{"title":"Psychiatric advance directives: challenges emerging from implementation and possible steps forward.","authors":"Marvin S Swartz,Jeffrey W Swanson","doi":"10.1002/wps.70037","DOIUrl":"https://doi.org/10.1002/wps.70037","url":null,"abstract":"","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"30 1","pages":"145-146"},"PeriodicalIF":73.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968436","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}
Ian H Kratter,Christopher W Austelle,Jennifer I Lissemore,Masataka Wada,Andrew Geoly,Anna Chaiken,Irakli Kaloiani,Noriah Johnson,Stephanie Wan,Lena Kozyr,Ethan Makarewycz,Brendan Wong,Malvika Sridhar,Flint M Espil,Nick Bassano,Bora Kim,Jarrod Ehrie,Adi Maron-Katz,Claudia Tischler,Romina Nejad,Jean-Marie Batail,Angela L Phillips,Eleanor J Cole,Tiffany J Ford,Brandon S Bentzley,Booil Jo,Alan F Schatzberg,David Spiegel,Cammie Rolle,Gregory L Sahlem,Nolan R Williams
Stanford neuromodulation therapy (SNT) is a rapid-acting, high-dose, intermittent theta-burst stimulation protocol. Although it has previously demonstrated efficacy for treatment-resistant depression (TRD) in a randomized controlled trial (RCT), replication in a larger sample is needed. Additionally, the electrophysiological effects of SNT remain unknown. Here we report results from a new double-blind, sham-controlled RCT along with electroencephalography (EEG) findings from the initial and current trials. In the current RCT, 53 participants with TRD were enrolled, and 48 who continued to meet entry criteria were randomized to receive active (N=24) or sham (N=24) SNT. At 1-month, remission (primary outcome) was achieved in 50.0% of active vs. 20.8% of sham participants (χ2 1,48=4.5, p=0.035), and response (secondary outcome) similarly favored active treatment (54.2% vs. 25.0%; χ2 1,48=4.3, p=0.039). Beta band EEG findings converged across trials: frontal beta power decreased significantly following active but not sham SNT in both the initial pilot study and the current trial. Additionally, beta baseline activity and post-SNT changes related to treatment efficacy in the current study. Specifically, greater post-SNT reduction in left anterior cingulate cortex (L-ACC) beta power correlated with greater clinical improvement immediately (rho=0.48, p=0.019) and 1-month after (rho=0.51, p=0.012) active SNT. Moreover, higher pre-treatment L-ACC beta power predicted greater subsequent clinical benefit from active SNT (immediate-post: β=-10.26, p=0.0042; 1-month after: β=-9.00, p=0.024). Neither of these L-ACC beta power findings was observed with sham stimulation. In sum, this study replicates SNT's therapeutic efficacy, identifies left frontal beta suppression as a potential mechanism of action, and highlights baseline L-ACC beta power as a candidate scalable pre-treatment biomarker of efficacy.
{"title":"Stanford neuromodulation therapy for treatment-resistant depression: a randomized controlled trial confirming efficacy, and an EEG study providing insight into mechanism of action and a potentially predictive biomarker of efficacy.","authors":"Ian H Kratter,Christopher W Austelle,Jennifer I Lissemore,Masataka Wada,Andrew Geoly,Anna Chaiken,Irakli Kaloiani,Noriah Johnson,Stephanie Wan,Lena Kozyr,Ethan Makarewycz,Brendan Wong,Malvika Sridhar,Flint M Espil,Nick Bassano,Bora Kim,Jarrod Ehrie,Adi Maron-Katz,Claudia Tischler,Romina Nejad,Jean-Marie Batail,Angela L Phillips,Eleanor J Cole,Tiffany J Ford,Brandon S Bentzley,Booil Jo,Alan F Schatzberg,David Spiegel,Cammie Rolle,Gregory L Sahlem,Nolan R Williams","doi":"10.1002/wps.70032","DOIUrl":"https://doi.org/10.1002/wps.70032","url":null,"abstract":"Stanford neuromodulation therapy (SNT) is a rapid-acting, high-dose, intermittent theta-burst stimulation protocol. Although it has previously demonstrated efficacy for treatment-resistant depression (TRD) in a randomized controlled trial (RCT), replication in a larger sample is needed. Additionally, the electrophysiological effects of SNT remain unknown. Here we report results from a new double-blind, sham-controlled RCT along with electroencephalography (EEG) findings from the initial and current trials. In the current RCT, 53 participants with TRD were enrolled, and 48 who continued to meet entry criteria were randomized to receive active (N=24) or sham (N=24) SNT. At 1-month, remission (primary outcome) was achieved in 50.0% of active vs. 20.8% of sham participants (χ2 1,48=4.5, p=0.035), and response (secondary outcome) similarly favored active treatment (54.2% vs. 25.0%; χ2 1,48=4.3, p=0.039). Beta band EEG findings converged across trials: frontal beta power decreased significantly following active but not sham SNT in both the initial pilot study and the current trial. Additionally, beta baseline activity and post-SNT changes related to treatment efficacy in the current study. Specifically, greater post-SNT reduction in left anterior cingulate cortex (L-ACC) beta power correlated with greater clinical improvement immediately (rho=0.48, p=0.019) and 1-month after (rho=0.51, p=0.012) active SNT. Moreover, higher pre-treatment L-ACC beta power predicted greater subsequent clinical benefit from active SNT (immediate-post: β=-10.26, p=0.0042; 1-month after: β=-9.00, p=0.024). Neither of these L-ACC beta power findings was observed with sham stimulation. In sum, this study replicates SNT's therapeutic efficacy, identifies left frontal beta suppression as a potential mechanism of action, and highlights baseline L-ACC beta power as a candidate scalable pre-treatment biomarker of efficacy.","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"141 1","pages":"105-116"},"PeriodicalIF":73.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968441","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}
{"title":"Social inclusion in mental health: a Latin American perspective.","authors":"Franco Mascayano","doi":"10.1002/wps.70011","DOIUrl":"https://doi.org/10.1002/wps.70011","url":null,"abstract":"","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"17 1","pages":"93-94"},"PeriodicalIF":73.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968482","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}
{"title":"Euthanasia for mental suffering in young people: a critical global perspective.","authors":"Jim van Os,Damiaan Denys","doi":"10.1002/wps.70036","DOIUrl":"https://doi.org/10.1002/wps.70036","url":null,"abstract":"","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"39 1","pages":"143-144"},"PeriodicalIF":73.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968443","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}
Gonzalo Salazar de Pablo,Joao Almeida,Jesus Camacho,José Suárez Campayo,Ana Catalan,Mihai Pop,Claudia Aymerich,Maria Rogdaki,Delbert G Robinson,Nina Schooler,Philip McGuire,Wing-Chung Chang,Eric Yu-Hai Chen,Merete Nordentoft,Carsten Hjorthøj,Nikolai Albert,Marie Starzer,Vinod Srihari,Marcelo Valencia,Celso Arango,John Kane,Paolo Fusar-Poli,Christoph U Correll
Early intervention services (EIS) for psychosis have demonstrated superiority to usual care/modular care (UC/MC) until the end of their delivery. However, the maintenance effects of EIS care after transition to UC/MC are less clear. We aimed to compare these effects vs. UC/MC at least one year after the end of EIS care. This PRISMA and MOOSE-compliant systematic review searched PubMed, EMBASE, PsycINFO and Web of Science databases and Cochrane Central Register of Reviews, without time or language restrictions. We included studies initially designed as randomized controlled trials (RCTs) comparing EIS vs. UC/MC in patients with early-phase psychosis, in which both the intervention and control groups were followed for at least 12 months after cessation of EIS care in the intervention group. Co-primary outcomes were psychiatric hospitalization, duration of hospitalization, and drop-out at the end of follow-up (preferably 5 years post-EIS initiation). Secondary outcomes were severity of total, positive and negative symptoms; quality of life, work involvement, remission, legal offences, antipsychotic use, and suicide attempts. We meta-analyzed six RCTs with data from 13 papers, including 1,416 individuals (mean age: 23.9 years, females: 36.7%). After 2-3 years of receiving UC/MC, subsequent to 2-3 years of EIS care or UC/MC, individuals who originally received EIS care spent less days hospitalized than those continuing UC/MC (n=5, standardized mean difference, SMD=0.128, 95% CI: 0.019-0.237, p=0.021). However, although we confirmed the superiority of EIS care to UC/MC at the end of the intervention period (except for work involvement and legal offences), the two groups did not differ significantly at 2-3 years post-EIS care regarding hospitalization, all-cause drop-out, quality of life; severity of total, positive and negative symptoms; work involvement, remission, legal offences, antipsychotic use, and suicide attempts. In summary, EIS care did not maintain its superiority over UC/MC 2-3 years after its cessation across meta-analyzable outcomes, except for duration of hospitalizations. These results support the need to further develop and potentially extend full or individualized EIS delivery.
精神病的早期干预服务（EIS）已经证明优于常规护理/模块化护理（UC/MC），直到其交付结束。然而，过渡到UC/MC后EIS护理的维持效果尚不清楚。我们的目的是在EIS治疗结束至少一年后比较这些效果与UC/MC。这个符合PRISMA和moose标准的系统综述检索了PubMed、EMBASE、PsycINFO和Web of Science数据库以及Cochrane Central Register of Reviews，没有时间和语言限制。我们纳入了最初设计为随机对照试验（RCTs）的研究，比较EIS与UC/MC在早期精神病患者中的疗效，在干预组停止EIS治疗后，干预组和对照组都被随访了至少12个月。共同的主要结局是精神病住院、住院时间和随访结束时的退出（最好是在eis开始后5年）。次要结局是总症状、阳性症状和阴性症状的严重程度；生活质量、工作投入、缓解、违法行为、抗精神病药物使用和自杀企图。我们荟萃分析了来自13篇论文的6项随机对照试验，包括1416名个体（平均年龄：23.9岁，女性：36.7%）。接受UC/MC治疗2-3年后，再接受EIS治疗或UC/MC治疗2-3年后，最初接受EIS治疗的患者住院天数少于继续接受UC/MC治疗的患者（n=5，标准化平均差，SMD=0.128, 95% CI: 0.019-0.237, p=0.021）。然而，尽管我们在干预期结束时证实了EIS护理优于UC/MC（工作参与和违法行为除外），但在EIS护理后2-3年，两组在住院、全因退学、生活质量方面没有显着差异；总阳性和阴性症状的严重程度；工作投入、病情缓解、违法行为、抗精神病药物的使用和自杀企图。综上所述，除了住院时间外，EIS治疗在停止治疗2-3年后并没有保持其优于UC/MC的优势。这些结果支持进一步开发和潜在地扩展完整或个性化EIS交付的必要性。
{"title":"Do early intervention services for psychosis maintain their effects after transition to usual/modular care? A systematic review and meta-analysis.","authors":"Gonzalo Salazar de Pablo,Joao Almeida,Jesus Camacho,José Suárez Campayo,Ana Catalan,Mihai Pop,Claudia Aymerich,Maria Rogdaki,Delbert G Robinson,Nina Schooler,Philip McGuire,Wing-Chung Chang,Eric Yu-Hai Chen,Merete Nordentoft,Carsten Hjorthøj,Nikolai Albert,Marie Starzer,Vinod Srihari,Marcelo Valencia,Celso Arango,John Kane,Paolo Fusar-Poli,Christoph U Correll","doi":"10.1002/wps.70012","DOIUrl":"https://doi.org/10.1002/wps.70012","url":null,"abstract":"Early intervention services (EIS) for psychosis have demonstrated superiority to usual care/modular care (UC/MC) until the end of their delivery. However, the maintenance effects of EIS care after transition to UC/MC are less clear. We aimed to compare these effects vs. UC/MC at least one year after the end of EIS care. This PRISMA and MOOSE-compliant systematic review searched PubMed, EMBASE, PsycINFO and Web of Science databases and Cochrane Central Register of Reviews, without time or language restrictions. We included studies initially designed as randomized controlled trials (RCTs) comparing EIS vs. UC/MC in patients with early-phase psychosis, in which both the intervention and control groups were followed for at least 12 months after cessation of EIS care in the intervention group. Co-primary outcomes were psychiatric hospitalization, duration of hospitalization, and drop-out at the end of follow-up (preferably 5 years post-EIS initiation). Secondary outcomes were severity of total, positive and negative symptoms; quality of life, work involvement, remission, legal offences, antipsychotic use, and suicide attempts. We meta-analyzed six RCTs with data from 13 papers, including 1,416 individuals (mean age: 23.9 years, females: 36.7%). After 2-3 years of receiving UC/MC, subsequent to 2-3 years of EIS care or UC/MC, individuals who originally received EIS care spent less days hospitalized than those continuing UC/MC (n=5, standardized mean difference, SMD=0.128, 95% CI: 0.019-0.237, p=0.021). However, although we confirmed the superiority of EIS care to UC/MC at the end of the intervention period (except for work involvement and legal offences), the two groups did not differ significantly at 2-3 years post-EIS care regarding hospitalization, all-cause drop-out, quality of life; severity of total, positive and negative symptoms; work involvement, remission, legal offences, antipsychotic use, and suicide attempts. In summary, EIS care did not maintain its superiority over UC/MC 2-3 years after its cessation across meta-analyzable outcomes, except for duration of hospitalizations. These results support the need to further develop and potentially extend full or individualized EIS delivery.","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"81 1","pages":"95-104"},"PeriodicalIF":73.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968475","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}
{"title":"Off-label use of medications in psychiatry: the need and the caveats.","authors":"Eduard Vieta","doi":"10.1002/wps.70035","DOIUrl":"https://doi.org/10.1002/wps.70035","url":null,"abstract":"","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"21 1","pages":"142-143"},"PeriodicalIF":73.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968427","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}
{"title":"Nutritional psychiatry on the move: the activities of the ECNP Nutrition Network to leverage nutrition for brain health.","authors":"Francesca Cirulli,Suzanne L Dickson","doi":"10.1002/wps.70020","DOIUrl":"https://doi.org/10.1002/wps.70020","url":null,"abstract":"","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"34 1","pages":"155-156"},"PeriodicalIF":73.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968442","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}
{"title":"Reframing psychiatry of intellectual developmental disorders: from margins to mainstream, from classification to care.","authors":"Kerim Munir,Ashok Roy,Marco Bertelli,Gregorio Katz,Luis Salvador-Carulla","doi":"10.1002/wps.70023","DOIUrl":"https://doi.org/10.1002/wps.70023","url":null,"abstract":"","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"101 1","pages":"157-158"},"PeriodicalIF":73.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968478","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}
{"title":"New WHO guidance on mental health and well-being across government sectors.","authors":"Michelle Funk,Natalie Drew,Celline Cole,Maria Francesca Moro","doi":"10.1002/wps.70016","DOIUrl":"https://doi.org/10.1002/wps.70016","url":null,"abstract":"","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"34 1","pages":"147-148"},"PeriodicalIF":73.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968481","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：