Nature mental health最新文献

Nature mental health Pub Date : 2025-04-08 DOI: 10.1038/s44220-025-00420-8

引用次数: 0

The paradox of clozapine in Black people with treatment-resistant schizophrenia

Nature mental health Pub Date : 2025-04-08 DOI: 10.1038/s44220-025-00411-9

Eromona Whiskey, Christian Bachmann, Olubanke Dzahini, David Taylor, Ebenezer Oloyede

引用次数: 0

Comparative effectiveness of long-acting injectable versus oral antipsychotic medication after a first episode of psychosis

Nature mental health Pub Date : 2025-04-08 DOI: 10.1038/s44220-025-00407-5

Alejandro G. Szmulewicz, Gonzalo Martínez-Alés, Roger Logan, Ridha Joober, Maria Ferrara, Christian Kelly, Diane Fredrikson, Lorna E. Thorpe, Sarah Conderino, Covadonga M. Díaz-Caneja, Vinod Srihari, Lakshmi N. Yatham, Deepak K. Sarpal, Ann K. Shinn, Celso Arango, Jai L. Shah, Dost Öngür, Miguel A. Hernán, on behalf of the FEP-CAUSAL Collaboration

{"title":"Comparative effectiveness of long-acting injectable versus oral antipsychotic medication after a first episode of psychosis","authors":"Alejandro G. Szmulewicz, Gonzalo Martínez-Alés, Roger Logan, Ridha Joober, Maria Ferrara, Christian Kelly, Diane Fredrikson, Lorna E. Thorpe, Sarah Conderino, Covadonga M. Díaz-Caneja, Vinod Srihari, Lakshmi N. Yatham, Deepak K. Sarpal, Ann K. Shinn, Celso Arango, Jai L. Shah, Dost Öngür, Miguel A. Hernán, on behalf of the FEP-CAUSAL Collaboration","doi":"10.1038/s44220-025-00407-5","DOIUrl":"10.1038/s44220-025-00407-5","url":null,"abstract":"Switching to long-acting injectable (LAI) antipsychotic therapy as compared with continuation of oral therapy after a first episode of psychosis (FEP) may reduce the risk of relapse and hospitalization, as reported in some randomized trials. However, other trials and network meta-analyses reported no risk reduction. We emulated two target trials using data from the FEP-CAUSAL Collaboration, an international consortium of observational cohorts of people with FEP. The first target trial was designed to ask a similar question as the European Long-Acting Antipsychotics in Schizophrenia Trial (EULAST) trial, which compared the 18-month hospitalization risk between patients assigned to LAI therapy (aripiprazole, risperidone or paliperidone) and those on continuation of oral therapy. We benchmarked the observational estimates to those from the actual trial. The second target trial extended the first to examine the 3-year risks of psychotic relapses and in subgroups (prior relapses, non-adherence, substance use disorder). Of 2,228 individuals with FEP, 1,067 were eligible for the benchmarking analyses. Both our target trial emulation and EULAST showed little effect of LAI therapy initiation on the 18-month hospitalization risk. In the extended analysis (1,193 individuals), the 3-year risk difference of psychotic relapse comparing LAI therapy initiation with oral continuation was –7.0% (95% CI: –12.1, –0.7). The risk difference was substantially lower in subgroups with a prior relapse (–15.5%, 95%CI: –24.1, –5.5) or prior non-adherence (–21.9, 95% CI: –41.9, –2.0). We estimated that, compared with oral therapy continuation, LAI therapy initiation reduced psychotic relapses over 3 years. LAI therapy initiation may be particularly beneficial in vulnerable subgroups. This study reveals that in people with first episode of psychosis receiving oral antipsychotic medication, switching to long-acting injectable antipsychotic therapy may reduce psychotic relapses, especially in vulnerable subgroups, such as those with prior relapses or non-adherence to antipsychotic medication.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"3 4","pages":"421-428"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143801937","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}

引用次数: 0

Improving mental health diagnostic quality through cognitively tractable definitions

Nature mental health Pub Date : 2025-04-01 DOI: 10.1038/s44220-025-00404-8

Philip Millroth, August Collsiöö

引用次数: 0

Maternal neuroplasticity and mental health during the transition to motherhood

Nature mental health Pub Date : 2025-04-01 DOI: 10.1038/s44220-025-00399-2

Natalia Chechko, Susanne Nehls

{"title":"Maternal neuroplasticity and mental health during the transition to motherhood","authors":"Natalia Chechko, Susanne Nehls","doi":"10.1038/s44220-025-00399-2","DOIUrl":"10.1038/s44220-025-00399-2","url":null,"abstract":"The first 6 weeks postpartum are characterized by major changes in the bodies of cisgender women and an increased vulnerability to psychiatric disorders such as postpartum depression (PPD). This Perspective addresses the debate over the onset of PPD in the first 6 weeks postpartum and its probable relationship to physiological adaptation processes. Fluctuations in hormone levels during pregnancy and childbirth trigger simultaneous changes in brain structure and function, which are particularly dynamic in the first 6 weeks postpartum. At the same time, rapid hormone withdrawal coincides with mood disorders such as ‘baby blues’ or PPD. Understanding the covariance between the temporal trajectories of hormonal adaptations, time-dependent neuroplasticity and the onset of mood disorders may shed valuable light on the highly sensitive time frame of the first 6 weeks postpartum, which, in addition to being a critical period of transition, may prove to be crucial for the onset of PPD. In this Perspective, the authors highlight the importance of the first 6 weeks after birth for postpartum neuroplasticity, and discuss multiple occurring processes that may contribute to the onset of postpartum depression.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"3 4","pages":"396-401"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143801903","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}

引用次数: 0

Embracing complexity in resilience research

Nature mental health Pub Date : 2025-03-28 DOI: 10.1038/s44220-025-00403-9

Sarah R. Lowe

引用次数: 0

Addressing the oversight of hemispheric differences in psychiatry research

Nature mental health Pub Date : 2025-03-28 DOI: 10.1038/s44220-025-00405-7

Annakarina Mundorf, Sebastian Ocklenburg

引用次数: 0

Subgroup-specific brain connectivity alterations in early stages of psychosis

Nature mental health Pub Date : 2025-03-27 DOI: 10.1038/s44220-025-00394-7

Ludovica Mana, Ane López-González, Yasser Alemán-Gómez, Philipp S. Baumann, Raoul Jenni, Luis Alameda, Lilith Abrahamyan Empson, Paul Klauser, Philippe Conus, Patric Hagmann, Manel Vila-Vidal, Gustavo Deco

{"title":"Subgroup-specific brain connectivity alterations in early stages of psychosis","authors":"Ludovica Mana, Ane López-González, Yasser Alemán-Gómez, Philipp S. Baumann, Raoul Jenni, Luis Alameda, Lilith Abrahamyan Empson, Paul Klauser, Philippe Conus, Patric Hagmann, Manel Vila-Vidal, Gustavo Deco","doi":"10.1038/s44220-025-00394-7","DOIUrl":"10.1038/s44220-025-00394-7","url":null,"abstract":"Functional brain scans have shown that connectivity alterations are strongly associated with the first episode of psychosis, yet it is not well understood whether these alterations vary with the clinical status of patients at the time of scanning. This cross-sectional study aimed to identify brain connectivity properties that differentiate remitting and non-remitting early psychosis (EP) patients from healthy controls and to explore the mechanisms underlying these differences. To this end, we analyzed resting-state fMRI and DSI data from 88 EP patients categorized by their remission ability after the first episode of psychosis. We focused on differences between stage III remitting–relapsing (EP3R) and stage III non-remitting (EP3NR) patients. Opposing functional connectivity (FC) alterations were observed: EP3NR patients exhibited lower FC compared with controls, while EP3R patients showed higher FC, possibly reflecting compensatory mechanisms. Whole-brain network modeling revealed lower local stability affecting the ability to regulate the flow of stimuli across the network in stage III patients, particularly in EP3R, which may indicate an adaptation to impaired network conductivity. These findings highlight subgroup-specific brain alterations and underscore the importance of considering this source of heterogeneity in psychosis research. This magnetic resonance imaging study identified distinct brain connectivity profiles for different clinical remission trajectories after a first episode of psychosis.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"3 4","pages":"408-420"},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143801904","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}

引用次数: 0

Emotions and individual differences shape human foraging under threat

Nature mental health Pub Date : 2025-03-12 DOI: 10.1038/s44220-025-00393-8

Hailey A. Trier, Jill X. O’Reilly, Lisa Spiering, Sandy Ma Yishan, Nils Kolling, Matthew F. S. Rushworth, Jacqueline Scholl

{"title":"Emotions and individual differences shape human foraging under threat","authors":"Hailey A. Trier, Jill X. O’Reilly, Lisa Spiering, Sandy Ma Yishan, Nils Kolling, Matthew F. S. Rushworth, Jacqueline Scholl","doi":"10.1038/s44220-025-00393-8","DOIUrl":"10.1038/s44220-025-00393-8","url":null,"abstract":"A common behavior in natural environments is foraging for rewards. However, this is often in the presence of predators. Therefore, one of the most fundamental decisions for humans, as for other animals, is how to apportion time between reward-motivated pursuit behavior and threat-motivated checking behavior. To understand what affects how people strike this balance, we developed an ecologically inspired task and looked at both within-participant dynamics (moods) and between-participant individual differences (questionnaires about real-life behaviors) in two large internet samples (n = 374 and n = 702) in a cross-sectional design. For the within-participant dynamics, we found that people regulate task-evoked stress homeostatically by changing behavior (increasing foraging and hiding). Individual differences, even in superficially related traits (apathy–anhedonia and anxiety–compulsive checking) reliably mapped onto unique behaviors. Worse task performance, due to maladaptive checking, was linked to gender (women checked excessively) and specific anxiety-related traits: somatic anxiety (reduced self-reported checking due to worry) and compulsivity (self-reported disorganized checking). While anhedonia decreased self-reported task engagement, apathy, strikingly, improved overall task performance by reducing excessive checking. In summary, we provide a multifaceted paradigm for assessment of checking for threat in a naturalistic task that is sensitive to both moods as they change throughout the task and clinical dimensions. Thus, it could serve as an objective measurement tool for future clinical studies interested in threat, vigilance or behavior–emotion interactions in contexts requiring both reward seeking and threat avoidance. This study explores the impact of mood and individual differences on trading off between possible rewards and checking for the presence for threat and escaping to safety in a gamified foraging task.","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":"3 4","pages":"444-465"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44220-025-00393-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143801935","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}

引用次数: 0

Repurposing semaglutide to treat alcohol use disorder

Nature mental health Pub Date : 2025-03-11 DOI: 10.1038/s44220-025-00400-y

Ana Donnelly

引用次数: 0