JAMA Psychiatry最新文献

{"title":"Psychiatric, Neurological, and Somatic Comorbidities in Intermittent Explosive Disorder.","authors":"Yanli Zhang-James, John Paliakkara, Joshua Schaeffer, Joseph Strayhorn, Stephen V Faraone","doi":"10.1001/jamapsychiatry.2024.4465","DOIUrl":"10.1001/jamapsychiatry.2024.4465","url":null,"abstract":"<p><strong>Importance: </strong>Intermittent explosive disorder (IED) is an understudied psychiatric condition marked by impulsive aggression and poorly regulated emotional control, often resulting in interpersonal and societal consequences. Better understanding of comorbidities can improve screening, diagnosis, and treatment.</p><p><strong>Objective: </strong>To investigate the prevalence of IED and its associations with psychiatric, neurological, and somatic disorders.</p><p><strong>Design, setting, and participants: </strong>In this cohort study, matched groups of patients with and without IED were identified from the TriNetX Research Network (dated January 31, 2024). Electronic medical record data were analyzed. The mean (SD) time from the first to last known visits was 4.8 (5.4) years.</p><p><strong>Exposure: </strong>Lifetime diagnosis of IED.</p><p><strong>Main outcomes and measures: </strong>Main outcomes were International Statistical Classification of Diseases, Tenth Revision, Clinical Modification diagnostic categories and root codes. Cox proportional hazard models were used to estimate and compare probabilities of acquiring other diagnoses. Key measures include the numbers and proportions of patients with these diagnoses and adjusted hazard ratios (HRs) for IED.</p><p><strong>Results: </strong>Overall, 30 357 individuals with IED and 30 357 demographically matched controls were included. In each group, 21 313 (70%) were male, with a mean (SD) age at the first visit 26 (17) years. Despite only 0.03% of the total patient population having an IED diagnosis, extensive comorbidities with psychiatric, neurological, and somatic conditions were found. A notable 95.7% of individuals with IED (29 054 individuals) had another psychiatric diagnosis. All psychiatric subcategories and 92% of the psychiatric diagnoses were significantly associated with IED, with HRs ranging from 2.1 (95% CI, 2.0-2.2) for substance use disorder to 76.6 (95% CI, 65.4-89.6) for disorders of adult personality and behavior (excluding IED). Among neurological conditions, neurodegenerative diseases (HR, 5.0; 95% CI, 4.1-6.1) and epilepsy (HR, 4.9; 95% CI, 4.3-5.6) had the highest HRs, followed by movement disorders (HR, 3.1; 95% CI, 2.8-3.5), cerebral palsy (HR, 2.6; 95% CI, 2.2-3.0), and sleep disorders (HR, 2.2; 95% CI, 2.1-2.3). Significant associations with IED were also observed for many somatic diseases, including obesity (HR, 1.6; 95% CI, 1.5-1.7), hyperlipidemia (HR, 1.5; 95% CI, 1.4-1.5), hypertension (HR, 1.6; 95% CI, 1.5-1.7), and gastroesophageal reflux disease (HR, 1.7; 95% CI, 1.7-1.9).</p><p><strong>Conclusion and relevance: </strong>These findings highlight the extensive comorbidities between IED and psychiatric, neurological, and somatic disorders, emphasizing the need for integrated diagnostic and treatment approaches addressing both psychological and physical health aspects of IED. Limitations related to reliance on medical records and low diagnostic rat","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"358-367"},"PeriodicalIF":22.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005788","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}

{"title":"Social Determinants of Health and Suicide-Related Outcomes: A Review of Meta-Analyses.","authors":"Peter Jongho Na, Jeonghyun Shin, Ha Rim Kwak, Jaewon Lee, Dylan J Jester, Piumee Bandara, Jim Yong Kim, Christine Y Moutier, Robert H Pietrzak, Maria A Oquendo, Dilip V Jeste","doi":"10.1001/jamapsychiatry.2024.4241","DOIUrl":"10.1001/jamapsychiatry.2024.4241","url":null,"abstract":"<p><strong>Importance: </strong>Preventing suicide is one of the top priorities in public health policy. Identifying key social determinants of health (SDOH) in suicide risk is critical for informing clinical practices, future research, and policy solutions to prevent suicide.</p><p><strong>Objective: </strong>To examine the associations of SDOH with suicide-related outcomes.</p><p><strong>Data sources: </strong>Studies published before July 2023 were searched through PubMed, PsycINFO, Embase, and Web of Science. The date of the search was August 4, 2023.</p><p><strong>Study selection: </strong>We included the most up-to-date meta-analyses reporting associations between SDOH and suicide-related outcomes.</p><p><strong>Data extraction and synthesis: </strong>Three independent reviewers extracted data and conducted quality assessment using the Joanna Briggs Institute Checklist for Systematic Reviews and Research Syntheses.</p><p><strong>Main outcomes and measures: </strong>The main outcomes of interest were suicide mortality, suicide attempt, and suicidal ideation.</p><p><strong>Results: </strong>A total of 46 meta-analyses met inclusion criteria. For suicide mortality, justice system-involved individuals in the community, exposure to others' and parental suicide, firearm accessibility, divorce, experience in foster care, release from incarceration, and midlife (age 35-65 years) unemployment were the SDOH with consistently strong effects. Individuals released from incarceration demonstrated a high prevalence of suicide mortality (114.5 per 100 000 persons). With regard to suicide attempt, experience of childhood abuse and maltreatment and sexual assault, gender and sexual minority status, and parental suicide mortality were the strongest risk factors. The prevalence of suicide attempt among homeless individuals (28.9%; 95% CI, 21.7%-37.2%) and incarcerated female youths (27%; 95% CI, 20%-34%) and adults (12.2%; 95% CI, 7.1%-17.2%) was high. For suicidal ideation, identification as bisexual and intimate partner violence in women were the strongest risk factors. The prevalence of lifetime suicidal ideation in homeless individuals was 41.6% (95% CI, 28.6%-56.0%). Protective factors associated with reduced risk of suicide mortality were religious affiliation and being married. School connectedness showed protective associations against suicide attempt and suicidal ideation.</p><p><strong>Conclusions and relevance: </strong>Tailoring interventions and future research for identified priority subpopulations, such as justice system-involved individuals in the community, and implementing policy measures addressing the SDOH that showed strong associations with suicide mortality, attempts, and ideation, such as gun licensing requirements, are critical to counteracting social and environmental forces that increase suicide risk.</p>","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"337-346"},"PeriodicalIF":22.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11964833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914812","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}

{"title":"Searching the Brain for the Cause of Psychosis.","authors":"Stephan Heckers","doi":"10.1001/jamapsychiatry.2024.4455","DOIUrl":"10.1001/jamapsychiatry.2024.4455","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"335-336"},"PeriodicalIF":22.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399196","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}

{"title":"Native Hawaiian and Pacific Islander Data in Overdose Research.","authors":"Nikki Kalani Apana, Megan Y Gimmen, Kekoa Taparra","doi":"10.1001/jamapsychiatry.2024.4848","DOIUrl":"10.1001/jamapsychiatry.2024.4848","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"427"},"PeriodicalIF":22.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449137","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}

{"title":"Strengthening Safeguards for Psychiatric Uses of Ketamine.","authors":"Brian S Barnett, Roger D Weiss, Gerard Sanacora","doi":"10.1001/jamapsychiatry.2024.4787","DOIUrl":"10.1001/jamapsychiatry.2024.4787","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"333-334"},"PeriodicalIF":22.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399198","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}

{"title":"Effective Treatment for Mental and Substance Use Disorders in 21 Countries.","authors":"Daniel V Vigo, Dan J Stein, Meredith G Harris, Alan E Kazdin, Maria Carmen Viana, Richard Munthali, Lonna Munro, Irving Hwang, Timothy L Kessler, Sophie M Manoukian, Nancy A Sampson, Ronald C Kessler","doi":"10.1001/jamapsychiatry.2024.4378","DOIUrl":"10.1001/jamapsychiatry.2024.4378","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Accurate baseline information about the proportion of people with mental disorders who receive effective treatment is required to assess the success of treatment quality improvement initiatives.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To examine the proportion of mental and substance use disorders receiving guideline-consistent treatment in multiple countries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;In this cross-sectional study, World Mental Health (WMH) surveys were administered to representative adult (aged 18 years and older) household samples in 21 countries. Data were collected between 2001 and 2019 and analyzed between February and July 2024. Twelve-month prevalence and treatment of 9 DSM-IV anxiety, mood, and substance use disorders were assessed with the Composite International Diagnostic Interview. Effective treatment and its components were estimated with cross-tabulations. Multilevel regression models were used to examine predictors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;The main outcome was proportion of effective treatment received, defined at the disorder level using information about disorder severity and published treatment guidelines regarding adequate medication type, control, and adherence and adequate psychotherapy frequency. Intermediate outcomes included perceived need for treatment, treatment contact separately in the presence and absence of perceived need, and minimally adequate treatment given contact. Individual-level predictors (multivariable disorder profile, sex, age, education, family income, marital status, employment status, and health insurance) and country-level predictors (treatment resources, health care spending, human development indicators, stigma, and discrimination) were traced through intervening outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the 56 927 respondents (69.3% weighted average response rate), 32 829 (57.7%) were female; the median (IQR) age was 43 (31-57) years. The proportion of 12-month person-disorders receiving effective treatment was 6.9% (SE, 0.3). Low perceived need (46.5%; SE, 0.6), low treatment contact given perceived need (34.1%; SE, 1.0), and low effective treatment given minimally adequate treatment (47.0%; SE, 1.7) were the major barriers, but with substantial variation across disorders. Country-level general medical treatment resources were more important than mental health treatment resources. Other than for the multivariable disorder profile, which was associated with all intermediate outcomes, significant predictors were largely mediated by treatment contact.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;In addition to the gaps in treatment quality, these results highlight the importance of increasing perceived need, the largest barrier to effective treatment; the importance of training primary care treatment clinicians in recognition and treatment of mental disorders; the need to improve the continuum of care, es","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"347-357"},"PeriodicalIF":22.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189526","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}

{"title":"Error in Funding.","authors":"","doi":"10.1001/jamapsychiatry.2025.0003","DOIUrl":"10.1001/jamapsychiatry.2025.0003","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"427"},"PeriodicalIF":22.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399194","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}

{"title":"Effective Components of Collaborative Care for Depression in Primary Care: An Individual Participant Data Meta-Analysis.","authors":"Hannah Schillok, Jochen Gensichen, Maria Panagioti, Jane Gunn, Lukas Junker, Karoline Lukaschek, Caroline Jung-Sievers, Philipp Sterner, Lukas Kaupe, Tobias Dreischulte, Mohammed K Ali, Enric Aragonès, David B Bekelman, Birgit Herbeck Belnap, Robert M Carney, Lydia A Chwastiak, Peter A Coventry, Karina W Davidson, Maria L Ekstrand, Alison Flehr, Susan Fletcher, Lars P Hölzel, Klaas Huijbregts, Viswanathan Mohan, Vikram Patel, David A Richards, Bruce L Rollman, Chris Salisbury, Gregory E Simon, Krishnamachari Srinivasan, Jürgen Unützer, Kenneth B Wells, Thomas Zimmermann, Markus Bühner","doi":"10.1001/jamapsychiatry.2025.0183","DOIUrl":"10.1001/jamapsychiatry.2025.0183","url":null,"abstract":"<p><strong>Importance: </strong>Collaborative care is a multicomponent intervention for patients with chronic disease in primary care. Previous meta-analyses have proven the effectiveness of collaborative care for depression; however, individual participant data (IPD) are needed to identify which components of the intervention are the principal drivers of this effect.</p><p><strong>Objective: </strong>To assess which components of collaborative care are the biggest drivers of its effectiveness in reducing symptoms of depression in primary care.</p><p><strong>Data sources: </strong>Data were obtained from MEDLINE, Embase, Cochrane Library, PubMed, and PsycInfo as well as references of relevant systematic reviews. Searches were conducted in December 2023, and eligible data were collected until March 14, 2024.</p><p><strong>Study selection: </strong>Two reviewers assessed for eligibility. Randomized clinical trials comparing the effect of collaborative care and usual care among adult patients with depression in primary care were included.</p><p><strong>Data extraction and synthesis: </strong>The study was conducted according to the IPD guidance of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline. IPD were collected for demographic characteristics and depression outcomes measured at baseline and follow-ups from the authors of all eligible trials. Using IPD, linear mixed models with random nested effects were calculated.</p><p><strong>Main outcomes and measures: </strong>Continuous measure of depression severity was assessed via validated self-report instruments at 4 to 6 months and was standardized using the instrument's cutoff value for mild depression.</p><p><strong>Results: </strong>A total of 35 datasets with 38 comparisons were analyzed (N = 20 046 participants [57.3% of all eligible, with minimal differences in baseline characteristics compared with nonretrieved data]; 13 709 [68.4%] female; mean [SD] age, 50.8 [16.5] years). A significant interaction effect with the largest effect size was found between the depression outcome and the collaborative care component therapeutic treatment strategy (-0.07; P < .001). This indicates that this component, including its key elements manual-based psychotherapy and family involvement, was the most effective component of the intervention. Significant interactions were found for all other components, but with smaller effect sizes.</p><p><strong>Conclusions and relevance: </strong>Components of collaborative care most associated with improved effectiveness in reducing depressive symptoms were identified. To optimize treatment effectiveness and resource allocation, a therapeutic treatment strategy, such as manual-based psychotherapy or family integration, may be prioritized when implementing a collaborative care intervention.</p>","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":""},"PeriodicalIF":22.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709752","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}

{"title":"Prescription Stimulant Prescribing, Nonmedical Use, and Shortages: US FDA Research and Response.","authors":"Joshua P Rising, Robert M Califf","doi":"10.1001/jamapsychiatry.2025.0099","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.0099","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":""},"PeriodicalIF":22.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709855","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}

{"title":"Caring for Patients With Severe Anorexia Nervosa-A Capacity Evaluation Cannot Save Us.","authors":"Emily G Holmes, Jane A Hartsock, Amy S Martin","doi":"10.1001/jamapsychiatry.2025.0102","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.0102","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":""},"PeriodicalIF":22.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709750","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}