Lancet PsychiatryPub Date : 2025-02-18DOI: 10.1016/s2215-0366(25)00029-x
{"title":"Thanks to our peer reviewers for 2024","authors":"","doi":"10.1016/s2215-0366(25)00029-x","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00029-x","url":null,"abstract":"Every year, the editorial team at <em>The Lancet Psychiatry</em> relies on expert advice from hundreds of peer reviewers, for which we are always grateful. Our reviewers provide constructive, helpful guidance, for us as editors and for our authors. Several of our reviewers also bring their expertise as people with lived experience of a mental disorder and we are especially grateful for the insight they offer.","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"11 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443142","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}
Lancet PsychiatryPub Date : 2025-02-18DOI: 10.1016/s2215-0366(25)00006-9
Orestis Zavlis, Peter Fonagy, Patrick Luyten
{"title":"The most important aims of psychotherapy: to love, to work, and to find meaning","authors":"Orestis Zavlis, Peter Fonagy, Patrick Luyten","doi":"10.1016/s2215-0366(25)00006-9","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00006-9","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"12 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443394","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}
Lancet PsychiatryPub Date : 2025-02-18DOI: 10.1016/s2215-0366(25)00027-6
Satish Suhas
{"title":"India needs a national social media policy for children, adolescents, and young adults","authors":"Satish Suhas","doi":"10.1016/s2215-0366(25)00027-6","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00027-6","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"31 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443396","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}
Lancet PsychiatryPub Date : 2025-02-18DOI: 10.1016/s2215-0366(24)00445-0
Peter Fonagy, Elizabeth Simes, Karen Yirmiya, James Wason, Barbara Barrett, Alison Frater, Angus Cameron, Stephen Butler, Zoe Hoare, Mary McMurran, Paul Moran, Mike Crawford, Stephen Pilling, Elizabeth Allison, Jessica Yakeley, Anthony Bateman
{"title":"Mentalisation-based treatment for antisocial personality disorder in males convicted of an offence on community probation in England and Wales (Mentalization for Offending Adult Males, MOAM): a multicentre, assessor-blinded, randomised controlled trial","authors":"Peter Fonagy, Elizabeth Simes, Karen Yirmiya, James Wason, Barbara Barrett, Alison Frater, Angus Cameron, Stephen Butler, Zoe Hoare, Mary McMurran, Paul Moran, Mike Crawford, Stephen Pilling, Elizabeth Allison, Jessica Yakeley, Anthony Bateman","doi":"10.1016/s2215-0366(24)00445-0","DOIUrl":"https://doi.org/10.1016/s2215-0366(24)00445-0","url":null,"abstract":"<h3>Background</h3>Antisocial personality disorder is a major health and social problem, but scepticism about its treatability has restricted development of the evidence base for psychological treatments. Mentalisation-based treatment (MBT) tailored for antisocial personality disorder (MBT-ASPD) can address problematic behaviours by improving the ability to understand and regulate the negative effects of thoughts and feelings. This study aimed to evaluate the clinical and cost-effectiveness of MBT-ASPD compared with probation as usual in reducing aggressive behaviours from baseline to 12 months of follow-up.<h3>Methods</h3>The Mentaliziation for Offending Adult Males (MOAM) trial was a multicentre, two-group, pragmatic, assessor-masked, randomised controlled superiority trial in England and Wales. Eligible participants were male, aged 21 years or older, convicted of an offence and under National Probation Service supervision at one of 13 sites, identified through the Community Personality Disorder Pathways Service, met DSM-5 criteria for antisocial personality disorder, and scored at least 15 on the Overt Aggression Scale-Modified (OAS-M). After a three-stage screening process, consenting participants were randomly allocated (1:1), stratified by site, age, probation order type, and remaining probation duration, to either MBT-ASPD plus probation as usual, or probation as usual alone. Participants in the MBT-ASPD group were offered 12 months of weekly 75-min group therapy sessions and monthly 50 min individual sessions. Probation as usual lasted up to 12 months, after which participants continued under National Probation Service supervision for the remainder of their term. Investigators and data collectors were masked to treatment allocation. The primary outcome was aggression measured by the OAS-M at 12 months after random allocation. Data were collected by a hybrid team of traditional researchers and researchers with lived experience of the criminal justice system. The primary analysis was conducted in the intention-to-treat population using a linear mixed-effects model, adjusted for baseline at each follow-up timepoint (months 3, 6, 9, 12, 15, 18, 21, and 24). This trial is registered with ISRCTN (ISRCTN 32309003), and all pre-planned follow-ups are complete.<h3>Findings</h3>Between Jan 2, 2016, and Aug 31, 2018, 1946 individuals were referred to the study; after the screening process, 313 participants were randomly allocated (156 [50%] to probation as usual and 157 [50%] to MBT-ASPD plus probation as usual). Participants had a mean age of 34·2 years (SD 9·3); the majority of participants (247 [79%]) identified as White British, Irish, or White Other; followed by Black British (Caribbean, African, or Other; 30 [10%]) or Mixed (29 [9%]). At 12 months after random allocation, mean OAS-M scores were significantly higher in the probation as usual group (mean score 186 [SD 153]) than in the MBT-ASPD group (90 [126]), with an adjusted mean difference ","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"5 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443141","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}
Lancet PsychiatryPub Date : 2025-02-18DOI: 10.1016/s2215-0366(25)00034-3
Lois W Choi-Kain
{"title":"Mentalisation-based treatment for antisocial personality disorder: reviving the social contract","authors":"Lois W Choi-Kain","doi":"10.1016/s2215-0366(25)00034-3","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00034-3","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"32 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443393","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}
Lancet PsychiatryPub Date : 2025-02-12DOI: 10.1016/s2215-0366(24)00404-8
Tom H Rosenström, Suoma E Saarni, Samuli I Saarni, Jaakko Tammilehto, Jan-Henry Stenberg
{"title":"Efficacy and effectiveness of therapist-guided internet versus face-to-face cognitive behavioural therapy for depression via counterfactual inference using naturalistic registers and machine learning in Finland: a retrospective cohort study","authors":"Tom H Rosenström, Suoma E Saarni, Samuli I Saarni, Jaakko Tammilehto, Jan-Henry Stenberg","doi":"10.1016/s2215-0366(24)00404-8","DOIUrl":"https://doi.org/10.1016/s2215-0366(24)00404-8","url":null,"abstract":"<h3>Background</h3>According to meta-analyses of randomised controlled trials (RCTs), therapist-guided internet-delivered cognitive behavioural therapy (iCBT) is as effective a treatment for depression as traditional face-to-face CBT (fCBT), despite its substantially lower costs. However, RCTs are not always representative of routine practice, which could inflate effectiveness estimates. We combined rich data with counterfactual causal statistical reasoning to provide an fCBT–iCBT comparison complementary to RCTs.<h3>Methods</h3>In this retrospective cohort study, we linked full archived therapist-guided iCBT and fCBT cohort registries with multiple Finnish social and health care registries. The therapist-guided iCBT programme with third-wave principles and the fCBTs were provided by HUS Helsinki University Hospital to people with depression without acute suicide or substance-misuse risk; fCBT was delivered in the Uusimaa region, whereas therapist-guided iCBT was nationwide and excluded people with treatment-interfering psychotic, neurological, or personality disorders, chronic or bipolar depression, or aged under 16 years. The primary outcome was the causal average treatment effect (ATE) for the difference in during-treatment symptom reductions between fCBT and therapist-guided iCBT, with symptoms measured by the Patient Health Questionnaire-9 (PHQ-9). If only one PHQ-9 report was recorded, no change was recorded, thereby penalising dropout. For an optimal and robust (a posteriori-balanced) ATE estimate, we applied targeted maximum likelihood machine learning. There was no involvement of individuals with lived experience in the research and writing process.<h3>Findings</h3>The guided iCBT registry recorded patients from Dec 12, 2018, to Dec 22, 2022, and the fCBT registry spanned Aug 28, 2018, to Sept 28, 2022. From the total of 32 343 registered therapies, 392 people were included from the fCBT registry and 5467 people from the iCBT registry. Four people in the fCBT group and 21 in the guided iCBT group had missing baseline data, therefore the main sample for analysis contained 5834 patients (4101 [70%] were female and 1733 [30%] were male) with a mean age of 35 years (SD 12). Altogether, 5455 (94%) patients were registered with Finnish as their native language. The ATE estimate indicated that the PHQ-9 score declined 0·745 points (95% CI 0·156–1·334) more in the iCBT group than in the fCBT group. Sensitivity analyses concurred.<h3>Interpretation</h3>Considered alongside previous RCTs, our findings suggest that short first-line treatments with therapist-guided iCBT are at least as effective and efficacious as fCBT. Our findings eliminate error sources and extend the representativeness of the population for this cost-effective treatment.<h3>Funding</h3>The Research Council of Finland (Academy of Finland).<h3>Translation</h3>For the Finnish translation of the abstract see Supplementary Materials section.","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"16 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401780","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}
Lancet PsychiatryPub Date : 2025-02-11DOI: 10.1016/s2215-0366(24)00370-5
David J Nutt
{"title":"Drug development in psychiatry: 50 years of failure and how to resuscitate it","authors":"David J Nutt","doi":"10.1016/s2215-0366(24)00370-5","DOIUrl":"https://doi.org/10.1016/s2215-0366(24)00370-5","url":null,"abstract":"The past 50 years have seen remarkable advances in the science of medicine. The pharmacological treatments of disorders such as hypertension, immune disorders, and cancer are fundamentally different from those used in the 1970s, and are now more often based on disorder-specific pathologies. The same cannot be said for psychiatric medicines: despite remarkable advances in neuroscience, very few innovative treatments have been developed in this field since the 1970s. For depression, schizophrenia, anxiety disorders, and ADHD, pharmacological classes of medicines discovered through serendipity in the 1950s are still used despite hundreds of billions of US dollars being spent on drug discovery attempts based on new neuroscience targets. This Personal View presents my opinion on the reasons innovation in psychiatric treatment has not progressed as well as in other disorders. As a researcher in the field, I offer suggestions as to how this situation must be rectified soon, as by most analyses mental illness is becoming a major health burden globally. Most of my evidence is referenced, but where I have unpublished knowledge gained from consulting with pharmaceutical companies, it is presented as an opinion.","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"63 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143393417","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}
Lancet PsychiatryPub Date : 2025-02-11DOI: 10.1016/s2215-0366(25)00035-5
Dana Churbaji, Richard Bryant, Nexhmedin Morina
{"title":"Towards collective healing: peacebuilding and mental health in Syria","authors":"Dana Churbaji, Richard Bryant, Nexhmedin Morina","doi":"10.1016/s2215-0366(25)00035-5","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00035-5","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"22 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143393416","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}