JAMA Psychiatry最新文献

{"title":"Occurrence of Psychosis and Bipolar Disorder in Individuals With Attention-Deficit/Hyperactivity Disorder Treated With Stimulants","authors":"Gonzalo Salazar de Pablo, Claudia Aymerich, Juan Pablo Chart-Pascual, Marco Solmi, Javier Torres-Cortes, Nessma Abdelhafez, Ana Catalan, Olivier Corbeil, Nicoletta Adamo, Philip Shaw, Paolo Fusar-Poli, Samuele Cortese","doi":"10.1001/jamapsychiatry.2025.2311","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.2311","url":null,"abstract":"ImportanceIndividuals with attention-deficit/hyperactivity disorder (ADHD) may present with psychosis or bipolar disorder (BD) following treatment with stimulants. The extent to which this occurs is currently unclear.ObjectiveTo meta-analytically quantify the occurrence of psychosis or BD after exposure to stimulants in individuals with ADHD and assess possible moderating factors.Data SourcesPubMed, Web of Science, Ovid/PsycINFO, and Cochrane Central Register of Reviews were searched from inception until October 1, 2024, without language restrictions.Study SelectionStudies of any design with <jats:italic>DSM</jats:italic> or <jats:italic>International Classification of Diseases</jats:italic>–defined ADHD populations exposed to stimulants, where psychosis or BD outcomes were evaluated.Data Extraction and SynthesisPRISMA Preferred Reporting Items for Systematic Reviews and Meta-analyses and MOOSE Meta-analysis of Observational Studies in Epidemiology guidelines were followed, the protocol was registered, and the Newcastle-Ottawa scale and Cochrane risk of bias-2 tool were used for quality appraisal. Random-effects meta-analysis, subgroup analyses, and meta-regressions were conducted.Main Outcomes and MeasuresFor the proportion of individuals developing psychotic symptoms, psychotic disorders, and BD, effect sizes are reported as percentages with 95% CIs. For the comparison between amphetamines and methylphenidate, effect sizes are presented as odds ratios with 95% CIs.ResultsSixteen studies (N = 391 043; mean [range] age, 12.6 [8.5-31.1] years; 288 199 [73.7%] male) were eligible. Among individuals with ADHD prescribed stimulants, 2.76% (95% CI, 0.73-9.88; k = 10; n = 237 035), 2.29% (95% CI, 1.52-3.40; k = 4; n = 91 437), and 3.72% (95% CI, 0.77-16.05; k = 4; n = 92 945) developed psychotic symptoms, a psychotic disorder, and BD, respectively. Heterogeneity across the studies was significant (<jats:italic>I</jats:italic><jats:sup>2</jats:sup> > 95%). Psychosis occurrence risk was significantly higher in individuals exposed to amphetamines than to methylphenidate (odds ratio [OR], 1.57, 95% CI, 1.15-2.16; k = 3, n = 231 325). Subgroup analyses showed significantly higher prevalence of psychotic symptoms in studies from North America and in those with longer follow-up periods. Increased psychosis occurrence was associated with a higher proportion of female participants, smaller sample sizes, and higher dose of stimulants.Conclusions and RelevanceThis systematic review and meta-analysis found a nonnegligible occurrence of psychotic symptoms, psychotic disorders, or BD in individuals with ADHD treated with stimulants. Amphetamines were associated with higher occurrence compared to methylphenidate. The included studies cannot establish causality, highlighting the need for further research, including randomized clinical trials and mirror-image studies comparing individuals exposed and not exposed to stimulants. Nonetheless, clinicians should ","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"20 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930747","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":"Semaglutide Treatment of Antipsychotic-Treated Patients With Schizophrenia, Prediabetes, and Obesity","authors":"Ashok A. Ganeshalingam, Nicolai Uhrenholt, Sidse Arnfred, Peter Gæde, Signe Düring, Elsebeth N. Stenager, Nick Bünger, Andreas K. Pedersen, Niels Bilenberg, Jan Frystyk","doi":"10.1001/jamapsychiatry.2025.2332","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.2332","url":null,"abstract":"ImportancePatients with schizophrenia have reduced life expectancy due to cardiovascular disease and obesity-related type 2 diabetes, exacerbated by second-generation antipsychotic (SGA) medication. Existing interventions have shown limited effect.ObjectivesTo assess the effect of the once-weekly glucagon-like peptide-1 receptor agonist semaglutide in SGA-treated adults (aged 18-60 years) with schizophrenia, prediabetes (glycosylated hemoglobin A<jats:sub>1<jats:sc>c</jats:sc></jats:sub> [HbA<jats:sub>1<jats:sc>c</jats:sc></jats:sub>], 5.7%-6.4% of total hemoglobin) (to convert HbA<jats:sub>1<jats:sc>c</jats:sc></jats:sub> from percentage of total hemoglobin to mmol/mol, use the following formula: (HbA<jats:sub>1<jats:sc>c</jats:sc></jats:sub> % − 2.152)/0.09148), and overweight or obesity (body mass index [BMI], calculated as weight in kilograms divided by height in meters squared, ≥27).Design, Setting, and ParticipantsThis placebo-controlled, double-blinded randomized clinical trial was conducted from January 2022 to May 2024, with 30 weeks of follow-up, among regional community-based mental health services in 2 regions of Denmark (Region of Southern Denmark and Region of Zealand). SGA-treated patients with schizophrenia, prediabetes, and overweight or obesity were randomized to semaglutide or placebo. Data analysis was completed from May 2024 to January 2025.InterventionOnce-weekly subcutaneous semaglutide or placebo for 30 weeks; semaglutide was titrated up to 1.0 mg/week over 8 weeks.Main Outcomes and MeasuresThe primary outcome was change in HbA<jats:sub>1<jats:sc>c</jats:sc></jats:sub>. Secondary end points included changes in body weight, schizophrenia symptoms based on Positive and Negative Syndrome Scale 6 (PANSS-6) score, and physical and mental quality of life (QoL) (assessed via the 36-item Short Form Survey, version 2 [SF-36v2]).ResultsA total of 154 patients were recruited and randomized 1:1 to semaglutide or placebo (87 female participants (56.5%); mean [SD] age, 38.3 [10.7] years). Of 154 randomized patients, 141 (91.5%) completed the trial—74 of 77 patients randomized to semaglutide (96%) and 67 of 77 randomized to placebo (87%). Semaglutide reduced HbA<jats:sub>1<jats:sc>c</jats:sc></jats:sub> by 0.46% of total hemoglobin (95% CI, −0.56% to −0.36%) and body weight by 9.21 kg (95% CI, −11.68 to −6.75). An HbA<jats:sub>1<jats:sc>c</jats:sc></jats:sub> less than 5.7% of total hemoglobin was achieved in 81% vs 19% of patients treated with semaglutide and placebo, respectively (<jats:italic>P</jats:italic> < .001); improvements in high-density cholesterol by 10.81 mg/dL (95% CI, 2.70-18.53; <jats:italic>P</jats:italic> = .007) and triglycerides by −29.20 mg/dL (95% CI, −55.75 to 2.65; <jats:italic>P</jats:italic> = .03) (to convert to millimoles per liter, multiply by 0.0113) were also observed. Finally, semaglutide improved physical QoL by 3.75 points on the SF-36v2 (95% CI, 1.52-5.98; <jats:italic>P</jats:italic> = .001","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"32 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930746","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":"Polygenic Contributions to Lithium Augmentation Outcomes in Unipolar Depression","authors":"Julia Kraft, Pichit Buspavanich, Alice Braun, Georgia Panagiotaropoulou, Peter Schlattmann, Hannah Buchbauer, Karl Heilbron, Urs Heilbronner, Thomas G. Schulze, Stephan Ripke, Roland Ricken, Mazda Adli","doi":"10.1001/jamapsychiatry.2025.2039","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.2039","url":null,"abstract":"ImportanceLithium augmentation is an effective treatment for patients with major depression after inadequate antidepressant response, but therapeutic outcomes vary considerably between individuals. Molecular studies may provide novel insights into treatment prediction and guide personalized therapy.ObjectiveTo investigate the association of polygenic risk scores (PRS) for schizophrenia (SCZ), major depressive disorder (MDD), and bipolar disorder (BIP) with clinical outcomes after lithium augmentation.Design, Setting, and ParticipantsThis cohort study analyzed prospectively assessed treatment outcomes in patients who underwent lithium augmentation. Disorder-specific PRS were calculated using well-powered genome-wide association study summary statistics. Participants were recruited from 13 psychiatric hospitals, primarily in the greater Berlin area, between 2008 and 2020. They were patients with MDD who showed inadequate response to at least 1 antidepressant, a baseline score of 12 or more on the 17-item Hamilton Depression Rating Scale (HAMD-17), adequate treatment duration (≥4 weeks), and no diagnostic or co-medication changes. Data analysis was conducted between June 2022 and November 2023.ExposurePolygenic risk scores for MDD, SCZ, or BIP.Main Outcomes and MeasuresResponse was defined as a 50% or greater reduction in HAMD-17 score, remission as a HAMD-17 score of 7 or less. Cox proportional hazards models, adjusted for ancestry, demographic, and clinical covariates, were used to estimate hazard ratios (HRs) for favorable outcomes.ResultsAmong 193 patients (mean [SD] age, 49.5 [13.4] years; 118 [61.1%] female and 75 [38.9%] male), higher BIP-PRS were associated with both response (HR, 1.29; 95% CI, 1.02-1.63; <jats:italic>P</jats:italic> = .03) and remission (HR, 1.52; 95% CI, 1.14-2.04; <jats:italic>P</jats:italic> = .004), explaining 2.51% and 4.53% of the variability in treatment outcomes, respectively. Individuals in the highest tertile of the BIP-PRS distribution had a 2.02-fold (95% CI, 1.15-3.53) higher likelihood of response and a 2.26-fold (95% CI, 1.17-4.36) higher chance of remission compared with those in the lowest tertile. Additionally, lower MDD-PRS was associated with better response to lithium augmentation (HR, 0.81; 95% CI, 0.66-1.00; <jats:italic>P</jats:italic> = .048; Nagelkerke <jats:italic>R</jats:italic><jats:sup>2</jats:sup> = 1.99%). No significant associations were observed between SCZ-PRS and response (HR, 1.00; 95% CI, 0.80-1.24; <jats:italic>P</jats:italic> = .97) or remission (HR, 1.12; 95% CI, 0.85-1.48; <jats:italic>P</jats:italic> = .42).Conclusions and RelevanceIndividuals carrying a higher polygenic burden for BIP and lower polygenic risk for MDD are more likely to benefit from lithium augmentation. Our findings suggest that disease-related PRS may aid in developing treatment prediction models for lithium augmentation response in depression, potentially informing clinical decision-making.","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"30 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930749","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":"Erratum: Omission in Byline.","authors":"","doi":"10.1001/jamapsychiatry.2025.1960","DOIUrl":"10.1001/jamapsychiatry.2025.1960","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1001/jamapsychiatry.2025.0183.].</p>","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"947"},"PeriodicalIF":17.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12287931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690291","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, Christina M van der Feltz-Cornelis, 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":"868-876"},"PeriodicalIF":17.1,"publicationDate":"2025-09-01","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":"Errors in Numbers in Meta-Analysis.","authors":"","doi":"10.1001/jamapsychiatry.2025.1716","DOIUrl":"10.1001/jamapsychiatry.2025.1716","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"947"},"PeriodicalIF":17.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642600","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 Byline.","authors":"","doi":"10.1001/jamapsychiatry.2025.1797","DOIUrl":"10.1001/jamapsychiatry.2025.1797","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"947"},"PeriodicalIF":17.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484441","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":"Rescheduling Cannabis-Medicine or Politics?","authors":"Bertha K Madras, Paul J Larkin","doi":"10.1001/jamapsychiatry.2025.1116","DOIUrl":"10.1001/jamapsychiatry.2025.1116","url":null,"abstract":"<p><strong>Importance: </strong>In 2023, the US Department of Health and Human Services (HHS) issued a letter to the administrator of the Drug Enforcement Administration (DEA) recommending rescheduling of cannabis (marijuana) from Schedule I to Schedule III under the Controlled Substances Act (CSA). This recommendation marked a significant departure from previous, consistent, and long-standing federal decisions on cannabis scheduling.</p><p><strong>Objective: </strong>To critique the arguments made by HHS for recommending marijuana rescheduling.</p><p><strong>Evidence: </strong>The HHS secretary (advisor) and US attorney general (decision maker) must consider 8 factors and a 5-part test when deciding whether to reschedule a controlled substance. CSA classification criteria include whether a drug has currently accepted medical use, whether it has abuse potential, and whether use is safe under medical supervision. HHS undermined these established legal scheduling criteria by introducing new, untested criteria.</p><p><strong>Findings: </strong>HHS failed to adequately address the adverse effects of cannabis use, including the high prevalence of cannabis use disorder among users, risks associated with youth consumption, growing evidence linking cannabis to psychosis, and other significant concerns. HHS asserted that cannabis is widely accepted as a legitimate form of medicine, despite the reality that only a small fraction of patient-care physicians recommend it for symptom relief, in practices that often diverge from the norms of medical practice. Finally, the US Food and Drug Administration has not approved cannabis as a medicine, as evidence is deficient in several key areas, including data from high-quality clinical trials, standardized cannabis formulations, established purity, defined routes of administration, dosing guidelines, and specific frequencies of use.</p><p><strong>Conclusions and relevance: </strong>The HHS rationale for reclassifying cannabis in myriad forms (edibles, smokables, drinkables, vaping products, suppositories) and potencies relies on a questionable selection of comparator drugs, downplays distinctive adverse events among cannabis users, and claims, unconvincingly, that cannabis has wide acceptance in medical practice supported by scientific evidence.</p>","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"934-939"},"PeriodicalIF":17.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266287","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":"Antipsychotic Drugs and Dysregulated Glucose Homeostasis","authors":"Emily C. C. Smith, Sri Mahavir Agarwal, Kristoffer J. Panganiban, Kateryna Maksyutynska, Jonathan Monteiro, Jiwon Lee, Femin Prasad, Andrew Ji, Divia Shah, Samantha Cavalier, Reva U. Prabhune, Emril Radoncic, Zilu Yang, Kaitlin Fuller, Michael J. McCarthy, Tyler R. Prestwood, Jacob S. Ballon, Christoph U. Correll, Margaret K. Hahn, Zachary Freyberg","doi":"10.1001/jamapsychiatry.2025.2240","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.2240","url":null,"abstract":"ImportanceAntipsychotic drug (AP)–induced glucose homeostasis changes are often attributed to AP-induced weight gain. Nevertheless, dysregulated glucose control can occur independently of weight gain.ObjectiveTo examine the association between AP use and glucose homeostasis while considering weight gain propensity, medication type, and treatment duration.Data SourcesMEDLINE, Embase, PsychINFO, CINAHL, the Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science were searched from inception through February 3, 2025.Study SelectionBlinded randomized clinical trials (RCTs) comparing changes in glucose homeostasis–related parameters between patients with severe mental illness or healthy volunteers assigned to AP or control (placebo or no intervention) groups were included. Studies were limited to English-language human studies without restrictions on study length, AP type, or previous AP exposure. Of 22 773 unique citations, 163 RCTs met inclusion criteria, with 127 studies included in the meta-analysis.Data Extraction and SynthesisEach article was screened independently by 2 authors using predefined inclusion and exclusion criteria. Data extraction and risk of bias assessment were completed using a standardized spreadsheet. Data were analyzed via random-effects meta-analysis, with subgroup analyses for diagnosis, study length, AP type, age, concomitant medication use, and previous AP exposure. Metaregressions identified covariate effects. Data analysis was completed from October 2023 to February 2025.Main Outcomes and MeasuresPrimary study outcomes were changes in fasting glucose, fasting insulin, and glycated hemoglobin (HbA&lt;jats:sub&gt;1&lt;jats:sc&gt;c&lt;/jats:sc&gt;&lt;/jats:sub&gt;) following AP treatment. Secondary outcomes included any other glucose metabolism–related parameters including, but not limited to, insulin resistance and hyperglycemia.ResultsA total of 35 952 AP-treated patients and 19 010 placebo-treated patients were included in the qualitative synthesis, while 28 975 AP-treated and 15 101 placebo-treated patients were included in the meta-analysis. AP use was associated with significantly increased fasting glucose (mean difference [MD], 0.72 mg/dL; 95% CI, 0.54-1.08 [to convert to millimoles per liter, multiply by 0.0555]; &lt;jats:italic&gt;P&lt;/jats:italic&gt; &amp;amp;lt; .001), fasting insulin (MD, 1.94 μIU/mL; 95% CI, 1.28-2.61 [to convert to picomoles per liter, multiply by 6]; &lt;jats:italic&gt;P&lt;/jats:italic&gt; &amp;amp;lt; .001), glycated hemoglobin (MD, 0.04%; 95% CI, 0.02%-0.05% [to convert to proportion of total hemoglobin, multiply by 0.01]; &lt;jats:italic&gt;P&lt;/jats:italic&gt; &amp;amp;lt; .001), and hyperglycemia (odds ratio, 1.29; 95% CI, 1.04-1.59; &lt;jats:italic&gt;P&lt;/jats:italic&gt; = .02) vs placebo. Findings were corroborated in healthy volunteers. Subgroup analyses suggested that AP type, diagnosis, age, concomitant medication use, and previous AP exposure do not consistently affect dysglycemia risk. In metaregression analyses, AP-associate","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"34 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144910598","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":"Questionable Data and Design in Esketamine Study.","authors":"Florian Naudet,Ioana A Cristea,Andre Gillibert","doi":"10.1001/jamapsychiatry.2025.2056","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.2056","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"60 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930327","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}