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[Comment] Harmonising terminology for type 1 diabetes: the EDENT1FI lexicon initiative

As screening and early treatment for type 1 diabetes become more widespread, the European action for the Diagnosis of Early Non-clinical Type 1 diabetes For disease Interception (EDENT1FI) consortium highlights the need for clearer, more consistent terminology. In this context, the group proposes a set of preferred terms to support communication around early-stage type 1 diabetes, including the use of ‘early-stage’ or ‘presymptomatic’ type 1 diabetes for stages 1 and 2, and ‘symptomatic type 1 diabetes’ for stage 3.

[Comment] Type 2 diabetes subtypes classification: a global reckoning with heterogeneity

For decades, type 2 diabetes has been managed as a monolithic condition, defined by hyperglycaemia and treated via uniform, stepwise algorithms. Although operationally convenient, this practice increasingly fails to account for the biological heterogeneity of type 2 diabetes. Just as oncology evolved from treating cancer as a single disease to recognising distinct malignancies with targeted therapies, a similar transformation is now underway in the field of type 2 diabetes.1 A syndromic framework grounded in molecular pathophysiology could ultimately reorient diabetes care towards precise, stratified risk prediction, personalised prevention, and targeted therapy.

[Comment] Semaglutide 7·2 mg: another step towards tackling diseases mediated by obesity

In The Lancet Diabetes & Endocrinology, the STEP-UP T2D and STEP-UP trial groups present new findings on the efficacy and safety of higher-dose semaglutide (7·2 mg once weekly) in individuals with obesity, both with and without type 2 diabetes.1,2 These trials build upon the foundational evidence supporting semaglutide 2·4 mg as an effective bodyweight management drug for people with diseases mediated by obesity. The clinical trials of semaglutide, and its main incretin-based alternative tirzepatide, have consistently shown very substantial and well sustained bodyweight loss and major therapeutic benefits across a range of secondary conditions—notably type 2 diabetes, prediabetes, hypertension, sleep apnoea, and heart failure.

[Comment] The need for improved diabetes detection and treatment

Diabetes, a public health challenge affecting millions of people worldwide, is associated with severe complications such as heart disease, kidney failure, retinopathy, neuropathy, and premature mortality.1,2 Diabetes profoundly affects quality of life. According to the Global Burden of Diseases, Injuries, and Risk Factor Study (GBD), 561 million people worldwide were living with diabetes in 2023.3,4 This number is projected to rise to 1·3 billion by 2050,4 which illustrates the enormous challenges faced by health-care systems and societies globally.

[Comment] Peripheral CB1 receptor blockade for treatment of obesity

The endocannabinoid system—comprising cannabinoid receptors (CB1 and CB2), lipid-derived ligands, and metabolic enzymes—plays a major role in regulating energy homoeostasis.1 CB1 receptors are abundant in the brain, where they influence emotionality, cognition, and social behaviour, but are also found in peripheral metabolic organs such as adipose tissue, liver, and pancreas. In these organs, CB1 activation promotes lipogenesis, reduces insulin sensitivity, and impairs leptin action, contributing to obesity-related metabolic dysfunction.

[Editorial] World Heart Day: diabetes and cardiovascular risk

Cardiovascular disease is one of the leading causes of death globally. Tragically, as many as 80% of heart disease and stroke cases could be avoided through prevention. For people with diabetes, the risk of developing cardiovascular disease is increased, and cardiovascular disease is also one of the leading causes of death and morbidity in this population. On Sept 29, World Heart Day draws attention to this concerning reality. This year's theme, “Don't Miss a Beat”, emphasises prevention and collective action—promoting a heart-healthy lifestyle, and calling on individuals, governments, and communities to help reduce the risk of heart disease.

[Personal View] Lithium as a disease-modifying drug for bipolar disorder

Lithium is a classic, primary treatment for bipolar disorder that has paradoxically been used less over time, especially in North America, which goes against the accumulating evidence for its efficacy. Bipolar disorder is increasingly conceptualised as a chronic, potentially progressive condition worsened and accelerated by each mood episode, which might resemble multiple sclerosis or rheumatoid arthritis as a condition that requires disease-modifying treatments to change illness trajectory. In this Personal View, we argue that lithium acts like a disease-modifying drug in bipolar disorder.

[Review] Brain structure in schizophrenia: what do we know and what next?

Meta-analyses and mega-analyses of structural MRI and diffusion MRI studies in thousands of people with schizophrenia have shown reduced brain volumes and structural connectivity relative to healthy control participants. Some of these structural differences probably present pre-morbidly. Severity of schizophrenia symptoms and cognitive impairment consistently correlate. Convergent findings with different analytical methods show that the results are not artefactual. Post-mortem studies add validity and point to a pathophysiology of reduced neuronal size and dendritic arborisation, which is multifactorial.

[Articles] Association between hyperemesis gravidarum and depression: a national register-based controlled study in Finland

The bidirectional association between hyperemesis gravidarum and depression suggests shared underlying biological mechanisms and highlights the long-term mental health burden associated with hyperemesis gravidarum. This finding emphasises the importance of systematic psychiatric screening during and after pregnancy, as well as the assessment of lifetime depression history in reproductive care. Improved collaboration between psychiatry, gynaecology, and primary care is essential to enhance patient outcomes.

[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.