JAMA Psychiatry最新文献

{"title":"Changes in Characteristics Associated With ADHD and ASD Diagnoses Over Time","authors":"Magnus Elias Tarp, Mette Lise Lousdal, Charlotte Ulrikka Rask, Kathrine M. Keyes, Tomáš Formánek, Isabell Brikell, Xiaoqin Liu, Genona T. Maseras, Oleguer Plana-Ripoll","doi":"10.1001/jamapsychiatry.2026.2722","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2026.2722","url":null,"abstract":"Importance Diagnoses of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) have increased substantially in recent decades, but it is unclear whether associations of prediagnostic characteristics with these diagnoses have changed over time. Objective To examine temporal trends in associations between well-defined risk factors and subsequent diagnoses of ADHD and ASD. Design, Setting, and Participants This population-based matched case-control study was conducted using nationwide Danish registry data for individuals born between January 1, 1994, and December 31, 2022, followed up to age 18 years. Individuals diagnosed with ADHD or ASD before age 18 years between 2012 and 2022 were included as cases. Each case was matched to 10 controls without these diagnoses by sex, birth year, municipality of residence, and country of birth. Data were analyzed from April 2025 through June 2026. Exposure A list of 19 prediagnostic characteristics, including parental and family factors, birth and perinatal factors, and health care use. Main Outcomes and Measures Associations between prediagnostic characteristics and ADHD or ASD diagnoses by year of diagnosis, estimated as odds ratios (ORs) with 95% CIs using conditional logistic regression. Results Of 2 194 951 children and adolescents in the registry, 100 323 individuals (4.6%) were diagnosed with ADHD or ASD before age 18 years, among whom 71 317 children and adolescents were diagnosed between 2012 and 2022 and included as cases (26 452 female [37.1%]; median [IQR] age at diagnosis, 11.4 [8.1 to 14.9] years), matched with 713 170 controls. Individuals diagnosed with ADHD or ASD differed from controls across all characteristics, but differences diminished over time, with ORs attenuating toward the null, particularly for socioeconomic and perinatal factors. For example, the OR for low birth weight decreased from 1.54 (95% CI, 1.41 to 1.68) in 2012 to 2013 to 1.17 (95% CI, 1.10 to 1.24) in 2020 to 2022. Attenuation was greater for ADHD than ASD (eg, household income: mean yearly change in OR, 6.5% [95% CI, 5.7% to 7.3%] for ADHD; mean yearly change in OR, 0.7% [95% C, −0.1% to 1.5%] for ASD) and more pronounced among individuals diagnosed at ages 10 to 17 years than at younger ages. Patterns were similar across sexes and in analyses restricted to cases with higher diagnostic certainty. Conclusions and relevance This study found that from 2012 to 2022, children and adolescents diagnosed with ADHD or ASD became increasingly similar to peers without these diagnoses. These findings suggest that increasing diagnostic rates may reflect changes in diagnostic practices or health care capacity rather than changes in underlying risk alone and should not be interpreted as evidence that ADHD or ASD have become less impairing at the individual level.","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"79 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148909333","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":"GLP-1 Receptor Agonist Prescriptions Among People With and Without Serious Mental Illness","authors":"Emma E. McGinty, Pradhyumna Wagle, Gail L. Daumit","doi":"10.1001/jamapsychiatry.2026.2667","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2026.2667","url":null,"abstract":"This cross-sectional study examines glucagon-like peptide-1 (GLP-1) prescriptions among adults with vs without severe mental illness from 2018 to 2024 using national insurance claims.","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"43 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148870236","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":"Serial Ketamine Infusions for Treatment-Resistant Bipolar Depression","authors":"Diana K. Orsini, Sara Di Luch, George Tomlinson, Gabrielle F. M. Lovell, Shreya Vasudeva, Nelson B. Rodrigues, Danica E. Johnson, Alastair J. Flint, Cristian-Daniel Llach, Roger S. McIntyre, Rodrigo B. Mansur, Keyvan Karkouti, Amer M. Burhan, Erica Kaczmarek, Noah Chisamore, Anuj Bhatia, Neilesh Soneji, Anahita Joshi, Deep Grewal, Rachel Laframboise, Joshua D. Rosenblat","doi":"10.1001/jamapsychiatry.2026.2658","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2026.2658","url":null,"abstract":"Importance Antidepressant efficacy of intravenous (IV) ketamine has been demonstrated in major depressive disorder; however, the efficacy and safety of ketamine for bipolar depression remain largely unknown, with limited data available in this specific population. Objective To evaluate the efficacy, safety, and tolerability of adjunctive IV ketamine compared with midazolam for treatment-resistant bipolar I or II depression (TRBD). Design, Setting, and Participants The Ket-BD study (Ketamine for Treatment-Resistant Bipolar Disorder) was an investigator-led, double-blind, midazolam-controlled randomized clinical trial conducted at 3 sites in Ontario, Canada, from July 2022 to November 2025. Participants included adult outpatients (aged 21-65 years) with a primary bipolar I or II disorder <jats:italic>DSM-5</jats:italic> diagnosis with a current moderate to severe major depressive episode (Montgomery-Åsberg Depression Rating Scale [MADRS] score ≥21), having had at least 2 failed trials of evidence-based pharmacotherapies. Data were analyzed from November 2025 through February 2026. Interventions Participants were randomized 1:1 to receive 4 flexibly dosed 40-minute infusions over 2 weeks of either ketamine (0.5-0.75 mg/kg) or midazolam (0.02-0.03 mg/kg) adjunctive to a stable dose of at least 1 mood stabilizer or antipsychotic. Main Outcomes and Measures The primary outcome was change in depression symptom severity measured by the observer-rated MADRS score from baseline to end of treatment (day 14). Safety and tolerability were assessed with close evaluation for potential treatment-emergent mania, hypomania, mixed features, or psychosis. Results Of 68 randomized participants (mean [SD] age, 44.4 [11.8] years; 38 female [55.8%]), 63 were included in the final efficacy analysis as 5 participants withdrew (1 ketamine, 4 midazolam) before the primary end point. In the primary efficacy analysis, controlling for sex, bipolar type, and baseline MADRS, the mean MADRS score at day 14 was significantly lower in the ketamine group compared to the midazolam group (between-group difference = −7.3 points; 95% CI, −12.0 to −2.5; <jats:italic>P</jats:italic> = .003; Cohen <jats:italic>d</jats:italic> = 0.7). No cases of mania, hypomania, psychosis, or suicide attempts were observed in either group. One case of mixed features (subthreshold hypomanic symptoms) was observed in each group. After the first infusion, 31 of 66 participants (47%) correctly guessed treatment allocation. Conclusions and Relevance In TRBD, adjunctive IV ketamine was well tolerated and associated with significant antidepressant effects compared to midazolam. Trial Registration ClinicalTrials.gov Identifier: <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" ext-link-type=\"uri\" xlink:href=\"https://clinicaltrials.gov/study/NCT05004896?cond=NCT05004896&amp;amp;amp;viewType=Card&amp;amp;amp;rank=1\">NCT05004896</jats:ext-link>","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"22 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148870240","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 25-Year Evolution of Lithium as a Disease-Modifying Agent in Dementia: A Narrative Review.","authors":"Gregory J Moore, Niranjan Bose, Ioline D Henter, Husseini K Manji","doi":"10.1001/jamapsychiatry.2026.1296","DOIUrl":"10.1001/jamapsychiatry.2026.1296","url":null,"abstract":"<p><strong>Importance: </strong>Lithium, a long-established cornerstone therapy for bipolar disorder, is a biologically plausible disease-modifying agent for neurodegenerative disorders, including mild cognitive impairment (MCI) and Alzheimer disease (AD).</p><p><strong>Observations: </strong>Rather than targeting a single pathology like amyloid or tau, lithium acts across multiple cellular resilience pathways. Chronic lithium exposure induces the anti-apoptotic protein B-cell lymphoma 2 (Bcl-2), enhances brain-derived neurotrophic factor (BDNF) signaling, inhibits glycogen synthase kinase-3β (GSK-3β), stabilizes mitochondrial function, and reduces oxidative stress. These convergent mechanisms promote neuronal survival and synaptic integrity. In humans, proton magnetic resonance spectroscopy studies found that lithium increased N-acetylaspartate levels, consistent with improved neuronal viability, and structural magnetic resonance imaging (MRI) studies found that lithium preserved gray matter and/or reversed illness-related atrophy in hippocampal and corticolimbic regions. In addition, extensive evidence demonstrates that low-dose lithium (approximately 0.3mM)-significantly lower than traditional psychiatric doses (0.6-1.0mM)-exerts robust neurotrophic and neuroprotective effects. Preclinical models have found that these concentrations stimulate hippocampal neurogenesis, promote structural plasticity, and protect against proteotoxic injury. Furthermore, epidemiological studies have associated cumulative lithium exposure with reduced dementia risk, and early randomized clinical trials in MCI suggest cognitive stabilization and favorable tau biomarker changes at low, well-tolerated doses. The recent repletion hypothesis suggests that lithium may also function as a physiological trace element, but these findings await independent replication.</p><p><strong>Conclusions and relevance: </strong>These convergent data support a prospective clinical trial of low-dose lithium orotate to slow disease progression in MCI. Such an approach would prioritize established neuroprotective mechanisms while potentially mitigating the kidney and thyroid risks associated with higher-dose carbonate formulations. If low-dose lithium can indeed meaningfully alter disease trajectory, it would represent a much-needed, accessible, and inexpensive treatment that may be especially relevant in low- and middle-income countries.</p>","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"976-986"},"PeriodicalIF":18.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217337","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":"Error in Table.","authors":"","doi":"10.1001/jamapsychiatry.2026.2240","DOIUrl":"10.1001/jamapsychiatry.2026.2240","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"992"},"PeriodicalIF":18.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13373731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148446633","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":"Changes in Genetic Contributions to ASD and ADHD by Year of Diagnosis.","authors":"Sonja LaBianca, Mette Lise Lousdal, Morten Dybdahl Krebs, Ole Sahlholdt Hansen, Kajsa-Lotta Georgii Hellberg, Mischa Lundberg, Johanne Østerby Sørensen, Jesper R Gådin, Henrik Ohlsson, Jakob Grove, Anders Børglum, Esben Agerbo, Thomas Werge, Clara Albiñana, Bjarni J Vilhjálmsson, Kenneth S Kendler, Oleguer Plana-Ripoll, Andrew J Schork","doi":"10.1001/jamapsychiatry.2026.1450","DOIUrl":"10.1001/jamapsychiatry.2026.1450","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;The incidences of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) have increased markedly over recent decades, raising concerns about the emergence of new risk factors. Current literature typically attributes increased rates to changes in diagnostic practice, stigmatization, and awareness, but critically few studies have explored changes in underlying risk factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To assess changes in the genetic risk profile of individuals diagnosed with ASD or ADHD by year of incident diagnosis and explore results in comparison with those expected under simulated scenarios.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This cohort study used data from the Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH2015) study, a population-based case-cohort in Denmark among individuals with incident diagnoses for ASD and ADHD made from 1994 to 2016. Data were analyzed from January 2024 until September 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Exposure: &lt;/strong&gt;Year of incident diagnosis. Regression models tested changes in the mean genetic risk profile of individuals diagnosed in each consecutive year (1994-2016), adjusting for age, sex, and ancestry.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes: &lt;/strong&gt;Polygenic scores for psychiatric (ADHD, ASD, depression, bipolar, and schizophrenia) and cognitive-behavioral (addiction, educational attainment, IQ, neuroticism, and risk-taking) outcomes were used to capture genetic risk profiles of diagnosed individuals. Empirical trends were compared with those expected under different simulated drivers of increasing rates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 17 071 individuals with incident diagnoses for ASD (4196 female [24.6%]; mean [SD] age at diagnosis, 9.7 [4.6] years) and 20 111 with diagnoses for ADHD (5960 female [29.6%]; mean [SD] age at diagnosis, 11.0 ([4.7] years) were analyzed. A more recent ADHD diagnosis was associated with decreased genetic risk for ADHD as shown by difference in mean polygenic score (β estimate per 10-year increase, -0.06 SDs; 95% CI, -0.09 to -0.03 SDs; P = .001) and other disorders, including ASD, bipolar, and schizophrenia (eg, ASD: β per 10-year increase, -0.07 SDs; 95% CI, -0.10 to -0.03 SDs; P &lt; .001). Similarly, a more recent ASD diagnosis was associated with decreased genetic risk for ASD (β per 10-year increase, -0.07 SDs; 95% CI, -0.10 to -0.04 SDs; P &lt; .001) and other disorders and traits, including bipolar disorder, schizophrenia, and educational attainment (eg, bipolar disorder: β per 10-year increase, -0.05 SDs; 95% CI, -0.08 to -0.02 SDs; P = .001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;By analyzing multiple polygenic scores together with simulated expectations, this study could disambiguate among competing hypotheses about scenarios that may be associated with increased rates of ADHD and ASD diagnoses. Findings support broadening diagnostic criteria as an explanati","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"921-929"},"PeriodicalIF":18.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13254805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217230","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 Results.","authors":"","doi":"10.1001/jamapsychiatry.2026.2129","DOIUrl":"10.1001/jamapsychiatry.2026.2129","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"992"},"PeriodicalIF":18.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404713","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":"Do Likes Reinforce Depression?","authors":"Quentin J M Huys, Amy Orben","doi":"10.1001/jamapsychiatry.2026.1373","DOIUrl":"10.1001/jamapsychiatry.2026.1373","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"898-899"},"PeriodicalIF":18.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404742","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 in Schizophrenia-A Top Clinical Trial.","authors":"Dost Öngür","doi":"10.1001/jamapsychiatry.2026.2043","DOIUrl":"10.1001/jamapsychiatry.2026.2043","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"900"},"PeriodicalIF":18.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360842","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":"Failure to Update ClinicalTrials.gov Record for a Clinical Trial.","authors":"Dost Ongur","doi":"10.1001/jamapsychiatry.2026.2544","DOIUrl":"10.1001/jamapsychiatry.2026.2544","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"901"},"PeriodicalIF":18.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148591654","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}