Lancet Psychiatry最新文献

{"title":"Marketing of supplements to people with ADHD reinforces stigma.","authors":"Ava C Wilson","doi":"10.1016/S2215-0366(26)00114-8","DOIUrl":"10.1016/S2215-0366(26)00114-8","url":null,"abstract":"","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":" ","pages":"728-730"},"PeriodicalIF":21.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870071","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":"Optimising and personalising task-shared psychosocial interventions for common mental disorders: a Bayesian component network meta-analysis of individual participant data.","authors":"Davide Papola, Federico Tedeschi, Orestis Efthimiou, Mathias Harrer, Jinane Abi Ramia, Ceren Acarturk, Aemal Akhtar, Mhd Salem Alkneme, Richard Bryant, Sebastian Burchert, Dixon Chibanda, Anne M De Graaff, Rabih El Chammay, Zeynep Ilkkursun, Mark Jordans, Christine Knaevelsrud, Brandon A Kohrt, Gulsah Kurt, Venla Lehti, Marx R Leku, Niina Markkula, Camila Matsuzaka, Marcelo F Mello, Naser Morina, Jill K Murphy, Etheldreda Nakimuli-Mpungu, Atif Rahman, Julia Spaaij, Wietse A Tol, Nguyen C Vu, Ahmed Waqas, Edith van 't Hof, Eirini Karyotaki, Marianna Purgato, Marit Sijbrandij, Pim Cuijpers, Toshi A Furukawa, Vikram Patel, Corrado Barbui","doi":"10.1016/S2215-0366(26)00193-8","DOIUrl":"10.1016/S2215-0366(26)00193-8","url":null,"abstract":"<p><strong>Background: </strong>Although psychosocial interventions delivered by non-specialist providers effectively treat common mental disorders such as depression and anxiety, the treatment-specific elements driving their efficacy remain largely unknown. Our aim was to compare and rank the efficacy of the individual active components of task-shared psychosocial interventions and to predict efficacy using individual participant characteristics.</p><p><strong>Methods: </strong>We performed a systematic review and Bayesian individual participant data component network meta-analysis of RCTs comparing different task-shared psychosocial interventions with control conditions for the treatment of adults with common mental disorders. We searched MEDLINE, Embase, PsycINFO, and CENTRAL from database inception to March 15, 2023. We included additional datasets published up to May 29, 2026 and unpublished RCTs. We sought individual participant data from the trial authors. A purpose-built taxonomy of treatment-specific elements was used to dismantle interventions into their constituent components. The primary outcome was efficacy in reducing symptoms of common mental disorders, as measured at study endpoint. We used incremental mean difference to indicate the added benefit (or detrimental effect) of adding a component to a treatment. We assessed the risk of bias of the included studies with the revised Cochrane Risk of Bias tool. The protocol was published in a peer-reviewed journal.</p><p><strong>Findings: </strong>We included 34 RCTs, from which 30 trials (89%) contributed individual participant data from 10 612 participants. Of these participants, 7662 were women (72·2%) and 2950 were men (27·8%). The mean age of participants was 36·7 years (SD 5·5). Findings identified strengthening social support (incremental mean difference -9·48; 95% credible interval [CrI] -13·29 to -6·60), behavioural activation (-4·15; -7·48 to -0·05), and problem management (-4·08; -5·37 to -2·83) as the most beneficial components. Relaxation (7·97; 3·35 to 12·11) and, less clearly, cognitive reframing (5·17; 0·78 to 9·15) were identified as detrimental components. Interaction analyses revealed that component effects vary systematically by baseline severity and other sociodemographic characteristics. Ethnicity data were not available. Individuals with lived experience contributed to the interpretation of results. Personalised effect estimates can be computed via a freely accessible web application.</p><p><strong>Interpretation: </strong>Strengthening social support, problem management, and behavioural activation were associated with the greatest incremental benefit within task-shared psychosocial interventions for adults with depression or anxiety.</p><p><strong>Funding: </strong>European Commission.</p>","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":" ","pages":"747-760"},"PeriodicalIF":21.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671061","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":"10.1016/S2215-0366(26)00117-3","url":null,"abstract":"","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":" ","pages":"730-731"},"PeriodicalIF":21.1,"publicationDate":"2026-09-01","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":"Beyond task sharing: the next step for global mental health.","authors":"Laura Shields-Zeeman, Felix Bolinski","doi":"10.1016/S2215-0366(26)00236-1","DOIUrl":"10.1016/S2215-0366(26)00236-1","url":null,"abstract":"","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":" ","pages":"721-723"},"PeriodicalIF":21.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671087","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":"Open Dialogue versus treatment as usual for adults presenting in crisis to mental health services in England (the ODDESSI Trial): a multisite cluster-randomised trial.","authors":"Stephen Pilling, Thomas Craig, Katherine Clarke, Petrina Chu, Kirsty James, Jaakko Seikkula, Manuel Gomes, Jiunn Wang, Emma Mckenzie, Nicole Sze Chi Chan, Tom Cant, Sarah Carr, Victoria Clark, Joanna Curwen, Corrine Hendy, Mark Hopfenbeck, Yasmin Ishaq, Gareth Jarvis, Amy Jebreel, Jahara Khatun, Catherine Kinane, Sarah Noordally, Shaeda Nourmand, James Osborne, Georgie Parker, Daniel Scott, Jerry Tew, Sonia Johnson, Douglas Ziedonis, Timothy Weaver, Sabine Landau, Russell Razzaque","doi":"10.1016/S2215-0366(26)00229-4","DOIUrl":"https://doi.org/10.1016/S2215-0366(26)00229-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Open Dialogue is a person-centred, transdiagnostic model of mental health care that emphasises continuity, therapeutic relationships, and collaboration with the service user's social network. Open Dialogue is a service-wide approach to care involving network meetings with the service user, members of their social network, and usually two practitioners who support the network throughout the duration of care. In this cluster-randomised trial, we aimed to evaluate the clinical effectiveness of Open Dialogue versus treatment as usual for adults presenting in crisis to community mental health services in England.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This multicentre, parallel two-arm, cluster-randomised, controlled superiority trial was conducted in mental health services in five National Health Service trusts in London and the South of England. Clusters were defined at the level of primary care practices within service catchment areas. Participants were adults aged 18 years or older presenting in crisis to mental health services and registered with a practice within trial clusters. Randomisation was done at the cluster level (1:1), stratified by catchment area, and balanced on average general practice (GP) list size and Index of Multiple Deprivation (2015). The chief investigator, senior statistician, and assessors of the primary outcome were masked in the study. Participants either received Open Dialogue or treatment as usual, which refers to the functional team model currently implemented throughout English mental health services. The primary outcome was time (days) to first relapse following initial recovery from the index crisis censored at the end of the 2-year follow-up period. Participant-reported secondary outcomes were EuroQol Visual Analogue Scale, Social Provisions Scale, Lubben Social Network Scale, Questionnaire about the Process of Recovery, and the Client Satisfaction Questionnaire, measured at five timepoints over 2 years, and clinical measures were extracted from electronic health records. People with relevant lived experience were involved in the design and execution of the study. Fidelity to the model of care in Open Dialogue and treatment as usual, and adherence to the delivery of Open Dialogue, were measured prior to each site starting participant recruitment, then every 6 months thereafter until the final participant follow-up in that site. The trial was retrospectively registered (ISRCTN52653325) and is complete.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;185 general practices associated with six mental health Trusts across England were identified for screening. 105 practices were excluded, and 80 were included in cluster formation, forming 32 clusters that were randomly assigned (16 to treatment as usual and 16 to the Open Dialogue intervention). One mental health trust (two clusters) withdrew, resulting in five mental health trusts (30 clusters) participating in the trial. Between June 25, 2019, and Dec 9, 20","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":" ","pages":""},"PeriodicalIF":21.1,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833844","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":"Relapse or rebound: the case for personalisation in antipsychotic discontinuation.","authors":"Rajeev Krishnadas, C A Smitha","doi":"10.1016/S2215-0366(26)00270-1","DOIUrl":"https://doi.org/10.1016/S2215-0366(26)00270-1","url":null,"abstract":"","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":" ","pages":""},"PeriodicalIF":21.1,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814608","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":"Relapse trajectories and antipsychotic discontinuation in schizophrenia from individual participant data of five trials from the Yale Open Data Access database: a meta-analysis.","authors":"Krisya Louie, Sameer Jauhar, Jose Rubio, Bodyl Brand, Toby Pillinger, Oliver D Howes, Robert A McCutcheon","doi":"10.1016/S2215-0366(26)00225-7","DOIUrl":"https://doi.org/10.1016/S2215-0366(26)00225-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Antipsychotics reduce risk of relapse in schizophrenia, but longer-term use is associated with adverse effects, often prompting dose reduction or discontinuation. Although discontinuation increases relapse risk, the clinical course is heterogeneous. Rapid relapse following antipsychotic discontinuation has been observed in clinical trials and could reflect a direct pharmacological consequence of stopping medication, as opposed to re-emergence of underlying illness. We aimed to identify distinct trajectories of symptom change preceding relapse, to examine whether trajectory membership was associated with treatment arm and baseline clinical characteristics, and to compare symptom profiles at time of relapse between individuals whose illness relapsed following discontinuation and those whose illness relapsed during continued treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;For this meta-analysis, on May 4, 2025, we searched the Yale University Open Data Access project database for randomised, double-blind, discontinuation trials of antipsychotics in individuals with schizophrenia or schizoaffective disorder. No language restrictions were applied. We included double-blind, placebo-controlled, relapse-prevention, randomised trials of antipsychotic medications. Studies with available individual participant data were included if participants were first treated with antipsychotic drugs for more than 3 months and clinically stabilised before they were randomly assigned to placebo (discontinuation) or continued active treatment. We excluded studies that involved diagnoses other than schizophrenia or schizoaffective disorder. We analysed longitudinal symptom data (using the Positive and Negative Syndrome Scale [PANSS]) from individuals whose illness relapsed. Latent class mixed modelling identified distinct trajectories of symptom change preceding relapse. We first examined associations between trajectory membership and treatment discontinuation or continuation. We then compared symptom profiles at both baseline and point of relapse, between both trajectory groups and discontinuation status. The study was not preregistered; the Yale University Open Data Access project ID is 2025-0740.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;We identified five randomised, double-blind, placebo-controlled, discontinuation trials of oral and long-acting injectable (LAI) paliperidone. In our analysis, we included 271 participants from the LAI trials (155 men [57%] and 116 women [43%], mean age 38·4 years [SD 11·2, range 18-65]) and 146 from the oral trials (72 men [49%] and 74 women [51%], mean age 34·8 years [SD 11·5, range 18-61]). Two latent classes of relapse were identified: rapid and delayed onset, with rapid relapse associated with more severe symptoms at point of relapse. The proportion with rapid relapse did not differ between continuation and discontinuation groups in either LAI (discontinuation 39 [20%] of 197, continuation eight [11%] of 74; p=0·1","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":" ","pages":""},"PeriodicalIF":21.1,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814661","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":"Mental health law and policy in Argentina: from rights expansion to rollback.","authors":"Alejandra Barcala","doi":"10.1016/S2215-0366(26)00197-5","DOIUrl":"https://doi.org/10.1016/S2215-0366(26)00197-5","url":null,"abstract":"","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":" ","pages":""},"PeriodicalIF":21.1,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799972","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":"Beyond mental health law reform: Argentina and the clinical challenges of implementation.","authors":"Alejandra Maddocks, Marta B Rondón","doi":"10.1016/S2215-0366(26)00241-5","DOIUrl":"https://doi.org/10.1016/S2215-0366(26)00241-5","url":null,"abstract":"","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":" ","pages":""},"PeriodicalIF":21.1,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799951","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":"From prediction to decision: prediction-based decision rules and target trial emulation in ADHD.","authors":"Miguel Garcia-Argibay, Stephen V Faraone, Zheng Chang, Samuele Cortese, Henrik Larsson","doi":"10.1016/S2215-0366(26)00227-0","DOIUrl":"https://doi.org/10.1016/S2215-0366(26)00227-0","url":null,"abstract":"<p><p>More than 100 prediction models have been developed to support the diagnosis, prognosis, or treatment of ADHD, yet none has reached routine clinical practice. In this Personal View, we argue that an important reason for this implementation gap is the absence of clearly defined prediction-based decision rules-formalised mappings from a model's output to specific clinical actions. Most published models report discrimination metrics such as the area under the receiver-operating-characteristic curve, but do not specify what a clinician should do differently for a patient classified as at high risk versus low risk. Without this link to action, even an accurate model remains clinically inert. We describe how prediction-based decision rules, combined with target trial emulation of their clinical utility in large observational datasets, offer a feasible path forward. We illustrate the approach with two worked ADHD examples (treatment intensity guided by predicted persistence and medication selection guided by predicted treatment response) and propose four priorities to shift the field from model development towards decision-oriented evaluation and implementation.</p>","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":" ","pages":""},"PeriodicalIF":21.1,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800024","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}