Lancet Psychiatry最新文献

{"title":"Gaps in crisis intervention: a global survey of suicide helplines","authors":"Limalemla Jamir, Ramyadarshni Vadivel, Sharad Philip","doi":"10.1016/s2215-0366(24)00408-5","DOIUrl":"https://doi.org/10.1016/s2215-0366(24)00408-5","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"15 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142992241","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: 44–53","authors":"","doi":"10.1016/s2215-0366(25)00004-5","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00004-5","url":null,"abstract":"<em>Robson EM, Husin Mohamad H, Dashti SG, et al. Tracking the course of depressive and anxiety symptoms across adolescence (the CATS study): a population-based cohort study in Australia.</em> Lancet Psychiatry <em>2024; published online Dec 4. https://doi.org/10.1016/S2215-0366(24)00361-4</em>—In this Article, the author S Ghazaleh Dashti's name was misspelled and Mohamad Husin is the second author's surname. This correction has been made to the online version as of Jan 21, 2025, and will be made to the printed version.","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"74 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142992244","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":"Comparative effectiveness of antipsychotic treatment strategies for relapse prevention in first-episode schizophrenia in Finland: a population-based cohort study","authors":"Heidi Taipale, Antti Tanskanen, Oliver Howes, Christoph U Correll, John M Kane, Jari Tiihonen","doi":"10.1016/s2215-0366(24)00366-3","DOIUrl":"https://doi.org/10.1016/s2215-0366(24)00366-3","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;The best pharmacological treatment practices for relapse prevention in patients with first-episode schizophrenia are unclear. We aimed to assess different treatment strategies used before and after the first relapse, and their associations with subsequent relapse risk.&lt;h3&gt;Methods&lt;/h3&gt;In this population-based cohort study, we enrolled individuals (aged ≤45 years) with first-episode schizophrenia who were hospitalised and subsequently relapsed between 1996 and 2014 from the nationwide Finnish Hospital Discharge Register. Individuals who had not been taking antipsychotics within the year preceeding initial hospitalisation and who had a relapse within 5 years of discharge were included in the analyses. Treatment strategies were assessed during the 30 days before hospitalisation for the first relapse and 30 days after discharge and were categorised as either long-acting injectable, clozapine, non-clozapine oral antipsychotic monotherapy, non-clozapine oral antipsychotic polypharmacy, and antipsychotic non-use. Adjusted hazard ratios (aHRs) of the risk of second relapse based on treatment type were analysed with Cox regression models for 2 years after the first relapse, or until death or end of data linkage (Dec 31, 2017). People with lived experience of schizophrenia were not involved in the research and writing process.&lt;h3&gt;Findings&lt;/h3&gt;Between Jan 31, 1996 and Dec 31, 2017, 3000 individuals had their first psychosis relapse and were eligible for analysis. Mean age was 30·0 years (SD 7·6), 1069 (35·6%) of patients were women and 1931 (64·4%) men. No ethnicity data were available. 2148 (71·7%) had a second relapse within 2 years. Before first relapse, most individuals were either not using antipsychotics (n=1366 [45·5%]), or were using non-clozapine oral antipsychotic monotherapy (n=973 [32·4%]). Compared with continuing the same treatment strategy used before the first relapse, switching to clozapine was associated with the lowest risk of second relapse compared with continuing any non-clozapine oral antipsychotic monotherapy (aHR 0·66, 95% CI 0·49–0·89; relapse rate 73·2% with oral non-clozapine antipsychotic monotherapy continuation &lt;em&gt;vs&lt;/em&gt; 57·1% with switch to clozapine). Switching to another non-clozapine oral antipsychotic monotherapy (0·99, 0·76–1·28) was approximately as unhelpful in preventing the next relapse as switching to antipsychotic non-use (1·07, 0·80–1·42).&lt;h3&gt;Interpretation&lt;/h3&gt;In patients with first-episode schizophrenia having their first psychosis relapse despite use of non-clozapine oral antipsychotics, continuation with the same antipsychotic modality or switch to another non-clozapine oral antipsychotic did not show evidence of being beneficial in relapse prevention, suggesting that clozapine should be started instead. This finding, together with existing knowledge of decreased risk of mortality associated with clozapine, challenges current treatment guidelines that recommend clozapine as a third-line tre","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"105 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142992246","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":"Fahmy Hanna: a passion for equity","authors":"Cahal McQuillan","doi":"10.1016/s2215-0366(25)00002-1","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00002-1","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"6 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142992249","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":"Rejection of the hijab is not a psychiatric diagnosis","authors":"Siroos Mirzaei, Danuta Wasserman, Thomas G Schulze, Daniela Dörfler, Thomas Wenzel","doi":"10.1016/s2215-0366(24)00409-7","DOIUrl":"https://doi.org/10.1016/s2215-0366(24)00409-7","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"32 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142992243","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":"Evaluating the global landscape of suicide helpline services: a global survey across 105 countries","authors":"Gladson Vaghela, Le Van Truong, Vu Thi Thu Trang, Abdelrahman M Makram, I-Chun Hung, Mai Ngoc Luu, Nguyen Hai Nam, Randa Elsheikh, My Duc Thao Trieu, Le Thi Bich Trang, Zeeshan Khan, Cyril Nnaemeka Ikeanyionwu, Engy M Makram, Nguyen Tran Minh Duc, Minh-Hang Nguyen, Tan Weiling Amanda, Zia Baig, Karim Chafee, Shaimaa Yousry Fadel, Thuan Khac Nguyen, Nguyen Tien Huy","doi":"10.1016/s2215-0366(24)00354-7","DOIUrl":"https://doi.org/10.1016/s2215-0366(24)00354-7","url":null,"abstract":"<h3>Background</h3>Suicide helpline services (SHSs) are viewed as an essential part of suicide prevention. In the context of increased demand experienced by the services through the COVID-19 pandemic, as well as reduced funding, we aimed to evaluate such services to help assess their effectiveness and resilience.<h3>Methods</h3>This multinational cross-sectional survey, conducted from Sept 1, 2022, to Feb 28, 2023, evaluated SHSs in 150 countries. Local collaborators created an SHS directory, and a 42-question questionnaire was distributed via Survey Monkey through Find A Helpline and local collaborators. A team of experts, including individuals with lived experience, helped shape the research questions and study design. We did descriptive statistical analysis of answers to the questions, and data were further analysed using the Bayesian Model Averaging method to predict managers’ or supervisors’ low overall satisfaction with the service (MS-LOSS).<h3>Findings</h3>The study involved 446 responses from 105 countries for descriptive statistics. 354 (79·4%) of 446 services had insufficient funding, 249 (55·8%) had post-COVID-19 budget reductions, and 278 (62·3%) observed a sharp rise in suicide help requests during the COVID-19 pandemic. 420 responses were used for finding the optimal logistic model, which had an area under the curve of 0·679, indicating that pre-service training for volunteers was significantly associated with a reduction in MS-LOSS (odds ratio 0·16 [95% CI 0·07–0·31]; p&lt;0·001), as was having a quality assurance structure (0·15 [0·02–0·70]; p=0·030). Higher MS-LOSS was associated with staff training only every 2–3 years instead of one or more times per year (2·87 [1·23–6·85], p=0.016) and with dilemmas with providing services in severe cases (1·68 [1·06–2·68]; p=0·028).<h3>Interpretation</h3>Global SHS reports indicate that both pre-task and ongoing training for volunteers and staff, coupled with a quality assurance structure, could decrease MS-LOSS. Our findings emphasise the need for training for volunteers, continuous training programmes for staff, and on-site support for individuals at risk of suicide.<h3>Funding</h3>RSTMH Small Grants Award 2021, UK NIHR, and MEXT.","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"32 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142992247","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":"Exploring the involvement of people with lived experience of mental disorders in co-developing outcome measures: a systematic review","authors":"Niamh Molloy, Imogen Kilcoyne, Hannah Belcher, Til Wykes","doi":"10.1016/s2215-0366(24)00376-6","DOIUrl":"https://doi.org/10.1016/s2215-0366(24)00376-6","url":null,"abstract":"People with lived experience of mental health difficulties have highlighted that research outcomes do not capture issues they feel are important. This mismatch might affect the validity of trials, such that beneficial effects could be missed or results could be counted as a benefit when they are not. Co-development of patient-reported outcome measures ensures patient perspectives are captured adequately. To identify mental health outcome measures that meet a strict definition of being co-developed and to describe the methods and quantity of involvement at each pre-defined stage of measure co-development, we searched five electronic databases (MEDLINE, Web of Science, Scopus, PsycINFO, and Embase) for relevant papers, alongside a search of the non-peer reviewed literature and handsearching. The study was registered on PROSPERO (CRD42024520941). Retrieved papers were independently screened and quality was assessed following PRISMA guidelines. Extracted data were synthesised narratively. The search identified 23 mental health outcome measures from 34 papers. The most frequent types of involvement to co-develop outcomes were service-user researchers and lived experience groups as advisors undertaking activities such as leading qualitative exercises, but there were gaps. Many benefits were reported such as increased relevancy and acceptability of the measures. Based on these findings, recommendations for methods and a novel scale for judging quantity of involvement for co-development were identified, but challenges for co-development remain. The reviewed papers show that co-development is possible and could provide more relevant and meaningful outcomes for clinical practice and research.","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"11 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142992248","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 prevention in schizophrenia spectrum disorders","authors":"Lindsay A Bornheimer","doi":"10.1016/s2215-0366(24)00441-3","DOIUrl":"https://doi.org/10.1016/s2215-0366(24)00441-3","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"5 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142987247","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":"Underlying mechanisms and efficacy of a suicide-focused psychological intervention for psychosis, the Cognitive Approaches to Combatting Suicidality (CARMS): a multicentre, assessor-masked, randomised controlled trial in the UK","authors":"Patricia Gooding, Daniel Pratt, Danielle Edwards, Yvonne Awenat, Richard J Drake, Richard Emsley, Steven Jones, Navneet Kapur, Fiona Lobban, Sarah Peters, Bradley Boardman, Kamelia Harris, Charlotte Huggett, Gillian Haddock","doi":"10.1016/s2215-0366(24)00399-7","DOIUrl":"https://doi.org/10.1016/s2215-0366(24)00399-7","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;There is a need for theoretically grounded and testable suicide-focused psychological therapies, especially in people with severe mental health problems, specifically non-affective psychosis. We aimed to test both the underlying mechanisms and efficacy of a suicide-focused therapy, cognitive behavioural suicide prevention for psychosis (CBSPp).&lt;h3&gt;Methods&lt;/h3&gt;We did a multicentre, assessor-masked, randomised controlled trial conducted at four UK National Health Service (NHS) sites. Participants were eligible for enrolment if they were 18 years or older; met ICD-10 criteria for non-affective psychosis (F20–F29); had self-reported suicidal experiences in the 3 months before recruitment; were under the care of an NHS mental health services team; were not receiving a psychological therapy as part of a similar trial; had sufficient competency in the English language not to need an interpreter to participate; and were able to give informed consent. After screening for eligibility and completion of baseline assessments, participants were randomly allocated in a 1:1 ratio to either the treatment as usual group (control) or CBSPp therapy plus standard treatment group (treatment), with stratification by use of antidepressant medication and NHS site. Randomisation took place using an online Sealed Envelope randomisation procedure conducted and overseen by the Manchester Academic Health Sciences Centre Clinical Trials Unit (MCTU). This system was accessed only by specially allocated staff (eg, the CARMS Trial Manager or the MCTU Trial manager). When the system randomly allocated a participant, an unmasked email confirmation was sent to the unmasked coprincipal investigator and the CARMS Trial Manager (also unmasked). Assessors, the trial statistician, and one coprincipal investigator were masked to allocation group. Participants were informed of their randomised allocation group by an unmasked CARMS staff member. Experts-by-experience were involved in all stages of the research. For those in the treatment group, approximately 24 one-to-one therapy sessions were offered, usually weekly, for around 50 min per session. Assessments were conducted at baseline, month 6, and month 12. The primary outcome was suicide ideation severity measured by the 25-item Adult Suicide Ideation Questionnaire (ASIQ), assessed at month 6 relative to baseline. Outcome analyses used mixed models in the intention-to-treat population. Planned mediation indirect linear regression models examined appraisals of poor social support, emotional difficulties, interpersonal problem-solving difficulties, defeat, entrapment, and hopelessness as mediators at 6 months with allocation condition (treatment &lt;em&gt;vs&lt;/em&gt; control) as the predictor variable and suicidal ideation severity (ASIQ) at 6 months as the outcome variable, whilst controlling for baseline levels of the mediator and outcome variables. The trial was registered before recruitment at &lt;span&gt;&lt;span&gt;ClinicalTrials.gov&lt;/","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"20 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142987240","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":"Time to report estimands in randomised controlled trials","authors":"Erica Neill, Ravi Iyer, Philip Sumner, Andrew Mackinnon","doi":"10.1016/s2215-0366(24)00439-5","DOIUrl":"https://doi.org/10.1016/s2215-0366(24)00439-5","url":null,"abstract":"The first quarter of the 21st century has seen critical advances in the conduct and reporting of clinical trials in all fields of medicine. Beyond the foundational requirement for prospective registration, the widespread adoption of the intention-to-treat principle, appropriate treatment of missing data, and a focus on the clinical relevance of outcomes have predominated. However, there is growing awareness of the need for further refinements in many aspects of our trials.","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"1 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934680","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}