Current Opinion in Psychiatry最新文献

Treatment trials for negative symptoms in schizophrenia. 精神分裂症阴性症状的治疗试验

IF 4.9 2区医学

Current Opinion in Psychiatry Pub Date : 2026-05-01 Epub Date: 2025-12-29 DOI: 10.1097/YCO.0000000000001067

Louise Birkedal Glenthøj, Mette Ødegaard Nielsen, Merete Nordentoft

{"title":"Treatment trials for negative symptoms in schizophrenia.","authors":"Louise Birkedal Glenthøj, Mette Ødegaard Nielsen, Merete Nordentoft","doi":"10.1097/YCO.0000000000001067","DOIUrl":"10.1097/YCO.0000000000001067","url":null,"abstract":"Purpose of review: Negative symptoms in schizophrenia remain an unmet treatment need. Recent guidelines and meta-analyses suggest that some pharmacological and psychosocial interventions show modest efficacy. Adding to this evidence, this review summarizes randomized clinical trials (RCTs) published between January 2024 and October 2025 on pharmacological, psychosocial, physical, digital, and neuromodulatory interventions targeting negative symptoms.Recent findings: Most recent RCTs were small and methodologically heterogeneous, and effects on negative symptoms were generally modest. Exercise-based and body-oriented interventions, CBT-based interventions, psychosocial programmes, and digital tools were feasible and often associated with within-group improvement, but rarely superior to active controls or treatment as usual; only a larger yoga trial showed clear added benefit. Cognitive remediation did not directly reduce negative symptoms, but recent work indicates that negative symptoms moderate the translation of cognitive gains into functional improvement. Pharmacological trials yielded mixed results, with signals for muscarinic agonist-antagonist treatment, selected repurposed agents, and sulforaphane. Neuromodulation studies, particularly intermittent theta burst stimulation and transcutaneous auricular vagus nerve stimulation, suggested small to moderate improvements that depended on stimulation parameters and treatment duration.Summary: Current evidence confirms that negative symptoms are modifiable and underscores the need for adequately powered, mechanism-informed, multimodal trials with long-term follow-up.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"216-221"},"PeriodicalIF":4.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hikikomori in the urban digital era: a psychodynamic, transdiagnostic model and multimodal interventions. 城市数字时代的“隐蔽青年”：心理动力学、跨诊断模型和多模式干预。

IF 4.9 2区医学

Current Opinion in Psychiatry Pub Date : 2026-05-01 Epub Date: 2026-03-10 DOI: 10.1097/YCO.0000000000001081

Takahiro A Kato

{"title":"Hikikomori in the urban digital era: a psychodynamic, transdiagnostic model and multimodal interventions.","authors":"Takahiro A Kato","doi":"10.1097/YCO.0000000000001081","DOIUrl":"10.1097/YCO.0000000000001081","url":null,"abstract":"Purpose of review: Hikikomori (prolonged social withdrawal) was first described in Japan and was initially regarded as culture-bound. It is now recognized as a global mental health concern, more prevalent in urban settings and frequently comorbid with psychiatric disorders. In the post - COVID - 19 era, home - centered lifestyles have become increasingly normative, prompting a reconceptualization of hikikomori beyond reduced outing frequency. Drawing on over two decades of clinical and research experience, we propose a psychodynamic (developmental and attachment-informed), transdiagnostic, and multidimensional framework and outline assessment and intervention strategies for urban digital societies.Recent findings: International frameworks distinguish pathological from non-pathological hikikomori based on psychological distress and functional impairment. Emerging evidence implicates attachment insecurity, early adversity, and transdiagnostic biological pathways involving inflammation, and neurodevelopmental mechanisms. Early-phase pathological hikikomori is associated with increased risk of depression and gaming disorder, with possible relevance of modern-type depression. Digital tools, including online engagement and virtual reality based interventions, may provide low-threshold gateways to reach otherwise hard-to-reach individuals.Summary: In contemporary urban life, physical isolation per se is not necessarily pathological. Translating a biopsychosocial-cultural model integrating psychopathology and attachment into structured assessment, family-based approaches, clinical care, and digital interventions is essential to prevent long-term pathological hikikomori.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"234-241"},"PeriodicalIF":4.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13034759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147376460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Schizophrenia research in the post-COVID era: Emerging trends in 2026. 后covid时代的精神分裂症研究：2026年的新趋势。

IF 4.9 2区医学

Current Opinion in Psychiatry Pub Date : 2026-05-01 Epub Date: 2026-03-26 DOI: 10.1097/YCO.0000000000001078

Lynn E DeLisi

引用次数: 0

The impact of telemedicine and digital mental health in urban areas in Hong Kong. 远程医疗及数码精神健康对香港市区的影响。

IF 4.9 2区医学

Current Opinion in Psychiatry Pub Date : 2026-05-01 Epub Date: 2026-02-23 DOI: 10.1097/YCO.0000000000001066

Teris Cheung, Kwan Hin Fong, Yu-Tao Xiang

{"title":"The impact of telemedicine and digital mental health in urban areas in Hong Kong.","authors":"Teris Cheung, Kwan Hin Fong, Yu-Tao Xiang","doi":"10.1097/YCO.0000000000001066","DOIUrl":"10.1097/YCO.0000000000001066","url":null,"abstract":"Purpose of review: This review examines the evolving role of telemedicine and digital mental health (DMH) in Hong Kong's urban healthcare landscape, focusing on accessibility, equity, and user engagement across diverse populations.Recent findings: Telemedicine platforms such as HA Go have improved continuity of care and reduced stigma in mental health services. The pandemic accelerated the use of remote tools, revealing both strong public receptivity and persistent challenges related to regulation, usability, and clinical confidence. DMH interventions have expanded across age groups, including chatbot-based mindfulness programs for university students and digital games for primary school children. These studies highlight the importance of digital health literacy, cultural adaptation, and tailored approaches that address disparities in access and engagement shaped by socioeconomic status, age, and regional differences.Summary: Hong Kong's digital health ecosystem is at a critical juncture. While infrastructure and public receptivity are strong, sustained progress requires inclusive design, clearer legal frameworks, and cross-sector collaboration. Telemedicine and DMH must evolve beyond crisis-driven adoption to deliver personalized, equitable, and trustworthy care across age, socioeconomic status, and regional divides.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"280-285"},"PeriodicalIF":4.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Violent acts committed in the early phases of schizophrenia in the USA: risk factors, misconceptions, and implications for prevention. 美国精神分裂症早期阶段的暴力行为：危险因素、误解和预防意义

IF 4.9 2区医学

Current Opinion in Psychiatry Pub Date : 2026-05-01 Epub Date: 2026-02-23 DOI: 10.1097/YCO.0000000000001080

Yveton Isnor, Raquelle Mesholam-Gately, Lynn E DeLisi

{"title":"Violent acts committed in the early phases of schizophrenia in the USA: risk factors, misconceptions, and implications for prevention.","authors":"Yveton Isnor, Raquelle Mesholam-Gately, Lynn E DeLisi","doi":"10.1097/YCO.0000000000001080","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001080","url":null,"abstract":"Purpose of review: Public discussion has increasingly focused on violent incidents involving individuals diagnosed with schizophrenia, particularly those who are nonadherent with treatment or are in the early stages of illness before treatment needs are recognized.Recent findings: Although people with serious mental illness are somewhat more likely to commit violent acts than those in the general population, only a small proportion of individuals with schizophrenia do so, and they are far more often victims than perpetrators of violence. Misconceptions linking schizophrenia with violence contribute to stigma, delay early diagnosis and intervention, and divert attention from contributing factors such as substance use disorders. While structured assessment tools exist, precise methods for identifying those at highest risk for committing a violent act remain limited.Summary: Early recognition of the prodromal phase of schizophrenia, combined with timely pharmacological and psychosocial interventions, can meaningfully reduce the risk of violence. Ongoing research should emphasize improving predictive tools and promoting effective prevention and treatment strategies.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":"39 3","pages":"222-225"},"PeriodicalIF":4.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147510203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Urbanization, mental health, and oral health inequalities in left-behind youth: a systematic review and meta-analysis. 城市化、心理健康和留守青年口腔健康不平等：系统回顾和荟萃分析

IF 4.9 2区医学

Current Opinion in Psychiatry Pub Date : 2026-05-01 Epub Date: 2026-01-12 DOI: 10.1097/YCO.0000000000001060

Jake Ball, Kelly Lin, Yvette Rainbow, Jing Sun

{"title":"Urbanization, mental health, and oral health inequalities in left-behind youth: a systematic review and meta-analysis.","authors":"Jake Ball, Kelly Lin, Yvette Rainbow, Jing Sun","doi":"10.1097/YCO.0000000000001060","DOIUrl":"10.1097/YCO.0000000000001060","url":null,"abstract":"Purpose of review: This systematic review and meta-analysis evaluated mental and oral health outcomes among left-behind children (LBC) affected by urbanization-driven rural-urban labour migration. Although mental health impacts of parental migration are increasingly recognized, oral health outcomes remain underexplored. This review synthesizes available evidence, quantifies disparities, and identifies shared social and structural determinants.Recent findings: Thirty-three studies met inclusion criteria. Pooled analyses revealed significantly higher depressive symptoms among LBC compared to non-LBC peers [standardized mean difference (SMD) = 0.16, 95% confidence interval (CI): 0.03-0.29], with increased risk of elevated depressive symptoms [odds ratio (OR) = 1.36, 95% CI: 1.01-1.83]. LBC also experienced higher rates of permanent tooth caries (SMD = 0.15, 95% CI: 0.05-0.25) and were less likely to attend dental care in the past year (OR = 0.80, 95% CI: 0.67-0.94). Greater distress was observed in cases of shorter parental separation and when both parents had migrated. Factors such as caregiver education, quality of parent-child communication, and school climate consistently influenced outcomes across both mental and oral health domains.Summary: LBC experience a dual burden of psychological distress and unmet dental need, reflecting the effects of urbanization-related parental migration. These disparities are shaped by caregiving discontinuity, reduced access to preventive services, and socio-environmental stressors. Findings highlight the need for integrated responses, including caregiver training, school-based prevention, and equitable health entitlements. Addressing shared determinants across mental and oral health domains offers a feasible path toward improved outcomes and greater equity.Trial registration: PROSPERO ID: CRD420251152265.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"251-268"},"PeriodicalIF":4.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Loneliness and psychosis: an integrative review. 孤独与精神病：一项综合综述。

IF 4.9 2区医学

Current Opinion in Psychiatry Pub Date : 2026-05-01 Epub Date: 2026-01-05 DOI: 10.1097/YCO.0000000000001058

Gil Grunfeld, Sohee Park, Daniel Fulford

{"title":"Loneliness and psychosis: an integrative review.","authors":"Gil Grunfeld, Sohee Park, Daniel Fulford","doi":"10.1097/YCO.0000000000001058","DOIUrl":"10.1097/YCO.0000000000001058","url":null,"abstract":"Purpose of review: This review synthesizes emerging research on loneliness in psychosis, integrating neurocognitive, social, developmental, and phenomenological perspectives. We highlight how loneliness operates as both a precipitant and consequence of psychosis symptoms, discuss its manifestations across the psychosis spectrum, and outline conceptual and clinical priorities for advancing person-centered research and clinical care.Recent findings: Loneliness is highly prevalent in psychotic disorders and strongly associated with psychiatric symptom severity, instability of self-concept, and overall reduced wellbeing. Neurocognitive models demonstrate that chronic loneliness heightens social threat sensitivity and alters brain networks supporting social cognition and emotion regulation in individuals with psychosis. Longitudinal data show bidirectional relationships between loneliness and paranoia, psychotic-like experiences, and social-cognitive biases. Qualitative work emphasizes loneliness as a profound barrier to recovery across stages of illness. Understudied contributors, including attachment disruptions, social defeat, context, solitude, and disturbances in self and identity, shape subjective experiences of loneliness beyond objective isolation.Summary: Loneliness in psychosis is multidimensional, driven by interacting cognitive, interpersonal, developmental, and contextual processes. Future research should refine definitional distinctions of loneliness in psychosis phenomenology, incorporate dynamic and mixed-methods paradigms, and examine individual-specific and interpersonal mechanisms. Clinically, evidence supports treatments that prioritize meaning making, improving existing relationships, and addressing social biases, integrating cognitive, meta-cognitive, and narrative approaches.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"201-208"},"PeriodicalIF":4.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Artificial intelligence for schizophrenia: from unimodal prediction to multimodal characterization. 精神分裂症的人工智能：从单峰预测到多峰表征。

IF 4.9 2区医学

Current Opinion in Psychiatry Pub Date : 2026-05-01 Epub Date: 2026-01-19 DOI: 10.1097/YCO.0000000000001076

Xinhui Li, Vince D Calhoun

{"title":"Artificial intelligence for schizophrenia: from unimodal prediction to multimodal characterization.","authors":"Xinhui Li, Vince D Calhoun","doi":"10.1097/YCO.0000000000001076","DOIUrl":"10.1097/YCO.0000000000001076","url":null,"abstract":"Purpose of review: Artificial intelligence is increasingly advancing both fundamental research and clinical applications in schizophrenia. This review surveys recent literature on artificial intelligence driven approaches for schizophrenia diagnosis, treatment, management, and characterization, using multiple data modalities such as neuroimaging, electrophysiology, electronic health records, and genomic data.Recent findings: Recent work shows substantial progress in leveraging machine learning and deep learning for diagnostic label prediction, treatment response modeling, and brain network characterization. While many studies continue to improve feature extraction and classification methods within single modalities, there is a growing trend to utilize multiple data sources to capture the complexity of schizophrenia from a comprehensive perspective. Emerging themes include multimodal fusion methodologies to identify linked correlates of schizophrenia, as well as data-driven approaches to learn subgroups, brain networks, and psychosis continua. The rise of large-scale multimodal datasets, foundation models, and mechanistic interpretability methods holds promise for scalable symptom assessment and biomarker identification, thereby better supporting early intervention and personalized treatment.Summary: Current literature highlights a shift from unimodal prediction to holistic, multimodal characterization of schizophrenia. Transforming these artificial intelligence models into clinical tools, however, requires careful attention to patient privacy and data bias, alongside rigorous validation across diverse populations and settings.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"192-200"},"PeriodicalIF":4.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146141279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The digital pandemic in youth: unpacking the algorithmic impact on mental health in an urbanized world. 青少年中的数字流行病：揭示城市化世界中算法对心理健康的影响。

IF 4.9 2区医学

Current Opinion in Psychiatry Pub Date : 2026-05-01 Epub Date: 2026-02-23 DOI: 10.1097/YCO.0000000000001082

Kuan-Pin Su, Soanseng Hsuan-Cheng Chen, Jane Pei-Chen Chang

{"title":"The digital pandemic in youth: unpacking the algorithmic impact on mental health in an urbanized world.","authors":"Kuan-Pin Su, Soanseng Hsuan-Cheng Chen, Jane Pei-Chen Chang","doi":"10.1097/YCO.0000000000001082","DOIUrl":"10.1097/YCO.0000000000001082","url":null,"abstract":"Purpose of review: Rapid urbanization and the algorithmically mediated digital environment have been linked to a \"digital pandemic\" in youth mental health. As Generation Z transitions from play-based to phone-based childhoods, understanding how digital architecture interacts with urban stressors is critical. This review delineates the socio-neurobiological mechanisms underlying this crisis and proposes a comprehensive multi-tiered public health framework for technology-led intervention.Recent findings: Emerging evidence suggests that attention-optimizing algorithms exploit neurodevelopmental vulnerabilities, intensifying negative affect and maladaptive social comparison. Recent studies link digital immersion to circadian disruption, hypothalamic-pituitary-adrenal axis dysregulation, and systemic low-grade inflammation. Urban stressors - including sensory overload and reduced green space - further sensitize the \"social brain,\" creating an evolutionary mismatch that amplifies algorithmic influence and psychological distress.Summary: We define the \"digital pandemic\" as a population-level phenomenon associated with algorithmic pathogenesis, and propose a \"Digital Precision Psychiatry\" framework that shifts the clinical paradigm from episodic, subjective observation to continuous, objective management. By utilizing digital phenotyping and Just-in-Time Adaptive Interventions (JITAI), this vertically integrated strategy aims to restore bio-psycho-social resilience in youth, turning the digital environment from a source of pathology into a tool for neuroprotection.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"269-279"},"PeriodicalIF":4.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clozapine treatment in the early stages of schizophrenia. 氯氮平在精神分裂症早期的治疗。

IF 4.9 2区医学

Current Opinion in Psychiatry Pub Date : 2026-05-01 Epub Date: 2026-02-06 DOI: 10.1097/YCO.0000000000001059

Ashkhan J Davani, Juan A Gallego, Anil K Malhotra

{"title":"Clozapine treatment in the early stages of schizophrenia.","authors":"Ashkhan J Davani, Juan A Gallego, Anil K Malhotra","doi":"10.1097/YCO.0000000000001059","DOIUrl":"10.1097/YCO.0000000000001059","url":null,"abstract":"Purpose of review: Clozapine is the most effective treatment for antipsychotic nonresponse, yet its use in the early stages of schizophrenia remains substantially delayed. Because the first several years after diagnosis represent a critical window for influencing long-term outcomes, clarifying the benefits, risks, and implementation challenges of earlier clozapine initiation is both timely and clinically relevant. This review synthesizes recent evidence on clozapine effectiveness, safety, and utilization within the first five years of illness.Recent findings: Across cohort studies, registry analyses, and meta-analyses, clozapine demonstrates superior response and relapse-prevention outcomes when used following early treatment failure or relapse. Sequential treatment data show diminishing returns with repeated nonclozapine antipsychotic trials, whereas clozapine maintains comparatively higher response rates. Earlier initiation, particularly within three years of first episode, is associated with improved negative symptoms and functioning. Despite these advantages, clozapine remains markedly underutilized, with substantial delays. Safety profiles in first episode and early-phase samples mirror established risks, with serious adverse events uncommon in the short term.Summary: Evidence supports considering clozapine earlier in the treatment sequence for early-stage schizophrenia, particularly after initial nonresponse or relapse. System-level interventions and emerging biomarker-guided strategies may reduce delays and improve long-term outcomes.","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"209-215"},"PeriodicalIF":4.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13034744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147347341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0