Climate change is a global health crisis with substantial mental health consequences. Despite its growing impact, climate-related mental health topics remain insufficiently integrated into medical education. This review synthesizes studies describing educational interventions and assessment tools that address the intersection of climate change and mental health. We conducted a narrative literature review across PubMed, Education Resources Information Center, and PsycINFO in March 2025. Studies were included if they described an educational intervention related to climate-health topics with mental health content or relevance, involved learners in health-related fields, and reported outcomes using validated or author-developed instruments. Fifteen studies met inclusion criteria. Seven described educational interventions, including longitudinal curricula, clerkship sessions, telementoring, and innovative formats such as narrative medicine and reflective tool kits. Fourteen studies included assessment tools, though only one reported psychometric validation (Cronbach's α=0.90). To characterize heterogeneity, studies were grouped by type of climate-health educational focus: direct clinical mental health education (n=9), general climate health education with mental health implications (n=3), and climate-health curricular gap analyses (n=3). Across interventions, outcomes demonstrated improved knowledge, confidence, and preparedness to address climate-related psychological impacts, but barriers remain, particularly limited faculty training, institutional constraints, and absence of validated evaluation frameworks. Current efforts to integrate climate-mental health topics into medical education are promising but still fragmented. Advancing the field requires standardized curricula with explicit and related mental health content, validated assessment tools, interdisciplinary faculty development, learner-centered approaches, climate justice and health equity principles in training, inclusion in board exams, and long-term evaluation.

Peer support has proven effective in improving clinical, psychosocial, and recovery-oriented outcomes for persons with serious mental health challenges. This review builds on this evidence with the goal of identifying the competencies and implementation features of peer support interventions. We identified 41 articles for inclusion. Eligible studies consisted of randomized controlled trials that tested the effectiveness of peer support services for adults living with serious mental health challenges. We extracted and synthesized data on the competencies peer supporters demonstrated and implementation elements, including recruitment, training, supervision, and quality monitoring. Most studies were from high-income country settings, with the majority from the United States (75.6%). A competency taxonomy was developed based on the Substance Abuse and Mental Health Services Administration’s peer support core competencies guidelines, and through additional thematic content analysis. Out of the 16 peer support and clinical competencies identified, the most frequently deployed peer support competencies were collaboration and care (90%), providing support (83%), and communication (73%); the most frequently deployed clinical competency was mental health diagnosis and psychoeducation (51%). Peers were primarily recruited from community organizations. Although reports on training length and format were inconsistent, trainings were most often reported as in person and ranged from a few hours to 192 hours. Supervisors of peer supporters included more experienced peer supporters, clinicians, or other staff, and supervision consisted of reviewing quality ratings and providing feedback on specific cases. Our findings confirm the salience of a relatively small set of competencies across peer support interventions which could be considered universal for standardization and scaling up, as well as best practices for training and supervision. Future research should aim to identify additional competencies that are contextually sensitive or address the needs of vulnerable groups.

Traumatic brain injury (TBI) is frequently associated with significant neuropsychiatric sequelae. Recovery trajectories are highly variable; injury severity is only one influence. Other factors, including preexisting psychiatric or psychological factors and psychosocial contexts also influence recovery. In this clinical challenge, we present the case of a young woman with a history of psychiatric comorbidity who developed complex neuropsychiatric symptoms after sustaining a TBI following a motor vehicle accident. Her clinical presentation included posttraumatic headache, chronic pain, visual disturbances, difficulty returning to work, and prominent anxiety and posttraumatic stress disorder symptoms. These challenges required a coordinated, multidisciplinary approach to treatment, focused both on symptom management and functional recovery. Psychotherapy played a central role, with a modified exposure-based approach augmented by biofeedback tools and pharmacotherapy. Over time, this integrative strategy resulted in meaningful improvement in the patient's neuropsychiatric symptoms and functional recovery. This case highlights the role of collaborative, tailored treatment for patients with overlapping neurological and psychiatric sequelae of TBI. It also underscores the unique contribution of psychotherapy when combined with medication and technology-enabled interventions, demonstrating how these strategies can optimize recovery in complex outpatient presentations of TBI.

After participating in this CME activity, the psychiatrist should be better able to:• Explain the evidence supporting the efficacy of tCBT in reducing anxiety and depression symptoms in adolescents.• Discuss the impact of tCBT on adolescent's overall functioning.• Identify factors that may influence treatment outcomes, including the role of parental involvement. Transdiagnostic cognitive behavioral therapy (tCBT) is an emerging treatment modality that targets shared psychological mechanisms across disorders. Use of tCBT for treating emotional disorders in adolescents compared to a waitlist control, however, remains underexplored. This study assessed the efficacy of tCBT in treating emotional disorders among adolescents through a meta-analysis of randomized controlled trials (RCTs). This meta-analysis included RCTs that examined tCBT interventions delivered to adolescents (aged 10-19) with clinically diagnosed anxiety, depression, and/or mixed emotional disorders. Eligible studies used standardized cognitive behavioral therapy-based transdiagnostic protocols and compared outcomes with waitlist control groups. Searched databases included PubMed, Cochrane Library, and ClinicalTrials.gov. Seven trials with a combined sample of 324 participants met inclusion criteria. Primary outcomes included changes in anxiety and depression symptoms, with overall functioning as a secondary outcome. Standardized mean differences (SMDs) were pooled using a random-effects model. Subgroup analyses were performed based on parental involvement. tCBT significantly improved anxiety (SMD = -0.59; 95% CI: -0.95, -0.23; p= 0.001), depression (SMD = -0.57; 95% CI: -0.98, -0.16; p = 0.006), and overall functioning (SMD = -0.56; 95% CI: -0.99, -0.13; p = 0.01) compared to waitlist controls. Subgroup analyses indicated that greater parental involvement associated with stronger treatment effects, particularly for depressive symptoms. The risk of bias was low in most included studies. Transdiagnostic CBT appears to be an effective intervention for managing emotional disorders in adolescents, offering benefits across anxiety, depression, and functioning.

Clinicians are commonly asked to make complex and potentially risky decisions in the face of uncertainty and incomplete information. Physicians frequently employ heuristics, or mental shortcuts, to convert challenging clinical questions into much simpler ones. Psychiatrists often encounter such challenges when asked to comment on the safety of intravenous haloperidol (IVH), particularly regarding risks of prolonging the corrected QT interval (QTc) or developing Torsades de Pointes (TdP). In light of the 2007 Food and Drug Administration warning about the risk of developing TdP with IVH, some providers, and even some institutions, have used QTc cut-off values to indicate when one can and cannot use IVH safely for managing acute agitation. In this perspective, we argue that (1) this practice represents an inappropriate use of a heuristic rather than a necessary risk-benefit calculation, and (2) that our updated understanding of the complex relationships among IVH, QTc, and TdP does not support the use of QTc cut-off values. We address some common misconceptions about the associations among IVH, QTc, and TdP, and discuss how reframing the decision-making process related to this dilemma may improve clinical care.

Structural influences on mental health and mental health care have been a core focus from the origins of population-based mental health research. This perspective piece provides context for current work by discussing a selection of theoretical ideas and empirical study examples. The goal is to illustrate several basic concepts that have guided research over the past century and a half and highlight a selection of recent empirical findings that continue presenting challenges to the field. The examples emphasize that, despite the long history of research and theory connecting social structure and mental health, major, robust findings remain unexplained. These examples demonstrate the importance of continuing to research structural influences on mental health. Doing so will guide our understanding of causality and policy design to address inequities in illness burden and treatment.

Smartphone-based cognitive assessments have emerged as promising tools for frequent and ecologically valid monitoring of cognitive function in real-world settings. These tools enable continuous capture of cognitive and behavioral patterns, including intra-individual variability, practice-related improvement, and contextual influences. Repeated assessments offer a unique opportunity to detect subtle cognitive changes over time. The interpretability and clinical utility of the metadata generated by such assessments, however, remain underexplored. In this review, we consider the current landscape of smartphone-derived cognitive metadata in the context of cognitive and affective disorders. We focus on emerging evidence linking metadata features to functional outcomes and symptom fluctuations across conditions such as schizophrenia, bipolar disorder, and depression. Additionally, we discuss methodological considerations for optimizing metadata analysis, including test design, sampling frequency, and analytical strategies. We propose that cognitive metadata may serve as sensitive indicators of early cognitive change and support personalized mental health monitoring and targeted intervention.

Anti-GAD65 encephalitis-like other autoimmune encephalitis conditions-poses a significant diagnostic challenge; its heterogeneous neuropsychiatric phenotypes mimic primary psychiatric disorders. The broad pathophysiological spectrum, ranging from limbic dysfunction to catatonia, underscores the need for systematic approaches that integrate immunotherapy with neuromodulation when standard interventions fail. We present a 78-year-old woman with no prior psychiatric history who developed acute-onset catatonia with visual hallucinations. Neurological evaluation revealed markedly elevated anti-GAD65 antibodies despite unremarkable neuroimaging and electroencephalography. Initial treatment with lorazepam and intravenous immunoglobulin achieved partial response. Recurrent catatonia and treatment-refractory psychosis prompted a trial of electroconvulsive therapy (ECT), which led to sustained remission through maintenance ECT. This case illustrates three critical clinical practice points: (1) late-onset catatonia necessitates comprehensive evaluation of autoimmune etiologies, including paired serum-cerebrospinal fluid antibody testing; (2) partial response to immunotherapy does not preclude more aggressive symptomatic management; and (3) ECT can effectively treat catatonia secondary to autoimmune illnesses. We conclude that successful management of anti-GAD65 encephalitis necessitates a multidisciplinary team for thorough neuro-immunological assessment, nuanced psychopharmacology, and timely neuromodulation.

After participating in this CME activity, the psychiatrist should be better able to:• Describe the mental, physical, and social health risks experienced by individuals bereaved by suicide across different kinship groups.• Identify key gaps in the current suicide bereavement research literature and explain their implications for clinical postvention strategies.• Differentiate suicide bereavement-related risks by kinship group (offspring, parents, spouses, siblings) and age at the time of loss.• Recognize populations with the highest suicide bereavement-related vulnerabilities. Suicide bereavement is a global public health problem associated with adverse physical and mental health outcomes. While population-based registry studies offer a promising avenue to understand the impacts of suicide bereavement, there has been no systematic review of results from such studies. This systematic review examines mental, physical, and social health outcomes among suicide-bereaved individuals in global population-based registry studies, with a focus on differences in findings by outcome, kinship, and comparison group. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for studies registered in PubMed and PsycInfo. The review was conducted in April 2025. The initial search revealed 404 unique records. After screening and full-text review, 36 studies published between 2005-2024 were included. Most frequently, studies examined bereaved offspring (n = 20), followed by bereaved parents (n = 8), spouses (n = 5), siblings (n = 5), and unspecified familial relations (n = 5). Overall, suicide loss was frequently associated with adverse health outcomes, including mortality, particularly due to suicide, and mental health (e.g., major depression, self-harm), and some physical health concerns. Associations meaningfully differed by kinship and comparison group. This is the first systematic review on population-based registry research concerning relationships between suicide loss and adverse mental, physical, and social health outcomes. Future studies should examine patterns of disease comorbidity, expand types of kinship examined (e.g., roommates), and probe how risk varies by time since loss.