JAMA Psychiatry最新文献

{"title":"Sweetened Beverages and Incident All-Cause Dementia Among Older Adults","authors":"Hui Chen, Yihong Ding, Klodian Dhana, Puja Agarwal, Todd Beck, Kumar B. Rajan, Debora Melo van Lent, Yuan Ma, Geng Zong, Kjetil Bjornevik, Changzheng Yuan","doi":"10.1001/jamapsychiatry.2025.1230","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.1230","url":null,"abstract":"ImportanceIntake of sweetened beverages, including sugar-sweetened beverages (SSB) and artificially sweetened beverages (ASB), has been linked to multiple health outcomes, but their associations with dementia risk among older adults are unclear.ObjectiveTo assess whether the consumption of SSB and ASB is associated with the risk of all-cause dementia in older adults.Design, Setting, and ParticipantsThis multicohort study examined data from US adults aged 65 and older enrolled in the Health and Retirement Study (2013), the Atherosclerosis Risk in Communities study (1987-1995), the Chicago Healthy and Aging Project (1993-2012), the Rush Memory and Aging Project (1997-2005), the Framingham Heart Study original cohort (1986-1994), and its offspring cohort (1991-2001). Data were analyzed from May 27 to September 24, 2024.ExposuresSSB and ASB intake was assessed using validated food frequency questionnaires.Main Outcomes and MeasuresThe primary outcome was all-cause dementia ascertained at least 2 years after baseline from active research follow-ups and passive surveillance. Cox proportional hazard regression models were used to assess the associations of SSB and ASB with incident dementia.ResultsOf 10 974 participants (60.0% female, mean [SD] age: 73.2 [6.8] years), 2445 developed incident all-cause dementia over 116 067 person-years of follow-up. Consumption of SSB and ASB in older adulthood was not associated with dementia risk in later life. The pooled hazard ratio (HR) per serving per week for SSB was 0.99 (95% CI, 0.98-1.01; <jats:italic>P</jats:italic> = .18; <jats:italic>I</jats:italic><jats:sup>2</jats:sup> = 0%) and for ASB was 1.00 (95% CI, 0.99-1.01; <jats:italic>P</jats:italic> = .99; <jats:italic>I</jats:italic><jats:sup>2</jats:sup> = 1%). The pooled HRs comparing the highest (≥1 serving per day) with lowest (0 to &amp;amp;lt;1 serving per month) consumption groups were 0.90 (95% CI, 0.78-1.03) for SSB and 1.00 (95% CI, 0.83-1.21) for ASB. These findings were similar across cohorts and subgroups. In contrast, an inverse association was observed for the Mediterranean diet score (HR, 0.92; 95% CI, 0.85-0.99 per 5-unit increment) as a positive control.Conclusions and RelevanceIn this study, late-life consumption of SSB or ASB was not associated with the risk of dementia. However, given their detrimental effects on metabolic health and related chronic diseases during early life and midlife, the effects of early-life consumption of SSB and ASB on the risk of dementia warrant further investigation.","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"15 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319999","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":"Functional vs Structural Cortical Deficit Pattern Biomarkers for Major Depressive Disorder.","authors":"Peter Kochunov, Bhim M Adhikari, David Keator, Daniel Amen, Si Gao, Nicole R Karcher, Demetrio Labate, Robert Azencott, Yewen Huang, Hussain Syed, Hongjie Ke, Paul M Thompson, Danny J J Wang, Braxton D Mitchell, Jessica A Turner, Theo G M van Erp, Neda Jahanshad, Yizhou Ma, Xiaoming Du, William Burroughs, Shuo Chen, Tianzhou Ma, Jair C Soares, L Elliot Hong","doi":"10.1001/jamapsychiatry.2025.0192","DOIUrl":"10.1001/jamapsychiatry.2025.0192","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Major depressive disorder (MDD) is a severe mental illness characterized more by functional rather than structural brain abnormalities. The pattern of regional homogeneity (ReHo) deficits in MDD may relate to underlying regional hypoperfusion. Capturing this functional deficit pattern provides a brain pattern-based biomarker for MDD that is linked to the underlying pathophysiology.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To examine whether cortical ReHo patterns provide a replicable biomarker for MDD that is more sensitive than reduced cortical thickness and evaluate whether the ReHo MDD deficit pattern reflects regional cerebral blood flow (RCBF) deficit patterns in MDD and whether a regional vulnerability index (RVI) thus constructed may provide a concise brain pattern-based biomarker for MDD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, settings, and participants: &lt;/strong&gt;The UK Biobank (UKBB) participants had ReHo and structural measurements. Participants from the Enhancing Neuroimaging Genetics Through Meta-Analysis (ENIGMA) Consortium were included for measuring the MDD structural cortical deficit pattern. The UKBB ReHo and ENIGMA cortical thickness effect sizes for MDD were used to test the deficit patterns in the Amish Connectome Project (ACP) with ReHo, structural, and RCBF data. Finally, the Ament Clinic Inc (ACI) sample had RCBF data measured using single-photon emission computed tomography. Data were analyzed from August 2021 to September 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Exposures: &lt;/strong&gt;ReHo and structural measurements.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Included in this analysis were 4 datasets: (1) UKBB (N = 4810 participants; 2220 with recurrent MDD and 2590 controls; mean [SD] age, 63.0 [7.5] years; 1121 female [50%]), (2) ENIGMA (N = 10 115 participants; 2148 with MDD and 7957 healthy controls; mean [SD] age, 39.9 [10.0] years; 5927 female [59%]), (3) ACP (N = 204 participants; 68 with a lifetime diagnosis of MDD and 136 controls; mean [SD] age, 41.0 [14.5] years; 104 female [51%]), and (4) ACI (N = 372 participants; 296 with recurrent MDD and 76 controls; mean [SD] age, 45.3 [17.2] years; 189 female [51%]). MDD participants had lower cortical ReHo in the cingulum, superior temporal lobe, frontal lobe, and several other areas, with no significant differences in cortical thickness. The regional pattern of ReHo MDD effect sizes was significantly correlated with that of RCBF obtained from 2 independent datasets (Pearson r = 0.52 and Pearson r = 0.46; P &lt; 10-4). ReHo and RCBF functional RVIs showed numerically stronger effect sizes (Cohen d = 0.33-0.90) compared with structural RVIs (Cohen d = 0.09-0.20). Elevated ReHo-based RVI-MDD values in individuals with MDD were associated with higher depression symptom severity across cohorts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;Results of this case-control study suggest that the ReHo MDD deficit pattern reflected cortical hypoperfusion and was regionally specific in MDD. ReHo-based RVI ","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"582-590"},"PeriodicalIF":17.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763974","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 Figure.","authors":"","doi":"10.1001/jamapsychiatry.2025.0781","DOIUrl":"10.1001/jamapsychiatry.2025.0781","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"627"},"PeriodicalIF":22.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972158","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":"Transcranial Magnetic Stimulation in Ukraine.","authors":"Noah S Philip","doi":"10.1001/jamapsychiatry.2025.0209","DOIUrl":"10.1001/jamapsychiatry.2025.0209","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"551-552"},"PeriodicalIF":22.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811412","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":"Refining Social Determinants of Suicide Risk Research.","authors":"Ping-I Lin, Nawar Nayeem, Erick Messias","doi":"10.1001/jamapsychiatry.2025.0333","DOIUrl":"10.1001/jamapsychiatry.2025.0333","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"627"},"PeriodicalIF":22.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caring for Patients With Severe Anorexia Nervosa-A Capacity Evaluation Cannot Save Us.","authors":"Emily G Holmes, Jane A Hartsock, Amy S Martin","doi":"10.1001/jamapsychiatry.2025.0102","DOIUrl":"10.1001/jamapsychiatry.2025.0102","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"547-548"},"PeriodicalIF":22.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Local Anesthetics Adulterating the Illicit Fentanyl Supply.","authors":"Joseph J Palamar,Joshua S DeBord,Alex J Krotulski,Bruce A Goldberger","doi":"10.1001/jamapsychiatry.2025.0952","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.0952","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"8 4 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103858","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":"Private Equity Among US Psychiatric Hospitals.","authors":"Morgan C Shields,Yuanyuan Yang,Susan H Busch","doi":"10.1001/jamapsychiatry.2025.0689","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.0689","url":null,"abstract":"ImportancePrivate equity (PE) ownership in health care has increased, but evidence for its association with health care quality is mixed. Moreover, there is no evidence regarding inpatient psychiatric hospitals, despite considerable patient vulnerabilities.ObjectiveTo describe trends in PE ownership of psychiatric hospitals from 2013 through 2021 and the cross-sectional association between PE ownership and hospital staffing and quality.Design, Setting, and ParticipantsIn this cross-sectional study, a novel dataset of PE ownership of psychiatric hospitals in the US was constructed using industry sources and web searches. Characteristics of 87 PE-owned psychiatric hospitals in 2021 were compared with 530 non-PE-owned psychiatric hospitals. Regression models were used to estimate adjusted differences in hospital staffing and quality. Participants included all Medicare-participating freestanding psychiatric hospitals in the US (N = 617). These data were analyzed from September 2023 to October 2024.ExposurePE ownership.Main Outcomes and MeasuresMain outcomes were staffing ratios, national quality measures (restraint and seclusion rates, 7- and 30-day follow-up rates, postdischarge medication continuation, and 30-day all-cause readmission rates). Other studied characteristics included institutional characteristics (region, number of beds), services provided, measures of case mix (populations served, hospital average Diagnosis Related Group score among Medicare beneficiaries), occupancy rates, and average length of stay.ResultsBy 2021, of the 617 freestanding psychiatric hospitals in the US, 87 (14.10%), representing 4660 beds (6.30%), were PE owned, with two-thirds of PE-owned facilities in the southern US (63.22%). In adjusted models, PE ownership was associated with significantly lower staff per patient day among registered nurses (0.12 vs 0.15; P = .048 and medical social workers (0.02 vs 0.04; P = .005). Yet, PE-owned facilities performed better on quality measures, including lower reported hours of restraint use (0.03 vs 0.24 hours per 1000 patient hours; P < .001), 30-day readmissions (19.40% vs 20.16%; P = .047), and higher 7-day (29.34% vs 26.28%; P = .03) and 30-day (52.92% vs 49.08%; P = .01) follow-up visits.Conclusions and RelevancePE ownership of psychiatric hospitals is growing rapidly. In 2021, these facilities had significantly lower staffing ratios, even after controlling for observable case-mix factors. No evidence of lower quality among PE-owned facilities was found, although existing measures are limited. Expansions of US Centers for Medicare & Medicaid Services quality measures to include patient experiences will provide information on new dimensions of quality in these facilities.","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"97 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103856","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":"Loss of PTSD Diagnosis in Response to Evidence-Based Treatments: A Systematic Review and Meta-Analysis.","authors":"Tiffany Milligan,Derek Smolenski,Jose Lara-Ruiz,Marija S Kelber","doi":"10.1001/jamapsychiatry.2025.0695","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.0695","url":null,"abstract":"ImportanceIn recent decades, evidence-based psychotherapies to treat posttraumatic stress disorder (PTSD) have been developed with robust evidence bases. However, efficacy observed in clinical trials is not always directly applicable to clinical practice.ObjectiveTo estimate the percentage of patients in both military and veteran (hereafter milvet) and nonmilvet populations that lose their PTSD diagnosis after treatment.Data SourcesWe used the PTSD Repository to identify studies with adults with a DSM-IV/DSM-5 PTSD diagnosis based on a validated assessment. The repository, maintained by the US National Center for PTSD, is continually updated with randomized clinical trials and includes studies published from January 1988 on.Study SelectionFor eligibility, PTSD had to be the primary treatment target, with psychotherapy applied as monotreatment. Eligible studies reported the number of participants who did not meet diagnostic criteria for PTSD posttreatment. When this review was initiated (October 2023), the repository contained 496 unique studies. Data analysis was completed from October 2023 to June 2024.Data Extraction and SynthesisThe repository follows Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines and uses Cochrane Risk of Bias 2.0. We used mixed-effects logistic regression models to estimate diagnosis loss and incorporated milvet status and sex as covariates.Main Outcomes and MeasuresThe primary outcome was the proportion of participants who no longer met criteria for a diagnosis of PTSD posttreatment as assessed by a validated instrument.ResultsWe included 34 randomized clinical trials (N = 3208 participants). Point estimates of diagnosis loss across trauma-focused treatments for nonmilvet samples ranged from 65% to 86%. Milvet samples had lower proportions of diagnosis loss in studies of cognitive processing therapy and prolonged exposure compared to nonmilvet samples, ranging from 44% to 50%. There was substantial overlap between the covariates of milvet status and sex. An exploratory analysis identified eye movement desensitization and reprocessing as having the highest proportion of diagnosis loss, but there was substantial heterogeneity, and none of the studies were milvet-focused or conducted in the US. Also, 95% confidence intervals partially overlapped for all trauma-focused treatment estimates.Conclusions and RelevanceThis systematic review and meta-analysis contributes to the substantial literature on psychotherapeutic treatments for PTSD by meta-analyzing the probabilities of diagnosis loss for each psychotherapy. Diagnosis loss data are a relatively straightforward way to discuss potential benefits when initiating a therapy or when discussing potential barriers to progress in treatment.","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"14 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103857","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":"Glucagon-Like Peptide 1 Receptor Agonists and Mental Health: A Systematic Review and Meta-Analysis.","authors":"Aureliane C S Pierret,Yuya Mizuno,Pippa Saunders,Eshaya Lim,Riccardo De Giorgi,Oliver D Howes,Robert A McCutcheon,Barbara McGowan,Piya Sen Gupta,Daniel Smith,Khalida Ismail,Toby Pillinger","doi":"10.1001/jamapsychiatry.2025.0679","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.0679","url":null,"abstract":"ImportancePeople with obesity and diabetes have poorer psychiatric and cognitive outcomes and lower quality of life (QOL) compared with those without. Glucagon-like peptide 1 receptor agonists (GLP1-RAs) are treatments for diabetes and obesity that may also influence psychiatric outcomes.ObjectiveTo conduct a meta-analysis of randomized placebo-controlled trials to evaluate psychiatric, cognitive, and QOL outcomes with GLP1-RA treatment.Data SourcesMEDLINE, Embase, PsycINFO, and CENTRAL databases were searched from inception through June 24, 2024.Study SelectionDouble-blind placebo-controlled trials comparing GLP1-RA to placebo in adults with overweight/obesity and/or diabetes, reporting on psychiatric, cognition, or QOL outcomes, were included.Data Extraction and SynthesisData extraction was performed in parallel by 2 reviewers. Random-effects meta-analysis was performed. Effect size measures were log risk ratios (log[RR]) and standardized mean differences (Hedges g). The quality of studies was appraised using the Cochrane risk-of-bias tool (RoB2). Certainty of evidence was assessed via GRADEpro.Main Outcomes and MeasuresMain outcomes were risk of psychiatric adverse events (serious and nonserious) and change in mental health symptom severity, health-related quality of life, and cognition.ResultsEighty randomized clinical trials involving 107 860 patients were included in the meta-analysis. The mean (SD) age of participants across studies in the meta-analysis was 60.1 (7.1) years; 43 251 were female (40.1%) and 64 608 male (59.9%). GLP1-RA treatment was not associated with a significant difference in risk of serious psychiatric adverse events (log[RR] = -0.02; 95% CI, -0.20 to 0.17; P = .87) and nonserious psychiatric adverse events (log[RR] = -0.03; 95% CI, -0.21 to 0.16], P = .76), or depressive symptom change (g = 0.02; 95% CI, -0.51 to 0.55; P = .94), compared with placebo. GLP1-RA treatment was associated with improvements in restrained eating (g = 0.35; 95% CI, 0.13 to 0.57; P = .002) and emotional eating behavior (g = 0.32; 95% CI, 0.11 to 0.54; P = .003) and in mental health-related QOL (g = 0.15; 95% CI, 0.07 to 0.22; P < .001), physical health-related QOL (g = 0.20; 95% CI, 0.14 to 0.26; P < .001), diabetes-related QOL (g = 0.23; 95% CI, 0.15 to 0.32; P < .001), and weight-related QOL (g = 0.27; 95% CI, 0.18 to 0.35; P < .001) compared with placebo.Conclusions and RelevanceIn patients with overweight/obesity and/or diabetes , GLP1-RA treatment is not associated with increased risk of psychiatric adverse events or worsening depressive symptoms relative to placebo and is associated with improvements in QOL, restrained eating, and emotional eating behavior. These findings provide reassurance regarding the psychiatric safety profile of GLP1-RAs and suggest that GLP1-RA treatment contributes to both physical and emotional well-being.","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"54 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945442","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}