The research found that self-directed CBT-CP was associated with modest improvements in pain interference at four months, with those gains sustained through to twelve months. Participants in the self-directed group also showed small to moderate improvements across a range of secondary outcomes at four months. Notably, session-completion rates were higher among those using the self-directed format compared with those receiving clinician-delivered therapy.

Chronic pain affects a significant proportion of the population and places a substantial burden on healthcare systems. CBT is an established psychological treatment for chronic pain, but access to clinician-delivered therapy can be limited by availability, cost, and logistical barriers. The findings suggest that scalable, self-directed formats could help address this gap, potentially increasing the overall uptake of an evidence-based intervention.

The authors conclude that self-directed CBT-CP may represent an effective and more accessible alternative to traditional clinician-delivered care, with implications for how psychological pain management services are designed and delivered.

The study was led by corresponding author Alicia Heapy, PhD, and is published in JAMA (doi:10.1001/jama.2026.7861). The full text is freely accessible here.

The population-based retrospective cohort study, which analysed data from more than 1.8 million Canadian adults, examined how initial prescribing patterns influence whether patients go on to use benzodiazepines over the long term. The findings highlight a critical window of opportunity at the point of first prescription, suggesting that the decisions clinicians make early on can have a significant bearing on a patient’s longer-term trajectory.

Benzodiazepines are widely prescribed for conditions including anxiety, insomnia, and seizure disorders, but long-term use carries well-documented risks including dependence, cognitive impairment, and difficulties with withdrawal. Concerns about overprescribing and the potential for harm have made identifying modifiable risk factors a priority for researchers and health systems alike.

The study – funded by a Womenmind Grant to co-principal investigators at the Centre for Addiction and Mental Health (CAMH) – found that three initial prescribing characteristics were associated with earlier discontinuation: keeping the initial course short, prescribing a single benzodiazepine rather than multiple agents, and opting for short-acting formulations over longer-acting ones.

The research team say the results could directly inform prescribing guidelines, offering clinicians practical, evidence-based levers for reducing the risk of patients transitioning from short-term to long-term use.

The full paper, Association between initial benzodiazepine prescribing patterns and time to benzodiazepine discontinuation: A population-based retrospective cohort study, is freely available at https://plos.io/4uxybkF.

Image: Researchers assess long-term benzodiazepine use in Canada.

Credit: Haley Lawrence, Unsplash (CC0, https://creativecommons.org/publicdomain/zero/1.0/)

Social anxiety disorder, sometimes referred to as social phobia, is a mental health condition characterized by an intense fear of being judged or embarrassed in social situations, often leading to significant distress, impaired relationships and work performance, reduced quality of life, and substantial economic costs to society. “Social anxiety is becoming more common in Canada, and understanding why this increase is happening is essential for improving mental health support,” said Tak-Lai Nellie Chau, recent MSW graduate of the Factor-Inwentash Faculty of Social Work (FIFSW), University of Toronto.

The research revealed that nearly 14% of Canadian adults have experienced social anxiety at some point in their lives, up from just over 8% in 2002.

While the study did not examine why social anxiety may have increased, the authors hypothesize that recent social changes, such as increased use of social media and the effects of the COVID-19 pandemic, may be contributing to this rise.

Young People Are Most at Risk

The research shows a strong pattern: younger Canadians are far more likely to experience social anxiety than older adults. About 1 in 4 or 24% of people aged 20 to 24 had a social anxiety disorder at some point in their life, compared to only 6.2% of those aged 65 and older.

Digital communication and reduced face-to-face interaction could be to blame.

“Young adulthood is a key life stage where social pressures are high, which may increase vulnerability to social anxiety,” said Stephen A. Oliver, recent MSW graduate of the FIFSW, University of Toronto. “Add to this the experience of increased isolation during the pandemic, growing pressures to achieve certain ideals on social media, and increased polarization and those pressures are bound to  intensify.”

Early Life Experiences and Childhood Trauma Play a Role

The study also found that early life experiences are strongly associated with social anxiety disorders.  Individuals who experienced childhood sexual abuse or witnessed domestic violence had significantly higher rates of social anxiety disorder.

The prevalence of lifetime social anxiety was also linked to chronic pain, multiple health conditions, and substance use disorders, showing that social anxiety often overlaps with other challenges.

“These findings highlight the importance of a life course approach to understanding mental health,” said Esme Fuller-Thomson, Director of the Institute for Life Course and Aging, and Professor at the FIFSW, University of Toronto. “Childhood experiences can cast a long shadow on adult mental health”.

Social Support Makes a Difference

The research showed that people with low social support — those who felt they didn’t have someone to rely on — were much more likely to have a social anxiety disorder.

At the same time, people who reported that spirituality was important in their lives were less likely to struggle with social anxiety.

“While our study did not test treatments directly, there is strong evidence from other research that cognitive behavioural therapy can be highly effective for social anxiety. Given that one in four young Canadians are affected, improving access to these evidence-based supports is essential,” said Fuller-Thomson.

The study, led by researchers at the Institute for Health Metrics and Evaluation (IHME) in collaboration with partners at the University of Queensland and published in The Lancet, identified that mental disorders disproportionately impact people aged 15–19 and women. It examined the prevalence and burden of mental disorders across both sexes, 25 age groups, 21 regions, and 204 countries and territories from 1990 to 2023, making it the most comprehensive analysis of mental disorder burden to date.

The study assessed 12 mental disorders, with anxiety disorders and major depressive disorder (MDD) ranking 11th and 15th, respectively, in burden among 304 diseases and injuries worldwide.

Mental disorders are now the leading driver of disability worldwide. 

In 2023, mental disorders accounted for 171 million disability-adjusted life years (DALYs) globally, placing these conditions as the fifth-leading cause of total disease burden. DALYs are a measure of overall health loss, combining years lived with disability and years of life lost due to premature death. Mental disorders accounted for more than 17% of all years lived with disability worldwide. This reflects the substantial and growing impact of mental disorders across populations.

Recent increases have been driven largely by anxiety disorders and major depressive disorder. Since 2019, the age-standardized prevalence of major depressive disorder has risen by about 24%, while anxiety disorders have increased by more than 47%, with both conditions peaking in the years following the COVID-19 pandemic.

“These rising trends may reflect both the lingering effects of pandemic-related stress and longer-term structural drivers such as poverty, insecurity, abuse, violence, and declining social connectedness. Addressing this growing challenge will require sustained investment in mental health systems, expanded access to care, and coordinated global action to better support populations most at risk,” said first author Dr. Damian Santomauro, Associate Professor at the Queensland Centre for Mental Health Research in partnership with the University of Queensland. Dr. Santomauro is also an Affiliate Assistant Professor at IHME.

The burden peaks in adolescence and disproportionately affects women. 

Mental disorders affect individuals across all stages of life, but the types of conditions and their impact vary by age. In early childhood, conditions such as autism spectrum disorder, attention-deficit/hyperactivity disorder (ADHD), conduct disorder, and idiopathic developmental intellectual disability are most prevalent, with boys affected at higher rates than girls. As children grow into adolescence, anxiety and MDD are the leading contributors to mental disorder burden.

“Our findings show that mental disorder burden peaks among 15–19-year-olds, which is a critical developmental period that can shape trajectories for education, employment, and relationships,” said co-author Dr. Alize Ferrari, Honorary Associate Professor at the Queensland Centre for Mental Health Research in partnership with the University of Queensland. Dr. Ferrari is also an Affiliate Assistant Professor at IHME.

In 2023, 620 million women of all ages were living with a mental disorder compared to 552 million men of all ages globally. Women accounted for 92.6 million DALYs, compared to 78.6 million among men, indicating a higher overall burden. These differences are likely shaped by a complex mix of factors, including greater exposure to domestic violence and sexual abuse, increased caregiving responsibilities, and structural inequalities such as gender discrimination.

Mental disorders impact populations worldwide, highlighting gaps in care. 

Mental disorders burden increased in every region of the world between 1990 and 2023, though the scale and pattern of that burden differ substantially across regions and levels of development. High-income regions such as Australasia and Western Europe recorded some of the highest burden rates globally, particularly in countries like the Netherlands, Portugal, and Australia. Large increases in mental disorder burden rates were also observed in Western sub-Saharan Africa and parts of South Asia.

These patterns translate into substantial impacts for communities worldwide. Mental disorders impact families and caregivers, reduce workforce participation and productivity, and place growing demands on health systems and government resources. GBD analyses estimate that only about 9% of individuals with major depressive disorder globally receive minimally adequate treatment, with less than 5% receiving adequate care in 90 countries. Across 204 countries and territories, only a small number of high-income settings, including Australia, Canada, and the Netherlands, have treatment coverage exceeding 30%, highlighting major global gaps in care.

Expanding access to services, particularly in low- and middle-income countries, will be critical to improving coverage. Achieving this will require coordinated global action and sustained investment in mental health systems to improve outcomes worldwide.

For interviews with the authors, please contact IHME’s Media Team at ihmemedia@uw.edu.

A new study published today [14 May] in The Lancet Psychiatry provides the most comprehensive view of dosage effects for five commonly used medications for ADHD.

To help patients and clinicians choose the right dosage, the international research team led by Professor Samuele Cortese from the University of Southampton has also developed a free online tool based on the findings.

The research was funded by the National Institute for Health and Care Research (NIHR).

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental conditions, affecting about five per cent of school-age children and two to three per cent of adults.

Medication is a key part of treatment, and prescriptions have increased substantially in recent years. However, most clinical guidelines provide limited guidance on the most effective dosages.

Finding the right dose is important to avoid dosages that are too low to be effective or too high, causing unwanted side effects. To identify this dosage ‘sweet spot’, the research team analysed data from 113 clinical trials, including more than 25,000 participants.

They used an advanced method called dose–effects network meta-analysis, which allowed them to estimate how different doses of each medication affect both effectiveness and side effects.

The results show that patterns differ between medications and age groups.

Dr Mikail Nourredine from the University of Lyon, first author of the study, said: “Overall, our findings suggest that clinicians should avoid using doses that are too low to be effective. If symptoms are not well controlled, the dosage may need to be increased.

“We also found no evidence that going beyond the licensed maximum doses improves average effectiveness, and higher doses are usually linked to more side effects. However, our results derive from group averages. Specific individuals with ADHD may benefit from and tolerate well unlicensed doses.”

Evidence from other studies shows that a substantial proportion of children and adolescents are prescribed low dosages without appropriate increases. That’s despite timely and adequate dose adjustments being associated with better adherence to treatment.

Professor Cortese, an NIHR Research Professor at the University of Southampton, commented: “Our study and the tool have the potential to support shared decision-making between clinicians, patients, and families when choosing the best dose. It is not only a clinician’s decision – patients and caregivers should be involved.

“The tool helps show what can be expected from each dose so that the patient knows why that particular dose has been chosen. We are continuing research to further personalise these recommendations based on individual patient characteristics.”

The study Pharmacological interventions for ADHD: a systematic review and dose-effect network meta-analysis is published in The Lancet Psychiatry and is available online.

Steve Williams, Media Manager, University of Southampton, press@soton.ac.uk or 023 8059 3212.

1. The study Pharmacological interventions for ADHD: a systematic review and dose-effect network meta-analysis will be published in The Lancet Psychiatry. An advanced copy is available upon request.
2. The online tool is available here: https://mikailnourredine.github.io/ADORMA/
3. For interviews, please contact Steve Williams, Media Manager, University of Southampton, press@soton.ac.uk or 023 8059 3212.

Previous meta-analyses looking at the use of antidepressants during pregnancy and risk of neurodevelopmental disorders in children were conducted nearly a decade ago and limited by small study numbers and a lack of controlling for additional factors. This new meta-analysis provides the best evidence to date that the small increase in risk of autism or ADHD in the children of women who used antidepressants when pregnant identified in many studies is not caused by the medication.

“We know many parents-to-be worry about the potential impact of taking medication during pregnancy; our study provides reassuring evidence that commonly used antidepressants do not increase the risk of neurodevelopmental disorders such as autism and ADHD in children. While all medications carry risks, so too does stopping antidepressants during pregnancy due to an increased risk of relapse. Therefore, for women with moderate-severe depression, doctors and patients must carefully weigh the potential risks and benefits of continuing antidepressant treatment during pregnancy against the potential harms of untreated depression,” says author Dr Wing-Chung Chang, University of Hong Kong.

He continues, “Although our study found a small increase in the risk of autism and ADHD in the children of women who had used antidepressants during pregnancy, it also found that this risk disappeared when we accounted for other factors. The increased risk was also seen in the children of fathers who took antidepressants and of mothers with antidepressant use before, but not during, pregnancy. Together, this suggests that it is not the antidepressants themselves causing an increased risk in autism and ADHD but it is more likely to be due to other factors, including genetic predisposition to conditions such as ADHD, autism, and mental health conditions.”

Authors pooled data from 37 studies which included more than 600,000 pregnant women taking antidepressants and almost 25 million pregnancies with no antidepressant use.

Before controlling for key factors such as mental health conditions, the analysis found that antidepressant use by the mother during pregnancy was associated with a 35% increased risk of ADHD and a 69% increased risk of autism. However, this became greatly reduced or non-significant in analyses that better controlled for confounding factors. Use of antidepressants during pregnancy by the father was associated with a 46% increase in the risk of ADHD and a 28% increase in the risk of autism.

Among studies with analyses restricted to mothers with mental health disorders, all selective serotonin reuptake inhibitors (SSRIs) were found to not be associated, only amitriptyline/nortriptyline remained associated with increased ADHD and autism risk. Amitriptyline/nortriptyline are currently considered second or third options as treatments for depression and are often prescribed for treatment-resistant depression. Therefore, women treated with these may have more severe, chronic, or complex underlying mental health conditions than those receiving more common antidepressants, which could be influencing the association between amitriptyline/nortriptyline and increased ADHD and autism risk.

The study found no difference in risk between high and low doses of antidepressants.

“The evidence suggests a link between either parent having a mental health condition and a slightly higher risk of ADHD or autism. In addition to genetic factors, this link could be explained by the home and social environment as ongoing family stress, changes in how the family functions, and differences in how parents behave and care for their children may influence neurodevelopment. There is a need to ensure both parents have access to support and treatment for mental health conditions; for their own sake and to support neurodevelopment of their child,” says Dr. Joe Kwun-Nam Chan, University of Hong Kong.

The researchers note some limitations of their study, including that data on important factors such as socioeconomic status, lifestyle risk factors and low birth weight was lacking in the studies. Additionally, there was only a small number of studies looking at antidepressant use in specific trimesters or exact doses and dose changes, which makes it harder to draw conclusions about these. Finally, women who are prescribed antidepressants tend to have more severe depression than those who are not, so some bias may remain even after controlling for mental health status.

Writing in a linked Comment, Lisa Vitte, Emmanuel Devouche and Gisele Apter from University Rouen Normandy (France), who were not involved in the study, say, “Chang and colleagues’ study adds knowledge and confirms some of the pre-existing knowledge on the use of antidepressants during pregnancy: that they should continue to be taken as they protect maternal mental health and do not harm fetal development. This result is of considerable impact after many contradictory and controversial studies.”

There was no funding source for this study. The study was conducted by researchers from the University of Hong Kong.

The labels have been added to this press release as part of a project run by the Academy of Medical Sciences seeking to improve the communication of evidence. For more information, please see: http://www.sciencemediacentre.org/wp-content/uploads/2018/01/AMS-press-release-labelling-system-GUIDANCE.pdf. If you have any questions or feedback, please contact The Lancet press office at pressoffice@lancet.com

Quotes from Authors cannot be found in the text of the Article but have been supplied for the press release. The Comment quote is taken directly from the linked Comment.

https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(26)00089-1/fulltext

Obesity has a wide range of potential underlying causes, including mental and psychosocial factors. These factors include financial difficulties, mental stress and loneliness. This study aimed to examine whether these factors occur differently between people with normal weight, overweight or obesity.

The authors used data from the Dutch version of the online screening tool CheckCausesObesity.com This screening tool identifies possible underlying causes of obesity based on international guideline- and evidence-based algorithms. This is an online screening tool that helps identify the underlying causes of obesity in an individual. It systematically maps lifestyle factors, biological, psychological, social, and medication-related factors, as well as more rare medical (eg genetic) causes and also comorbidities, using guideline-based algorithms. All factors are explored in depth through detailed patient input. As part of a comprehensive assessment of multiple lifestyle factors, hormonal, genetic and medical factors which can contribute to overweight, this tool also includes questions about financial problems, loneliness and stress, as well as sex, weight, height and birthyear, enabling the researchers to calculate BMI and age. Patients complete the questions in this screening tool at home, and the results support a more personalized and medically informed treatment approach.

Statistical modelling was performed to explore the associations between financial problems, loneliness, stress and BMI classes (normal weight (BMI 20-24.9 kg/m²), overweight (BMI 25-29.9 kg/m²), obesity class 1 (BMI 30-34.9 kg/m²), obesity class 2 (BMI 35-39.9 kg/m²), and obesity class 3 (BMI ≥40 kg/m2)). Thereafter, statistical analyses were performed, adjusting for age and sex. Finally, potential sex differences in the results were assessed.

The screening tool was completed by 44.407 adults, between June 2024 and November 2025. Mean age was 52 years and the majority were female (76.7%). All the results reported below were statistically significant. The authors looked first at financial difficulties, which were present in 5.4% of the respondents with no difference between men and women. A higher proportion of respondents indicated having financial problems with increasing BMI (normal weight: 4.3%, overweight: 4.7%, obesity class 1: 5.0%, obesity class 2: 6.0% and obesity class 3: 7.2%). Respondents without financial problems had a lower BMI than those indicating they had financial problems (mean BMI: 33.2 kg/m² and 34.5 kg/m²). The association between financial issues and BMI was comparable between men and women.

Secondly, they examined stress, which was reported more frequently by women (34.5%) than by men (22.5%). Respondents experienced more stress with increasing BMI (normal weight: 27.5%, overweight: 28.6%, obesity class 1: 31.2%, obesity class 2: 34.3% and obesity class 3: 37.3%). Accordingly, respondents indicating experiencing stress had a higher mean BMI compared to those without stress (mean BMI: 34.0 kg/m² and BMI: 33.1 kg/m² respectively). This association did not differ between men and women. To explore the reasons underlying respondents’ stress, participants could elaborate on their stress experiences. These qualitative responses were analysed and organised into clusters representing the most frequently reported stress domains. According to these clusters, the three most experienced stress domains were work-related, focused on general well-being or concerns about family-members.

Thirdly, loneliness was more often reported in women (8.7%) than in men (6.3%), and more prevalent among respondents with increasing class of obesity (normal weight: 7.7%, overweight: 7.0%, obesity class 1: 7.6%, obesity class 2: 8.5%, obesity class 3: 11.7%). In addition, individuals who reported loneliness had a higher BMI (mean BMI 34.5 kg/m²) than those without loneliness (mean BMI 33.3 kg/m²). Interestingly, the results suggest that loneliness is more strongly associated with a higher BMI in men than in women.

The authors conclude: “This study shows that higher BMI is associated with more financial problems, loneliness, and stress. These relationships may be bidirectional. On the one hand, higher BMI may contribute to stigma and social isolation, reduced work capacity, and increased healthcare costs. On the other hand, financial strain, chronic stress and social isolation may influence lifestyle coping behaviours, and even biological processes that promote weight gain. Broader environmental factors may further reinforce these patterns. Further research is needed to better understand these mechanisms and to inform prevention and support strategies for individuals facing financial difficulties, mental stress, and loneliness in the context of obesity.

Rates of depression and anxiety have increased worldwide since the COVID-19 pandemic, and more people are pursuing mental health treatment as a result. However, there is limited up-to-date data describing how these individuals seek out and receive care. Detailed, population-level information can help healthcare systems meet this growing population’s needs.

To make a start on gathering this data, Kruk and her colleagues surveyed 32,419 adults in 18 high-, low-, and medium-income countries. More than 1,000 people from each country responded. Participants self-reported data via the People’s Voice Survey in 2022 and 2023.

First, survey respondents self-assessed their physical and mental health (the latter including “poor,” “fair,” “good,” “very good,” and “excellent”). Then, they quantified their overall confidence in the healthcare system, their own use of healthcare services, the typical quality of care received, and their ability to manage their own mental health (a metric called patient activation).

Across all countries, respondents reporting poor mental health were more likely to report chronic illness, poorer overall health, lower patient activation, worse care quality and lower confidence in the healthcare system. Between 0.9% (Lao PDR) and 52.4% (UK) of these respondents reported receiving mental health care in the last year. Respondents in Nigeria reported the best overall mental health (4.7% people reported the lowest proportion of “poor” or “fair” mental health (4.7%), while respondents in China had the highest proportion (39.6%).

The researchers hope these results can help the countries in question — and individual healthcare systems — better serve the needs of those with poor mental health. While this is a descriptive study, the researchers posit patient activation as a potential target for elevating overall health and wellness.

The authors acknowledge that big-picture data doesn’t describe individuals’ specific experiences within the healthcare system. They suggest comparison across similar health systems and tracking system performance over time to continuously improve health services.

The authors add, “What stands out from this study is that poor mental health doesn’t exist in isolation. People reporting poor mental health were nearly twice as likely to have a chronic illness and far less likely to feel empowered to manage their own health. Health systems need to stop treating mental health in a silo and recognize that these patients are showing up across all areas of care — and often with more complex needs.”

Kruk adds, “As a research consortium working across very different health systems, we expected to find variation, and we did, in treatment access. But the experience gap was remarkably consistent: people with poor mental health had worse care, more unmet needs, and less trust in the system, regardless of where they lived. Health systems globally need to rethink how they serve this growing group, not just whether they can reach them.”

Freely available paper in PLOS Medicine: https://plos.io/3O045Xd

Citation: Kruk ME, Kapoor NR, Arsenault C, Carai S, Daray FM, Doubova SV, et al. (2026) Health system use and experience among people with poor mental health: A cross-sectional analysis of the People’s Voice Survey in 18 countries. PLoS Med 23(5): e1004745. https://doi.org/10.1371/journal.pmed.1004745

Author countries: United States of America, Greece, Argentina, Mexico, Peru, Ethiopia, India, South Africa, Republic of Korea, United Kingdom, Nigeria, Italy, China

Funding: This work was supported by the Bill & Melinda Gates Foundation (https://www.gatesfoundation.org/ INV-005254) to MEK; the Swiss Agency for Development and Cooperation (https://www.eda.admin.ch/deza/en/home.html; 81067262) to MEK; Merck Sharp & Dohme LLC (https://www.merck.com) to MEK; the Inter-American Development Bank (https://www.iadb.org/en; Project No. RG-T3768) to EGE; and the Taejae Research Foundation (https://taejaefoundation.or.kr/en) to JO. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

But there are few evidence-based interventions to help this age group problem-solve and reduce stress. To address the gap, Rutgers University researchers tested the efficacy of Bright IDEAS, a problem-solving skills training intervention based on cognitive-behavioral therapy, in reducing depression and anxiety and improving their overall health-related quality of life in people ages 18 to 39, which the National Cancer Institute defines as “young adults.”

Their study, published in JAMA Network Open, found young adults who participated in the Bright IDEAS program showed significant reductions in depression and anxiety symptoms and improvements in their quality of life compared with members of the control group.

“Bright IDEAS participants felt less overwhelmed and more empowered,” said Katie Devine, Associate Director of the New Jersey Pediatric Hematology and Oncology Research Center of Excellence at Rutgers Cancer Institute, New Jersey’s only National Cancer Institute-designated Comprehensive Cancer Center together with RWJBarnabas Health. “This shows that a relatively brief intervention delivered by trained professionals can have a profound impact on patient well-being.”

Bright IDEAS teaches a five-step tactical approach to problem solving (IDEAS is an acronym standing for the steps of problem-solving: Identify the problem, Define your options, Evaluate options, Act and See if it worked) in a positive context (as in “bright”).

“The goal is by improving problem-solving skills, young adults will be better equipped to identify and act on problems and thus reduce symptoms of distress and improve quality of life,” said Devine, an author of the study who also is an associate professor at Rutgers Robert Wood Johnson Medical School.

The Bright IDEAS intervention is completed over six video sessions by licensed mental health professionals or supervised trainees who are trained to deliver the Bright IDEAS program.

“In each session, they address challenges and walk through the problems to identify solutions,” Devine says. “Instead of feeling overwhelmed about how to manage what is happening to them, they become empowered to manage their stressors.”

The study included 344 young adults between 18 and 39 who were within four months of a first cancer diagnosis and who were undergoing systemic therapy such as chemotherapy, radiation, immunotherapy or stem cell transplant at Rutgers Cancer Institute in New Brunswick, N.J., Memorial Sloan Kettering Cancer Center in New York, and Moffitt Cancer Center in Tampa.

Researchers conducted a randomized controlled trial, with half the participants receiving Bright IDEAS and the other half receiving usual psychosocial care of visits with a social worker and provided resources. The participants were surveyed to measure their symptoms at three and six months after enrollment.

“We are next planning a trial in community oncology settings, where most young adults receive their treatment, to make Bright IDEAS more accessible to patients who may not have access to large urban cancer centers,” Devine said.

Other Rutgers authors involved in the study are Sharon Manne, Kristine Levonyan-Radloff, Shengguo Li and Pamela Ohman Strickland.

The team analyzed data from the 2024 National Survey on Drug Use and Health (NSDUH). This was the first year the large‑scale, nationally representative survey asked psilocybin‑specific questions, enabling the researchers to gain a more accurate picture of past‑year use among the 58,633 respondents. Previous national surveys have grouped psilocybin with other hallucinogens and have focused on lifetime use rather than its use during the past 12 months.

“Prior surveys only captured lifetime use, which tells us little about current use patterns; someone who tried psilocybin once in college a decade ago and someone using it regularly today look identical in that data. Past-year gives us a much more clinically relevant picture of who is using psilocybin right now and what factors are associated with their use,” said first author Kevin Yang, MD, resident physician in the Department of Psychiatry at UC San Diego School of Medicine.

The research found:

• 18–25 year-olds had 1.4x the odds of psilocybin use compared to those ages 35–49, while those over 50 had about one-third lower odds
• Males had 1.7x the odds compared to females and white respondents had 2.5x the odds of Black respondents and 1.4x the odds of Hispanic respondents
• The use of cannabis and hallucinogens like LSD, MDMA and ketamine was strongly associated with past-year psilocybin use.
• Alcohol use disorder and prescription stimulant misuse were also correlated with psilocybin use.
• Individuals with a major depressive episode in the past year had higher odds of psilocybin use.

The findings have implications for clinical practice. Over the past decade, clinical trials have revealed that psilocybin has promising therapeutic effects for depression and treatment‑resistant depression, but the safety profile of unsupervised, naturalistic use remains unclear. Unlike controlled clinical settings where participants are carefully screened, doses are standardized, and psychological support is provided, naturalistic use lacks these safeguards.

“When psilocybin is used outside of a clinical setting, the risks look very different. We’ve seen reports of anxiety, paranoia and prolonged psychological distress, and there are also potential interactions with antidepressants that clinicians need to look out for,” said Yang.

He says the findings highlight the need for clinicians to be aware of psilocybin use among their patients, particularly those with depression.

“With 8 million Americans using psilocybin in the past year, this is something that psychiatrists and other clinicians should be asking about, including why patients are using it and what benefits they perceive, as well as being prepared to counsel them on harm reduction and potential risks,” said Yang.

Looking forward, Yang says longitudinal studies that track the mental health of people over time as they use psilocybin are needed, as well as increased public health surveillance as de‑criminalization and potential FDA approval of the substance progress.

Additional co-authors on the study include: Avery Eun, UC San Diego School of Medicine; Joseph J. Palamar, NYU Grossman School of Medicine.

Read the full study here.

Diabetes and obesity have long been linked to an increased risk of mental health symptoms. Similarly, individuals with mental disorders have an elevated risk of metabolic diseases such as obesity and diabetes. Researchers have working to disentangle the connections between these conditions.

Previous evidence on the effects of GLP-1 medications on anxiety and depressive disorders has been somewhat inconsistent, but it has been largely based on small studies. The new paper, published in The Lancet Psychiatry, includes data from nearly 100,000 participants, over 20,000 of whom had used GLP-1 medications to treat diabetes and obesity. Participants were followed through Swedish national registers between 2009 and 2022.

The results showed that the use of GLP-1 medications – particularly semaglutide – was associated with a reduction in workplace absence and in lower rates of hospital care for psychiatric issues. During periods of semaglutide use, the reduction was 42% compared with periods when GLP-1 medications were not used. For depression, the risk was 44% lower, and for anxiety disorders, 38% lower.

In addition, semaglutide use was associated with a lower risk of substance use disorders: hospital care and sickness absence related to substance use were 47% lower during periods of semaglutide use compared with periods without GLP-1 medication. The use of GLP-1 receptor agonists was also associated with a reduced risk of suicidal behaviour.

One of the study’s authors, Professor Mark Taylor from Griffith University, says such results were to be expected: ‘An earlier study examining Swedish registers found the use of GLP-1 medications to be associated with a reduced risk of alcohol use disorder. Alcohol-related problems often have downstream effects on mood and anxiety, so we expected the effect to be positive on these as well.’

However, the magnitude of the association surprised the researchers. ‘Because this is a registry-based study, we cannot determine exactly why or how these medications affect mood symptoms, but the association was quite strong,’ says Prof Markku Lähteenvuo from the University of Eastern Finland. ‘It is possible that, in addition to factors such as reduced alcohol consumption, weight loss-related improvements in body image, or relief associated with better glycaemic control in diabetes, there may also be direct neurobiological mechanisms involved – for example, through changes in the functioning of the brain’s reward system.’

“When we negatively interpret a situation, it impacts how we feel and respond—especially in people experiencing anxiety and depression,” said senior author Courtney Beard, PhD,  director of the Cognition and Affect Research Education (CARE) Laboratory at McLean Hospital, a member of the Mass General Brigham healthcare system. “By providing a simple, game-like exercise through an app, we have shown that we can help individuals gain insight into their thinking patterns in a more accessible and engaging way, that leads to meaningful improvements.”

Access to evidence-based treatments for anxiety and depression remains a significant challenge for many individuals due to provider shortages, high costs, and stigma surrounding mental health care. Digital tools have the potential to bridge these gaps; however, most available apps are not rigorously studied, resulting in a wide variance in quality and effectiveness. In addition, users often drop off these apps shortly after download. The researchers designed HabitWorks with these limitations in mind, working with an advisory board of individuals with lived experience of anxiety and depression.

In their new study, the investigators enrolled 340 adults across 44 states, who were randomized to use the HabitWorks app for four weeks or to a control condition that involved self-assessment surveys tracking symptoms of depression and anxiety.

Participants using HabitWorks reported significantly greater improvements in interpretation bias, functioning, and overall mental health symptom severity after one month compared to the control group. HabitWorks also achieved excellent retention rates with 77.8% of participants still using the app in week 4 and 84.4% of participants completing the post-intervention assessment.

“One thing that makes our approach unique in digital mental health is its focus on short, five-minute exercises,” said lead author Alexandra Silverman, PhD, a clinical investigator in the CARE Laboratory. “Unlike traditional interventions that mimic long therapy sessions, HabitWorks aligns with how people use their phones in short bursts, creating an approach that fits into daily life.”

HabitWorks is currently not available to the public. Further research is needed to identify which populations would benefit most from HabitWorks, the longevity of its effects and methods for delivering the intervention beyond a research setting. For more information on HabitWorks and to sign up for its waitlist, visit this website.

Authorship: In addition to Silverman and Beard, Mass General Brigham authors include Gabriela Kovarsky Rotta and Doah Shin.
Disclosures: None.
Funding: This work was supported by the National Institute of Mental Health (R01MH12937) and by Harvard Medical School’s Livingston Fellowship and McLean Hospital’s Pope-Hintz Endowed Fellowship.
Paper cited: Silverman, A. et al. “Randomized Controlled Trial of Smartphone-Based Interpretation Bias Intervention for Anxiety and Depression” Journal of Consulting and Clinical Psychology DOI: xxx