Lancet Psychiatry最新文献

{"title":"Mental health research funding: from snapshot to shared infrastructure.","authors":"Raliza Stoyanova","doi":"10.1016/S2215-0366(26)00119-7","DOIUrl":"https://doi.org/10.1016/S2215-0366(26)00119-7","url":null,"abstract":"","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":" ","pages":""},"PeriodicalIF":24.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857437","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":"Harnessing placebo effects and mitigating nocebo effects: implications for clinical practice in psychiatry and medicine.","authors":"Matthew J Burke,Dasha A Sandra,Marta Peciña,Jay A Olson,Adriano Mollica,Matthew Butler,Jay H Moss,Timothy R Nicholson,Tor D Wager,Ted J Kaptchuk","doi":"10.1016/s2215-0366(25)00340-2","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00340-2","url":null,"abstract":"In psychiatry and medicine, there is a long history of framing placebo effects primarily as nuisance factors and focusing on how they should be minimised in clinical trials. However, a new view on placebo effects has emerged with advances in understanding their complex neurobiology and observations of unexpectedly large placebo responses in recent psychiatric trials. In particular, novel therapeutic device trials for depression have shown placebo-group remission rates nearing 50%. Instead of considering these studies as a failure and moving on, questions should be raised on how such responses are possible and how these effects can be harnessed for the benefit of patients. There have also been important new insights into the mechanisms of nocebo effects and analogous questions on how best to mitigate the effect of negative expectations on symptoms and medication side-effects. In this Review, paper 1 of 2 on reconceptualising placebo and nocebo effects, we discuss the rationale, strategies, and ethical considerations related to harnessing placebo effects and mitigating nocebo effects in clinical practice, including discussion of target patient populations, traditional pure and impure placebos, authorised deception, honest open-label placebo, pharmacotherapy dose reduction via conditioned placebo, nocebo education, nocebo reframing, and other ways to apply principles underlying placebo and nocebo effects, such as shifting mindsets and enhancing the therapeutic context. Lastly, we highlight the centrality of this topic to psychiatry, but explore how better understanding the interactions of mind, brain, and body-epitomised by placebo and nocebo effects-has crucial relevance across medicine.","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"1 1","pages":"413-425"},"PeriodicalIF":64.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147702274","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":"Measuring and appraising placebo effects in clinical trials: contemporary challenges and approaches in psychiatry.","authors":"Joseph J Taylor,Balázs Szigeti,Noah D Silverberg,Masoud Ahmadzad-Asl,Marina Kare,Ryan Webler,Diana K Orsini,Joshua D Rosenblat,Tom Bschor,Christopher Baethge,Mark Sinyor,Timothy R Nicholson,Tor D Wager,Matthew J Burke","doi":"10.1016/s2215-0366(26)00018-0","DOIUrl":"https://doi.org/10.1016/s2215-0366(26)00018-0","url":null,"abstract":"Placebo effects are among the greatest paradoxes in medical research. Although more data on placebos are available from placebo-controlled trials than on any treatment in medicine, there has been comparatively little deep interrogation of issues related to their measurement, appraisal, and interpretation. Most of the work that has been done, including that in psychiatry, is narrowly focused on strategies for mitigating placebo effects and the challenges they might pose. In this Review, paper 2 of 2 on reconceptualising placebo and nocebo effects, we shift our focus from clinical practice to clinical trials. First, we review established and emerging approaches for navigating placebo effects in randomised controlled trials. Second, we examine three major challenges in contemporary psychiatric research that have recently highlighted the topic of placebo effects: (1) blinding and expectancy in psychedelic trials, (2) large placebo responses in interventional psychiatry trials (ie, device or procedure-based therapeutics), and (3) implications of overlapping neurobiological mechanisms between placebo effects and psychiatric treatments.","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"38 1","pages":"426-440"},"PeriodicalIF":64.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147702272","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":"Putting placebo effects in a new light.","authors":" The Lancet Psychiatry","doi":"10.1016/s2215-0366(26)00096-9","DOIUrl":"https://doi.org/10.1016/s2215-0366(26)00096-9","url":null,"abstract":"","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"439 1","pages":"365"},"PeriodicalIF":64.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147702275","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":"Magnetic seizure therapy: balancing efficacy and cognition.","authors":"Sarah Kayser,Andreas J Fallgatter,Christian Plewnia","doi":"10.1016/s2215-0366(26)00095-7","DOIUrl":"https://doi.org/10.1016/s2215-0366(26)00095-7","url":null,"abstract":"","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"24 1","pages":"366-367"},"PeriodicalIF":64.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147702261","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":"Confirmatory efficacy and safety trial of magnetic seizure therapy versus right unilateral ultra-brief electroconvulsive therapy in depression (CREST-MST): a randomised, double-blind, non-inferiority trial in Canada and the USA.","authors":"Daniel M Blumberger,Shawn M McClintock,Kevin E Thorpe,Carol A Tamminga,Karen Foley,Mustafa M Husain,Tyler S Kaster,Yuliya Knyahnytska,Daphne Voineskos,Kala J Bailey,Joshua J Hubregsen,Cory R Weissman,Zafiris J Daskalakis","doi":"10.1016/s2215-0366(26)00060-x","DOIUrl":"https://doi.org/10.1016/s2215-0366(26)00060-x","url":null,"abstract":"BACKGROUNDMagnetic seizure therapy (MST) is an innovative convulsive therapy that is clinically beneficial for patients with depression and has fewer cognitive adverse effects. This trial aimed to confirm the efficacy, tolerability, and cognitive safety of MST compared with right unilateral ultra-brief pulse-width (RUL-UB) electroconvulsive therapy (ECT).METHODSThis multisite randomised, double-blind, parallel-group, non-inferiority trial was conducted at three academic centres across Canada and the USA. Participants aged 18 years and older with major depressive disorder (MDD) received treatment until they achieved remission, dropped out, or up to 21 total treatments. MST was delivered using a twin coil in a midline frontal position. Remission of depression on the Hamilton Rating Scale for Depression-24 item and worsening of autobiographical memory on the Autobiographical Memory Test (AMT) were the coprimary outcomes. The non-inferiority margin was 15% absolute difference in remission rates and AMT worsening was defined as 25% reduction, corresponding to one standard deviation reduction in performance. People with lived experience were not directly involved; the study was informed by indirect feedback from previous trials and clinical discussions with people with depression who declined ECT. The trial is registered with ClinicalTrials.gov, NCT03191058.FINDINGSBetween June 26, 2018 and March 1, 2024, 292 participants were enrolled, of whom 239 were randomly assigned and three withdrew before treatment across study sites (RUL-UB ECT: mean age 45·5 years [SD 14·8, range 18-78], 80% White, 65 [55%] female, 54 [45%] male; MST: mean age 44·5 years [SD 13·8, range 18-75], 100 [85%] White, 70 [60%] female, 47 [40%] male). Enrolment concluded before reaching the intended sample size. The difference in remission rates was 5·3% in favour of RUL-UB ECT (27·8%) compared with MST (22·5%), establishing non-inferiority of MST (Z-test p=0·048 [95% CI -4·4 to 14·9]). More RUL-UB ECT participants had worsening autobiographical memory (17·3%) compared with MST participants (2·7%; p=0·0003). 12 participants in the RUL-UB ECT group and three participants in the MST group withdrew from treatment due to non-serious adverse events.INTERPRETATIONMST showed non-inferior efficacy relative to RUL-UB ECT in achieving remission of depression, and a more favourable cognitive safety profile. Collectively, the overall risk-benefit profile of MST supports its consideration as a first-line convulsive therapy in MDD, particularly in those who refuse RUL-UB ECT.FUNDINGNational Institutes of Mental Health.","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"65 1","pages":"376-386"},"PeriodicalIF":64.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147702273","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 global prevalence of major depressive disorder during the peripartum period: a systematic review and meta-regression.","authors":"Alize J Ferrari, Paul A Miller, Jamileh Shadid, Ana Mantilla Herrera, Salma M Ahmed, Pari Malpani, Taylor S Noyes, Izumi Chihara, Theresa A McHugh, Ni Gusti Ayu Nanditha, Theo Vos, Nicholas J Kassebaum, M Ashworth Dirac, Damian F Santomauro","doi":"10.1016/S2215-0366(26)00085-4","DOIUrl":"https://doi.org/10.1016/S2215-0366(26)00085-4","url":null,"abstract":"<p><strong>Background: </strong>For a meaningful global health response to major depressive disorder (MDD) during the peripartum period, its global distribution needs to be understood. The aim of this study was to conduct a systematic review of the prevalence of MDD during the peripartum period to assess sources of data heterogeneity and trends in prevalence during pregnancy and the postpartum period.</p><p><strong>Methods: </strong>This systematic review and meta-regression quantified MDD during pregnancy and up to 12 months postpartum among women and girls aged 10-59 years, across world regions. We searched PubMed, Embase, PsycINFO, and grey literature sources for studies published between Jan 1, 1980, and Oct 23, 2025. We included data from cross-sectional or longitudinal surveys of women and girls assessing the prevalence of MDD during the peripartum period. MDD was defined with criteria from the DSM or ICD. Most studies included patients receiving perinatal care from hospitals with population-representative catchments. Preference was given to studies encompassing pregnancies of all gestational lengths; however, studies restricted to singleton or full-term births were included. Extracted prevalence data were non-identifiable and pre-aggregated from existing sources. Records generated in the electronic and grey literature searches were combined and titles, abstracts, and full texts were reviewed by AJF, PAM, JS, AMH, SMA, and PM. Their decisions and related disagreements were reviewed by senior authors (AJF and DFS). The meta-regression analysis quantified sources of measurement error within the available data and assessed the prevalence of MDD during the peripartum period and by location. We followed the PRISMA guidelines (PROSPERO ID CRD42022358108). Members of our authorship team have lived experience perspectives in mental disorders, but we did not consult individuals diagnosed with MDD during the peripartum period.</p><p><strong>Findings: </strong>Of 31 812 potentially eligible studies, we screened the titles and abstracts of 25 616 studies, and included 1025 studies in the qualitative synthesis. We included 1505 prevalence datapoints from 780 studies eligible for stage two analysis, representing 2 018 198 women and girls from 90 countries and 19 world regions. Symptom scales identifying MDD symptoms overestimated its prevalence by between 71·3% (95% uncertainty interval [UI] 54·3-89·8) for the Edinburgh Postnatal Depression Scale in the postpartum period and 121·9% (91·7-156·8) for Patient Health Questionnaire during pregnancy, compared with diagnostic interview. MDD prevalence during the peripartum period was highest during the first 2 weeks postpartum (p<0·0001) and remained significantly elevated throughout the postpartum year (p<0·0001) compared with pregnancy. After adjusting for changes over the peripartum period and biases due to measurement error, the overall prevalence of MDD was 6·2% (95% UI 5·9-6·6) at any point in time during","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":" ","pages":""},"PeriodicalIF":24.8,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822573","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":"Precision language in ADHD research.","authors":"Stephen V Faraone, Michael J Miller","doi":"10.1016/S2215-0366(26)00117-3","DOIUrl":"https://doi.org/10.1016/S2215-0366(26)00117-3","url":null,"abstract":"","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":" ","pages":""},"PeriodicalIF":24.8,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822514","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":"Managing in war, planning for peace: second report of The Lancet Psychiatry Commission on mental health in Ukraine.","authors":"Irina Pinchuk, Bennett L Leventhal, Alisa Ladyk-Bryzghalova, Lars Lien, Yuliia Yachnik, Marisa Casanova Dias, Volodymyr Virchenko, Peter Szatmari, Olena Protsenko, Gary A Chaimowitz, Dan Chisholm, Viktoriia Kolokolova, Anthony P S Guerrero, Stanislav Chumak, Olha Myshakivska, Paul G Robertson, Mark D Hanson, Howard Yee Liu, Livia J De Picker, Marina Kupchik, Mariana Pinto da Costa, James G Scott, Milton L Wainberg, Rebecca W Brendel, Robert van Voren, Inna Feldman, Svitlana Kaminska, Marianne Schulze, Maryana Kravtsenyuk, Semen Gluzman, Oksana Zbitnieva, Norman Sartorius, Danuta Wasserman, Geert Dom, Christina W Hoven, Afzal Javed, Vinay Lakra, Norbert Skokauskas","doi":"10.1016/S2215-0366(26)00053-2","DOIUrl":"https://doi.org/10.1016/S2215-0366(26)00053-2","url":null,"abstract":"","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":" ","pages":""},"PeriodicalIF":24.8,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822561","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":"Correction to Lancet Psychiatry 2026; 13: 376-86.","authors":"","doi":"10.1016/s2215-0366(26)00116-1","DOIUrl":"https://doi.org/10.1016/s2215-0366(26)00116-1","url":null,"abstract":"","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"23 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719382","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}