Lancet Psychiatry最新文献

{"title":"Avatar therapy: does 3D add value?","authors":"Mark Hayward","doi":"10.1016/s2215-0366(25)00210-x","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00210-x","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"647 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144547521","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":"Immersive virtual reality-assisted therapy targeting persistent auditory verbal hallucinations in patients diagnosed with schizophrenia spectrum disorders in Denmark: the Challenge assessor-masked, randomised clinical trial","authors":"Lisa Charlotte Smith, Ditte Lammers Vernal, Lise Sandvig Mariegaard, Annette Gosvig Christensen, Jens Einar Jansen, Gry Schytte, Louise Angelou Stokbro, Nikolai Albert, Mads Juul Christensen, Neil Thomas, Carsten Hjorthøj, Merete Nordentoft, Louise Birkedal Glenthøj","doi":"10.1016/s2215-0366(25)00161-0","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00161-0","url":null,"abstract":"<h3>Background</h3>Auditory verbal hallucinations are among the most frequent and debilitating symptoms of schizophrenia spectrum disorders (henceforth termed schizophrenia), particularly in patients with treatment-resistant symptoms. Current treatment options have suboptimal response rates and innovative interventions are needed. This study aimed to evaluate the efficacy and safety of a novel immersive virtual reality-assisted therapy (Challenge-VRT) for auditory verbal hallucinations.<h3>Methods</h3>In this randomised, assessor-masked, parallel-group superiority clinical trial, patients with schizophrenia were recruited from outpatient psychiatric services across three Danish regions. Key inclusion criteria were age 18 years or older, auditory verbal hallucinations for at least 3 months, and insufficient symptom response to antipsychotic medication. Exclusion criteria included being unable to identify a dominant voice, current substance dependence, and organic brain disorder. Participants were randomly assigned (1:1) via a secure web-based system using permuted blocks (block size 12), stratified by site and antipsychotic treatment. Allocation was concealed from outcome assessors. Participants were assigned to either Challenge-VRT (seven weekly immersive virtual reality sessions plus two booster sessions) or a control intervention of enhanced treatment-as-usual, matched in frequency and duration. Challenge-VRT was co-developed with individuals with lived experience of auditory verbal hallucinations. The primary outcome was clinician-rated auditory verbal hallucination severity measured by the Psychotic Symptoms Rating Scales-Auditory Hallucinations total score (PSYRATS-AH) at 12 weeks post baseline. Secondary outcomes were PSYRATS-AH frequency, PSYRATS-AH-Distress, The Voice Power Differential Scale, the Voices Acceptance and Action Scale, the Assertive Responding to Voices subscale from the Approve–Voices, and the Personal and Social Performance Scale, all at 12 weeks. Analyses followed the intention-to-treat principle and used linear mixed models. This study is registered with <span><span>ClinicalTrials.gov</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>, number <span><span>NCT04661163</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>, and is now completed.<h3>Findings</h3>Between Nov 16, 2020, and June 14, 2023, 399 patients were referred for potential study inclusion, 62 patients were excluded (declined to participate or unable to be contacted), and 337 were assessed for eligibility. Of these, 66 did not meet the inclusion criteria. 271 participants were randomly assigned to Challenge-VRT (n=140) or enhanced treatment-as-","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"19 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144547520","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":"Absolute neutrophil count and adverse drug reaction monitoring during clozapine treatment: consensus guidelines from a global Delphi panel","authors":"Dan Siskind, Korinne Northwood, Toby Pillinger, Sherry Chan, Christoph Correll, Robert O Cotes, Susanna Every-Palmer, Maggie Hahn, Oliver D Howes, John M Kane, Deanna Kelly, Nicole Korman, Julia Lappin, Cristián Mena, Nick Myles, Robert A McCutcheon","doi":"10.1016/s2215-0366(25)00098-7","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00098-7","url":null,"abstract":"Despite its superior effectiveness for treatment-resistant schizophrenia, clozapine has a high burden of adverse drug reactions (ADRs), which require monitoring and treatment. This global Delphi study has established consensus guidelines for absolute neutrophil count (ANC) thresholds for consideration of clozapine cessation and provided monitoring protocols for ADR management. Recommendations include lowering ANC cessation thresholds to 1·0 × 10⁹ cells per L (0·5 × 10⁹ cells per L for Duffy antigen receptor for chemokines-null individuals) and discontinuing routine ANC monitoring after 2 years. Comprehensive ADR monitoring every 3 months should address the metabolic syndrome, constipation, gastro-oesophageal reflux, sialorrhea, nocturnal enuresis, tachycardia, sleep apnoea, sedation, and other ADRs. Consumer representatives underscored the need for shared decision-making, streamlined monitoring, and accessible patient education. Although barriers persist, these findings support updating global policies to reduce burden on patients, enhance adherence, and optimise clinical outcomes. Incorporating evidence-based guidelines into practice could transform clozapine care, balancing safety with practicality to improve the lives of those with treatment-resistant schizophrenia.","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"11 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533881","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 26. https://doi.org/10.1016/S2215-0366(25)00124-5","authors":"","doi":"10.1016/s2215-0366(25)00213-5","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00213-5","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"20 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533861","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":"Non-suicidal self-injury: proposal to shift designation from disorder to a clinical specifier","authors":"Gregory J Lengel, Jennifer J Muehlenkamp, Maria Zetterqvist, Brooke A Ammerman, Amy M Brausch, Jason J Washburn","doi":"10.1016/s2215-0366(25)00169-5","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00169-5","url":null,"abstract":"After strong scientific advocacy from experts in the field, non-suicidal self-injury disorder was listed within the DSM-5 as a condition requiring further study. Over the past decade, numerous studies of the proposed non-suicidal self-injury disorder criteria have called into question their validity and reliability, raising questions regarding the clinical utility of non-suicidal self-injury disorder, and suggesting that the disorder criteria would require extensive diagnostic revision to be viable. The high co-occurrence of non-suicidal self-injury with a variety of other established psychiatric disorders, combined with evidence that few individuals meet criteria for non-suicidal self-injury disorder in the absence of comorbid conditions, suggests that non-suicidal self-injury could be better conceptualised as a transdiagnostic behaviour. As a result of the growing scientific evidence calling into question non-suicidal self-injury disorder as a diagnosis, we are proposing reclassifying non-suicidal self-injury as a clinical specifier. In this Personal View, we outline the rationale for a shift from a disorder to a non-suicidal self-injury specifier, introduce proposed specifier criteria grounded in the scientific literature and lived experience research, and explore potential risks and benefits of a shift to a specifier.","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"64 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144521046","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":"Pramipexole augmentation for the acute phase of treatment-resistant, unipolar depression: a placebo-controlled, double-blind, randomised trial in the UK","authors":"Prof Michael Browning DPhil, Prof Philip J Cowen MD, Ushma Galal MSc, Prof Ashley Baldwin MD, Prof Anthony J Cleare MD, Jonathan Evans MD, Prof Quentin J M Huys MD, Prof David Kessler MD, Micheal Kurkar MD, Neil Nixon MD, Abhinav Rastogi FRCPsych, Stuart Watson MD, Prof Ly-Mee Yu DPhil, Sam Mort PGCert, Prof Judit Simon DPhil, Agata Laszewska PhD, Alexander C Lewis BSc, Sophie M Roberts BSc, Victoria Fiske MBChB, Lisa M Frending MSc, Catherine Money BSc, Beata R Godlewska MD, Howard T Ryland MD, Don Chamith Halahakoon MBChB, Laurence Astill Wright MBChB, Barbara Salas MBBS, Apoorva Peddada MBBS, Mourad Wahba MRCPsych, Katharine S Taylor MBBS, Jess Kerr-Gaffney PhD, Duncan Swiffen MD, Caroline Zangani MD, Katharine A Smith MD, Prof Catherine J Harmer DPhil, Prof John R Geddes MD, PAX-D study group","doi":"10.1016/s2215-0366(25)00194-4","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00194-4","url":null,"abstract":"About 30% of patients with depression treated with antidepressant medication do not respond sufficiently to the first agents used. Pramipexole might usefully augment antidepressant medication in such cases of treatment-resistant depression, but data on its effects and tolerability are scarce. We aimed to assess the efficacy and tolerability of pramipexole augmentation of ongoing antidepressant treatment, over 48 weeks, in patients with treatment-resistant depression.","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"4648 2 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144515628","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: 447–56","authors":"","doi":"10.1016/s2215-0366(25)00211-1","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00211-1","url":null,"abstract":"","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"27 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144515629","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 Psychiatric Genomics Consortium: discoveries and directions","authors":"Prof Arpana Agrawal PhD, Prof Cynthia M Bulik PhD, Prof Dawit Shawel Abebe PhD, Prof Ole A Andreassen MD, Elizabeth G Atkinson PhD, Karmel W Choi PhD, Prof Aiden Corvin MD, Helena L Davies PhD, Prof Lea K Davis PhD, Anna R Docherty PhD, Prof Howard J Edenberg PhD, Prof Barbara Franke PhD, Prof Joel Gelernter MD, Paola Giusti-Rodríguez PhD, Prof John M Hettema MD, Prof Jens Hjerling-Leffler PhD, Hailiang Huang PhD, Emma C Johnson PhD, Prof Cathryn M Lewis PhD, Yi Lu PhD, Mary-Ellen Lynall PhD, Joanna Martin PhD, Prof Andrew M McIntosh MD, Janitza L Montalvo-Ortiz PhD, Niamh Mullins PhD, Prof Caroline M Nievergelt PhD, Kevin S O'Connell PhD, Prof Michael C O'Donovan PhD, Adeniran Okewole MSc, Roseann E Peterson PhD, Prof Danielle Posthuma PhD, Prof Jonathan Sebat PhD, Prof Jordan W Smoller MD, Reeteka Sud PhD, Biju Viswanath MD, Prof James T R Walters PhD, Hyejung Won PhD, Prof Naomi R Wray PhD, Prof Patrick F Sullivan MD, The Coordinating Committee of the Psychiatric Genomics Consortium","doi":"10.1016/s2215-0366(25)00124-5","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00124-5","url":null,"abstract":"Research by the Psychiatric Genomics Consortium (PGC) has advanced the discovery of common and rare genetic variations that contribute to the susceptibility to many psychiatric disorders and neurodevelopmental conditions. This Review reflects on major findings from the past 5 years of research by the PGC in five priority areas: discovery of common variants using genome-wide association studies; rare variation and its interplay with polygenic risk; using genetics to go beyond diagnostic boundaries; ascribing functional attributes to genomic discoveries; and developing and implementing processes for data sharing, outreach to various communities, and training. The insights gained in these domains frame the agenda for the next phase of PGC research. In addition to accelerating integrative findings of common and rare variants within, and across, multiple psychiatric disorders and neurodevelopmental conditions, the next phase will use multiple populations to elucidate genetic causes, integrate results with rapidly accumulating multimodal functional genomics data to gain mechanistic understanding, convert genetic findings to clinically actionable phenotypes, such as treatment response, and address the emerging use of polygenic scores. Together, these next steps will highlight the biological underpinnings of psychiatric disorders and neurodevelopmental conditions, which continue to contribute to global morbidity and mortality.","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"634 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144515631","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":"USAID's mental health work can and must live on","authors":"Jerome T Galea, Abir Aldhalimi, Kathleen O'Donnell Burrows, Maura Reap, Lyla Schwartz, Florence F Fanelli, Wendy Wheaton, Teresa Parr","doi":"10.1016/s2215-0366(25)00198-1","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00198-1","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144479201","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":"Electroconvulsive therapy: reaffirming the case for caution, consent, and rights","authors":"Michelle Funk, Natalie Drew, Soumitra Pathare, Alberto Vasquez Encalada, Peter McGovern, Sarah Price Hancock, John Read","doi":"10.1016/s2215-0366(25)00192-0","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00192-0","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"70 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144371040","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}