Reimagining community mental health: adapting interventions for culturally rich, low-resource settings
Feasibility and acceptability of the Problem Management for Moms programme for improving maternal mental health in Zambia: an open-label trial
Psychological distress is common among mothers in low-income and middle-income countries, limiting their capacity to care for themselves and their children. This study aimed to test the feasibility and acceptability of an adapted psychosocial intervention for distressed mothers in low-resource settings.
Embracing complexity in psychiatry-from reductionistic to systems approaches
The understanding and treatment of psychiatric disorders present unique challenges due to these conditions' multifaceted nature, comprising dynamic interactions between biological, psychological, social, and environmental factors. Traditional reductionistic approaches often simplify these conditions into linear cause-and-effect relationships, overlooking the complexity and interconnectedness inherent in psychiatric disorders. Advances in complex systems approaches provide a comprehensive framework to capture and quantify the non-linear and emergent properties of psychiatric disorders. This Personal View emphasises the importance of identifying rules for generative models that govern brain and behaviour over time, which might contribute to personalised assessments and interventions for psychiatric disorders. For instance, mood fluctuations in bipolar disorder can be understood through dynamical systems modelling, which identifies modifiable parameters, such as circadian disruption, that can be addressed through targeted therapies such as light therapy. Similarly, recognition of depression as an emergent property arising from complex interactions highlights the need for integrated treatment strategies that enhance adaptive reactions in the individual. A framework for quantifying multilevel interactions and network dynamics can help researchers and clinicians to understand the interplay between neural circuits, behaviours, and social contexts. Probabilistic models and self-organisation concepts contribute to building concrete dynamical systems models of mental disorders, facilitating early identification of risk states and promoting resilience through adaptive interventions delivered with optimal timing. Embracing these complex systems approaches in psychiatry could capture the true nature of psychiatric disorders as properties of a dynamic complex system and not the manifestation of any lesion or insult. This line of thinking might improve diagnosis and treatment, offering new hope for individuals affected by psychiatric conditions and paving the way for more effective, personalised mental health care.
Prevalence, correlates, tolerability-related outcomes, and efficacy-related outcomes of antipsychotic polypharmacy: a systematic review and meta-analysis
Antipsychotic polypharmacy remains a clinical reality, despite an increased risk of adverse events and little evidence of additional efficacy compared with antipsychotic monotherapy. In this systematic review and meta-analysis, we aimed to provide a comprehensive assessment of antipsychotic polypharmacy prevalence, trends, and correlates across mental disorders.
Consultation-liaison psychiatry: how the intervention tested in The HOME Study differs from US practice - Authors' reply
Why mental health should be embedded across climate and health discussions at COP29
Consultation-liaison psychiatry: how the intervention tested in The HOME Study differs from US practice
Associations between white matter microstructure and cognitive decline in major depressive disorder versus controls in Germany: a prospective case-control cohort study
Cognitive deficits are a key source of disability in individuals with major depressive disorder (MDD) and worsen with disease progression. Despite their clinical relevance, the underlying mechanisms of cognitive deficits remain poorly elucidated, hampering effective treatment strategies. Emerging evidence suggests that alterations in white matter microstructure might contribute to cognitive dysfunction in MDD. We aimed to investigate the complex association between changes in white matter integrity, cognitive decline, and disease course in MDD in a comprehensive longitudinal dataset.
Economic inequalities in adolescents' internalising symptoms: longitudinal evidence from eight countries
Research, mainly conducted in Europe and North America, has shown an inequitable burden of internalising mental health problems among adolescents from poorer households. We investigated whether these mental health inequalities differ across a diverse range of countries and multiple measures of economic circumstances.
Correction to Lancet Psychiatry 2024; published online Oct 8. https://doi.org/10.1016/S2215-0366(24)00286-4
Global action on problematic usage of the internet: announcing a Lancet Psychiatry Commission
Sex-sensitive and gender-sensitive care for patients with mental disorders
Correction to Lancet Psychiatry 2023; published online Oct 22. S2215-0366(23)00273-0