Lancet Psychiatry最新文献

{"title":"Long-acting oral weekly risperidone (LYN-005) for schizophrenia in the USA (STARLYNG-1): a multicentre, open-label, non-randomised phase 3 trial","authors":"Leslie Citrome, Nayana Nagaraj, Giovanni Traverso, Todd Dumas, Richard Scranton","doi":"10.1016/s2215-0366(25)00135-x","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00135-x","url":null,"abstract":"<h3>Background</h3>Medication non-adherence and insufficiently managed disease worsen outcomes in people with schizophrenia. We aimed to compare the bioavailability of a long-acting oral weekly formulation of risperidone, LYN-005, with daily oral risperidone at steady state.<h3>Methods</h3>In this open-label, non-randomised, phase 3 trial, clinically stable participants with schizophrenia or schizoaffective disorder were enrolled from five sites across the USA while residing in an inpatient facility for 5 weeks (with the exception of days 9–13). After a 7-day run-in period with immediate-release risperidone (2 mg or 6 mg), participants received five doses of long-acting oral weekly LYN-005 (15 mg or 45 mg, respectively), with a supplemental half dose of daily immediate-release risperidone during week 1. Primary endpoints compared pharmacokinetic parameters of LYN-005 (minimum concentration [C<sub>min</sub>] at weeks 1 and 5, and maximum concentration [C<sub>max</sub>] and average concentration [C<sub>avg</sub>] at week 5) with those of immediate-release risperidone on the last day of the run-in period. Prespecified primary endpoint criteria were geometric mean ratios for C<sub>min</sub> at week 1 and week 5 (90% CI ≥0·8), C<sub>max</sub> at week 5 (90% CI ≤1·25), and C<sub>avg</sub> at week 5 (0·8 ≤90% CI ≤1·4). No people with lived experience were involved in the study design. This study was 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>, <span><span>NCT05779241</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 has been completed.<h3>Findings</h3>Between April 13, 2023 and Dec 1, 2023, 83 participants were enrolled in the study (62 [75%] male and 21 [25%] female; 67 [81%] Black or African American, mean age 49·3 years [SD 11·5]), of whom 47 participants completed the 5-week study. In the pharmacokinetic analysis (n=44), sustained release of the active moiety was observed across all doses of LYN-005. Geometric mean ratios of LYN-005 versus immediate-release risperidone were 1·02 (90% CI 0·93–1·12) for C<sub>min</sub> at week 1, and 1·04 (90% CI 0·87–1·23), 0·84 (0·77–0·92), and 1·03 (0·93–1·13) for C<sub>min</sub>, C<sub>max</sub>, and C<sub>avg</sub>, respectively, at week 5 and met predetermined criteria. In individuals taking LYN-005 (n=67), gastrointestinal treatment-emergent adverse events were most common (44 [66%] participants), with one serious treatment-emergent adverse event reported.<h3>Interpretation</h3>Weekly LYN-005 provided sustained release of risperidone at therapeutic concentrations with similar bioavailability to immediate-release risperidone. Patients re","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"140 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144260497","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-mental health inpatient and emergency care hospital costs associated with four mental disorders in Europe: a modelling study","authors":"Dennis Wienand, Guy M Goodwin, Judit Simon","doi":"10.1016/s2215-0366(25)00138-5","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00138-5","url":null,"abstract":"<h3>Background</h3>The prevalence of physical health conditions is higher among people with mental disorders than the general population, and these conditions have subsequent excess costs. Estimating the magnitude of these excess costs would support better integrated mental and physical health care. The aim of this study was to estimate the excess annual hospital costs of non-mental health related inpatient and emergency care utilisation for four mental disorders in 32 European countries.<h3>Methods</h3>In this modelling study, we obtained data on the working-age population (aged 20–64 years) of 32 European countries from the European Statistical Agency, the 2019 Global Burden of Disease, Injuries, and Risk Factors Study, epidemiological and cost evidence syntheses, and listed country-specific estimates. We estimated the non-mental health inpatient costs and emergency care hospital costs associated with the excess physical health burden of alcohol use disorders, bipolar disorder, depressive disorders, and schizophrenia in purchasing power standard Euros (PPS€) for 2019. Total physical comorbidity hospital costs were calculated by summing attributable non-mental health inpatient and emergency hospital costs across all physical health diagnoses by ICD-10 category for each mental disorder in all countries. Excess costs represent the proportion of total costs that were attributable to the excess physical health burden. People with lived experiences informed the original project plans.<h3>Findings</h3>In 2019, there were 312·5 million people of working age across 32 European countries. Total annual non-mental health inpatient and emergency care hospital costs were PPS€20·3 billion for alcohol use disorders, PPS€6·7 billion for bipolar disorder, PPS€26·5 billion for depressive disorders, and PPS€1·8 billion for schizophrenia, with considerable variation observed among countries. The proportion of excess costs were 59·4% (PPS€12·1 billion) for alcohol use disorder, 56·7% (PPS€3·8 billion) for bipolar disorder, 52·7% (PPS€14·0 billion) for depressive disorders, and 35·6% (PPS€0·7 billion) for schizophrenia.<h3>Interpretation</h3>These first comprehensive European estimates indicate that non-mental health inpatient and emergency care hospital costs contributed substantially to the total costs associated with four mental disorders. The excess costs equated to 1·8% of the included countries’ overall health-care expenditure and 0·16% of their gross domestic products. Estimates are conservative because they are limited to diagnosed mental disorders prevalent among working-age adults. A 1·0% reduction in the excess physical health burden of these mental disorders could lead to annual savings of more than PPS€190 million in non-mental health hospital costs in Europe.<h3>Funding</h3>European College of Neuropsychopharmacology.","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"65 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144260498","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":"Lithium as a disease-modifying drug for bipolar disorder","authors":"Robert M Post, Victor W Li, Michael Berk, Lakshmi N Yatham","doi":"10.1016/s2215-0366(25)00097-5","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00097-5","url":null,"abstract":"Lithium is a classic, primary treatment for bipolar disorder that has paradoxically been used less over time, especially in North America, which goes against the accumulating evidence for its efficacy. Bipolar disorder is increasingly conceptualised as a chronic, potentially progressive condition worsened and accelerated by each mood episode, which might resemble multiple sclerosis or rheumatoid arthritis as a condition that requires disease-modifying treatments to change illness trajectory. In this Personal View, we argue that lithium acts like a disease-modifying drug in bipolar disorder. Although the pathophysiology of bipolar disorder remains unclear, many of the mechanisms implicated in bipolar disorder, and the surrogate markers associated with this condition, are uniquely affected by lithium treatment from the DNA and cellular levels to the structure and function of the brain and other body systems. Clinical trial and cohort study evidence shows that lithium is effective and probably superior to other medications used to treat bipolar disorder, and that long-term outcomes are better with lithium than non-lithium regimens. Conceptualisation of lithium as a disease-modifying agent might help to increase clinical use by doctors, especially early in the disease course to better serve our patients.","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"2 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144252611","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":"Pain and suicide risk: a blind spot in psychiatric assessment","authors":"Nilson N Mendes Neto, Marcelo Zacarkim, Jessika M Mendes","doi":"10.1016/s2215-0366(25)00160-9","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00160-9","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"33 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228695","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":"Autism in schizophrenia and its original link to self-disorder: returning a borrowed concept","authors":"Mads Gram Henriksen, Kasper Møller Nielsen, Laurent Mottron, Julie Nordgaard","doi":"10.1016/s2215-0366(25)00132-4","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00132-4","url":null,"abstract":"Autism was introduced by Eugen Bleuler in 1910 as a defining feature of schizophrenia, and it remained so for 80 years. However, the concept was borrowed by Leo Kanner and Hans Asperger to describe another condition (infantile autism) and eventually awareness of autistic features in schizophrenia declined. Today, autistic features are by default considered indicative of autism spectrum disorder, and patients with schizophrenia, who exhibit autistic features, risk being misdiagnosed with autism spectrum disorder and receiving inadequate treatment. To aid differential diagnosis and treatment, it is important to rediscover what autism in schizophrenia is, and how it differs from autism spectrum disorder. We present a reading of the seminal works that shaped the understanding of autism in schizophrenia and extract four key insights: autistic features are common in schizophrenia; autistic features are found both in behaviours and experiences; autism in schizophrenia can be defined as a frail immersion in the lifeworld, manifesting as a pervasive inability to take for granted what others consider matter of fact; and autism is hypothesised to be caused by self-disorder. Contemporary psychopathological research corroborates the idea that autism is caused by self-disorder, a concept that could substantially aid differential diagnostic resources.","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"100 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144211306","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":"Values and preferences regarding the health sector response to interpersonal violence against transgender and gender-diverse individuals: a systematic review","authors":"Rose Pollard Kaptchuk, Katrina S Kennedy, Brooke Wong, Ping Teresa Yeh, Erin E Cooney, Caitlin Kennedy","doi":"10.1016/s2215-0366(25)00091-4","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00091-4","url":null,"abstract":"Transgender and gender-diverse (TGD) people are disproportionately affected by interpersonal violence and face barriers to accessing post-violence health services globally. Post-violence care guidelines are broadly applicable, but specific considerations for TGD individuals have not been synthesised. In this systematic review, we synthesise the values and preferences of TGD adults and health providers related to post-violence health services. We searched PubMed, Embase, CINAHL, Cochrane Central, LILACS, and PsycINFO for qualitative and quantitative studies reporting on values and preferences related to health services received or sought by TGD adults following interpersonal violence published between Jan 1, 2013, and March 31, 2024. We qualitatively summarised findings by study design, location, and population, and we provided confidence ratings using GRADE CERQual. We included 16 studies reporting data from ten countries. Themes included health provider education, quality of care, inclusive advertising, TGD-inclusive policies and service environments, representation of TGD individuals within service roles, dedicated services, cross-sectoral health navigation and coordination, mental health care, and accessibility of post-violence health-care locations. Health provider training, gender-affirming policies and practices, and inclusive environments can increase access and enhance effectiveness of post-violence health services for TGD individuals. Tailored guidelines for post-violence care provision to TGD people are needed to ensure equitable access globally.","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"4 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201505","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: 355–65","authors":"","doi":"10.1016/s2215-0366(25)00171-3","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00171-3","url":null,"abstract":"<em>Farhat LC, Lannes A, Del Giovane C, et al. Comparative cardiovascular safety of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis.</em> Lancet Psychiatry <em>2025;</em> 12: <em>355–65</em>—In this Article, the spelling of the name Anneka Tomlinson was incorrect. This correction has been made to the online version as of May 29, 2025.","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"26 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176726","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":"Political abuse in psychiatry: avoid repeating history","authors":"CheyAnne Olivia Rivera","doi":"10.1016/s2215-0366(25)00141-5","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00141-5","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"5 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144165594","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":"Suicide decriminalisation in the United Arab Emirates","authors":"Sumaya Al Marzooqi, Mark Mohan Kaggwa, Adel El Sheikh, Amani Ahmed Ibrahim, Gary Andrew Chaimowitz, Andrew Toyin Olagunju","doi":"10.1016/s2215-0366(25)00140-3","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00140-3","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"18 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144130263","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: 410–20","authors":"","doi":"10.1016/s2215-0366(25)00165-8","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00165-8","url":null,"abstract":"<em>Horsdal HT, Albiñana C, Zhu Z, et al. Convergent evidence linking neonatal vitamin D status and risk of neurodevelopmental disorders: a Danish case-cohort study.</em> Lancet Psychiatry 2025; 12: <em>410–20</em>—In this Article, Prof P B Mortensen's degree should read DrMedSc; the second sentence of the Findings subsection in the Summary and the second sentence of the Results section, should end “...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 had DBP measurements.”; the first sentence of the Measures subsection in the Methods section, should read “The genotypes and 25(OH)D and DBP concentrations were assessed in neonatal dried blood spots, taken as part of routine screening at birth from all babies born in Denmark since 1981.²⁰”; and the last sentence of the Acknowledgments should read “We acknowledge the input of the late David M Hougaard, and the late Bent Nørgaard Pedersen.” These corrections have been made to the online version as of May 22, 2025.","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"10 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144122684","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}