Lancet Psychiatry

Reimagining community mental health: adapting interventions for culturally rich, low-resource settings
Dalal N, Chambwe C, Maila B and Chilengi R
Feasibility and acceptability of the Problem Management for Moms programme for improving maternal mental health in Zambia: an open-label trial
Fink G, Melero-Dominguez M, Chembe M, de Vernisy-Romero D, Tembo T, Billima T, Paul R, Alegria M, Parkerson D, Rockers PC, Banda Z, Lungu G, Sikazwe D and Falgas-Bague I
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.
Youth mental health in Tunisia: challenges and resources
Ouali U, Aissa A, Larnaout A, Abbes Z, Charfi F, Bouden A and Ventura J
Embracing complexity in psychiatry-from reductionistic to systems approaches
Öngür D and Paulus MP
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
Højlund M, Köhler-Forsberg O, Gregersen AT, Rohde C, Mellentin AI, Anhøj SJ, Kemp AF, Fuglsang NB, Wiuff AC, Nissen L, Sørensen MA, Madsen NM, Wagner CB, Agharazi A, Søndergaard C, Sandmark M, Reinhart J and Correll CU
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.
Correction to Lancet Psychiatry 2024; 11: 910-33
Consultation-liaison psychiatry: how the intervention tested in The HOME Study differs from US practice - Authors' reply
Sharpe M and Walker J
Why mental health should be embedded across climate and health discussions at COP29
Massazza A, Alonzo N, Augustinavicius J, Batz CS, Beagley J, Carvalho LR, Daniel M, Fleury J, Guluzade N, Hijazi Z, Lawrance EL, El Omrani O, Uakkas S, Ugo V and Umesh H
Consultation-liaison psychiatry: how the intervention tested in The HOME Study differs from US practice
Oldham MA and Triplett P
Norbert Skokauskas: research is not just an academic exercise
Burki T
Ghana's law decriminalising attempted suicide needs revision
Quarshie EN and Oppong Asante K
Associations between white matter microstructure and cognitive decline in major depressive disorder versus controls in Germany: a prospective case-control cohort study
Flinkenflügel K, Meinert S, Hirtsiefer C, Grotegerd D, Gruber M, Goltermann J, Winter NR, Stein F, Brosch K, Leehr EJ, Böhnlein J, Dohm K, Bauer J, Redlich R, Hahn T, Repple J, Opel N, Nitsch R, Jamalabadi H, Straube B, Alexander N, Jansen A, Nenadić I, van den Heuvel MP, , Kircher T and Dannlowski U
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
Steare T, Evans-Lacko S, Araya M, Cueto S, Dang HH, Ellanki R, Garman E, Lewis G, Rose-Clarke K and Patalay P
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.
The challenges of antipsychotic polypharmacy
Tiihonen J and Taipale H
Correction to Lancet Psychiatry 2024; 11: 910-33
Priority setting for mental health in Gaza
Jamei YA and Barbui C
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
Fineberg NA, Demetrovics Z, Potenza MN, Mestre-Bach G, Ekhtiari H, Roman-Urrestarazu A, Achab S, Kattau T, Bowden-Jones H, Thomas SA, Babor TF, Kidron B and Stein DJ
Misuse of prediction models in psychiatric research
Narita ZC and Furukawa TA
Sex-sensitive and gender-sensitive care for patients with mental disorders
Lenz B and Derntl B
Correction to Lancet Psychiatry 2023; published online Oct 22. S2215-0366(23)00273-0