JAMA Psychiatry

doi: 10.1001/jamapsychiatry.2023.4948pmid: 38170541

Key PointsQuestionWhat is the efficacy of fully unsupervised home-use transcranial direct current stimulation (tDCS) combined with either a digital psychological intervention or digital placebo for the treatment of a major depressive episode? FindingsIn this randomized clinical trial including 210 adults with a major depressive episode, no statistically significant differences were detected between home-use tDCS combined with either a digital psychological intervention or digital placebo vs sham in reducing depressive symptoms after 6 weeks. MeaningThe findings indicate that unsupervised home use tDCS should not be currently recommended in clinical practice.

doi: 10.1001/jamapsychiatry.2023.5051pmid: 38294785

Key PointsQuestionIs age stratification relevant for estimating the prevalence and burden associated with mental disorders and substance use disorders in the period from childhood to early adulthood? FindingsIn this cross-sectional study using data from the 2019 Global Burden of Disease study, there was a high prevalence of mental disorders affecting children and youths, indicating that more than 1 of 10 (or 293 million) individuals aged 5 to 24 years globally live with a diagnosable mental disorder—in terms of burden, around one-fifth of all disease-related disability (considering all causes) was attributable to mental disorders among this population. Additionally, this age period encompasses about one-fourth of the mental disorder burden across the entire life course. MeaningGiven the implications of the early onset and lifetime burden of mental and substance use disorders for policy making, age-disaggregated data are essential for a more accurate understanding of vulnerability and more effective prevention and intervention initiatives.

Key PointsQuestionWhat is the association of each component and delivery format of cognitive behavioral therapy for chronic insomnia with outcomes? FindingsThis systematic review and component network meta-analysis including 241 trials found that cognitive restructuring, third-wave components, sleep restriction, stimulus control, and in-person format may be beneficial. Cognitive restructuring, third-wave components and in-person delivery were mainly associated with improved subjective sleep quality, while sleep restriction and stimulus control were associated both with improved sleep quality and self-reported sleep continuity. MeaningThe findings suggest that beneficial cognitive behavioral therapy for insomnia may include cognitive restructuring, third-wave components, sleep restriction, stimulus control, and in-person format.

doi: 10.1001/jamapsychiatry.2023.5083pmid: 38198165

Key PointsQuestionCan multivariate machine learning approaches identify the neural signature of major depressive disorder in individual patients? FindingsIn this case-control neuroimaging study that included 1801 patients with depression and healthy controls, the best machine learning algorithm only achieved a diagnostic classification accuracy of 62% across major neuroimaging modalities. MeaningAlthough multivariate neuroimaging markers increase predictive power compared with univariate analyses, no depression biomarker could be uncovered that is able to identify individual patients.

doi: 10.1001/jamapsychiatry.2023.5483pmid: 38324323

Key PointsQuestionWhat is the current status of functional magnetic resonance imaging drug cue reactivity (FDCR) research, and how could it support the discovery of biomarkers to facilitate intervention development and clinical care for substance use disorders? FindingsIn this systematic review including 415 FDCR studies, results from 357 studies could potentially help develop diagnostic, prognostic, susceptibility, severity, monitoring, predictive, or response biomarkers. Substantial heterogeneity in task and study design was identified that can hinder biomarker development. MeaningA sizable literature supports the development of FDCR-derived biomarkers, but moving forward requires large-scale collaboration, methodological harmonization and optimization, and clinical and analytical validation.