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.
CABG-AI-Supported Discharge Education
Conditions: Coronary Artery Disease; Postoperative Care; Patient Discharge; Recovery of Function; Anxiety; Pain; Stress, Physiological; Surgical Nursing; Nursing; Discharge Education
Interventions: Behavioral: AI-Supported Individualized Discharge Education; Behavioral: Standard Discharge Education
Sponsors: Hasan Kalyoncu University
Not yet recruiting
Interventions: Behavioral: AI-Supported Individualized Discharge Education; Behavioral: Standard Discharge Education
Sponsors: Hasan Kalyoncu University
Not yet recruiting
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.
CARED : A Novel Rapid Treatment Paradigm for Depression
Conditions: Major Depressive Disorder
Interventions: Device: Intermittent Theta Burst Stimulation (iTBS); Device: Transcranial Alternating Current Stimulation (tACS); Behavioral: Psychotherapy; Device: Sham (Placebo) Transcranial Alternating Current Stimulation (tACS)
Sponsors: University of North Carolina, Chapel Hill; Foundation of Hope for the Research and Treatment of Mental Illness
Not yet recruiting
Interventions: Device: Intermittent Theta Burst Stimulation (iTBS); Device: Transcranial Alternating Current Stimulation (tACS); Behavioral: Psychotherapy; Device: Sham (Placebo) Transcranial Alternating Current Stimulation (tACS)
Sponsors: University of North Carolina, Chapel Hill; Foundation of Hope for the Research and Treatment of Mental Illness
Not yet recruiting
Efficacy of Spectrally Optimized Light on Cognitive Impairment in Major Depressive Disorder and Its Neuroimaging Mechanisms
Conditions: Major Depressive Disorder (MDD); Neuroimaging; Bright Light Treatment; Cognitive Impairment
Interventions: Device: bright light; Device: dim red light(placebo)
Sponsors: Peking University Sixth Hospital
Not yet recruiting
Interventions: Device: bright light; Device: dim red light(placebo)
Sponsors: Peking University Sixth Hospital
Not yet recruiting
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.
Optimized, Neuroplasticity-Enhanced-Depression (ONE-D) Transcranial Magnetic Stimulation (TMS) Treatment for Female Athletes With Co-morbid Depression and Concussion
Conditions: Concussion; Depression
Interventions: Device: ONE-D TMS protocol and d-cycloserine (125 mg)
Sponsors: University of Florida
Not yet recruiting
Interventions: Device: ONE-D TMS protocol and d-cycloserine (125 mg)
Sponsors: University of Florida
Not yet recruiting
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.