The American journal of psychiatry最新文献

{"title":"Mobile Health for Alcohol Use Assessment: Longitudinal Effects of Breathalyzer Self-Monitoring in Everyday Contexts.","authors":"Yang Lu, Catharine E Fairbairn, Jiaxu Han, Nigel Bosch","doi":"10.1176/appi.ajp.20241170","DOIUrl":"10.1176/appi.ajp.20241170","url":null,"abstract":"<p><strong>Objective: </strong>Although mobile health-tracking technologies have burgeoned, offering objective health information to consumers on an unprecedented scale, opportunities to directly test effects of such monitoring have been limited. Low-cost mobile breathalyzers are one tool commonly employed for blood alcohol concentration (BAC) assessment. The authors explored outcomes linked with BAC-tracking technologies, examining effects on alcohol use and self-estimation of BAC levels in a large U.S. sample.</p><p><strong>Methods: </strong>Participants (N=32,179) were individuals who voluntarily purchased a mobile breathalyzer and provided at least three ad-lib readings between 2016 and 2022. A paired smartphone application prompted users to enter a BAC self-estimate (a guess) before the measured BAC level was displayed. Analyses included observations collected during active consumption (BAC >0.00%) from breathalyzer users who opted to share anonymized data. Breathalyzer users who displayed inattentive patterns of guessing were excluded from self-estimation analyses. The final dataset comprised 787,393 BAC readings and 387,643 self-estimates.</p><p><strong>Results: </strong>The accuracy of BAC guesses increased by 2.38% over the course of breathalyzer use. Associations between breathalyzer use and BAC levels varied significantly according to participants' initial drinking levels (b=-0.0062, 95% CI=-0.0065, -0.0059). Among heavy-drinking participants, BAC levels decreased on average from 0.106% to 0.096%, whereas the reverse trend was observed for lighter-drinking participants, whose levels increased from 0.058% to 0.067%. A similar interaction emerged for BAC underestimation (b=-0.0058, 95% CI=-0.0066, -0.0049), with odds of underestimation decreasing among heavy-drinking and increasing among light-drinking participants.</p><p><strong>Conclusions: </strong>The results indicate promise for mobile BAC-tracking technologies as a low-impact intervention with the potential to decrease drinking among individuals who drink heavily-a population particularly susceptible to alcohol-related problems. In contrast, inverted trends emerged for light-drinking individuals, highlighting the need for empirical research in the fast-moving landscape of digital health.</p>","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":" ","pages":"251-259"},"PeriodicalIF":14.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12875647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Substance Use Disorders.","authors":"Ned H Kalin","doi":"10.1176/appi.ajp.20260189","DOIUrl":"https://doi.org/10.1176/appi.ajp.20260189","url":null,"abstract":"","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":"183 4","pages":"217-219"},"PeriodicalIF":14.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to Linke et al.","authors":"","doi":"10.1176/appi.ajp.20241043correction","DOIUrl":"https://doi.org/10.1176/appi.ajp.20241043correction","url":null,"abstract":"","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":"183 4","pages":"275"},"PeriodicalIF":14.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biosocial Implications of Indigenous Trauma.","authors":"Joseph P Gone","doi":"10.1176/appi.ajp.20250166","DOIUrl":"https://doi.org/10.1176/appi.ajp.20250166","url":null,"abstract":"","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":" ","pages":"appiajp20250166"},"PeriodicalIF":14.7,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147439143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Finding a Medication for Negative Symptoms in Schizophrenia: Why So Many Failures?","authors":"Stephen R Marder","doi":"10.1176/appi.ajp.20251316","DOIUrl":"https://doi.org/10.1176/appi.ajp.20251316","url":null,"abstract":"","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":"183 3","pages":"154-155"},"PeriodicalIF":14.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inner-Directed Therapy in MDMA-Assisted Psychotherapy.","authors":"Michael D Alpert, Casey Paleos, Chantelle Thomas","doi":"10.1176/appi.ajp.20250554","DOIUrl":"10.1176/appi.ajp.20250554","url":null,"abstract":"","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":" ","pages":"180-182"},"PeriodicalIF":14.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145553178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Safety and Efficacy of Xanomeline and Trospium Chloride in Schizophrenia: A 52-Week Open-Label Extension Trial.","authors":"Inder Kaul, Amy Claxton, Colin Sauder, Tejendra Patel, Soumya Chaturvedi, David Brown, Haiyuan Zhu, Ronald Marcus, Sharon Sawchak, Stephen K Brannan","doi":"10.1176/appi.ajp.20241186","DOIUrl":"10.1176/appi.ajp.20241186","url":null,"abstract":"<p><strong>Objective: </strong>Xanomeline and trospium chloride (X/T) reduced symptoms and was generally well tolerated in two phase 3, 5-week, randomized, double-blind, placebo-controlled trials in adults with schizophrenia. The authors evaluated the long-term safety, tolerability, and efficacy of X/T in an open-label extension of the two phase 3 trials.</p><p><strong>Methods: </strong>EMERGENT-4 was a 52-week open-label extension trial of participants who completed the EMERGENT-2 and EMERGENT-3 acute trials. Between February 2021 and October 2023, 152 participants initiated twice-daily oral doses of xanomeline 50 mg/trospium 20 mg and titrated to a maximum dosage of twice-daily oral xanomeline 125 mg/trospium 30 mg. The primary endpoint was the proportion of participants reporting a treatment-emergent adverse event (TEAE). Efficacy measures included Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impressions severity scale (CGI-S).</p><p><strong>Results: </strong>A total of 156 (42.6%) of the 366 participants who completed EMERGENT-2 or EMERGENT-3 enrolled in EMERGENT-4; of these 34 (21.8%) enrolled participants completed the 52-week treatment period. Overall, 81 (53.3%) of 152 treated participants experienced at least one TEAE. Consistent with the acute trials, the most common treatment-related adverse events were gastrointestinal disorders (e.g., nausea, vomiting, dyspepsia, dry mouth) that were mild or moderate in intensity and resolved with continued treatment. No new safety or tolerability issues were observed. X/T was not associated with clinically meaningful motor symptoms, hyperprolactinemia, weight gain, or adverse effects on metabolic parameters. X/T was associated with continued symptom improvement over the trial duration. Mean changes in PANSS total score from acute trial baseline to week 52 were -33.8 and -31.3 in the treatment groups receiving X/T and placebo, respectively, in the acute trials. Similar patterns of continued improvement were observed for scores on the CGI-S, PANSS positive subscale, and PANSS negative subscale.</p><p><strong>Conclusions: </strong>Long-term treatment with X/T over 52 weeks was safe, generally well tolerated, and associated with durable symptom improvement in people with schizophrenia.</p>","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":" ","pages":"183-192"},"PeriodicalIF":14.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overlooked Methodological Limitations in the Study of Grip Strength and Default Mode Network Connectivity in Early Psychosis.","authors":"Chao Li, Peng Sun","doi":"10.1176/appi.ajp.20250991","DOIUrl":"https://doi.org/10.1176/appi.ajp.20250991","url":null,"abstract":"","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":"183 3","pages":"214"},"PeriodicalIF":14.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personalizing Brain Stimulation for Psychiatric Disorders: From Circuits to Closed-Loop Control.","authors":"Christopher C Cline, Corey J Keller","doi":"10.1176/appi.ajp.20251327","DOIUrl":"10.1176/appi.ajp.20251327","url":null,"abstract":"<p><p>Transcranial magnetic stimulation (TMS) is an established treatment for depression, yet response rates remain at 50% 1 month after treatment. Despite two decades of clinical use, substantial room for improvement remains. This overview examines biomarker-guided personalization of brain stimulation. The authors trace the translational path from invasive circuit-level insights through noninvasive biomarkers to clinical deployment. With validated biomarkers, systematic optimization becomes possible: stimulation parameter tuning, state-dependent approaches, augmentation strategies, and closed-loop systems. The path forward requires randomized trials demonstrating that biomarker-guided personalization improves outcomes beyond standard care, justifying increased complexity and costs. Success would mark an important pathway in interventional psychiatry's evolution to precision medicine.</p>","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":"183 3","pages":"169-179"},"PeriodicalIF":14.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Problematic Alcohol Use and Various Psychiatric Disorders: A Genetically Informed Study.","authors":"Bruce Lawford, Alexander Norrie","doi":"10.1176/appi.ajp.20250814","DOIUrl":"https://doi.org/10.1176/appi.ajp.20250814","url":null,"abstract":"","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":"183 3","pages":"215-216"},"PeriodicalIF":14.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}