Lancet Psychiatry最新文献

{"title":"Ensuring inclusive mental health care for deaf patients","authors":"","doi":"10.1016/s2215-0366(26)00066-0","DOIUrl":"https://doi.org/10.1016/s2215-0366(26)00066-0","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"7 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489339","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":"Association between GLP-1 receptor agonist use and worsening mental illness in people with depression and anxiety in Sweden: a national cohort study","authors":"Heidi Taipale, Mark Taylor, Markku Lähteenvuo, Ellenor Mittendorfer-Rutz, Antti Tanskanen, Jari Tiihonen","doi":"10.1016/s2215-0366(26)00014-3","DOIUrl":"https://doi.org/10.1016/s2215-0366(26)00014-3","url":null,"abstract":"<h3>Background</h3>People with diabetes have an elevated risk of developing depression, anxiety, and suicide. GLP-1 receptor agonists are licensed to treat diabetes and obesity, but data on whether these medications alleviate or exacerbate anxiety, depression, and self-harm are mixed. We studied the risk of worsening mental illness in people already diagnosed with depression, anxiety, or both who were prescribed antidiabetic medications including GLP-1 receptor agonists.<h3>Methods</h3>The study cohort, identified from national Swedish electronic health registers, included people with a diagnosis of depression or anxiety disorder who used any antidiabetic medication between the years 2009 and 2022. GLP-1 receptor agonists, individually and as a group, were compared with non-use of GLP-1 receptor agonists and directly with other second-line antidiabetic medications. A within-individual design was used for all comparisons to reduce confounding, comparing periods of use versus periods of non-use of a medication in the same individual. The primary outcome was worsening of mental illness, defined as a composite of psychiatric hospitalisation; sick leave from work for more than 14 days for psychiatric reasons; hospitalisation due to self-harm; or death by suicide. Secondary outcomes were worsening of depression or anxiety, analysed separately, worsening of substance use disorder, and self-harm. Within-individual stratified Cox models with adjusted hazard ratios (aHRs) and 95% CIs were used. A person with related lived experience was involved in the design and write-up of this study.<h3>Findings</h3>The cohort included 95 490 people (56 976 [59·7%] female and 38 514 [40·3%] male) with a mean age of 50·6 years (SD 12·3). Ethnicity data were not available. GLP-1 receptor agonists were used by 22 480 individuals during the follow-up period. Compared with non-use of GLP-1 receptor agonists, semaglutide (aHR 0·58 [95% CI 0·51–0·65]) and liraglutide (0·82 [0·76–0·89]) were associated with lower risk of worsening mental illness, whereas exenatide (1·01 [0·69–1·46]) and dulaglutide (1·01 [0·85–1·20]) were not. Semaglutide was associated with a decreased risk of worsening depression (0·56 [0·44–0·71]), of worsening anxiety (0·62 [0·52–0·73]), and of worsening substance use disorder (0·53 [0·35–0·80]). Liraglutide was associated only with lower risk of worsening depression (0·74 [0·64–0·87]). GLP-1 receptor agonists as a group were associated with a reduced risk of self-harm (0·56 [0·34–0·92]).<h3>Interpretation</h3>For anxiety and depression that co-occur with diabetes and obesity, semaglutide and, to a lesser extent, liraglutide might be useful dually effective therapeutic options. Randomised controlled trials evaluating these findings are warranted.<h3>Funding</h3>Sigrid Jusélius Foundation, Jane and Aatos Erkko Foundation, and Finnish Ministry of Social Affairs and Health.","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"12 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489342","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":"Anticipating psychiatric disorders without neglecting social determinants","authors":"Jude Mary Cénat","doi":"10.1016/s2215-0366(26)00035-0","DOIUrl":"https://doi.org/10.1016/s2215-0366(26)00035-0","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"17 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489340","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":"Effectiveness of the Systems Analysis and Improvement Approach to optimise outpatient mental, neurological, and substance-use disorder treatment cascades in Mozambique: a cluster-randomised trial","authors":"Vasco F J Cumbe, Alberto Muanido, Morgan Turner, João Nhalimue Jala, Ernesto Eusébio Armando, Flávia Faduque, Ernesto Rodrigo Xerinda, Kenneth Sherr, Brian P Flaherty, Monisha Sharma, Bradley H Wagenaar","doi":"10.1016/s2215-0366(26)00034-9","DOIUrl":"https://doi.org/10.1016/s2215-0366(26)00034-9","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;To our knowledge, there are no evidence-based implementation strategies for care cascade optimisation of mental, neurological, and substance use (MNS) disorder treatment in low-income and middle-income countries. This trial evaluated the effectiveness of the Systems Analysis and Improvement Approach for Mental Health (SAIA-MH) implementation strategy to improve MNS disorder care cascade outcomes in Mozambique.&lt;h3&gt;Methods&lt;/h3&gt;We conducted a 3-year, cluster-randomised trial comparing an 8-month baseline period with a 2-year implementation period. All patients diagnosed with MNS disorders across government facilities in Mozambique were eligible. Eligible facilities were required to be naive to the SAIA-MH implementation strategy; currently providing MNS disorder services including prescribing medication; within a 3-h one-way drive from Chimoio City, Manica or Beira City, Sofala; have at least one psychiatric technician and one psychologist currently practising; and have at least 100 annual outpatient MNS disorder visits during 2020–21. Facilities were allocated to the SAIA-MH intervention or attentional placebo control (1:1) using constrained randomisation. Statistical analysts were masked during initial primary outcome assessment. The SAIA-MH strategy combines external facilitation, clinical consultation, and provider team meetings with system-engineering tools in a continuous quality improvement framework. The primary outcome was a combination of low functional impairment or functional improvement measured using the WHODAS 2.0. Secondary outcomes were medication adherence and appointment attendance. We involved people with related lived experience in all elements of the research and writing process. The study was registered at &lt;span&gt;&lt;span&gt;Clinicaltrials.gov&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;, &lt;span&gt;&lt;span&gt;NCT05103033&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;, and is completed.&lt;h3&gt;Findings&lt;/h3&gt;Between Feb 4, 2022, and Oct 14, 2024, 3837 patients with MNS disorders (2153 in the intervention group and 1684 in the control group) attended 33 055 outpatient visits across 16 government facilities in Mozambique (eight intervention; eight attentional placebo control). The mean age was 26·0 years (SD 15·4; range 0–103), 2038 (53·1%) were male and 1800 (46·9%) were female, and 2581 (67·3%) were diagnosed with epilepsy. Ethnicity data were not collected. 966 patients in the intervention group (with 7697 visits) and 785 in the control group (with 3804 visits) who had their first visit during the study period, who completed the WHODAS 2.0 measurement at that visit, and who were aged 15 years or older, w","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"12 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489341","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 role of male community health workers in global mental health services.","authors":"Zarmeen Shakil,Felix Teufel,Aisha Khizar Yousafzai","doi":"10.1016/s2215-0366(26)00062-3","DOIUrl":"https://doi.org/10.1016/s2215-0366(26)00062-3","url":null,"abstract":"","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"59 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147490053","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 efficacy and safety of cannabinoids for the treatment of mental disorders and substance use disorders: a systematic review and meta-analysis","authors":"Jack Wilson, Olivia Dobson, Andrew Langcake, Palkesh Mishra, Zachary Bryant, Janni Leung, Danielle Dawson, Myfanwy Graham, Maree Teesson, Tom P Freeman, Wayne Hall, Gary C K Chan, Emily Stockings","doi":"10.1016/s2215-0366(26)00015-5","DOIUrl":"https://doi.org/10.1016/s2215-0366(26)00015-5","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;Mental disorders and substance use disorders (SUDs) are among the leading reasons for which the medical use of cannabinoids has been approved, but their efficacy and safety in treating these conditions is yet to be established. We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) testing the efficacy and safety of cannabinoids as the primary treatment for mental disorders or SUDs.&lt;h3&gt;Methods&lt;/h3&gt;We searched Ovid MEDLINE, PsychINFO, Cochrane Central Register of Controlled Clinical Trials, Cochrane Database of Systematic Reviews, and Embase for peer-reviewed articles published between Jan 1, 1980, and May 13, 2025, evaluating the efficacy of cannabinoids in reducing or treating mental disorders and SUDs as the primary indication. Primary outcomes were remission of disorder or reduction in disorder symptoms. Safety was assessed via synthesis of all-cause and serious adverse events, which was used to calculate the number needed to treat to harm (NNTH). Two independent reviewers screened all studies and performed data extraction. Evidence was synthesised as odds ratios (ORs) for dichotomous measures and standardised mean differences (SMDs) for continuous measures, via random-effects meta-analysis in Review Manager, version 5.4. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias 2.0 tool. We evaluated the quality of the primary outcomes using the GRADE framework. The study was registered with PROSPERO (CRD42023392718).&lt;h3&gt;Findings&lt;/h3&gt;54 trials were identified for inclusion (2477 participants; 1713 [69%] males, 764 [31%] females; median age 33·3 years [IQR 28·1–38·05; ethnicity data not available). 24 (44%) of these trials had a high risk of bias, and the certainty of evidence for most outcomes was low. Our meta-analysis revealed that a combination of cannabidiol and delta-9-tetrahydrocannabinol reduced cannabis withdrawal symptoms (SMD –0·29, 95% CI –0·57 to –0·02) and weekly grams of cannabis use (–1·00, –1·69 to –0·30) among those with cannabis use disorder, and a reduction in tic severity among those with tic or Tourette's Syndrome (–0·68, –1·03 to –0·34) compared with placebo. Any cannabinoid type led to an increase in sleep time as recorded by an electronic device (0·54, 0·14 to 0·95) and sleep diary (0·55, 0·01 to 1·09) among those with insomnia. There was a reduction in autistic traits (–0·36, –0·66 to –0·07) among those with autism spectrum disorder. Cannabinoids led to an increase in cocaine craving among those with cocaine use disorder (0·69, 0·22 to 1·15) compared with placebo. There were no significant effects on outcomes associated with anxiety, anorexia nervosa, psychotic disorders, post-traumatic stress disorder, and opioid use disorder. There were insufficient data to meta-analyse studies of ADHD, bipolar disorder, obsessive-compulsive disorder, and tobacco use disorder. There was an absence of RCT evidence for the treatment of depression. Meta-analysis reveal","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"11 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147471134","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":"Community-led visions of care for better mental health","authors":"Rochelle A Burgess, Chika Nwaka, June Larrieta, Maurice Biriotti, Anna Kydd","doi":"10.1016/s2215-0366(26)00026-x","DOIUrl":"https://doi.org/10.1016/s2215-0366(26)00026-x","url":null,"abstract":"","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147448381","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":"Lived experience perspectives on the development of a Psychosis Metabolic Risk Calculator (PsyMetRiC)","authors":"Sunniva Haynes, Carina Andrews, Ashley Nsimbi, Shizana Arshad, Annabel E L Walsh","doi":"10.1016/s2215-0366(26)00032-5","DOIUrl":"https://doi.org/10.1016/s2215-0366(26)00032-5","url":null,"abstract":"","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"105 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147447168","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":"Cardiometabolic prediction models for young people with psychosis spectrum disorders in the UK (PsyMetRiC 2.0): a retrospective, multicohort clinical prediction model study","authors":"Benjamin I Perry, Emanuele F Osimo, Shuqing Si, Karla V B Hitchins, Clara Lewis, Ben Laws, Simon J Griffin, Golam M Khandaker, Graham K Murray, David Shiers, Carolyn A Chew-Graham, Peter B Jones, Alastair K Denniston, Marco Bardus, Sue Jowett, Annabel E L Walsh, Shizana Arshad, Tomas Formanek, Toby Pillinger, Robert A McCutcheon, Gerardo A Zavala","doi":"10.1016/s2215-0366(25)00398-0","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00398-0","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;Young people with psychosis spectrum disorders are at a high risk of cardiometabolic morbidity and subsequent premature mortality, but there are no accurate clinic-ready prediction models for this group. We aimed to collaboratively refine, extend, and validate the Psychosis Metabolic Risk Calculator (PsyMetRiC) prediction models for accuracy, clinical usefulness, and acceptability, and to translate the models into a regulated, clinically available medical device.&lt;h3&gt;Methods&lt;/h3&gt;In this retrospective, multicohort clinical prediction model study, we used primary care (Clinical Practice Research Datalink and QResearch) and secondary care (South London and Maudsley NHS Foundation Trust) datasets. Individuals from primary care sources were aged 16–35 years when they received a first recorded diagnosis of a psychosis-spectrum disorder between Jan 1, 2005, and Dec 31, 2015, with follow-up to Dec 31, 2020. Individuals from the secondary care source were enrolled in the psychosis early intervention service between Jan 1, 2012, and Dec 31, 2024. We developed models for a binary outcome of metabolic syndrome within 1–6 years using logistic regression; a time-to-event outcome of type 2 diabetes within 10 years using Weibull regression; and a binary outcome of clinically significant weight gain within 1 year using logistic regression. We revised existing predictors (hereafter referred to as the PsyMetRiC1 models) for finer detail and added new predictors: a family history of cardiometabolic disorder, antidepressant prescription, systolic blood pressure, and HbA&lt;sub&gt;1C&lt;/sub&gt; (hereafter PsyMetRiC2 models). Refinement and external validation were performed for metabolic syndrome models (PsyMetRiC1-MetS and PsyMetRiC2-MetS), and development and external validation were performed for the type 2 diabetes model (PsyMetRiC2-T2D). Development and internal validation were performed for the clinically significant weight gain model (PsyMetRiC2-WG), but external validation was not possible due to data availability. Partial versions without biochemical results were also developed for weight gain and metabolic syndrome models. We involved stakeholders including people with lived experience; and implemented the models in a web application compliant with regulatory standards in Great Britain.&lt;h3&gt;Findings&lt;/h3&gt;In total, we included 25 850 individuals (male, n=13 614 [52·7%]; female, n=12 236 [47·3%]; White European, 16 445 [63·6%]; Black African or Caribbean, south Asian, mixed, and east Asian or other n=9405 [36·3%]; and mean age 26·7 years [SD=5·4]). For primary care, we included 3989 individuals for development and 4347 individuals for external validation of metabolic syndrome outcomes; and 9181 individuals for development and 7487 individuals for external validation of type 2 diabetes outcomes. For secondary care, we included 846 individuals for development and internal validation of weight gain outcomes. For metabolic syndrome, the performance of PsyMetR","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"53 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147439901","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":"Stigmatising language in research and clinical care for body-focused repetitive behaviours","authors":"Polly Waite, Bridget Bradley, Clare E Mackay","doi":"10.1016/s2215-0366(26)00063-5","DOIUrl":"https://doi.org/10.1016/s2215-0366(26)00063-5","url":null,"abstract":"","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"44 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147392478","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}