Abstract Background Anxiety disorders, including subtypes such as social anxiety disorder (SAD), panic disorder (PD), and generalized anxiety disorder (GAD), are among the most common psychiatric disorders. They are characterized by excessive fear, anxiety, and behavioral disturbances, leading to significant impairments in social and occupational functioning. While both accelerated and suppressed epigenetic aging have been reported in various psychiatric disorders, findings in anxiety disorders remain limited. Aims & Objectives We investigated diagnostic subtype-specific patterns of epigenetic age acceleration in anxiety disorders and examined the influence of social functioning. Method DNA methylation (DNAm) was quantified in 266 healthy individuals and 30 individuals with anxiety disorders (11 SAD, 11 PD, and 8 GAD) using Illumina MethylationEPIC arrays. Epigenetic age acceleration was estimated using PCHannumG2013 as the primary clock, with sensitivity analyses conducted using four additional clocks. Social functioning was assessed with the Social Functioning Scale. Meta-analyses incorporating data from previous DNAm-based studies (423 healthy individuals and 278 individuals with anxiety disorders) were performed. Results Compared with healthy individuals, individuals with anxiety disorders had suppressed epigenetic age acceleration, particularly in SAD, in our cohort. Lower social functioning, especially impaired independence-competence and reduced prosocial activities, was associated with suppressed epigenetic age acceleration. Meta-analyses revealed suppressed epigenetic aging in patients with SAD and a marginal increase in patients with PD. Sensitivity analyses revealed that the suppression in SAD was consistently detected across clock types, except for DunedinPACE. Discussion & Conclusions Our findings suggest possible diagnostic subtype-specific differences in epigenetic age acceleration in anxiety disorders, which may indicate a potential protective role of social avoidance in patients with SAD and the influence of inflammatory processes in patients with PD.
K. Ohi, D. Fujikane, Y. Oida et al.· International Journal of Neu...· 0 citations
ABSTRACT Background Schizophrenia is characterized by positive symptoms, negative symptoms, and cognitive impairment and is primarily treated with antipsychotic medications. However, a subset of patients responds inadequately to treatment and is classified as having treatment‐resistant schizophrenia (TRS). The prevalence of TRS among patients with schizophrenia remains insufficiently characterized. This study aimed to determine the prevalence of TRS using nationwide data and standardized diagnostic criteria. Methods This study included patients with schizophrenia who were discharged between 2016 and 2024 from 205 institutions participating in the Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE) project and authorized to prescribe clozapine. TRS was defined according to standardized diagnostic criteria used in Japan. The prevalence of TRS was calculated among patients who underwent a TRS examination by their treating psychiatrist. Results Among 18 914 patients, 9870 (52.2%) underwent a TRS examination. Among these 9870 patients, 2819 were classified as having TRS, corresponding to a prevalence of 28.6%. Among the 2819 patients with TRS, 1307 were prescribed clozapine at discharge, corresponding to a clozapine treatment rate of 46.4%. Conclusions This study had the largest sample size among single‐cohort studies investigating the prevalence of TRS. The prevalence of TRS was 28.6% among patients with schizophrenia who underwent a TRS examination and was nearly identical to the pooled prevalence reported in studies at low risk of bias in a previous meta‐analysis. These findings may provide important evidence regarding the prevalence of TRS in routine clinical practice.