From the Editor
Welcome 2026.
It’s our tradition that the New Year starts with a review of the best papers of the past year. So, as we enter the first weeks of 2026, let’s look back at 2025.
The list is hardly exhaustive, and many great papers aren’t listed here. But there is an important thread that runs through all of them: they tie into our clinical work. These 10 papers selected are interesting, informative, and – yes – relevant.
They cover everything from AI to antidepressant withdrawal. And, yes, we touch on sex, too.
DG
“Incidence and Nature of Antidepressant Discontinuation Symptoms: A Systematic Review and Meta-Analysis”
Michail Kalfas, Dimosthenis Tsapekos, Matthew Butler, et al.
JAMA Psychiatry, September 2025
Patients often ask about the risk of severe withdrawal should they stop antidepressants. Some even bring up the 2019 Lancet Psychiatry study (drawing from an online survey), which found that half of patients who quit these meds experienced severe withdrawal symptoms.
How common are discontinuation symptoms? Michail Kalfas (of King’s College London) and his co-authors attempt to answer that question in this JAMA Psychiatry paper. They did a systematic review and meta-analysis by analyzing 50 studies involving almost 18 000 people.
“This systematic review and meta-analysis indicated that the mean number of discontinuation symptoms at week 1 after stopping antidepressants was below the threshold for clinically significant discontinuation syndrome.”
“Brief Cognitive Behavioral Therapy for Suicidal Military Personnel and Veterans: The Military Suicide Prevention Intervention Research (MSPIRE) Randomized Clinical Trial”
Craig J. Bryan, Lauren R. Khazem, Justin C. Baker, et al.
JAMA Psychiatry, December 2025
There is more and more interest in BCBT, a focused psychotherapy for those with suicidal thoughts, based on CBT. Could it help prevent suicide attempts among military personnel and vets? This paper attempts to find out. Importantly, the RCT compared two psychotherapies, finding a hazard ratio of 0.25 for BCBT. Nice.
“This RCT found that BCBT reduced the risk of suicide attempts among military personnel and veterans with recent suicidal ideation and/or suicidal behaviors and was more effective than an active psychotherapy that has been shown to reduce suicidal ideation.”
“A 20-year longitudinal cohort study of post-traumatic stress disorder in World Trade Center responders”
Frank D. Mann, Monika A. Waszczuk, Sean A. P. Clouston, et al.
Nature Mental Health, 27 May 2025
What is the course of PTSD? In a remarkable study – probably the longest and largest one on this disorder – Frank D. Mann (of Stony Brook University) and his co-authors looked at survivors of the World Trade Center attack, involving 13 000 responders, more than 81 000 observations, and spanning 20 years.
Many improved with time – but often after a full decade had passed; see the figure below. A minority (roughly 10%) became worse. “These results imply that PTSD is a chronic condition that can last at least 20 years after initial trauma and has highly variable symptom courses that are only weakly related to demographic characteristics…”
“Therapeutic Use of Cannabis and Cannabinoids: A Review”
Michael Hsu, Arya Shah, Ayana Jordan, et al.
JAMA, 26 November 2025 Online First
Many look to cannabis and cannabinoids for medical purposes; one US survey found that more than one in four people did. It’s an enthusiasm stoked and encouraged by a private industry.
But what does the literature say? In an impressive review paper with 124 citations, Dr. Michael Hsu (of the University of California, Los Angeles) and his co-authors are thorough and thoughtful, drawing on papers and clinical guidelines and more, analyzing everything from cancer pain to insomnia. “Despite the accumulation of new studies, evidence is insufficient for the use of cannabis or cannabinoids for most medical conditions.”
“Randomized Trial of a Generative AI Chatbot for Mental Health Treatment”
Michael V. Heinz, Daniel M. Mackin, Brianna M. Trudeau, et al.
NEJM AI, 27 March 2025
Is AI a game changer in terms of offering psychotherapy that could be easily accessible? Dr. Michael V. Heinz (of Dartmouth College) and his co-authors report on a new RCT comparing those who received therapy from a chatbot with a wait-list control group. People in the chatbot group had lower scores on scales. And, importantly, “participants rated the therapeutic alliance as comparable to that of human therapists.”
“As the first RCT of its kind, our study supports the feasibility, acceptability, and effectiveness of a fine-tuned, fully GenAI–powered chatbot for treating mental health symptoms.”
“Contingency Management for Stimulant Use Disorder and Association With Mortality: A Cohort Study”
Lara N. Coughlin, Devin C. Tomlinson, Lan Zhang, et al.
The American Journal of Psychiatry, November 2025
Can nudging patients with a stimulant use disorder save lives? Lara N. Coughlin (of the University of Michigan) and her co-authors did a retrospective cohort study, comparing those who received contingency management with those who didn’t, looking at outcomes and 12 months of data, and involving 1 481 patients and an equal number of people in the control group.
“The magnitude of the decrease in risk for death among those who received contingency management compared with those with stimulant use disorder in the control group is clinically important and is similar in magnitude to the reduction in all-cause mortality from treating opioid use disorder with buprenorphine…”
Caution here: the data was retrospective. Still, whoa.
“Do you have depression? A summative content analysis of mental health-related content on TikTok”
Roxanne Turuba, Marco Zenone, Raman Srivastava, et al.
Digital Health, 17 January 2025
Many look to social media for medical advice. In this Digital Health study, the authors looked at popular TikTok videos, conducting a summative content analysis.
The main finding in a sentence: the videos were widely viewed but often misleading and largely free of reference to scientific evidence and research. Ouch. Still, the popularity can’t be ignored; videos had billions of view. (Yes, billions.) “Healthcare practitioners and researchers may consider increasing their presence on the platform to promote the dissemination of evidence-based information to a wider and more youth-targeted population.”
“‘Finding a relationship’: Conversations between mental health and social care staff, and service users about service users’ romantic relationships”
Angelica Emery-Rhowbotham, Helen Killaspy, Sharon Eager, Brynmor Lloyd-Evans
PLOS Mental Health, 8 May 2025
This paper has a small n. It’s published in a journal that doesn’t even have an impact factor. Yet, it’s the one paper on the list that may change your practice today.
Emery-Rhowbotham (of University College London) and her co-authors explore the problem of relationships and our patients. They report both qualitative and quantitative data from 63 providers, finding that many recognize the need to discuss relationships with patients (who are often lonely), but feel that they lack the training to do so.
The study raises larger questions and touches our unease with all things sexual as it relates to patients. How often do we ask people with schizophrenia about their dating? Or inquire about the sexual desires of older patients? Or ask about sexual side effects of the medications we prescribe?
“Task-sharing and telemedicine delivery of psychotherapy to treat perinatal depression: a pragmatic, noninferiority randomized trial”
Daisy R. Singla, Richard K. Silver, Simone N. Vigod, et al.
Nature Medicine, 3 March 2025
Perinatal depression is common – and yet many women in Canada and other high-income countries don’t receive care. How to address the gap in access? Singla and her co-authors took a page from those working in low-income countries; they trained up non-specialists to offer psychotherapy (specifically, behavioural activation).
“In this large, multisite trial, we found that nonspecialists (individuals without a specialized mental health background), were noninferior to specialists in delivering BA…”
“The Duality of My Night in the Emergency Room”
Emily A. Kumpf
Psychiatric Services, November 2025
From a distance, the ED visit was a great success. The young woman, who was experiencing a manic episode, walked into a hospital and received the care she needed. As she observes, it “arguably saved my life that night.” But she was also restrained and medicated. The experience was traumatic. She thought she was going to die from the injection. And she notes: “To my surprise, I woke up the next morning.”
Years have passed. She has run marathons, started Ph.D. work at a prestigious university, and has had meaningful relationship. She also has healed from the experience. “As I near the end of my 20s, I have learned the power of forgiveness, acceptance, self-compassion, and common humanity.”
She describes it all in a beautifully written paper.
* * *
For those interested in reading more of the “best papers of the year,” you can find choices from 2023 and 2024, here:
https://davidgratzer.com/reading-of-the-week/reading-of-the-week-the-best-of-2023/
and here:
https://davidgratzer.com/reading-of-the-week/reading-of-the-week-the-best-of-2024/
Reading of the Week. Every week I pick articles and papers from the world of Psychiatry.
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