Dementia in China is increasingly burdensome yet remains underrecognized and undertreated due to low awareness and persistent stigma. Community-based strategies are urgently needed to address these barriers. By using real-world data from an 18-month dementia campaign in Wuhan, we retrospectively evaluated the feasibility and efficacy of opinion leader intervention (OLI), a novel, community-driven approach, in improving dementia knowledge, reducing stigma, and promoting screening among older urban adults.

Starting in August 2023, a three-phase campaign was launched, targeting 3550 residents aged ≥60 years in the Jiangdijie community, Wuhan. The pre-intervention phase (6 months) included monthly expert-led dementia education lectures at a senior center (30–60 attendees/session). The traditional intervention phase (next 6 months) involved distributing brochures in public areas and doubling lecture frequency. The final OLI phase (6 months) engaged 19 trained opinion leaders to disseminate knowledge, encourage screening, and model preventive behaviors during daily interactions. Free dementia screening was available throughout the campaign. Outcomes—dementia knowledge scores, stigma-related attitude scores, and screening participation rates—were assessed via samples randomly drawn from the elderly residents at the end of each phase (T0: n = 100, T1: n = 117, T2: n = 100).

Dementia knowledge scores among older adults increased from 12.27 (T0) to 13.51 (T1), with a significant jump to 17.63 post-OLI (T2 vs T1, p < 0.001). Stigmatizing attitudes scores improved from 2.11 (T0) to 2.43 (T1), rising further to 2.98 at T2 (T2 vs T1, p = 0.010). Participation rates in dementia screening rose from 18.0% (T0) to 23.9% (T1), surging to 46.0% post-OLI (T2 vs T1, p < 0.001).

The OLI was associated with marked improvements in dementia knowledge, reduced stigma, and higher screening uptake compared with traditional health education methods. These findings highlight OLI's potential as a feasible strategy to enhance dementia awareness and care in Chinese urban communities.

Traditional school bullying and cyberbullying are common experiences that adversely affect the present and future mental health of adolescents. Cyberbullying has also increased during the last decade due to the growing use of the internet, mobile technological tools, and social network systems. This study aimed to investigate the risk factors of traditional school bullying and cyberbullying.

The sample comprised 5491 adolescents (53.7% male and 46.3% female) from Grades 7 to 12 in 15 public schools. Participants were administered a self-report survey, including sociodemographics, school bullying, cyberbullying, and related variables. A logistic regression analysis was performed to examine the factors related to school bullying and cyberbullying involvement.

Boys were more prone to be perpetrators or victim-perpetrators of both school and cyberbullying. The results revealed that carrying a cutting tool, short sleep duration, using the computer and mobile phone longer, and poor academic performance were risk factors for being a perpetrator (p < 0.05). In addition, school bullying involvement was related to thin or overweight body perception (p < 0.001). Regression analysis indicated that being a victim or perpetrator of school bullying showed more significant risks for being a victim or perpetrator of cyberbullying (p < 0.001).

We found common risk factors for both types of bullying and an overlap between school bullying and cyberbullying. These findings should be considered for developing new intervention programs and policies for preventing bullying in Turkey.

Understanding the factors that sustain physical activity among college students is crucial for promoting a healthy lifestyle, as emphasized by the United Nations’ Sustainable Development Goal 3. While the link between physical activity and health outcomes is established, less is known about how physical exercise self-efficacy (PESE) influences persistent exercise behavior (PEB) through different forms of physical activity engagement (PAE). This study investigates whether PESE promotes PEB via cognitive, emotional, and behavioral engagement, based on self-determination theory (SDT) and engagement theory.

An online cross-sectional survey was conducted from July 16 to August 16, 2023, involving 900 Chinese college students recruited through convenience sampling on the Questionnaire Star platform, the participants were selected through convenience sampling, which ensured the inclusion of a diverse demography across various grades, educational backgrounds, and study fields. Before the participants provided informed consent, they were briefed on the study’s objectives, data processing procedures, and privacy protections. Validated scales assessed PESE, PAE, and PEB. Data quality was ensured by excluding invalid or incomplete responses. Statistical analyses were performed in several stages. Using SPSS, item and reliability analyses of the research instrument were performed to confirm internal consistency. Then, the confirmatory factor analysis was performed for each scale by using AMOS. Finally, structural equation modeling was used to validate the proposed research model and conduct path analysis, thereby assessing the hypothesized relationships among PESE, PAE, and PEB.

PESE positively influenced cognitive, emotional, and behavioral engagement in physical activity. These forms of engagement, in turn, positively affected fluency experience (FE), which subsequently enhanced PEB. The findings indicate that PESE augments FE by improving PAE, leading to sustained exercise behavior among college students.

The study demonstrates the critical role of PESE in fostering persistent exercise behavior through its impact on cognitive, emotional, and behavioral engagement. These insights highlight the importance of designing interventions that enhance PESE and PAE to promote long-term commitment to physical activity among college students, supporting broader health and well-being goals.

Obsessive-Compulsive Disorder (OCD) patients are often comorbid with depression and anxiety. However, limited research has explored this comorbidity from the perspective of individuals with depression and anxiety exhibiting obsessive-compulsive symptoms (OCS). This study aims to investigate the prevalence and potential associations between depression, anxiety, and OCS in the adolescent patient population.

A retrospective study was employed in this research. A total of: 327 drug-naive, first-episode adolescent patients aged 10 to 19 years, presenting both depressive and anxiety symptoms, were recruited from the Shanghai Pudong New Area Mental Health Center in China. The Chinese version of the Symptom Checklist-90 (SCL-90) was used to assess the severity of OCS. Binary logistic regression was applied to analyze the influence of depression and anxiety levels on OCS.

More than half (52.3%) of the 327 adolescent participants with depressive and anxiety symptoms had severe obsessive-compulsive symptoms (OCS). Additionally, 35.9% had moderate OCS, 12.9% had mild OCS, and only 2.8% were symptom-free. The results also indicated a significant correlation between OCS and both depression (β = 0.073, Wald χ² < 0.001, p < 0.005) and anxiety levels (β = 0.066, Wald χ² < 0.005, p < 0.001).

The findings provide valuable insights into the predictive ability of depression and anxiety level in the development of OCS and OCD during adolescence, highlighting the importance of early identification and intervention. Future studies should include a larger and more diverse sample, with the incorporation of professional clinical evaluations to further verify these results.

The study was registered at https://www.chictr.org.cn/, registration number: ChiCTR2300070007.

To investigate the potential toxic effects of prenatal exposure to valproic acid (VPA) on microglia-neuron communication in the brain, with a specific focus on the alterations in key molecules involved in this process, namely CX3CL1/CX3CR1 and CD200/CD200R, during the early stages of life in a rat model of autism.

Pregnant female rats were administered either sterile saline or VPA on embryonic day 12.5. The brains of the rat offspring were collected on postnatal day 30 for analysis. Immunohistochemical techniques and enzyme-linked immunosorbent assay (ELISA) were employed to assess changes in microglia-neuron crosstalk.

The study revealed a significant reduction in CD200 levels within the hippocampus of rats on postnatal day 30 following prenatal exposure to VPA, indicating an impairment in CD200/CD200R signaling. Additionally, there was no observed increase in microglial numbers or any pathological alterations in the hippocampus. Additionally, no significant changes in the levels of CX3CL1 and CX3CR1 were noted in the VPA-exposed rats compared with the control group.

Prenatal exposure to VPA resulted in a decrease in CD200 expression within the hippocampus, potentially disrupting the communication between microglia and neurons. The findings suggest that VPA may modify the interactions between microglia and neurons, which could lead to neuroinflammation due to hyperactivated microglia. These disruptions have the potential to affect synaptic connectivity and contribute to the development of neurodevelopmental disorders, including autism. Further research is necessary to clarify the underlying mechanisms and implications for pathological conditions associated with autism spectrum disorder (ASD).

This study was conducted to provide a comprehensive scale that evaluates the risk of repeated inpatient hospitalizations in chronic psychiatric diseases in order to predict and prevent repeated hospitalizations.

The study population consisted of individuals with chronic psychiatric diseases (n = 390) receiving inpatient treatment at the adult psychiatry inpatient services of Turkey Ankara Bilkent City Hospital. The sample number calculation was made based on 10 times the number of scale items. For the pilot component of the research, data was collected between February, 2023 and January, 2024. An ‘Informed Voluntary Consent Form’, a ‘Sociodemographic Data Collection Form’, the ‘Discharge Readiness Scale’, and the ‘Repeated Clinical Hospitalization Risk Assessment Draft Scale for Chronic Psychiatric Diseases’ were used as data collection tools. During the development stages, the validity and reliability of the scale were analyzed.

The Content Validity Index (CVI) value of the scale items was calculated as 0.98. Cronbach’s alpha of the scale was found to be 0.833.

The ‘Repeated Clinical Hospitalization Risk Assessment Scale in Chronic Psychiatric Diseases’ is a valid and reliable scale for the Turkish population in terms of measuring risk level.

Stabilisation and Referral Areas (SARA) are a unique model of Short Stay Psychiatry inpatient care. This protocol details the comprehensive evaluation of a new SARA service within the Royal Darwin Hospital located in remote and regional Australia. Located in the Northern Territory (NT) there are just 17 specialised mental health beds per 100,000 compared to the national average of 27 per 100,000. There have been no previous evaluations of SARA services in regional and remote Australian settings, therefore their acceptability and potential effects on consumer outcomes in these unique settings is unknown. This study protocol attempts to address this knowledge gap.

A mixed method study with triangulation and including mirror methodology.

A service evaluation protocol is proposed to be conducted over an initial 12 months period with a mirror image component to enable comparison of consumer outcomes prior to the service inception. The service evaluation is guided by the “Reach, Effectiveness, Adoption, Implementation and Maintenance” (RE-AIM) framework and utilized both qualitative and quantitative measures to comprehensively describe the service.

Results will include both qualitative and quantitative data using the “R”, “E” and “A” component (Reach, Effectiveness and Adoption) of the RE-AIM framework.

Emergency departments (EDs) are not well suited to persons experiencing mental health crisis and efforts need to be made to improve the delivery of service as well as patient flow. Minimizing wait times in ED is paramount. SARA is an innovative model of care that may address some of these issues. Evaluating its performance across a range of measures is key to improving and progressing the service. The unique context of the service location which has a large First Nations population and its remote setting adds further weight to the need to understand this model within this geographical context.

Intermittent Explosive Disorder (IED) is an impulse-control disorder characterized by the inability to control emotions and behaviors, resulting in behaviors that violate social norms and the rights of others. The IED Screening Questionnaire (IED-SQ) is a valuable tool that can quickly identify the presence of IED in adults by Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) criteria. This study evaluated a form of the IED-SQ that had been translated into Turkish, and investigated the reliability and validity of the Turkish version of the IED-SQ.

Seventy-one adult IED patients and 68 adult controls participated. The Barratt Impulsivity Scale (BIS-11), Minnesota Impulse Control Disorder Interview Scale (MIDI), Buss Perry Aggression Questionnaire (BPAQ), Symptom Checklist 90-Revised (SCL-90-R), Wender Utah Rating Scale (WURS), and IED-SQ were administered to the participants.

The Cronbach’s α coefficient of the IED-SQ was 0.74. The subscales of the BPAQ, including physical aggression, verbal aggression, hostility, and anger, along with the attention and non-planning impulsivity subscales of the BIS-11, were incorporated into the multivariate analysis to identify factors independently associated with the IED-SQ. According to the model, the correct classification percentage was found to be 95%.

This study demonstrated that the Turkish version of the IED-SQ is valid and reliable and can be used in clinical practices to identify the presence of IED.

Borderline personality disorder (BPD) is a complex mental health condition characterized by instability in interpersonal relationships, affect regulation, and impulse control. A core feature of BPD is identity disturbance, marked by a persistently unstable self-image and sense of self. Despite clinical recognition, the precise nature of identity disturbance remains ambiguous, with no clear consensus on its specific manifestations and measurable parameters. With the scoping review projected in this protocol, we aim to define what has been said in the literature about identity disturbance, its types, and methods of measurement.

Scoping review protocol.

Included publications will comprise empirical and theoretical studies focusing on identity disturbance in individuals diagnosed with BPD. Databases will include PubMed, PsycINFO, Scopus, and Web of Science Core Collection, supplemented by Google for grey literature. Data will be screened by two reviewers and discrepancies will be resolved through discussion or a third reviewer if necessary. Extracted data will include study details, methodological data, definitions of identity, conceptualizations of identity disturbance, types of disturbance, and assessment tools.

The forthcoming results will have the potential to make significant contributions to both theoretical and empirical knowledge on identity disturbance in BPD. It is expected that the results of the review will help to inform and improve therapeutic strategies, enabling more tailored and effective interventions for BPD patients with identity disturbance.

Understanding gene expression and functional connectivity (FC) changes in depressed patients with anxiety can help develop personalized therapies. Herein we examine the link between transcriptome data and FC differences in patients with major depressive disorder with significant anxiety (MDD/ANX+) and patients with major depressive disorder without significant anxiety (MDD/ANX-).

We compared the FC between the MDD/ANX+ group (n = 294) and the MDD/ANX- group (n = 218) to identify FC differences at both edge-based and network levels. Using the Allen Human Brain Atlas, we performed partial least squares regression analysis to identify genes associated with the observed FC disparities, followed by a functional enrichment analysis.

The results from both edge-based and network-level FC analyses consistently indicated significantly increased FC between the subcortical network (SC) and visual network, as well as between the SC and dorsal attention network, in the MDD/ANX+ group compared with the MDD/ANX- group. Additionally, transcriptome-neuroimaging correlation analysis revealed that the expression of 1066 genes was spatially correlated with the FC differences between the MDD/ANX+ and MDD/ANX- groups. These genes were enriched in translation at synapses and adenosine triphosphate (ATP) generation.

Our results indicate that gene expression variations in synaptic translation and ATP generation may affect FC and anxiety risk in MDD patients.

To investigate the risk factors for relapse among elderly schizophrenia patients undergoing maintenance phase treatment, aiming to offer insights for relapse prevention in this population.

A survey was conducted of elderly schizophrenia patients in the maintenance phase who attended outpatient clinics at a specialized psychiatric hospital from October, 2021 to September, 2023. The survey included both general and clinical data. Univariate analysis and multivariate non-conditional logistic regression analysis were conducted to identify independent risk factors for relapse in elderly schizophrenic patients undergoing maintenance phase treatment. A receiver operating characteristic (ROC) curve was drawn based on logistic regression results and the area under the curve (AUC) was used to evaluate the predictive value of each risk factor for relapse studied in these patients.

A total of 247 patients were collected, with 225 patients included in the analysis: 75 in the recurrence group and 150 in the non-recurrence group. Multivariate logistic regression analysis indicated: Irregular medication status (odds ratio (OR) = 3.302, 95% confidence interval (CI): 1.386–7.871), low exercise frequency (OR = 2.770, 95% CI: 1.141–6.726), family care points (OR = 0.647, 95% CI: 0.514–0.813), life event points (OR = 1.353, 95% CI: 1.194–1.533), and sleep duration (OR = 0.630, 95% CI: 0.504–0.788) as independent influencing factors for relapse during the maintenance phase of elderly patients with schizophrenia. The AUC for predicting relapse varied among these factors: Medication status (AUC: 0.660, 95% CI: 0.594–0.726), exercise frequency (AUC: 0.663, 95% CI: 0.599–0.727), family care (AUC: 0.691, 95% CI: 0.618–0.764), life events (AUC: 0.792, 95% CI: 0.731–0.853), and sleep duration (AUC: 0.789, 95% CI: 0.718–0.859). When considering all influencing factors, the AUC for predicting relapse during maintenance phase treatment of elderly patients with schizophrenia was 0.908 (95% CI: 0.867–0.949).

Medication status, exercise frequency, family care, life events and sleep duration emerged as independent influencing factors for relapse among elderly schizophrenia patients during maintenance phase treatment. Paying attention to these influencing factors simultaneously is suggested to prevent recurrence.

This study aimed to establish the validity and reliability of a fear of failure scale for adolescents.

The study involved 279 secondary school students enrolled in the 2020–2021 academic year. Internal consistency, item-total score correlation, and split-half methods were used to determine reliability, while exploratory and confirmatory factor analyses were employed to determine validity.

The two split-in-half method calculations found a Guttman Split-in-Half coefficient of 0.855 and a Spearman-Brown coefficient of 0.857. Cronbach’s Alpha was 0.802 for the first half (items 1–9) and 0.774 for the second half (items 10–17). CFA analyses showed that a three-factor solution fit the data, but some goodness-of-fit indices fell below acceptable levels. To improve the model, error covariances of certain items were correlated based on modification indices. The final values were Minimum Discrepancy of Confirmatory Factor Analysis/Degrees of Freedom (CMIN/df) = 2.727, Goodness of Fit Index (GFI) = 0.911, Adjusted Goodness of Fit Index (AGFI) = 0.863, Comparative Fit Index (CFI) = 0.673, Root Mean Square Error of Approximation (RMSEA) = 0.079, χ² = 160.9, Degrees of Freedom (DF) = 59. Factor loadings ranged from 0.52 to 0.83 for the first factor, 0.68 to 0.85 for the second factor, and 0.55 to 0.84 for the third factor.

The fear of failure scale is a reliable and valid measurement tool. A review of the existing literature revealed a lack of scales that assess the physical, emotional, and thought dimensions of fear of failure among individuals aged 11–14 years. This gap underscores the potential for measurement-based research in this domain. Through this study, a valid and reliable scale was developed to evaluate fear of failure in adolescents within the 11–14 year-age range, thereby addressing this critical need.

The Coronavirus disease 2019 (COVID-19) pandemic caused a range of mental health problems, particularly self-harm. Lockdowns are the usual methods of responding to these public health emergencies. However, the effect of the COVID-19 lockdown on self-harm remains poorly characterized. This study aimed to investigate the influence of the COVID-19 pandemic on the incidence of self-harm. The findings may inform future policy development and strategies for managing pandemic-related mental health challenges.

A meta-analysis was conducted using several database searches: APA PsycINFO, Embase, PubMed, Web of Science, CNKI, and Wan Fang. Published studies with data on the incidence of self-harm during visits to medical institutions, before and during the COVID-19 pandemic, were included. The pooled risk ratio (RR) value of self-harm incidence variation before and during the COVID-19 lockdown period, expressed as the comparison of clinical institution visits before and during the pandemic, was calculated.

Fifteen retrospective cohort studies with observational designs involving 253,600 participants were included. The pooled RR value of self-harm incidence variation was 1.386 (95% confidence interval (CI), 1.205–1.595, I² = 58.9%, p = 0.002). The subgroup analysis showed that “emergency department type” (p = 0.004) and “mean age of the sample” were the sources of the RR values’ heterogeneity (p = 0.026).

Our findings suggest that the lockdown during the COVID-19 pandemic was a risk factor for self-harm. Therefore, special attention should be paid to individuals visiting the emergency department and the middle-aged and elderly populations.

This study was registered in PROSPERO (CRD42023373026), https://www.crd.york.ac.uk/PROSPERO/view/CRD42023373026.

To explore the effects of smartphone-based hospital-family transitional care on symptom burden and quality of life in elderly patients with depression.

This study retrospective analyzed the clinical data of 168 elderly patients with depression admitted to our hospital from January 2022 to January 2024. A total of 79 patients were included in the reference group (routine transitional management), and 89 subjects were included in the observation group (smartphone-based hospital-family transitional care). The symptom burden and quality of life in both groups before and after management were compared. The main statistical methods used in this study were the chi-squared test and the Mann-Whitney U test.

Before discharge, no significant difference existed in Geriatric Depression Scale (GDS) scores, P300 latency, P300 amplitude, Montreal Cognitive Assessment (MoCA) scores, and the scores of each domain in the World Health Organization Quality of Life (WHOQOL)-BREF between the two groups (all p > 0.05). After 5 months, the observation group demonstrated a significantly lower GDS score (p = 0.016), shorter P300 latency (p < 0.001), higher P300 amplitude (p < 0.001), higher MoCA score (p = 0.001), and significantly higher scores in physiological, psychological, and environmental domains than the reference group (p < 0.001), with no significant difference in social relation domain (p > 0.05).

Smartphone-based hospital-family transitional care can improve the symptom burden, cognitive function, and quality of life of elderly patients with depression.

The Montreal Cognitive Assessment Basic scale (MoCA-B) is more sensitive than the Mini-Mental State Examination (MMSE) for detecting mild cognitive impairment due to Alzheimer’s disease (AD). To explore the diagnostic efficacy of the Chinese version of the MoCA-B against the MMSE for post-stroke cognitive impairment (PSCI).

Eighty four patients with acute cerebral infarction were grouped into a post-stroke cognitive normal (PSCN) or a PSCI group based on their scores on the Clinical Dementia Rating scale (CDR), the gold standard for diagnosing PSCI. They were evaluated by using the MMSE and MoCA-B scales, then the area under the receiver operating characteristic (ROC) curve (AUC) was used for evaluation.

Most factors of the MoCA-B were significantly different between the two groups, and the PSCN group completed the MoCA-B faster (p < 0.05). The AUC analysis showed that for the MoCA-B with a cut-off total score of 23, sensitivity = 85.71%, specificity = 61.22%, Youden’s J Index = 0.469, and AUC = 0.832. For the MMSE with a cut-off total score of 25, sensitivity = 70.59%, specificity = 93.75%, Youden’s J Index = 0.643, and AUC = 0.885. The AUC of the MMSE was higher than that of the MoCA-B (p > 0.05). The MoCA-B had greater sensitivity and negative predictive value than the MMSE. When considering the cutoffs for identifying mild cognitive impairment (MCI) across different education levels, the MoCA-B had a higher positive rate for PSCI identification (51.2% vs 25%, p < 0.001), indicating that the MoCA-B is suitable for identifying PSCI.

The MoCA-B demonstrates higher sensitivity and negative predictive value compared with the MMSE in the screening of post-stroke cognitive impairment patients.

This study investigated the association between brain-derived neurotrophic factor (BDNF) gene polymorphisms and antidepressant response in patients with first-episode late-life depression (LLD).

A total of 72 patients with first-episode LLD were recruited and 57 completed an 8-week course of antidepressant treatment. Participants were assessed at baseline and post-treatment using the 17-item Hamilton Depression Rating Scale (HAMD-17) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Serum BDNF levels were measured via Enzyme-Linked Immunosorbent Assay (ELISA) and BDNF gene polymorphisms were genotyped using the Agena® MassARRAY system.

After 8 weeks, 17 of the 57 patients with LLD showed effective treatment response (effective group), while 40 were classified as ineffective. Significant post-treatment improvements were observed across the cohort in HAMD-17 and RBANS scores, and serum BDNF levels compared with baseline (p < 0.05). However, the effective and ineffective groups did not have significantly different RBANS scores or serum BDNF levels (p > 0.05). Binary logistic regression identified male sex (OR = 10.094, p = 0.007) and BDNF gene polymorphism (OR = 6.559, p = 0.003) as predictors of treatment efficacy.

Antidepressant treatment for 8 weeks altered serum BDNF levels in patients with LLD, with male patients carrying the Val/Val genotype potentially responded better to conventional antidepressants. The small sample size may limit the generalizability of these findings.

The study was registered at https://www.chictr.org.cn (registration number: ChiCTR1900024445).

Eye movement desensitization and reprocessing (EMDR) is recommended by major health organizations for trauma treatment, but its efficacy for borderline personality disorder (BPD) remains unestablished. This study aims to evaluate EMDR’s effectiveness in treating BPD through a randomized controlled trial (RCT) and compare its outcomes with cognitive behavioral therapy (CBT).

A total of 76 individuals participated in the RCT, with 18 patients (78% female) completing the study. Participants were randomly assigned to receive either EMDR (n = 8) or CBT (n = 10) via teletherapy sessions. Trauma symptoms were assessed using the international trauma questionnaire (ITQ), BPD symptoms were assessed using the Personality Assessment Inventory-Borderline Features Scale (PAI-BOR), and post-traumatic growth (PTG) was assessed using the post-traumatic growth inventory (PTGI). Additionally, attentional evaluations were conducted at behavioral and electroencephalographic levels through an oddball paradigm. A final comparison was made between a participant who did not complete the therapeutic process and a participant who did.

Both EMDR and CBT treatments significantly improved trauma and BPD symptoms, as well as post-traumatic growth. The effect size was moderate for ITQ (η² = 0.615) and PTGI (η² = 0.610), and low for PAI-BOR (η² = 0.147). Symptomatic participants showed a decrease in ITQ (p = 0.006) and PAI-BOR (p = 0.047) scores, and an increase in PTGI scores (p = 0.028).

Both EMDR and CBT significantly improved trauma and BPD symptoms, as well as post-traumatic growth. Additionally, EMDR showed benefits in response accuracy and speed, with a correct response rate of 97% when comparing two participants (with and without therapy). However, completely clean electroencephalography (EEG) data were not obtained from both participants for a deeper comparison.

The study was registered at https://doi.org/10.1186/ISRCTN91146045, registration number: ISRCTN91146045, registration date: 21 May 2021.

Agitation represents a serious and prevalent symptomatology within acute schizophrenia. This study aims to conduct a nuanced comparison of the efficacy and safety profiles of intramuscular (IM) ziprasidone versus IM haloperidol in the management of agitation among patients with acute schizophrenia.

This investigation was structured as a randomized, 3-day study, utilizing flexible dosing strategies. It included 69 patients diagnosed with schizophrenia, who were randomly allocated to receive either IM ziprasidone (n = 35, 20 to 40 mg/day) or IM haloperidol (n = 34, 5 to 10 mg/day). The primary endpoints included comparative analyses of the change in Positive and Negative Syndrome Scale (PANSS) total scores and Positive and Negative Syndrome Scale Excited Component (PANSS-EC) scores from baseline to study completion across the two groups.

At baseline, there were no significant differences between the IM ziprasidone and haloperidol groups. Both treatments led to significant reductions in PANSS-EC total scores (haloperidol, p = 0.001; ziprasidone, p = 0.001) and PANSS total scores (haloperidol, p = 0.001; ziprasidone, p = 0.001) from baseline to study endpoint. Nevertheless, no significant difference was observed between the two groups in terms of changes in PANSS-EC scores (p = 0.312) and PANSS total scores (p = 0.159) from baseline to endpoint. The haloperidol group exhibited a higher incidence of adverse events compared with the ziprasidone group, reaching statistical significance (p = 0.027).

Our findings indicate that both medications are equally effective in controlling agitation symptoms. However, ziprasidone exhibited superior characteristics in safety and tolerability, particularly in reducing the incidence of extrapyramidal symptoms.

The study was registered at https://www.chictr.org.cn/showproj.html?proj=246996, registration number: ChiCTR2500100002, date of registration: 1 April 2025.

Septum pellucidum is a thin midline brain structure located in the anterior brain, running in a median-sagittal or midsagittal direction. This study aims at testing whether cavum septum pellucidum (CSP) and cavum vergae (CV) could predict clozapine pre- scribing in patients with schizophrenia. This study also assesses the relationship between CSP/CV and some clinical findings in patients with schizophrenia.

190 patients diagnosed with schizophrenia who underwent neuroanatomical evaluation with magnetic resonance imaging during inpatient treatment were included in the study. A personal data form, Positive and Negative Syndrome Scale (PANSS) were given to each patient at admission and discharge. The presence or absence of CSP/CV was recorded as “yes” or “no”.

The presence of CSP/CV was found to be associated with the number of hospital admissions, the number of electroconvulsive therapy sessions received, PANSS total score at admission, PANSS total score at discharge and clozapine use. In the logistic regression model created, the presence of CSP and total PANSS score were found to predict clozapine prescribing (respectively p = 0.001, p = 0.016). The Nagelkerke’s R² value was found to be 0.167.

This study holds the distinction of being the first in the field to investigate the relationship between clozapine prescribing and the presence of CSP/CV in schizophrenia patients. There is a need for longitudinal-cohort studies that can better express effect to identify the conditions associated with CSP/CV.

Given their great importance, as one of the most prescribed types of therapeutic drugs worldwide, we have analyzed the role of serendipity in the discovery of new antidepressants, ranging from selective serotonin reuptake inhibitors to more contemporary developments.

We carried out a historical analysis of the discovery of new antidepressants, resorting to the original articles published on their development (initial pharmacological and clinical information) and applied an operational criterion of serendipity developed by our group.

Selective serotonin reuptake inhibitors (fluoxetine, fluvoxamine, citalopram, paroxetine, sertraline, and escitalopram), selective dopamine and noradrenaline reuptake inhibitors (bupropion), noradrenaline and serotonin reuptake inhibitors (venlafaxine, milnacipram, duloxetine, and desvenlafaxine), selective noradrenaline reuptake inhibitors (reboxetine), noradrenergic and specific serotonergic antidepressants (mirtazapine), melatonergic agonists (agomelatine), and serotonin modulators and stimulators (vortioxetine, vilazodone, tianeptine) correspond to the type IV pattern. Moclobemide, a reversible monoamine oxidase inhibitor, corresponds to the type II pattern, for which the initial serendipitous findings (i.e., the chance discovery of the inhibitory effects of monoamine oxidase (MAO) whilst being studied for their antihyperlipidemic properties) led to subsequent non-serendipitous discoveries (clinical antidepressant efficacy). Ketamine, a glutamatergic modulator, corresponds to the type III pattern, characterized by a non-serendipitous origin (initial development as an anesthetic agent) leading to a serendipitous observation (the discovery of antidepressant efficacy in individuals illicitly using).

The majority of new antidepressants adhere to a type IV pattern, characterized by a rational and targeted design process where serendipity played no part, except moclobemide (type II pattern) and ketamine (type III pattern).