The American journal of psychiatry最新文献

{"title":"Convergent Metabolic Dysregulations But Divergent Contributing Pathways Across Severe Mental Disorders: The Power of Combining Genetics and Metabolomics.","authors":"Brenda W J H Penninx, Yuri Milaneschi","doi":"10.1176/appi.ajp.20260392","DOIUrl":"https://doi.org/10.1176/appi.ajp.20260392","url":null,"abstract":"","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":"183 7","pages":"437-439"},"PeriodicalIF":14.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364819","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":"2026 Annual Meeting: Presidential Address.","authors":"Theresa M Miskimen Rivera","doi":"10.1176/appi.ajp.26183005","DOIUrl":"https://doi.org/10.1176/appi.ajp.26183005","url":null,"abstract":"","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":"183 7","pages":"440-441"},"PeriodicalIF":14.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364836","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":"Understanding Substance Use Characteristics Among Individuals Across the Sexual Identity Spectrum.","authors":"E Thomas Lewis, Sudie E Back, Kathleen T Brady","doi":"10.1176/appi.ajp.20260501","DOIUrl":"https://doi.org/10.1176/appi.ajp.20260501","url":null,"abstract":"","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":"183 7","pages":"435-436"},"PeriodicalIF":14.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364847","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":"Trauma and Adverse Outcomes: Cause, Consequence, or Shared Vulnerability?","authors":"Ian Kelleher","doi":"10.1176/appi.ajp.20260118","DOIUrl":"https://doi.org/10.1176/appi.ajp.20260118","url":null,"abstract":"","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":"183 7","pages":"433-434"},"PeriodicalIF":14.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364856","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":"Substance Use Patterns Across the Sexual Identity Spectrum Among U.S. Individuals.","authors":"Kevin H Yang, Letitia A Mueller, Benjamin H Han, Joseph J Palamar","doi":"10.1176/appi.ajp.20250206","DOIUrl":"10.1176/appi.ajp.20250206","url":null,"abstract":"<p><strong>Objective: </strong>The authors sought to examine substance use patterns across the sexual identity spectrum, particularly among individuals who describe their sexual identity using different terms or express uncertainty about their orientation-groups that remain poorly understood beyond lesbian, gay, or bisexual (LGB) categories.</p><p><strong>Methods: </strong>Using data from the 2023 National Survey on Drug Use and Health among individuals ≥12 years of age (N=52,525), the authors examined past-year substance use across five sexual identity groups: heterosexual, gay/lesbian, bisexual, those using a different term to describe their sexual identity, and those unsure of their identity. Associations were examined between sexual identity (overall and disaggregated by sex using sex-specific heterosexual reference groups) and past-year use of cannabis, hallucinogens, cocaine, inhalants, methamphetamine, and misuse of prescription opioids, tranquilizers/sedatives, and stimulants.</p><p><strong>Results: </strong>Substance use was higher across all other sexual identity groups compared with heterosexual individuals. Bisexual and gay/lesbian individuals showed elevated odds across most substances examined, particularly inhalants, hallucinogens, and cannabis. Both individuals using different terms and those unsure of their sexual identity showed elevated odds for inhalants, hallucinogens, cannabis, and prescription tranquilizer/sedative misuse, with those using different terms additionally showing elevated odds for prescription stimulant misuse. In sex-disaggregated analyses, both males and females showed elevated odds across multiple substances, with females generally showing elevations across a greater number of substances, although some estimates for males were suppressed due to small sample sizes.</p><p><strong>Conclusions: </strong>These findings extend our understanding of substance use beyond LGB categories, revealing nuanced patterns among emerging identity groups, underscoring the importance of targeted screening and prevention strategies.</p>","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":" ","pages":"472-481"},"PeriodicalIF":14.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12949925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146215537","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":"Social Determinants of Health in Psychiatric Disorders: Exciting Opportunities for Biopsychosocial Research and Clinical Care.","authors":"Dilip V Jeste, Elvis Gyan","doi":"10.1176/appi.ajp.20260402","DOIUrl":"https://doi.org/10.1176/appi.ajp.20260402","url":null,"abstract":"<p><p>Social determinants of health (SDoHs) are increasingly recognized as important contributors to the development, course, and outcomes of psychiatric disorders. However, their integration into clinical psychiatry and mechanistic models remains limited. This overview synthesizes emerging evidence on the biopsychosocial mechanisms through which SDoHs influence mental health. There is a need to distinguish between individual-level, clinically actionable health-related social needs and family-, community-, and society-level structural SDoHs, and to consider both adverse and protective social factors. Converging research demonstrates that social experiences are biologically embedded through interacting pathways, including exposomics, epigenetics, allostatic load, accelerated inflammaging, immune dysregulation, and gut-brain-microbiome signaling. These mechanisms influence neural circuitry underlying stress regulation, reward processing, and social cognition. Psychological processes-including individual differences in resilience, wisdom, compassion, and purpose in life-shape responses to SDoHs and are supported by identifiable neurobiological substrates. Social connection has emerged as a central, potentially modifiable SDoH that is strongly associated with whole health and longevity. Loneliness and social isolation have become major global public health challenges. The authors propose a biopsychosocial framework that integrates social exposures, biological mechanisms, neural systems, and psychological processes to better understand the risk, course, and prevention of mental illnesses. Clinical and public health implications include the need for routine assessment of SDoHs, incorporation of protective factors at individual and societal levels, and development of pragmatic, multidomain interventions. Finally, rapidly evolving digital technologies, including artificial intelligence, offer new opportunities but also require careful governance. Advancing toward human-centered \"artificial wisdom\" may enhance the capacity of technology to promote whole health in individuals with mental illnesses globally.</p>","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":"183 7","pages":"450-460"},"PeriodicalIF":14.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364851","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":"Reports to the Membership.","authors":"","doi":"10.1176/appi.ajp.26183004","DOIUrl":"https://doi.org/10.1176/appi.ajp.26183004","url":null,"abstract":"","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":"183 7","pages":"496-509"},"PeriodicalIF":14.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364864","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":"Risk of Presentation for Sexual Abuse After a First Emergency Department Presentation for Self-Harm in Childhood or Adolescence.","authors":"Matisse Blundell, Paul Kurdyak, Janice Du Mont, Louise Gallagher, Daphne J Korczak, Suneeta Monga, Jacob A S Vorstman","doi":"10.1176/appi.ajp.20250691","DOIUrl":"10.1176/appi.ajp.20250691","url":null,"abstract":"<p><strong>Objective: </strong>Self-harm in childhood and adolescence is associated with a range of adverse outcomes. Limited evidence suggests that these individuals are at elevated risk of experiencing sexual violence in adolescence and young adulthood. This population-based cohort study identified children and adolescents with a first presentation to health services for self-harm and examined their risk of subsequent presentation for sexual abuse or assault.</p><p><strong>Methods: </strong>Health administrative data were used to identify all children and adolescents with a first presentation for self-harm over a 10-year period (2013-2022) in the province of Ontario, Canada (population 16 million). Time to first presentation for sexual abuse or assault was compared to that of individuals in a control group matched on age, sex, and area-level socioeconomic status using Cox proportional hazards modeling.</p><p><strong>Results: </strong>The cohort included 139,233 individuals. After a first presentation for self-harm, the 10-year cumulative incidence of presentation for sexual abuse was 9.06% (95% CI=8.55, 9.57), compared to 1.26% (95% CI=1.17, 1.36) for the control group (hazard ratio=8.32, 95% CI=7.68, 9.02). Risk remained elevated after adjustment for factors influencing vulnerability to sexual abuse (hazard ratio=5.06, 95% CI=4.53, 5.65). Results were similar for the outcome of sexual assault (cumulative incidence, 4.14% [95% CI=3.76, 4.51] versus 0.48% [95% CI=0.41, 0.54]; fully adjusted hazard ratio=6.44, 95% CI=5.38, 7.71). Sex-stratified analyses revealed a greater absolute risk for females.</p><p><strong>Conclusions: </strong>Presentation for self-harm during childhood and adolescence, in addition to being concerning for potential sexual abuse history, may be a marker of vulnerability for future sexual abuse or assault. These findings suggest a need for further research and implications for clinical practice.</p>","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":" ","pages":"461-471"},"PeriodicalIF":14.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146215535","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":"Divergent Patterns of Genetic Overlap Between Severe Mental Disorders and Metabolic Markers.","authors":"Dennis van der Meer, Alexey A Shadrin, Sara E Stinson, Elise Koch, Jaroslav Rokicki, Zillur Rahman, Jacob Bergstedt, Aigar Ottas, Ida E Sønderby, Linn Rødevand, Julian Fuhrer, Daniel S Quintana, Anders M Dale, Kevin S O'Connell, Srdjan Djurovic, Kelli Lehto, Lili Milani, Maris Alver, Ole A Andreassen","doi":"10.1176/appi.ajp.20250259","DOIUrl":"10.1176/appi.ajp.20250259","url":null,"abstract":"<p><strong>Objective: </strong>Bipolar disorder, major depressive disorder (MDD), and schizophrenia are severe mental disorders and are each associated with poor cardiometabolic health. Mapping genetic relationships of these heritable disorders with blood markers of metabolic activity may uncover biological pathways underlying this important shared clinical feature.</p><p><strong>Methods: </strong>The authors charted genetic overlap of the three disorders, type 2 diabetes, coronary artery disease, and body mass index (BMI) with 249 circulating metabolites through linkage disequilibrium score regression and bivariate Gaussian mixture modeling. Causal relationships and functionally annotated shared genetic variants were estimated, and enrichment across brain and body tissues was investigated.</p><p><strong>Results: </strong>All three disorders had extensive overlap with the metabolites. The pattern of genetic correlations was similar between MDD, type 2 diabetes, coronary artery disease, and BMI (Spearman's correlation r_s>0.93), opposite in direction to the pattern found for schizophrenia and bipolar disorder (MDD-bipolar disorder r_s=-0.74; MDD-schizophrenia r_s=-0.83). Notably, this genetic divergence contrasted with phenotypic associations, which were similar across all three disorders. The metabolites had widespread, robust causal effects on the disorders and cardiometabolic traits. The authors mapped 1,056 genes shared between the individual disorders and metabolites to disorder-specific processes related to metabolic activity, mitochondrial function, and synaptic processes. These genes were expressed throughout the brain, heart, and liver.</p><p><strong>Conclusions: </strong>Severe mental disorders have strong associations with metabolites, and MDD has a distinctly different genetic relationship than bipolar disorder and schizophrenia do. The study findings suggest that metabolic pathways are involved in the development of severe mental disorders and can play a central role in disentangling disorder-specific etiologies. The \"metabolic psychiatry\" approach applied here has high potential to guide development of targeted interventions.</p>","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":" ","pages":"482-493"},"PeriodicalIF":14.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146215539","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":"Social Determinants of Health, Digital Therapeutics, and Other Promising Findings.","authors":"Ned H Kalin","doi":"10.1176/appi.ajp.20260500","DOIUrl":"https://doi.org/10.1176/appi.ajp.20260500","url":null,"abstract":"","PeriodicalId":520786,"journal":{"name":"The American journal of psychiatry","volume":"183 7","pages":"431-432"},"PeriodicalIF":14.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364813","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}