Autism was introduced by Eugen Bleuler in 1910 as a defining feature of schizophrenia, and it remained so for 80 years. However, the concept was borrowed by Leo Kanner and Hans Asperger to describe another condition (infantile autism) and eventually awareness of autistic features in schizophrenia declined. Today, autistic features are by default considered indicative of autism spectrum disorder, and

Transgender and gender-diverse (TGD) people are disproportionately affected by interpersonal violence and face barriers to accessing post-violence health services globally. Post-violence care guidelines are broadly applicable, but specific considerations for TGD individuals have not been synthesised. In this systematic review, we synthesise the values and preferences of TGD adults and health providers

A seminal text in psychoanalytic literature, “The Use of an Object and Relating Through Identifications,” like the Sphinx, continues to challenge us. At birth, the infant attempts to destroy the object, and if the mother survives this destruction, the child gains a sense of reality. In this essay, Winnicott challenges classical conceptions of aggression, viewing destruction as an expression of love

Farhat LC, Lannes A, Del Giovane C, et al. Comparative cardiovascular safety of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis. Lancet Psychiatry 2025; 12: 355–65—In this Article, the spelling of the name Anneka Tomlinson was incorrect. This correction has been made to the online version as of May 29, 2025

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ImportanceAlthough early maternal warmth strongly predicts adolescent health, questions remain about the biopsychosocial mechanisms underlying this association.ObjectiveTo understand how maternal warmth at 3 years of age shapes adolescent social safety schemas at 14 years of age and physical and mental health at 17 years of age.Design, Setting, and ParticipantsThe Millennium Cohort Study tracks approximately

OBJECTIVE Reduced cognitive functions are commonly associated with diminished self-control abilities. Research on cognitive functions in gaming disorder and other specific types of problematic usage of the Internet (PUI) remains rare. The aim of this study was to compare performance in different cognitive domains between clinically validated groups of individuals with and without specific PUI. METHODS

OBJECTIVE The authors sought to determine whether genetic predispositions to cognitive ability or psychiatric conditions interact with anticholinergic burden (AChB) to impact cognition and brain structure in individuals with psychotic disorders. METHODS Participants with psychosis spectrum disorders (N=1,704) from the Bipolar-Schizophrenia Network for Intermediate Phenotypes (B-SNIP) consortium, 18-65

OBJECTIVE The authors sought to estimate national trends in suicidal thoughts and attempts among high school students with and without health-risk behaviors. METHODS Data were analyzed from the 2007 to 2021 Youth Risk Behavior Survey, a biennial cross-sectional survey of U.S. high school students (unweighted sample, N=119,654). Suicidal thoughts were defined as seriously considering attempting suicide

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Horsdal HT, Albiñana C, Zhu Z, et al. Convergent evidence linking neonatal vitamin D status and risk of neurodevelopmental disorders: a Danish case-cohort study. Lancet Psychiatry 2025; 12: 410–20—In this Article, Prof P B Mortensen's degree should read DrMedSc; the second sentence of the Findings subsection in the Summary and the second sentence of the Results section, should end “...we measured 25(OH)D

INTRODUCTION Relapse rates in individuals with alcohol use disorder (AUD) are particularly high following inpatient treatment. Innovative strategies should specifically target the transitional gap between completion of inpatient treatment and uptake of standard continuing care. This study aimed to determine whether Appstinence, a digital approach that combines a smartphone app intervention with adjunct

INTRODUCTION Coronary heart disease (CHD) has serious implications for patients´ quality of life (QoL). Psychological distress affects 15 to 40% of patients with CHD and is robustly associated with poorer prognosis. Blended collaborative care (BCC), a telephone-delivered intervention involving non-physician care managers that address both psychological and medical factors can be applied for secondary

Gao Y, Staginnus M, and the ENIGMA-Antisocial Behavior Working Group. Cortical structure and subcortical volumes in conduct disorder: a coordinated analysis of 15 international cohorts from the ENIGMA-Antisocial Behavior Working Group. Lancet Psychiatry 2024; 11: 620–32—The appendix of this Article has been corrected as of May 21, 2025.

ImportancePrivate equity (PE) ownership in health care has increased, but evidence for its association with health care quality is mixed. Moreover, there is no evidence regarding inpatient psychiatric hospitals, despite considerable patient vulnerabilities.ObjectiveTo describe trends in PE ownership of psychiatric hospitals from 2013 through 2021 and the cross-sectional association between PE ownership

ImportanceIn recent decades, evidence-based psychotherapies to treat posttraumatic stress disorder (PTSD) have been developed with robust evidence bases. However, efficacy observed in clinical trials is not always directly applicable to clinical practice.ObjectiveTo estimate the percentage of patients in both military and veteran (hereafter milvet) and nonmilvet populations that lose their PTSD diagnosis

This Viewpoint examines the use of local anesthetics to adulterate synthetic opioids, particularly illicitly manufactured fentanyl, and the dangers associated with exposure to these drugs.

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There is growing evidence linking neonatal vitamin D deficiency to an increased risk of schizophrenia, ADHD, and autism spectrum disorder (ASD). The aim of this study was to examine the association between two vitamin D biomarkers (25 hydroxyvitamin D [25(OH)D] and vitamin D-binding protein [DBP], and their related genetic correlates) and the risk of six mental disorders.

Anxiety and its disorders are common in later life. Given the known risks of psychopharmacological treatments in older adults, clinical decision making for anxiety management should be guided by the strongest available evidence. This study aimed to comprehensively synthesise evidence on the pharmacological treatment of anxiety in older adults.

Non-remission after psychological therapy for major depressive disorder is common, yet there are no established further-line treatments. In the UK National Health Service (NHS) Talking Therapies programme, about 50% of patients with depression who come to the end of the stepped care pathway do not show remission of symptoms. We aimed to investigate whether mindfulness-based cognitive therapy (MBCT)

This Viewpoint discusses a proposal to identify candidates for drug repurposing and allocate US Food and Drug Administration funds to cover the cost of evaluating and approving such drugs for their novel indications.

ImportanceAmong hospitalized older adults, prolonged use of antipsychotic medications (APMs) following hospital discharge may increase the risk of APM-associated adverse events. There are limited data on whether early discontinuation of APMs is associated with reduced adverse clinical outcomes compared with APM continuation after discharge.ObjectiveTo compare clinical outcomes between discontinuation

ImportancePeople with obesity and diabetes have poorer psychiatric and cognitive outcomes and lower quality of life (QOL) compared with those without. Glucagon-like peptide 1 receptor agonists (GLP1-RAs) are treatments for diabetes and obesity that may also influence psychiatric outcomes.ObjectiveTo conduct a meta-analysis of randomized placebo-controlled trials to evaluate psychiatric, cognitive,

ImportanceThe rates of suicide and suicide attempts are rising precipitously among early adolescents aged 10 to 14 years in the US. While suicide attempts in this age group are more common and associated with lower lethality than in older age groups, very little is known about these individuals’ long-term social and psychiatric outcomes.ObjectivesTo examine the adult outcomes of individuals making

Nomura N, Siafis S, Schneider-Thoma J, et al. The trajectory of sedative adverse events caused by antipsychotics: a meta-analysis of individual participant data from randomised, placebo-controlled, clinical trials inacute phase schizophrenia. Lancet Psychiatry 2025; 12: 266–75—The appendix of this Article has been corrected as of May 8, 2025.

Importance Childhood maltreatment (CM) is associated with psychiatric disorders. The underlying mechanisms are complex and involve genetics. Objective To investigate the polygenic architecture of CM-exposed individuals across psychiatric conditions and if genetics modulates absolute CM risk in the presence of high-impact risk factors such as parental psychiatric diagnoses. Design, Setting, and Participants

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Introduction Borderline personality disorder (BPD) is a severe and prevalent psychiatric disorder. Mentalization-based therapy (MBT) is an evidence-based intervention for BPD, which is often delivered as a long-term psychotherapy program for BPD. We previously published a randomized clinical trial assessing short-term versus long-term MBT for BPD 16 months after randomization as the primary follow-up

This Personal View provides a normative and conceptual analysis of the intersection between the recovery movement and psychiatry. Although recovery emerged as a grassroots social justice movement emphasising empowerment and systemic change, psychiatry remains rooted in the medical paradigm. We aim to develop a nuanced conceptual framework that fosters academic debate and meaningful implementation,

ImportanceRepresentation of race and ethnicity in randomized clinical trials (RCTs) is critical for understanding treatment efficacy across populations with different racial and ethnic backgrounds.ObjectiveTo examine race and ethnicity representation and reporting across RCTs of pharmacotherapies for mental disorders.Data SourcesPubMed (Medline), Embase (Ovid), APA PsycInfo, and Web of Science were

ImportanceEmotional well-being (EWB) is an emerging therapeutic target for managing and preventing symptoms associated with Alzheimer disease and related dementias (ADRD). However, more research is needed to establish causal inferences between brain changes, EWB, and behavioral changes observed in typical aging and ADRD.ObservationsThis article presents a framework for using a cross-species behavioral

ImportanceIt has been hypothesized that the association between acute-phase treatment with antipsychotic (vs placebo) and outcomes might be larger in individuals who were not recently treated compared to recently treated individuals. However, evidence is still lacking.ObjectiveTo compare the association between antipsychotic (vs placebo) acute-phase treatment and outcomes in individuals who were not

BACKGROUND Stress-related disorders such as adjustment disorder (AD) and exhaustion disorder (ED) are associated with substantial suffering and high societal costs. Cognitive behavioral therapy (CBT) is a promising treatment for symptom reduction but has not been rigorously compared with other active treatments. This study aimed to investigate the efficacy of CBT compared to an active control treatment

OBJECTIVE Brain structural alterations are consistently reported in depressive disorders, yet it remains unclear whether these alterations exist prior to disorder onset and thus may reflect a preexisting vulnerability. The authors investigated prospective adolescent neurodevelopmental risk markers for depressive disorder onset, using data from a 15-year longitudinal study. METHODS A community sample

OBJECTIVE Problematic alcohol use (PAU) adversely affects the clinical course of psychiatric disorders. Genetic studies have suggested that genetic factors underlie the co-occurrence of PAU with psychiatric disorders. This study aimed to elucidate shared genetic architectures, prioritizing genes that disorders may have in common. METHODS Using genome-wide association data of PAU including 435,563 samples

Chronic inflammation plays a prominent role in multiple medical disorders, including psychiatric diseases such as major depression. Exposure to inflammatory stimuli leads to changes in neurotransmitter systems and neurocircuits in the brain that are associated with depressive symptoms. Blockade of inflammatory cytokines can reduce depressive symptoms in medically ill and medically healthy individuals

Individuals with severe mental illness, including schizophrenia and bipolar disorder, have elevated rates of physical health conditions, contributing to increased morbidity and mortality. While environmental factors such as adverse effects from medication and lifestyle changes play a role, the contribution of genetic liability to physical health comorbidities remains underexplored. We investigated

OBJECTIVE The authors investigated recent national trends in outpatient mental health care and psychotherapy. METHOD Service data from four representative surveys of the U.S. household population, the 2018-2021 Medical Expenditure Panel Survey, were analyzed focusing on adults with outpatient mental health visits (N=17,821) including psychotherapy visits (N=6,415). The authors present trends in age

OBJECTIVE There is tremendous public health interest in cost-efficient, scalable interventions to improve post-disaster mental health. The authors examined the efficacy of Bounce Back Now (BBN), a mobile application, versus an enhanced usual care app (EUC). METHODS A population-based trial was conducted with a diverse sample of 1,357 adults affected by Hurricane Harvey, Irma, Maria, Florence, or Michael