Weight gain and impaired glucose metabolism are common complications of antipsychotic treatment in schizophrenia spectrum disorders (SSD). While beneficial in other populations, the efficacy and safety of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in SSD remain unclear. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating GLP-1 RAs versus placebo in SSD patients treated with antipsychotics. PubMed, Scopus, and Web of Science were searched until January 2026. Random-effects models were used to pool mean differences (MDs), standardized mean differences (SMDs), and risk ratios (RRs), as appropriate. Seven RCTs including 481 participants were included. Compared with placebo, GLP-1 RAs significantly reduced body weight (MD −6.98 kg; 95% CI −10.53 to −3.43), BMI (MD −2.51 kg/m²; 95% CI −3.51 to −1.51), waist circumference (MD −5.05 cm; 95% CI −6.66 to −3.44), HbA1c (MD −0.32 percentage points; 95% CI −0.38 to −0.26), and fasting blood glucose (MD −0.54 mmol/L; 95% CI −0.83 to −0.25). Heterogeneity was substantial for body weight (I²=93%) and BMI (I²=80%). No significant effects emerged for blood pressure or lipid parameters. Psychiatric symptom severity did not differ between GLP-1 RAs and placebo (SMD −0.05; 95% CI −0.36 to 0.25). Gastrointestinal adverse events were more frequent with GLP-1 RAs than with placebo, while overall study drop-out did not differ between groups. GLP-1 RAs improve short-term anthropometric and glycemic outcomes in SSD patients treated with antipsychotics. However, the limited number of trials, substantial heterogeneity in weight-related outcomes, and relatively short follow-up warrant cautious interpretation and further large-scale RCTs.
Postpartum depression (PPD) affects approximately 17% of women globally and is predicted by prior mental illness and socioeconomic disadvantage. Emerging evidence suggests that negative bias in the cognitive processing of infant cues and heightened reactivity to infant distress during pregnancy contribute to PPD risk and may thus represent a treatment target. This randomized controlled trial examined whether prenatal affective cognitive training (PACT) reduces PPD risk by modulating negative biases in pregnant women at heightened risk. Of 280 women assessed, 147 at heightened risk were randomized to PACT or care as usual (CAU). PACT comprised five individualized 90-minute sessions over five weeks, combining computerized and virtual-reality tasks targeting negative cognitive bias, attentional bias, emotion regulation, and working memory in response to infant stimuli. Affective cognition was assessed at baseline and post-intervention; mood was rated at baseline, post-intervention, and weekly for six weeks after birth. Diagnostic interviews (Present State Examination) were conducted six months postpartum. The primary outcome was PPD incidence within six months postpartum; secondary outcomes included depressive symptoms over the first six weeks and changes in affective cognition. Follow-up data were available for 121 (83%) participants (PACT n = 54; CAU n = 67). PACT did not significantly reduce PPD overall (p = 0.18) or depressive symptoms (p = 0.31) but increased positive interpretation of infant emotions (p = 0.003). Exploratory analyses indicated lower PPD incidence among multiparous participants receiving PACT than CAU (5% vs. 35%; OR=0.10, 95% CI [0.01–0.92], p = 0.04) and additional parity-specific changes in affective cognition. These exploratory findings require replication in larger trials. Trial registration The trial was registered at ClinicalTrials.gov with Trial number NCT06046456 on 21 September 2023 https://clinicaltrials.gov/study/NCT06046456.
In youth–i.e., adolescents and young adults–mental disorders represent a major burden on well-being and quality of life. This scientometric study aimed to map research trends concerning any mental disorder in youth. We searched the Web of Science Core Collection for studies published between 01/01/1985 and 28/08/2025, using keywords on mental disorders and youth. Co-citation reference networks were extracted. R-bibliometrix/CiteSpace were used. 65,684 studies were included, forming a well-structured co-reference network. A trend in the 1980s concerned the prevalence/outcomes of specific mental disorders such as depressive and anxiety disorders. In the 1990s/2000s, research trends concerned assessment tools, pharmacotherapy (e.g., antidepressants, antipsychotics), bipolar disorders and schizophrenia. In the 2010s, early intervention for psychosis was a dominant focus, influencing prevention in mental health. The 2010s also focused on ADHD, eating disorders, gaming disorder, autism, depression and suicide, fMRI, and transgender health, beyond gender dysphoria. In the 2020s, a recent trend has increasingly focused on global evidence on the age at onset and burden across mental disorders, access to care, network analysis, and COVID-19. Over time, research has broadened the focus from adolescence to youth across mental health problems. Both disorder-specific and transdiagnostic research trends were observed. Novel trends in 2023–2025 included substance use, lifestyle psychiatry, evidence synthesis and non-suicidal self-injury. Most studies were conducted in Western countries. Underrepresented research areas included the involvement of youth with lived/living experience in identifying meaningful outcomes, open science, implementation research, economic evaluations, machine-learning approaches, and social determinants of mental health.
