{"title":"Considering ADHD in the context of eating disorders through a neuro-affirming lens.","authors":"Lauren Makin, Kate Tchanturia","doi":"10.1097/YCO.0000000000001117","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001117","url":null,"abstract":"<p><strong>Purpose of review: </strong>Research on neuro-affirming eating disorder (ED) care has expanded rapidly but has focused primarily on Autism. Attention to attention-deficit/hyperactivity disorder (ADHD) in ED populations has increased only recently. This review summarizes emerging research on ADHD in EDs and considers implications for neuro-affirming clinical practice.</p><p><strong>Relevant findings: </strong>ADHD is overrepresented in ED populations and is associated with increased clinical complexity, including higher rates of binge eating, psychological distress, and functional difficulties in work and social domains. Current evidence suggests that links between ADHD and EDs are unlikely to be explained solely by core ADHD features such as inattention, impulsivity, or hyperactivity. Instead, research highlights indirect and interactional pathways involving emotional burden, reward sensitivity, and sensory processing differences. ADHD may also influence treatment experiences, with patients often benefiting from greater external structure and support with building routine. Strengths-based, collaborative, and creative approaches are also beneficial. However, recognition of ADHD within ED services remains inconsistent, and clinicians report uncertainty around screening, diagnosis, and pharmacological management.</p><p><strong>Summary: </strong>Improving recognition of ADHD within ED services and adapting treatment approaches to reflect ADHD-related differences may enhance treatment engagement and outcomes. Further research is needed to clarify mechanisms linking ADHD and EDs and to guide neuro-affirming service development.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988511","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}
{"title":"Rituals, routines, habits, or compulsions? Exploring frequently occurring and patterned behaviors in eating disorders.","authors":"Matilda Mela, Riikka Lämsä, Anna Keski-Rahkonen","doi":"10.1097/YCO.0000000000001118","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001118","url":null,"abstract":"<p><strong>Purpose of review: </strong>This scoping review examines rituals, routines, habits, compulsions, and other frequently occurring patterned behaviors associated with eating disorders. It is based on a content analysis of a systematic MEDLINE (Ovid) and PsychINFO literature search of scientific articles published between 2020 and early 2026.</p><p><strong>Recent findings: </strong>Terminology used to describe rituals, routines, habits, compulsions, and other frequently occurring patterned behaviors in eating disorder research was rich but inconsistent. Similar behaviors were variably interpreted as features of eating disorders, autism, or the obsessive-compulsive spectrum. These patterned behaviors were commonly interpreted within a cognitive inflexibility framework but were also viewed as compensatory symptoms and habits that become more ingrained over time. Although they often receded with successful treatment, authors highlighted the difficulty of defining, measuring, and managing them. Studies on these behaviors were often cross-sectional and did not consistently assess change. Contextual factors, such as personal meaning, cultural beliefs, and environment, were also noted to shape them.</p><p><strong>Summary: </strong>Rituals, routines, habits, and compulsions might be best understood as transdiagnostic phenomena that reflect shared underlying mechanisms. Future research should standardize terminology and measurement to better understand and address these behaviors in the management of eating disorders.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975750","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}
Valsamma Eapen, Anthea A Stylianakis, Irina Voineagu
{"title":"From genotype to phenotype: understanding the genetic basis of autism.","authors":"Valsamma Eapen, Anthea A Stylianakis, Irina Voineagu","doi":"10.1097/YCO.0000000000001115","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001115","url":null,"abstract":"<p><strong>Purpose of review: </strong>This paper covers some of the key findings on the topic of genetic influences in autism over the last 12-18 months, which consist of significant conceptual shifts and new insights from recent technological advances.</p><p><strong>Recent findings: </strong>Autism is a highly heritable condition, with significant heterogeneity of the genes that influence the development of this condition. The heterogeneity of autism, and multiple pathways contributing to the development of an autistic phenotype, create challenges in our understanding, diagnosis, and management of this condition.Recent studies of common genetic variation and polygenic risk scores have focussed on resolving phenotypic heterogeneity and identifying meaningful autism subtypes. Rare-variant discovery has expanded across ancestries, the X chromosome, noncoding loci, structural variants, and tandem repeats, aided by long-read and pangenome-informed sequencing. Single-cell multiomics, spatial perturbation methods and human organoid models have connected genetic variation to cell-type-specific and developmental phenotypes, while also revealing substantial mutation-specific effects and methodological sensitivity. Genetic testing increasingly provides aetiological diagnoses and informs medical surveillance. Recent developments also illustrate the therapeutic potential of gene-first approaches for selected monogenic neurodevelopmental disorders.</p><p><strong>Summary: </strong>Recent developments have expanded our understanding of the way the genetic basis of autism manifests phenotypically.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975579","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}
{"title":"Eating disorders in Southern Africa: an update on prevalence, recognition, and clinical implications.","authors":"Lot Sternheim, Hans W Hoek, Bernou Melisse","doi":"10.1097/YCO.0000000000001116","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001116","url":null,"abstract":"<p><strong>Purpose of review: </strong>Recent publications call for research on eating disorders in Southern Africa. However, research is scarce, dated and heavily relies on unvalidated self-reports conducted mainly among young, urban women. This narrative review deliberate challenges in recognizing and identifying eating disorder pathology in Southern African populations and discusses research and clinical implications.</p><p><strong>Recent findings: </strong>The prevalence in Southern Africa is 0.7%, and 0.5-4.7% for the named eating disorders. Cultural, linguistic, and dietary practices may obscure recognition of eating disorder pathology. Evidence on body image concerns is mixed, suggesting that these differ from Western contexts. Interactions between ethnicity and broader socio-cultural factors remain underexplored. These gaps highlight the need for contextually relevant research and for co-developing interventions with local researchers, clinicians, and individuals with lived experience.</p><p><strong>Summary: </strong>The comprehension of eating disorder pathology in Southern African populations remains limited. Understanding and including linguistic, socio-cultural and socio-economic factors is essential. Qualitative research offers an important starting point to explore body image, disordered eating thoughts and behaviors, and underlying mechanisms in these populations.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944359","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}
{"title":"Metabolic health in severe mental illness: bridging the mortality gap - a narrative review.","authors":"Kousar Ishaq, Gerardo A Zavala, Najma Siddiqi","doi":"10.1097/YCO.0000000000001121","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001121","url":null,"abstract":"<p><strong>Purpose of review: </strong>People with severe mental illness (SMI) continue to experience a marked mortality gap, driven largely by preventable cardiometabolic conditions. This review examines recent advances in metabolic health that move the field beyond monitoring towards earlier, more proactive, and better integrated interventions.</p><p><strong>Recent findings: </strong>Recent pharmacological evidence supports metformin's role in mitigating antipsychotic-induced weight gain, and also supports glucagon-like peptide-1 receptor agonists as effective treatments for established obesity and dysglycaemia in SMI. Evidence for behavioural interventions suggests that meaningful improvement, including remission of metabolic syndrome, is achievable when interventions are sufficiently intensive, tailored, and embedded within routine care, rather than delivered as low-intensity education alone. Updated clinical guidance endorses a \"screen and intervene\" approach and promotes integrated models of mental and physical healthcare, but major implementation gaps remain, particularly in low- and middle-income settings. Finally, emerging genetic and biological evidence indicates that metabolic dysfunction may be partly intrinsic to SMI, underscoring the clinical relevance of metabolic psychiatry.</p><p><strong>Summary: </strong>Metabolic health in SMI should now be considered a core therapeutic target. The central challenge is not only recognising the problem, but also implementing effective metabolic interventions, at scale, across diverse, often siloed, care settings.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975646","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}
{"title":"The role of inflammation in neurodevelopment and childhood psychiatric disorders.","authors":"Alexandra U Zezulin, Jonathan Posner","doi":"10.1097/YCO.0000000000001122","DOIUrl":"https://doi.org/10.1097/YCO.0000000000001122","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review examines how prenatal inflammation may contribute to psychiatric and neurodevelopmental disorders, with a focus on maternal immune activation, microglial programming, and epigenetic mechanisms.</p><p><strong>Recent findings: </strong>Recent studies have found that inflammation during pregnancy is associated with changes in brain development and neurodevelopmental outcomes in children. Animal research indicates that maternal immune activation can cause long-lasting changes in gene expression, neural circuitry, and microglial activity. Two-hit models suggest that prenatal inflammation may prime microglia, making the brain more vulnerable to later stress, infections, or adversity. Interventions that target microglia, reduce inflammation, or provide enriched environments may reduce downstream behavioral and neurodevelopmental effects.</p><p><strong>Summary: </strong>Inflammation in early life may increase the risk of psychiatric disorders by altering placental signals, fetal brain development, and neuroimmune regulation. Preventing inflammation during pregnancy and reducing stress and adversity after birth may help protect against later mental health problems.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905315","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}
{"title":"Bipolar disorder and the risk of developing dementia - a systematic review and meta-analysis.","authors":"Lars Vedel Kessing, Klaus Munkholm","doi":"10.1097/YCO.0000000000001100","DOIUrl":"10.1097/YCO.0000000000001100","url":null,"abstract":"<p><strong>Purpose of review: </strong>To present an up-to-date systematic review and meta-analysis on the risk of dementia in patients with bipolar disorder.</p><p><strong>Recent findings: </strong>We included 22 studies investigating the risk of developing dementia among patients with bipolar disorder of which 21 studies provided data for the meta-analysis, comprising a total of 185 306 patients with bipolar disorder and 10 702 744 participants without bipolar disorder. Random effects meta-analysis showed an increased risk of being diagnosed with dementia in patients diagnosed with bipolar disorder [odds ratio (OR): 3.13 (95% CI: 2.40-4.09), I2 = 99.8%, 21 studies]. In a secondary analysis excluding studies with overlapping populations, the pooled effect estimate was OR = 2.60 (95% CI 1.76-3.85, I2 = 99.9%, 11 studies). The evidence was uncertain due to substantial and unexplained between-study heterogeneity, methodological limitations, and risk of bias in the included studies.</p><p><strong>Summary: </strong>Patients with bipolar disorder have an increased risk of developing dementia, but the evidence is uncertain.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"390-399"},"PeriodicalIF":5.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148148227","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}
{"title":"Bipolar disorder in later life: lifestyle and physical health.","authors":"Osvaldo P Almeida","doi":"10.1097/YCO.0000000000001079","DOIUrl":"10.1097/YCO.0000000000001079","url":null,"abstract":"<p><strong>Purpose of review: </strong>To review the association between bipolar disorder in later life, lifestyle measures and physical health.</p><p><strong>Recent findings: </strong>Unhealthy lifestyle behaviours are more frequent among individuals with than without bipolar disorder, and recent retrospective cohort studies using the UK Biobank and Primary Care Clinical Practice Research Datalink have produced results suggesting that hazardous lifestyles may individually and together increase the risk of incident bipolar disorder, including later in life. In addition, new investigations using data from the GAGE-BD consortium and the Australian Pharmaceutical Benefits Scheme suggest that physical health morbidities are generally more prevalent among older women than men with bipolar disorder.</p><p><strong>Summary: </strong>The findings of recent studies indicate that bipolar disorder is associated with unhealthy or hazardous lifestyles and that the association between them may be reciprocal. Lifestyle behaviours seem to have additive effects on physical morbidity, and this may help guide the introduction of harm-minimisation interventions. Bipolar disorder is also associated with high physical health burden, which seems to be more pronounced in women than men. The reasons behind such sex-discrepancy are unclear.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"385-389"},"PeriodicalIF":5.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364114","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}
Diana Czepiel, Els van der Ven, Marit Sijbrandij, Hans W Hoek
{"title":"Rethinking mental disorders in COVID-19: evidence from prepandemic longitudinal data.","authors":"Diana Czepiel, Els van der Ven, Marit Sijbrandij, Hans W Hoek","doi":"10.1097/YCO.0000000000001103","DOIUrl":"10.1097/YCO.0000000000001103","url":null,"abstract":"<p><strong>Purpose of review: </strong>To synthesize longitudinal evidence of mental health outcomes, including prepandemic symptom measurements, among individuals with preexisting mental disorders during the COVID-19 pandemic.</p><p><strong>Recent findings: </strong>Symptom exacerbation commonly occurred in bulimia nervosa, binge-eating disorder, substance use disorders and in obsessive-compulsive psychopathology related to contamination, while symptom improvement was consistently observed in bipolar disorders. In autism spectrum, schizophrenia spectrum and posttraumatic stress disorders, contrasting symptom patterns were reported, possibly reflecting differences in preexisting demographic and clinical profiles and contextual influences. Symptoms in depressive and anxiety disorders, anorexia nervosa and obsessive-compulsive psychopathology unrelated to contamination remained largely stable. Across most disorders, individuals with chronic mental disorders or higher prepandemic symptom levels more frequently showed stable or improving trajectories than those with milder presentations or recent-onset disorders.</p><p><strong>Summary: </strong>Given the small number of methodologically diverse studies, definitive statements regarding differential impact of the pandemic across disorders or underlying mechanisms remain premature. Nevertheless, current evidence does not indicate a generalised deterioration in individuals with preexisting mental disorders, including those with the highest prepandemic symptom burden. While some disorder-specific differences emerged, likely reflecting interactions between contextual changes and preexisting disorder processes, the overall picture is more nuanced than frequently portrayed in pandemic-related literature.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"375-384"},"PeriodicalIF":5.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13566447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148519977","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}
Paula Villela Nunes, Luisa de Siqueira Rotenberg, Lucas Melo Neves, Beny Lafer
{"title":"Lifestyle and psychotherapy interventions for older adults with bipolar disorder.","authors":"Paula Villela Nunes, Luisa de Siqueira Rotenberg, Lucas Melo Neves, Beny Lafer","doi":"10.1097/YCO.0000000000001092","DOIUrl":"10.1097/YCO.0000000000001092","url":null,"abstract":"<p><strong>Purpose of review: </strong>Bipolar disorder (BD) in older adults presents unique clinical challenges, and nonpharmacological interventions are an important component of comprehensive care, with more favorable side-effect profiles. This review synthesizes recent evidence on lifestyle and psychotherapy interventions for older adults with BD.</p><p><strong>Recent findings: </strong>Evidence derives predominantly from observational studies, with few interventional trials. Lifestyle analysis - largely from large-scale biobank cohorts - identifies smoking, sleep dysregulation, sedentary behavior, suboptimal diet, and weight extremes as modifiable risk factors associated with BD onset and course. Despite guideline recommendations, cognitive behavioral therapy for insomnia remains underutilized in BD. In psychotherapy, recovery-oriented and strengths-based models, including Recovery-focused Therapy and Functional Remediation for older adults, show feasibility and acceptability, with a randomized trial underway. Physical activity research is severely limited by absence of interventional studies in older adults with BD, with available evidence indicating that cognitive function and sedentary behavior may be bidirectionally associated.</p><p><strong>Summary: </strong>Lifestyle and psychotherapy interventions for older adults with BD remain limited by paucity of interventional evidence, particularly for this age group. Integrated, age-sensitive, and recovery-oriented approaches hold promise. Future research must prioritize trials that include older adults and address lifestyle factors and their impact on course, cognition and psychosocial functioning.</p>","PeriodicalId":11022,"journal":{"name":"Current Opinion in Psychiatry","volume":" ","pages":"425-431"},"PeriodicalIF":5.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765118","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}