Recent changes to US research funding are having far-reaching consequences that imperil the integrity of science and the provision of care to vulnerable populations. Resisting these changes, the BJPsych Portfolio reaffirms its commitment to publishing mental science and advancing psychiatric knowledge that improves the mental health of one and all.

Recent changes instituted by the US government pose a sinister threat to the integrity of science worldwide. We roundly refute the many contrived assertions that have been unfairly levelled against scientists and their natural philosophy and implore them to champion the apodictic principles of science.

As assisted dying moves towards legalisation, it is imperative that research be undertaken to inform eligibility and ensure that proper safeguards are instituted. To achieve a meaningful understanding of physician-assisted suicide, such research must draw on professionals with a wide range of expertise and include people with lived experience.

In the post-COVID-19 pandemic era, a ‘digital-first’ agenda is being adopted in health/social care services, while digital exclusion has not been fully addressed. People with severe mental illness face profound inequalities at many levels (i.e. social, financial and health). Digital exclusion may further exacerbate some of these inequalities.

Biomarkers alone cannot resolve psychiatry’s diagnostic challenges, particularly the boundary between normal variation and pathology. Diagnosis should prioritise the subjective, phenomenological experiences of patients rather than solely relying on biological evidence, emphasising a framework centred on suffering, debilitation and societal impact.

Lamotrigine is beneficial in bipolar disorder and is often prescribed to patients during their period of reproductive potential. We summarise aspects of the pharmacology of lamotrigine, highlight its uses in psychiatric practice, drawing attention to recent findings relating to potential hazards arising from lamotrigine exposure in utero, and make some suggestions for clinical management.

‘Complex emotional needs’ has emerged in the UK as a label to refer to individuals given a diagnosis of a personality disorder. We argue that this name change is insufficient to address the harms associated with the personality disorder construct; rather, it risks broadening its scope, and thereby the construct’s harms.

This editorial examines the rise of attention-deficit hyperactivity disorder (ADHD) in the digital age, suggesting that excessive digital media use may mimic or exacerbate ADHD symptoms. We propose examining ADHD through the lens of a spectrum condition, highlighting the importance of considering both genetic and environmental factors in its diagnosis and treatment.

This editorial suggests ways in which mental health science reform could yield more robust research and faster clinical progress. These include better animal and other models, a shift to transdiagnostic and clinically pragmatic classification systems, improved measurement, mission mapping and an entrepreneurial mindset aimed at taking advances rapidly to scale.

There has been substantial recent renewed interest and investment to assess the therapeutic potential of psychedelic compounds in addiction disorders. This editorial discusses the available evidence from randomised trials and future research directions in the field, together with potential implications for patients, professionals and the wider addiction treatment system.

Attention-deficit hyperactivity disorder (ADHD) is commonly considered a neurodevelopmental disorder, with symptoms present before 12 years of age. Increasingly, adults who have no evidence of impairment in childhood are seeking treatment for ADHD. In this Editorial, we propose that psychiatry considers conceptual changes to better understand impairment and distress caused by inattention and disorganisation in adulthood.

Psychiatrists and anthropologists both rely on observation, discourse analysis and access to participants’ internal and external worlds. Ethnographic fieldwork, a key method in medical anthropology, offers a powerful tool to establish a robust evidence base of how to address mental health inequalities in ethnic minority communities.

A quirky truth is that the oldest biomarker findings are largely metabolic. These had minimal impact on contemporary thought and research and were largely ignored. They have been rediscovered and validated almost 100 years later, informing our understanding of neurobiology and medical comorbidity and spurring contemporary treatment discovery efforts.

For over four decades, isotretinoin has shown unparalleled efficacy in the management of severe recalcitrant acne. However, controversies exist about its psychiatric safety profile. This editorial discusses the alleged causal role of isotretinoin in the development of psychiatric adverse events in light of the best available evidence.

Franco Basaglia (1924–1980) has a particular relevance to psychiatry today as he combined social critique with psychiatric reform. In the new ‘metacommunity’ era in psychiatry, his radical and critical thinking provides important tools, as does his enduring message that ‘freedom is (still today) therapeutic’.

This article explores the potential of 3,4-methylenedioxymethamphetamine (MDMA)-assisted therapy to enhance exposure and response prevention in obsessive–compulsive disorder treatment. We discuss the mechanisms of MDMA, including fear extinction, psychological flexibility, and empathogenic effects that may improve adherence and efficacy, as well as highlighting important safety considerations for further research.

Bupropion is not licensed as an antidepressant in the UK, limiting its use. We highlight bupropion’s distinct pharmacological profile and its potential benefits in treatment-resistant depression and people experiencing selective serotonin reuptake inhibitor-induced sexual dysfunction. The National Health Service repurposing medicines programme could improve equity of access for UK patients.

Geriatric (old age) psychiatry faces growing challenges amid Europe’s ageing population. This editorial emphasises the need for specialised training, mentorship and subspecialty recognition to attract young psychiatrists. By addressing structural gaps and fostering innovation, the field offers a rewarding career in enhancing older adults’ mental healthcare and quality of life.

This editorial highlights increasing prevalence and treatment rates of apparently disparate disorders. We ask whether cross-disorder factors including greater mental health literacy, social media and a shift to psychiatric explanations for distress contribute to these trends. We highlight a consequence: the changing doctor–patient relationship and its impacts.