News & Comment

Despite obsessive–compulsive disorder (OCD) being recognized as a global diagnosis with similar rates across countries, there is still a severe lack of trained specialists and high levels of underdiagnosis. This ‘treatment gap,’ together with high treatment resistance in OCD, poses a major challenge to healthcare systems and patients. To overcome barriers to access, there is an urgent need to expand the workforce via specialized training and to provide personalized treatment via digital tools, home-based scalable interventions and alternative treatment modalities.

Canada is home to a prolonged public health crisis of overdose deaths, which increasingly involves psychostimulant drugs that are neglected in the intervention response. In this Comment, we examine the risks and harms of psychostimulant use, available interventions, and gaps for improved prevention and treatment.

In this Correspondence, Pinto-Venegas and Abarca-Brown discuss the use of psychotropic drugs by youth in Chile, reflecting on historical and social forces, challenging stigma-focused views and urging services to address informal networks and everyday self-medication.

Autism research is entering a new and pivotal phase, as growing recognition of its biological and clinical heterogeneity presents challenges to previous paradigms and the adequacy of a single diagnostic label. Moving forward, incorporating a neurodiversity lens and embracing individual variability in autism will be a necessary step to improve research, outcomes and lives.

The tension between gold-standard double-blind randomized controlled trials and the overt psychoactive effects of psychedelics increases the risk of extrapolation fallacy, with potentially harmful downstream consequences.

People with lived experience of mental health conditions have historically been excluded from meaningful participation in psychiatric genetic and genomic research. This Comment outlines five key actions that the US National Institute of Mental Health, the largest funder of mental health research, can take to more effectively center people with lived experience in genetic and genomic research.

Youth mental health trajectories are inherently complex, and current tools cannot reliably forecast who will deteriorate, recover or relapse. This Comment discusses why digital measurement-based care offers a scalable, evidence-based solution for continuous and adaptive care, and proposes five recommendations to address the structural and behavioral conditions needed for digital measurement-based care to become routine practice.

Multiple transdiagnostic frameworks now shape the study of mental health, each illuminating distinct dimensions of psychopathology. Aligning these approaches may be key to developing a more coherent science capable of advancing diagnosis, prevention and intervention.

Psychedelic-assisted therapy shows promise for mental health treatment but faces regulatory, methodological and safety challenges. In this Comment, we propose using artificial intelligence and virtual reality to simulate similar experiences to those produced by traditional psychedelic compounds for use in psychedelic-assisted therapy modalities.

Genomic studies of attention-deficit/hyperactivity disorder (ADHD) have advanced the understanding of its neurobiology but are still constrained by one of the most pronounced Eurocentric biases in psychiatric genetics. Expanding ADHD genomics to under-represented populations, particularly in Latin America, offers a unique opportunity to yield transformative discoveries by capturing the genetic diversity of admixed individuals. We call for a global, coordinated effort to prioritize diversity in ADHD research, not only to foster innovation in precision psychiatry but also to ensure that these advancements benefit all populations equitably.

Data science competitions offer a collaborative, inclusive approach to tackling the complexity of brain health research. This Comment explores the challenges faced by competition organizers and how they can harness diverse expertise to address data heterogeneity, assess modeling strategies and translate findings into practice.

Behavioral health and mental health are distinct but overlapping concepts. Behavioral health is a systems-oriented framework to address complex mental health conditions through integrated, continuous care. Although it holds promise for improving access and outcomes, its potential remains constrained by fragmented delivery systems and social inequities.

Collaborations between neuroscientists and traditional medical practitioners can strengthen the scientific foundations of traditional medicine and enrich neuroscience with culturally grounded insights. Such partnerships, built on mutual learning, can promote more equitable and context-sensitive mental health research.

A behavioral healthcare workforce — concordant in race, ethnicity, lived experience, language, and geography with the populations it serves — is urgently needed to end the US behavioral health crisis.

Stimulant medications are the first-line treatment for ADHD, with non-stimulants often used if stimulants are ineffective. Here, by reinterpreting randomized controlled trials, addressing heterogeneity of treatment effects, and considering societal impact, we argue for equal consideration of stimulant and non-stimulants as first-line treatment options.

With rising temperatures and widening inequities, researchers, clinicians and policymakers all must confront the consequences of climate change. From the mental health burden associated with humid heat and eco-anxiety to the need for climate-aware clinical training and digital mental health, this issue underscores both the urgency and complexity of adapting health systems to a warming world.

Disparities in cardiovascular health among Black and Latina women are exacerbated by chronic stressors and limited access to mental health care. Culturally adapted mindfulness-based interventions represent promising strategies to address these disparities, potentially improving cardiovascular health by integrating sociocultural contexts and unique stressors into mental health practices.

This Comment proposes a receptor-informed, neuroimaging-integrated framework for guiding personalized, mechanism-based psychedelic therapies.

Dementia affects more than 55 million people worldwide, and AI companions powered by large language models are emerging as a scalable option for prevention and care. This Comment considers the unique promise, concerns, and regulations surrounding AI companions for dementia.