Cambridge Health Alliance (CHA) is a healthcare provider in Cambridge, Somerville and Boston's metro-north communities in Massachusetts. CHA offers services including primary care, specialty care, and mental health/substance use services. It includes two acute care hospitals, primary care and specialty practice facilities, and the Cambridge Public Health Department. CHA maintains an affiliation with Beth Israel Deaconess Medical Center in Boston and is a Tufts University School of Medicine and Harvard Medical School teaching affiliate..
PURPOSE:Black maternal filicide is a rare but devastating form of family violence that remains poorly understood within women's mental health research. Existing scholarship has often emphasized individual psychiatric pathology while paying less attention to the structural conditions that shape maternal psychological distress, access to care, and opportunities for prevention. This study advances a structural psychological analysis of Black maternal filicide, examining how structural adversity contributes to severe mental health crises. METHODS:Using a qualitative comparative case study design, we examined four highly publicized cases of Black maternal filicide in the United States between 2011 and 2022. Data were drawn from publicly available court records, media reporting, and psychological evaluations where available. Guided by structural determinants of health, structural violence, Black feminist thought, and reproductive justice frameworks, we conducted a cross-case thematic analysis examining maternal psychological symptoms, institutional responses, and post-event narratives. RESULTS:Four interrelated themes emerged: severe psychological distress including depression, dissociation, and psychosis occurring without sustained access to mental health care; socioeconomic precarity, particularly housing instability, that intensified maternal stress; institutional surveillance without meaningful support across child welfare, housing, and mental health systems; and racialized media and legal responses that prioritized punishment over prevention. Across cases, maternal psychological crises unfolded within conditions of cumulative structural adversity and chronic trauma. CONCLUSIONS:These findings suggest that maternal filicide in these cases cannot be understood solely as individual pathology but must also be examined within broader structural environments that shape maternal mental health. Addressing maternal psychological distress requires structural interventions that expand access to mental health care, reduce socioeconomic precarity, and shift institutional responses from surveillance to prevention.
To investigate whether the use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in methadone-treated patients with opioid use disorder (OUD) and type 2 diabetes (T2D) is associated with improved cardiometabolic and mental health outcomes. This retrospective population-based cohort study of adults (≥ 18 years) on methadone with both OUD and T2D (hemoglobin A1c ≥ 6.5
Purpose of reviewPublic discussion has increasingly focused on violent incidents involving individuals diagnosed with schizophrenia, particularly those who are nonadherent with treatment or are in the early stages of illness before treatment needs are recognized.Recent findingsAlthough people with serious mental illness are somewhat more likely to commit violent acts than those in the general population, only a small proportion of individuals with schizophrenia do so, and they are far more often victims than perpetrators of violence. Misconceptions linking schizophrenia with violence contribute to stigma, delay early diagnosis and intervention, and divert attention from contributing factors such as substance use disorders. While structured assessment tools exist, precise methods for identifying those at highest risk for committing a violent act remain limited.SummaryEarly recognition of the prodromal phase of schizophrenia, combined with timely pharmacological and psychosocial interventions, can meaningfully reduce the risk of violence. Ongoing research should emphasize improving predictive tools and promoting effective prevention and treatment strategies.
Early studies of large language models (LLMs) in clinical settings have largely treated artificial intelligence (AI) as a tool rather than an active collaborator. As LLMs demonstrate expert-level diagnostic performance, the focus shifts from whether AI can offer valuable suggestions to how it integrates into physicians’ diagnostic workflows. We conducted a randomized controlled trial (n = 70 clinicians) to assess a custom system designed for collaborative diagnostic reasoning. The design involved independent diagnostic assessments by the clinician and AI, followed by an AI-generated synthesis integrating both perspectives, highlighting agreements, disagreements, and offering commentary. We evaluated two collaborative workflows: AI as first opinion (preceding clinician) and AI as second opinion (following clinician). Both improved clinician diagnostic accuracy over conventional resources, (85% and 82% vs. 75%). Performance was comparable across workflows and not statistically different from AI-alone accuracy (90%), highlighting the potential of collaborative AI to complement clinician expertise. Qualitative analyses illustrate how workflow design shapes human-AI interaction. C: NCT06911645.
Schizophrenia and related psychoses occur in all human populations, with the highest rates of diagnosis among Black individuals and those of mainly African ancestry1. Decades of research have established a highly heritable and polygenic basis for schizophrenia, which is mostly shared across populations2-4. However, a recruitment bias towards European cohorts5 has led to discoveries that are poorly generalizable to African populations. This exclusion of the world's most genetically diverse populations narrows our understanding of disease biology and risks exacerbating health disparities. Here we show that electronic health records linked with genomic data from the Million Veteran Program (MVP)6-a national research programme that looks at the effects of genes, lifestyle, military experiences and exposures on the health and wellness of veterans-enable a comprehensive assessment of schizophrenia genetics in populations of African ancestry in the USA. We identify ancestry-independent associations in African populations and expand the catalogue of implicated regions by more than 100 loci. Through statistical fine-mapping and integrative transcriptomic analyses, we refine disease-associated signals to consensus genes with convergent neurobiological functions. These findings provide a much-needed view of schizophrenia's genetic architecture in populations of African ancestry, and offer biological insights that both extend previous work and broaden its global relevance.
