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[Articles] Disease relapse, all-cause mortality, and adverse events associated with long-acting injectable antipsychotics versus oral antipsychotics in older people with schizophrenia in Hong Kong: a population-based within-subject analysis

In older individuals with schizophrenia, LAI antipsychotics were associated with lower risk of disease relapse and mortality, without increased risk of adverse events, than oral antipsychotics, except for elevated risk of extrapyramidal symptoms specifically related to first-generation LAI antipsychotics. Overall, LAI antipsychotics, especially second-generation medications, could be more broadly considered for long-term use among this population, particularly at an early stage of disease.

[Articles] Clinical effectiveness of the Circle of Security-Parenting group intervention for birthing parents in perinatal mental health services in England (COSI): a pragmatic, multicentre, assessor-masked, randomised controlled trial

COS-P plus treatment-as-usual did not demonstrate greater clinical effectiveness compared with treatment-as-usual alone when delivered in NHS community perinatal mental health services. Therefore, COS-P should not be recommended for inclusion in routine community perinatal mental health services care, as it does not provide any additional clinical benefit when added to the current treatment-as-usual available in improving parental psychopathology, parenting, or infant outcomes.

[Corrections] Correction to Lancet Psychiatry 2025; published online Sept 16. https://doi.org/10.1016/S2215-0366(25)00206-8

McPhail L, Smartt C, Musyimi C, et al. Programmes for people who are homeless and have severe mental illness in low-income and middle-income countries: a systematic review. Lancet Psychiatry 2025; published online Sept 16. https://doi.org/10.1016/S2215-0366(25)00206-8—In this systematic review, table 1 has been updated to correct programme information. This correction has been made to the online version as of Oct 1, 2025, and will be made to the printed version.

[Corrections] Correction to Lancet Psychiatry 2017; 4: 715–24

Signorini G, Singh SP, Boricevic-Marsanic V, et al. Architecture and functioning of child and adolescent mental health services: a 28-country survey in Europe. Lancet Psychiatry 2017; 4: 715–24—In this Health Policy, the numbers of inpatient beds for psychiatric treatment per 100 000 young people in table 1 and paragraph 5 of page 717 have been corrected. This correction has been made as of Sept 19, 2025.

[Corrections] Correction to Lancet Psychiatry 2025; published online Aug 4. https://doi.org/10.1016/S2215-0366(25)00240-8

Sun J, Rose-Clarke K, Bao YP, Wang Z, Lu L. Child and adolescent mental health policy advancement in China. Lancet Psychiatry 2025; published online Aug 4. https://doi.org/10.1016/S2215-0366(25)00240-8—In this Comment, the email address for the corresponding author was incorrect. This correction has been made to the online version as of Aug 11, 2025, and will be made to the printed version.

[Insight] Theresa Miskimen Rivera: taking her seat at the APA with Latina spirit

Coming from a lineage of strong women has helped shape Theresa Miskimen Rivera's identity and drive. A clinical professor of psychiatry at Rutgers, Robert Wood Johnson Medical School (NJ, USA), she is also the current President of the American Psychiatric Association (APA), an esteemed position in which she hopes to leverage policy change by connecting with policy makers themselves, “because there is no health without mental health”, she says.

[Comment] New restrictive practices in mental health practice in Denmark

In May, 2025, the Danish Parliament agreed on a landmark 10-year mental health reform plan,1 substantially investing in prevention, early intervention, and expanded services. However, alongside these advances, one element has raised considerable concern: the legalisation of new forms of restrictive practices, including isolation (in forensic services, in locked patient rooms), upward restraint (such as during transfer), and expanded criteria for forced treatment and rapid tranquillisation. These changes, expected to take effect in 2026–27,1 broaden the legal scope of existing practices and introduce previously prohibited ones.

[Comment] Climate change and mental health: announcing a new Lancet Psychiatry Commission

Climate change is an existential threat to humanity and the ecosystems we rely on, impacting many aspects of human life, including mental health.1,2 Rising temperatures, extreme weather events, loss of habitats, environmental degradation, and resulting socioeconomic instability are some of the drivers associated with increasing incidence of psychological distress, psychiatric disorders, suicide, and mental health-related mortality.2 Climate change-related displacement, food insecurity, and economic hardship exert chronic stress, disproportionately affecting low-income populations, young people, older adults, individuals with pre-existing conditions, and Indigenous peoples, thus amplifying health disparities.

[Comment] Child and adolescent mental health policy advancement in China

Mental health disorders affect approximately one in seven children and adolescents globally, representing a major public health challenge that often begins early in life but remains underaddressed.1 In China, this burden is intensifying amid rapid socioeconomic transformation, urbanisation, widening rural–urban disparities, increased academic pressure, and evolving family dynamics.2 While in the last 30 years the number of mental disorder cases among children and adolescents decreased by 21·9% in China, age-standardised prevalence increased by 4·8%.

[Comment] Advancing mental health care and research in rare diseases

Rare diseases are defined as those that affect fewer than 1 in 2000 people in any WHO region. Over 7000 such diseases are known and more than 300 million people globally (between 3·5% and 5·9% of the population)1 are estimated to live with one of these diseases. As 72% of rare diseases are genetic and 70% of them start in childhood, effects on mental health are often lifelong and family-wide.2 The prevalence of depression (39·3% of patients with rare diseases) and anxiety (44·2% of patients with rare diseases) is substantially higher in patients with rare diseases than in the general population (depression 10·8–20·6%; anxiety disorders 16·6%).

[Comment] Hyperemesis gravidarum, perinatal depression, and the need for integrated maternal and infant care

Hyperemesis gravidarum affects 0·3–3·6% of women1 and is the leading cause of hospital admissions during the first trimester of pregnancy.2 Hyperemesis gravidarum is associated with serious consequences not only for the mother's physical health, but also for her mental health, particularly the risk of peripartum depression. Peripartum depression is recognised as the leading cause of illness during the perinatal period.3 Numerous studies have noted the existence of an association between hyperemesis gravidarum and depression; a meta-analysis by Mitchell-Jones and colleagues4 showed significantly higher depression scores in pregnant women with hyperemesis gravidarum than in controls without the disorder.

[Comment] Antipsychotics for older adults with schizophrenia

Schizophrenia is a chronic and relapsing psychiatric disorder that is now the third most common cause of disability-adjusted life years among older adults (aged ≥60 years).1 The estimated prevalence rate of schizophrenia among older adults is approximately 0·1–0·5%.2 Given the global population increase of older adults, there will be approximately 10 million older individuals with schizophrenia worldwide by 2050.1 Despite this population growth, data on these individuals are scarce, with only 1% of scientific literature on schizophrenia devoted to this population.

[Comment] COS-P as an adjunct treatment for perinatal mental health difficulties

Circle of Security-Parenting (COS-P) is an attachment-based parenting intervention typically offered in a group format, utilising videos of families. It focuses on helping caregivers respond to their children's attachment needs.1 It has seen rapid uptake,2 with more than 50 000 facilitators trained worldwide in the condensed COS-P. Research has not been able to keep pace with this prolific uptake, and as a result, there is a paucity of rigorous evidence on the efficacy of COS-P across the varied populations and settings where it is being utilised.

[Editorial] Lessons from Greek mythology for an AI world

Classical Greek texts feature many examples of mortals acting against advice and experiencing adverse consequences, such as Icarus flying too close to the sun or Pandora opening a box containing evils and miseries that were then released into the world. Pandora was curious, and curiosity is a foundational feature of good science: the desire to discover and understand more about the world in which we live. Modern scientific equivalents of Pandora's box might be nuclear power, genetic engineering, and artificial intelligence (AI).

[Clinical Picture] Primary thyroid diffuse large B-cell lymphoma in a teenager

A 17-year-old boy with no personal or family history presented at St Louis Hospital in Paris in October, 2024 with a thyroid goitre that progressed over several weeks, rapidly causing dysphonia. A CT showed invasion of the thyroid gland by a lobulated structure infiltrating both lobes and the isthmus, measured at 75 × 46 mm (figure A). Biological investigations showed no abnormalities (normal complete blood count, and normal thyroid-stimulating hormone, thyroglobulin, and calcitonin levels). Thyroid fine needle aspiration disclosed the presence of large cells with dispersed chromatin (figure B).