Objective: Schizophrenia is associated with increased risk of cardiovascular disease (CVD), although there is variation in risk among individuals. There are indications of shared genetic etiology between schizophrenia and CVD, but the nature of the overlap remains unclear. The aim of this study was to fill this gap in knowledge. Methods: Overlapping genetic architectures between schizophrenia and CVD

Abstract not available

Background Side-effects of psychiatric medication impair quality of life and functioning. Furthermore, they contribute to morbidity, mortality, stigma, and poor treatment concordance resulting in relapse of psychiatric illness. Guidelines recommend discussing side-effects with patients when making treatment decisions, but a synthesis of antidepressant and antipsychotic side-effects to guide this process

The effectiveness of mental health care can be improved through coordinated and wide-scale outcome measurement. The International Consortium for Health Outcomes Measurement has produced collaborative sets of outcome measures for various mental health conditions, but no universal guideline exists for eating disorders. This Position Paper presents a set of outcomes and measures for eating disorders as

Background Accurate psychiatric risk assessment requires biomarkers that are both stable and adaptable to development. Functional network connectivity (FNC), which steadily reconfigures over time, potentially contains abundant information to assess psychiatric risks. However, the absence of suitable analytical methodologies has constrained this area of investigation. Methods We investigated brain-wide

Background Cognitive function and general psychopathology are two important classes of human behavior dimensions, individually relate to mental disorders across diagnostic categories. However, whether the two transdiagnostic dimensions link to common or distinct brain networks that convey resilience or risk for the development of psychiatric disorders remains unclear. Method The current study is a

BACKGROUND Understanding why only a subset of trauma-exposed individuals develop posttraumatic stress disorder (PTSD) is critical for advancing clinical strategies. A few behavioral (deficits in fear extinction) and biological (blunted glucocorticoid levels, small hippocampal size, and rapid-eye movement sleep (REMS) disturbances) traits have been identified as potential vulnerability factors. However

Background Despite considerable effort towards understanding the neural basis of autism spectrum disorder (ASD) using case-control analyses of resting-state functional magnetic resonance imaging data, findings are often not reproducible, largely due to biological and clinical heterogeneity among individuals with ASD. Thus, exploring the individual-shared and individual-specific altered functional connectivity

Background Persecutory delusions are a major psychiatric problem that often do not respond sufficiently to standard pharmacological or psychological treatments. We developed a new brief automated virtual reality (VR) cognitive treatment that has the potential to be used easily in clinical services. We aimed to compare VR cognitive therapy with an alternative VR therapy (mental relaxation), with an

In the same way that beauty lies in the eye of the beholder, what a stimulus does to the brain is determined not simply by the nature of the stimulus, but by the nature of the brain receiving the stimulus, at that instant of time. Therapeutic brain stimulation, over the past decades, typically applied open-loop fixed protocols and has largely ignored this principle. Only recent neuro-technological

Transcranial Magnetic Stimulation (TMS) is capable of noninvasively inducing lasting neuroplastic changes when applied repetitively across multiple treatment sessions. In recent years, repetitive TMS has developed into an established evidence-based treatment for various neuropsychiatric disorders such as depression. Despite significant advancements in our understanding of the mechanisms of action of

Non-invasive brain stimulation (NIBS) treatments have gained considerable attention as a potential therapeutic intervention for psychiatric disorders. The identification of reliable biomarkers for predicting clinical response to NIBS has been a major focus of research in recent years. Neuroimaging techniques, such as electroencephalography (EEG) and (functional) magnetic resonance imaging (fMRI), have

Abstract not available

Abstract not available

Background Internalising disorders are highly prevalent emotional dysregulations during preadolescence but clinical decision-making is hampered by high heterogeneity. During this period impulsivity represents a major risk factor for psychopathological trajectories and may act on this heterogeneity given the controversial anxiety–impulsivity relationships. However, how impulsivity contributes to the

Background The COVID-19 pandemic and associated lockdowns were predicted to have a major impact on suicidal behaviour, including self-harm. However, current studies have produced contradictory findings with limited trend data.Aims Nine years of linked individual-level administrative data were utilised to examine changes in hospital-presenting self-harm and ideation (thoughts of self-harm or suicide)

Objective: The authors investigated the frequency and determinants of long-term use and risk of dose escalation of benzodiazepines and benzodiazepine-related drugs (benzodiazepine receptor agonists, or BZRAs). Methods: All adults ages 20–80 years living in Denmark on January 1, 2000 (N=4,297,045) were followed for redeemed prescriptions of BZRAs in the Danish National Prescription Registry from January

Objective: The aims of this study were to investigate secular trends and distribution of body mass index (BMI) among individuals with bipolar disorders and the general population between 2008 and 2019. Methods: Data were from the Swedish National Quality Register for Bipolar Disorder, where 24,423 adults with bipolar disorders were identified, and from the national Swedish Living Conditions Surveys

Abstract not available

Abstract not available

Abstract not available

Abstract not available

Abstract not available

Abstract not available

Background Childhood maltreatment is a risk factor for the development of post-traumatic stress disorders and psychosis. However, the association between post-traumatic stress disorder (PTSD), including complex PTSD, and psychotic symptoms is unknown. We investigated whether the presence of PTSD and complex PTSD was associated with psychotic symptom severity within survivors of developmental trauma

Background Recovery colleges were developed in England to support the recovery of individuals who have mental health symptoms or mental illness. They have been founded in many countries but there has been little international research on recovery colleges and no studies investigating their staffing, fidelity, or costs. We aimed to characterise recovery colleges internationally, to understand organisational

Background Although structured tools have been widely used to predict violence risk in specialist mental health settings, there is uncertainty about the extent and quality of evidence of their predictive performance. We aimed to systematically review the predictive performance of tools used to assess violence risk in forensic mental health, where they are routinely administered. Methods In our systematic

Abstract not available

In both the ICD-11 and the DSM-5, the core symptoms of depression are reported to be depressed mood (e.g., feeling sad, down or hopeless) and markedly diminished interest or pleasure in activities. However, in the ICD-10 diagnostic guidelines, a third core symptom was also identified: “fatigue or low energy”. In two regions of the world (Latin America and East Asia), “fatigue” is the most commonly

McIntyre et al1, in their excellent paper appearing in this issue of the journal, successfully tackle a critical issue in the field of depression: how should we define treatment-resistant depression (TRD) and how can we best manage it? They point out that a consensus definition of TRD with demonstrated predictive utility in terms of clinical decision-making and health outcomes does not currently exist

We provide here the first bottom-up review of the lived experience of depression, co-written by experts by experience and academics. First-person accounts within and outside the medical field were screened and discussed in collaborative workshops involving numerous individuals with lived experience of depression, family members and carers, representing a global network of organizations. The material

Populations with common physical diseases – such as cardiovascular diseases, cancer and neurodegenerative disorders – experience substantially higher rates of major depressive disorder (MDD) than the general population. On the other hand, people living with MDD have a greater risk for many physical diseases. This high level of comorbidity is associated with worse outcomes, reduced adherence to treatment

The later years of the 20th and the beginning of the 21st century – coinciding with deinstitutionalization and shift to managing mental health problems outside of hospitals – have been characterized by several socioeconomic trends which are of major importance for the strategies of community mental health care1, 2. The rampant urbanization is one of these trends. All the predictions are in agreement

When combined with pharmacotherapy, family psychoeducation and skills training are key strategies for preventing, delaying or minimizing the severity of illness episodes in major psychiatric disorders1-3. High levels of expressed emotion – as indicated by critical comments, hostility and/or emotional overinvolvement from caregivers – are associated with high rates of recurrence in patients with schizophrenia

Task-sharing – in which specialists train, supervise and support non-specialist health care providers – is proven to be acceptable, feasible and effective in scaling up mental health care for depressive and anxiety disorders1. In this perspective, we focus on reasons for and barriers to task-sharing of psychological interventions in primary health care. We also cover what the World Health Organization

The expression “mental health literacy” was introduced in 1997 by Jorm et al1, referring to “knowledge and beliefs about mental disorders which aid their recognition, management or prevention”. Compared to contemporaneous programmes aiming to reduce stigma and discrimination related to mental illness, this construct reflected a broader and positively framed public mental health goal. However, the concept

Treatment-resistant depression (TRD) is common and associated with multiple serious public health implications. A consensus definition of TRD with demonstrated predictive utility in terms of clinical decision-making and health outcomes does not currently exist. Instead, a plethora of definitions have been proposed, which vary significantly in their conceptual framework. The absence of a consensus definition

With the increasing recognition that major depressive disorder (MDD) is one of the world greatest public health problems1, 2, there have recently been concerted efforts to ensure that people suffering from this condition are promptly recognized, accurately diagnosed, and vigorously treated. Indeed, a relatively wide range of proven treatments are now available to help depressed people, and health care

As admirably detailed by McIntyre et al1, most definitions of treatment-resistant depression (TRD) weight failure to respond to a set of antidepressant medications and other physical treatment options. Is this the optimal paradigm when major depressive episodes may be caused not only by biological factors, but also by social and psychological ones? Wouldn't we expect, for example, that a woman depressed

I think we should be grateful to McIntyre et al1 for their extraordinarily thorough and balanced review of treatment-resistant depression (TRD). They note that this condition poses a plethora of clinical research challenges. Here I offer a few suggestions that might make research more cost-efficient and clinically generalizable. First, we should develop tools to systematically identify treatable causes

Congratulations are well deserved for this review by 27 psychiatric leaders, representing 14 countries, including 294 references1. This highly researched, well-written paper describes the characteristics of treatment-resistant depression (TRD), including prevalence, risks, clinical features, costs, public health burden, management and treatments. Despite the wealth of information provided, lingering

McIntyre et al1 provide an excellent overview of “treatment-resistant depression” (TRD) and of the ways future research can contribute to a better knowledge on how to handle the many patients with depression who do not respond to treatment. However, I argue here that the notion of TRD is based on a misconception of the effects of treatments in depression, and that it is much better to focus research

Depressive episodes can be of mild intensity and transient, but – especially in tertiary care settings – they are often chronic and/or relapsing. As clinicians we often see people towards the latter end of this spectrum, including “treatment-resistant depression” (TRD), and spend much of our efforts in treating them. McIntyre et al1 competently and comprehensively review the TRD definition, prevalence

Interest in the use of serotonergic agonists such as psilocybin in treatment-resistant depression (TRD) has grown more quickly than the evidence on which to base a final opinion, as emphasized by McIntyre et al1 in their review. Psilocybin, once metabolized to psilocin, activates 5-HT2A receptors, enhancing GABA function in local circuits in the cortex and increasing connectivity between functional

McIntyre et al's paper1 is not just another literature review on the topic of treatment-resistant depression (TRD). It puts everyone in agreement and offers a concrete basis for a constructive reflection on the subject. More than that, it invites us to approach TRD in all its facets, the most complex but also those still unsuspected. Since the 1970s, the scientific literature on TRD has abounded with