Guangzhou Psychiatric Hospital

Alcohol Use Disorder (AUD) is a global health challenge, affecting 10–15% of the population, with significant social, health, and economic consequences. Although pharmacotherapies such as disulfiram, naltrexone, and acamprosate are available, their effectiveness is limited and patient adherence is often poor. Repetitive transcranial magnetic stimulation (rTMS), a non-invasive neuromodulation technique that targets neural circuits implicated in addiction. Emerging evidence suggests that rTMS may reduce alcohol craving and consumption, although results have been mixed. This review examines the neural mechanisms by which rTMS may influence AUD, summarizes current clinical evidence of its efficacy, and discusses future directions.

BackgroundsRelatively few studies have focused on the associations between family-related factors and adolescents’ mental health in China. This study aimed at investigating the associations between per capita living space, parental socioeconomic status, and depressive symptoms among adolescents.MethodsWe conducted a cross-sectional survey to investigate the mental health of adolescents in Guangzhou, China. Per capita living space was calculated by dividing the total housing size by the number of residents. Parental socioeconomic status included the education and employment status. Depressive symptoms were measured with the Patient Health Questionnaire–9. Mixed logistic regression analyses with school as a random intercept were used to explore the association between per capita living space, socioeconomic status, and depressive symptoms. Restrictive cubic spline (RCS) was used to examine whether the relationship between per capita living space and depression was linear.ResultsCompared with adolescents living in a house with per capita living space less than 10 m2, those living in space of 10–20 m2, 20–30 m2 had significantly lower odds of depressive symptoms, with no significant association observed for space over 30 m2. RCS analysis identified a non-symmetric U-shaped association. With the increase of per capita living space, the risk of depressive symptoms first decreased sharply, then rose and finally arrived at a plateau. Subgroup analyses stratified by sex and housing ownership showed similar nonlinear patterns that were observed in the full sample. Higher parental educational levels and maternal unemployment were associated with lower odds of depressive symptoms, whereas paternal unemployment was associated with higher depression risk only among girls.ConclusionsOur study highlights the significant and complex influence of family-related social determinants including per capita living space and parental socioeconomic status on adolescents’ depressive symptoms. Extremely small living spaces are associated with depressive symptoms, moderate spaces are linked to less depression, while excessively large spaces offer no additional benefit. Prevention to promote adolescents’ mental health should prioritize adolescents with these socioeconomic disadvantages.Clinical trial numbernot applicable.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12889-025-23779-w.

Major depressive disorder (MDD) is the most prevalent mental illness. Antidepressants with rapid efficacy and acceptable tolerance have been investigated for many years. A preclinical study performed by our group revealed that the dysregulation of extracellular ATP is related to the pathophysiology of depression and that the medial prefrontal cortex-lateral habenula pathway is a potential cellular and neural circuit target for ATP involvement in depression-like behaviour. Moreover, through small-sample clinical trials, the group has preliminarily discovered the antidepressant effect of ATP. However, the antidepressant effects of and neural circuit mechanisms underlying ATP in depressed patients remain largely unexplored. This study pioneers the intravenous use of escitalopram in combination with oral escitalopram for the treatment of MDD, thus representing a new direction in antidepressant research. This clinical study is a single-centre, randomised, double-blind, placebo-controlled, superiority trial involving 120 MDD patients evenly divided into two groups. The experimental group will receive an intravenous injection of 10 mL ATP in 100 mL normal saline (NS) two times per day (BD) for 2 weeks, whereas the control group will receive 110 mL NS BD for 2 weeks. All of the participants will take 10 mg of oral escitalopram daily for 4 weeks, with flexible adjustment thereafter based on clinical response. Our primary outcome will be the change in the Hamilton Depression Rating Scale 24 (HAMD-24) score from baseline to 2 and 4 weeks. The secondary outcomes assessment (at 1, 2, 4, 12 and 24 weeks) will be done by the Montgomery-Asberg Depression Rating Scale, HAMD-24, Hamilton Anxiety Scale, Beck Depression Inventory, Snaith-Hamilton Pleasure Scale, Clinical Global Impression, Insomnia Severity Index, Columbia-Suicide Severity Rating Scale, Side Effect Rating Scale of Asberg, MRI, cognitive function and cytokine level analyses. The study protocol and all of the related materials were approved by the Institutional Ethics Committee of Nanfang Hospital, Southern Medical University (No. NFEC-2024-070, NFEC-2020-153, Guangzhou, China). Results will be disseminated through peer-reviewed publications and conference presentations. NCT06266715.