Psychiatry news.

In a double-blind randomized trial of 68 adults with treatment-resistant bipolar depression, four adjunctive ketamine infusions reduced depressive symptoms more than midazolam at day 14. No mania or hypomania was observed, but the small sample and short treatment period limit safety conclusions.

An observational computational study identified approximately 1.5 million phenotype-associated brain cells from 584 donors with Alzheimer’s-related phenotypes. The PASCode framework linked cell subpopulations and gene-expression patterns to pathology, cognition and depression, with findings validated in external datasets.

A cross-sectional study of 200 participants found lower angiotensin-converting enzyme (ACE) protein levels in cerebrospinal fluid and serum among patients with early-stage psychosis than healthy controls. Serum levels were also lower in treatment-resistant cases, but canonical enzymatic activity did not differ between patient subgroups.

A population-based Danish registry study identified 549,541 parental couples and 822,209 offspring to examine similarity in psychiatric and somatic diagnoses. Simulations estimated that nonrandom mating increased psychiatric disorder prevalence by 1.8% and family-based heritability estimates by 12.5% compared with a random-mating scenario.

A Danish registry-based matched case-control study compared 71,317 children and adolescents diagnosed with ADHD or ASD with 713,170 controls. Associations between prediagnostic characteristics and diagnosis weakened from 2012 to 2022, particularly for socioeconomic and perinatal factors and for ADHD.

A case-control study across 17 international cohorts compared MRI data from 369 females with bulimia nervosa and 417 healthy controls. Bulimia nervosa was associated with modest reductions in nucleus accumbens volume and temporal cortical surface area, while binge-eating frequency correlated with lower surface area in several regions.

A scoping review of 134 studies involving 151,134 participants found heterogeneous diagnostic categories associated with neurodivergence and neurodiversity. Autism and ADHD were most frequently included, while 21.6% of studies specified no clinical diagnoses.

A JAMA Psychiatry Special Communication draws on African mental health care approaches to propose four principles for scalable, culturally responsive services. The framework emphasizes workforce development, community-based care, systems integration, and culturally responsive care, while noting uneven implementation and limited long-term evidence.

A cross-sectional analysis of 67,532 person-year observations from the Medical Expenditure Panel Survey estimated annual US mental health expenditures at $174 billion, or 7.0% of medical spending. Mood and anxiety disorders accounted for the largest aggregate expenditures, while spending per treated individual was highest for substance use disorders.

An observational analysis compared structural MRI data from 45,900 controls and 2,698 people with neurological, psychiatric or addiction-related conditions. Alzheimer’s disease and mild cognitive impairment showed the strongest associations with older predicted brain age; ADHD and autism showed no significant overall difference from controls.