Importance Nearly all psychopathology is inherently continuous, but both clinical practice and research often require categorical decisions (eg, treat or wait, pay for treatment or decline, enroll in study or not); therefore, thresholds are applied to continuous phenomena to guide…
Importance Psychedelic drugs possess acute psychoactive effects that can compromise blinding integrity in randomized clinical trials (RCTs). Functional unblinding, when participants or raters correctly identify treatment allocation based on subjective effects, may bias outcomes through expectancy effects, challenging the validity…
Importance Preclinical evidence and case reports suggest potential therapeutic benefits of ketogenic diets (KDs) in the treatment of depression, but evidence from well-controlled randomized clinical trials (RCTs) is lacking. Objective To assess the efficacy of a KD compared with a…
This article discusses the increasing prevalence of individuals seeking mental health help from artificial intelligence (AI) and recommends strategies to help patients navigate AI use.
Importance Psychiatric classification faces longstanding challenges, including heterogeneous diagnostic categories, high comorbidity rates, limited interrater reliability, and modest clinical utility. Successive revisions of systems such as the DSM since 1980 have done little to resolve these issues. How to move forward? Observations This narrative…
Importance Adults with severe mental illness (SMI) face a 10- to 20-year reduction in life expectancy, largely due to heightened cardiometabolic diseases. Low levels of physical activity (PA) and prolonged sedentary behavior (SB) are modifiable risk factors that contribute to this…
Importance Major depressive disorder (MDD) is a debilitating neuropsychiatric disease associated with high risk of death by suicide. MDD is heterogeneous, and genome-wide association studies (GWASs) have established that MDD is polygenic, reporting thousands of small-effect variants. There is a significant…
Importance Preliminary studies suggest heart rate variability biofeedback (HRVB) may reduce craving and negative affect in individuals with substance use disorder (SUD), but few studies have evaluated whether this translates into improved substance use outcomes, and no prior studies have examined…
This article illustrates the assumption of path symmetry in current theories of psychopathology and calls for the development of dynamical systems of mental illness that incorporate asymmetry.
Importance Psilocybin use has surged in the US following decriminalization efforts and promising clinical trial results. Mirroring early cannabis legalization, public access and enthusiasm are outpacing regulatory oversight and scientific understanding, posing potential risks to public health. Objective To review emerging evidence…
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