JAMA Psychiatry最新文献

{"title":"Structural Brain Volumes and Delay Discounting","authors":"Bryan Youngwoo Yoon,Wonjin Kim,Dohyeon Kim,Joon Yul Choi,Wi Hoon Jung","doi":"10.1001/jamapsychiatry.2026.2329","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2026.2329","url":null,"abstract":"This cross-sectional study evaluates a multilayer perceptron model for estimating delay discounting among college-aged adults.","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"1 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149020511","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":"Genetic Risk as Statistical Topology Rather Than Biological Essence.","authors":"Andrea Raballo, Michele Poletti, Antonio Preti","doi":"10.1001/jamapsychiatry.2026.2920","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2026.2920","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982627","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":"Genetic Risk as Statistical Topology Rather Than Biological Essence-Reply.","authors":"Kenneth S Kendler, Henrik Ohlsson, Kristina Sundquist","doi":"10.1001/jamapsychiatry.2026.2917","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2026.2917","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982645","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":"Mapping Clinical Diagnoses Associated With Neurodiversity and Neurodivergence in Mental Health Research","authors":"Alessio Bellato, Martine R. P. Long, Morena Barilà, Giorgia Frigeri, Luigi Rizzo, Sabrina Serafino, Andrea Bilbow, Nina Hovén, Aurelie Baranger, Pietro Cirrincione, Yiling Ke, Conni Langdown, Jing Li, Sophia Lipscombe, Julia Ribeiro, Emma Sgariboldi, Sarah L. Chellappa, Giorgia Michelini, Lucia Margari, Emilia Matera, Maria Giuseppina Petruzzelli, Samuele Cortese","doi":"10.1001/jamapsychiatry.2026.2851","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2026.2851","url":null,"abstract":"Importance The terms <jats:italic toggle=\"yes\">neurodivergence</jats:italic> and <jats:italic toggle=\"yes\">neurodiversity</jats:italic> are increasingly used across mental health and broader clinical literature, as well as in clinical practice, clinical service commissioning, and policy contexts, despite their lack of clinical and diagnostic specificity. Objective To quantitively map clinical diagnoses associated with the terms <jats:italic toggle=\"yes\">neurodivergence</jats:italic> and <jats:italic toggle=\"yes\">neurodiversity</jats:italic> in the empirical mental health literature through a scoping review conducted with experts with lived experience . Evidence Review Following JBI methods and the PRISMA extension for scoping reviews, PubMed/Medline, Web of Science, Embase, and PsycINFO were searched up to August 1, 2025, and identified 134 studies including 151 134 participants that recruited participants defined as <jats:italic toggle=\"yes\">neurodivergent</jats:italic> or <jats:italic toggle=\"yes\">neurodiverse</jats:italic> . Findings Participants were primarily identified through self-reported diagnoses (n = 56 [41.8%]) or self-identification (n = 50 [37.3%]). A heterogeneous range of diagnoses was associated with <jats:italic toggle=\"yes\">neurodivergence</jats:italic> and <jats:italic toggle=\"yes\">neurodiversity</jats:italic> , most commonly autism (n = 92 [68.7%]), followed by ADHD (n = 86 [64.2%]), dyslexia (n = 44 [32.8%]), dyspraxia (n = 21 [15.7%]), anxiety disorder (n = 20 [14.9%]), and dyscalculia (n = 17 [12.7%]). Notably, 29 studies (21.6%) did not specify any clinical diagnoses. Conclusions and relevance While <jats:italic toggle=\"yes\">neurodivergence</jats:italic> and <jats:italic toggle=\"yes\">neurodiversity</jats:italic> are valuable for capturing lived experience, their lack of specificity may introduce substantial heterogeneity in research focused on clinical categories. These findings suggest prioritizing precise diagnostic descriptors in clinical practice and research involving clinically defined conditions, while reserving <jats:italic toggle=\"yes\">neurodivergent</jats:italic> for studies and contexts focused on self-identification and identity.","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"267 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148973476","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 Case for More Aggressive Masking in Psychedelic Trials","authors":"Kevin H. Yang, Boris D. Heifets, Andrew Krystal, Josh D. Woolley","doi":"10.1001/jamapsychiatry.2026.2858","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2026.2858","url":null,"abstract":"This Viewpoint discusses the UMBRAA (unidentifiable multidrug blinding with reduced, authorized awareness) strategy to address the masking problem in psychedelic trials.","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"78 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148973480","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":"Structural Brain Correlates of Bulimia Nervosa Diagnosis and Symptom Severity","authors":"Laura A. Berner, Anusha Phadnis, Margaret L. Westwater, Saren H. Seeley, Guido K. W. Frank, Megan E. Shott, Rachel Marsh, Carrie J. McAdams, Alessio Maria Monteleone, Giammarco Cascino, Hans-Christoph Friederich, Joe J. Simon, Cara Bohon, Kelsey Hagan, Elske Vrieze, Nicolas Leenaerts, Jochen Seitz, Luca Lavagnino, Giovanni Abbate-Daga, Federico D’Agata, Sarah Fischer, Paul Fletcher, Michael R. Lowe, Claire Sun, Esther Walton, Sophia I. Thomopoulos, Clara A. Moreau, Stefan Ehrlich, Paul M. Thompson","doi":"10.1001/jamapsychiatry.2026.2842","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2026.2842","url":null,"abstract":"Importance Bulimia nervosa (BN) ranks second among eating disorders in both prevalence and disease burden, but its neurobiology is poorly understood. Progress has been limited by neuroimaging studies with inconsistent findings across small samples. Objective To identify reliable structural brain correlates of BN diagnosis and severity across multiple cohorts worldwide. Design, Setting, and Participants This case-control study used 3-dimensional T1-weighted magnetic resonance imaging (MRI) and clinical data. Prospective meta-analyses assessed group differences in cortical thickness (CT), surface area (SA), and subcortical volumes (SV) and associations with symptom severity. Data were analyzed between February 1, 2022, and October 1, 2025. Thirteen international sites (17 cohorts) participating in the Enhancing Neuroimaging Genetics through Meta-Analysis (ENIGMA) Eating Disorders Working Group were included, yielding a total of 369 participants with BN and 417 healthy control individuals. Main Outcomes and Measures Regional CT, SA, and SV extracted from T1-weighted MRI scans (uniformly preprocessed using ENIGMA-standardized pipelines and quality control procedures); binge eating severity; and compensatory behavior severity. Results Participants were all female with a mean (range) age of 23.6 (12.0-53.6) years. Relative to control individuals, the BN group had lower nucleus accumbens volume (Cohen <jats:italic toggle=\"yes\">d</jats:italic> , −0.20; 95% CI, −0.34 to −0.06) and lower cortical SA of the superior temporal ( <jats:italic toggle=\"yes\">d</jats:italic> , −0.26; 95% CI, −0.41 to −0.12) and transverse temporal cortices ( <jats:italic toggle=\"yes\">d</jats:italic> , −0.24; 95% CI, −0.38 to −0.10). We did not observe significant group differences in CT. Most differences remained significant when controlling for cohort-level variation in body mass index, illness duration, depressive symptoms, psychotropic medication use, and purging as a compensatory behavior. Binge-eating frequency was associated with lower SA of the superior temporal cortex, insula, pars orbitalis, and medial orbitofrontal, rostral middle frontal, and isthmus and posterior cingulate gyri ( <jats:italic toggle=\"yes\">r</jats:italic> value range, −0.20 to −0.14) but not CT or SV. No anatomical characteristics were associated with total compensatory behaviors. Conclusions and Relevance This case-control study found that localized brain structural alterations, mostly in SA, were associated with BN and BN symptoms. These findings provide evidence implicating reward, cognitive control, interoceptive, and social cognition circuits in the pathophysiology of BN, advancing neurobiological models of a disorder with a poorly characterized brain basis.","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"28 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148973169","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":"Cannabis Commercialization as a Modifiable Public Health Exposure","authors":"Jodi M. Gilman, Cheryl Y. S. Foo, Andrew S. Hyatt, A. Eden Evins","doi":"10.1001/jamapsychiatry.2026.2869","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2026.2869","url":null,"abstract":"This Viewpoint describes how policies shaping cannabis commercialization constitute a modifiable exposure and, thus, may influence psychiatric risk and suggests mitigation strategies.","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"12 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148973477","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":"Population-Level Implications of Parental Similarity for the Prevalence and Heritability of Psychiatric Disorders","authors":"Saeid Rasekhi Dehkordi, Joeri Meijsen, Ryan Waples, Richard Zetterberg, Dorte Helenius, Giorgos Athanasiadis, Morteza Vaez, John Shorter, Simone Montalbano, Kajsa-Lotta Hellberg, Morten Dybdahl Krebs, Andrés Ingason, Thomas Werge, Alfonso Buil","doi":"10.1001/jamapsychiatry.2026.2712","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2026.2712","url":null,"abstract":"Importance Partner similarity for psychiatric traits, often attributed to assortative mating, has been repeatedly documented, but its theoretical consequences for the prevalence and heritability of psychiatric disorders have been examined only under strong and often unrealistic assumptions and have never been empirically estimated using population-based data. Objective To quantify the extent of partner similarity for psychiatric and somatic disorders and to estimate its empirical intergenerational implications for the prevalence and heritability of psychiatric disorders and their corresponding somatic comorbidities. Design, Settings, and Participants This population-based cohort study used linked nationwide Danish registry data on residents born between 1969 and 2017. Parental pairs and offspring were identified through the Danish Civil Registration System, and psychiatric and somatic diagnoses were obtained from national health registers. Data were analyzed from 2021 to 2026. Main Outcomes and Measures Parental correlations for psychiatric and somatic disorders were calculated. Prevalence and heritability in the observed data were then compared with corresponding estimates under a random mating scenario. Results Among 4 244 585 Danish residents born between 1969 and 2017 (2 200 795 male [51.9%]; mean [SD] age, 26.3 [13.5] years for males and 25.9 [13.5] years for females), we identified 549 541 parental couples and 822 209 offspring. Parental correlations were substantial for psychiatric disorders overall ( <jats:italic toggle=\"yes\">r</jats:italic> = 0.28; SE, 0.003), with the highest within-disorder correlation observed for schizophrenia ( <jats:italic toggle=\"yes\">r</jats:italic> = 0.38; SE, 0.015) and the lowest for anorexia ( <jats:italic toggle=\"yes\">r</jats:italic> = 0.11; SE, 0.029). Cross-disorder correlations ranged from 0.01 to 0.26. Parental correlations were also observed for somatic illnesses but were weaker ( <jats:italic toggle=\"yes\">r</jats:italic> = 0.03-0.14) and were almost entirely accounted for by comorbid psychiatric disorders. Simulations further showed that this pattern of nonrandom mating inflated the prevalence and family-based heritability of any psychiatric disorder by 1.8% and 12.5%, respectively. Conclusions and Relevance These findings suggest that partner similarity for psychiatric disorders is substantial and includes both within- and cross-disorder patterns, suggesting assortative mating alongside other mechanisms that may generate similarity between coparents. Regardless of its underlying mechanisms, this structure contributes meaningfully to observed family-based heritability and prevalence and leads to clustering of familial disease risk with important societal and public health implications.","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"36 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148909317","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":"Rebalancing Global Suicide Prevention","authors":"Rakhi Dandona, Rajesh Sagar","doi":"10.1001/jamapsychiatry.2026.2709","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2026.2709","url":null,"abstract":"This Viewpoint, which uses India as a lens, examines how evidence from low- and middle-income countries can challenge prevailing assumptions about suicide pathways, prevention, surveillance, and whose evidence shapes global policy.","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"51 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148909329","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":"Angiotensin-Converting Enzyme in Patients With Early-Stage Psychosis","authors":"Kun Yang, Luisa Longo, Pasquale Di Carlo, Max Lam, Ruoyu Wang, Semra Etyemez, Marina Mihaljevic, Nicola G. Cascella, Frederick C. Nucifora, Jennifer M. Coughlin, Gerald Nestadt, Thomas W. Sedlak, Lindsay Hayes, Akira Sawa","doi":"10.1001/jamapsychiatry.2026.2588","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2026.2588","url":null,"abstract":"Importance A major challenge in the management of psychotic disorders is the lack of objective biomarkers. While angiotensin-converting enzyme ( &lt;jats:italic toggle=\"yes\"&gt;ACE&lt;/jats:italic&gt; ) has been identified as a risk gene for schizophrenia, a major knowledge gap remains regarding whether and how this genetic impact results in biological dysfunction through its protein product. Objective To compare ACE levels, enzymatic activity, and genetic variations between patients with early-stage psychosis and healthy controls and between patient subgroups with and without treatment-resistant psychosis. Design, Setting, and Participants This cross-sectional study included patients aged 13 to 35 years with early-stage psychosis (onset within the prior 2 years) who were recruited at the Johns Hopkins Schizophrenia Center in Baltimore, Maryland, between October 30, 2013, and February 9, 2018. Data were analyzed from June 1, 2018, to June 22, 2026. Exposure Early-stage psychosis. Main Outcomes and Measures The main outcomes were ACE protein levels in cerebrospinal fluid and serum, genomewide and &lt;jats:italic toggle=\"yes\"&gt;ACE&lt;/jats:italic&gt; gene–specific polygenic risk scores, and ACE canonical enzymatic activity in serum. Results The study included data from 200 participants (mean [SD] age, 22.8 [4.1] years; 129 [64.5%] male), including 78 healthy controls and 122 patients with early-stage psychosis. ACE protein levels were significantly lower in both cerebrospinal fluid (Cohen &lt;jats:italic toggle=\"yes\"&gt;d&lt;/jats:italic&gt; = −1.16; &lt;jats:italic toggle=\"yes\"&gt;P&lt;/jats:italic&gt; = .005) and serum (Cohen &lt;jats:italic toggle=\"yes\"&gt;d&lt;/jats:italic&gt; = −0.92; &lt;jats:italic toggle=\"yes\"&gt;P&lt;/jats:italic&gt; &amp;amp;lt; .001) in patients compared with controls, with significant correlations between biofluids ( &lt;jats:italic toggle=\"yes\"&gt;r&lt;/jats:italic&gt; = 0.34; &lt;jats:italic toggle=\"yes\"&gt;P&lt;/jats:italic&gt; = .04). In patients with psychosis, higher &lt;jats:italic toggle=\"yes\"&gt;ACE&lt;/jats:italic&gt; genetic burden for schizophrenia was associated with lower ACE protein levels ( &lt;jats:italic toggle=\"yes\"&gt;r&lt;/jats:italic&gt; = −0.35; &lt;jats:italic toggle=\"yes\"&gt;P&lt;/jats:italic&gt; = .002) but not with ACE canonical (renin-angiotensin system) enzymatic activity. Patients with treatment-resistant cases had lower serum ACE protein levels than patients with non–treatment-resistant cases (Cohen &lt;jats:italic toggle=\"yes\"&gt;d&lt;/jats:italic&gt; = −0.50; &lt;jats:italic toggle=\"yes\"&gt;P&lt;/jats:italic&gt; = .03). There was no difference in canonical enzymatic activity between these 2 patient subgroups. Conclusions and Relevance This cross-sectional study found that ACE protein levels were significantly lower in cerebrospinal fluid and serum in patients with early-stage psychosis compared with controls. Between patient subgroups, ACE protein levels were significantly lower in serum in patients with treatment-resistant psychosis compared with those with non–treatment-resistant psychosis. A contrast was observed between ACE protein le","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"36 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148909332","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}