2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T80f,Adults with severe mental illness (SMI) face a 10- to 20-year reduction in life expectancy, largely due to heightened cardiometabolic diseases. Low levels of physical activity (PA) and prolonged sedentary behavior (SB) are modifiable risk factors that contribute to this mortality gap. Although strong evidence demonstrates that PA is safe and effective in improving psychiatric and physical outcomes, systematic integration into clinical practice remains limited. Individuals with SMI are among the most physically inactive groups in society, often spending more than 10 hours per day sedentary and rarely meeting recommended PA recommendations. Low PA and high SB exacerbate neuroinflammatory, neuroendocrine, and cardiometabolic pathways implicated in psychiatric morbidity. Recent meta-analyses show that structured PA, that is, exercise, produces moderate to large reductions in depressive and psychotic symptoms, as well as benefits for cognition, quality of life, and cardiometabolic health. Evidence also suggests that mentally passive SB, such as prolonged television viewing, are associated with poorer mental health outcomes. Physical activity should be individualized to each person's capabilities and preferences, emphasizing forms they find enjoyable. Two sessions of strength training weekly are advised, and greater mental health benefits typically arise from leisure or active travel PA. To guide translation into care, the 5A framework (Ask, Assess, Advise, Assist, Arrange) provides a structured, pragmatic approach: clinicians can screen for PA and SB, assess readiness and safety, provide tailored advice, support motivation and goal setting, and arrange follow-up, referral, and community support. PA should be considered a core component of psychiatric care. By systematically promoting PA and reducing prolonged SB through structured clinical frameworks, psychiatrists and other mental health professionals can improve symptoms, enhance physical and cognitive health, and help narrow the life expectancy gap experienced by people with SMI.31:Ta14, Importance Adults with severe mental illness (SMI) face a 10- to 20-year reduction in life expectancy, largely due to heightened cardiometabolic diseases. Low levels of physical activity (PA) and prolonged sedentary behavior (SB) are modifiable risk factors that contribute to this mortality gap. Although strong evidence demonstrates that PA is safe and effective in improving psychiatric and physical outcomes, systematic integration into clinical practice remains limited. Observations Individuals with SMI are among the most physically inactive groups in society, often spending more than 10 hours per day sedentary and rarely meeting recommended PA recommendations. Low PA and high SB exacerbate neuroinflammatory, neuroendocrine, and cardiometabolic pathways implicated in psychiatric morbidity. Recent meta-analyses show that structured PA, that is, exercise, produces moderate to large reductions in depressive and psychotic symptoms, as well as benefits for cognition, quality of life, and cardiometabolic health. Evidence also suggests that mentally passive SB, such as prolonged television viewing, are associated with poorer mental health outcomes. Physical activity should be individualized to each person’s capabilities and preferences, emphasizing forms they find enjoyable. Two sessions of strength training weekly are advised, and greater mental health benefits typically arise from leisure or active travel PA. To guide translation into care, the 5A framework (Ask, Assess, Advise, Assist, Arrange) provides a structured, pragmatic approach: clinicians can screen for PA and SB, assess readiness and safety, provide tailored advice, support motivation and goal setting, and arrange follow-up, referral, and community support. Conclusions and Relevance PA should be considered a core component of psychiatric care. By systematically promoting PA and reducing prolonged SB through structured clinical frameworks, psychiatrists and other mental health professionals can improve symptoms, enhance physical and cognitive health, and help narrow the life expectancy gap experienced by people with SMI. 32:T451,Schizophrenia-spectrum disorders (SSD) are characterized by interruptions in one's sense of self, cognitive dysfunction, disorganized thinking, belief inflexibility, and unusual experiences such as hallucinations and delusions. Disruptions in metacognition-skill in reflecting upon one's own and other's thought processes-have increasingly been viewed as a core foundation of these features of SSD. We focus this review on Metacognitive Reflection and Insight Therapy (MERIT) and Metacognitive Training (MCT), two metacognitive therapies for SSD designed to improve integration in perceptions of self and others, and to gain greater awareness of biases and the fallibility of cognitions, respectively. We explicate their theoretical underpinnings, treatment targets, and commonly used techniques and summarize their evidence base. We also provide a brief overview of two related therapies, cognitive remediation and cognitive behavioral therapy, with a focus on identifying their metacognitive components, and we compare mechanisms of action, efficacy, and evidence base across these different approaches.33:T466,Schizophrenia-spectrum disorders (SSD) are characterized by interruptions in one's sense of self, cognitive dysfunction, disorganized thinking, belief inflexibility, and unusual experiences such as hallucinations and delusions. Disruptions in metacognition—skill in reflecting upon one's own and other's thought processes—have increasingly been viewed as a core foundation of these features of SSD. We focus this review on Metacognitive Reflection and Insight Therapy (MERIT) and Metacognitive Training (MCT), two metacognitive therapies for SSD designed to improve integration in perceptions of self and others, and to gain greater awareness of biases and the fallibility of cognitions, respectively. We explicate their theoretical underpinnings, treatment targets, and commonly used techniques and summarize their evidence base. We also provide a brief overview of two related therapies, cognitive remediation and cognitive behavioral therapy, with a focus on identifying their metacognitive components, and we compare mechanisms of action, efficacy, and evidence base across these different approaches.34:T76a,Many individuals can use cannabis without harm, but individuals with psychosis are particularly vulnerable to negative effects from cannabis. No studies to date have investigated how recreational cannabis legalization (RCL) affects cannabis use in individuals with psychosis. To assess impacts of RCL in cannabis use among individuals who have ever been diagnosed with a psychotic illness or episode in the US. This study used data from 2014 to 2022 on state-level RCL with 5 years of follow-up from the Population Assessment of Tobacco and Health, a nationally representative longitudinal cohort study of 1856 adults aged 18 years and older in the US. The study sample consisted of individuals with a lifetime history of psychosis. Data were analyzed between January and June 2025. Percentage point (pp) changes in 30-day use of cannabis after RCL compared with control states using difference-in-differences methods. The study sample consisted of 1856 individuals, with a mean age of 36.6 years (SD, 14.8 years) contributing 7465 responses, and was 50.2% White, 58.2% female, and had a 30-day cannabis-use rate of 31.8%. Individuals with psychosis in RCL states significantly increased their 30-day cannabis use by 9.53 pp (95% CI, 3.05-16.00 pp; P = .004), with sensitivity analyses showing significant estimates after retail outlets opened but not before, and no changes in higher frequency use. In this study, individuals with psychosis reported a large increase in current cannabis use following legalization and commercialization of cannabis in their state, and by larger amounts than previously reported estimates of the general population. Given how cannabis can negatively affect illness course and health service utilization in individuals with psychosis, these results should be considered by regulators designing policies around taxation, potency, advertising, and health warnings.35:Tc06, Importance Many individuals can use cannabis without harm, but individuals with psychosis are particularly vulnerable to negative effects from cannabis. No studies to date have investigated how recreational cannabis legalization (RCL) affects cannabis use in individuals with psychosis. Objective To assess impacts of RCL in cannabis use among individuals who have ever been diagnosed with a psychotic illness or episode in the US. Design, Setting, and Participants This study used data from 2014 to 2022 on state-level RCL with 5 years of follow-up from the Population Assessment of Tobacco and Health, a nationally representative longitudinal cohort study of 1856 adults aged 18 years and older in the US. The study sample consisted of individuals with a lifetime history of psychosis. Data were analyzed between January and June 2025. Main Outcomes and Measures Percentage point (pp) changes in 30-day use of cannabis after RCL compared with control states using difference-in-differences methods. Results The study sample consisted of 1856 individuals, with a mean age of 36.6 years (SD, 14.8 years) contributing 7465 responses, and was 50.2% White, 58.2% female, and had a 30-day cannabis-use rate of 31.8%. Individuals with psychosis in RCL states significantly increased their 30-day cannabis use by 9.53 pp (95% CI, 3.05-16.00 pp; P = .004), with sensitivity analyses showing significant estimates after retail outlets opened but not before, and no changes in higher frequency use. Conclusions and Relevance In this study, individuals with psychosis reported a large increase in current cannabis use following legalization and commercialization of cannabis in their state, and by larger amounts than previously reported estimates of the general population. Given how cannabis can negatively affect illness course and health service utilization in individuals with psychosis, these results should be considered by regulators designing policies around taxation, potency, advertising, and health warnings. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Psychosis: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Psychosis (condition). Clinician-written summaries and actionable practice insights. 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The practice takeaway is inferred from the article's stated purpose, not confirmed findings.","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.2500","tag_type":"warning","value":"Only the abstract was provided — no methods, data, sample size, or findings are available. Summaries are based solely on the abstract's framing.","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.2500","tag_type":"warning","value":"Study design is classified as Commentary/Perspective based on the abstract language ('implores clinicians'); this should be confirmed against the full article.","value_numeric":null}],"summaries":{"what_studied":"Whether interaction with AI models may induce delusional or delusional-like beliefs in users, and how clinicians might address this phenomenon.","limitations":"The abstract provides no empirical data, sample, or methods — the full article content is unavailable, making it impossible to assess evidence quality or specific findings.","practice_takeaway":"Clinicians should begin asking patients about AI interactions as part of psychiatric assessment, as AI use may be a novel environmental factor contributing to delusional-like thinking."}},{"doi":"10.1016/j.biopsych.2026.06.025","pmid":"42610992","title":"Cannabis Use and Age-Related Acceleration of Psychosis Onset: A Meta-Analysis","journal_title":"Biological Psychiatry","journal_issn":"0006-3223","published_at":"2026-08-18T00:00:00.000Z","url":"https://doi.org/10.1016/j.biopsych.2026.06.025","source_score":156,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-23T07:33:00.262Z","updated_at":"2026-08-23T07:33:00.262Z","tags":[{"paper_doi":"10.1016/j.biopsych.2026.06.025","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.biopsych.2026.06.025","tag_type":"category","value":"Neurosciences","value_numeric":null},{"paper_doi":"10.1016/j.biopsych.2026.06.025","tag_type":"category","value":"Psychiatry","value_numeric":null},{"paper_doi":"10.1016/j.biopsych.2026.06.025","tag_type":"condition","value":"Cannabis Use Disorder","value_numeric":null},{"paper_doi":"10.1016/j.biopsych.2026.06.025","tag_type":"condition","value":"Psychosis","value_numeric":null},{"paper_doi":"10.1016/j.biopsych.2026.06.025","tag_type":"generic","value":"cannabis","value_numeric":null},{"paper_doi":"10.1016/j.biopsych.2026.06.025","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.biopsych.2026.06.025","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1016/j.biopsych.2026.06.025","tag_type":"modality","value":"Cannabis","value_numeric":null},{"paper_doi":"10.1016/j.biopsych.2026.06.025","tag_type":"sample_size","value":"n=71073","value_numeric":71073},{"paper_doi":"10.1016/j.biopsych.2026.06.025","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.biopsych.2026.06.025","tag_type":"study_design","value":"Meta-Analysis","value_numeric":null},{"paper_doi":"10.1016/j.biopsych.2026.06.025","tag_type":"warning","value":"Sample size reported as combined total of cannabis users (18,272) and nonusers (52,801) = 71,073; individual study-level Ns vary. The <20-year-old subgroup showed no significant AAO difference, which is counterintuitive and may reflect selection or ascertainment bias — clinicians should interpret this subgroup result cautiously.","value_numeric":null},{"paper_doi":"10.1016/j.biopsych.2026.06.025","tag_type":"warning","value":"The impact_flag 'practice_changing' is applied given the large evidence base and clear dose-age gradient, but causality remains unproven due to observational study designs.","value_numeric":null}],"summaries":{"what_studied":"This meta-analysis examined whether cannabis use is associated with an earlier age at onset (AAO) of psychosis, pooling 181 samples from 149 cohort and case-control studies (18,272 cannabis users vs. 52,801 nonusers) identified from MEDLINE, Embase, and PsycInfo through April 2025.","key_result":"Cannabis use was associated with a mean earlier psychosis onset of **2.50 years** overall. The effect grew with later typical onset age: no difference in the <20-year-old group, but 1.60, 4.43, and 6.30 years earlier in the 20–<25, 25–<30, and ≥30 age groups, respectively. Sample mean onset age was a strong independent moderator (z = −7.59, p < .0001).","limitations":"- Relies on cohort and case-control study designs; cannot establish causation.\n- Between-study heterogeneity is expected given the broad range of included samples and methodologies.\n- Cannabis potency and frequency of use data were not uniformly reported across studies, limiting dose-response analysis.","practice_takeaway":"Clinicians should counsel patients—especially adults over 20—that cannabis use is linked to meaningfully earlier psychosis onset, with the gap widening substantially in older age groups. Public health messaging about cannabis and psychiatric risk should not be limited to adolescents."}},{"doi":"10.1192/bjp.2026.10747","pmid":"42572970","title":"Improving outcomes for people with co-occurring autism and psychosis: from diagnostic overshadowing to system-wide clinical capability","journal_title":"The British Journal of Psychiatry","journal_issn":"0007-1250","published_at":"2026-08-10T00:00:00.000Z","url":"https://doi.org/10.1192/bjp.2026.10747","source_score":9,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-17T13:33:33.635Z","updated_at":"2026-08-17T13:33:33.635Z","tags":[{"paper_doi":"10.1192/bjp.2026.10747","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1192/bjp.2026.10747","tag_type":"category","value":"Psychiatry","value_numeric":null},{"paper_doi":"10.1192/bjp.2026.10747","tag_type":"condition","value":"Autism Spectrum Disorder","value_numeric":null},{"paper_doi":"10.1192/bjp.2026.10747","tag_type":"condition","value":"Psychosis","value_numeric":null},{"paper_doi":"10.1192/bjp.2026.10747","tag_type":"condition","value":"Schizophrenia","value_numeric":null},{"paper_doi":"10.1192/bjp.2026.10747","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1192/bjp.2026.10747","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1192/bjp.2026.10747","tag_type":"modality","value":"Antipsychotic","value_numeric":null},{"paper_doi":"10.1192/bjp.2026.10747","tag_type":"modality","value":"Cognitive Behavioural Therapy","value_numeric":null},{"paper_doi":"10.1192/bjp.2026.10747","tag_type":"modality","value":"Psychosocial Intervention","value_numeric":null},{"paper_doi":"10.1192/bjp.2026.10747","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1192/bjp.2026.10747","tag_type":"study_design","value":"Expert Editorial / Narrative Review","value_numeric":null},{"paper_doi":"10.1192/bjp.2026.10747","tag_type":"warning","value":"Study design label 'Expert Editorial / Narrative Review' reflects the hybrid nature of this piece — it includes a structured recommendations table but is not a formal systematic review.","value_numeric":null},{"paper_doi":"10.1192/bjp.2026.10747","tag_type":"warning","value":"The '1 in 20' prevalence estimate is the authors' own approximation; they explicitly note that definitive epidemiological studies are still awaited.","value_numeric":null},{"paper_doi":"10.1192/bjp.2026.10747","tag_type":"warning","value":"This is a guest editorial with no primary data; all recommendations are expert consensus and should be interpreted accordingly (Level 7 evidence).","value_numeric":null}],"summaries":{"what_studied":"This guest editorial examines why people with co-occurring autism spectrum disorder (ASD) and psychosis are poorly served by current psychiatric systems, and proposes system-level reforms to assessment, service pathways, and treatment across mainstream psychosis services.","key_result":"Approximately 1 in 20 individuals with psychosis have co-occurring ASD. This group faces longer durations of untreated psychosis, higher treatment discontinuation, greater medication side-effect burden, and more fragmented care than those with either condition alone. Apparent 'treatment resistance' may often reflect insufficiently adapted care rather than intrinsic non-response.","limitations":"This is an expert editorial, not a systematic review or primary study — no new data were collected or analysed. Prevalence estimates are acknowledged as uncertain pending definitive epidemiological studies. Evidence on optimal service adaptations and outcomes of pathway redesign is largely absent.","practice_takeaway":"Psychosis services should embed neurodevelopmentally informed assessment (focusing on change from baseline and developmental history), routine environmental and therapeutic adaptations, and proactive side-effect monitoring for autistic patients — treating these as standard practice, not specialist exceptions. Co-produced staff training should be offered service-wide and included in psychiatry curricula."}},{"doi":"10.1007/s12671-026-02913-8","pmid":null,"title":"Traditional Buddhist Mindfulness Versus Secular Mindfulness-Based Cognitive Therapy for Residual Depressive Symptoms in Patients Treated for Depressive Disorder: A Pilot Randomized Controlled Trial","journal_title":"Mindfulness","journal_issn":"1868-8527","published_at":"2026-06-27T00:00:00.000Z","url":"https://doi.org/10.1007/s12671-026-02913-8","source_score":5,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":false,"crossref":true,"unpaywall":true},"created_at":"2026-07-06T13:36:11.563Z","updated_at":"2026-07-06T13:36:11.563Z","tags":[{"paper_doi":"10.1007/s12671-026-02913-8","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1007/s12671-026-02913-8","tag_type":"category","value":"Psychology, Clinical","value_numeric":null},{"paper_doi":"10.1007/s12671-026-02913-8","tag_type":"condition","value":"Anxiety Disorders","value_numeric":null},{"paper_doi":"10.1007/s12671-026-02913-8","tag_type":"condition","value":"Chronic Illness","value_numeric":null},{"paper_doi":"10.1007/s12671-026-02913-8","tag_type":"condition","value":"Depressive Disorder","value_numeric":null},{"paper_doi":"10.1007/s12671-026-02913-8","tag_type":"condition","value":"Post-Traumatic Stress Disorder","value_numeric":null},{"paper_doi":"10.1007/s12671-026-02913-8","tag_type":"condition","value":"Psychosis","value_numeric":null},{"paper_doi":"10.1007/s12671-026-02913-8","tag_type":"condition","value":"Somatization Disorders","value_numeric":null},{"paper_doi":"10.1007/s12671-026-02913-8","tag_type":"condition","value":"Substance Use Disorders","value_numeric":null},{"paper_doi":"10.1007/s12671-026-02913-8","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1007/s12671-026-02913-8","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1007/s12671-026-02913-8","tag_type":"modality","value":"Mindfulness-Based Cognitive Therapy","value_numeric":null},{"paper_doi":"10.1007/s12671-026-02913-8","tag_type":"modality","value":"Mindfulness-Based Stress Reduction","value_numeric":null},{"paper_doi":"10.1007/s12671-026-02913-8","tag_type":"sample_size","value":"n=81","value_numeric":81},{"paper_doi":"10.1007/s12671-026-02913-8","tag_type":"study_design","value":"Evidence Map / Systematic Review of Systematic Reviews","value_numeric":null},{"paper_doi":"10.1007/s12671-026-02913-8","tag_type":"warning","value":"Critical metadata mismatch: The paper title and DOI reference a 2026 pilot RCT comparing traditional Buddhist mindfulness vs. secular MBCT for residual depressive symptoms, but the full text provided is a 2014 RAND/VA Evidence Map of Mindfulness—a completely different document. All extracted content reflects the 2014 evidence map, not the 2026 RCT described in the title. Clinicians seeking the pilot RCT should verify the correct source.","value_numeric":null},{"paper_doi":"10.1007/s12671-026-02913-8","tag_type":"warning","value":"Sample size tag reflects number of included systematic reviews (n=81), not individual trial participants.","value_numeric":null},{"paper_doi":"10.1007/s12671-026-02913-8","tag_type":"warning","value":"The evidence map pools across heterogeneous mindfulness intervention types; intervention-specific conclusions (e.g., MBSR vs. MBCT vs. other) should be interpreted with caution.","value_numeric":null}],"summaries":{"limitations":"- Evidence map gives a broad overview only; it does not provide definitive effectiveness estimates for any single indication.\n- Most comparisons are vs. passive controls (waitlist/TAU); head-to-head comparisons with active treatments showed no significant advantage for mindfulness.\n- Adverse event reporting was sparse or absent across nearly all included reviews.","what_studied":"This 2014 VA-commissioned evidence map synthesized 81 systematic reviews (up to February 2014) covering a broad range of mindfulness interventions—primarily MBSR and MBCT—across diverse clinical conditions in adults, with priority focus on PTSD, stress, depression, and wellness.","key_result":"The most consistent effect across all pooled analyses was for **depression** (effect sizes ranged from Cohen's d 0.23 to 0.72 vs. passive controls). MBCT reduced depression relapse risk (RR 0.66; 95% CI 0.53–0.82; 5 RCTs). Positive pooled effects were also found for anxiety, psychological distress, somatization symptom severity, and overall mental health with MBSR and MBCT vs. passive controls. Evidence for PTSD, stress, and pain was limited or inconsistent.","practice_takeaway":"MBCT has the strongest evidence base for preventing depression relapse in patients with recurrent major depressive disorder (≥3 prior episodes), and both MBSR and MBCT show consistent small-to-moderate effects on depressive symptoms across clinical populations. Evidence for PTSD, stress, and pain remains insufficient to guide practice changes without further research."}},{"doi":"10.1001/jamapsychiatry.2026.1674","pmid":"42340705","title":"Neurometabolites and Antipsychotic Response in Psychosis","journal_title":"JAMA Psychiatry","journal_issn":"2168-622X","published_at":"2026-06-24T00:00:00.000Z","url":"https://doi.org/10.1001/jamapsychiatry.2026.1674","source_score":17,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-27T13:27:31.780Z","updated_at":"2026-06-27T13:27:31.780Z","tags":[{"paper_doi":"10.1001/jamapsychiatry.2026.1674","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.1674","tag_type":"category","value":"Psychiatry","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.1674","tag_type":"condition","value":"Psychosis","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.1674","tag_type":"condition","value":"Schizophrenia","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.1674","tag_type":"condition","value":"Treatment-Resistant Schizophrenia","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.1674","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.1674","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.1674","tag_type":"modality","value":"Antipsychotic","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.1674","tag_type":"modality","value":"Magnetic Resonance Spectroscopy","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.1674","tag_type":"sample_size","value":"n=1844","value_numeric":1844},{"paper_doi":"10.1001/jamapsychiatry.2026.1674","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.1674","tag_type":"study_design","value":"Individual Participant Data Meta-Analysis","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.1674","tag_type":"warning","value":"Effect sizes (Glass Δ 0.21–0.64) are small to moderate — the impact_flag 'practice_changing' reflects the biomarker and treatment-target implications highlighted by the authors, but individual predictive utility remains limited.","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.1674","tag_type":"warning","value":"The DOI and publication date (June 24, 2026) are in the future relative to known literature; content is treated as provided. No independent verification of the source was possible.","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.1674","tag_type":"warning","value":"The mega-analysis (n=1189) and meta-analysis (n=1844) use overlapping but non-identical study sets; sample size tag reflects the larger meta-analysis denominator.","value_numeric":null}],"summaries":{"what_studied":"This individual participant data (IPD) mega-analysis and meta-analysis examined differences in brain neurometabolites (glutamate, glutamate+glutamine, choline, myo-inositol, NAA, GABA, glutathione) across medial frontal cortex, DLPFC, thalamus, and basal ganglia between antipsychotic nonresponders, responders, and healthy controls in psychosis (1189 participants, 18 studies for mega-analysis; 1844 participants, 23 studies for meta-analysis).","key_result":"Antipsychotic nonresponders showed elevated medial frontal glutamate (Glass Δ = 0.21, P = .02), glutamate+glutamine (Glass Δ = 0.29, P = .002), choline (Glass Δ = 0.22, P = .03), and myo-inositol (Glass Δ = 0.35, P = .001) vs. responders; in first-episode psychosis, glutamate+glutamine elevation was prospectively confirmed (Glass Δ = 0.41, P = .002), and myo-inositol was most elevated in treatment-resistant cases (Glass Δ = 0.64, P = .001).","limitations":"- Effect sizes are small to moderate, limiting individual-level predictive utility.\n- Studies contributing IPD were heterogeneous in design, patient selection, and MRS acquisition methods.\n- Analyses were limited to regions and metabolites with sufficient data; some metabolites (e.g., GABA, glutathione) may have been underpowered.","practice_takeaway":"Elevated medial frontal glutamate and myo-inositol may serve as future biomarkers to flag patients at risk of antipsychotic nonresponse, especially in first-episode psychosis. These findings support prioritizing glutamate-targeting and anti-inflammatory treatment trials in patients who fail standard antipsychotics."}},{"doi":"10.1080/10903127.2026.2690178","pmid":"42307216","title":"Ketamine versus propofol for sedation in acute psychiatric emergencies during aeromedical retrieval: a randomized clinical trial","journal_title":"Prehospital Emergency Care","journal_issn":"1090-3127","published_at":"2026-06-17T00:00:00.000Z","url":"https://doi.org/10.1080/10903127.2026.2690178","source_score":2,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-27T13:27:49.192Z","updated_at":"2026-06-27T13:27:49.192Z","tags":[{"paper_doi":"10.1080/10903127.2026.2690178","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2690178","tag_type":"category","value":"Emergency Medicine","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2690178","tag_type":"condition","value":"Acute Psychiatric Agitation","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2690178","tag_type":"condition","value":"Psychosis","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2690178","tag_type":"generic","value":"ketamine","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2690178","tag_type":"generic","value":"propofol","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2690178","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2690178","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2690178","tag_type":"modality","value":"Dissociative Anesthetic","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2690178","tag_type":"modality","value":"Sedative-Hypnotic","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2690178","tag_type":"sample_size","value":"n=170","value_numeric":170},{"paper_doi":"10.1080/10903127.2026.2690178","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2690178","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2690178","tag_type":"warning","value":"Population is predominantly First Nations Australian males with psychosis — generalizability to broader or urban psychiatric populations is uncertain.","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2690178","tag_type":"warning","value":"The impact_flag 'practice_changing' is assigned cautiously given early stopping and single-center limitations; the finding is notable but not yet definitive.","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2690178","tag_type":"warning","value":"The open-label design may have influenced clinician satisfaction ratings and potentially sedation management decisions.","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2690178","tag_type":"warning","value":"Trial was stopped early due to low enrollment, which may have inflated the apparent treatment effect size — results should be interpreted with caution.","value_numeric":null}],"summaries":{"what_studied":"This RCT compared ketamine vs. propofol for sedation of non-intubated, acutely agitated patients during aeromedical retrieval in regional Australia. The primary outcome was a composite of airway, breathing, circulatory, and aspiration adverse events; secondary outcomes included clinician satisfaction and medication efficacy (RASS target achievement).","key_result":"Adverse events were significantly less common with ketamine than propofol (12.4% vs. 24.7%; RR = 0.50, 95% CI 0.25–0.99; p = 0.039). Efficacy (reaching target RASS) was similar between agents (OR 0.73, 95% CI 0.50–1.07). Clinicians rated propofol higher on satisfaction (median Likert 4 [IQR 4,5] vs. 4 [IQR 2,4]; p = 0.0007).","limitations":"- Trial stopped early due to low enrollment (n=170 of planned sample), reducing statistical power.\n- Single-center, open-label design limits blinding and generalizability.\n- Highly specific population (75.9% First Nations, 82.4% psychosis diagnosis) may limit applicability to other settings.","practice_takeaway":"In aeromedical retrieval of acutely agitated psychiatric patients, ketamine is associated with roughly half the rate of adverse events compared to propofol — consider it as the safer first-line agent despite lower clinician satisfaction scores. Clinician preference for propofol should be weighed against its higher adverse event burden in this setting."}},{"doi":"10.1176/appi.ajp.20251257","pmid":"42265595","title":"Gray Matter Iron and Neuromelanin in Psychosis: A Systematic Review and Meta-Analysis of MRI Studies","journal_title":"American Journal of Psychiatry","journal_issn":"0002-953X","published_at":"2026-06-10T00:00:00.000Z","url":"https://doi.org/10.1176/appi.ajp.20251257","source_score":22,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-18T13:24:29.775Z","updated_at":"2026-06-18T13:24:29.775Z","tags":[{"paper_doi":"10.1176/appi.ajp.20251257","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20251257","tag_type":"category","value":"Psychiatry","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20251257","tag_type":"condition","value":"Psychosis","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20251257","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20251257","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20251257","tag_type":"modality","value":"Antipsychotic","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20251257","tag_type":"sample_size","value":"n=1692","value_numeric":1692},{"paper_doi":"10.1176/appi.ajp.20251257","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20251257","tag_type":"study_design","value":"Systematic Review and Meta-Analysis","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20251257","tag_type":"warning","value":"Age and sex breakdowns for included samples were not reported in the abstract; the 'adult' and 'mixed sex' tags are inferred from typical psychosis research populations.","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20251257","tag_type":"warning","value":"The 27 included reports represent a relatively small literature; between-study heterogeneity in MRI acquisition protocols and psychosis subtypes (e.g., schizophrenia vs. bipolar with psychosis) may affect generalizability.","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20251257","tag_type":"warning","value":"The elevated NM-MRI signal in the substantia nigra is confounded by antipsychotic dosage; the paper explicitly notes that confounding by indication cannot be excluded, so this finding should not be interpreted as a pure disease marker.","value_numeric":null}],"summaries":{"what_studied":"A systematic review and meta-analysis of iron-sensitive MRI and neuromelanin-sensitive MRI (NM-MRI) studies in psychosis, comparing 879 individuals with psychosis to 813 healthy controls across subcortical brain regions (caudate, putamen, globus pallidus, thalamus, substantia nigra).","key_result":"Psychosis was associated with lower R2* across all examined regions (Hedges' g: −0.27 to −0.40), lower QSM in the substantia nigra (g=−0.61), lower R2 in the caudate nucleus (g=−0.30), and higher NM-MRI values in the substantia nigra (g=+0.39) — the latter correlated with antipsychotic dose (β=0.001, 95% CI=0.0003–0.0018).","limitations":"- Higher nigral NM-MRI may reflect antipsychotic exposure rather than primary disease (confounding by indication cannot be ruled out).\n- All included studies are case-control designs; no longitudinal data to establish directionality.\n- Small total sample (n=1,692 across 27 reports) limits subgroup precision.","practice_takeaway":"Subcortical iron appears broadly reduced in psychosis, while neuromelanin-bound iron in dopamine neurons is elevated — but clinicians should interpret NM-MRI findings cautiously given the strong link to antipsychotic dosage. Longitudinal studies are needed before these biomarkers can guide treatment decisions."}},{"doi":"10.2196/96894","pmid":"42189634","title":"When AI Colludes: Clinical Reliability of Training and Preference Data as a Trustworthy-AI Criterion","journal_title":"JMIR Mental Health","journal_issn":"2368-7959","published_at":"2026-05-26T00:00:00.000Z","url":"https://doi.org/10.2196/96894","source_score":40,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-30T13:22:54.579Z","updated_at":"2026-05-30T13:22:54.579Z","tags":[{"paper_doi":"10.2196/96894","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.2196/96894","tag_type":"category","value":"Psychiatry","value_numeric":null},{"paper_doi":"10.2196/96894","tag_type":"condition","value":"Depression","value_numeric":null},{"paper_doi":"10.2196/96894","tag_type":"condition","value":"Mental Health Disorders","value_numeric":null},{"paper_doi":"10.2196/96894","tag_type":"condition","value":"Psychosis","value_numeric":null},{"paper_doi":"10.2196/96894","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.2196/96894","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.2196/96894","tag_type":"modality","value":"Large Language Model","value_numeric":null},{"paper_doi":"10.2196/96894","tag_type":"modality","value":"Reinforcement Learning From Human Feedback","value_numeric":null},{"paper_doi":"10.2196/96894","tag_type":"study_design","value":"Viewpoint / Conceptual Analysis","value_numeric":null},{"paper_doi":"10.2196/96894","tag_type":"warning","value":"The cited disempowerment study (Sharma et al., 2026) reports potential rather than confirmed harm; the paper is careful to note this distinction, but readers should not overinterpret the cited statistics as evidence of direct patient harm.","value_numeric":null},{"paper_doi":"10.2196/96894","tag_type":"warning","value":"The 'collusion' construct is adapted from clinical psychiatry as a structural analogy — the paper explicitly notes it is not a psychodynamic claim and AI systems have no intent or countertransference.","value_numeric":null},{"paper_doi":"10.2196/96894","tag_type":"warning","value":"This is a conceptual viewpoint with no original empirical data; all clinical claims are illustrative hypotheses, not quantified findings.","value_numeric":null}],"summaries":{"what_studied":"This conceptual viewpoint examines whether human-generated text and preference judgments used to train large language models (LLMs) are clinically reliable, specifically applying the psychiatric construct of 'collusion' (uncritical acceptance of an unreliable account) as an analytic lens across three AI pipeline layers: pretraining corpora, preference data/posttraining, and deployment-time interaction.","key_result":"Collusion-like dynamics are most likely at the preference-data and deployment layers, where user or labeler input is reinforced without corroboration. Existing mitigations (Constitutional AI, reward-model evaluation, red-teaming, grounded generation, live monitoring) do not yet incorporate clinical expertise in self-report reliability. Three proposals are made: clinical input into preference-data design and red-teaming, routine clinical inquiry about AI use in psychiatric assessments, and adding self-report reliability as an explicit trustworthy-AI criterion in frameworks like FUTURE-AI and WHO LLM guidance.","limitations":"This is a conceptual paper with no empirical data; clinical examples (mania, psychosis, depression) are illustrative and not epidemiologically calibrated. Whether clinician involvement in data curation actually improves safety remains untested.","practice_takeaway":"Clinicians should routinely ask patients about AI use during psychosocial and risk assessments, particularly in new-onset psychosis and crisis presentations. Mental health professionals and professional bodies should advocate for clinical self-report reliability to be built into AI governance frameworks and preference-data design."}},{"doi":"10.1080/17522439.2026.2634654","pmid":null,"title":"Song-making in a group (SING): a longitudinal study for people experiencing psychosis","journal_title":"Psychosis","journal_issn":"1752-2439","published_at":"2026-04-08T00:00:00.000Z","url":"https://doi.org/10.31234/osf.io/aevy6_v1","source_score":33,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":false,"crossref":true,"unpaywall":true},"created_at":"2026-05-07T22:50:35.183Z","updated_at":"2026-05-07T22:50:35.183Z","tags":[{"paper_doi":"10.1080/17522439.2026.2634654","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1080/17522439.2026.2634654","tag_type":"category","value":"Psychology, Clinical","value_numeric":null},{"paper_doi":"10.1080/17522439.2026.2634654","tag_type":"condition","value":"Psychosis","value_numeric":null},{"paper_doi":"10.1080/17522439.2026.2634654","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1080/17522439.2026.2634654","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1080/17522439.2026.2634654","tag_type":"modality","value":"Music Therapy","value_numeric":null},{"paper_doi":"10.1080/17522439.2026.2634654","tag_type":"study_design","value":"Longitudinal Study","value_numeric":null},{"paper_doi":"10.1080/17522439.2026.2634654","tag_type":"warning","value":"Level of evidence assigned as '4' (case series/longitudinal observational) based on study design label; actual level may differ if a control group is present.","value_numeric":null},{"paper_doi":"10.1080/17522439.2026.2634654","tag_type":"warning","value":"Only metadata (title, DOI, journal, date) was provided — no abstract or full text was available. Summaries, tags, and evidence level are based on the title and study design label only. Key numerical results, sample size, comparator, and specific outcomes could not be extracted. Please verify all fields against the full paper.","value_numeric":null},{"paper_doi":"10.1080/17522439.2026.2634654","tag_type":"warning","value":"Sex/gender of participants could not be determined from available information.","value_numeric":null}],"summaries":{"what_studied":"A longitudinal study evaluated group song-making (SING) as a music therapy intervention for people experiencing psychosis, tracking outcomes over time.","key_result":"Specific numerical outcomes are not available from the provided metadata alone; the study reports longitudinal findings on the effects of group song-making for individuals with psychosis.","limitations":"Details on sample size, comparator group, follow-up duration, and specific outcome measures are not extractable from the provided metadata.","practice_takeaway":"Group song-making may offer a structured, creative intervention for people with psychosis; clinicians should review the full study for specific effect sizes before integrating it into practice."}},{"doi":"10.1001/jamapsychiatry.2026.0026","pmid":"41779424","title":"Integrating Physical Activity Into Routine Psychiatric Care","journal_title":"JAMA Psychiatry","journal_issn":"2168-622X","published_at":"2026-03-04T00:00:00.000Z","url":"https://doi.org/10.1001/jamapsychiatry.2026.0026","source_score":179,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-05-11","doi":"10.1001/jamapsychiatry.2026.0026","days":"7","issn":"2168-622X","rank":"6","field":"Clinical Medicine","score":"179","category":"Psychiatry","categories":["Psychiatry"],"_categories":["Psychiatry"]},"pubmed":{"doi":"10.1001/jamapsychiatry.2026.0026","title":"Integrating Physical Activity Into Routine Psychiatric Care: A Review.","journal":"JAMA psychiatry","methods":"","results":"","abstract":"$30","keywords":[],"pubmed_id":"41779424","conclusions":"","publication_date":"2026-03-04T00:00:00"},"crossref":{"DOI":"10.1001/jamapsychiatry.2026.0026","URL":"https://doi.org/10.1001/jamapsychiatry.2026.0026","ISSN":["2168-622X"],"link":[{"URL":"https://jamanetwork.com/journals/jamapsychiatry/articlepdf/2845751/jamapsychiatry_stubbs_2026_rv_260001_1777052907.13931.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"535","type":"journal-article","issue":"5","score":1,"title":["Integrating Physical Activity Into Routine Psychiatric Care"],"author":[{"given":"Brendon","family":"Stubbs","sequence":"first","affiliation":[{"name":"Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom"},{"name":"Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria"},{"name":"Comprehensive Centre for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria"}]},{"given":"Ruimin","family":"Ma","sequence":"additional","affiliation":[{"name":"Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, United Kingdom"}]},{"given":"Megan","family":"Teychenne","sequence":"additional","affiliation":[{"name":"Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia"}]},{"given":"Florence","family":"Kinnafick","sequence":"additional","affiliation":[{"name":"School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom"}]},{"given":"Nilufar","family":"Mossaheb","sequence":"additional","affiliation":[{"name":"Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria"},{"name":"Comprehensive Centre for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria"}]},{"given":"Nicole","family":"Korman","sequence":"additional","affiliation":[{"name":"Metro South Addiction and Mental Health Services, Brisbane, Queensland, Australia"},{"name":"Queensland Centre of Mental Health Research, Wacol, Queensland, Australia"},{"name":"Faculty of Health, Medicine and Behavioural Sciences, University of Queensland, Brisbane, Queensland, Australia"}]},{"given":"Mike","family":"Trott","sequence":"additional","affiliation":[{"name":"Metro South Addiction and Mental Health Services, Brisbane, Queensland, Australia"},{"name":"Queensland Centre of Mental Health Research, Wacol, Queensland, Australia"},{"name":"Faculty of Health, Medicine and Behavioural Sciences, University of Queensland, Brisbane, Queensland, Australia"}]},{"given":"Simon","family":"Rosenbaum","sequence":"additional","affiliation":[{"name":"Nutrition, Exercise and Social Equity Research Group, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia"}]},{"given":"Felipe","family":"Schuch","sequence":"additional","affiliation":[{"name":"Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil"},{"name":"Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil"},{"name":"Faculty of Health Sciences, Universidad Autónoma de Chile, Providência, Chile"}]},{"given":"Joseph","family":"Firth","sequence":"additional","affiliation":[{"name":"Division of Psychology and Mental Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom"},{"name":"Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom"}]},{"given":"Davy","family":"Vancampfort","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium"},{"name":"University Psychiatric Centre, KU Leuven, Leuven, Belgium"}]}],"issued":{"date-parts":[[2026,5,1]]},"member":"10","prefix":"10.1001","source":"Crossref","volume":"83","created":{"date-time":"2026-03-04T16:30:39Z","timestamp":1772641839000,"date-parts":[[2026,3,4]]},"indexed":{"date-time":"2026-05-06T15:22:23Z","timestamp":1778080943138,"date-parts":[[2026,5,6]]},"subject":[],"abstract":"$31","language":"en","relation":{},"resource":{"primary":{"URL":"https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2845751"}},"subtitle":["A Review"],"deposited":{"date-time":"2026-05-06T15:00:33Z","timestamp":1778079633000,"date-parts":[[2026,5,6]]},"issn-type":[{"type":"print","value":"2168-622X"}],"published":{"date-parts":[[2026,5,1]]},"publisher":"American Medical Association (AMA)","reference":[{"DOI":"10.1016/S2215-0366(19)30132-4","key":"yrv260001r1","year":"2019","issue":"8","author":"Firth","volume":"6","first-page":"675","unstructured":null,"article-title":"The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness.","journal-title":"Lancet Psychiatry","doi-asserted-by":"publisher"},{"DOI":"10.1002/wps.20420","key":"yrv260001r2","year":"2017","issue":"2","author":"Correll","volume":"16","first-page":"163","unstructured":null,"article-title":"Prevalence, incidence and mortality from cardiovascular disease in patients with pooled and specific severe mental illness: a large-scale meta-analysis of 3,211,768 patients and 113,383,368 controls.","journal-title":"World Psychiatry","doi-asserted-by":"publisher"},{"DOI":"10.1007/s10654-018-0380-1","key":"yrv260001r3","year":"2018","issue":"9","author":"Patterson","volume":"33","first-page":"811","unstructured":null,"article-title":"Sedentary behaviour and risk of 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estimates.","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.0026","tag_type":"warning","value":"Study design is ambiguous between a narrative review and a clinical viewpoint/editorial; classified as narrative review based on content.","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.0026","tag_type":"warning","value":"The 'practice_changing' flag reflects the paper's strong advocacy for a systematic clinical shift, but the underlying evidence is from meta-analyses of varying quality, not a new trial.","value_numeric":null}],"summaries":{"what_studied":"This review evaluates the evidence for integrating physical activity (PA) and reducing sedentary behavior (SB) into routine psychiatric care for adults with severe mental illness (SMI), using the 5A clinical framework (Ask, Assess, Advise, Assist, Arrange) as a practical implementation guide.","key_result":"Structured PA produces moderate to large reductions in depressive and psychotic symptoms per recent meta-analyses, with additional benefits for cognition, quality of life, and cardiometabolic health; adults with SMI often spend >10 hours/day sedentary and rarely meet PA recommendations.","limitations":"This is a narrative review/viewpoint without a systematic search protocol or primary data; effect sizes cited are drawn from external meta-analyses rather than original trial data; implementation barriers (e.g., staffing, resources) are discussed qualitatively without formal evaluation.","practice_takeaway":"Use the 5A framework to screen, advise, and arrange PA support for every patient with SMI — two weekly strength-training sessions and leisure or active-travel PA are practical starting targets. Reducing mentally passive sedentary time (e.g., prolonged TV viewing) is an additional, actionable goal alongside increasing PA."}},{"doi":"10.1146/annurev-clinpsy-061724-085601","pmid":"41238221","title":"Metacognitive and Related Approaches in the Treatment of Schizophrenia-Spectrum Disorders","journal_title":"Annual Review of Clinical Psychology","journal_issn":"1548-5943","published_at":"2025-11-15T00:00:00.000Z","url":"https://doi.org/10.1146/annurev-clinpsy-061724-085601","source_score":9,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-05-10","doi":"10.1146/annurev-clinpsy-061724-085601","days":"7","issn":"1548-5943","rank":"8","field":"Clinical Medicine","score":"9","category":"Psychology, Clinical","categories":["Psychology, Clinical"],"_categories":["Psychology, Clinical"]},"pubmed":{"doi":"10.1146/annurev-clinpsy-061724-085601","title":"Metacognitive and Related Approaches in the Treatment of Schizophrenia-Spectrum Disorders.","journal":"Annual review of clinical psychology","methods":"","results":"","abstract":"$32","keywords":["MCT","MERIT","Metacognitive Training","cognitive behavioral therapy","cognitive remediation","psychosis","psychosocial","schizophrenia"],"pubmed_id":"41238221","conclusions":"","publication_date":"2025-11-15T00:00:00"},"crossref":{"DOI":"10.1146/annurev-clinpsy-061724-085601","URL":"https://doi.org/10.1146/annurev-clinpsy-061724-085601","ISSN":["1548-5943","1548-5951"],"link":[{"URL":"https://www.annualreviews.org/content/journals/10.1146/annurev-clinpsy-061724-085601?crawler=true&mimetype=application/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"373-396","type":"journal-article","issue":"1","score":1,"title":["Metacognitive and Related Approaches in the Treatment of Schizophrenia-Spectrum Disorders"],"author":[{"given":"Joanna M.","family":"Fiszdon","sequence":"first","affiliation":[{"name":"1Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA; email: joanna.fiszdon@yale.edu"},{"name":"2Psychology Service, VA Connecticut Healthcare System, West Haven, Connecticut, USA"}]},{"given":"Ashley M.","family":"Schnakenberg Martin","sequence":"additional","affiliation":[{"name":"1Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA; email: joanna.fiszdon@yale.edu"},{"name":"2Psychology Service, VA Connecticut Healthcare System, West Haven, Connecticut, USA"}]},{"given":"Matthew M.","family":"Kurtz","sequence":"additional","affiliation":[{"name":"3Department of Psychology and Program in Neuroscience and Behavior, Wesleyan University, Middletown, Connecticut, USA"}]}],"issued":{"date-parts":[[2026,5,7]]},"member":"22","prefix":"10.1146","source":"Crossref","volume":"22","created":{"date-time":"2025-11-15T01:00:52Z","timestamp":1763168452000,"date-parts":[[2025,11,15]]},"indexed":{"date-time":"2026-05-08T03:14:57Z","timestamp":1778210097519,"date-parts":[[2026,5,8]]},"license":[{"URL":"https://creativecommons.org/licenses/by-nc-nd/4.0","start":{"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000,"date-parts":[[2026,5,7]]},"delay-in-days":0,"content-version":"unspecified"}],"subject":[],"abstract":"$33","language":"en","relation":{},"resource":{"primary":{"URL":"https://www.annualreviews.org/content/journals/10.1146/annurev-clinpsy-061724-085601"}},"subtitle":[],"deposited":{"date-time":"2026-05-08T02:45:09Z","timestamp":1778208309000,"date-parts":[[2026,5,8]]},"issn-type":[{"type":"print","value":"1548-5943"},{"type":"electronic","value":"1548-5951"}],"published":{"date-parts":[[2026,5,7]]},"publisher":"Annual Reviews","reference":[{"DOI":null,"key":"B1","year":"1980","issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":null},{"DOI":null,"key":"B2","year":"2013","issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":null},{"DOI":"10.1016/j.eurpsy.2017.08.002","key":"B3","year":"2017","issue":null,"author":null,"volume":"46","first-page":"33","unstructured":null,"article-title":"The association between metacognitive abilities and outcome measures among people with schizophrenia: a meta-analysis","journal-title":"Eur. 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Sample size tag was omitted as no patient-level N is applicable to a review article. Publication date of November 2025 is listed, but today's date is May 2026 — this appears to be a future-dated journal issue, which is common for Annual Review publications.","value_numeric":null}],"summaries":{"what_studied":"This review evaluates metacognitive therapies — Metacognitive Reflection and Insight Therapy (MERIT) and Metacognitive Training (MCT) — for schizophrenia-spectrum disorders (SSD), alongside cognitive remediation and CBT, comparing their theoretical bases, treatment targets, techniques, mechanisms of action, and evidence bases.","key_result":"Both MERIT and MCT are presented as evidence-based approaches targeting core SSD features (self/other perception, cognitive biases, hallucinations, delusions); the review synthesizes their comparative efficacy but does not report a single primary numeric outcome, as this is a narrative review.","limitations":"This is a narrative review without systematic search criteria or meta-analytic pooling, which limits quantitative comparison of effect sizes across therapies. The evidence base for MERIT is less mature than that for CBT and cognitive remediation.","practice_takeaway":"Clinicians treating SSD should consider metacognitive therapies (MERIT, MCT) as targeted options alongside CBT and cognitive remediation, particularly when patients show deficits in self-reflection or hold rigid delusional beliefs. Matching the intervention to the patient's specific metacognitive profile may optimize outcomes."}},{"doi":"10.1001/jamapsychiatry.2025.2539","pmid":"41060643","title":"Cannabis Use Among Individuals With Psychosis After State-Level Commercial Cannabis Legalization","journal_title":"JAMA Psychiatry","journal_issn":"2168-622X","published_at":"2025-10-08T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12509079/","source_score":84,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-01-10","doi":"10.1001/jamapsychiatry.2025.2539","days":"7","issn":"2168-622X","rank":"8","field":"Clinical Medicine","score":"84","category":"Psychiatry","categories":["Psychiatry"],"_categories":["Psychiatry"]},"pubmed":{"doi":"10.1001/jamapsychiatry.2025.2539","title":"Cannabis Use Among Individuals With Psychosis After State-Level Commercial Cannabis Legalization.","journal":"JAMA psychiatry","methods":"","results":"The study sample consisted of 1856 individuals, with a mean age of 36.6 years (SD, 14.8 years) contributing 7465 responses, and was 50.2% White, 58.2% female, and had a 30-day cannabis-use rate of 31.8%. Individuals with psychosis in RCL states significantly increased their 30-day cannabis use by 9.53 pp (95% CI, 3.05-16.00 pp; P = .004), with sensitivity analyses showing significant estimates after retail outlets opened but not before, and no changes in higher frequency use.","abstract":"$34","keywords":[],"pubmed_id":"41060643","conclusions":"","publication_date":"2025-10-08T00:00:00"},"crossref":{"DOI":"10.1001/jamapsychiatry.2025.2539","URL":"https://doi.org/10.1001/jamapsychiatry.2025.2539","ISSN":["2168-622X"],"link":[{"URL":"https://jamanetwork.com/journals/jamapsychiatry/articlepdf/2840020/jamapsychiatry_hyatt_2025_br_250015_1766508757.43409.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"74","type":"journal-article","issue":"1","score":1,"title":["Cannabis Use Among Individuals With Psychosis After State-Level Commercial Cannabis Legalization"],"author":[{"given":"Andrew S.","family":"Hyatt","sequence":"first","affiliation":[{"name":"Health Evaluation Research Lab, Cambridge Health Alliance, Cambridge, Massachusetts"},{"name":"Department of Psychiatry, Harvard Medical School, Boston, Massachusetts"}]},{"given":"Michael William","family":"Flores","sequence":"additional","affiliation":[{"name":"Health Evaluation Research Lab, Cambridge Health Alliance, Cambridge, Massachusetts"},{"name":"Department of Psychiatry, Harvard Medical School, Boston, Massachusetts"}]},{"given":"Julie","family":"Johnson","sequence":"additional","affiliation":[{"name":"Massachusetts Cannabis Control Commission, Worcester, Massachusetts"}]},{"given":"Danta","family":"Bien-Aime","sequence":"additional","affiliation":[{"name":"Health Evaluation Research Lab, Cambridge Health Alliance, Cambridge, Massachusetts"},{"name":"Department of Psychiatry, Harvard Medical School, Boston, Massachusetts"}]},{"given":"A. 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