JAMA PsychiatryPub Date : 2024-12-01DOI: 10.1001/jamapsychiatry.2024.2273
Kelly L Green, Shari Jager-Hyman, Maria A Oquendo
{"title":"Suicide Risk-A Specific Intervention Target.","authors":"Kelly L Green, Shari Jager-Hyman, Maria A Oquendo","doi":"10.1001/jamapsychiatry.2024.2273","DOIUrl":"10.1001/jamapsychiatry.2024.2273","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"1171-1172"},"PeriodicalIF":22.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JAMA PsychiatryPub Date : 2024-12-01DOI: 10.1001/jamapsychiatry.2024.2399
Adam Pines, Leonardo Tozzi, Claire Bertrand, Arielle S Keller, Xue Zhang, Susan Whitfield-Gabrieli, Trevor Hastie, Bart Larsen, John Leikauf, Leanne M Williams
{"title":"Psychiatric Symptoms, Cognition, and Symptom Severity in Children.","authors":"Adam Pines, Leonardo Tozzi, Claire Bertrand, Arielle S Keller, Xue Zhang, Susan Whitfield-Gabrieli, Trevor Hastie, Bart Larsen, John Leikauf, Leanne M Williams","doi":"10.1001/jamapsychiatry.2024.2399","DOIUrl":"10.1001/jamapsychiatry.2024.2399","url":null,"abstract":"<p><strong>Importance: </strong>Mental illnesses are a leading cause of disability globally, and functional disability is often in part caused by cognitive impairments across psychiatric disorders. However, studies have consistently reported seemingly opposite findings regarding the association between cognition and psychiatric symptoms.</p><p><strong>Objective: </strong>To determine if the association between general cognition and mental health symptoms diverges at different symptom severities in children.</p><p><strong>Design, setting, and participants: </strong>A total of 5175 children with complete data at 2 time points assessed 2 years apart (aged 9 to 11 years at the first assessment) from the ongoing Adolescent Brain and Cognitive Development (ABCD) study were evaluated for a general cognition factor and mental health symptoms from September 2016 to August 2020 at 21 sites across the US. Polynomial and generalized additive models afforded derivation of continuous associations between cognition and psychiatric symptoms across different ranges of symptom severity. Data were analyzed from December 2022 to April 2024.</p><p><strong>Main outcomes and measures: </strong>Aggregate cognitive test scores (general cognition) were primarily evaluated in relation to total and subscale-specific symptoms reported from the Child Behavioral Checklist.</p><p><strong>Results: </strong>The sample included 5175 children (2713 male [52.4%] and 2462 female [47.6%]; mean [SD] age, 10.9 [1.18] years). Previously reported mixed findings regarding the association between general cognition and symptoms may consist of several underlying, opposed associations that depend on the class and severity of symptoms. Linear models recovered differing associations between general cognition and mental health symptoms, depending on the range of symptom severities queried. Nonlinear models confirm that internalizing symptoms were significantly positively associated with cognition at low symptom burdens higher cognition = more symptoms) and significantly negatively associated with cognition at high symptom burdens.</p><p><strong>Conclusions and relevance: </strong>The association between mental health symptoms and general cognition in this study was nonlinear. Internalizing symptoms were both positively and negatively associated with general cognition at a significant level, depending on the range of symptom severities queried in the analysis sample. These results appear to reconcile mixed findings in prior studies, which implicitly assume that symptom severity tracks linearly with cognitive ability across the entire spectrum of mental health. As the association between cognition and symptoms may be opposite in low vs high symptom severity samples, these results reveal the necessity of clinical enrichment in studies of cognitive impairment.</p>","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"1236-1245"},"PeriodicalIF":22.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11359114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142080334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JAMA PsychiatryPub Date : 2024-12-01DOI: 10.1001/jamapsychiatry.2024.2561
Søren Dinesen Østergaard, Natalie C Momen, Uffe Heide-Jørgensen, Oleguer Plana-Ripoll
{"title":"Risk of Suicide Across Medical Conditions and the Role of Prior Mental Disorder.","authors":"Søren Dinesen Østergaard, Natalie C Momen, Uffe Heide-Jørgensen, Oleguer Plana-Ripoll","doi":"10.1001/jamapsychiatry.2024.2561","DOIUrl":"10.1001/jamapsychiatry.2024.2561","url":null,"abstract":"<p><strong>Importance: </strong>According to the World Health Organization, more than 700 000 individuals worldwide die by suicide each year. Medical conditions likely increase the risk of suicide.</p><p><strong>Objective: </strong>To (1) provide age- and sex-specific pairwise estimates of the risk of suicide across a comprehensive range of medical conditions, (2) investigate whether there is a dose-response-like relationship at play (ie, the higher the disability burden due to medical morbidity, the higher the risk of suicide), and (3) determine if the risk of suicide with medical conditions is particularly pronounced among those who had mental disorder preceding the medical conditions.</p><p><strong>Design, setting, and participants: </strong>This cohort study was an observational study of population-based data for all individuals living in Denmark at some point between 2000 and 2020. The data analysis took place from September 2023 to May 2024.</p><p><strong>Exposures: </strong>Thirty-one specific medical conditions as well as prior mental disorder.</p><p><strong>Main outcomes and measures: </strong>The main outcome was suicide. Associations between the 31 specific medical conditions, nested within 9 categories, and suicide were examined via Poisson regression, yielding incidence rate ratios (IRRs). Subsequent analyses included an interaction term to assess whether a previous hospital-treated mental disorder modified the associations. Finally, the association between the disability burden of medical conditions and suicide was examined for those with and without prior mental disorder, respectively.</p><p><strong>Results: </strong>A total of 6 635 857 individuals (3 337 613 females and 3 298 244 males) were included in the analyses of the associations between medical conditions and suicide. Except for endocrine disorders, all categories of medical conditions were associated with a statistically significant increased risk of suicide (which was most pronounced for gastrointestinal conditions [IRR, 1.7; 95% CI,1.5-1.8], cancer [IRR, 1.5; 95% CI, 1.4-1.6], and hematological conditions [IRR, 1.5; 95% CI, 1.3-1.6]). Interaction between mental disorder and individual medical conditions did not seem to play a major role for suicide risk. For those without but not for those with mental disorder, there was a dose-response-like relationship between the disability burden of medical conditions and suicide.</p><p><strong>Conclusions and relevance: </strong>Medical conditions are generally associated with increased risk of suicide in a dose-response-like manner. Individuals with hospital-treated mental disorder appear to be at such elevated risk of suicide that additional disability associated with medical conditions has little impact in this regard.</p>","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"1198-1206"},"PeriodicalIF":22.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JAMA PsychiatryPub Date : 2024-12-01DOI: 10.1001/jamapsychiatry.2024.4051
{"title":"Error in Results and Figure.","authors":"","doi":"10.1001/jamapsychiatry.2024.4051","DOIUrl":"10.1001/jamapsychiatry.2024.4051","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"1279"},"PeriodicalIF":22.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11579883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JAMA PsychiatryPub Date : 2024-12-01DOI: 10.1001/jamapsychiatry.2024.3072
John N Constantino, Laura J Dilly
{"title":"An Architecture for Transformation in Child Mental Health.","authors":"John N Constantino, Laura J Dilly","doi":"10.1001/jamapsychiatry.2024.3072","DOIUrl":"10.1001/jamapsychiatry.2024.3072","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"1165-1166"},"PeriodicalIF":22.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JAMA PsychiatryPub Date : 2024-12-01DOI: 10.1001/jamapsychiatry.2024.2546
Jared T Hinkle, Marianna Graziosi, Sandeep M Nayak, David B Yaden
{"title":"Adverse Events in Studies of Classic Psychedelics: A Systematic Review and Meta-Analysis.","authors":"Jared T Hinkle, Marianna Graziosi, Sandeep M Nayak, David B Yaden","doi":"10.1001/jamapsychiatry.2024.2546","DOIUrl":"10.1001/jamapsychiatry.2024.2546","url":null,"abstract":"<p><strong>Importance: </strong>A clear and comprehensive understanding of risks associated with psychedelic-assisted therapy is necessary as investigators extend its application to new populations and indications.</p><p><strong>Objective: </strong>To assess adverse events (AEs) associated with classic psychedelics, particularly serious AEs (SAEs) and nonserious AEs (NSAEs) requiring medical or psychiatric evaluation.</p><p><strong>Data sources: </strong>The search for potentially eligible studies was conducted in the Scopus, MEDLINE, PsycINFO, and Web of Science databases from inception through February 8, 2024.</p><p><strong>Study selection: </strong>Two independent reviewers screened articles of classic psychedelics (lysergic acid diethylamide [LSD], psilocybin, dimethyltryptamine [DMT], and 5-methoxy-N,N-dimethyltryptamine [5-MeO-DMT]) involving administration in clinical or research contexts.</p><p><strong>Data extraction and synthesis: </strong>AE data were extracted and synthesized by 2 reviewers and were used for random-effects meta-analysis of AE frequency and heterogeneity. Risk of bias assessment focused on AE ascertainment (eg, systematic assessment and quality of follow-up).</p><p><strong>Main outcomes and measures: </strong>A hybrid approach was used for capture of all reported AEs following high-dose classic psychedelic exposure and confirmatory capture of AEs of special interest, including suicidality, psychotic disorder, manic symptoms, cardiovascular events, and hallucinogen persisting perception disorder. AEs were stratified by timescale and study population type. Forest plots of common AEs were generated, and the proportions of participants affected by SAEs or NSAEs requiring medical intervention were summarized descriptively.</p><p><strong>Results: </strong>A total of 214 unique studies were included, of which 114 (53.3%) reported analyzable AE data for 3504 total participants. SAEs were reported for no healthy participants and for approximately 4% of participants with preexisting neuropsychiatric disorders; among these SAEs were worsening depression, suicidal behavior, psychosis, and convulsive episodes. NSAEs requiring medical intervention (eg, paranoia, headache) were similarly rare. In contemporary research settings, there were no reports of deaths by suicide, persistent psychotic disorders, or hallucinogen persisting perception disorders following administration of high-dose classic psychedelics. However, there was significant heterogeneity in the quality of AE monitoring and reporting. Of 68 analyzed studies published since 2005, only 16 (23.5%) described systematic approaches to AE assessment, and 20 studies (29.4%) reported all AEs, as opposed to only adverse drug reactions. Meta-analyses of prevalence for common AEs (eg, headache, anxiety, nausea, fatigue, and dizziness) yielded comparable results for psilocybin and LSD.</p><p><strong>Conclusions and relevance: </strong>In this systematic review and meta-analysis, cl","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"1225-1235"},"PeriodicalIF":22.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JAMA PsychiatryPub Date : 2024-11-13DOI: 10.1001/jamapsychiatry.2024.3409
Rita Rosner, Jörn Rau, Anette Kersting, Winfried Rief, Regina Steil, Anna-Maria Rummel, Anna Vogel, Hannah Comtesse
{"title":"Grief-Specific Cognitive Behavioral Therapy vs Present-Centered Therapy","authors":"Rita Rosner, Jörn Rau, Anette Kersting, Winfried Rief, Regina Steil, Anna-Maria Rummel, Anna Vogel, Hannah Comtesse","doi":"10.1001/jamapsychiatry.2024.3409","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2024.3409","url":null,"abstract":"ImportanceProlonged grief disorder (PGD) is included as a new diagnosis in international classification systems. Treatments following a cognitive behavioral model are most effective, but comparisons with active control treatments are scarce.ObjectiveTo examine whether integrative cognitive behavioral therapy for prolonged grief (PG-CBT) is superior to present-centered therapy (PCT).Design, Setting, and ParticipantsThis was a rater-blinded, multicenter, randomized clinical trial (stratified by center and relationship to the deceased) with enrollment from April 2017 to May 2022. The setting included 4 university outpatient clinics in Germany. Eligible participants were aged 18 to 75 years and had PGD based on the Prolonged Grief Disorder 13 (PG-13) interview. Participants were randomized 1:1 to PG-CBT and PCT.InterventionsPG-CBT focused on the exposure to the worst moment of the loss and cognitive restructuring of grief-related cognitions in combination with solution-focused and experiential methods (eg, walk to the grave exercise). PCT was adapted in session length and number to PG-CBT and focused on a supportive relationship and coping with daily problems that may have arisen from the loss or grief symptoms.Main Outcomes and MeasuresAll outcomes were assessed at baseline, after treatment, and 12 months after randomization at follow-up. The primary outcome was a blinded assessment of the PG-13 severity score at follow-up. Secondary outcomes were self-reported depressive, somatic, and overall psychopathological symptoms.ResultsOf 544 treatment-seeking individuals experiencing bereavement, 212 eligible participants (mean [SD] age, 51.8 [13.3] years; 173 female [82%]) with PGD based on the PG-13 interview were randomized to PG-CBT and PCT (n = 106 in each condition). In the intention-to-treat analysis, both treatments yielded high reductions in PGD severity at follow-up (PG-CBT: Cohen <jats:italic>d</jats:italic> = 1.64; 95% CI, 1.31-1.97; PCT: Cohen <jats:italic>d</jats:italic> = 1.38; 95% CI, 1.09-1.66). After treatment, participants receiving PG-CBT demonstrated significantly greater reductions in PGD severity than those receiving PCT (Cohen <jats:italic>d</jats:italic> = 0.31; 95% CI, 0.03-0.57). At follow-up, this effect was only visible on a trend level (Cohen <jats:italic>d</jats:italic> = 0.28; 95% CI, −0.02 to 0.57), whereas participants in the PG-CBT group had significantly less depressive and general psychopathological symptoms. Twenty-three participants (20%) discontinued PG-CBT treatment, and 17 participants (16%) discontinued PCT.Conclusion and RelevanceThis randomized clinical trial demonstrates that PG-CBT was superior to PCT after treatment and at follow-up with regard to comorbid symptoms. Both treatments were shown to be effective and acceptable, showing the potential for dissemination and increasing patient choice.Trial registrationGerman Clinical Trials Register (DRKS) identifier: <jats:ext-link xmlns:xlink=\"http://www.w3.org/199","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"22 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142610551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JAMA PsychiatryPub Date : 2024-11-13DOI: 10.1001/jamapsychiatry.2024.3532
Daniel T. Myran, Michael Pugliese, Jennifer Xiao, Tyler S. Kaster, M. Ishrat Husain, Kelly K. Anderson, Nicholas Fabiano, Stanley Wong, Jess G. Fiedorowicz, Colleen Webber, Peter Tanuseputro, Marco Solmi
{"title":"Emergency Department Visits Involving Hallucinogen Use and Risk of Schizophrenia Spectrum Disorder","authors":"Daniel T. Myran, Michael Pugliese, Jennifer Xiao, Tyler S. Kaster, M. Ishrat Husain, Kelly K. Anderson, Nicholas Fabiano, Stanley Wong, Jess G. Fiedorowicz, Colleen Webber, Peter Tanuseputro, Marco Solmi","doi":"10.1001/jamapsychiatry.2024.3532","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2024.3532","url":null,"abstract":"ImportanceInterest in and use of hallucinogens has been increasing rapidly. While a frequently raised concern is that hallucinogens may be associated with an increased risk of psychosis, there are limited data on this association.ObjectivesTo examine whether individuals with an emergency department (ED) visit involving hallucinogen use have an increased risk of developing a schizophrenia spectrum disorder (SSD).Design, Settings, and ParticipantsThis population-based, retrospective cohort study (January 2008 to December 2021) included all individuals aged 14 to 65 years in Ontario, Canada, with no history of psychosis (SSD or substance induced). Data were analyzed from May to August 2024.ExposureAn incident ED visit involving hallucinogen use.Main Outcomes and MeasuresDiagnosis of SSD using a medical record–validated algorithm. Associations between ED visits involving hallucinogens and SSD were estimated using cause-specific adjusted hazard models. Individuals with an incident ED visit involving hallucinogens were compared with members of the general population (primary analysis) or individuals with ED visits involving alcohol or cannabis (secondary analysis).ResultsThe study included 9 244 292 individuals (mean [SD] age, 40.4 [14.7] years; 50.2% female) without a history of psychosis, with a median follow-up of 5.1 years (IQR, 2.3-8.6 years); 5217 (0.1%) had an incident ED visit involving hallucinogen use. Annual rates of incident ED visits involving hallucinogens were stable between 2008 and 2012 and then increased by 86.4% between 2013 and 2021 (3.4 vs 6.4 per 100 000 individuals). Individuals with ED visits involving hallucinogens had a greater risk of being diagnosed with an SSD within 3 years compared with the general population (age- and sex-adjusted hazard ratio [HR], 21.32 [95% CI, 18.58-24.47]; absolute proportion with SSD at 3 years, 208 of 5217 with hallucinogen use [3.99%] vs 13 639 of 9 239 075 in the general population [0.15%]). After adjustment for comorbid substance use and mental health conditions, individuals with hallucinogen ED visits had a greater risk of SSD compared with the general population (HR, 3.53; 95% CI, 3.05-4.09). Emergency department visits involving hallucinogens were associated with an increased risk of SSD within 3 years compared with ED visits involving alcohol (HR, 4.66; 95% CI, 3.82-5.68) and cannabis (HR, 1.47; 95% CI, 1.21-1.80) in the fully adjusted model.Conclusions and RelevanceIn this cohort study, individuals with an ED visit involving hallucinogen use had a greater risk of developing an SSD compared with both the general population and with individuals with ED visits for other types of substances. These findings have important clinical and policy implications given the increasing use of hallucinogens and associated ED visits.","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"70 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142610548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JAMA PsychiatryPub Date : 2024-11-13DOI: 10.1001/jamapsychiatry.2024.3599
Markku Lähteenvuo, Jari Tiihonen, Anssi Solismaa, Antti Tanskanen, Ellenor Mittendorfer-Rutz, Heidi Taipale
{"title":"Repurposing Semaglutide and Liraglutide for Alcohol Use Disorder","authors":"Markku Lähteenvuo, Jari Tiihonen, Anssi Solismaa, Antti Tanskanen, Ellenor Mittendorfer-Rutz, Heidi Taipale","doi":"10.1001/jamapsychiatry.2024.3599","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2024.3599","url":null,"abstract":"ImportancePreliminary studies suggest that glucagon-like peptide-1 receptor (GLP-1) agonists, used to treat type 2 diabetes and obesity, may decrease alcohol consumption.ObjectiveTo test whether the risk of hospitalization due to alcohol use disorder (AUD) is decreased during the use of GLP-1 agonists compared with periods of nonuse for the same individual.Design, Setting, and ParticipantsThis cohort study was an observational study conducted nationwide in Sweden using data from January 2006 to December 2023. The population-based cohort was identified from registers of inpatient care, specialized outpatient care, sickness absence, and disability pension. Participants were all residents aged 16 to 64 years who had a diagnosis of AUD.ExposuresThe primary exposure was use of individual GLP-1 agonists (compared with nonuse of GLP-1 agonists), and the secondary exposure was medications with indication for AUD.Main Outcomes and MeasuresThe primary outcome was AUD hospitalization analyzed in a Cox regression within-individual model. Secondary outcomes were any substance use disorder (SUD)–related hospitalization, somatic hospitalization, and suicide attempt.ResultsThe cohort included 227 866 individuals with AUD; 144 714 (63.5%) were male and 83 154 (36.5%) were female, with a mean (SD) age of 40.0 (15.7) years. Median (IQR) follow-up time was 8.8 (4.0-13.3) years. A total of 133 210 individuals (58.5%) experienced AUD hospitalization. Semaglutide (4321 users) was associated with the lowest risk (AUD: adjusted hazard ratio [aHR], 0.64; 95% CI, 0.50-0.83; any SUD: aHR, 0.68; 95% CI, 0.54-0.85) and use of liraglutide (2509 users) with the second lowest risk (AUD: aHR, 0.72; 95% CI, 0.57-0.92; any SUD: aHR, 0.78; 95% CI, 0.64-0.97) of both AUD and SUD hospitalization. Use of any AUD medication was associated with a modestly decreased risk (aHR, 0.98; 95% CI, 0.96-1.00). Semaglutide (aHR, 0.78; 95% CI, 0.68-0.90) and liraglutide (aHR, 0.79; 95% CI, 0.69-0.91) use were also associated with decreased risk of somatic hospitalizations but not associated with suicide attempts (semaglutide: aHR, 0.55; 95% CI, 0.23-1.30; liraglutide: aHR, 1.08; 95% CI, 0.55-2.15).Conclusions and RelevanceAmong patients with AUD and comorbid obesity/type 2 diabetes, the use of semaglutide and liraglutide were associated with a substantially decreased risk of hospitalization due to AUD. This risk was lower than that of officially approved AUD medications. Semaglutide and liraglutide may be effective in the treatment of AUD, and clinical trials are urgently needed to confirm these findings.","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"11 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142610134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}