psychiatry

The American Psychiatric Association has unveiled the new features of the forthcoming Diagnostic and Statistical Manual of Mental Disorders (DSM) in five articles published in The American Journal of Psychiatry. Among the highlights are the proposed change of name — it will become the Diagnostic and Scientific Manual — and the intention for it to be more dynamic, incorporating biomarkers for diagnosis and integrating the socioeconomic, cultural and environmental determinants of health. According to the authors, the aim is to enable a more personalised and inclusive clinical practice, aligned with scientific rigour. The most recent update was published in 2022 with the DSM-5-TR, and specialists are currently unaware of the date of the next edition, as they reported during a briefing with journalists.

The use of ADHD medication increased ‘substantially’ in five European countries between 2010 and 2023 — including Spain — especially among adult women, according to a study funded by the European Medicines Agency. In Spain (based on data from the SIDIAP in Catalonia), the median age of people using these drugs during the study period was 14, similar to Germany and the United Kingdom, but younger than in Belgium (19) and the Netherlands (20). One-third of these people are women, and one-quarter had previously been prescribed antidepressants. The analysis is based on prescription data for five medicines and is published in The Lancet Regional Health Europe.

A large international study has analyzed genomic data from over one million people with 14 different psychiatric disorders, such as depression, anxiety, and schizophrenia. According to their analysis, five groups of diseases can be identified that share a significant number of genetic variants. Furthermore, common genetic markers were detected among these 14 disorders. The results are published in the journal Nature. 

Different antidepressant drugs cause different side effects in the body, in parameters such as heart rate, blood pressure or body weight, according to a meta-analysis published by The Lancet. For example, agomelatine administration is associated with weight loss, while other molecules such as maprotiline are associated with weight gain. The research brings together 151 studies and 17 reports from the US Food and Drug Administration (FDA), including more than 58,000 people and comparing 30 antidepressant drugs with a placebo.

An oral formulation of risperidone could be administered weekly instead of daily to treat patients with schizophrenia with the same efficacy, according to a phase III clinical trial published in The Lancet Psychiatry. The study included 83 patients in the United States.

A team has analysed data from a survey of more than 3,000 teenagers aged 11-19 in the UK. Their findings show that those with mental health problems spend an average of 50 minutes more per day on social media than those who do not suffer from them. According to the authors, who publish the results in the journal Nature Human Behaviour, further research is needed to know if this is a causal relationship.

An international team has carried out a review of studies and a meta-analysis on the cardiovascular safety of the drugs used to treat ADHD (attention deficit hyperactivity disorder). Their conclusions are that most of them, and not just the stimulants, affect the pulse and blood pressure. According to the authors, who publish the results in the journal The Lancet Psychiatry, although the changes are slight, ‘professionals should monitor blood pressure and pulse in patients with ADHD treated with any pharmacological intervention’.

A team of researchers from the United Kingdom has conducted a phase 2/3 clinical trial in people with a psychotic disorder to study the efficacy of interaction with a digital avatar in alleviating the discomfort generated by hearing voices. After analyzing it in 345 people, they conclude that it can reduce the frequency of occurrence at 16 and 28 weeks. The discomfort provoked is reduced at 16 weeks, but not at 28 weeks. The team publishes the results in the journal Nature Medicine.

A phase 2 clinical trial has tested the efficacy and safety of a transcranial magnetic stimulation device used at home to treat major depression in 174 patients. After dividing them into two groups, one group received the treatment and the other a placebo procedure. After ten weeks, both groups had improved their symptoms, but the improvement in the active treatment group was 0.4 points greater on the Hamilton depression scale. According to the authors, who publish the results in the journal Nature Medicine, ‘it could potentially serve as a first-line treatment for major depression’.

A report by the Lancet Commission on Self-Harm highlights that at least 14 million episodes of self-harm occur each year - particularly among young people and in low- and middle-income countries. The paper argues that their impact has been neglected by governments globally and sets out a series of recommendations to reduce their incidence.