Lancet Psychiatry最新文献

{"title":"Managing psychiatric emergencies in Gaza with a destroyed psychiatric hospital","authors":"Abd-Elrahman Zakaria Abu-Rokba, Faten Mahmoud Alnemer, Mai Zaki Abdelal, Safaa Walid Shaqura","doi":"10.1016/s2215-0366(25)00335-9","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00335-9","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"44 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145455296","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 global epidemiology of personality disorder: a systematic review and meta-regression","authors":"Jamileh Shadid, Alize J Ferrari, Bo Bach, Martin Sellbom, Carla Sharp, Joost Hutsebaut, Delfine d'Huart, Damian F Santomauro, Andrew Chanen","doi":"10.1016/s2215-0366(25)00299-8","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00299-8","url":null,"abstract":"<h3>Background</h3>Personality disorder is a persistent and pervasive mental disorder, defined as an enduring pattern of inner experience and behaviour that deviates markedly from the expectations of an individual's culture, but it remains under-recognised in global mental health estimates. To our knowledge, no comprehensive synthesis has quantified the global prevalence, mortality, or diagnostic stability of personality disorder using population-representative data. We aimed to address these gaps to support future burden of disease modelling.<h3>Methods</h3>We conducted a systematic review and meta-regression of population-based surveys following PRISMA and GATHER guidelines. Eligible studies were cross-sectional or longitudinal studies published in peer-reviewed journals that reported prevalence or mortality associated with any personality disorder using DSM or ICD diagnostic criteria on representative samples. Personality disorder encompassed paranoid, schizoid, schizotypal, antisocial, borderline, histrionic, narcissistic, avoidant, dependent, obsessive-compulsive, and other specified and unspecified personality disorders. Studies using self-report instruments and non-representative samples (eg, clinical, incarcerated, or university populations) were excluded. Studies were identified through systematic searches in PubMed, Embase, and PsycINFO from Jan 1, 1980, to Feb 13, 2024. Studies were reviewed (by JS and a research assistant), and eligible data were extracted by JS. All data were non-identifiable and pre-aggregated from existing sources. Study quality was assessed using Joanna Briggs Institute critical appraisal tools. Due to data availability, we did two separate meta-regression analyses to estimate the prevalence and standardised mortality ratios associated with personality disorder, and a descriptive analysis to examine diagnostic stability. Between-study heterogeneity was assessed using the <em>I</em><sup>2</sup> statistic. Meta-regression models assessed the effect of study-level covariates. Members of our authorship team have lived personal experience with mental disorders, but we did not consult individuals diagnosed with personality disorder for this work. The study is registered with PROSPERO, CRD42021269169.<h3>Findings</h3>We identified 60 studies across 28 countries. Prevalence analyses included 139 373 individuals, and mortality analyses included 392 420 individuals with a personality disorder. Between-study heterogeneity was high for prevalence (<em>I</em><sup>2</sup>=98·8%) and mortality (<em>I</em><sup>2</sup>=99·4%). Study quality assessment indicated that 59 studies were of high quality, with only one study of moderate quality. Pooled prevalence of any personality disorder ranged from 4·1% (95% uncertainty interval [UI] 2·8–6·0) in low-income and middle-income countries to 5·2% (3·7–7·3) in high-income countries for mid-age 43 years. Prevalence was found to be higher among male individuals (compared with female individu","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145434576","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":"Transdiagnostic effectiveness and safety of clozapine in individuals with psychotic, affective, and personality disorders: nationwide and meta-analytic comparisons with other antipsychotics","authors":"Jurjen J Luykx, Mark Colgan, Eduard Vieta, Aleksi Hamina, Peter F J Schulte, Christoph U Correll, Ellenor Mittendorfer-Rutz, Dan Siskind, Johannes Lieslehto, Antti Tanskanen, Jari Tiihonen, Heidi Taipale","doi":"10.1016/s2215-0366(25)00297-4","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00297-4","url":null,"abstract":"<h3>Background</h3>Pharmacotherapy with clozapine is listed as an optional treatment for several psychiatric disorders in guidelines across the globe. Nonetheless, its transdiagnostic effectiveness across most psychiatric disorders remains uncertain due to scant evidence. We therefore aimed to assess the effectiveness and safety of clozapine across multiple psychiatric disorders.<h3>Methods</h3>This cohort study used nationwide register-based data from Finland and Sweden in individuals aged 16 years or older diagnosed with schizophrenia, schizoaffective disorder, delusional disorder, bipolar disorder, psychotic depression, major depressive disorder, and borderline personality disorder (BPD). The effectiveness of clozapine was compared with other oral antipsychotics as a group, and for bipolar disorder additionally against mood stabilisers. The primary outcome was all-cause psychiatric hospitalisation. Secondary outcomes were all-cause hospitalisation or mortality as a composite outcome, all-cause discontinuation (for which clozapine use was compared with olanzapine use), and disorder-specific hospitalisations (eg, hospitalisation due to psychosis for schizophrenia-spectrum disorders and hospitalisation due to mood episodes for affective disorders). A within-individual design was used, where each patient served as their own control, minimising selection bias. Data were analysed separately in each country and combined using meta-analytical methods. People with lived experience were not involved in the research and writing process.<h3>Findings</h3>The study population included 505 474 individuals, of whom 283 809 (56·1%) were women and 221 665 (43·9%) were men, with a mean age of 41·6 years (SD 4·4). Data on ethnicity were unavailable. Altogether, clozapine was used by 19 910 individuals. Parsed by disorder, clozapine was used by 12·2–18·7% (n=5258 in Sweden, 10 115 in Finland) of people with schizophrenia, 8·8–20·7% (n=1131, n=1591) with schizoaffective disorder, 1·8% (n=341; data only available in Sweden) with delusional disorder, 0·5% (n=118, n=331) with major depressive disorder, 0·5–0·6% (n=490, n=371) with bipolar disorder, 0·3–0·6% (n=39, n=111) with psychotic depression, and 0·3% (n=36; data only available in Sweden) with BPD. Clozapine use was associated with reduced psychiatric hospitalisation risks versus other oral antipsychotics in all disorders, except for BPD. The greatest reductions were observed in schizophrenia (meta-analysis of adjusted hazard ratios [maHR] 0·70 [95% CI 0·67–0·72]) and schizoaffective disorder (maHR 0·71 [0·67–0·74]), followed by delusional disorder (adjusted hazard ratio 0·73 [0·60–0·89]), major depressive disorder (maHR 0·74 [0·66–0·84]), psychotic depression (maHR 0·76 [0·61–0·96]), and bipolar disorder (maHR 0·77 [0·69–0·87]). Moreover, we found no evidence of increased all-cause hospitalisation or mortality risks associated with clozapine use for all disorders examined. Furthermore, for all disorders studied ","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"156 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145428156","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":"Clozapine: superior yet underused","authors":"Tom Bschor","doi":"10.1016/s2215-0366(25)00326-8","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00326-8","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"89 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145428157","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":"Ketamine versus ECT for major depression: flawed evidence base.","authors":"Richard Braithwaite,Ana Jelovac,Charles H Kellner,Alexander Sartorius,Pascal Sienaert,Declan M McLoughlin","doi":"10.1016/s2215-0366(25)00300-1","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00300-1","url":null,"abstract":"","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"109 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369487","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":"Psychotic symptoms during pharmacological treatment of ADHD: clinical considerations and research needs","authors":"Samuele Cortese, Miguel Garcia-Argibay, Dominic Oliver, Zheng Chang, Luis C Farhat, Michael H Bloch, Gonzalo Salazar de Pablo, Henrik Larsson, Marco Solmi, Christoph U Correll, Paolo Fusar-Poli","doi":"10.1016/s2215-0366(25)00248-2","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00248-2","url":null,"abstract":"In this Personal View, we address key questions to support evidence-based prevention and management of psychotic symptoms that might occur during ADHD pharmacotherapy. We begin by examining evidence showing a significantly increased occurrence of psychotic disorders in individuals with ADHD, independent of ADHD medications (pooled relative risk, odds ratio, or hazard ratio=4·74, 95% CI 4·11–5·46). We then examine whether ADHD medications play a causal role, noting that current evidence does not support such a causal link, at least for methylphenidate. We explore how vulnerability to psychosis varies across individuals with ADHD. Regarding the different steps involved in prescribing ADHD medications, we discuss the importance of balancing potential risks—such as emergence of psychotic symptoms—against the demonstrated benefits of pharmacological treatment for ADHD. Next, we present strategies for screening individuals for vulnerability to psychosis before initiating ADHD medication. We then offer guidance on the clinical management of psychotic symptoms that might arise during ADHD pharmacotherapy, including considerations of dosage and medication type. Finally, we identify key research priorities in this area. Overall, this paper provides an empirical framework, grounded in evidence and clinical practice, to guide the next steps in the field.","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"45 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314673","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":"Anti-inflammatories for depression: challenges and ASPIRations","authors":"Courtney Worrell, Bernhard T Baune, Francesco Benedetti, Annamaria Cattaneo, Livia De Picker, Jennifer C Felger, Stefan M Gold, Femke Lamers, Marion Leboyer, Giulia Lombardo, Fanni-Laura Mäntylä, Andrew H Miller, Valeria Mondelli, Brenda W J H Penninx, Luca Sforzini, Dan J Stein, Benedetta Vai, Erik Van der Eycken, Anthony Woods, Carmine M Pariante, Joël Zwiep","doi":"10.1016/s2215-0366(25)00308-6","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00308-6","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"2 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314675","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 prevalence and estimated burden of somatoform disorders: a systematic review and meta-analysis of their epidemiology","authors":"Emma Johanne Poulsen Siig, Viktoria-Maria Hvidtfelt Lykke, Ana Maria Mantilla Herrera, Terese Sara Høj Jørgensen, Alize J Ferrari, Damian F Santomauro","doi":"10.1016/s2215-0366(25)00272-x","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00272-x","url":null,"abstract":"<h3>Background</h3>Somatoform disorders have adverse health impacts but are excluded from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). This study aimed to present a proof of concept for quantifying the global prevalence and health burden of somatoform disorders measured in years of life with disability (YLDs).<h3>Methods</h3>We conducted a systematic review and meta-analysis estimating the global prevalence and burden of somatoform disorders. We searched PsycINFO, Embase, and PubMed for epidemiological surveys of the general population, published between Jan 1, 1980, and Feb 19, 2024, and adhering to definitions from the DSM or the ICD. Meta-regressions pooled prevalence for subtypes of somatoform disorders and their aggregate, while testing sources of variation in the data. Pooled adjusted prevalence estimates for the aggregate of somatoform disorders were combined with GBD disability weights to estimate YLDs. Authors of this paper have lived experience perspectives in mental disorders but individuals diagnosed with somatoform disorders were not consulted for this work. This study is registered with PROSPERO, CRD42024517736.<h3>Findings</h3>We included 41 studies, from 23 countries, mostly covering the GBD high-income super-region. There were 122 153 individuals (mean age 46·3 years, range 11–99 years). The proportion of female participants ranged from 37·5% to 66·4% in studies reporting sex-disaggregated data. Disaggregations by ethnicity were not available. The pooled prevalence of somatoform disorders was 4·6% (95% CI 3·1–7·0). Prevalence among females (7·7% [5·1–11·5]) was significantly higher than among males (2·8% [1·8–4·3], p&lt;0·0001). The prevalence across subtypes of somatoform disorders varied by age and sex depending on the disorder. YLDs were estimated at 662·4 (350·2–974·6) per 100 000 person-years, suggesting somatoform disorders could be the second most burdensome mental disorder globally compared against mental disorders from GBD 2021.<h3>Interpretation</h3>Somatoform disorders are common and disabling disorders that warrant further consideration within future GBD studies, and more broadly within mental health planning and response. More effort is required to accumulate data from low-income and middle-income countries and explore temporal trends in the prevalence of somatoform disorders.<h3>Funding</h3>University of Copenhagen, Queensland Health, and University of Queensland.","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"84 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145295133","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":"Hyperemesis gravidarum, perinatal depression, and the need for integrated maternal and infant care","authors":"Lisa Vitte, Emmanuel Devouche, Gisele Apter","doi":"10.1016/s2215-0366(25)00303-7","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00303-7","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"54 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145288729","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":"Theresa Miskimen Rivera: taking her seat at the APA with Latina spirit","authors":"Jules Morgan","doi":"10.1016/s2215-0366(25)00310-4","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00310-4","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"85 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145288731","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}