Evolving approaches to mood disorders

This issue highlights recent advances in understanding, preventing and managing mood disorders, with an emphasis on service delivery, emerging treatments and social and developmental determinants.

Digital technologies and artificial intelligence (AI) are increasingly applied in mental health care, including earlier detection of depressive symptoms, personalised interventions and improved monitoring (Maidment et al., 2026). These approaches are particularly relevant given the heterogeneity of mood disorders. However, important challenges remain, including data governance, potential bias and the lack of comprehensive regulatory frameworks. The authors propose 10 recommendations to support safer implementation in Australia, covering governance (e.g. a National Expert Advisory Group and national guidelines), research and data infrastructure, workforce investment and public engagement.

Mobile-based cognitive behavioural therapy (CBT) represents a more immediate extension of digital technologies. In a systematic review of 10 randomised controlled trials (n = 1896), Sathe et al. (2026) reported modest reductions in depressive symptoms among adolescents and young adults following mobile-based CBT, with some improvements in quality of life. However, small effect sizes and limited evidence of sustained benefit suggest that these approaches may be best considered adjunctive to standard care. In addition, there was no significant effect on anxiety (d = −0.16).

Treatment-resistant depression remains a major clinical challenge, prompting growing interest in novel interventions, including ketamine, transcranial magnetic stimulation and psilocybin-assisted therapies (Giri et al., 2026). However, despite an expanding evidence base, access remains uneven, particularly in public services. Specialist clinics may therefore help concentrate expertise and improve access, although implications for service organisation and resource allocation require further consideration.

Two articles highlight the importance of early life factors in the development of mood disorders. Carpendale et al. (2026) demonstrate that patterns of social-emotional functioning in middle childhood are associated with later mental health outcomes, including presentations of externalising disorders, internalising disorders and self-harm or suicidal ideation. Their findings are consistent with a dual-factor model in which both symptoms and competencies contribute to risk (Carpendale et al., 2026). This approach supports the potential value of early interventions that promote social and emotional skills alongside the identification and management of emerging symptoms.

Similarly, social connectedness is a key protective factor in reducing the risk of suicidal ideation and non-suicidal self-injury among young people (Robertson et al., 2026). These outcomes are closely associated with mood disorders, and the findings suggest that interventions aimed at enhancing social inclusion may have broader benefits for mental health (Robertson et al., 2026). Conversely, experiences such as homelessness and financial stress are associated with increased risk, reinforcing the relevance of socioeconomic context in understanding and addressing depression.

The pharmacological management of mood disorders in younger populations is considered by Kassie et al. (2026), who reported substantial rates of persistent antidepressant use beyond 1 or 2 years among children and adolescents. While continued treatment may reflect ongoing clinical need, the duration of use raises questions regarding long-term management and monitoring (Kassie et al., 2026). Variations in persistence by demographic factors also suggest that prescribing patterns may be influenced by a range of considerations beyond symptom severity alone.

Lifestyle-based interventions are increasingly popular for treating depression, but there is limited information on outcomes. Radovic et al. (2026) therefore examined predictors of response and adverse events following this type of intervention. Their results suggest that both benefits and risks vary across participants, with factors such as age and metabolic status influencing outcomes (Radovic et al., 2026). For instance, older age and overseas place of birth were associated with benefit, while older age and higher glucose levels were associated with a greater risk of adverse events (Radovic et al., 2026).

The final article addresses suicide among medically and surgically admitted patients in general hospital settings. Although not limited to patients with diagnosed mood disorders, the findings are relevant given the association between depression and suicide (Schrader et al., 2026). Rates were higher than those in the general population, with the rate per patient-year showing limited change over time. However, the number of suicides per admission did decline (Schrader et al., 2026). This research underscores the ongoing difficulty of suicide prevention in general hospitals and the need for continued attention to patient safety, particularly among those with co-occurring medical and psychiatric conditions (Schrader et al., 2026).