The edition · Psychiatry
Social support and problem-solving carry task-shared therapy; relaxation may drag it down
An individual-participant network meta-analysis dismantles lay-delivered psychological care into its parts; excess COVID-19 deaths in severe mental illness outlasted the vaccine roll-out; and glutamate marks antipsychotic non-response.
The edition in brief
Five items for psychiatrists. A Bayesian component network meta-analysis of individual data from 10,612 adults in 30 trials of task-shared psychosocial care found strengthening social support (incremental mean difference −9.48), behavioural activation (−4.15) and problem management (−4.08) added the most benefit, while relaxation (+7.97) and, less clearly, cognitive reframing (+5.17) were associated with worse outcomes. In a whole-England cohort of 13.5 million people with COVID-19, those with severe mental illness had higher all-cause mortality (aHR 1.56), and the gap widened rather than closed after vaccination began; by study end 79.4% were fully vaccinated against 87.2% of others. A mega-analysis of 1,189 people found raised medial frontal glutamate, choline and myo-inositol in antipsychotic non-responders, a research signal rather than a test. A US cohort of over a million matched pairs associated hospitalisation with infection in any body system with more psychiatric and neurological diagnoses over two years. The FDA recorded a supplement to Alembic's generic asenapine application. The pearl: build physical-health review and vaccination into every severe mental illness follow-up.
Excess COVID-19 deaths in severe mental illness persisted after vaccination began
Make vaccination follow-through, not just the first dose, part of routine care for severe mental illness.
Raised frontal glutamate marks antipsychotic non-response
Antipsychotic non-response has a measurable glutamatergic signature, which supports early recognition and timely clozapine rather than more dopamine blockers.
Hospitalisation with infection linked to later psychiatric and neurological diagnoses
Take a recent serious infection into account when a new psychiatric or cognitive problem appears.
FDA records a supplement to Alembic's generic asenapine
No change to how asenapine is prescribed; this is a generic licence supplement.
Put the physical-health review on the same page as the mental state
Every severe mental illness review should include a short physical-health check and vaccination status.
Which parts of lay-delivered therapy work: social support, activation, problem-solving
Build brief task-shared care for depression and anxiety around social support, behavioural activation and problem-solving.
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