The approval of the first non–dopamine-blocking therapy for schizophrenia marks a defining moment in psychiatry. Muscarinic M1/M4 modulation, alongside emerging TAAR1 and glutamatergic pathways, signals a shift beyond dopamine dominance toward circuit-level integration. These advances embody mechanistic humility: the scientific courage to prioritize clinical signal over mechanistic certainty. It is the scientific curiosity to revisit older hypotheses, question single-pathway models, and integrate multiple mechanisms. Building on the recognition of dopamine blockade’s experiential burdens, this new era guides psychiatry toward a pluralistic framework. The challenge for 2026 is not to replace dopamine, but to rebalance it, moving from receptor blockade dominance to circuit modulation informed pluralistic treatment. This evolution aims to restore harmony not just among neural circuits, but within the lived experience of patients.
Associations between adult ADHD core symptoms, cognitive flexibility, and emotional eating: a case-control study
IntroductionAttention-deficit/hyperactivity disorder (ADHD) in adults often co-occurs with eating disorders (EDs), potentially through shared difficulties in emotional regulation, and executive functions. This study explored the associations between cognitive flexibility as a component of executive functions, core adult ADHD symptom dimensions and emotional eating-related eating behaviorsin adults with ADHD and healthy controls, within the framework of executive functions.MethodsThis case-control study included 76 adults with ADHD and 69 healthy controls. Participants completed the Self-Report Wender-Reimherr Adult Attention Deficit Disorder Scale (SR-WRAADDS), Emotional Eating Questionnaire (EEQ), Hospital Anxiety and Depression Scale, Cognitive Control and Flexibility Questionnaire (CCFQ), and Berg’s Card Sorting Test. Group differences were tested with t-tests, correlations with Spearman’s ρ, and hierarchical regression (Approval No: I11-798-23).ResultsThe ADHD group had significantly higher EEQ scores (t = 5.39, p =0.001). The ADHD group also showed lower CCFQ total score (t (125) = –5.52, p <0.001). EEQ scores were positively correlated with SR-WRAADDS Attention Deficit (ρ =0.331, p =0.003), and CCFQ Cognitive Control over Emotion (ρ = −0.256, p =0.02). Regression analysis identified attention deficit as the only significant predictor of the EEQ total scorein the ADHD group.DiscussionOur findings suggest that impairments in executive functioning—including cognitive flexibility, attentional regulation, and emotion-related control mechanisms—may play a more central role in the relationship between ADHD and emotional eating-related eating behaviors. Longitudinal studies are warrented to further elucidate these mechanisms.
Narcolepsy as an immune-associated hypothalamic encephalopathy: orexin dysfunction and implications for precision sleep medicine
Narcolepsy can no longer be adequately conceptualized by excessive sleepiness and cataplexy. It is increasingly recognized as a multisystem hypothalamic encephalopathy, rooted in the selective loss or dysfunction of orexin neurons, yet extending across motor, psychiatric, metabolic, and autonomic domains. Over the past two decades, convergent genetic, neuropathological, and immunological evidence has positioned narcolepsy type 1 as increasingly consistent with the spectrum of immune-mediated neurological diseases while challenging the validity of current classifications that hinge on cataplexy or multiple sleep latency testing. Borderland phenotypes, variable orexin biology, and post-infectious or secondary forms underscore the limitations of rigid categorical nosologies and support a spectrum-based framework. Advances in immunology, imaging, and systems biology highlight the limitations of purely symptomatic treatment and support the exploration of mechanism-based interventions, including orexin receptor agonism, immune-targeted strategies in early disease, and regenerative or circuit-repair approaches. In this narrative review, based on literature identified through searches of PubMed, Web of Science, and Scopus through December 2025, we synthesize evidence across epidemiology, pathophysiology, diagnosis, and therapy, and propose an integrative clinical algorithm that moves beyond categorical diagnoses toward a phenotype–biomarker–mechanism stratification model. We suggest that narcolepsy should no longer be considered a rare curiosity of sleep medicine but rather a model disorder illuminating the vulnerability of hypothalamic circuits and the complex interplay between sleep, emotion and immunity.
Evidence of monkeypox virus clade IIb lineage A.2.2 in the Republic of the Congo and co-circulation of clade Ia, Ib and clade IIb
Nature Medicine, Published online: 03 April 2026; doi:10.1038/s41591-026-04256-2
Whole-genome phylogenetic analyses have identified a case of monkeypox virus clade IIb lineage in the Republic of the Congo and co-circulation of three clade lineages, emphasizing the importance of improved surveillance given the risk of possible recombination events in the future.
The exposome of brain aging across 34 countries
Nature Medicine, Published online: 03 April 2026; doi:10.1038/s41591-026-04302-z
Exposome analyses across 34 countries showed that social exposures were associated with faster functional brain aging and physical exposures with faster structural brain aging.
Target product profiles for treatments to delay or prevent symptomatic Alzheimer’s disease
Nature Medicine, Published online: 03 April 2026; doi:10.1038/s41591-026-04305-w
To accelerate therapeutic development and equip stakeholders with clear benchmarks, the authors outline target product profiles for therapies designed to delay or prevent the onset of clinical symptoms of Alzheimer’s disease.
Opinion: Subscription pricing could expand access to HIV prevention breakthrough while controlling costs
Figure 2 from the PURPOSE-1 trial changed the world.
Between gray and red bars representing the study’s background HIV incidence and the arms randomized to receive oral pre-exposure prophylaxis (PrEP) was white space filled only by a previously unimaginable number: zero. Zero infections over one year among the 2,134 cisgender adolescent girls and young women who received the novel long-acting injectable antiretroviral lenacapavir.
Opinion: My patient would rather take a peptide than a statin. That reveals an uncomfortable truth in medicine
A patient came to my office recently and told me she had stopped her statin. She’d been on it for two years. Her coronary artery calcium score was 280 and LDL was 168, up almost 100 points since she had stopped taking her statin. Her father had died from a heart attack at 58.
When I asked about the decision, she crossed her arms and furrowed her brow.
Supreme Court conversion therapy decision could ripple through medicine
The U.S. Supreme Court ruling this week against Colorado’s ban on licensed mental health providers engaging in gender and sexuality “conversion therapy” could narrow the authority of state medical boards to regulate aspects of health providers’ care that involves speech, according to legal experts. The implications could extend far beyond matters related to LGBTQ+ rights to other forms of talk therapy, telehealth, and physician advice on Covid-19, vaccines, or reproductive care.
Because the therapist who challenged the law, Kaley Chiles, engages in talk therapy — without prescribing medications or having any physical contact with patients — the majority decided that the Colorado law constitutes a restriction on her speech due to her particular viewpoint, or opinion. In an 8-1 decision, the judges sent the case back to a lower court for a higher level of judicial scrutiny, which will likely result in the ban being overturned.
Relatix Health Applies for ARIA Funding to Build Digital Trust for Neurodiverse Communities
We’re proud to share that Relatix Health has applied for funding from the UK’s Advanced Research and Invention Agency (ARIA) under its Trust Everything, Everywhere programme. This initiative explores how trust can be built across the digital and physical worlds, and we believe that conversation must include people whose minds work differently.
Our proposal focuses on one of the most pressing and least understood challenges of the digital age: how people with neurodevelopmental and neurodiverse conditions, including autism, ADHD, schizophrenia, borderline traits, and psychopathy, experience, interact with, and build trust in AI systems. In a world increasingly mediated by algorithms, the ways these systems interpret, respond to, and store our most personal thoughts and data matter profoundly.
Throughout history, individuals living with stigmatized neurocognitive conditions have been marginalized or misrepresented by institutions, by society, and now, potentially, by AI. Some may over-trust technology that feels neutral or supportive; others may under-trust it because of past harm or bias. We want to ensure that digital systems meet people where they are, building trust rather than eroding it, while protecting privacy and supporting quality of life, health, and wellbeing.
Through this work, Relatix Health aims to lead the way in ethical and inclusive neuro-AI design: protecting privacy, reducing stigma, and helping define standards for responsible data handling in the era of AI. Our goal is to make sure that the next generation of AI-driven tools, from chatbots to diagnostics, truly serves everyone, regardless of how their brain is wired.
We know how often things have already gone wrong, from chatbots unintentionally encouraging depressive or paranoid thoughts, to credit and gambling platforms optimizing for addiction or impulsive behaviour. These systems were not built with sufficient safeguards for people with neurodevelopmental conditions, who may react differently to AI-optimized interactions. Many respond by disengaging digitally, and may feel that an AI-driven world is a minefield because it was not built for them.
Join us in shaping a radically different future where cognitive diversity and digital trust can coexist, and AI tools are built to truly support and empower. To learn more about our mission or to collaborate, contact our team.