Lancet Psychiatry最新文献

{"title":"Infection, inflammation, and personalisation: time for an integrated approach to clozapine monitoring","authors":"Scott R Clark, Catharine Toben, Magdalene C Jawahar, Azmeraw T Amare, Lyle J Palmer, K Oliver Schubert","doi":"10.1016/s2215-0366(25)00237-8","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00237-8","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"97 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719616","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":"Clozapine use and risk of infections in patients with schizophrenia in Hong Kong: a population-based cohort study","authors":"Yuqi Hu, Wenxin Tian, Cuiling Wei, Qi Sun, Song Song, Lingyue Zhou, Rachel Yui Ki Chu, Wenlong Liu, Boyan Liu, Amy Pui Pui Ng, Krystal Chi Kei Lee, Heidi Ka Ying Lo, Wing Chung Chang, William Chi Wai Wong, Esther Wai Yin Chan, Ian Chi Kei Wong, Francisco Tsz Tsun Lai","doi":"10.1016/s2215-0366(25)00201-9","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00201-9","url":null,"abstract":"<h3>Background</h3>Infection is the leading natural cause of mortality in patients with schizophrenia, and use of antipsychotics might be associated with an increased risk of infections. This study aimed to examine the association of clozapine use with the incidence of various infectious diseases.<h3>Methods</h3>In this population-based cohort study, we used territory-wide electronic health records from the Hong Kong Hospital Authority. Individuals aged 18 years or older with a diagnosis of schizophrenia (ICD-9-CM code 295) based on records from Jan 1, 2002, to Dec 31, 2023 were considered for inclusion. We included patients who used clozapine or olanzapine continuously for at least 90 days and excluded those who had previously used fewer than two other antipsychotic medications, to identify a cohort of patients with long-term antipsychotic use who had treatment resistance. Olanzapine was chosen as a comparator due to its similar chemical structure and often overlapping indication with clozapine. The primary outcome was the occurrence of any infectious disease, identified by a range of ICD-9-CM codes, with subtypes analysed as secondary outcomes. Propensity score-based inverse probability of treatment weighting was applied to balance covariates. Weighted hazard ratios (HRs) for infection in patients using clozapine versus those using olanzapine were estimated by Cox proportional hazards models. Weighted absolute differences in incidence rate were also estimated. People with lived experience of schizophrenia were not involved in the design or conduct of the study.<h3>Findings</h3>We identified 53 092 individuals with clozapine or olanzapine initiation between Jan 1, 2004 and Dec 31, 2023, with 2002–03 used as a wash-out period to exclude individuals having used the two antipsychotics before. After exclusion of participants without a schizophrenia diagnosis and who did not meet the other selection criteria, the final cohort consisted of 11 051 patients (1450 using clozapine and 9601 using olanzapine). Overall, 6031 (54·6%) patients were female and 5020 (45·4%) were male. Mean age was higher in the olanzapine group (45·33 years [SD 14·55]) than in the clozapine group (40·59 years [12·26]). No ethnicity data were available. The incidence of infection overall was increased in patients using clozapine (weighted incidence rate 7·26 per 100 person-years) compared with those using olanzapine (6·00 per 100 person-years; weighted HR 1·25 [95% CI 1·13–1·39]). The weighted absolute difference in incidence rate was 1·27 infections per 100 person-years (95% CI 0·55–2·04). The risk was notably higher in older age ranges, with weighted HRs rising from 1·24 (1·08–1·42) in those aged 18–44 years (weighted absolute difference 0·81 per 100 person-years [0·13–1·55]) to 1·41 (1·15–1·72) in those aged 45–54 years (2·23 per 100 person-years [0·82–3·86]), and 1·45 (1·14–1·84) in those aged 55 years or older (4·70 per 100 person-years [1·29–8·45]). Secondary analyses ident","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"37 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719612","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 2025; published online July 2. https://doi.org/10.1016/S2215-0366(25)00098-7","authors":"","doi":"10.1016/s2215-0366(25)00241-x","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00241-x","url":null,"abstract":"<em>Siskind D, Northwood K, Pillinger T, et al. Absolute neutrophil count and adverse drug reaction monitoring during clozapine treatment: consensus guidelines from a global Delphi panel.</em> Lancet Psychiatry <em>2025; published online July 2. https://doi.org/10.1016/S2215-0366(25)00098-7</em>—In this Position Paper, the third sentence of the Summary should have read “Recommendations include lowering ANC thresholds for consideration of clozapine cessation”. The fourth sentence of the Summary should have read “Comprehensive ADR monitoring, with ANC monitoring in the first 2 years, then every 3 months after discontinuing routine ANC monitoring”. The fourth and fifth sentences in the second paragraph of the Discussion should have read “ADRs should be checked alongside ANC monitoring for the first 2 years. With discontinuation of ANC monitoring after 2 years of patients taking clozapine, ADRs should be monitored once every 3 months”. The fourth and fifth sentences in the final paragraph of the Discussion should have read “ADR monitoring should be done alongside ANC monitoring for the first 2 years. After discontinuing ANC monitoring, ADR monitoring should be done routinely every 3 months”. Figure 1 should have read “ADRs should be monitored with ANC testing appointments for the first 2 years, then ADR only (not ANC testing) every 3 months after 2 years”. These corrections have been made to the online version as of July 22, 2025, and will be made to the printed version.","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"52 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144684588","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 power of words: respectful language in ADHD research","authors":"Blandine French, Tycho J Dekkers, Isabella Barclay, Melissa H Black, Sven Bölte, David Daley, Julia Ernst, Madeleine Groom, Branko M van Hulst, Maxime de Jong, Anna Kaiser, Julia Kerner auch Koener, Jonna Kuntsi, Giorgia Michelini, Anna Price, Diane Purper-Ouakil, Joske Rijmen, Jan R Wiersema, Dora Wynchank, Joanna Martin","doi":"10.1016/s2215-0366(25)00167-1","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00167-1","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"12 1 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144677733","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":"Advancing mental health care and research in rare diseases","authors":"Kwok Ying Chan, Man Lui Chan","doi":"10.1016/s2215-0366(25)00205-6","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00205-6","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"17 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144664464","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 2025; published online July 2. https://doi.org/10.1016/S2215-0366(25)00098-7","authors":"","doi":"10.1016/s2215-0366(25)00239-1","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00239-1","url":null,"abstract":"<em>Siskind D, Northwood K, Pillinger T, et al. Absolute neutrophil count and adverse drug reaction monitoring during clozapine treatment: consensus guidelines from a global Delphi panel.</em> Lancet Psychiatry <em>2025; published online July 2. https://doi.org/10.1016/S2215-0366(25)00098-7</em>—In this Position Paper, Robert A McCutcheon should have been the final author. This correction has been made to the online version as of July 16, 2025, and will be made to the printed version.","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"16 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645430","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 2025; 12: 579–89","authors":"","doi":"10.1016/s2215-0366(25)00235-4","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00235-4","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"8 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645431","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":"Real-world effectiveness of clozapine augmentation with antidepressants: within-subject data evidence from two European nationwide cohorts","authors":"Heidi Taipale, Dan Siskind, Antti Tanskanen, Ellenor Mittendorfer-Rutz, Christoph U Correll, Jari Tiihonen","doi":"10.1016/s2215-0366(25)00163-4","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00163-4","url":null,"abstract":"<h3>Background</h3>Only 40% of people with treatment-resistant schizophrenia will have an adequate response to clozapine. Data on the effect of antidepressant augmentation on these patients are scarce. We aimed to study the effectiveness and safety of antidepressant augmentations to clozapine in two nationwide cohorts.<h3>Methods</h3>For this within-subject data evidence study, data from two cohort studies were analysed then meta-analysed, including patients with schizophrenia using clozapine identified from Finnish (1996–2017) and Swedish (2006–23) nationwide registers, followed up from first clozapine use until death or end of data linkage. Clozapine augmentation with specific antidepressants was compared with clozapine use only. The primary outcome was schizophrenia relapse (hospital admission with ICD-10 F20–F29 diagnosis), and the secondary outcome was somatic hospital admission. The risk of outcomes (expressed as adjusted hazard ratio [aHR]) was assessed by a within-individual cohort design, using each individual as their own control. Ethnicity data were not available. People with lived experience were not involved.<h3>Findings</h3>The analysis included 23 206 clozapine users (9531 women and 13 675 men), with a mean age of 41·3 years (SD 13·5). The lowest risk of relapse was observed for sertraline (meta-analysis aHR 0·76 [95% CI 0·69–0·83]), duloxetine (aHR 0·78 [0·68–0·89]), and escitalopram (0·85 [0·79–0·92]). When antidepressants were recategorised by dose, the lowest risk of relapse was observed for standard doses of sertraline at 30–54 mg/day (aHR 0·49 [0·27–0·89]), escitalopram 6–10 mg/day (aHR 0·57 [0·37–0·88]), and duloxetine 18–32 mg/day (aHR 0·59 [0·46–0·75]). No antidepressant was associated with an increased risk of somatic hospital admission at low or standard dose, whereas high-dose use was associated with increased risk, although most of the risk estimates were not significant.<h3>Interpretation</h3>This meta-analysis from two nationwide cohorts indicates that SSRI and SNRI augmentation therapies for people with treatment-resistant schizophrenia are associated with a substantially decreased risk of relapse at standard dose, unlike other antidepressants. Potential benefits associated with augmentation must be balanced against risks of possible deleterious somatic outcomes, which were observed only when antidepressants were used at high doses.<h3>Funding</h3>Sigrid Jusélius Foundation.","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"30 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144640592","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":"Self-guided digital psychotherapy for borderline personality disorder – Authors' reply","authors":"Nele Assmann, Gitta Jacob, Anja Schaich, Thomas Berger, Tristan Zindler, Linda Betz, Stefan Borgwardt, Arnoud Arntz, Eva Fassbinder, Jan Philipp Klein","doi":"10.1016/s2215-0366(25)00200-7","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00200-7","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"10 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144640590","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 2025; published online June 23. https://doi.org/10.1016/S2215-0366(25)00192-0","authors":"","doi":"10.1016/s2215-0366(25)00216-0","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00216-0","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"120 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144640618","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}