Recovery Colleges (RCs) are community-based, co-produced educational initiatives that promote personal recovery, mental health, and well-being through collaborative learning grounded in recovery principles and adult education. Rather than functioning as clinical interventions, Recovery Colleges provide educational environments in which people with lived experience, professionals, relatives, and community members engage in shared learning and knowledge exchange. Despite their growing international implementation, many Recovery Colleges continue to rely on insecure, short-term funding arrangements, limiting their long-term sustainability and integration within recovery-oriented mental health systems. This Perspective examines the rationale for sustainable structural support by synthesizing current conceptual developments, emerging empirical findings, and practice-based experiences, with particular attention to lessons from German-speaking countries. Five evidence-informed arguments are discussed across individual, organizational, system, and community levels: Recovery Colleges may contribute to (1) strengthening self-determination and empowerment, (2) complement recovery-oriented mental health systems through education and peer-supported learning, (3) contribute to reducing stigma and strengthening mental health literacy, (4) foster co-production and recovery-oriented organizational cultures, and (5) support social inclusion and community participation. Although qualitative and mixed-methods studies increasingly suggest beneficial experiences associated with Recovery College participation, the current evidence base remains heterogeneous, and conclusions regarding effectiveness, cost-effectiveness, and broader system-level impacts require further high-quality research. Accordingly, Recovery Colleges should be understood as promising recovery-oriented educational infrastructures rather than established clinical interventions with demonstrated effectiveness. Sustainable structural support may enable Recovery Colleges to maintain their educational philosophy, co-production principles, and community-based orientation while becoming more sustainably embedded within mental health systems. Investment in Recovery Colleges therefore represents an investment in participatory, recovery-oriented infrastructures that recognize lived experience as a valuable source of knowledge and strengthen opportunities for inclusion, empowerment, and collaborative learning.
A Pilot Study of a DBT-Informed Caregiver Risk Management Workshop
Conditions: Caregivers; Suicide; Nonsuicidal Self Injury; Adolescent; Young Adult
Interventions: Behavioral: Workshop and consultation for caregivers of at risk youth
Sponsors: University of California, San Francisco
Not yet recruiting
Interventions: Behavioral: Workshop and consultation for caregivers of at risk youth
Sponsors: University of California, San Francisco
Not yet recruiting
Enhancing a Behavioral Intervention Using Rest-Activity Rhythm Monitoring via a Consumer Wearable in Older Dementia Caregivers and People With Dementia: Feasibility and Acceptability Study
Background: Despite being established risk factors for poor mental or brain health outcomes in aging, rest-activity rhythm (RAR) disturbances are not routinely monitored or treated. This is, in part, due to a lack of clinician-friendly RAR monitoring systems. Objective: We tested the feasibility and acceptability of personalizing a 6-week behavioral intervention using RAR monitoring from a consumer wearable device (Apple Watch). We selected a target population study of people with dementia and their family caregivers, given that rest-activity pattern disturbances are common in these groups. Methods: This single-arm trial enhanced a behavioral activation rhythm treatment with the Apple Watch–based app myRhythmWatch, providing users and their therapists with objective RAR monitoring for customizing therapy. Therapists used information from the myRhythmWatch app to visualize the participants’ behavioral patterns, identify treatment targets, and track progress. Participants included 21 older adults (15 dementia caregivers: mean age 61.8, SD 8.4 years; 6 people with dementia: mean age 81.45, SD 8.5 years). Feasibility outcomes were as follows: (1) proportion adherent enough to assess RARs (defined as ≥3 consecutive valid days with ≥20 hours per day) and (2) the total number of valid days. Acceptability was measured via the Likert scale to gauge participants’ satisfaction with the intervention. We secondarily examined preintervention and postintervention changes in depression (9-item Patient Health Questionnaire scores) and insomnia (Insomnia Severity Index) scores among a smaller group of 11 caregivers who completed these measures. Results: All 21 participants obtained the minimum data requirement for characterizing an RAR snapshot. Caregivers averaged 35 valid RAR monitoring days, and all 15 caregivers were still using the app at week 6 of the trial. In contrast, people with dementia averaged 30 valid days, and of the 6 people with dementia, only 6 were active users at the end of the trial. On average, caregivers completed 5.7 (SD 0.46) of the 6 therapy sessions offered, and participant satisfaction with program components was “high.” Depression symptoms improved with medium preintervention and postintervention effect sizes (=2.417; =.02; Hedges =0.67, 95% CI 0.04‐1.28), and there were large effect size improvements in insomnia symptoms (=3.377; =.004; Hedges =0.94, 95% CI 0.25‐1.61). Conclusions: These findings show that older adults without dementia were highly engaged with RAR monitoring. This supports the feasibility of personalizing interventions for older adults with objective RAR monitoring. Randomized controlled trials are warranted to determine whether adding RAR monitoring improves intervention efficiency, efficacy, or durability. While feasible in a subset of people with dementia, we observed lower use rates indicating that there are more barriers to implementing long-term consumer wearable–based RAR monitoring in people with dementia. Trial Registration: Clinicaltrials.gov NCT05309577; https://clinicaltrials.gov/study/NCT05309577
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Autism Target Discovered in Endothelial Cells in Genetic Deletion Mouse Model
Researchers at The Ottawa Hospital and at the University of Ottawa have been able to reverse certain behavioral symptoms in a mouse model of autism by fixing a problem in the endothelial cells (ECs) of brain blood vessels. Building on studies in a 16p11.2 deletion mouse model of ASD that identified brain endothelial cell abnormalities, the team linked 16p11.2 deletion with reduced levels of ATP in endothelial cells. They found that activating P2Y2 receptors rescued the 16p11.2-deletion-associated mouse behaviors.
The results present a promising new treatment target for autism spectrum disorder (ASD) symptoms. “The road from discovery to clinical trials is long, but we’re excited by the possibility that our findings might one day improve the daily lives of people with autism,” said Baptiste Lacoste, PhD, senior scientist at The Ottawa Hospital and professor at the University of Ottawa.
Baptiste is senior author of the team’s published paper in Neuron (“Purinergic receptor activation rectifies autism-associated endothelial dysfunction”), in which they concluded “These findings suggest that P2Y2 receptor activation represents a promising strategy to rescue brain EC dysfunction and, in turn, improve autism-related behaviors in the 16p11.2 deletion ASD syndrome.”
Autism is a neurodevelopmental condition with widely varying characteristics. Some of the behavioral symptoms can make life more challenging. While many people with autism have found ways to manage these symptoms, no drug treatment exists.
Lacoste’s team previously discovered that blood vessels in the brain don’t work properly in mouse models with a 16p11.2 deletion, one of the most common genetic mutations seen in autism. They were the first to look at what was happening in the blood vessels of the brain. “Recent evidence in a 16p11.2 deletion mouse model of autism spectrum disorder (ASD) revealed brain endothelial abnormalities postnatally, but the endothelial alterations eliciting these changes remain unknown,” they wrote.
Through their newly reported work the researchers have now found that the problem began in the endothelial cells lining the blood vessels. These cells make sure blood quickly gets to the parts of the brain that are active. This responsive blood supply is needed for proper brain function.
However, the endothelial cells in the 16p11.2 deletion mice don’t respond quickly enough. This happens early in brain development and causes behavioral symptoms later in life, including hyperactivity, repetitive movements, and motor learning impairment.
Headed by former PhD student, Julie Ouellette, PhD, the research team looked at what was wrong with these endothelial cells and whether it could be fixed. They discovered that the cells had half the normal level of ATP. “We demonstrate that 16p11.2 deletion induced EC dysfunction is caused by a bioenergetic failure with reduced intracellular ATP,” they explained. While ATP is usually considered an energy molecule, in this case the cell was missing its target, called a P2Y2 receptor, on its surface. “The identified energetic failure was restricted to ECs, emphasizing these cells as key contributors to ASD pathophysiology,” the investigators added.
By activating this P2Y2 receptor, the researchers were able to restore the cell’s function, increase blood flow in the brain, and reverse the behavioral symptoms in adult mice. This was achieved using a drug known to activate P2Y2 and which is currently approved for humans in Japan and South Korea to treat dry eye syndrome.
“Activation of ATP signaling via endothelial P2-class purinergic receptors, specifically P2Y2, rescued EC dysfunction, restoring angiogenic capacity in vitro, endothelium-dependent cerebrovascular reactivity ex vivo, and activity-dependent cerebral blood flow (CBF) in vivo,” the team stated. “A selective pharmacological P2Y2 agonist also rescued adult 16p11.2-deficient behavioral phenotypes.”
Lacoste said, “It’s as if these cells are asleep, and now we can wake them up. And we may only need to treat them once to wake them up permanently. We will test that further, but it’s an encouraging feature for a future treatment.”
In their paper the authors concluded, “Taken together, this study demonstrates that metabolic reprogramming of brain ECs via purinergic receptor engagement represents a promising therapeutic avenue for ASD.” They also point out that the study only looked at adult mice. This means targeting P2Y2 could reverse behavioral symptoms that were already well established.
Next, the team plans to treat mice earlier in life to see if early treatment has additional benefits. The team has also filed a patent application for using P2Y2 activation in the blood vessels to treat autism symptoms. They are interested in exploring drug development with the aim of eventual clinical trials.
The post Autism Target Discovered in Endothelial Cells in Genetic Deletion Mouse Model appeared first on GEN – Genetic Engineering and Biotechnology News.
Generative AI Adoption in Psychotherapy Practice Among Mental Health Professionals: Multicountry Cross-Sectional Survey
<strong>Background:</strong> Generative AI (GenAI) tools, such as OpenAI’s ChatGPT, Google’s Gemini, and Microsoft Copilot, are being adopted across health care settings. Despite the popularity of GenAI, empirical data on the extent of adoption by mental health clinicians in routine psychotherapy practice are scarce. <strong>Objective:</strong> This study aimed to characterize purposeful GenAI use among mental health professionals providing psychotherapy, including tools used, purposes, perceived workload effects, and the organizational context surrounding use. <strong>Methods:</strong> We conducted a cross-sectional online survey between January 13, 2026, and March 30, 2026. A convenience sample of trained mental health professionals who had provided psychotherapy within the previous 12 months was recruited through professional associations and academic and clinical mailing lists, with snowball dissemination by email. The survey assessed lifetime purposeful GenAI use in psychotherapy practice; tools and purposes of use; perceived work burden reduction; and, for the previous 12 months, employer or professional organization encouragement, prohibition, and participation in AI training. Descriptive statistics were calculated. Univariable logistic regression models were used to examine associations between GenAI use and candidate factors. Variables meeting an entry criterion of <i>P</i><.10 were entered into a multivariable logistic regression; statistical significance was set at <i>P</i><.05. <strong>Results:</strong> A total of 766 mental health professionals who provide psychotherapy in 30 countries completed the survey. Of these, 54.6% (n=418, 95% CI 51.0%-58.1%) reported having purposely used at least 1 GenAI tool in clinical psychotherapy practice. ChatGPT was the most frequently used tool (354/418, 84.7%, 95% CI 81.2%-88.2%). The most commonly reported clinical purpose was assisting with treatment planning (175/418, 41.9%, 95% CI 37.1%-46.7%), followed by managing administrative tasks (n=173, 41.4%, 95% CI 36.6%-46.1%) and generating psychoeducational materials for clients (n=166, 39.7%, 95% CI 35.0%-44.4%). Among AI users, 82.8% (346/418, 95% CI 79.1%-86.4%) reported that these tools reduced their overall work burden. Only 18.1% (139/766, 95% CI 15.4%-20.9%) of respondents reported institutional encouragement to use GenAI tools, while 81.1% (n=621, 95% CI 78.3%-83.9%) reported not having received any professional training on AI use. In multivariable logistic regression (α=.05), younger age was associated with GenAI use, while practice setting showed mixed evidence of association. The overall adjusted effect of practice setting did not reach statistical significance (<i>P</i>=.07), although urban practitioners had lower odds of GenAI use than rural practitioners (adjusted odds ratio 0.614, 95% CI 0.388-0.971; <i>P</i>=.04). <strong>Conclusions:</strong> This study extends previous predominantly national and profession-specific research by providing a multicountry, multiprofessional snapshot of reported GenAI use in psychotherapy practice. Use extended beyond administrative tasks into clinically consequential activities, including treatment planning and psychoeducation, while participation in professional AI training remained relatively uncommon. Findings highlight the need for professional bodies, health systems, and training programs to develop practical guidance and competencies for safe, privacy-conscious, and clinically appropriate GenAI use.
The STORY MINE Digital Recovery Narrative Intervention for Personal Recovery in Mental Health Care: Pilot Randomized Controlled Trial
Background: Hope and confidence support personal recovery by helping individuals with mental illness to rediscover meaning, enhance social connections, and build fulfilling lives. Digital recovery narrative interventions may help stimulate these recovery processes by providing access to hopeful lived-experience stories. Objective: This pilot feasibility randomized controlled trial evaluated the feasibility, acceptability, and exploratory outcome signals of STORY MINE, a novel digital intervention based on hopeful recovery narratives, to support personal recovery among adult service users receiving specialized mental health care at a Dutch psychiatric institute. Methods: Adult service users receiving outpatient specialized mental health care were recruited through clinician referral and self-enrollment. Participants (N=28) were randomized (1:1) to either intervention (STORY MINE access for 12 wk alongside care as usual) or control (care as usual only). Feasibility and acceptability were assessed via platform usage data, evaluation questions embedded within the intervention, and postintervention feedback. Quantitative outcomes were assessed at baseline and postintervention using validated self-report questionnaires on mental health confidence, hope, self-stigma, and personal recovery. Descriptive statistics and exploratory effect sizes with 95% CIs were calculated. Qualitative feedback was analyzed thematically to explore user experiences and perceived impact. Results: All participants (N=28) completed self-report questionnaires, while 13 of 14 participants in the intervention group provided evaluation feedback. Feasibility and acceptability were rated positively (mean 7.7, SD 2.52). Engagement was low, with a mean of 2.77 (SD 1.49) active login days per participant over 12 weeks, with some participants reporting minor technical barriers to use. Participants reported mixed perceived recognition (identification with narratives) and relevance (perceived applicability), but qualitative findings indicated perceived benefits including increased meaning-making, inspiration, and connectedness to recovery narratives. Some reported STORY MINE contributed to their recovery process (eg, narratives provided practical tips and evoked meaning-making and more positive self-evaluation). However, mixed emotional responses were reported; one participant reported narratives triggered distressing memories. Exploratory analyses showed small negative effect sizes for mental health confidence (Cohen =−0.32, 95% CI −1.07 to 0.42), hope (Cohen =−0.45, 95% CI −1.20 to 0.30), and self-stigma (Cohen =−0.33, 95% CI −1.08 to 0.42), and a medium negative effect size for personal recovery (Cohen =−0.53, 95% CI −1.28 to 0.22). These effect estimates decreased after excluding 2 participants experiencing an acute mental health crisis during the study period. Conclusions: STORY MINE appears feasible and acceptable as a supplement to specialized mental health care, although low engagement and mixed emotional responses highlight the need for refinement, particularly to improve user engagement, emotional safety, perceived relevance, and accessibility of the intervention. Findings should be interpreted cautiously given the pilot design and small sample size. A fully powered randomized controlled trial is warranted to evaluate effectiveness.
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Psychological and Contextual Factors of AI Acceptance Among Informal Caregivers of People Living With Dementia: Cross-Sectional Pilot Study
Background: Informal caregivers make up a large share of the care provided to people living with dementia, and experience an elevated risk for anxiety, depression, and caregiving burden. Technology-based interventions, such as mobile apps, aim to support informal caregivers by providing information, training, and mental or social support. Considering the diverse nature of the caregiver experience, AI is being incorporated into such interventions to create more tailored and specific support; however, AI hesitancy may serve as a significant barrier to usage. Objective: The study aimed to preliminarily assess the levels of AI acceptance in adult informal caregivers of people living with dementia, and generate hypotheses regarding the psychological and contextual factors of AI acceptance. Methods: Adult, unpaid caregivers were recruited through social media and community partners. A cross-sectional, web-based survey was administered through Qualtrics (Qualtrics, LLC) to evaluate AI acceptance and psychological flexibility (PF). AI acceptance was measured using the Attitude Towards Artificial Intelligence (ATTARI-12) scale, while PF was measured using the Personalized Psychological Flexibility Index (PPFI). Social needs were assessed by the ’Accountable Health Communities Health Related Social Needs (AHC-HRSN) tool (Centers for Medicare and Medicaid Services). Descriptive, correlational, and regression analyses were performed to examine the associations between these factors and AI acceptance. Results: Overall, 31 informal caregivers of people living with dementia completed the survey. With an average age of 60 (SD 10.6) years old, the majority of caregivers were women (29/31, 94%), Caucasian (25/31, 81%), highly educated (24/31, 77% completed some form of higher education), and currently serving in a caregiver role (21/31, 68%). Mean PPFI and ATTARI-12 scores were moderate (66.4, SD 10.3, and 3.01, SD 0.55, respectively), demonstrating a neutral attitude regarding AI use. In bivariate analyses, ATTARI-12 differed by the caregiver-perceived illness severity (<.001). Linear regression suggested trends that the PPFI acceptance subscale (β=.05, 95% CI 0.002‐0.097; =.04) was associated with ATTARI-12 scores. Conclusions: This study suggests that caregivers’ acceptance of such technology may vary according to their care recipient’s disease severity and the acceptance subscale of the PPFI. Additionally, the study provides justification for using the ATTARI-12 and PPFI scales to assess AI acceptance and PF in informal caregivers of people living with dementia, respectively. Future research should explore these factors across a larger and more diversified cohort to further generalize and confirm our findings.
Managing School Avoidance in Children With Obsessive-Compulsive Disorder
– Elizabeth Deckler, MD1,2,3, Stephanie Rohrig, PhD2,3, Anthony Puliafico, PhD1,2
– Columbia University Medical Center, NewYork-Presbyterian Hospital, Weill Cornell Medical Center
What is School Avoidance?
School avoidance refers to a young person missing school due to anxiety or another mental health concern. School avoidance is different from truant behavior, when a student misses school without a lawful or valid excuse, and school withdrawal, when a parent holds a child back from school. School avoidance can be very distressing for children and their parents. Frequent school absence puts the child at risk of falling behind both academically and socially. School avoidance is a clinical concern that pediatricians and child and adolescent providers see regularly.
School avoidance is not a diagnosis, but rather a behavior that is often associated with mental health symptoms. It is typically seen in children with obsessive-compulsive disorder, social anxiety disorder, separation anxiety disorder, generalized anxiety disorder, and panic disorder, among other psychiatric conditions. This is expected because going to school triggers the exact discomfort children with these conditions try very hard to avoid. Children with social anxiety may fear interacting with peers and teachers. Those with separation anxiety fear leaving their parents. Children with generalized anxiety or panic disorders worry that their symptoms will flare up while at school.
How are OCD and School Avoidance Related?
Many children struggling with obsessive-compulsive disorder experience some degree of school avoidance. Obsessive-compulsive disorder, or OCD, is a mental health condition characterized by frequent intrusive thoughts, images, or urges (obsessions) and repetitive acts or behaviors intended to ease the anxiety caused by the obsessions (compulsions). A 2025 study published in Child Psychiatry & Human Development examined the relationship between OCD and school avoidance. The study, which took place in Sweden, included 385 children with OCD. At their first visit, 22% of the 385 children were attending school only partially or not at all. The study found that after these children were treated for OCD, more than half of them were able to return to school. The high degree of school avoidance in children with OCD, as well as the improvement in school attendance with OCD treatment, highlights the relationship between the two conditions.
What Does School Avoidance Look Like Within OCD?
School avoidance looks different in every child. Common reasons for school avoidance among children with OCD have included obsessions relating to school performance, compulsions that interfere with the child’s ability to get to school, and contamination of school bathrooms. A prolonged morning ritual, anxiety about using public transportation, and embarrassment over performing compulsions in a public setting are also commonly reported.
The following case example illustrates how school avoidance can develop in a child with OCD.
“Molly is a 15-year-old adolescent in 9th grade at her local high school. She earns good grades, participates in multiple extracurriculars, and plays soccer on her school’s team. She was diagnosed with OCD in fifth grade after her teachers noticed that she felt compelled to open and close her locker exactly four times whenever she used it. She was able to successfully treat her obsessions and compulsions with exposure and response prevention therapy (ERP). However, several years later, her OCD symptoms returned and became more severe. Homework that would usually take two hours to complete now took six. Molly spent hours proofreading her essays for errors until it felt “just right,” checking over her math homework exactly four times, and repeatedly reviewing her online homework portal to confirm that her assignments were uploaded. She knew that the double checking was excessive, but she struggled to stop. Molly also had an intense fear of germs. Using the bathroom at school became a struggle. She noticed that every time she entered the school bathroom, she needed to wash her hands for ten minutes to help her feel safe from the germs.
After two months of struggling with these compulsions, Molly started avoiding school. At first, she missed about one day every two weeks. But after a few weeks, she was missing several days per week. To Molly, staying home felt easier than facing anxiety-provoking situations at school. Once she started falling behind in her schoolwork as a result of missing class, she found it even more difficult to return. The thought of explaining her absences to teachers and peers, as well as the incomplete assignments piling up, made Molly feel like it would be impossible to return.
Molly’s experience is surprisingly common. The relationship between obsessive-compulsive disorder and school avoidance is seen clinically and is well established in the literature. However, practical guidance on preventing school avoidance in children with OCD, and helping children who are already avoiding school return, can be hard to find.
What Can We Do? Recommendations for Parents:
Parents play a significant role in preventing school avoidance in their children. A major aspect of OCD treatment is parental education on limiting accommodation. Parental accommodation refers to changes in routines or behaviors made to reduce a child’s distress. Examples of this include helping the child perform compulsions, planning meals around foods that the child sees as safe, and allowing the child to stay home from school due to their anxiety. If a child with OCD starts avoiding school for any reason, parents should tell their treating clinician as soon as possible.
It may feel easier to allow children to miss school when anxious, but this is counterproductive. Parents need to set limits around missing school. We recommend that parents limit children’s access to screens while they are home from school. Parents can also set clear limits, such as not allowing preferred after-school activities on days when the child does not attend school. Children should view staying home from school as boring.
Parents should also validate their child’s anxiety. OCD is a serious mental health condition that causes significant distress. When children express their worries about school to parents, they should listen, ask follow-up questions, and relay their understanding and care for the child. However, parents should be careful not to reassure the child. Reassurance seeking is a common behavior in OCD, and children with OCD struggle with uncertainty. Seeking reassurance is a form of compulsion. For children to improve their OCD symptoms, they need to practice experiencing uncertainty without reassurance. Examples of reassurance seeking include asking a parent if they believe the school bathroom is clean, having a parent confirm that they performed their rituals correctly, and asking if they think they are going to fail an upcoming quiz.
Exposure and response prevention, a critical part of the treatment for OCD, involves exposing children to places, thoughts, or situations that trigger their obsessive fear. The child then resists the urge to perform a compulsion. This type of therapy is challenging. Over time, this exercise decreases the fear and anxiety associated with the trigger. Children can participate in exposure and response prevention at school. If the child’s obsessive fear involves school performance, attending school and completing assignments exposes them to that trigger. If germs are an obsessive fear, using the bathroom at school is a helpful exercise in ERP. We recommend parents recognize the difficulty of this type of therapy and praise the child for facing triggers at school.
What to Expect From Your Child’s Therapy
The first step in treatment is evaluating current OCD symptoms. Your clinician will do a thorough assessment of your child’s obsessions and compulsions, particularly those related to attending school. If this is the first time your child is receiving treatment for OCD, your clinician will likely recommend a combination of exposure and response prevention therapy and medication, as research has shown this to be the most effective approach. It is also common for school avoidance to emerge in children who have already been undergoing treatment for OCD. In that case, your child’s therapist will assess for changes in the condition that may warrant a different treatment plan.
The most important part of therapy for school avoidance is school reentry. Your therapist will work with you and your child to create a plan for returning to school. School reentry plans look different for every child. They can range from going back to school full time immediately to seeing the guidance counselor one day, attending one class the next day, and slowly working up to a full school day. Some children need more support returning to school, and in these cases, your therapist may recommend utilizing a higher level of care. Higher levels of care include partial hospital programs and intensive outpatient programs. Partial hospital programs and intensive outpatient programs are forms of mental health treatment where the patient lives at home but attends a treatment program during the day. At these programs, your child will meet daily with providers such as psychiatrists, therapists, and social workers experienced in treating school avoidance.
How to Advocate for Your Child in School
Schools can be invaluable partners in treating your child’s school avoidance. Parents should request that the school designate a “go-to” person for the student to meet with if they are struggling with mental health difficulties at school. This allows the child to see school as a safe place to experience OCD symptoms. Parents should also ask the school to implement the reentry plan the child developed with the therapist. We recommend parents work closely with their child’s teachers to manage missing assignments and prevent falling behind academically.
The post Managing School Avoidance in Children With Obsessive-Compulsive Disorder appeared first on International OCD Foundation.
Self-medication of attention-deficit/hyperactivity disorder symptoms with psychoactive substances in adults: a scoping review of how symptom-relief motives are framed and operationalised across substances
IntroductionAdults with attention-deficit/hyperactivity disorder (ADHD) use tobacco, cannabis, alcohol, cocaine and non-prescribed stimulants far more than the general population. The self-medication hypothesis holds that people with ADHD, including those undiagnosed, use substances to relieve core symptoms rather than for recreation or shared vulnerability to addiction, and is widely invoked to reframe illicit substance use as undiagnosed ADHD. How this claim is framed and tested has not been mapped across substances.ObjectiveTo map the literature invoking self-medication of ADHD symptoms in adults, substance by substance, and to characterise how each source frames the concept relative to misuse, recreational or shared-liability accounts.Eligibility criteriaEmpirical studies, reviews, commentaries, preprints and trial-register records on self-medication of ADHD symptoms with a psychoactive substance in adults or predominantly adult samples; English; inception to 21 July 2026.Information sourcesPubMed, OpenAlex and Consensus, with ClinicalTrials.gov and a preprint search. Searches were conditioned on self-medication and motive terminology, so the corpus maps the self-medication literature and does not sample the misuse or shared-liability literature independently.Charting methodsSources were charted for substance, design, population, operationalisation of self-medication, and a framing category (self-medication-framed; mixed; misuse- or shared-liability-framed; neutral/descriptive). A descriptive map was built by substance. No critical appraisal or evidence-strength ranking was made.ResultsOf 937 records identified and 820 screened, 109 sources (1986–2026) met the criteria. Coverage was heaviest for non-prescribed stimulants (n=35), cannabis (n=29), nicotine (n=25) and alcohol (n=17); no eligible ketamine source was identified. Self-medication framing was most prevalent, and uniquely accompanied by experimental data, for nicotine; prevalent but observational for cannabis; coexisted with academic and recreational motives for stimulants; and alcohol was mostly framed as comorbidity or shared liability. Self-medication was overwhelmingly inferred from association or motive report rather than tested against symptom change.ConclusionsSelf-medication framing is substance-specific in prevalence and accompanying evidence. Because the search was conditioned on self-medication terminology, the map describes how the literature frames the claim and does not adjudicate between competing accounts. Applying self-medication as a blanket explanation for substance use in people with ADHD symptoms is not warranted by how the claim has been tested.
Timely outpatient follow-up and readmission risk in schizophrenia
Timely outpatient follow-up after psychiatric hospitalization has been proposed as a key strategy to reduce readmission; however, evidence in patients with first-admission schizophrenia remains limited. Using the Korean National Health Insurance Claims Database, we conducted a nationwide retrospective cohort study of 1,961 patients with first-admission schizophrenia, defined as having no psychiatric service utilization during the preceding three years. We examined whether outpatient follow-up within 30 days after discharge was associated with the risk of readmission within 365 days. Adjusted Cox proportional hazards models were used to estimate hazard ratios across multiple cumulative follow-up periods (60, 90, 120, 150, 180, and 365 days), controlling for sociodemographic and clinical factors. Kaplan–Meier analysis was used to assess differences in readmission-free survival. Among the study population, 53.2% received outpatient follow-up within 30 days after discharge. When evaluated across progressively longer cumulative follow-up periods, outpatient follow-up was associated with a significantly lower risk of readmission at 60 days (aHR = 0.52, 95% CI: 0.29–0.95), 90 days (aHR = 0.55, 95% CI: 0.35–0.88), 120 days (aHR = 0.63, 95% CI: 0.43–0.94), 150 days (aHR = 0.66, 95% CI: 0.46–0.95), and 180 days (aHR = 0.70, 95% CI: 0.51–0.98), but not at 365 days (aHR = 0.79, 95% CI: 0.61–1.02). Kaplan–Meier analysis showed longer readmission-free survival in the follow-up group, although the difference was more pronounced over shorter follow-up durations. Timely outpatient follow-up was associated with reduced readmission risk over shorter cumulative follow-up periods, with attenuation of the association as the follow-up duration increased.