Lancet PsychiatryPub Date : 2025-01-01Epub Date: 2024-07-04DOI: 10.1016/S2215-0366(24)00203-7
Florence Butlen-Ducuing, Francisca Silva, Ivana Silva, Pavel Balabanov, Steffen Thirstrup
{"title":"Applying the EU regulatory framework for the clinical use of psychedelics.","authors":"Florence Butlen-Ducuing, Francisca Silva, Ivana Silva, Pavel Balabanov, Steffen Thirstrup","doi":"10.1016/S2215-0366(24)00203-7","DOIUrl":"10.1016/S2215-0366(24)00203-7","url":null,"abstract":"","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":" ","pages":"7-9"},"PeriodicalIF":30.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555767","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}
Lancet PsychiatryPub Date : 2024-12-19DOI: 10.1016/s2215-0366(24)00401-2
Jakub S Bil
{"title":"Advancing global mental health diplomacy through a rights-based approach","authors":"Jakub S Bil","doi":"10.1016/s2215-0366(24)00401-2","DOIUrl":"https://doi.org/10.1016/s2215-0366(24)00401-2","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"20 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857904","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}
Lancet PsychiatryPub Date : 2024-12-19DOI: 10.1016/s2215-0366(24)00363-8
{"title":"The global epidemiology and health burden of the autism spectrum: findings from the Global Burden of Disease Study 2021","authors":"","doi":"10.1016/s2215-0366(24)00363-8","DOIUrl":"https://doi.org/10.1016/s2215-0366(24)00363-8","url":null,"abstract":"<h3>Background</h3>High-quality estimates of the epidemiology of the autism spectrum and the health needs of autistic people are necessary for service planners and resource allocators. Here we present the global prevalence and health burden of autism spectrum disorder from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 following improvements to the epidemiological data and burden estimation methods.<h3>Methods</h3>For GBD 2021, a systematic literature review involving searches in PubMed, Embase, PsycINFO, the Global Health Data Exchange, and consultation with experts identified data on the epidemiology of autism spectrum disorder. Eligible data were used to estimate prevalence via a Bayesian meta-regression tool (DisMod-MR 2.1). Modelled prevalence and disability weights were used to estimate health burden in years lived with disability (YLDs) as the measure of non-fatal health burden and disability-adjusted life-years (DALYs) as the measure of overall health burden. Data by ethnicity were not available. People with lived experience of autism were involved in the design, preparation, interpretation, and writing of this Article.<h3>Findings</h3>An estimated 61·8 million (95% uncertainty interval 52·1–72·7) individuals (one in every 127 people) were on the autism spectrum globally in 2021. The global age-standardised prevalence was 788·3 (663·8–927·2) per 100 000 people, equivalent to 1064·7 (898·5–1245·7) autistic males per 100 000 males and 508·1 (424·6–604·3) autistic females per 100 000 females. Autism spectrum disorder accounted for 11·5 million (7·8–16·3) DALYs, equivalent to 147·6 (100·2–208·2) DALYs per 100 000 people (age-standardised) globally. At the super-region level, age-standardised DALY rates ranged from 126·5 (86·0–178·0) per 100 000 people in southeast Asia, east Asia, and Oceania to 204·1 (140·7–284·7) per 100 000 people in the high-income super-region. DALYs were evident across the lifespan, emerging for children younger than age 5 years (169·2 [115·0–237·4] DALYs per 100 000 people) and decreasing with age (163·4 [110·6–229·8] DALYs per 100 000 people younger than 20 years and 137·7 [93·9–194·5] DALYs per 100 000 people aged 20 years and older). Autism spectrum disorder was ranked within the top-ten causes of non-fatal health burden for people younger than 20 years.<h3>Interpretation</h3>The high prevalence and high rank for non-fatal health burden of autism spectrum disorder in people younger than 20 years underscore the importance of early detection and support to autistic young people and their caregivers globally. Work to improve the precision and global representation of our findings is required, starting with better global coverage of epidemiological data so that geographical variations can be better ascertained. The work presented here can guide future research efforts, and importantly, decisions concerning allocation of health services that better address the needs of all autistic individuals","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"111 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857903","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}
Lancet PsychiatryPub Date : 2024-12-17DOI: 10.1016/s2215-0366(24)00360-2
Edoardo G Ostinelli, Marcel Schulze, Caroline Zangani, Luis C Farhat, Anneka Tomlinson, Cinzia Del Giovane, Samuel R Chamberlain, Alexandra Philipsen, Susan Young, Phil J Cowen, Andrea Bilbow, Andrea Cipriani, Samuele Cortese
{"title":"Comparative efficacy and acceptability of pharmacological, psychological, and neurostimulatory interventions for ADHD in adults: a systematic review and component network meta-analysis","authors":"Edoardo G Ostinelli, Marcel Schulze, Caroline Zangani, Luis C Farhat, Anneka Tomlinson, Cinzia Del Giovane, Samuel R Chamberlain, Alexandra Philipsen, Susan Young, Phil J Cowen, Andrea Bilbow, Andrea Cipriani, Samuele Cortese","doi":"10.1016/s2215-0366(24)00360-2","DOIUrl":"https://doi.org/10.1016/s2215-0366(24)00360-2","url":null,"abstract":"<h3>Background</h3>The comparative benefits and harms of available interventions for ADHD in adults remain unclear. We aimed to address these important knowledge gaps.<h3>Methods</h3>In this systematic review and component network meta-analysis (NMA), we searched multiple databases for published and unpublished randomised controlled trials (RCTs) investigating pharmacological and non-pharmacological interventions for ADHD in adults from database inception to Sept 6, 2023. We included aggregate data from RCTs comparing interventions against controls or any other eligible active intervention for the treatment of symptoms in adults (ages ≥18 years) with a formal diagnosis of ADHD. Pharmacological therapies were included only if their maximum planned doses were considered eligible according to international guidelines. We included RCTs of at least 1-week duration for medications, of at least four sessions for psychological therapies, and of any length deemed appropriate for neurostimulation. For RCTs of medications, cognitive training, or neurostimulation alone, we included only double-blind RCTs. At least two authors independently screened the identified records and extracted data from eligible RCTs. Our primary outcomes were efficacy (change in ADHD core symptom severity on self-rated and clinician-rated scales at timepoints closest to 12 weeks) and acceptability (all-cause discontinuation). We estimated standardised mean differences (SMDs) and odds ratios (ORs) using random effects pairwise and component NMA, dismantling interventions into specific therapeutic components. This study was registered with PROSPERO (CRD42021265576). People with relevant lived experience were involved in the conduct of the research and writing process.<h3>Findings</h3>Of 32 416 records, 113 unique RCTs encompassing 14 887 participants were eligible for analysis (6787 [45·6%] females, 7638 [51·3%] males, 462 [3·1%] sex not reported). The RCTs encompassed pharmacological therapies (63 [55·8%] of 113 RCTs; 6875 participants), psychological therapies (28 [24·8%] of 113 RCTs; 1116 participants), neurostimulatory therapy and neurofeedback (ten [8·8%] of 113 RCTs; 194 participants), and control conditions (97 [85·8%] of 113 RCTs; 5770 participants). For reduction of ADHD core symptoms at 12 weeks on both self-reported and clinician-reported rating scales, atomoxetine (self-reported scale SMD –0·38, 95% CI –0·56 to –0·21; clinician-reported scale –0·51, –0·64 to –0·37) and stimulants (0·39, –0·52 to –0·26; –0·61, –0·71 to –0·51) had higher efficacy than placebo (Confidence in Network Meta-Analysis [CINeMA] ranging between very low and moderate). Cognitive behavioural therapy (–0·76, –1·26 to –0·26), cognitive remediation (–1·35, –2·42 to –0·27), mindfulness (–0·79, –1·29 to –0·29), psychoeducation (–0·77, –1·35 to –0·18), and transcranial direct current stimulation (–0·78; –1·13 to –0·43) were better than placebo only on clinician-reported measures. Regarding acceptability, al","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"114 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142841234","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}
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