Can personality disorder treatments be reduced to just a few months?

The evidence base for personality disorder treatments, like dialectical behavioural therapy (DBT) or mentalisation-based treatment (MBT), points towards treatments that last at least a year. Within the mental health field in general, though, in many countries there's a drive towards offering shorter treatments. But how short is too short, considering the needs of people with personality-related difficulties and the challenges in developing a therapeutic relationship?

In this episode, Mike Crawford talks about a new study into a treatment of just 10 sessions using Structured Psychological Support, which draws on elements of DBT and MBT. We talk about the language used around personality disorder, how caution is now needed in reducing treatment duration, and about what to take forwards from this study for future treatment development.

Click here to read the full article:
https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(25)00372-4/fulltext

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How did the COVID-19 pandemic affect mental health? 

Now that some years have passed since the pandemic's height, we can learn more from synthesising all the evidence about its shorter and longer term effects. 

In this episode, Ethelreda Nakimuli and Peter Jones talk about two new papers that gather the past 5 years of work on the pandemic and mental health and policy approaches. They talk about the different effects of the pandemic on different groups' mental health, how mental health care was affected, and about what we can learn for future crises about different types of public health response to the pandemic.

Click here to read the full articles:

• https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(25)00247-0 /fulltext
• https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(25)00358-X/fulltext

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Body dissatisfaction has been rising among adolescents in recent years, and so have symptoms and diagnoses of mental disorders. To help us know what to do about increasing youth mental ill health, we need better understandings of what is driving it, but causal factors are hard to pin down. 

In this episode, Ilaria Costantini and Francesca Solmi talk about their new study that uses a longitudinal twin study to disentangle the genetic and environmental factors in the associations between adolescent body dissatisfaction and later symptoms of eating disorder and depression. We think about why body dissatisfaction is such a key factor and talk about ways it could be tackled.

Click here to read the full article: https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(25)00333-5/fulltext?dgcid=tlcom_podcast_acq-december25_lanpsy

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Weight gain is a typical side-effect of taking antipsychotics and can have a big impact on people. But for young people with bipolar disorder, metformin isn't commonly prescribed alongside an antipsychotic. In this episode, Melissa DelBello describes a huge randomised trial in the USA on metformin for young people with bipolar disorder taking antipsychotics, looking at its effects over a 2-year period.

Click here to read the full article: https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(25)00273-1/fulltext

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Up to 1 in 4 women and birthing parents experience perinatal mental health difficulties, but there isn't enough evidence around interventions that could help them, especially interventions that work with the parent-infant bond or that focus on a broad range of mental health difficulties rather than specific disorders. 

Camilla Rosan talks about what's needed in perinatal mental health services, and tells us about the trial she just led on Circle of Security-Parenting (COS-P), a group intervention for birthing parents with infants aged under 1 year.

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https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(25)00263-9/fulltext?dgcid=buzzsprout_icw_podcast_October_25_lanpsy

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People living with dementia often have behavioural and psychiatric symptoms, such as agitation, and when these are severe, antipsychotics can be prescribed. Guidelines recommend prescribing antipsychotics at the lowest possible dose for the shortest possible time, but does this really happen in practice? 

Juan Carlos Bazo Alvarez and Claudia Cooper's research team looked at primary care data from the UK, to assess prescribing practice, and found that prescriptions are higher and for longer than is recommended. In the podcast, we talk about their study and how things could be improved.

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https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(25)00261-5/fulltext?dgcid=buzzsprout_icw_podcast_September_25_lanpsy

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Why is physical health so important for people with mental illness? In this episode, we talk about a new paper on lifestyle interventions for people with mental illness, covering which aspects of those interventions are beneficial for physical and mental health, and looking at key recommendations for how to implement these interventions in mental health settings. 

Kasia Machaczek, Scott Teasdale, and Joe Firth talk about their new paper on this topic, which extends the work of a 2019 Lancet Psychiatry Commission on physical health in people with mental illness.

Read the Commission:

https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(25)00170-1/fulltext?dgcid=buzzsprout_icw_podcast_August_25_lanpsy

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What if you could see the voice inside your head? 

Auditory hallucinations in schizophrenia are often distressing, as the voices are often malicious and unrelenting. In a new type of immersive virtual reality-based therapy, a 3D avatar of the voice is built by the patient and therapist, and it is then confronted together during the sessions. 

In this podcast, we discuss the randomised controlled trial of a large study into this VR therapy, and we hear from one of the participants in the study and one of the study therapists, as well as the lead on the study.

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https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(25)00161-0?dgcid=buzzsprout_icw_podcast_July_25_lanpsy

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Transgender and gender diverse people experience disproportionately high levels of interpersonal violence, but they also face multiple barriers to receiving quality post-violence care, with knock-on effects for their mental health. 

Katrina Kennedy and Rose Pollard Kaptchuk talk with Sophia Davis about the values and preferences of trans and gender diverse people around post-violence health sector responses. Their review on this topic will inform new WHO guidelines on the health of trans and gender diverse people, and here they talk about the key themes they found.

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https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(25)00091-4/fulltext?dgcid=buzzsprout_icw_podcast_Jun_25_lanpsy

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Which medications should be the first choice for prescribing for anxiety in older adults? Anxiety is common in older adults, but a lot of research on medication for anxiety is done in younger adults and doesn't take into account the different needs of and side-effects risks for older adults.

Andrea Iaboni talks with Sophia Davis about her group's review of medications for anxiety in older adults, discussing the evidence base to inform patients and clinicians on antidepressants, benzodiazepines, and other medications. This study is part of a series of reviews to help create new Canadian treatment guidelines; read more about the guidelines here: https://ccsmh.ca/areas-of-focus/anxiety/

Read the full Article:

https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(25)00100-2/fulltext?dgcid=buzzsprout_icw_podcast_May_25_eclinm

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