JAMA Psychiatry最新文献

{"title":"Behavioral Activation for Perinatal Suicide Ideation","authors":"Parisa R. Kaliush, Nicolette C. Molina, Tara S. Berenbaum, Cindy-Lee Dennis, Bradley N. Gaynes, Samantha Meltzer-Brody, Mae Lynn Reyes-Rodríguez, Richard K. Silver, Alison M. Stuebe, Simone N. Vigod, Crystal E. Schiller, Daisy R. Singla","doi":"10.1001/jamapsychiatry.2025.2116","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.2116","url":null,"abstract":"ImportanceSuicide is a leading cause of maternal postpartum death. Evidence-based interventions are needed.ObjectiveTo determine whether the likelihood of endorsing suicide ideation (SI) changed during a brief behavioral activation (BA) psychotherapy for perinatal depression irrespective of clinician or delivery types.Design, Setting, and ParticipantsThis is a secondary analysis of a multisite, noninferiority, 4-arm randomized clinical trial called SUMMIT(Scaling Up Maternal Mental Health Care by Increasing Access to Treatment). SUMMIT compared clinicians (nonspecialist vs specialist) and modalities (telemedicine vs in person) in delivering BA. Participants were enrolled from January 2020 to October 2023. The study was conducted at university-affiliated networks in Chicago, Illinois; Chapel Hill, North Carolina; and Toronto, Canada. Pregnant (≤36 weeks) and postpartum (4-30 weeks) adults with depressive symptoms (Edinburgh Postnatal Depression Scale [EPDS] score ≥10) were enrolled. Secondary data analyses were conducted in November 2024.InterventionA manualized 6- to 8-session perinatal BA intervention delivered weekly.Main Outcomes and MeasuresThe primary outcome was SI, as measured by the EPDS item 10, assessed weekly and at 3 months postrandomization. SI endorsements were followed by the Columbia Suicide Severity Rating Scale (C-SSRS) for further safety assessment.ResultsA total of 1230 pregnant and postpartum adults were enrolled, among whom 1117 completed 1 or more treatment session and provided 1 or more week of EPDS data and thus were included in the current study. Of 1117 included participants, 264 (23.6%) endorsed SI during treatment, and mean (SD) age was 33.4 (4.9) years. Cumulative link mixed models indicated that the odds of endorsing SI decreased by 25% with each additional treatment session (odds ratio [OR], 0.75; 95% CI, 0.58-0.96; <jats:italic>P</jats:italic> = .03). The odds of endorsing SI decreased by 80% at 3 months postrandomization compared with any time during treatment (OR, 0.20; 95% CI, 0.14-0.27; <jats:italic>P</jats:italic> < .001). The odds of endorsing SI did not differ between clinician type (nonspecialist vs specialist) or modality (telemedicine vs in person). Goodness-of-fit χ<jats:sup>2</jats:sup> tests further indicated that participants were significantly more likely to endorse suicide thoughts on the C-SSRS at treatment onset compared with any other time point.Conclusions and RelevanceIn this secondary analysis of the SUMMIT noninferiority randomized clinical trial, the likelihood of endorsing SI decreased over the course of a brief BA psychotherapy for perinatal depression and most significantly at 3 months postrandomization, irrespective of clinician or delivery types. BA may be one evidence-based, scalable approach for perinatal suicide prevention.Trial RegistrationClinicalTrials.gov Identifier: <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" ext-link-type=\"uri\" xlink:href=\"https://www.","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"1 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899763","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":"Psychiatric and Substance Use Disorders After Nonfatal Firearm Injury.","authors":"Katherine A Koh,Mia Giuriato,Chana A Sacks,José R Zubizarreta,Zirui Song","doi":"10.1001/jamapsychiatry.2025.2110","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.2110","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"15 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930330","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-Reply.","authors":"Antonio Del Casale,Robert Preissner,Maurizio Simmaco","doi":"10.1001/jamapsychiatry.2025.2062","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.2062","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"14 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930329","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":"Samuel T Wilkinson,Taeho Greg Rhee","doi":"10.1001/jamapsychiatry.2025.2059","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.2059","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"32 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930328","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":"Collaborative Care for Opioid Use Disorder in Primary Care","authors":"John C. Fortney, Anna D. Ratzliff, Brittany E. Blanchard, Lori Ferro, Erin Chase, Julien Rouvere, Mark H. Duncan, Joseph O. Merrill, Tracy Simpson, Emily C. Williams, Elizabeth J. Austin, Geoffrey M. Curran, Michael Schoenbaum, Patrick J. Heagerty, Andrew J. Saxon","doi":"10.1001/jamapsychiatry.2025.2126","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.2126","url":null,"abstract":"ImportanceThe criterion-standard treatment for opioid use disorder (OUD) is medications for OUD (MOUD). However, less than a quarter of people with OUD receive MOUD. The collaborative care model (CCM) is an evidence-based practice that integrates mental and physical health treatment in primary care settings. Expanding CCM to include patients with OUD could improve MOUD initiation.ObjectiveTo compare the effectiveness of CCM for OUD and co-occurring mental health symptoms (intervention) with CCM for mental health symptoms only (active control).Design, Setting, and ParticipantsThis hybrid type 2a trial cluster-randomized 24 US primary care clinics to intervention or control. Participants included patients with OUD and mental health symptoms who were not receiving specialty mental health care or specialty substance use treatment. Study data were analyzed from February 2024 to January 2025.InterventionsThe control care team included primary care practitioners, care managers, and psychiatric consultants. Primary care practitioners prescribed psychotropic medications with psychiatric consultation. Care manager activities included patient education, engagement and self-management, shared decision-making, measurement-based care for mental health symptoms, and brief psychotherapy for mental health. The intervention had the same components as the control, with additional MOUD training and psychiatric consultation for primary care practitioners, measurement-based care for OUD, and brief psychotherapy for OUD.Main Outcomes and MeasuresParticipants completed research assessments at baseline, 3 months, and 6 months. The multiple primary outcomes were past-month number of days of using opioids and the Veterans RAND 12 Mental Health Component Summary score.ResultsA total of 254 patients (mean [SD] age, 40.9 [12.4] years; 139 women [59.9%]) participated in the trial. Most participants (172 of 212 [81.1%]) were taking MOUD at baseline. Days using opioids decreased in both the control and intervention groups. The intervention significantly reduced opioid use more than the control with a medium effect size (adjusted ratio of odds ratio, 0.10; 95% CI, 0.03-0.38; Cohen <jats:italic>d</jats:italic> = −0.44; <jats:italic>P</jats:italic> < .001). Mental Health Component Summary scores improved slightly in both the control and intervention groups. The intervention did not significantly improve scores more than control (adjusted difference in change, −1.20; 95% CI, −4.97 to 2.57; Cohen <jats:italic>d</jats:italic> = −0.09; <jats:italic>P</jats:italic> = .53).Conclusions and RelevanceFindings of this cluster randomized clinical trial indicate that OUD can be successfully managed in primary care with CCM, especially CCM for OUD and mental health symptoms. Primary care clinics with MOUD prescribers should consider implementing CCM for OUD and mental health.Trial RegistrationClinicalTrials.gov Identifier: <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" ext","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"13 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899762","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":"The Uncertain Future of the National Institute of Mental Health Data Archive.","authors":"Megan G Flores,Alexander K Thiersch,Stephanie A Rolin","doi":"10.1001/jamapsychiatry.2025.1973","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.1973","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"7 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144825837","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":"Efficacy and Safety of Seltorexant in Insomnia Disorder: A Randomized Clinical Trial.","authors":"Sofie Mesens,Andrew D Krystal,Rama Melkote,Haiyan Xu,Gahan Pandina,Jay B Saoud,Remy Luthringer,Adam Savitz,Wayne C Drevets","doi":"10.1001/jamapsychiatry.2025.1999","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.1999","url":null,"abstract":"ImportanceExisting pharmacological treatments for insomnia have significant limitations.ObjectiveTo assess the effective dose range, safety, and tolerability of the novel selective orexin-2 receptor antagonist seltorexant in insomnia disorder.Design, Setting, and ParticipantsThis randomized, double-blind, active- and placebo-controlled, dose-finding, polysomnography study was conducted from November 2017 to April 2019 at 55 sites in 6 countries and analyzed in August 2019. The timeline for submission of this data for publication was impacted by internal strategic decision-making. Adults (aged 18-64 years) and older adults (aged 65-85 years) with insomnia (Insomnia Severity Index score ≥15) and no psychiatric comorbidity were included.InterventionsParticipants were randomized 1:1:1:1:1 to receive nightly oral-seltorexant (5 mg, 10 mg, or 20 mg), placebo, or zolpidem (5-10 mg) for 14 days.Main Outcomes and MeasuresPrimary and key secondary outcomes included the dose-response relationship of night 1 latency to persistent sleep (LPS) and wake after sleep onset over the first 6 hours (WASO-6). Other secondary outcomes included night 13 LPS and WASO-6. Due to asymmetrical distributions of LPS and WASO-6 at baseline, log transformation was applied and results were expressed as back-transformed least-squares mean (LSM) ratios for comparisons between groups.ResultsOverall, 364 participants (mean [SD] age, 57.8 [12.4] years; 246 [67.6%] female) received seltorexant, 5 mg (n = 71), 10 mg (n = 74), or 20 mg (n = 71); placebo (n = 75); or zolpidem (n = 73). The night 1 dose-response relationship for LPS was significant (with trend test t statistics ≥3.99 and adjusted P values <.001 for all 4 prespecified models), with greater improvements in seltorexant, 10 mg and 20 mg, vs placebo (10 mg: LSM ratio, 0.64; 90% CI, 0.51-0.81; 20 mg: LSM ratio, 0.51; 90% CI, 0.41-0.64) and in seltorexant, 20 mg, vs zolpidem (LSM ratio, 0.71; 90% CI, 0.57-0.88). The night 1 dose-response relationship for WASO-6 was also significant, with trend test t statistics ≥3.99 and adjusted P values <.001 for all 4 prespecified models (seltorexant, 10 mg: LSM ratio, 0.68; 90% CI, 0.55-0.85; seltorexant, 20 mg: LSM ratio, 0.60; 90% CI, 0.48-0.74). Night 1 LPS and WASO-6 improvements were maintained on night 13 for seltorexant, 10 mg and 20 mg, but diminished for zolpidem. On night 13, compared with zolpidem, seltorexant, 10 mg and 20 mg, improved LPS by 30% and 28%, respectively, and seltorexant, 20 mg, improved WASO-6 by 31%. Treatment-emergent adverse events (TEAEs) were lower across the combined seltorexant doses (73/216 [33.8%]) relative to placebo (37/75 [49.3%]) and zolpidem (31/73 [42.5%]). Two participants experienced serious TEAEs during the double-blind phase (1 in the seltorexant, 20 mg, group and 1 in the zolpidem group). Three participants in the seltorexant, 5 mg, and 1 in the seltorexant, 20 mg, group experienced asymptomatic electrocardiogram-related TEAEs leading to discont","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"43 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144825842","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":"Benzodiazepine Prescribing Patterns Following Mass Traumatic Events.","authors":"Ofer Rahamim,Aviv Segev,Dana Sinai","doi":"10.1001/jamapsychiatry.2025.1981","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.1981","url":null,"abstract":"ImportanceWhile clinical guidelines generally advise caution with benzodiazepine use following trauma, prescribing patterns during mass traumatic events reveal tensions between formal recommendations and frontline care delivery.ObjectiveTo assess changes in benzodiazepine prescribing patterns following the October 7, 2023, terrorist attacks in Israel and examine factors associated with prescribing decisions.Design, Setting, and ParticipantsThis population-based retrospective cohort study was conducted using the electronic database of Clalit Health Services in Israel, the country's largest health care service, covering approximately 54% of the population. The number of individuals receiving benzodiazepine prescriptions in the 7- and 30-day periods following the October 7 attacks, in all Clalit Health Services' members aged 18 years or older who were actively insured as of October 7, 2023, were compared with the same population in 2022.Main Outcomes and MeasuresThe primary outcome was changes in overall and first-time benzodiazepine prescriptions during the 7-day and 30-day periods following October 7, 2023, compared with the same periods in 2022. Secondary outcomes included prescriber characteristics and factors associated with receiving new prescriptions.ResultsIn a population of nearly 4 million individuals, total benzodiazepine prescriptions increased by 219% in the first week (from 8600 to 27 408) and 57% over 30 days (from 54 969 to 86 568) compared with 2022. First-time prescriptions showed a 10-fold increase in the first week (from 329 to 3690) and a 268% increase over 30 days (from 2751 to 10 135). Primary care physicians issued 92.5% of new prescriptions. Geographic proximity to conflict zones (adjusted odds ratio, 2.34; 95% CI, 1.89-2.90) and preexisting anxiety diagnoses (adjusted odds ratio, 1.79; 95% CI, 1.63-1.96) were significantly associated with receiving new prescriptions.Conclusions and RelevanceIn this study, the October 7 attacks were associated with substantial increases in benzodiazepine prescribing, particularly among primary care physicians, revealing the tension between clinical guidelines and pragmatic crisis management. These findings suggest a need to better understand and support frontline prescribing decisions during mass trauma events through enhanced clinician training and support systems.","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"23 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144825840","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":"Dopamine and Mood in Psychotic Disorders: An 18F-DOPA PET Study.","authors":"Sameer Jauhar,Robert A McCutcheon,Matthew M Nour,Mattia Veronese,Maria Rogdaki,Ilaria Bonoldi,Matilda Azis,Thomas Whitehurst,Atheeshaan Arumuham,Ellis Onwordi,Federico Turkheimer,Philip McGuire,Allan H Young,Oliver D Howes","doi":"10.1001/jamapsychiatry.2025.1811","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.1811","url":null,"abstract":"ImportanceThere is limited neurobiological or trial evidence guiding treatment of comorbid affective syndromes in psychotic disorders. Given the use of dopamine-blocking antipsychotics, understanding dopamine function across these mood states is warranted.ObjectiveTo test for differences in dopamine synthesis capacity (Kicer) between affective syndromes across psychotic disorders and for association with psychotic symptom severity.Design, Setting, and ParticipantsIn this cross-sectional study using fluorine F 18-labeled fluorodopa (18F-DOPA) positron emission tomography (PET), individuals with first-episode psychosis and comorbid affective syndromes, including a current major depressive episode (MDE) or mixed/mania syndromes, and matched controls were recruited from early intervention services in inner-city London, United Kingdom. Data were collected from March 2013 to February 2022 and analyzed from October 1, 2023, to January 1, 2025.ExposureStriatal Kicer measured by 18F-DOPA PET.Main Outcomes and MeasuresStriatal Kicer and scores on the Positive and Negative Syndrome Scale, Hamilton Depression Rating Scale, Montgomery-Åsberg Depression Rating Scale, and Young Mania Rating Scale were determined.ResultsThe study included a total of 76 individuals (38 with first-episode psychosis and comorbid affective syndromes [25 with MDE and 13 with mixed/mania syndromes] and 38 matched controls). The mean (SD) age was 27.2 (8.9) years overall, 30.7 (12.8) years among those with MDE, 23.7 (3.1) years among those with mixed/mania syndromes, and 26.0 (6.0) years among controls. Sex distribution did not differ (MDE, 13 [52%] male; mixed/mania syndromes, 8 [62%] male; controls, 25 [66%] male; P = .56). Kicer (controlling for age and sex) was significant across groups in whole striatum (F2,71 = 4.04; P = .02; R2 = 0.13). People with psychosis and MDE had lower Kicer compared with those with psychosis and mixed/mania syndromes (β [SE], 0.014 [0.001]; P = .02), with the largest difference observed in the limbic striatum (Cohen d = 1.57; P < .001). In the overall psychosis sample, higher striatal Kicer was associated with greater positive psychotic symptoms (R2 = 0.13; β [SE], 0.000066 [0.000030]; P = .03), notably in the associative striatum (R2 = 0.15; P = .02). No significant association was found in the limbic striatum.Conclusions and RelevanceKicer was lower in psychosis and comorbid MDE than mixed/mania syndromes, and transdiagnostically, greater positive psychotic symptoms were associated with higher Kicer in the associative, but not limbic, striatum. This subregion dopamine dysregulation has relevance for dopamine-modulating therapeutic agents and drug discovery.","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"27 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144825838","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":"Cigarette Smoking During Recovery From Substance Use Disorders.","authors":"Michael J Parks,Carlos Blanco,MeLisa R Creamer,John H Kingsbury,Colm D Everard,Daniela Marshall,Heather L Kimmel,Wilson M Compton","doi":"10.1001/jamapsychiatry.2025.1976","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.1976","url":null,"abstract":"ImportanceCigarette smoking is more prevalent among those with than without other substance use disorders (SUDs). However, smoking cessation interventions are often absent from SUD treatment facilities.ObjectivesTo inform smoking cessation and SUD care by assessing smoking status and SUD recovery over time to determine whether transitioning from current to former smoking is associated with sustained SUD recovery.Design, Setting, and ParticipantsThis cohort study was conducted among a nationally representative cohort of US adults with history of SUD from the PATH (Population Assessment of Tobacco and Health) Study. The PATH Study is an ongoing, nationally representative, longitudinal cohort study in the US. Analyses included adults (aged ≥18 years) in the wave 1 cohort (recruited in 2013/2014) assessed annually over 4 years until wave 4 (2016/2018). A second nationally representative cohort (from 2016/2018 to 2023) was also assessed in sensitivity analyses. Data analysis was completed from June 2024 to September 2024.ExposureCigarette smoking (never, former, and current use).Main Outcomes and MeasuresThe primary outcome was SUD recovery, assessed via the Global Appraisal of Individual Needs-Short Screener SUD subscale, measured as high lifetime SUD symptoms (4-7 symptoms) and zero past-year symptoms (sustained remission) or high lifetime SUD symptoms with any past-year symptoms (current substance use or SUD). Fixed-effects logistic regression assessed within-person change in smoking and its association with SUD recovery, accounting for between-person confounders.ResultsAmong 2652 adults from 2013/2014 to 2016/2018, 41.9% of participants (95% CI, 39.4%-44.4%) were female, and mean age was 39.4 years (95% CI, 38.7-40.3). By self-reported race and ethnicity, 17.0% of participants (95% CI, 15.3%-18.9%) were Hispanic, 13.9% (95% CI, 12.2%-15.6%) were non-Hispanic Black, 63.1% (95% CI, 60.4%-65.7%) were non-Hispanic White, and 6.0% (95% CI, 4.9%-7.4%) were another non-Hispanic race (Asian, Native American/Alaska Native, Native Hawaiian/Other Pacific Islander, more than 1 race). Within-person change from current to former smoking was positively associated with SUD recovery: year-to-year change to former cigarette use was associated with a 30% increase in odds of recovery (odds ratio [OR], 1.30; 95% CI, 1.07-1.57), accounting for time-varying covariates and between-person differences. This association remained significant after lagging predictor by 1 year (OR, 1.43; 95% CI, 1.00-2.05) and in the second cohort assessed from 2016/2018 to 2022/2023 (OR, 1.37; 95% CI, 1.13-1.66).Conclusions and RelevanceIn this cohort study, within-person change from current to former smoking was associated with recovery from other SUDs. These results suggest that smoking cessation could be used as a tool to assist recovery processes and improve health among adults with an SUD.","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"746 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144825841","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}