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[Correspondence] Therapeutic family foster care: an overlooked model for severe mental disorders

The UN Convention on the Rights of Persons with Disabilities1 asserts that people living with severe mental disorders have the fundamental right to adequate housing, freedom of residence, and access to community-based support fostering autonomy and inclusion. Despite advances in community mental health care and hospital-based services, supported housing options for people with severe mental illness remain restricted. Many patients face a lack of suitable options when returning home or to family is not possible or desirable after long-term hospitalisation.

[Correspondence] Managing psychiatric emergencies in Gaza with a destroyed psychiatric hospital

The running of psychiatric wards during times of war has unique ethical challenges, as discussed by Weiser and colleagues.1 Unfortunately, in Gaza, we do not have the luxury of adapting inpatient care to the challenges of war, as the only psychiatric hospital in Gaza was destroyed in an Israeli attack in Nov, 2023.2 This destruction has left a clinical void for patients with severe mental illness who require hospital admission. As psychiatry residents, we have had to manage these patients in outpatient facilities, which have also been repeatedly targeted.

[Comment] Large language models as mental health providers

General purpose chatbots are routinely used for personal health questions, including mental health. Converging evidence from independent surveys,1 observational data from public forums,2 and media reports show extensive use of large language models (LLMs) by people with anxiety, depression, relationship problems, and in crisis situations. These data sources have methodological limitations, but they suggest LLM chatbots have already progressed from personal coaching into psychotherapeutic intervention.

[Comment] NMDAR autoantibodies modify the phenotype of psychosis in severe brain inflammation

N-methyl-D-aspartate receptor (NMDAR) autoantibodies are of growing relevance in psychiatric research and practice, after their initial discovery in the context of NMDAR-antibody encephalitis. Because the course of this disease is clearly modifiable with immunotherapies, identifying its phenotypic characteristics is important. NMDAR-antibody encephalitis, involving affective-psychotic symptoms, and primary psychoses can occur in psychiatric settings and cause similar symptoms, but they require different diagnoses.

[Comment] From mirror to mind: body dissatisfaction and mental health

One of the enduring challenges in mental health research is disentangling environmental from genetic influences. Drawing on longitudinal data from the UK-based Twins Early Development Study, in The Lancet Psychiatry, Ilaria Costantini and colleagues1 convincingly address this challenge and make a major contribution to understanding how adolescent body dissatisfaction might shape trajectories of mental health and bodyweight. Their combination of phenotypic, twin-difference, and twin-modelling analyses provides a methodologically rigorous approach to this complex question.

[Comment] More than medication

In The Lancet Psychiatry, Debora Zaccoletti and colleagues1 present a clinically meaningful and methodologically sound systematic review and meta-analysis comparing antidepressant deprescribing strategies in individuals with clinically remitted depression and anxiety. The authors’ thorough adherence to principles of scientific transparency gives much needed trustworthiness to analyses in a contested field. This work also provides a welcome and balanced contribution to the polarised debate around antidepressant discontinuation.

[Comment] Transdiagnostic prediction of serious mental disorders: opportunities and considerations

Both bipolar disorders and psychotic disorders are serious mental disorders that have a substantial effect on psychosocial functioning, quality of life, and life expectancy. Given that these disorders typically have onsets during late adolescence and early adulthood, they cause greatest effect at a time when young people are attempting to reach developmental milestones, and untreated psychosis or mood symptoms can disrupt educational and occupational goals. Thus, there is clear rationale and clinical need for earlier intervention, identifying those individuals at the greatest risk, and offering evidence-based treatments that might change the early progression of disorder, delaying—or optimally, preventing—the onset of the disorder.

[Editorial] Synthesising evidence for antidepressants

Thinking at different scales is challenging. Translating between scales is difficult, and it can be appealing to focus on one aspect, such as short-term solutions versus longer-term effects, but this can create simplified stories. Antidepressants are an area with particularly strong and polarised views, drawing on personal experience, conversations in online forums, and influential voices on social or traditional media. Even seemingly objective research can reach different conclusions despite starting from the same evidence base.

Current and Emerging Approaches to Evaluating Influenza Vaccine Performance

Randomized, placebo-controlled trials are widely accepted as the scientific reference standard to determine a causal association between an intervention and an outcome. They are pivotal for product licensure. Although such trials establish safety and efficacy with the assumption that bias has been eliminated, limitations remain. For vaccines, establishing the duration…

Estimating stellar-mass compact object accretion in AGN disks with a new method

A research team from the Yunnan Observatories of the Chinese Academy of Sciences (CAS), in collaboration with other researchers, has developed a new method to estimate how stellar-mass compact objects (COs)—including black holes, neutron stars, and white dwarfs—accrete matter within active galactic nucleus (AGN) disks. This work provides new insights into the evolution of these objects in extreme cosmic environments.

Sub-Saharan Africa has lost 24% of its biodiversity since pre-industrial times, study finds

Researchers from the School of Animal, Plant and Environmental Sciences (APES) have contributed significantly to a major African-led study revealing that sub-Saharan Africa has already lost 24% of its biodiversity since pre-industrial times. This means that, on average, the populations of diverse plants and animals across the region have declined by nearly a quarter.

Westerlund 1: First evidence of particle outflow from a young massive star cluster

Star clusters are of great importance in any galaxy: they are the birthplace of new stars, often containing massive stars of 10 solar masses or more. Such massive stars often drive powerful winds; the combined action of all stars in the cluster then leads to the formation of a "superbubble"—a cavity in the interstellar medium.

Ensuring people with opioid use disorder released from prison stay on the recovery path

More than half the people in jail or prison in the U.S. have been diagnosed with substance use disorder (SUD). By law, inmates in New York State with opioid use disorder must be provided with medication-assisted treatment within 24 hours of intake. So it's often incarceration that gives many of these people their first real chance at recovery.

The longest GRB ever detected is an intriguing puzzle

Gamma-ray bursts (GRB) are some of the most perplexing phenomena in nature. Even though astronomers have detected about 15,000 of them, with a new one each day, they're still mysterious. They're the most luminous, energetic explosions in the universe, and typically last only a few milliseconds, or a few minutes, with a handful of them lasting for a few hours.

Reptiles are neglected and mistreated. Here's how we can take better care of them

Reptiles get a bad rap. As symbols of evil or villainy in Western culture, they are often linked to sin and betrayal, an association that dates all the way back to the origins of Judeochristian theology. This is not the case in all cultures though. Many other traditions see crocodiles, snakes and turtles as gods, guardians or symbols of transformation.