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CONCLUSIONS: Neurocognitive, social cognitive, and metacognitive capacities-as experienced within an individual's social context-can buffer the effects of stress exposure on vulnerable individuals by enabling adaptive behavioral strategies and modulating maladaptive neurophysiologic responses. Resilience-promoting interventions that target these factors include: fostering safe and supportive social contexts for individuals at risk for or experiencing psychosis; developing their cognitive health...

Suicidal ideation and attempts are common in first-episode psychosis (FEP), but less is known about how these outcomes change in large, community-based, coordinated specialty care (CSC) settings. This longitudinal cohort study examined 2951 individuals with FEP enrolled in 87 CSC clinics across 15 states in the Early Psychosis Intervention Network between 2019 and 2024. Suicide-related outcomes were assessed at admission and every 6 months for up to 2 years. At admission, 34% reported suicidal...

CONCLUSIONS: Hospitalizations decreased substantially after CSC admission and remained low over 2 years in this large national FEP cohort. Prior hospitalization and markers of earlier illness course (younger age and shorter DUP) were associated with higher hospitalization burden, highlighting targets for CSC care refinement.

Schizophrenia, a serious mental illness, is associated with evidence of NMDA receptor (NMDAR) dysfunction and characterized by cognitive impairments that reflect impaired value updating and feedback-driven control. However, the cellular and circuit-level mechanisms underlying these disruptions remain unclear. Here, we test how NMDA receptor (NMDAR) signaling in the medial prefrontal cortex (mPFC) contributes to adaptive decision-making by combining targeted genetic ablation in mice and systemic...