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Article History
Received: 24 July 2025
Accepted: 8 May 2026
First Online: 15 June 2026
Competing interests
: For the DIRECT consortium, the authors declare no competing interests. Regarding ENIGMA MDD, H.J.G. has received travel grants and speakers honoraria from Neuraxpharm, Servier, Indorsia and Janssen Cilag. I.B.H. has previously led community-based and pharmaceutical industry-supported (Wyeth, Eli Lily, Servier, Pfizer and AstraZeneca) projects focused on the identification and better management of anxiety and depression. He is the chief scientific advisor to, and a 3.2% equity shareholder in, InnoWell Pty Ltd. InnoWell was formed by the University of Sydney (45% equity) and PwC (Australia; 45% equity) to deliver the $30 million Australian government-funded Project Synergy (2017–2020) and to lead transformation of mental health services internationally through the use of innovative technologies. J.C.S. has received funding from other sources, and potential conflict of interests include: Alkermes (advisory board), Boehringer Ingelheim (consultant), Compass Pathways (research grant), Johnson and Johnson (consultant), LivaNova (consultant), Relmada (research grant), Sunovion (research grant) and Mind Med (research grant). T.T.Y.: UCSF and NeuroQore have a clinical trials agreement that provides funds to UCSF, and a portion of these funds are provided to T.T.Y. for research collaboration and papers with NeuroQore. None of the funds from NeuroQore were used to support T.T.Y. for this paper. T.T.Y. is a professor and full-time UCSF faculty member, and he is paid by UCSF. T. Kircher received unrestricted educational grants from Servier, Janssen, Recordati, Aristo, Otsuka and Neuraxpharm.