Crisis care for young people at home, and the glucose check that pregnant patients on antipsychotics need

The edition in brief

A systematic review of 15 studies found that brief structured, family-focused and linkage-based crisis services for children and adolescents with depression or suicidality were associated with fewer emergency visits and admissions, though the evidence is mostly observational. A three-arm randomised trial found that connectivity-guided accelerated theta-burst stimulation gave larger early improvements in depression than the standard 5-cm rule, with the difference gone by week 12. The ODDESSI cluster trial of Open Dialogue in England did not lengthen time to relapse but was associated with fewer admissions and better self-rated recovery. On the regulatory side, FDA recorded a supplement to a generic clozapine application, an administrative action rather than a safety finding. The practice-changer is a meta-analysis of 21 observational studies: second-generation antipsychotics in pregnancy were associated with a 60% higher risk of gestational diabetes, which argues for timely glucose testing rather than stopping effective treatment.