This randomized clinical trial investigates if direct-to-patient mailed interventions reduce sedative use and improve sleep outcomes in patients.

This prognostic study develops a model based on administrative data for regular US Army soldiers that can predict suicides 1 to 120 months after leaving active service.

This cohort study examines 20 years of data for Danish patients who had electroconvulsive therapy (ECT) to compare the risk of hospitalization or suicidal behavior between patients who had continuing and maintenance ECT vs acute ECT alone.

The Original Investigation titled “Antipsychotic Drugs and Cognitive Function: A Systematic Review and Network Meta-Analysis,” published on October 16, 2024, was corrected to remove the word “pairwise” from the subtitle, add minus signs to the effect sizes, adapt the box sizes in Figure 3, and correct the data in Figure 4. This article was corrected online.

The US Department of Defense (DoD) Military Health System (MHS) is charged with, among other missions, providing health care to its more than 9.6 million beneficiaries, including servicemembers and their families. One of the DoD and MHS’s key priorities is suicide prevention. Since the beginning of the US military conflicts in Iraq and Afghanistan, the suicide rate among military servicemembers has steadily risen, and a whole-of-government approach that emphasizes the MHS’s unique role in the US health care landscape is needed to tackle this public health crisis.

This systematic review and meta-analysis assesses the frequency and severity of adverse events (AEs), including serious and nonserious AEs, among studies of classic psychedelics in 4 research databases.

This study assesses associations between cognition and mental health by symptom severity.

Autism is a heterogeneous condition characterized by differences in social, communication, ritualistic or repetitive, and sensory behaviors that have lifelong impacts on the lived experiences of the 2% to 3% of the US population who are affected. Decades of work capitalizing on autism’s high heritability by following up younger siblings of autistic children from infancy have demonstrated that differences in brain development are present in the first years of life, well before the defining symptoms of a diagnosis are appreciable, cementing autism as a quintessential developmental condition. Yet, few studies to date have accounted for a fundamental truth about brain development in their analytic approaches: cortical areas do not develop in isolation but are instead part of a complex coordinated system. It may in fact be the coordination of development across cortical areas, and their impact on circuit function, that differentiates autism from typical development and gives rise to its heterogeneous clinical-behavioral phenotype.

This case-control study investigates if, in autistic individuals compared with nonautistic individuals, brain regions develop differently in relation to each other and if these differences are associated with molecular/genomic mechanisms and symptomatology.

In Reply We thank Kikuchi and colleagues for their interest in our article in this issue of JAMA Psychiatry and welcome the opportunity to address their comments. In our article, we report relatively high pneumonia risks during the use of antipsychotics with high anticholinergic burden prescribed in high doses. Antipsychotics prescribed in monotherapy were associated with pneumonia risk, whereas polytherapy (≥2 antipsychotics used simultaneously) was not.

This Viewpoint advocates for proactively addressing concerns related to the diagnosis and treatment of attention-deficit/hyperactivity disorder (ADHD) in US adults to balance individual benefits with population-level risk.

To the Editor We read with great interest the article “Pneumonia Risk, Antipsychotic Dosing, and Anticholinergic Burden in Schizophrenia” in this issue of JAMA Psychiatry by Luykx et al. The study provided evidence that antipsychotic monotherapy, especially with clozapine, quetiapine, and olanzapine, was dose-dependently associated with an increased risk of pneumonia, and it suggested an involvement of the medications’ anticholinergic characteristics. However, we believe that the conclusion that antipsychotic polytherapy was not significantly associated with an increased risk of pneumonia should be interpreted with caution. In a study from Finland, medium to high doses of clozapine and high doses of olanzapine accounted for a large proportion of monotherapy, which made the pneumonia risk with monotherapy statistically detectable. However, high-dose (ie, defined daily dose [DDD] ≥1.1) polytherapy includes a considerably wider range of antipsychotic combinations, from high to low risk of pneumonia, which can dilute the risk. The authors pointed to the reduced doses per drug as a potential reason for the relative safety of polytherapy. Theoretically, additional antipsychotics should add pneumonia risk factors via additional anticholinergic load or other pharmacological mechanisms. The study by Luykx et al may suggest a potential risk of polytherapy consisting of high doses of clozapine, quetiapine, or olanzapine combined with other antipsychotics, which remains to be evaluated. Assessing the risk of pneumonia with polytherapy for higher DDD categories (eg, DDD ≥2.0) and evaluating the efficacy and safety of specific antipsychotic combinations and doses are important issues to be addressed.

This cross-sectional study uses data from 1135 male, European-American US military veterans to assess whether risk and protective factors influenced associations between posttraumatic stress disorder and epigenetic age.

This cross-sectional study estimates the use of health care services among middle-aged and older adults in India who were diagnosed with depression, received treatment, and were in remission.

Suicide is a pressing public health concern in the US and the last decades have seen rising suicide rates, but also increased research focused on the development and evaluation of effective suicide prevention treatments. Prior to the development and validation of suicide-specific treatments, traditional models conceptualized suicidal thoughts and behaviors as symptoms of psychiatric disorders, such as depression. It thus followed that treating the primary psychiatric disorder was sufficient to reduce suicide risk. We have since learned that while psychiatric diagnoses are one of many potential risk factors for suicide, suicide risk is transdiagnostic. Indeed, some suicidal patients do not meet criteria for any psychiatric disorder. There are now several efficacious suicide-specific psychosocial interventions that conceptualize and treat suicidal ideation and behaviors as the primary treatment targets and are recommended components of comprehensive suicide prevention approaches such as Zero Suicide.

This narrative review explores the need to establish more equitable interventions in public mental health, such as adopting a comprehensive approach that integrates multiple frameworks to address the complexity of mental health disparities, particularly in marginalized groups.

This randomized clinical trial assesses the effect of brief cognitive behavioral therapy on outcomes among suicidal inpatients.

This Viewpoint describes both the current barriers patients face when filling their prescriptions for buprenorphine at pharmacies and a list of proposed fixes requiring changes at the federal, state, insurance, and clinician level.

This cohort study examines data for the population of Denmark across 20 years to estimate suicide risk across a range of medical conditions, gauge any dose-response–like relationship between disability burden and suicide risk, and determine any role prior mental disorder might have.

This Viewpoint describes efforts to provide timely, comprehensive, and high-quality mental health care to a large population-representative subset of children within a single health system and demonstrate its potential impact and true cost.

This case-control study investigates if genetic risk for bipolar disorder and schizophrenia (psychosis) is associated with twin concordance for these disorders.

Mission Statement: JAMA Psychiatry strives to publish original, state-of-the-art studies and commentaries of general interest to clinicians and researchers in psychiatry, mental health, behavioral science, and allied fields. The journal seeks to inform its readers, to stimulate discussion into the nature, causes, treatment, and public health importance of mental illness, and to promote equity and justice for those affected by mental illness and for society.