Lancet Psychiatry最新文献

{"title":"Awais Aftab: a multidimensional approach to psychiatry","authors":"Talha Burki","doi":"10.1016/s2215-0366(25)00137-3","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00137-3","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"125 1","pages":"409"},"PeriodicalIF":64.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979537","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 big-data balancing act","authors":"","doi":"10.1016/s2215-0366(25)00136-1","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00136-1","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"122 1","pages":"395"},"PeriodicalIF":64.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979512","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":"Convergent evidence linking neonatal vitamin D status and risk of neurodevelopmental disorders: a Danish case-cohort study","authors":"Henriette Thisted Horsdal, Clara Albiñana, Zhihong Zhu, Sanne Grundvad Boelt, Nis Borbye-Lorenzen, Arieh S Cohen, Kristin Skogstrand, Lars Melgaard, Nadia Jensen MacSween, Marta Jadwiga Thorbek, Oleguer Plana-Ripoll, Liselotte Vogdrup Petersen, Cynthia M Bulik, Anders D B⊘rglum, Ole Mors, Merete Nordentoft, Thomas Werge, Gunn-Helen Moen, Shannon D’Urso, Naomi R Wray, John J McGrath","doi":"10.1016/s2215-0366(25)00099-9","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00099-9","url":null,"abstract":"<h3>Background</h3>There is growing evidence linking neonatal vitamin D deficiency to an increased risk of schizophrenia, ADHD, and autism spectrum disorder (ASD). The aim of this study was to examine the association between two vitamin D biomarkers (25 hydroxyvitamin D [25(OH)D] and vitamin D-binding protein [DBP], and their related genetic correlates) and the risk of six mental disorders.<h3>Methods</h3>We used a population-based, case-cohort sample of all individuals born in Denmark between 1981 and 2005. Using Danish health registers with follow-up to Dec 31, 2012, we identified individuals diagnosed with major depressive disorder, bipolar disorder, schizophrenia, ADHD, ASD, and anorexia nervosa based on ICD-10 criteria. Additionally, a random subcohort from the general population was selected. Based on neonatal dried blood spots, we measured concentrations of 25(OH)D and DBP. Our primary analyses were based on hazard ratios (HR) with 95% CI and absolute risks for the six mental disorders according to measured concentrations of 25(OH)D and DBP. As secondary analyses, we examined the association between genetic predictors of 25(OH)D and DBP, and the six mental disorders, and Mendelian randomisation analyses based on published summary statistics for 25(OH)D, DBP, and the six mental disorders. People with lived experience contributed to the development of the guiding hypothesis.<h3>Findings</h3>We used the total population from the iPSYCH2012 design (n=88 764), which included individuals who developed the six mental disorders, major depressive disorder (n=24 240), bipolar disorder (n=1928), schizophrenia (n=3540), ADHD (n=18 726), ASD (n=16 146), anorexia nervosa (n=3643), and the randomly sampled subcohort (n=30 000). Among those who met a range of inclusion criteria (eg, measured 25[OH]D, DBP or genotype, and predominantly European ancestry), we measured 25(OH)D or DBP in 71 793 individuals (38 118 [53·1%] male and 33 675 [46·9%] female); 65 952 had 25(OH)D and 66 797 the DBP measurements. Significant inverse relationships were found between 25(OH)D and schizophrenia (HR 0·82, 95% CI 0·78–0·86), ASD (HR 0·93, 95% CI 0·90–0·96), and ADHD (HR 0·89, 95% CI 0·86–0·92). A significant inverse relationship was found between DBP and schizophrenia (HR 0·84, 95% CI 0·80–0·88). Based on polygenic risk scores, higher concentrations of 25(OH)D (adjusted for DBP) were significantly associated with a reduced risk of both ASD and schizophrenia. Analyses based on Mendelian randomisation provided support for a causal association between both lower 25(OH)D and DBP concentrations and an increased risk of ADHD.<h3>Interpretation</h3>Convergent evidence finds that neonatal vitamin D status is associated with an altered risk of mental disorders. Our study supports the hypothesis that optimising neonatal vitamin D status might reduce the incidence of a range of neurodevelopmental disorders.<h3>Funding</h3>The Danish National Research Foundation.","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"29 1","pages":"410-420"},"PeriodicalIF":64.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979526","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":"Vitamin D status in newborns and long-term neuropsychiatric outcomes","authors":"Isabel Gamache, Wiame Belbellaj, Basile Jumentier, Despoina Manousaki","doi":"10.1016/s2215-0366(25)00130-0","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00130-0","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"1 1","pages":"396-397"},"PeriodicalIF":64.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979521","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":"Adolescent mental health measures","authors":"Laura Duncan, R Christopher Sheldrick","doi":"10.1016/s2215-0366(25)00101-4","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00101-4","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"122 1","pages":"407-408"},"PeriodicalIF":64.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979520","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 clinical trials for anxiety disorders in older adults","authors":"Carly J Johnco","doi":"10.1016/s2215-0366(25)00128-2","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00128-2","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"118 1","pages":"397-398"},"PeriodicalIF":64.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979513","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":"Mindfulness-based cognitive therapy versus treatment as usual after non-remission with NHS Talking Therapies high-intensity psychological therapy for depression: a UK-based clinical effectiveness and cost-effectiveness randomised, controlled, superiority trial","authors":"Thorsten Barnhofer, Barnaby D Dunn, Clara Strauss, Florian A Ruths, Barbara Barrett, Mary Ryan, Asha Ladwa, Frances Stafford, Roberta Fichera, Hannah Baber, Ailis McGuinness, Isabella Metcalfe, Daniel K Y Kan, Joanna Pooley, Delilah Harding, Emma Tassie, James Carson, Shelley Rhodes, Allan H Young, James Connors, Fiona C Warren","doi":"10.1016/s2215-0366(25)00105-1","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00105-1","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;Non-remission after psychological therapy for major depressive disorder is common, yet there are no established further-line treatments. In the UK National Health Service (NHS) Talking Therapies programme, about 50% of patients with depression who come to the end of the stepped care pathway do not show remission of symptoms. We aimed to investigate whether mindfulness-based cognitive therapy (MBCT) can improve clinical outcomes and whether the additional financial cost is worthwhile.&lt;h3&gt;Methods&lt;/h3&gt;We conducted a parallel, randomised, controlled, superiority trial in three sites in the UK (Devon, London, and Sussex). Patients with current major depressive disorder whose symptoms had not reached remission (assessed as Patient Health Questionnaire-9 [PHQ-9] score ≥10) after an adequate dose of NHS Talking Therapies high-intensity therapy (≥12 sessions) were recruited from 20 NHS Talking Therapies services. Participants were allocated through remote random assignment (1:1) to MBCT plus treatment as usual or treatment as usual alone at the UK Clinical Research Collaboration-registered Exeter Clinical Trials Unit with minimisation on depression severity (PHQ-9 score &lt;19 &lt;em&gt;vs&lt;/em&gt; ≥19), antidepressant use at baseline (yes &lt;em&gt;vs&lt;/em&gt; no), and recruitment site (Devon &lt;em&gt;vs&lt;/em&gt; London &lt;em&gt;vs&lt;/em&gt; Sussex). MBCT was delivered via videoconference and comprised an individual orientation session and eight weekly group sessions. The primary clinical outcome was reduction in depression symptomatology at 34 weeks after randomisation, using the PHQ-9. Cost-effectiveness was evaluated in terms of costs to primary, secondary, and tertiary health and social care services collected using the Adult Service Use Schedule and quality-adjusted life-years (QALYs) via health utilities derived from the EQ-5D. Primary outcome analyses were masked in the intention-to-treat population using observed data only. Lived experience experts were integral to all stages of this research. The trial was prospectively registered with ISRCTN, ISRCTN17755571.&lt;h3&gt;Findings&lt;/h3&gt;Between April 20, 2021, and Jan 24, 2023, we enrolled 234 eligible participants, 166 (71%) of whom identified as women, 65 (28%) as men, one (&lt;1%) as other, and two (1%) preferred not to say. The mean age was 42·5 years (SD 13·9). 201 (86%) of 234 participants were White. 118 participants were assigned to MBCT plus treatment as usual and 116 to treatment as usual alone, 101 and 102 of whom completed the final follow-up, respectively. At 34 weeks after randomisation, the MBCT plus treatment as usual group had significantly lower levels of depression symptomatology than the treatment as usual alone group (adjusted between-group difference –2·49, 95% CI –3·89 to –1·09; p=0·0006; Cohen's d –0·41, 95% CI –0·67 to –0·15). Utility scores were higher and costs were lower in the MBCT group (adjusted mean cost difference –£245·23, 95% CI –581·92 to 91·46; p=0·15) over the course of the study. The MBCT","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"4 1","pages":"433-446"},"PeriodicalIF":64.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979440","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":"Pharmacological treatment of anxiety in older adults: a systematic review and meta-analysis","authors":"Sarah E Neil-Sztramko, AnneMarie Levy, Alastair J Flint, Zahra Goodarzi, Amy Gough, Shanna C Trenaman, Michael Van Ameringen, Erica Weir, Anthony Yeung, Mahnoor R Akram, Titus A Chan, Sébastien Grenier, Heli Juola, Juliette Mojgani, Kristin Reynolds, Carly Whitmore, Andrea Iaboni","doi":"10.1016/s2215-0366(25)00100-2","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00100-2","url":null,"abstract":"<h3>Background</h3>Anxiety and its disorders are common in later life. Given the known risks of psychopharmacological treatments in older adults, clinical decision making for anxiety management should be guided by the strongest available evidence. This study aimed to comprehensively synthesise evidence on the pharmacological treatment of anxiety in older adults.<h3>Methods</h3>In this systematic review and meta-analysis, we searched MEDLINE, Cochrane Central, Embase, PsycINFO, and CINAHL from database inception to April 23, 2024, for randomised controlled trials on pharmacological treatments for anxiety in older adults (aged 60 years or older, mean age 65 years or older, or subgroup analyses meeting these criteria). Primary outcomes included reduction in anxiety symptoms, or treatment response, or remission. Standardised mean differences (SMD) were calculated for continuous variables and absolute difference and risk ratio (RR) for dichotomous variables. The risk of bias was assessed using the Cochrane Risk of Bias tool, and the certainty of evidence rated using GRADE. People with lived experience were involved in conducting this research. This trial is registered with PROSPERO (CRD42023407837).<h3>Findings</h3>We identified 19 eligible studies, including 2336 participants, 1592 (68·15%) of whom were women and 722 (30·91%) men, and sex was not reported for the other 22 (0·94%) participants. Only eight of 19 studies reported on race or ethnicity, and study participants were predominantly White (1309 [91·6%] of 1428), and no studies reported outcomes related to gender. Antidepressants were more effective than placebo or waitlist control in reducing anxiety symptoms (SMD –1·19 [95% CI –1·80 to –0·58), with moderate certainty of evidence and substantial heterogeneity (<em>I</em>² 92·34%; p&lt;0·0001). Antidepressants were also more effective than placebo or waitlist control in response or remission (RR 1·52 [95% CI 1·21 to 1·90]; absolute difference 146 per 1000 [95% CI 59 to 252]); with a low certainty of evidence and low heterogeneity (<em>I</em>² 8·09%; p=0·36). Planned subgroup analysis indicated selective serotonin reuptake inhibitors led to a greater reduction in anxiety symptoms (SMD –1·84 [95% CI –2·52 to –1·17]) compared with serotonin–norepinephrine reuptake inhibitors (SMD –0·46 [95% CI –0·65 to –0·27]), and there was no difference in response or remission. Benzodiazepines might reduce anxiety symptoms compared with placebo, but the evidence is very uncertain with high risk of bias. Meta-analyses for other drug classes for primary outcomes were not possible.<h3>Interpretation</h3>Antidepressants are more effective than placebo or waitlist for reducing anxiety symptoms, with evidence supporting their safety and tolerability in older adults. Evidence for the efficacy and safety of benzodiazepines is weak. These findings can guide evidence-based practice.<h3>Funding</h3>Public Health Agency of Canada.","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"10 1","pages":"421-432"},"PeriodicalIF":64.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979525","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: 266–75","authors":"","doi":"10.1016/s2215-0366(25)00159-2","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00159-2","url":null,"abstract":"<em>Nomura N, Siafis S, Schneider-Thoma J, et al. The trajectory of sedative adverse events caused by antipsychotics: a meta-analysis of individual participant data from randomised, placebo-controlled, clinical trials inacute phase schizophrenia.</em> Lancet Psychiatry <em>2025; <strong>12:</strong> 266–75</em>—The appendix of this Article has been corrected as of May 8, 2025.","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"19 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143926345","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":"Reproductive rights of women with severe mental disability and rights of their children in China","authors":"Yang Zhang, Xingbo Suo, Jin Gao","doi":"10.1016/s2215-0366(25)00040-9","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00040-9","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"31 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143920375","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}