Lancet Psychiatry最新文献

{"title":"International Guidelines for the Algorithmic Treatment of Schizophrenia (INTEGRATE)","authors":"Satish Suhas","doi":"10.1016/s2215-0366(25)00139-7","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00139-7","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"10 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144260494","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":"Semaglutide for clozapine-treated patients with schizophrenia","authors":"Sri Mahavir Agarwal, Margaret Hahn","doi":"10.1016/s2215-0366(25)00166-x","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00166-x","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"585 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144260492","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":"Rabih El Chammay: building hope and systems for mental health in Lebanon","authors":"Tony Kirby","doi":"10.1016/s2215-0366(25)00173-7","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00173-7","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"12 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144260207","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":"An intensive weight loss programme with behavioural support for people with type 2 diabetes at risk of eating disorders in England (ARIADNE): a randomised, controlled, non-inferiority trial","authors":"Elena Tsompanaki, Paul Aveyard, Rebecca J Park, Susan A Jebb, Dimitrios A Koutoukidis","doi":"10.1016/s2215-0366(25)00126-9","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00126-9","url":null,"abstract":"<h3>Background</h3>There are concerns that low-energy total diet replacement (TDR) programmes could trigger eating disorders, given their focus on weight and rigid dietary rules. We aimed to assess the effect of a TDR programme on eating disorder symptoms in people living with overweight or obesity and type 2 diabetes at high risk of developing an eating disorder.<h3>Methods</h3>In this randomised, controlled, non-inferiority trial, participants with type 2 diabetes, overweight, and eating disorder symptoms across England were randomly assigned (1:1) to a low-energy TDR programme with formula products and behavioural support delivered remotely, or usual care. In brief, the intervention comprised 12 weeks of low-energy TDR in a nutritionally complete package of soups, shakes, and bars. After the 12 weeks, the intervention continued with stepped food reintroduction (around 8 weeks) based on a low-energy, nutrient-rich diet, followed by weight maintenance advice (around 4 weeks), personalised to an individual participant's circumstances and preferences. Participants allocated to the control group received usual care for their diabetes. The primary outcome was the change in eating disorder symptoms using the Eating Disorders Examination Questionnaire (EDE-Q) global score at 6 months (programme end). Safety was determined by the incidence of cases with high suspicion of a new eating disorder. The primary outcome analysis had an upper non-inferiority margin for EDE-Q of +1 SD (0·72). People with lived experience were involved throughout the trial and provided input on study conceptualisation, protocol development, delivery of the intervention, and intervention materials. The 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>NCT05744232</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>.<h3>Findings</h3>Between March 8, 2023, and Sept 12, 2023, 56 participants were randomly assigned to the intervention group (28 participants) or control group (28 participants). Participants had a mean age of 49·9 years (SD 8·1). 35 (63%) of 56 participants were women, 20 (36%) were men, and one (2%) was non-binary. 54 (96%) of participants were White and two (4%) were Asian. Participants had a mean BMI of 39·6 kg/m<sup>2</sup> (SD 7·8) and a mean EDE-Q global score of 3·3 (0·4). 49 (88%) of 56 participants provided outcome data at 6 months and 45 (80%) at 1 year. At completion of the programme at 6 months, the mean weight loss was –13·9 kg (SD 11·2) in the intervention group and –3·7 kg (7·9) in the control group, with a between-group difference of –10·2 kg (95% CI –14·2 to –6·2). The","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"6 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144260206","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":"International Guidelines for the Algorithmic Treatment of Schizophrenia (INTEGRATE)","authors":"Nicholas Fabiano, David Puder, Joseph Firth, Nilufar Mossaheb, Brendon Stubbs","doi":"10.1016/s2215-0366(25)00127-0","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00127-0","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"5 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144260493","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":"International Guidelines for the Algorithmic Treatment of Schizophrenia (INTEGRATE) – Authors' reply","authors":"Robert A McCutcheon, Toby Pillinger, Dan Siskind","doi":"10.1016/s2215-0366(25)00142-7","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00142-7","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"41 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144260495","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":"Efficacy and safety of semaglutide versus placebo for people with schizophrenia on clozapine with obesity (COaST): a phase 2, multi-centre, participant and investigator- blinded, randomised controlled trial in Australia","authors":"Dan Siskind, Andrea Baker, Urska Arnautovska, Nicola Warren, Anthony Russell, Veronica DeMonte, Sean Halstead, Ravi Iyer, Nicole Korman, Gemma McKeon, Sarah Medland, Stephen Parker, Terry Stedman, Mike Trott","doi":"10.1016/s2215-0366(25)00129-4","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00129-4","url":null,"abstract":"<h3>Background</h3>People with schizophrenia have a 16–20-year reduction in life expectancy, primarily due to cardiometabolic disease. Clozapine, the most efficacious antipsychotic for treatment-resistant schizophrenia, is associated with weight gain and metabolic dysfunction. Glucagon-like peptide-1 receptor agonists, including semaglutide, contribute to substantial weight loss in the general population, but their effect and safety profile in people with schizophrenia remain unknown. We evaluated the efficacy and safety of semaglutide for weight reduction in individuals with schizophrenia who were prescribed clozapine.<h3>Methods</h3>COaST was an Australian randomised, placebo-controlled, multi-site trial, independent of pharmaceutical industry support, with methods informed by people with lived experience. Adults (aged 18–64 years) across six sites were randomly assigned (1:1) to once weekly subcutaneous semaglutide titrated to 2·0 mg or placebo for 36 weeks. Participants were included if they fulfilled criteria for schizophrenia or schizoaffective disorder, were prescribed clozapine for 18 weeks or more, had a BMI of at least 26 kg/m<sup>2</sup>, and had less than 5% bodyweight increase or loss in the previous 3 months. The primary outcome was percentage body weight change, analysed using a mixed model for repeated measures, at 36 weeks post-baseline assessment. All investigators and participants were masked to medication allocation. Secondary measures included clozapine and norclozapine concentrations and psychosis symptoms as measured by the Positive and Negative Syndrome Scale (PANSS). The protocol was prospectively registered with the Australia New Zealand Clinical Trials Registry (ACTRN12621001539820; recruitment finished, pending follow-up assessments).<h3>Findings</h3>166 individuals were screened for eligibility, 135 were excluded, and the remaining 31 were randomly assigned to either the semaglutide group (n=15) or the control group (n=16). 21 males and ten females were included in the study, with a mean age of 38·9 years (range 21–58). All participants assigned to each group were included in the analysis of the primary outcome. 84% of participants were White, 7% were from the Indian Subcontinent, 3% were Asian (not including from the Indian Subcontinent), 3% were Australian Aboriginal or Torres Strait Islanders, and 3% were New Zealand Māori or Pacific Islanders. Recruitment commenced on Aug 30, 2022 and was suspended in June, 2024 before achieving the intended number of 80 participants due to non-availability of the investigational product. At week 36, semaglutide yielded a 13·88% (SE 0·90) body weight reduction compared with 0·42% (SE 0·93) for placebo (between-group difference: –13·46%; p<0·0001). No differences were observed in clozapine or norclozapine concentrations or PANSS scores. Semaglutide was well tolerated, with no serious adverse events that were deemed to be related to the treatment, and low rates of constipation.<h","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"1 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144260496","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":"Division and integration","authors":"","doi":"10.1016/s2215-0366(25)00174-9","DOIUrl":"https://doi.org/10.1016/s2215-0366(25)00174-9","url":null,"abstract":"No Abstract","PeriodicalId":48784,"journal":{"name":"Lancet Psychiatry","volume":"4 1","pages":""},"PeriodicalIF":64.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144260491","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":"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}