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[Comment] The power of words: respectful language in ADHD research

Language is powerful. It reflects and shapes our understanding of the difficulties people face, the paradigms in which researchers and clinicians conduct research and practice while also influencing public perceptions and the expectations of people with lived experiences. Here, we aim to start a constructive dialogue around language use (ie, language that is respectful, not stigmatising, or discriminatory) related to ADHD, to encourage researchers, clinicians, and others to consider the potential impact of their words.

[Comment] Integrating moral injury into forensic psychiatry

Moral injury has garnered increasing attention in contemporary research, expanding from its initial association with military veterans to encompass a broader range of populations exposed to trauma and adversity. Potentially morally injurious events involve perceived transgressions of one's own moral code (perpetration) or betrayals by trusted authorities who have exposed the person to unnecessary danger or harm. The betrayal dimension was first highlighted by Shay in Vietnam veterans,1 by Freyd in people who have experienced child abuse,2 and more recently in ethnic, sexual, and gender minorities following perceived breaches of trust by family, friends, and public services, with adverse outcomes.

[Comment] Clozapine: superior yet underused

In The Lancet Psychiatry, Jurjen J Luykx and colleagues compared the effectiveness of clozapine with other psychotropic drugs using nationwide register-based data from Finland and Sweden on nearly 20 000 individuals treated with clozapine.1 The primary outcome was psychiatric hospitalisation, and—with the exception of borderline personality disorder—the investigators found superiority of clozapine over other antipsychotics (and, in bipolar disorder, over other mood stabilisers) for all diagnoses examined.

[Comment] Enhancing cognitive function in schizophrenia: we must make better choices

In this issue of the Lancet Psychiatry, Richard S E Keefe and colleagues1 report on the findings from a set of three phase 3 randomised, placebo-controlled, double-blind clinical trials of a drug called iclepertin for the treatment of cognitive impairment associated with schizophrenia (CIAS). Iclepertin is a selective GlyT1 inhibitor that was designed to try to improve NMDA receptor hypofunction in schizophrenia, one mechanism hypothesised to contribute to CIAS.

[Comment] Metformin: translating the evidence for prevention of weight gain

Melissa DelBello and colleagues1 should be commended on their clinical trial evaluating the effectiveness of metformin in mitigating weight gain in young people with bipolar disorder and related mood disorders taking second-generation antipsychotics. This clinical trial has many merits, including being sufficiently powered, and focusing on children and adolescents who are often neglected in clinical trials but are more prone to metabolic side effects. Furthermore, the trial had a long follow-up period of 2 years and examined the efficacy of an agent that is long off patent.

[Editorial] The importance of partnerships

The 2025 UN High-Level Meeting on the Prevention and Control of Noncommunicable Diseases and the Promotion of Mental Health marked an important turning point for mental health. Never before had the UN General Assembly put forth a political declaration with mental health as a central component. Although the declaration did not reach formal consensus endorsement, the message from the high-level meeting was clear: mental health is a global concern that requires a coordinated global response.

[Personal View] Life stage transitions for people with type 1 diabetes

Type 1 diabetes affects individuals of all ages, with different clinical priorities and support needs at different stages of life. In this Personal View, we define the two major transitions that occur across the lifespan in type 1 diabetes: the emerging adult transition (typically occurring between age 18 years and age 25 years, as individuals transition to self-management and transfer to adult care), and the older adult transition (occurring at variable ages as individuals develop comorbidities and complications that could require increased assistance with management and customisation of glycaemic targets).

[Review] Recent advances in research and care of familial hypercholesterolaemia

Heterozygous familial hypercholesterolaemia is a common, autosomal semi-dominant condition characterised by elevation of LDL cholesterol from birth and early onset of atherosclerotic cardiovascular disease. With major advances in knowledge about the disease, familial hypercholesterolaemia has become an exemplar for the practice of precision and personalised medicine. Beyond genetics, developments in clinical risk prediction algorithms and cardiovascular imaging have enabled more accurate risk stratification of patients.

[Articles] Cycle characterisation and clinical complications in patients with cyclic Cushing's syndrome: insights from an international retrospective cohort study

Even in specialised centres, cCS diagnosis and management remain challenging with high rates of spontaneous adrenal insufficiency, inappropriate surgeries, and poor outcomes. Ectopic cCS showed the most frequent and severe peaks. These findings might help to guide imaging localisations or the timing of BIPSS in patients with active occult ACTH-dependent cCS. Hypercortisolism needs to be biochemically confirmed before BIPSS to enable correct tumour localisation. Patients with suspected or proven cCS should be equipped with salivary cortisol collection kits to capture dynamic changes as well as being prescribed glucocorticoids to be used as a precaution.

[Corrections] Correction to Lancet Diabetes Endocrinol 2025; 13: 909–10

Maltese G, Kar P, Gallen G, Hicks D, Sinclair AJ. Addressing the educational needs of older adults with type 1 diabetes. Lancet Diabetes Endocrinol 2025; 13: 909–10—In this Correspondence, the title should have been Addressing the educational needs of older adults with type 1 diabetes. This correction has been made as of Oct 21, 2025.

[Corrections] Correction to Lancet Diabetes Endocrinol 2022; 10: 623–33

Inagaki N, Takeuchi M, Oura T, et al. Efficacy and safety of tirzepatide monotherapy compared with dulaglutide in Japanese patients with type 2 diabetes (SURPASS J-mono): a double-blind, multicentre, randomised, phase 3 trial. Lancet Diabetes Endocrinol 2022; 10: 623–33—Appendix 2 of this Article has been corrected as of Oct 15, 2025.

[Correspondence] Has the WHO Model Essential Medicines List lost its way?

The WHO's Model Essential Medicines List (EML), created in the 1970s, remains one of WHO's most successful tools in guiding countries' evidence-based, rational medicine selection. WHO states, “Essential medicines are those that effectively and safely treat the priority health-care needs of the population. They are selected by taking into consideration public health relevance, evidence of benefits and harms, and with consideration of costs, affordability and other relevant factors.”1

[Correspondence] The urgent need for a diabetes data rights charter

Data generated by diabetes devices—including continuous glucose monitors, smart pens, and insulin pumps—are fundamental to the care and long-term health of people with diabetes. Yet, despite their centrality, users of these devices do not have full access to and control over their own data. Regulatory frameworks such as the General Data Protection Regulation in the EU and UK, and the EU Data Act, establish much needed rights for device users. However, in practice, mechanisms to exercise these rights are often missing.

[Correspondence] The evolutionary basis for type 2 diabetes prevalence in the Arabian Peninsula

Across the Arabian Peninsula, home to the Gulf Cooperation Council (GCC) states, societies have transformed within a century from nomadic and agrarian life to globalised, oil-driven economies. With shifts in diet, physical activity, and daily living came a surge in metabolic disease, especially type 2 diabetes, in which the prevalence now exceeds 20–25% in countries such as Kuwait and Qatar.1 Lifestyle alone cannot explain this vulnerability. A deeper perspective is emerging, one grounded in evolutionary biology: that ancestral adaptations to survive scarcity might now predispose these populations to metabolic disease in an era of abundance.

[Comment] From reproduction to metabolism: FSH as a key modulator in menopause

Follicle-stimulating hormone (FSH), a glycoprotein secreted by gonadotroph cells of the anterior pituitary, is classically known as a key regulator of reproduction in both sexes, acting mainly on the gonads. It is a heterodimer with a common α-subunit and a hormone-specific β-subunit, signalling through the G protein-coupled FSH receptor. In females, FSH drives ovarian function by promoting follicle growth and maturation, supporting ovulation and luteinisation alongside luteinising hormone, and regulating essential gonadal processes, including development, gametogenesis, and steroidogenesis.