The Coronavirus has infected up to 900 million people as of 11 Jan 2023 in China Mainland, which is more than 60% of the population. The sudden and unprecedented nature of pandemic has resulted in a range of psychosomatic issues among the population. These issues can manifest in a variety of ways and it is important to address these issues as they can have serious consequences for individuals' mental and physical health. The lifting of lockdown measures in China presents an opportunity to address these issues and provide support to those who have been affected.

Objectives. It is a high risk for adolescents with first-episode major depressive disorder (MDD) to commit suicide. However, few studies reported the effect of modified electroconvulsive therapy (MECT) in first-episode antipsychotic-naive MDD adolescents. Methods. The study explores the alternations of regional homogeneity of modified electroconvulsive therapy to treat the first-episode antipsychotic-naive major depressive disorder. 72 first-episode MDD patients were recruited from Tianyou Hospital Affiliated to Wuhan University of Science and Technology from October 2017 to May 2020, and 65 of 72 completed the trial. Results. Before MECT treatment, ReHo values of the bilateral cerebellum and left cuneus were higher, and ReHo value of left postcentral and supramarginal gyrus was lower in MDD patients compared to healthy subjects (HS). After treatment, the MDD patients have higher ReHo values of the right insula and postcentral gyrus, while left fusiform gyrus were lower than the pretreatment. Compared to the HS, the ReHo values of left lingual gyrus, right calcarine cortex, and right mid occipital thalamus were higher in the posttreatment. In the posttreatment, left calcarine cortex and right cerebrum were lower than in healthy subjects. Conclusions. The study confirmed that MECT improves psychotic symptoms in patients with first-episode antipsychotic-naive MDD. These results further contributed to a more tailored treatment approach to MDD from the pathophysiological and neuroimaging views.

Adolescent major depressive disorder (MDD) involves complex and heterogeneous alterations in brain functional organization. A possible explanation is the disruption of individualized brain maturation during adolescence, which typically transitions from lower-order sensory to higher-order association regions. To test this hypothesis, we analyzed resting-state functional MRI data using advanced matrix decomposition techniques to extract organizational gradients, temporal dynamics, and information flow. Clustering sensory–association gradient features in our main sample (N_MDD = 302 and N_Controls = 207; ages 11-17) revealed two subtypes. Subtype 1 showed bottom‑up (sensory‑to‑association) flow, reduced synergy but heightened redundancy in sensory cortices, and a highly modular yet globally inefficient network—patterns consistent with aberrant sensory processing and impaired integration. Subtype 2 instead displayed a top‑down (association‑to‑sensory) flow, reduced synergy in association areas, elevated redundancy in sensory regions, and network efficiency between subtype 1 and healthy controls, suggesting compensatory higher‑order engagement. Subtypes also differed in age-related changes, clinical profiles, and neurobiological processing. These patterns were largely replicated in an independent sample (N_MDD = 73 and N_Controls = 28). Overall, the sensory-association axis distinguishes MDD subtypes, integrating functional heterogeneity, cortical dynamics, developmental trajectories, and genetic influences, offering new insights for pathophysiology and precision psychiatry.