Abstract:

Currently， adolescent mental health issues have become a major public health concern worldwide. As social environment， educational model， and family structure continue to change， emotional issues such as depression and anxiety among adolescents are characterized by rising incidence， an early onset age， and complex contributing factors. The traditional mental health management model， which focuses on symptom screening and disease diagnosis， is no longer sufficient to fully meet the needs for early identification， continuous monitoring， and precise intervention for adolescent mental health issues. In recent years， largescale population studies and advances in network analysis methods have further suggested that adolescent mental health is not determined by a single factor， but rather is the result of the combined influence of multiple factors， including individual characteristics， family environment， school stress， and social support. At the same time， different psychological symptoms do not play exactly the same role in the occurrence and maintenance of diseases. Identifying key symptoms and core risk factors helps improve the effectiveness of early intervention. Adolescent mental health services should be grounded in comprehensive mental health promotion. Risk identification should be conducted with due care， under conditions that ensure informed consent， privacy protection， explanation of results， follow-up assessment， referrals， and access to intervention resources. Based on symptoms， functioning， safety risks， influencing factors， and protective resources， a comprehensive assessment should be conducted to dynamically match inclusive promotion， early support， professional assessment， clinical intervention， and follow-up services. This paper discusses the multi-level support system， risk stratification strategy， and digital technology application in the management of adolescent mental health， and explores the service model suitable for the development of adolescent mental health in China， providing a reference for promoting adolescent mental health and improving the public health system.

Abstract:

Objective To investigate changes in serum levels of key pyroptosis-related factors， including gasdermin D（ GSDMD）， nucleotide-binding oligomerization domain-like receptor protein 3（ NLRP3）， interleukin（IL）- 1β， and IL-18 in patients with acute large artery atherosclerotic（ LAA） cerebral infarction， and to establish a predictive model for poor prognosis combining with clinical indicators. Methods A total of 223 patients with acute LAA cerebral infarction admitted to the First Affiliated Hospital of Henan Medical University between June 2023 and October 2024 were included in the study. According to the scores on the 3-month Modified Rankin Scale（ mRS）， patients were divided into a good prognosis group（ mRS≤ 2； n=150） and a poor prognosis group（ mRS ＞ 2； n=73）. Enzyme-linked immunosorbent assay（ ELISA） was used to detect the serum levels of GSDMD， NLRP3， IL-1β， and IL-18 in patients at admission and on day 7 of admission. Spearman rank correlation was used to analyze the correlation between various biomarkers and the National Institute of Health Stroke Scale（ NIHSS） score at admission and 3-month mRS score. Binary Logistic regression was used to analyze independent risk factors for poor prognosis. After adjusting for potential confounding factors such as age and coronary heart disease， a nomogram prediction model was constructed， and its predictive performance was evaluated using the receiver operating characteristic（ ROC） curve and the Hosmer-Lemeshow test. Results In the poor prognosis group， the GSDMD， NLRP3， IL-18 levels at admission 1 249.82（ 1 071.14， 1 444.40） pg/ml， 1 297.44（ 1 075.45，1 392.13） pg/ml， and（ 173.04±28.32） ng/ml， respectively， on day 7 of admission， the GSDMD， NLRP3， and IL-18 levels were（ 1 275.01±140.79） pg/ml， （1 264.45±216.49） pg/ml， and 49.65（ 48.84， 50.64） pg/ml， respectively， all of which were higher than those in the good prognosis group［ 1 109.25（ 956.85， 1 265.67） pg/ml， 1 160.55（ 911.05，1 346.26） pg/ml， （163.66±20.87） ng/ml， and（ 1 223.37±174.90） pg/ml，（ 1 137.43±237.93） pg/ml， and 43.68（ 38.84， 47.32） pg/ml］， all of which were statistically significant（ Z/t=-2.413，-2.597， -2.517，-2.368， 3.851， -7.719； all P＜0.05）. The difference in the change in serum IL-1β level between the two groups at admission and on day 7 of admission was statistically significant（ Z=-4.034， P ＜ 0.001）. Patients' serum levels of GSDMD， NLRP3， IL-1β， and IL-18 at admission， as well as GSDMD and IL-1β levels on day 7 of admission， were all positively correlated with the NIHSS score at admission（ r=0.344， 0.227， 0.153， 0.180， 0.149， 0.169； all P＜ 0.05）； serum GSDMD and NLRP3 levels at admission， as well as IL-1β levels on day 7 of admission， were all positively correlated with the 3-month mRS score（ r=0.201， 0.150， 0.367； all P＜ 0.05）， and all differences were statistically significant. Binary Logistic regression analysis showed that a high percentage of neutrophils at admission［ OR=1.073， 95%CI（ 1.007，1.143）， P=0.029）， a high NIHSS score at admission［ OR=1.584， 95%CI（ 1.316，1.907）， P＜0.001）， and a high GSDMD level at admission［ OR=1.004， 95%CI（ 1.001，1.006）， P=0.013］， and high IL-1β level on day 7 of admission［ OR=1.438， 95%CI（ 1.254，1.649）， P＜0.001］ were statistically independent risk factors for poor 3-month prognosis in patients with LAA cerebral infarction. The area under the ROC curve（ AUC） of the combined nomogram model for predicting poor prognosis was 0.959 ［95%CI（ 0.932，0.986）］， with a sensitivity of 89.04% and a specificity of 92.00%. The Hosmer-Lemeshow goodness-of-fit test showed good calibration of the model（ χ2=4.500，P=0.809）. Conclusions Elevated serum levels of GSDMD and IL-1β in patients with LAA cerebral infarction are positively correlated with poor prognostic outcomes， and a combined predictive model constructed by combining the baseline NIHSS score can improve the accuracy of prognostic assessment.

Abstract:

Objective To explore the research status， hot topics and evolution trends of adolescent depressive disorder and related mental health issues through CiteSpace-based visual analysis， so as to provide a reference for research in this field. Methods Using Web of Science， China National Knowledge Infrastructure， and WanFang Data as data sources， a search was conducted for Chinese and English literature on adolescent mental health published from January 1， 2000 to October 1， 2025. CiteSpace 6.4.R1 was used to perform a visual analysis of the included literature. Results A total of 23 719 articles were included（ 3 503 in Chinese and 20 216 in English）. The overall number of Chinese and English publications on adolescent depressive disorder and related mental health problems showed a steady upward trend， with a significant increase from 2020 to 2024. The analysis of co-occurrence words showed that depressive disorder， anxiety and suicidal ideation were the core themes of academic research in this field. Adolescent psychological and behavioral problems， emotional disorders and their risk factors（ such as lack of social support， internet addiction， and the impact of the pandemic） were hot topics. After 2022， keywords such as non-suicidal self-injury and COVID-19 began to emerge prominently. Conclusions From 2000 to 2025， the number of publications and the attention devoted to adolescent depressive disorder and related mental health problems have continued to rise， and research focus has gradually expanded to topics such as internet addiction， non-suicidal self-injury， suicide， social support， and interventions.

Abstract:

Objective To explore the impact mechanism of family functioning on the general quality of life of adolescents with anxiety， depression， and somatic symptoms， and analyze the chain-mediating effect of physical appearance and attributes， as well as anxiety， depression， and somatic symptoms in this relationship. Methods The cross-sectional study was conducted. Using convenience sampling， adolescents who visited the Department of Psychosomatic Medicine at Beijing Children's Hospital， Capital Medical University， between June 2024 and December 2025 were continuously enrolled as study subjects. Clinical assessments were conducted using the Family Assessment Device（ FAD）， Physical Appearance and Attribute Sub-Scale of Piers-Harris Children's Self-concept Scale， Screen for Child Anxiety Related Emotional Disorders（ SCARED）， Depression Self-Rating Scale for Children（ DSRSC）， Bodily Distress Syndrome（ BDS）， and Quality of Life Scale for Children and Adolescents（ QLSCA）. Based on the results of the normality test， Spearman rank correlation analysis was used to explore the relationships among the variables. After controlling for covariates such as gender and age， the PROCESS macro（ Model 6） was used to test for multiple chain-mediating effects. Results A total of 579 adolescents were included. The scores for the problem solving， communication， roles， affective responsiveness， affective involvement， behavior control， and general family functioning dimensions in FAD were 2.33（2.00，2.67），2.56（2.22，2.89），2.36（2.09，2.64），2.50（2.17，3.00），2.43（2.14，2.71），2.33（2.11，2.56）， and 2.33（ 2.00，2.75）， respectively. The score of the PHCSS Physical Appearance and Attribute Sub-Scale was 5.00（3.00，8.00）. The total scores of SCARED， DSRSC， BDS， and QLSCA self-satisfaction dimension were 38.00（ 20.00，54.00），20.00（ 13.00，25.00）， 34.00（ 17.00，51.00）， and 12.00（ 9.00，16.00）， respectively. There were statistically significant differences in the scores on the problem solving， communication， roles， affective responsiveness， affective involvement， behavioral control， and general family functioning dimensions of the FAD among patients of different genders（ all P ＜ 0.05）. There were no statistically significant differences in the scores for the aforementioned dimensions of FAD among the 12-， 13-， and 14-year-old age groups（ all P ＞ 0.05）. Correlation analysis showed that the total score of the general family functioning dimension in the FAD was negatively correlated with physical appearance and attributes， as well as QLSCA self-satisfaction dimension scores（ ρ=-0.442， -0.575； all P ＜ 0.001）， and positively correlated with SCARED， DSRSC， and BDS scores（ ρ=0.520， 0.605， 0.467； all P ＜ 0.001）， with statistically significant differences. The score for physical appearance and attributes was positively correlated with the QLSCA self-satisfaction dimension score（ ρ=0.599， P ＜ 0.001） and negatively correlated with the SCARED， DSRSC， and BDS scores（ ρ= -0.580， -0.639， and -0.474； all P＜ 0.001）， with these differences being statistically significant. SCARED， DSRSC， and BDS scores were positively correlated with each other（ ρ=0.754 to 0.819； all P ＜ 0.001）， and negatively correlated with QLSCA self-satisfaction dimension scores（ ρ=-0.805 to -0.690； all P＜0.001）， with statistically significant differences. The mediation analysis showed that a total of 21 chain-mediating pathways were significantly established with statistical differences（ P＜0.001）， The total indirect effects of the anxiety， depression， and somatic symptom models accounted for 55.0% to 87.6%， 66.8% to 92.4%， and 51.1% to 77.6% of the total effect, respectively. Conclusions The impairment of somatic self-awareness and the exacerbation of anxiety， depression， and somatic symptoms constitute the key psychopathological chain through which family dysfunction leads to a decline in adolescents' quality of life. In clinical interventions， in addition to managing superficial emotions and physical symptoms， there is an urgent need to implement systematic family therapy interventions（ especially optimizing family behavior control models） and to help adolescents rebuild a positive physical self-acceptance to fundamentally block pathological mechanisms and improve their quality of life.

Abstract:

Depressive disorders in children and adolescents carry a high disease burden and have long-term adverse effects； however， current resources for pharmacotherapy， psychotherapy， and specialized services still fall short of fully meeting clinical and public health needs. Music therapy， a non-pharmacological intervention conducted by professionals within a therapeutic relationship and using music as a medium， has garnered attention in recent years as a treatment for depressive disorders in children and adolescents. This review focuses on the concept of music therapy， the distinction between related terms， its mechanisms of action， classification methods， and the current status of its application both domestically and internationally. Overall， the application of music therapy for depressive disorders in children and adolescents has been well accepted and shows potential clinical value. However， existing studies still face issues such as small sample sizes， high heterogeneity in intervention protocols， insufficient reporting on therapist qualifications and the intervention process， and limited follow-up periods. Future multicenter， large-sample， standardized randomized controlled trials are needed to further clarify music therapy， target population， optimal intervention dosage， and mechanism of action， thereby providing a basis for the standardized application of its efficacy in comprehensive interventions for depressive disorders in children and adolescents.

Abstract:

Currently， depressive disorders among adolescents have become a major public health issue worldwide， with a continuously increasing prevalence and a high risk of self-injury and suicide， severely affecting adolescents' physical and mental development as well as their social functioning. The onset of depressive disorders in adolescents is closely linked to a variety of factors， including individual psychological characteristics， neurodevelopmental and biological abnormalities， family environment， and social factors. Its pathogenesis involves complex interactions among neurophysiological regulation， psychological and cognitive vulnerability， and environmental stressors. Psychotherapy， drug therapy， and collaborative interventions involving families， schools， and hospitals have become the primary treatment modes； however， clinical practice still faces challenges such as insufficient early identification， limited individualized treatment， and an inadequate long-term rehabilitation support system. This paper reviews the epidemiological characteristics， influencing factors， pathogenesis， treatment modes and clinical application issues of depressive disorders in adolescents， with the aim of providing guidance for the early prevention and control， standardized diagnosis and treatment， and the development of a comprehensive intervention system for depressive disorders in adolescents

Abstract:

Objective To investigate the prevalence and influencing factors of depressive disorder and anxiety in hospitalized patients with tuberculosis， so as to provide a basis for implementing comprehensive psychosocial support interventions in clinical practice. Methods Using the cross-sectional study design， 247 hospitalized patients from the Department of Tuberculosis of Beijing Chest Hospital， affiliated with Capital Medical University， were conveniently selected as study subjects between January 20 and February 15， 2026. Patients' socio-demographic and clinical baseline information were collected using the General Information Questionnaire， and the severity of depression and anxiety was assessed using the Patient Health Questionnaire-9（ PHQ-9） and Generalized Anxiety Disorder-7（ GAD-7）， respectively. Multivariate Logistic regression analysis was used to explore the influencing factors of depressive disorder and anxiety in hospitalized patients. Results A total of 247 questionnaires were distributed， with 196 valid responses， resulting in a valid response rate of 79.4%. The prevalence of depressive disorder（ PHQ-9 total score ≥5） among 196 hospitalized tuberculosis patients was 48.5%（ 95/196）， the prevalence of anxiety（ GAD-7 total score≥5） was 31.6%（ 62/196）， and the prevalence of comorbid depressive disorder and anxiety（ PHQ-9 total score ≥5 and GAD-7 total score ≥5） was 28.6%（ 56/196）. Univariate analysis showed that there were significant differences in the prevalence of depressive disorder among hospitalized tuberculosis patients with different family size， chronic disease， age， body mass index（ BMI） and use of Bedaquiline（ χ2/Z=8.557， 2.421，-2.014， -2.967，7.463； all P ＜ 0.2）. There were statistically significant differences in the prevalence of anxiety among hospitalized tuberculosis patients with different family size， drug resistance， use of Bedaquiline and age（ χ2/Z=3.908， 3.839， 1.807， -2.419； all P＜ 0.2）. After adjusting for confounding factors， multivariate Logistic regression analysis showed that high BMI［ OR=0.905， 95%CI（ 0.831， 0.984）， P=0.020］ and large family size［ OR=0.140， 95%CI（ 0.037， 0.529）， P=0.004］ were independent protective factors for depressive disorder in hospitalized patients with tuberculosis. Advanced age［ OR=0.976， 95%CI（ 0.957， 0.995）， P=0.013］ and larger family size［ OR=0.299， 95%CI（ 0.101， 0.889）， P=0.030］ were independent protective factors for anxiety in hospitalized patients with tuberculosis. Conclusions Hospitalized tuberculosis patients have a high incidence of depressive disorder， anxiety， and emotional comorbidity， and psychological issues are relatively common. High BMI and large family size are independent protective factors of depressive disorder in patients， while advanced age and family size are independent protective factors of anxiety. Clinical attention should be focused on hospitalized tuberculosis patients with low BMI， young age and small family size， and targeted psychological intervention should be carried out to effectively alleviate the negative emotions of patients and promote the recovery of the disease.

Abstract:

Objective To explore the mediating role of psychological capital between well-being and symptoms of anxiety and depression among resident physicians with standardized training（ hereinafter referred to as "standardized training resident physicians"）. Methods This study was a cross-sectional study. Using convenience sampling， standardized training resident physicians from 17 national Western medicine training bases in the Inner Mongolia Autonomous Region were selected as study subjects in October 2024. Assessments were conducted using the Psychological Capital Questionnaire-24（ PCQ-24）， 5-item World Health Organization Well-Being Index（ WHO-5）， and Patient Health Questionnaire Anxiety and Depression Scale（ PHQ-ADS）.Spearman rank correlation coefficient was used to analyze the correlation between different variables and further explore the mediating role of psychological capital and its four dimensions in the relationship between wellbeing， and symptoms of anxiety and depression. Data analysis was conducted using SPSS 27.0 and R 4.5.2 software. Results A total of 3 376 questionnaires were distributed， and 3 306 valid questionnaires were returned， resulting in a valid response rate of 97.93%. Among 3 306 participants， 1 332 participants（40.0%） exhibited symptoms of anxiety and depression（ PHQ-GAD score ≥ 10）. Correlation analysis showed that the PHQ-ADS score was negatively correlated with the PCQ-24 and its four dimensions scores， as well as with the WHO-5 score（ r=-0.414，-0.360，-0.384，-0.412，-0.413，-0.699； all P＜0.01）， and the PCQ-24 and its four dimensions score were positively correlated with the WHO-5 score（ r=0.417，0.375，0.395，0.409，0.404； all P＜ 0.01）， and all differences were statistically significant. Mediating effect analysis showed that psychological capital is composed of four dimensions： self-efficacy， hope， resilience， and optimism partially mediated the relationship between well-being and symptoms of anxiety and depression， with statistically significant differences （P＜ 0.001）. The mediating effect test showed that the mediating effect values of psychological capital between anxiety and depression symptoms and well-being was -0.040 ， accounting for 9.5% of the total effect（ P＜0.001）. Conclusions Well-being not only directly influences symptoms of anxiety and depression among standardized training resident physicians， but also indirectly influences these symptoms through psychological capital and its four dimensions. Enhancing the psychological capital of standardized training resident physicians（ particularly hope， resilience， and optimism） can effectively buffer the negative impact of anxiety and depression symptoms on well-being， thereby playing a mediating protective role.

Abstract:

Epilepsy is a common neurological disorder worldwide， and treatment with antiepileptic drugs（ AEDs） is currently the primary treatment method. However， approximately 30% of patients with epilepsy do not respond well to AEDs and develop drug-resistant epilepsy； a key reason for this is the insufficient penetration of AEDs across the blood-brain barrier（ BBB）. In recent years， the role of nanocarriers in the treatment of epilepsy has attracted increasing attention. Drug delivery systems based on nanocarriers not only prolong the circulation time of AEDs in the blood and improve their bioavailability， but also facilitate drug penetration across the BBB and enhance distribution in the target brain tissue. This paper reviews the structure and function of the BBB， and summarizes and prospects the application progress of nanocarriers in the treatment of epilepsy， thereby offering a novel strategy for the pharmacological treatment of epilepsy.

Abstract:

The 5-HT1B receptor， one of the serotonin（ 5-HT） receptors， serves as a key regulatory factor in the central nervous system. Owing to its dual nature as both an autologous and heterologous receptor， it exhibits spatiotemporal expression heterogeneity and functional duality across different brain regions， cell types， and neural circuits， acting as a "multifunctional switch" involved in the pathophysiological mechanisms of various neuropsychiatric disorders. This review systematically elucidates the complex roles of the 5-HT1B receptor in conditions such as depressive disorders， anxiety disorders， substance use disorders， impulsive aggressive behaviors， Parkinson's disease， and migraine. Existing medications， such as triptans and vortioxetine， have demonstrated their preliminary therapeutic potential. Future research should integrate multi-omics with precision intervention technologies to construct spatiotemporal dynamic functional maps and develop functionally selective ligands， thereby advancing the implementation of personalized treatment strategies.