Pub Date : 2025-12-10DOI: 10.1001/jamapsychiatry.2025.3695
Kamaldeep Bhui,Roisin Mooney
{"title":"Preventive Global Mental Health-A Balance of Policies and Practices.","authors":"Kamaldeep Bhui,Roisin Mooney","doi":"10.1001/jamapsychiatry.2025.3695","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.3695","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"28 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145711053","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}
Pub Date : 2025-12-03DOI: 10.1001/jamapsychiatry.2025.3639
Marie R. Sass, Mette Kruse Klausen, Christine R. Schwarz, Line Rasmussen, Malte E. B. Giver, Malthe Hviid, Christoffer Schilling, Alexandra Zamorski, Andreas Jensen, Maria Gefke, Heidi Storgaard, Peter S. Oturai, Andreas Kjaer, Bolette Hartmann, Jens J. Holst, Claus T. Ekstrøm, Maj Vinberg, Christoph U. Correll, Tina Vilsbøll, Anders Fink-Jensen
Importance Individuals with schizophrenia spectrum disorders treated with second-generation antipsychotics (SGAs) are at heightened risk for obesity, prediabetes, and type 2 diabetes, contributing to increased cardiovascular morbidity and premature mortality. Early intervention with glucagon-like peptide–1 receptor agonists (GLP-1RAs) may help mitigate long-term cardiometabolic risk. Objective To evaluate the efficacy of adjunctive semaglutide on glycemic control, weight-associated outcomes, and cardiometabolic risk factors in individuals with schizophrenia spectrum disorders receiving clozapine or olanzapine and exhibiting early glycemic abnormalities. Design, Setting, and Participants This was a multicenter, double-blind, placebo-controlled, randomized clinical trial. Participants were enrolled from 3 clinical sites in Denmark between September 2021 and August 2024. Screening individuals were aged 18 to 65 years with schizophrenia spectrum disorders and clozapine or olanzapine treatment initiated within the past 5 years. Participants had early-stage glycemic dysregulation (hemoglobin A <jats:sub>1c</jats:sub> [HbA <jats:sub>1c</jats:sub> ], 5.4%-7.4%) and were not receiving antidiabetic therapy. Interventions Participants received once-weekly subcutaneous semaglutide (1 mg) or a matching placebo, administered adjunctively to SGA therapy for 26 weeks. Main Outcomes and Measures The prespecified primary outcome was change in HbA <jats:sub>1c</jats:sub> level from baseline to week 26. The primary analysis adhered to the intention-to-treat principle. Results Of 104 individuals screened, 73 were randomized and 57 (78%) completed the trial. Baseline characteristics were comparable between groups. Mean (SD) age was 35 (12) years, 48 were female (65%), and mean (SD) body mass index was 36.1 (7.9). At week 26, semaglutide significantly reduced HbA <jats:sub>1c</jats:sub> level compared with placebo (mean difference, −0.25%; 95% CI, −0.33 to −0.16; <jats:italic>P</jats:italic> &lt; .001); 43% of participants (12 of 28) treated with semaglutide achieved low-risk HbA <jats:sub>1c</jats:sub> levels (&lt;5.4%) vs 3% with placebo. Greater reductions in body weight (−9.2 kg; 95% CI, −13.3 to −5.1 kg; <jats:italic>P</jats:italic> &lt; .001), waist circumference (−7.0 cm; 95% CI, −10.6 to −3.3 cm; <jats:italic>P</jats:italic> &lt; .001), and fat mass (−6.1 kg; 95% CI, −10.2 to −1.9 kg; <jats:italic>P</jats:italic> = .006) were observed with semaglutide. No differences in lipid levels, liver function, blood pressure, or psychiatric symptoms were observed. Gastrointestinal adverse events were common but mild and transient; psychiatric adverse events were similar across groups. Conclusions and Relevance Results of this randomized clinical trial show that adjunctive semaglutide significantly improved glycemic control and weight outcomes in individuals with schizophrenia spectrum disorders. Secondary outcomes were exploratory. These fi
{"title":"Semaglutide and Early-Stage Metabolic Abnormalities in Individuals With Schizophrenia Spectrum Disorders","authors":"Marie R. Sass, Mette Kruse Klausen, Christine R. Schwarz, Line Rasmussen, Malte E. B. Giver, Malthe Hviid, Christoffer Schilling, Alexandra Zamorski, Andreas Jensen, Maria Gefke, Heidi Storgaard, Peter S. Oturai, Andreas Kjaer, Bolette Hartmann, Jens J. Holst, Claus T. Ekstrøm, Maj Vinberg, Christoph U. Correll, Tina Vilsbøll, Anders Fink-Jensen","doi":"10.1001/jamapsychiatry.2025.3639","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.3639","url":null,"abstract":"Importance Individuals with schizophrenia spectrum disorders treated with second-generation antipsychotics (SGAs) are at heightened risk for obesity, prediabetes, and type 2 diabetes, contributing to increased cardiovascular morbidity and premature mortality. Early intervention with glucagon-like peptide–1 receptor agonists (GLP-1RAs) may help mitigate long-term cardiometabolic risk. Objective To evaluate the efficacy of adjunctive semaglutide on glycemic control, weight-associated outcomes, and cardiometabolic risk factors in individuals with schizophrenia spectrum disorders receiving clozapine or olanzapine and exhibiting early glycemic abnormalities. Design, Setting, and Participants This was a multicenter, double-blind, placebo-controlled, randomized clinical trial. Participants were enrolled from 3 clinical sites in Denmark between September 2021 and August 2024. Screening individuals were aged 18 to 65 years with schizophrenia spectrum disorders and clozapine or olanzapine treatment initiated within the past 5 years. Participants had early-stage glycemic dysregulation (hemoglobin A <jats:sub>1c</jats:sub> [HbA <jats:sub>1c</jats:sub> ], 5.4%-7.4%) and were not receiving antidiabetic therapy. Interventions Participants received once-weekly subcutaneous semaglutide (1 mg) or a matching placebo, administered adjunctively to SGA therapy for 26 weeks. Main Outcomes and Measures The prespecified primary outcome was change in HbA <jats:sub>1c</jats:sub> level from baseline to week 26. The primary analysis adhered to the intention-to-treat principle. Results Of 104 individuals screened, 73 were randomized and 57 (78%) completed the trial. Baseline characteristics were comparable between groups. Mean (SD) age was 35 (12) years, 48 were female (65%), and mean (SD) body mass index was 36.1 (7.9). At week 26, semaglutide significantly reduced HbA <jats:sub>1c</jats:sub> level compared with placebo (mean difference, −0.25%; 95% CI, −0.33 to −0.16; <jats:italic>P</jats:italic> &amp;lt; .001); 43% of participants (12 of 28) treated with semaglutide achieved low-risk HbA <jats:sub>1c</jats:sub> levels (&amp;lt;5.4%) vs 3% with placebo. Greater reductions in body weight (−9.2 kg; 95% CI, −13.3 to −5.1 kg; <jats:italic>P</jats:italic> &amp;lt; .001), waist circumference (−7.0 cm; 95% CI, −10.6 to −3.3 cm; <jats:italic>P</jats:italic> &amp;lt; .001), and fat mass (−6.1 kg; 95% CI, −10.2 to −1.9 kg; <jats:italic>P</jats:italic> = .006) were observed with semaglutide. No differences in lipid levels, liver function, blood pressure, or psychiatric symptoms were observed. Gastrointestinal adverse events were common but mild and transient; psychiatric adverse events were similar across groups. Conclusions and Relevance Results of this randomized clinical trial show that adjunctive semaglutide significantly improved glycemic control and weight outcomes in individuals with schizophrenia spectrum disorders. Secondary outcomes were exploratory. These fi","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"29 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145658273","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}
Pub Date : 2025-12-03DOI: 10.1001/jamapsychiatry.2025.3636
Christoph U Correll,Nicholas Fabiano,Mikkel Højlund,Marco Solmi
{"title":"Muscarinic Receptor Activators-What Is Their Place in Clinical Care?","authors":"Christoph U Correll,Nicholas Fabiano,Mikkel Højlund,Marco Solmi","doi":"10.1001/jamapsychiatry.2025.3636","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.3636","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"10878 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145663905","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}
Pub Date : 2025-12-03DOI: 10.1001/jamapsychiatry.2025.3652
Yajuan Si, James R. Wagner, Ronald C. Kessler
Importance As mental health challenges continue to increase globally, using rigorous surveillance frameworks is essential for delivering nuanced population-level insights and informing evidence-based policy decisions. Objective To develop a standard for using nonprobability and probability-based online panel surveys in psychiatric epidemiological research. Evidence Review The traditional use of high-quality probability samples to carry out psychiatric epidemiological surveys of the household population is facing increasing financial and operational challenges. Surveys from nonprobability and probability-based online panels have emerged as cost-effective alternatives with the additional advantage of rapid turnaround time, albeit with biases that can in some cases be substantial. Findings We recommend a middle ground of integrating surveys from online panels with small parallel high-quality probability samples to enhance the practicality of carrying out large-scale epidemiological studies while maintaining validity. The key features of such “hybrid designs” are as follows: use of a high-quality probability sample as a population surrogate to provide information about the distributions of otherwise unavailable variables that differentiate participants in online panels from the larger household population, inclusion in both surveys of measures that are both strongly associated with the outcomes of interest and strongly predictive of membership in the online panel, and use of best-practice statistical methods that blend results across the 2 samples. Such a hybrid design should be the minimally acceptable design for psychiatric epidemiological surveys of the household population given the biases known to exist in online panels. However, we also comment on several other designs that might be used for more rapid and less expensive exploratory analyses. Conclusions and Relevance Hybrid designs address both the biases of surveys from online panels and the operational problems of surveys from high-quality probability samples. They should be the minimally acceptable design for psychiatric epidemiological surveys of the household population.
{"title":"Probability, Probability-Based, and Nonprobability Surveys in Psychiatric Epidemiological Research","authors":"Yajuan Si, James R. Wagner, Ronald C. Kessler","doi":"10.1001/jamapsychiatry.2025.3652","DOIUrl":"https://doi.org/10.1001/jamapsychiatry.2025.3652","url":null,"abstract":"Importance As mental health challenges continue to increase globally, using rigorous surveillance frameworks is essential for delivering nuanced population-level insights and informing evidence-based policy decisions. Objective To develop a standard for using nonprobability and probability-based online panel surveys in psychiatric epidemiological research. Evidence Review The traditional use of high-quality probability samples to carry out psychiatric epidemiological surveys of the household population is facing increasing financial and operational challenges. Surveys from nonprobability and probability-based online panels have emerged as cost-effective alternatives with the additional advantage of rapid turnaround time, albeit with biases that can in some cases be substantial. Findings We recommend a middle ground of integrating surveys from online panels with small parallel high-quality probability samples to enhance the practicality of carrying out large-scale epidemiological studies while maintaining validity. The key features of such “hybrid designs” are as follows: use of a high-quality probability sample as a population surrogate to provide information about the distributions of otherwise unavailable variables that differentiate participants in online panels from the larger household population, inclusion in both surveys of measures that are both strongly associated with the outcomes of interest and strongly predictive of membership in the online panel, and use of best-practice statistical methods that blend results across the 2 samples. Such a hybrid design should be the minimally acceptable design for psychiatric epidemiological surveys of the household population given the biases known to exist in online panels. However, we also comment on several other designs that might be used for more rapid and less expensive exploratory analyses. Conclusions and Relevance Hybrid designs address both the biases of surveys from online panels and the operational problems of surveys from high-quality probability samples. They should be the minimally acceptable design for psychiatric epidemiological surveys of the household population.","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":"57 1","pages":""},"PeriodicalIF":25.8,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145658274","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}
Pub Date : 2025-12-01DOI: 10.1001/jamapsychiatry.2025.3382
{"title":"Error in Conflict of Interest Disclosures.","authors":"","doi":"10.1001/jamapsychiatry.2025.3382","DOIUrl":"10.1001/jamapsychiatry.2025.3382","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"1256"},"PeriodicalIF":17.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12573107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145389768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1001/jamapsychiatry.2025.3166
Michael P Hengartner, Martin Plöderl, John Read
{"title":"Short-Term Trials Underestimate Antidepressant Withdrawal.","authors":"Michael P Hengartner, Martin Plöderl, John Read","doi":"10.1001/jamapsychiatry.2025.3166","DOIUrl":"10.1001/jamapsychiatry.2025.3166","url":null,"abstract":"","PeriodicalId":14800,"journal":{"name":"JAMA Psychiatry","volume":" ","pages":"1255"},"PeriodicalIF":17.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145389827","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}
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