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

Background and Hypothesis The objective of this study was to identify documented negative symptoms of schizophrenia using natural language processing (NLP) and to characterize treatment patterns, healthcare resource utilization (HCRU), and costs among this patient population. Study Design This US retrospective cohort study used electronic health records (EHR) linked to administrative claims data from

Background Clozapine is the antipsychotic of choice for people with treatment-resistant schizophrenia (TRS) but is associated with the uncommon but potentially life-threatening adverse effect of myocarditis. However, there are no criteria for diagnosing clozapine-associated myocarditis (CAM) or global guidelines on detection and risk reduction, or for restarting clozapine after CAM.Aims To develop

Background and Hypothesis Little is understood about whether the high reported prevalence of dementia in people with psychosis reflects impairment present at psychosis onset. We hypothesized that relying on longitudinal data would help to distinguish stable deficits associated with psychotic disorders from subsequent decline. Study Design We prospectively assessed the Clinical Dementia Rating (CDR)

Background and Hypothesis The brain age gap (BAG) quantifies the difference between predicted brain age and chronological age. Prior research implicates higher BAG in psychotic disorders, suggesting accelerated brain aging. We hypothesized distinct brain aging profiles among biological subtypes of psychosis and intermediate BAG in their relatives. Study Design Brain age gap values were quantified in

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

Background and Hypothesis Schizophrenia is a devastating psychiatric disorder characterized by positive (eg, hallucinations) and negative (eg, reduced motivation) symptoms, and cognitive deficits. Chronic gastrointestinal tract issues exist as comorbid symptoms of schizophrenia. Recent findings indicate the involvement of the microorganisms that inhabit the gut, the microbiota (and the broader microbiome

Background Schizophrenia is associated with substantial physical and psychiatric comorbidities that increase the risk of severe outcomes in COVID-19 infection. However, few studies have examined the differences in care and outcomes among people with schizophrenia throughout the pandemic. We hypothesized that rates of in-hospital mortality, admission to the intensive care unit (ICU), and length of stay

Background and Hypothesis Pregnant women with schizophrenia are more likely to discontinue treatment, which could trigger a relapse of symptoms. However, data on patterns and risk factors related to antipsychotic discontinuation and re-initiation in Asian pregnant women are insufficient. Study Design We conducted a retrospective cohort study using a nationwide Korean database. The pregnancy group included

Background and Hypothesis Intergenerational factors are implicated in development of schizophrenia spectrum disorders. Studying psychosis spectrum (PS) symptoms dimensionally in a longitudinal, prospective intergenerational cohort can provide crucial insight into risk pathways. Thus, we established the Philadelphia Family Neurodevelopmental Cohort (PFNC), an intergenerational study that follows Philadelphia

Background and Hypothesis Schizophrenia presents significant treatment challenges, particularly due to medication resistance observed in some patients receiving antipsychotics. Emerging research suggests a potential link between impaired reinforcement learning, the severity of psychotic symptoms, and dopamine system abnormalities. Exploring reinforcement learning in therapeutic settings could provide

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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

Background and Hypothesis Large-scale whole exome sequencing (WES) analyses have implicated rare protein-truncating variants (PTVs) in the AKAP11 gene contributing to schizophrenia risk. Previous studies reported alterations of EEG characteristics and synaptic proteome in Akap11 mutant mice. We hypothesize that synaptic dysfunction contributes to AKAP11 deficiency in the pathogenesis of schizophrenia

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.

Background Sleep problems are common among people with psychosis. Research suggests poor sleep is causally related to psychosis, anxiety and depression.Aims This review investigates the effectiveness and acceptability of cognitive–behavioural therapy (CBT) in targeting sleep problems in people with and at risk of psychosis.Method Four databases were searched in line with PRISMA guidelines. Eligible

Attention-deficit hyperactivity disorder (ADHD) is commonly considered a neurodevelopmental disorder, with symptoms present before 12 years of age. Increasingly, adults who have no evidence of impairment in childhood are seeking treatment for ADHD. In this Editorial, we propose that psychiatry considers conceptual changes to better understand impairment and distress caused by inattention and disorganisation

Background and Hypothesis The multifactorial pathogenesis of schizophrenia (SZ) hinders the diagnosis and treatment of this disorder. Niacin skin flushing response (NSFR) has been identified as an endophenotype for SZ, but the proportion of blunted NSFR (BNR) varied between studies. This study aims to clarify the relationship between NSFR and SZ through a meta-analysis. Study Design PubMed, Embase

Cognitive impairment is a prominent feature of psychosis-spectrum disorders that impedes functional recovery. Globally, clinical guidelines recommend that evidence-based treatments, including cognitive remediation and cognitive compensation, are offered to people with psychosis with cognitive impairment. Clinical guidelines also recommend that, where possible, family is involved in the mental health

Although treatments for depression are effective, many patients do not respond. Many new innovations are currently being developed, claiming to substantially improve outcomes. We propose a new method to assess the strength of these innovations. Based on response rates of current treatments, we can estimate how many treatments are needed in total to realise response in >99% of patients if they were

Background Natural remission from common mental disorders (CMDs), in the absence of intervention, varies greatly. The situation in India is unknown.Aims This study examined individual, village and primary health centre (PHC)-level determinants for remission across two rural communities in north and south India and reports natural remission rates.Method Using pre-intervention trial data from 44 PHCs

People with intellectual disability experience significant health inequality, and consequently poor health outcomes. Although research can facilitate change, there is a risk of researchers propagating inequity by selecting methods that exclude people with some forms of intellectual disability. We argue for participatory research methods that enable inclusion.

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.

Background Shared decision-making (SDM) implementation remains limited in psychosis management, particularly within antipsychotic prescribing. When and why prescribers engage in SDM within these contexts is largely unknown. Part 1 of this two-part realist review aimed to understand the impact of structural and contextual factors on prescriber engagement in SDM within antipsychotic prescribing. Study

Background Shared decision-making (SDM) implementation remains limited in psychosis management, particularly within antipsychotic prescribing. When and why prescribers engage in SDM within these contexts is largely unknown. Part 2 of this 2-part realist review aimed to understand what SDM intervention strategies and local implementation contexts are responsible for successful prescriber engagement

Background and Hypothesis Cognitive impairment, a key feature of psychosis, is linked to poor functional outcomes. This study aimed to identify predictors and outcomes associated with cognitive decline in psychotic disorders. Study Design Data were taken from the Suffolk County Mental Health Project, a first-admission longitudinal cohort study of individuals with psychotic disorders. Participants were

Background and Hypothesis Neurodevelopmental risk-factor models of psychosis highlight the importance of early developmental deviations in the emergence of psychosis. However, few longitudinal studies map neurodevelopment and neurocognitive trajectories across age in preclinical psychosis. We investigated longitudinal trajectories in neurocognition and brain volume in a community cohort of adolescents

Background Foundational models of the psychoses included course as a core element differentiating patients. Current models, ICD-11 and DSM-5, only require symptom criteria to be met to make a diagnosis. We explore the proposition that making course designation essential, again, would improve the categorization of patients with psychotic disorders. Study Design We briefly discuss the history by which