methods:Clinical data of 60 patients with depression (depression group) who visited the Department of Psychiatry, Nanjing Brain Hospital Affiliated to Nanjing Medical University from October 2021 to June 2024 were prospectively collected, including 20 males and 40 females aged 16-41 years. During the same period, 75 healthy controls (healthy control group) were recruited, matched for gender and age, comprising 33 males and 42 females, aged 18-43 years. The Hamilton Depression Scale-17 items (HAMD-17) was used to assess the degree of depression in patients, and the score of the third item was used to divide the patients into a high suicidal ideation group of 37 cases (2-3 points) and a low suicidal ideation group of 23 cases (0-1 points). The Beck Scale for Suicide Ideation-Chinese Version (BSI-CV) was used to assess the intensity of suicidal ideation in patients in the last week and at the most severe stage. Brain imaging data of the subjects were collected using a CTF-275 channel magnetoencephalography device and a 3 T magnetic resonance imaging device. The functional connectivity matrix of the gamma sub-band depression group, healthy control group, high suicidal ideation group, and low suicidal ideation group was calculated using the envelope correlation method. The network-based statistics (NBS) algorithm was used to correct for multiple comparisons and compare the differences in brain network functional connectivity between the depression group/healthy control group and between the high/low suicidal ideation groups.Results:Compared with the healthy control group, the functional connectivity between the bilateral middle frontal gyrus, right inferior frontal gyrus orbital part, right anterior cingulate gyrus, left middle frontal gyrus orbital part, and right superior parietal lobule in the depression group was significantly enhanced in the low gamma frequency band (30-60 Hz) ( θ=3, P=0.042). Compared with the low suicidal ideation group, the functional connectivity between the right amygdala as a central node and the right superior frontal gyrus, left hippocampus, right upper temporal pole, and left transverse temporal gyrus in the high suicidal ideation group was significantly enhanced in the high gamma frequency band (60-90 Hz) ( θ=3, P=0.049). Conclusion:In the low gamma frequency band, patients with depression have neural dysfunction mainly in the frontal lobe. In the high gamma frequency band, patients with high suicidal ideation have functional connectivity abnormalities centered on the amygdala.

Depression poses a severe threat to human health, placing a heavy burden on society and families. Yet, challenges remain in prevention and treatment. Lifestyle medicine aims to use evidence-based lifestyle interventions to prevent, treat, and even reverse chronic progression. Exploring breakthroughs in depression intervention prevention and treatment from the perspective of lifestyle medicine presents an opportunity for interdisciplinary research. Future research should focus on leveraging implementation science, cost-effectiveness analysis, and understanding optimal pathways and mechanisms of action. This article provides a review of this important topic.

Schizophrenia is a severe mental disorder prioritized in psychiatric prevention and treatment with a global prevalence rate of approximately 1%. It typically onsets during adolescence and early adulthood with a chronic disease course, leading to a heavy burden on patients, families, and society. The etiology and pathological mechanisms of schizophrenia remain incompletely clarified. Current treatment strategies primarily rely on symptomatic pharmacological therapy. Delayed seeking help, long duration of untreated psychosis, insufficient treatment efficacy, adverse drug reactions, and poor treatment compliance are still challenges in the treatment of schizophrenia. Current research hotpots focus on uncovering the pathological mechanisms of the disease, exploring objective prediction indicators for early diagnosis and personalized treatment, and developing more effective treatment strategies. This article reviews significant research progress over the past decade in pathogenesis, clinical diagnosis, and development of treatment approaches for schizophrenia. It proposes future development directions to provide valuable insights for professionals in standardizing diagnosis and treatment and future research directions.

Alexithymia refers to a deficiency of emotional structure, but the neurologic and psychological mechanisms of non-suicidal self-injury (NSSI) in adolescents are still unclear. The neural basis of alexithymia may play a role in adolescents′ NSSI by affecting the function of emotion regulation and emotion expression. At the same time, NSSI is also considered to be a non-adaptive emotional regulation mode for alexithymia individuals, which interacts with personality factors and psychosocial factors. This study explored the neuropsychological mechanism of alexithymia in adolescent NSSI from the perspective of emotional function, and provided theoretical basis for early identification and precise intervention of alexithymia and adolescent NSSI.

Anticipatory anxiety is a negative emotion that arises when individuals encounter potential threats or uncertainties in the future. It is the core symptom of a variety of anxiety disorders, and is closely associated with the occurrence, severity, treatment outcome, and prognosis of anxiety disorders, which has garnered a growing amount of focus in clinical practice. Nevertheless, scientific research on anticipatory anxiety continues to face obstacles such as unclear pathological mechanisms, the absence of simple and consistent self-assessment tools, and effective interventions. To improve understanding of the role of anticipatory anxiety in the diagnosis and treatment of anxiety disorders, this study reviews pertinent domestic and international literature, and briefly introduces the concept, assessment and measurement, activation paradigm, pathological mechanisms, and interventions of anticipatory anxiety.

A 77-year-old male patient was admitted to the hospital with the main cause of memory loss, visual hallucination for more than one year, aggravated for two months with sensitivity and paranoia. The patient exhibited signs of loss of smell, axial hypertonia, upper limb hypertonia, slow start, and propulsive gait. Cranial MRI suggested cerebral atrophy, bilateral hippocampal atrophy, and multiple cavernous cerebral infarcts. Severe memory deficits, moderate intellectual deficits, MMSE score of 12, mildly abnormal electroencephalography, and polysomnographic monitoring suggested a high likelihood of apnea syndrome. Prior to the onset of the disease, the patient had a history of swinging, shouting, and cursing during nighttime sleep, according to his family members. The final diagnosis was Lewy body dementia.

This article compares the diagnostic criteria for Obsessive-Compulsive Disorder (OCD) in the Diagnostic and Statistical Manual of Mental Disorders-5 th edition (DSM-5) and the International Classification of Diseases-11 th edition (ICD-11), and systematically analyzes the issues in the conceptualization and symptom classification of OCD in China, combining the Chinese Classification and Diagnostic Criteria of Mental Disorders-3 rd edition (CCMD-3), domestic psychiatry textbooks, and the Chinese Guidelines for the Prevention and Treatment of OCD. The main issues identified include imprecise concept translation, inadequate logical structure in symptom classification, inappropriate terminology, and insufficient functional understanding of "obsession and compulsion". Based on these issues, new perspectives are proposed regarding the concepts and symptom classification of OCD in China. The aim of this article is to provide suggestions for optimizing the domestic theoretical framework of OCD and to promote academic exchange and development in the field of OCD diagnosis and treatment.

The interplay between psychological pain and physical pain is one of the key issues in the research of non-suicidal self-injury (NSSI). Psychological pain, driven by negative self-perception and difficulties in emotional regulation, activates specific brain regions, such as the anterior cingulate gyrus and insula, areas that overlap with neural networks involved in physical pain. Physical pain can, in turn, activate distinct neural pathways that temporarily alleviate psychological pain. However, repeated self-injury may lead to increased pain tolerance over time, contributing to a vicious cycle. This paper reviews the potential neural network connections and interactions between psychological and physical pain in the context of NSSI behavior. It also summarizes current clinical interventions and their effectiveness in treating NSSI, aiming to offer new insights for future research and clinical practice in preventing and treating NSSI.