American Journal of Psychiatry最新文献

{"title":"Prevalence and Correlates of Past-Year Psilocybin Use in the United States.","authors":"Kevin H Yang,Avery Eun,Joseph J Palamar","doi":"10.1176/appi.ajp.20251343","DOIUrl":"https://doi.org/10.1176/appi.ajp.20251343","url":null,"abstract":"","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"17 1","pages":"appiajp20251343"},"PeriodicalIF":17.7,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147731622","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":"Transcriptional Profiles of Somatostatin and Parvalbumin Interneuron Subtypes in the Human Dorsolateral Prefrontal Cortex: Implications for Schizophrenia.","authors":"John F Enwright,Alex M Tamburino,Tayfun Tumkaya,Ditte Lovatt,Jie Pan,Ramesh Gunaratna,Delphine Fagegaltier,Xiaohai Wang,Michael J Marino,Ken Fish,Dominique Arion,Guillermo Gonzalez-Burgos,David A Lewis","doi":"10.1176/appi.ajp.20250355","DOIUrl":"https://doi.org/10.1176/appi.ajp.20250355","url":null,"abstract":"OBJECTIVEAlterations in the somatostatin (SST) and parvalbumin (PVALB) classes of inhibitory GABAergic interneurons in the dorsolateral prefrontal cortex (DLPFC) are thought to contribute to the core cognitive impairments of schizophrenia. Both classes of interneurons are composed of multiple subtypes, but the distinguishing features and relative proportions of these subtypes have not been determined in the DLPFC. The aim of this study is to provide a comprehensive analysis of these subtypes from young and middle-age adults with no known psychiatric disorders.METHODSThe authors used single-nucleus RNA sequencing to determine the transcriptional profiles of interneuron subtypes in DLPFC tissue samples from discovery and validation cohorts; fluorescent in situ hybridization to validate selected findings; and comparisons of transcriptome and electrophysiology data from the Allen Brain Atlas to infer functional properties of selected subtypes.RESULTSThe relative proportions of five major interneuron classes and of 37 interneuron subtypes were highly consistent across 19 individuals. Eleven SST subtypes were identified, including two rare subtypes that likely produce dopamine or regulate blood flow, and a subtype derived from the caudal ganglionic eminence. Among the nine PVALB subtypes identified, chandelier cells were transcriptionally distinct from PVALB basket cells (PVBCs) and PVBC subtypes. Moreover, subsets of PVBCs were distinguished by high versus low PVALB expression and had distinctive molecular features consistent with differences in anatomical (i.e., perineuronal nets) and electrophysiological (i.e., firing properties) characteristics.CONCLUSIONSThe robust identification of discrete subtypes of SST and PVALB interneurons in the DLPFC from young and middle-age adults with no known psychiatric disorders provides the means to determine which specific subtypes could be altered in proportional representation and/or gene expression in schizophrenia.","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"571 1","pages":"appiajp20250355"},"PeriodicalIF":17.7,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147731621","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":"Envisioning Cannabinoid CB1 Receptor Biased Signaling as a Therapeutic Target for Schizophrenia.","authors":"Shih-Hsuan Ku,Sierra J Stringfield,Mary M Torregrossa,Robert A Sweet,Shinnyi Chou","doi":"10.1176/appi.ajp.20250886","DOIUrl":"https://doi.org/10.1176/appi.ajp.20250886","url":null,"abstract":"The relationship between the endocannabinoid system and the emergence and treatment of schizophrenia-related symptoms continues to be a topic of significant interest within psychiatry. Cannabis is the most widely used recreational drug worldwide, and individuals with schizophrenia use it at a much higher rate than the general population. The shared genetic risk for schizophrenia and cannabis use may partially account for this phenomenon. However, the exposure to cannabis in individuals at risk of schizophrenia appears to not only represent the manifestation of overlapping risks, but also pharmacological exacerbation of an already altered cortical system. Thus, cannabis use dose-dependently increases the likelihood of receiving a schizophrenia diagnosis, acutely exacerbates schizophrenia symptoms, and worsens long-term prognosis for individuals with schizophrenia. The psychoactive substance in cannabis, Δ9-tetrahydrocannabinol, targets the cannabinoid CB1 receptor (CB1R), a G protein-coupled receptor (GPCR). This brief review focuses on recent advances that may enable effective therapeutic targeting of CB1R for the treatment of schizophrenia, especially in individuals with comorbid schizophrenia and cannabis use. The authors summarize the current understanding of CB1R relevant to schizophrenia in sections covering the basic cortical biology and sex differences of CB1R; current knowledge of CB1R alterations in schizophrenia and the potential impact of comorbid cannabis use; recent cell type-specific findings that reconcile past discrepant research in the field; and advances in understanding of GPCR pharmacology and biased ligands that provide new opportunities for CB1R-targeted therapeutics. Derived from this more nuanced understanding of CB1R, the authors propose future directions with the potential to develop a CB1R-targeted treatment of schizophrenia.","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"13 1","pages":"appiajp20250886"},"PeriodicalIF":17.7,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147695027","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":"The Comparative Efficacy of Noninvasive Brain Stimulation for Suicidal Ideation: A Network Meta-Analysis.","authors":"Jenna M Traynor,Jacob W Koudys,Madeleine Weichel,Sapolnach Prompiengchai,Benjamin Walsh,Julia Nolan,Stephanie Bousleiman,Orly Lipsitz,Zafiris J Daskalakis,Daniel M Blumberger,Anthony C Ruocco","doi":"10.1176/appi.ajp.20250753","DOIUrl":"https://doi.org/10.1176/appi.ajp.20250753","url":null,"abstract":"OBJECTIVENoninvasive brain stimulation (NIBS) holds promise for reducing suicidal ideation (SI), but its cross-diagnostic efficacy remains unexamined. This systematic review and network meta-analysis examined the comparative efficacy of NIBS interventions on SI across psychiatric conditions and the lifespan.METHODSThe authors searched Embase, MEDLINE, PsycINFO, CINAHL, and the Cochrane CENTRAL Database from inception to March 2023 for randomized controlled trials (RCTs) with at least one NIBS arm and an outcome from the suicide item of a standardized measure or a suicide-specific measure. Studies that focused solely on invasive stimulation or excluded participants with SI were ineligible. Network meta-analyses examined the comparative efficacy of NIBS for treating SI, using standardized mean differences (Hedges' g). Analyses were first restricted to RCTs that recruited participants with SI at baseline (network 1), then were conducted on all identified RCTs (network 2), and, finally, were conducted to examine NIBS plus pharmacotherapy initiation (network 3).RESULTSSeventy-five studies met inclusion criteria for the systematic review, and 58 were included in meta-analyses. Studies in network 1 (three RCTs) used accelerated transcranial magnetic stimulation (TMS) over the left dorsolateral prefrontal cortex (DLPFC); no difference from sham TMS was found. In network 2 (25 RCTs), bitemporal electroconvulsive therapy (ECT) was favorable compared to sham stimulation for reducing SI, and all other NIBS interventions showed no benefit over sham NIBS. In network 3 (five RCTs), left DLPFC repetitive TMS plus escitalopram significantly reduced SI compared to sham TMS plus a selective serotonin reuptake inhibitor (SSRI).CONCLUSIONSAlthough the findings were limited by small numbers of studies in networks 1 and 3, large heterogeneity in study design and SI outcomes in network 2, and a focus mostly on treating patients with depression in networks 2 and 3, they support bitemporal ECT and high-frequency repetitive TMS combined with SSRIs as effective interventions for improving SI, and nonconvulsive NIBS without pharmacotherapy shows no benefit over sham NIBS.","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"22 1","pages":"appiajp20250753"},"PeriodicalIF":17.7,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147695190","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":"Precision Neuromodulation in Psychiatry: Focus on Temporal Interference Stimulation.","authors":"Larissa Albantakis,Giulio Tononi","doi":"10.1176/appi.ajp.20250873","DOIUrl":"https://doi.org/10.1176/appi.ajp.20250873","url":null,"abstract":"Transcranial electrical stimulation with temporal interference (TES-TI) is a noninvasive technique that uses multiple high-frequency carrier currents to generate a low-frequency amplitude-modulated envelope, enabling steerable and relatively focal engagement of deep regions with reduced off-target exposure compared to conventional TES approaches. This review outlines the biophysical principles and technical implementation of TES-TI, summarizes safety and feasibility data in humans, and considers potential applications in psychiatry. TES-TI is thought to engage neural circuits by modulating physiologically relevant oscillations (TI between 0.5 and 80 Hz) and is being explored at higher frequencies (TI at ∼130 Hz), as a noninvasive approach inspired by deep brain stimulation to influence pathological network activity. Features relevant to psychiatric application are discussed alongside current evidence for engagement of key targets. TES-TI is rapidly developing, and much remains to be investigated about parameter optimization (frequency, intensity, dose, and dosing schedules) and about the strength, durability, and clinical relevance of its effects. Taken together, current findings position TES-TI as a promising but still exploratory approach for noninvasively probing and modulating deep brain circuits relevant to psychiatric disorders, while underscoring the need for further study before clinical translation.","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"13 1","pages":"appiajp20250873"},"PeriodicalIF":17.7,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147585787","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":"Resting-State Functional Connectivity of the Amygdala and Hippocampus in PTSD: Results From the PGC-ENIGMA PTSD Working Group.","authors":"Cecilia A Hinojosa,Delin Sun,Courtney Russell,C Lexi Baird,Ahmed Hussain,Mohammad Sendi,Neda Jahanshad,Lauren E Salminen,Miranda Olff,Jessie L Frijling,Dick J Veltman,Saskia B J Koch,Laura Nawijn,Mirjam van Zuiden,Li Wang,Ye Zhu,Gen Li,Dan J Stein,Jonathan Ipser,Sheri-Michelle Koopowitz,Yuval Neria,Xi Zhu,Orren Ravid,Sigal Zilcha-Mano,Amit Lazarov,Benjamin Suarez-Jimenez,Ashley A Huggins,Kerry Ressler,Tanja Jovanovic,Negar Fani,Sven C Mueller,Anna R Hudson,Judith K Daniels,Anika Sierk,Antje Manthey,Henrik Walter,Nic J A van der Wee,Steven J A van der Werff,Robert R J M Vermeiren,Ivan Rektor,Pavel Říha,Milissa L Kaufman,Lauren A M Lebois,Justin T Baker,Anthony King,Israel Liberzon,Mike Angstadt,Nicholas D Davenport,Seth G Disner,Scott R Sponheim,Thomas Straube,David Hofmann,Guang Ming Lu,Rongfeng Qi,Xin Wang,Austin Kunch,Hong Xie,Yann Quidé,Wissam El-Hage,Shmuel Lissek,Hannah Berg,Josh Cisler,Marisa Ross,Ryan J Herringa,Daniel W Grupe,Jack B Nitschke,Richard J Davidson,Christine L Larson,Terri A deRoon-Cassini,Carissa W Tomas,Jacklynn M Fitzgerald,Brandee Feola,Jennifer Urbano-Blackford,Bunmi O Olatunji,Geoffrey May,Steven M Nelson,Evan M Gordon,Chadi G Abdallah,Ruth Lanius,Maria Densmore,Jean Théberge,Richard W J Neufeld,Lee A Baugh,Raluca M Simons,Jeffrey S Simons,Vincent A Magnotta,Kelene A Fercho,Jeremy Elman,Matthew Panizzon,Carol Franz,Michael J Lyons,William Kremen,Katie A McLaughin,Matthew Peverill,Kelly Sambrook,Paul M Thompson,Jennifer S Stevens,Rajendra A Morey,Sanne J H van Rooij","doi":"10.1176/appi.ajp.20250062","DOIUrl":"https://doi.org/10.1176/appi.ajp.20250062","url":null,"abstract":"OBJECTIVEStudies investigating resting-state functional connectivity of the amygdala and hippocampus have produced inconsistent findings. The authors' objective was to conduct the largest systematic comparison of alterations in functional connectivity of the amygdala and hippocampus in individuals with posttraumatic stress disorder (PTSD) using a multicohort mega-analysis with uniform processing steps and parameters across all cohorts.METHODSResting-state functional MRI data from 1,017 PTSD patients and 1,702 control participants from 32 international sites were centrally preprocessed with HALFpipe and analyzed using the Image-Based Meta- and Mega-Analysis (IBMMA) package for neuroimaging processing. Group-level seed-based whole-brain analyses were completed for the right and left amygdala and hippocampus. Additional correlation analyses were conducted between PTSD norm-severity scores and resting-state functional connectivity (rs-FC).RESULTSCompared to control participants, individuals with PTSD showed stronger rs-FC between the left amygdala seed and right hippocampus and amygdala and the left and right lingual gyri. Greater PTSD total norm-severity scores were significantly associated with rs-FC between the left amygdala and right hippocampus/amygdala and rs-FC between the right amygdala and left hippocampus/amygdala.CONCLUSIONSGreater connectivity between subcortical threat centers involved in fear processing, memory, and extinction learning characterizes the resting state in PTSD. Future directions include investigating how different interventions, such as brain stimulation, neurofeedback, and psychotherapy, might modulate the aberrant neural networks in PTSD.","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"9 1","pages":"appiajp20250062"},"PeriodicalIF":17.7,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147585786","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":"Personalized fMRI-Guided TMS Targeting the Threat Neurocircuitry in PTSD: A Randomized Clinical Trial.","authors":"Sanne J H van Rooij,Ryan Langhinrichsen-Rohling,Sean T Minton,Cecilia A Hinojosa,Joshua Lukemire,Rebecca Lipschutz,Rebecca Hinrichs,Natalie Merrill,Timothy D Ely,Kristina Dahlgren,Patlapa Sompolpong,Gregory Job,Patricio Riva-Posse,Paul E Holtzheimer,Vince D Calhoun,Joan A Camprodon,Sheila A M Rauch,Nadine J Kaslow,Kerry J Ressler,Tanja Jovanovic,William M McDonald","doi":"10.1176/appi.ajp.20250749","DOIUrl":"https://doi.org/10.1176/appi.ajp.20250749","url":null,"abstract":"OBJECTIVETranscranial magnetic stimulation (TMS) has shown promise in reducing posttraumatic stress disorder (PTSD) symptoms, with varied clinical results. A mechanistic understanding is needed to personalize treatment and improve response rates. The threat neurocircuitry, specifically the right amygdala, has consistently been implicated in PTSD pathophysiology. This neuroscience-informed trial aimed to modulate the threat neurocircuitry using functional MRI (fMRI)-guided TMS to treat PTSD.METHODSIn a double-blind clinical trial, 50 adults with PTSD symptoms were randomized to 10 twice-daily sessions of either 1-Hz TMS or sham TMS. TMS was delivered to an fMRI-guided target within the right dorsolateral prefrontal cortex with the strongest functional connection to the right amygdala. The primary outcomes were right amygdala threat reactivity, assessed by fMRI, and skin conductance reactivity during trauma recall, measured pre- and post-TMS. The secondary outcomes were hyperarousal and total PTSD symptoms (based on the PTSD Checklist for DSM-5), measured pre- and post-TMS and at a follow-up assessment between 3 and 6 months after TMS.RESULTSActive TMS significantly reduced right amygdala threat reactivity compared with sham TMS. No significant effect of TMS was observed on skin conductance reactivity. From pre- to post-TMS, significant reductions in hyperarousal and total PTSD symptoms were observed across groups, but no significant differences between groups were observed. From pre-TMS to follow-up, active TMS compared with sham TMS significantly reduced hyperarousal and total PTSD symptoms. Clinical findings were found to be robust in sensitivity analyses.CONCLUSIONSThis is the first clinical trial to demonstrate that personalized fMRI-guided TMS targeting the threat neurocircuitry reduces amygdala threat reactivity and improves long-term PTSD symptoms at follow-up. These findings suggest the potential for a personalized approach to neuromodulation in individuals with PTSD.","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"99 1","pages":"appiajp20250749"},"PeriodicalIF":17.7,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147585788","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":"Developmental Timing, Substance Exposure, and Persistent Brain Change: Recontextualizing Cannabis, Stimulants, and Opioids Across an Extended Neurodevelopmental Window.","authors":"Kevin P Hill,Mark S Gold","doi":"10.1176/appi.ajp.20260052","DOIUrl":"https://doi.org/10.1176/appi.ajp.20260052","url":null,"abstract":"","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"52 1","pages":"226-228"},"PeriodicalIF":17.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147583859","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":"Smoking Cessation Treatment: Still Seeking a New Approach?","authors":"Victoria Manning,Joshua B B Garfield","doi":"10.1176/appi.ajp.20260124","DOIUrl":"https://doi.org/10.1176/appi.ajp.20260124","url":null,"abstract":"","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"13 1","pages":"220-222"},"PeriodicalIF":17.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147583862","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":"Beyond Symptom Thresholds: Toward a Clinically and Culturally Inclusive Definition of Relapse in Schizophrenia.","authors":"Carlos De Las Cuevas","doi":"10.1176/appi.ajp.20251120","DOIUrl":"https://doi.org/10.1176/appi.ajp.20251120","url":null,"abstract":"","PeriodicalId":7656,"journal":{"name":"American Journal of Psychiatry","volume":"7 1","pages":"269-270"},"PeriodicalIF":17.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147583991","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}