Journal of Clinical Psychiatry最新文献

{"title":"A Case Series of Intimate Partner Violence in Older Adults Within an Older Persons' Mental Health Service.","authors":"Anant Sharma, Sharon Reutens, Anne P F Wand","doi":"10.4088/JCP.24m15495","DOIUrl":"10.4088/JCP.24m15495","url":null,"abstract":"<p><p><b>Purpose:</b> The aim of this case series is to explore the range of considerations (ethical, practical, and legal) for mental health clinical assessment and management of older adults experiencing intimate partner violence (IPV).</p><p><p><b>Case Series:</b> Three case reports are described. Participants were older adults presenting to an Older Persons Mental Health service in a metropolitan area who reported experiencing recent IPV (either as a survivor or perpetrator). Each case illustrates aspects of the complex issues to be considered in the assessment and management of IPV in older adults, including clinical factors (eg, cognition, interpersonal relationships, mental illness), ethical dilemmas, and legal, sociocultural, and practical considerations.</p><p><p><b>Conclusion:</b> This case series highlights the complexity in assessing and managing IPV in both members of the older adult dyad within a mental health service. Specific approaches to IPV are required given the physical, emotional, and cognitive interdependency often present in older adults.</p>","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"86 3","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Primer on Individual Participant Data Meta-Analysis and Its Strengths and Limitations.","authors":"Chittaranjan Andrade","doi":"10.4088/JCP.25f16001","DOIUrl":"10.4088/JCP.25f16001","url":null,"abstract":"<p><p>In conventional (aggregate data) meta-analysis, the results of many similar studies are statistically combined to yield a single pooled result. Conventional meta-analyses have many limitations. They cannot examine research questions that were not examined in the source studies, interactions between variables cannot be studied, granular analyses cannot be performed, and systematic biases in the source study data will be retained in the pooled results. Individual participant data meta-analysis (IPD-MA) differs from conventional meta-analyses in that, instead of pooling the results of already completed analyses from source studies, the statistical team obtains and processes individual participant data from the source studies. This allows the specification of a new study protocol that can be uniformly applied, across source studies, to the individual participant data. Matters that can thus be harmonized across the source studies include participant eligibility criteria, choice of exposures and outcomes, operational definitions of exposures and outcomes, time points for data examination, and the method of data analysis. IPD-MA can be performed as a 1-stage or 2-stage procedure; the latter is simpler. Whereas IPD-MA overcomes some of the limitations of conventional meta-analysis, it has its own limitations. Obtaining individual participant data can be difficult and time-consuming, reprocessing and reanalyzing source study data requires time and effort, and new biases may be introduced. The new biases arise from lack of availability of individual participant data from all source studies, limitation of the generalizability of findings when harmonization of the study protocol excludes subjects from analysis, loss of randomization structure when participant eligibility restrictions are applied in IPD-MAs of randomized controlled trials, and failure to adequately adjust for necessary covariates. Readers need to be aware of these biases, and authors of IPD-MAs need to report on the potential impact of these biases on their results.</p>","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"86 3","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Global Population-Based Study on the Association Between Ketamine and Esketamine With Suicidality Using WHO VigiBase.","authors":"Angela T H Kwan, Moiz Lakhani, Joshua D Rosenblat, Rodrigo B Mansur, Taeho Greg Rhee, Kayla M Teopiz, Bing Cao, Roger Ho, Sabrina Wong, Gia Han Le, Roger S McIntyre","doi":"10.4088/JCP.24m15534","DOIUrl":"10.4088/JCP.24m15534","url":null,"abstract":"<p><p><b>Background:</b> Ketamine and esketamine have been reported to rapidly alleviate various parameters of suicidality, with antisuicidal effects that may be independent of their rapid-acting antidepressant effects. However, it remains unclear whether ketamine and/or esketamine are associated with the emergence or worsening of suicidality.</p><p><p><b>Methods:</b> In this global observational pharmacovigilance cohort study, we analyzed suicidality reports associated with ketamine and esketamine using data from the World Health Organization's VigiBase, accessed from its inception through January 2024. Disproportionality was assessed using the reporting odds ratio (ROR), with significance defined as <i>P</i> < .05.</p><p><p><b>Results:</b> Compared to lithium, esketamine exhibited higher disproportionality for suicidal ideation (ROR = 5.13, 95% CI, 4.48-5.87, <i>P</i> < .0001), while ketamine showed lower disproportionality for suicidal ideation (ROR = 0.76, 95% CI, 0.58-0.99, <i>P</i> = .043), suicide attempt (ROR =0.17, 95% CI, 0.12-0.24, <i>P</i> < .0001), and completed suicide (ROR =0.30, 95% CI, 0.22-0.40, <i>P</i> < .0001). Esketamine also had lower RORs for suicide attempt (ROR = 0.46, 95% CI, 0.39-0.54, <i>P</i> < .0001) and completed suicide (ROR =0.36, 95% CI, 0.30-0.43, <i>P</i> < .0001). When fluoxetine was used as the reference, esketamine showed higher disproportionality for suicidal ideation (ROR = 3.34, 95% CI, 3.06-3.65, <i>P</i> < .0001), while ketamine had a lower ROR (ROR =0.49, 95% CI, 0.39-0.63, <i>P</i> < .0001). For suicidal behavior, esketamine had a lower ROR (ROR =0.37, 95% CI, 0.17-0.81, <i>P</i> = .012), and both ketamine (ROR =0.15, 95% CI, 0.10-0.21, <i>P</i> < .0001) and esketamine (ROR = 0.39, 95% CI, 0.34-0.45, <i>P</i> < .0001) had lower RORs for suicide attempt. Both agents also had lower RORs for completed suicides (ketamine: ROR = 0.24, 95% CI, 0.18-0.32, <i>P</i> < .0001; esketamine: ROR= 0.29, 95% CI, 0.25-0.35, <i>P</i> < .0001).</p><p><p><b>Conclusion:</b> Both increased and decreased RORs for suicidality parameters were observed with ketamine and esketamine, with similar results regardless of whether lithium or fluoxetine was used as the reference. However, causality between ketamine/esketamine use and changes in suicidality cannot be determined.</p>","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"86 3","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Zuranolone for Postpartum Depression in Real-World Clinical Practice.","authors":"Maxwell Z Price, Richard L Price","doi":"10.4088/JCP.25cr15876","DOIUrl":"https://doi.org/10.4088/JCP.25cr15876","url":null,"abstract":"","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"86 3","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using GenAI to Train Mental Health Professionals in Suicide Risk Assessment: Preliminary Findings.","authors":"Zohar Elyoseph, Inbar Levkovitch, Yuval Haber, Yossi Levi-Belz","doi":"10.4088/JCP.24m15525","DOIUrl":"https://doi.org/10.4088/JCP.24m15525","url":null,"abstract":"<p><p><b>Background:</b> Suicide risk assessment is a critical skill for mental health professionals (MHPs), yet traditional training in this area is often limited. This study examined the potential of generative artificial intelligence (GenAI)- based simulator to enhance self-efficacy in suicide risk assessment among MHPs.</p><p><p><b>Methods:</b> A quasiexperimental mixed methods study was conducted. Participants interacted with an AI-based simulator (AIBS) that embodied the role of a patient seeking suicide risk assessment. Each participant conducted a real-time risk assessment interview with the virtual patient and received comprehensive feedback on their assessment approach and performance. Quantitative data were collected through pre- and postintervention questionnaires measuring suicide risk assessment self efficacy and willingness to treat suicidal patients (using 11-point Likert scales). Qualitative data were gathered through open-ended questions analyzing participants' experiences, perceived benefits, and concerns regarding the AI simulator.</p><p><p><b>Results:</b> Among the 43 participating MHPs, we found a significant increase in self efficacy scores from preintervention (mean = 6.0, SD = 2.4) to postintervention (mean = 6.4, SD = 2.1, <i>P</i> < .05). Willingness to treat patients presenting suicide risk increased slightly from (mean = 4.76, SD =2.64) to (mean = 5.00, SD = 2.50) but did not reach significance. Participants reported positive experiences with the simulator, with high likelihood to recommend to colleagues (mean = 7.63, SD =2.27). Qualitative feedback indicated that participants found the simulator engaging and valuable for professional development. However, participants raised concerns about overreliance on AI and the need for human supervision during training.</p><p><p><b>Conclusion:</b> This preliminary study suggests that AIBSs show promise for improving MHPs' self-efficacy in suicide risk assessment. However, further research with larger samples and control groups is needed to confirm these findings and address ethical considerations surrounding AI use in suicide risk assessment training. AI powered simulation tools may have potential to increase access to training in mental health, potentially contributing to global suicide prevention efforts. However, their implementation should be carefully considered to ensure they complement rather than replace human expertise.</p>","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"86 3","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bright Light Therapy in the Morning or Midday for the Treatment of Nonseasonal Depression in Bipolar Disorder (LuBi): A Dose-Escalation Phase 1/2 Randomized Double-Blind Trial.","authors":"Pierre A Geoffroy, Sylvie Chevret, Sibylle Mauries, Cendrine Chaffaut, Ali Amad, Frank Bellivier, Victoire Benard, Philippe Courtet, Caroline Dubertret, Philip Gorwood, Nicolas Mazer, Lila Mekaoui, Emilie Olié, Guillaume Pataud, Guillaume Vaiva, Michel Lejoyeux, Dorothy Sit, Julia Maruani","doi":"10.4088/JCP.25m15826","DOIUrl":"10.4088/JCP.25m15826","url":null,"abstract":"<p><p><b>Objective:</b> This dose-escalation study aimed to evaluate the tolerance (hypomanic symptoms) and efficacy of bright light therapy (BLT) in depressed patients with bipolar disorder (BD) with mood stabilizers, using different schedules (duration and escalation), applied in morning or midday.</p><p><p><b>Methods:</b> Patients with BD I or II (<i>DSM-IV TR</i>) followed a 1-week placebo phase and were randomized to morning or midday BLT with dose escalation from 7.5 to 45 minutes/d, until September 2023. Inter- and intrasubject escalation were performed, with dose adjustments based on dose-limiting toxicities (DLTs) to determine the maximum tolerated dose (MTD) and target ceiling dose (TCD) of BLT exposure. The primary outcome measure, DLT, was assessed weekly after each dose initiation or increase and defined as a hypomanic switch (Young Mania Rating Scale [YMRS] score ≥12/60) or subsyndromic hypomanic symptoms (YMRS score 8-12).</p><p><p><b>Results:</b> Both groups reached the starting dose of 45 minutes without reaching the MTD or TCD, enrolling 38 patients (morning = 18 and midday = 16) and demonstrating good tolerance and acceptability. Two patients (6%) experienced a hypomanic switch at 45 minutes: 1 in the morning group (week 1) and 1 in the midday group (week 4). Five patients had subsyndromic hypomania. All symptoms improved within 3 days after dose reduction. Depressive symptoms (Montgomery Asberg Depression Rating Scale, <i>P</i> = .007) and Clinical Global Impression (CGI) scores (<i>P</i> < .001 for severity, <i>P</i> = .01 for improvement) significantly improved over time. A cumulative exposure effect was observed on CGI improvement (<i>P</i> = .038), alongside a starting dose effect over the weeks on CGI severity (<i>P</i> < .001) and the Flexibility Circadian Type Inventory (<i>P</i> = .042). The comparison between groups shows a higher CGI improvement score in the morning group (<i>P</i> = .035).</p><p><p><b>Conclusions:</b> BLT is a viable antidepressant strategy for BD, safely starting at 45 minutes regardless of timing. Occurring hypomanic symptoms, if any, resolve quickly after dose reduction, provided there is careful monitoring.</p><p><p><b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT03396744.</p>","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"86 3","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differentiating Subtypes of Major Depressive Disorder Using Serum Biomarkers.","authors":"Jae-Min Kim, Hee-Ju Kang, Ju-Yeon Lee, Ju-Wan Kim, Honey Kim, Min Jhon, Sung-Wan Kim, Il-Seon Shin","doi":"10.4088/JCP.25m15828","DOIUrl":"10.4088/JCP.25m15828","url":null,"abstract":"<p><p><b>Objective:</b> This study aimed to differentiate subtypes of major depressive disorder (MDD) using 14 serum biomarkers across 6 functional systems.</p><p><p><b>Methods:</b> We analyzed serum biomarkers in 993 MDD patients, categorized into melancholic (N = 157; 16.8%), atypical (N = 56; 6.0%), and unspecified (N = 720; 77.2%) subtypes according to <i>DSM-IV</i> criteria. Biomarkers included high sensitivity C-reactive protein, tumor necrosis factor-α, interleukins (IL-1β, IL-6, IL-4, IL-10), cortisol, brain-derived neurotrophic factor, serotonin, leptin, total ghrelin, total cholesterol, folate, and homocysteine. Quantile regression analyses adjusted for relevant covariates were used to estimate associations between biomarkers and MDD subtypes.</p><p><p><b>Results:</b> Significant differences in biomarker profiles were observed across MDD subtypes: the melancholic subtype showed higher cortisol levels compared to the unspecified subtype (<i>P</i> = .009) and lower serotonin levels compared to both the unspecified (<i>P</i> = .045) and atypical (<i>P</i> = .006) subtypes. Meanwhile, the atypical subtype exhibited elevated levels of IL-1β compared to the unspecified subtype (<i>P</i> = .036) and higher IL-4 levels than both melancholic and unspecified subtypes (all <i>P</i> < .001). These associations remained significant even after adjusting for covariates.</p><p><p><b>Conclusion:</b> Distinct serum biomarker profiles among MDD subtypes highlight their unique biological underpinnings. These findings enhance current understanding of the pathophysiology of different depressive subtypes and suggest targeted therapeutic approaches. Future research should focus on longitudinal studies to monitor these biomarkers over time and explore new biomarkers from genomics and proteomics to advance precision medicine in psychiatry.</p>","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"86 3","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Schizophrenia, Antipsychotic Drugs, and Risk of Breast Cancer.","authors":"Chittaranjan Andrade","doi":"10.4088/JCP.25f15960","DOIUrl":"10.4088/JCP.25f15960","url":null,"abstract":"<p><p>Breast cancer is the commonest form of cancer among women. Literature suggests that women with schizophrenia are less likely to be screened for breast cancer and that, among women with schizophrenia who develop breast cancer, mortality rates are higher. This article examines recent meta-analyses and recent observational studies on the risk of breast cancer in women with schizophrenia, especially in the context of treatment with first generation and second generation antipsychotic (FGA, SGA) drugs. This article also examines the most recent observational study in detail to help readers better understand how to critically appraise this and, by extension, other studies in the field. In summary, studies in the field suggest that there is a small but statistically significant increase in the risk of breast cancer in women with schizophrenia relative to women without psychiatric disorders as well as relative to women with other psychiatric disorders. Women who appear to be most at risk are those in the perimenopausal age range and those with several years of exposure to FGA or prolactin raising antipsychotics. Whereas the possibility of residual confounding in observational studies precludes ascribing a causal role for antipsychotics, given that FGA and prolactin-raising SGA are associated with other adverse effects, it seems reasonable, wherever possible, to prefer SGA over FGA, and prolactin-sparing over prolactin-raising antipsychotics. Women with schizophrenia, and especially those who use prolactin raising antipsychotics for long periods, should be monitored for the risk of breast cancer as a special part of monitoring general health; and modifiable risk factors for breast cancer should be addressed through appropriate behavioral and pharmacological interventions. Women with schizophrenia comprise a vulnerable population, and their medical health should not be neglected even when caring for their mental health absorbs attention and time. Suggestions are provided for directions for future research.</p>","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"86 3","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Adult Sexual Assault and Psychiatric Disorders: Results From the National Epidemiologic Survey on Alcohol and Related Conditions-III.","authors":"Domitille Tisseau, Elodie-Gaëlle Ngameni, Caroline Dubertret, Yann Le Strat, Sarah Tebeka","doi":"10.4088/JCP.24m15631","DOIUrl":"https://doi.org/10.4088/JCP.24m15631","url":null,"abstract":"<p><p><b>Background:</b> Sexual assault is a significant public health issue with high prevalence rates, particularly among women. Previous research suggests strong associations between sexual assault and psychiatric disorders, but studies focusing on adult sexual assault (ASA) and its sex specific consequences are limited.</p><p><p><b>Objective:</b> To estimate the prevalence of ASA in the US and assess its associations with psychiatric disorders and quality of life, focusing on sex differences.</p><p><p><b>Methods:</b> We analyzed cross-sectional data from the National Epidemiologic Study of Alcohol and Related Conditions III (NESARC-III), a nationally representative survey of US adults (N = 36,309). The study included assessments of self-reported ASA and lifetime psychiatric disorders (Alcohol Use Disorder and Associated Disabilities Interview Schedule 5) and quality of life (Short-Form 12-Item Survey version 2).</p><p><p><b>Results:</b> The prevalence of self-reported ASA was 2.6% (n =922), with higher rates in women (4.26%) compared to men (0.53%). ASA was associated with all lifetime psychiatric disorders and a poorer quality of life. Among participants who experienced ASA, 85.25% had at least one lifetime psychiatric disorder. Specifically, among women, 86.09% of victims had at least one lifetime psychiatric disorder (vs 54.43% in women control). The strongest associations were found with posttraumatic stress disorder (PTSD) (adjusted odds ratio [aOR] =5.96), borderline personality disorder (aOR= 4.06), and suicide attempts (aOR= 4.67). Among men, 78.27% of victims had at least one lifetime psychiatric disorder (vs 58.09% in men control). The strongest associations were with psychotic disorders (aOR=6.65), PTSD (aOR=6.62), and suicide attempts (aOR=5.01).</p><p><p><b>Conclusions:</b> ASA was associated with many psychiatric disorders and reduced quality of life, with significant sex differences. These findings highlight the need for targeted interventions and support for sexual assault survivors, emphasizing the importance of routine screening and sex-specific prevention strategies.</p>","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"86 3","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Treatment With Aripiprazole Monohydrate: Pharmacokinetic Advantages of Long-Acting Injectable Formulations, A Consensus Panel Report.","authors":"Joseph F Goldberg, Eric D Achtyes, Christoph U Correll, Martha Sajatovic, Stephen R Saklad","doi":"10.4088/JCP.plunlai2424ah1","DOIUrl":"10.4088/JCP.plunlai2424ah1","url":null,"abstract":"<p><p>Schizophrenia and bipolar I disorder (BP-I) are chronic, disabling psychiatric illnesses marked by high morbidity, elevated mortality, and functional deterioration, often exacerbated by poor adherence to oral antipsychotic medications. Long-acting injectable (LAI) antipsychotics were developed to address adherence challenges and have demonstrated clinical benefits including reduced non-adherence and relapse rates, fewer hospitalizations, and improved functioning and quality of life, and reduced mortality risk. Among available LAIs, aripiprazole offers a unique pharmacologic profile as the only partial dopamine agonist available in an LAI formulation. Aripiprazole monohydrate LAI is available as a once monthly and a once-every-two-month formulation. In this consensus panel report, five psychiatric experts convened to evaluate the pharmacokinetic properties, safety, efficacy, and clinical utility of aripiprazole monohydrate LAIs in the treatment of schizophrenia and BP-I. The panel focused particularly on the more recently approved once-every-2-month ready-to-use formulation. This article summarizes the evidence reviewed by the panel and highlights key considerations for optimizing the use of aripiprazole monohydrate LAIs in clinical practice to enhance treatment outcomes in patients with schizophrenia and BP-I.</p>","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"86 2","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}