Psychotic depression (PD) is a severe mental disorder leading to functional disability and high risk of suicide, but very little is known about the comparative effectiveness of medications used in its maintenance treatment. The objective of this study was to investigate the comparative effectiveness of specific antipsychotics and antidepressants, and their combinations, on the risk of psychiatric hospitalization

Psychotherapies are first‐line treatments for most mental disorders, but their absolute outcomes (i.e., response and remission rates) are not well studied, despite the relevance of such information for health care users, providers and policy makers. We aimed to examine absolute and relative outcomes of psychotherapies across eight mental disorders: major depressive disorder (MDD), social anxiety disorder

Work at the intersection of philosophy and psychiatry has an extensive and influential history, and has received increased attention recently, with the emergence of professional associations and a growing literature. In this paper, we review key advances in work on philosophy and psychiatry, and their related clinical implications. First, in understanding and categorizing mental disorder, both naturalist

Effect sizes of psychotherapies currently stagnate at a low‐to‐moderate level. Personalizing psychotherapy by algorithm‐based modular procedures promises improved outcomes, greater flexibility, and a better fit between research and practice. However, evidence for the feasibility and efficacy of modular‐based psychotherapy, using a personalized treatment algorithm, is lacking. This proof‐of‐concept

The impact of air pollution and climate change on mental health has recently raised strong concerns. However, a comprehensive overview analyzing the existing evidence while addressing relevant biases is lacking. This umbrella review systematically searched the PubMed/Medline, Scopus and PsycINFO databases (up to June 26, 2023) for any systematic review with meta‐analysis investigating the association

We provide here the first bottom‐up review of the lived experience of mental disorders in adolescents co‐designed, co‐conducted and co‐written by experts by experience and academics. We screened first‐person accounts within and outside the medical field, and discussed them in collaborative workshops involving numerous experts by experience – representing different genders, ethnic and cultural backgrounds

In response to the mass adoption and extensive usage of Internet‐enabled devices across the world, a major review published in this journal in 2019 examined the impact of Internet on human cognition, discussing the concepts and ideas behind the “online brain”. Since then, the online world has become further entwined with the fabric of society, and the extent to which we use such technologies has continued

The potential of artificial intelligence (AI) in health care is being intensively discussed, given the easy accessibility of programs such as ChatGPT. While it is usually acknowledged that this technology will never replace clinicians, we should be aware of imminent changes around AI supporting: a) routine office work such as billing, b) clinical documentation, c) medical education, and d) routine

The paper by Kirkbride et al in this issue of the journal1 presents a masterful and comprehensive overview of the existing evidence demonstrating associations between an array of adverse social experiences and circumstances and the development and persistence of mental ill-health. It proceeds by providing a rallying cry for a revolution to topple the dominant focus of psychiatrists and resource-allocation

Borderline personality disorder (BPD) was introduced in the DSM-III in 1980. From the DSM-III to the DSM-5, no major changes have occurred in its defining criteria. The disorder is characterized by instability of self-image, interpersonal relationships and affects. Further symptoms include impulsivity, intense anger, feelings of emptiness, strong abandonment fears, suicidal or self-mutilation behavior

Functional neuroimaging emerged with great promise and has provided fundamental insights into the neurobiology of schizophrenia. However, it has faced challenges and criticisms, most notably a lack of clinical translation. This paper provides a comprehensive review and critical summary of the literature on functional neuroimaging, in particular functional magnetic resonance imaging (fMRI), in schizophrenia

The first conceptualization of mental health can be traced back to 1948, when J.C. Flugel, Chairman of the First International Congress of Mental Health, proposed to define it as “a condition which permits the optimal development, physical, intellectual and emotional, of the individual, so far as this is compatible with that of other individuals”. In 1950, at the second session of the Expert Committee

Functional neurological disorder (FND) is classified in the DSM-5-TR as “functional neurological symptom disorder (conversion disorder)” and in the chapter on mental disorders of the ICD-11 as “dissociative neurological symptom disorder”. Neurologists, who most commonly make the initial diagnosis, are usually barely aware of such classification systems, and use a variety of terms – such as “functional”

Medical assistance in dying (MAID) – defined as voluntary euthanasia and/or physician-assisted suicide – for people with a terminal illness is becoming available in more jurisdictions around the world. By contrast, MAID in people with a non-terminal illness and, more specifically, in people with a psychiatric disorder remains a controversial topic. Belgium is one of the very few countries where euthanasia

Physician-assisted death (PAD) – i.e., the prescription and administration of lethal medications by physicians – is increasingly available as an option for people struggling with psychiatric disorders. Although PAD was initially promoted as a means of easing suffering for people with terminal conditions, a growing number of jurisdictions have extended access to all causes of intractable and severe

People exposed to more unfavourable social circumstances are more vulnerable to poor mental health over their life course, in ways that are often determined by structural factors which generate and perpetuate intergenerational cycles of disadvantage and poor health. Addressing these challenges is an imperative matter of social justice. In this paper we provide a roadmap to address the social determinants

Kirkbride et al1 provide a comprehensive overview of the social determinants of mental health. Their paper reviews the evidence for the causal influence of those determinants on population mental health and demonstrates the potential for prevention interventions that address those determinants across the life course. They argue convincingly that we stand at the threshold of a new era in prevention

It is easy to agree with Kirkbride et al1 that a causal link exists between social factors and later mental health. Indeed, when the term “social factors” is defined as broadly as it is in their paper to include biological exposures due to the physical environment, we know from population genetics that social factors (i.e., the environment) are the most important causes (i.e., heritability is less

Amidst long arcs of the pendulum between attention to psychosocial and neurobiological factors in mental health, substantive progress now depends on these two approaches being seen as complementary and synergistic rather than contradictory. From this launchpad, Kirkbride et al's paper1 is an impressive, high-level and up-to-date overview regarding the role of social determinants in mental health and

Kirkbride et al's outstanding paper1 updates recommendations from the perspective of social determinants of health to mitigate the onset of mental disorders and lay out a roadmap for an effective prevention plan. They explain that the maldistribution of essential social determinants is not random, is shaped by policy and by those in power, and could reproduce intergenerational inequities in people's

Kirkbride et al1 provide a comprehensive, rigorous and thoughtful overview of the literature on social determinants of mental health, focusing on evidence for both causal effects of determinants and effectiveness of interventions. They also put forward a series of recommendations, focusing on how to prioritize prevention and intervention that attends to social justice and poverty alleviation with more

An extensive literature has documented the association of psychosocial work stressors – e.g., job strain, effort-reward imbalance, organizational injustice, long working hours, job insecurity, shift work, workplace harassment and bullying – with mental health problems1-4. However, the implications for population mental health of the changing nature of work in the 21st century have not been sufficiently

Kirkbride et al1 provide convincing evidence of a causal relationship between social determinants and poorer mental health outcomes. The extent, complexity and prevalence of these determinants could lead to hopelessness at the prospect of addressing the inequalities and inequities involved. However, the authors instil hope and optimism by providing examples of interventions delivered at the family

Social factors have an important impact on the onset of and recovery from mental illness1. Where individuals live, how they live and what factors impinge on their living, including their access to nutrition, to housing, to recreation, as well as their pattern of interactions with other people around them, have consequences and relevance for their emotions and behaviours. The fact that humans are social

Narratives describing first-hand experiences of recovery from mental health problems are widely available. Emerging evidence suggests that engaging with mental health recovery narratives can benefit people experiencing mental health problems, but no randomized controlled trial has been conducted as yet. We developed the Narrative Experiences Online (NEON) Intervention, a web application providing self-guided

Anxiety disorders are very prevalent and often persistent mental disorders, with a considerable rate of treatment resistance which requires regulatory clinical trials of innovative therapeutic interventions. However, an explicit definition of treatment-resistant anxiety disorders (TR-AD) informing such trials is currently lacking. We used a Delphi method-based consensus approach to provide internationally

Eating disorders (EDs) are known to be associated with high mortality and often chronic and severe course, but a recent comprehensive systematic review of their outcomes is currently missing. In the present systematic review and meta-analysis, we examined cohort studies and clinical trials published between 1980 and 2021 that reported, for DSM/ICD-defined EDs, overall ED outcomes (i.e., recovery, improvement

The mental health care available for depression and anxiety has recently undergone a major technological revolution, with growing interest towards the potential of smartphone apps as a scalable tool to treat these conditions. Since the last comprehensive meta-analysis in 2019 established positive yet variable effects of apps on depressive and anxiety symptoms, more than 100 new randomized controlled

The Mental Health Priority Area of the Wellcome Trust recently posited that sleep and circadian rhythm disturbances (SCRDs) are a plausible nexus for linking aspects of the biology, phenomenology, course and treatment of major mood, anxiety and psychotic disorders1. This emphasis fits well with the currently spreading trend to develop more effective and scalable forms of indicated prevention, early

In a period in which they keep on struggling for equal chances in several fields, women still need to strive for a medical treatment which takes sex differences into account. Medical practice has long been implicitly led by the notion that only reproductive organs differ between the sexes. Yet, significant sex differences have been clearly documented in blood, immune system, liver, kidneys, stomach