Generative AI chatbots for mental health offer great promise in expanding access to evidence-based psychotherapies. A number of recent reports have described chatbots that draw from behavior change theories central to human-delivered treatments. This review details the diversity in theories selected for chatbots, and how chatbots have been evaluated in respect to delivering upon theoretical models. Overall, there was limited adoption of best practices in measurement of treatment fidelity from human therapist trials. Thus, skepticism is frequently warranted regarding claims of alignment with behavior change approaches, yet there is reason for optimism in the role of chatbots in expanding access to evidence-based interventions along with rigorous testing and validation.

This article reviews the rationale for, and the mechanisms of action of, benzodiazepines (BZs) in the treatment of catatonia, a potentially lethal neuropsychiatric condition that disrupts affect, behavior, cognition, and motor functioning. Following a case presentation that highlights the typical manifestations of catatonia, strategies for refining the diagnosis and approaching treatment decisions are discussed. In addition, the use of lorazepam as a diagnostic tool is discussed, as are the indications for the maintenance, tapering, and discontinuation of lorazepam. Adverse effects and contraindications of BZs, along with alternative treatment approaches for those with catatonia, are also presented to guide treatment decisions, which are of critical importance in patients with co-morbid medical and neurological conditions.

Aggressive behaviors in children and adolescents are a common reason for psychiatric referrals, yet assessment and treatment remain complicated by lack of a standardized nosology of aggression. As a result, clinical trials targeting aggression often include youth with heterogeneous underlying diagnoses, complicating cross-study comparisons and limiting generalizability. This review summarizes current evidence for pharmacologic interventions for pediatric aggression based on the underlying diagnosis. Current evidence supports the use of stimulant medications and adjunctive risperidone for youth with attention-deficit/hyperactivity disorder (ADHD) and aggression that is resistant to monotherapy with the stimulant. Risperidone, divalproex, lithium and haloperidol demonstrated benefit in reducing aggression in youth with conduct disorder. Several other antipsychotics have limited evidence for use in this population. There is preliminary evidence that suggests potential benefit for the use of clonidine for youth with ADHD and aggression. This report outlines current pharmacologic strategies and highlights the need for better targeted interventions to guide clinical decision making.

Recognizing and addressing acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) in critically ill patients is crucial for improving both short- and long-term recovery outcomes. Patients in the ICU often experience significant psychological stress due to the severity of their illness, medical interventions, and unfamiliar, high-stress surroundings, all of which contribute to the development of these disorders. This article explores the epidemiology, risk factors, and patho-physiology of ASD and PTSD in the ICU setting. It reviews the differential diagnosis and complex interplay of medical and mental health comorbidities. The psychological impact of critical care including post-intensive care syndrome (PICS) and the importance of ongoing evaluation is discussed. Nonpharmaco-logical interventions such as cognitive behavioral therapy (CBT) and ICU diaries, as well as pharmacological strategies, are reviewed. The influence of social determinants of health (SDOH), the impact on families, and their involvement in care are also considered.

Cognitive-behavioral therapy (CBT) is the gold standard intervention for pediatric anxiety disorders, and it can be delivered in primary care settings. Pediatric primary care providers (PCPs) are in a uniquely impactful position to assess and treat anxiety disorders due to their first-line contact with youth and their families. Universal screening for anxiety disorders by PCPs is recommended for early detection. Pediatric anxiety can often be managed in primary care through psychoeducation, brief exposure-based CBT, and parent-guided resources; however, more severe or complex cases may require referral. Integrated behavioral health models of care may improve access to CBT for anxiety by embedding mental health providers within primary care teams. Further, evidence-based interventions have shown that PCPs and integrated behavioral health providers can deliver effective care to improve outcomes for anxious youth.

Anxiety disorders and clinically significant anxiety symptoms are highly prevalent in children with autism spectrum disorders (ASD), and a growing body of research has addressed how to diagnose and treat them in older children. These anxiety symptoms can interfere with children's ability to benefit from interventions designed to address symptoms of ASD. Many preschoolers with autism also exhibit anxiety that significantly affects their daily functioning. Some symptoms of anxiety can be challenging to disentangle from traits of autism, but correctly identifying clinical anxiety in children with autism is important, as studies suggest that it responds to psychosocial intervention even in this age range. This article provides an overview of the assessment and treatment of anxious symptoms in young children with ASD. Several skills-based interventions designed to reduce anxiety in young children are reviewed. Recommendations for providers are offered. [ Psychiatr Ann . 2025;55(4):e98–e101.]

The Diagnostic and Statistical Manual of Mental Disorders (DSM) has served as the cornerstone of psychiatric diagnosis for decades, offering a standardized framework for classification, research, and treatment. This article provides a historical review of the development of the DSM , from early theoretical foundations rooted in Kraepelin's descriptive psychiatry to the transformative impact of DSM-III 's medicalized approach and the adoption of Feighner Criteria. Despite its utility in improving diagnostic reliability and facilitating research advancements, the DSM has faced increasing scrutiny for its limitations in validity and its inability to fully address the complexity of mental illness. Emerging frameworks, such as the Research Domain Criteria (RDoC) and the Hierarchical Taxonomy of Psychopathology (HiTOP), aim to refine psychiatric nosology through dimensional and biologically informed approaches. By highlighting the DSM 's strengths and challenges, this article underscores the need for continued innovation to capture the nuanced interplay of biological, psychological, and sociological factors in mental health. [ Psychiatr Ann . 2024;54(12):e320–e324.]