The British Journal of Psychiatry最新文献

{"title":"Transdiagnostic efficacy of lurasidone on depressive symptoms: systematic review and meta-analysis of randomised controlled trials: commentary, Chen et al.","authors":"Yang-Chieh Brian Chen,Chih-Sung Liang,Ping-Tao Tseng,Chih-Wei Hsu","doi":"10.1192/bjp.2025.10463","DOIUrl":"https://doi.org/10.1192/bjp.2025.10463","url":null,"abstract":"","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"54 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145305374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical effectiveness, implementation effectiveness and cost-effectiveness of a community singing intervention for postnatal depressive symptoms, SHAPER-PND: randomised controlled trial.","authors":"Rebecca H Bind,Andrew J Lawrence,Carolina Estevao,Katie Hazelgrove,Kristi Priestley,Lavinia Rebecchini,Riddhi Laijawala,Celeste Miller,Andy Healey,Joan Agwuna,Nick Sevdalis,Ioannis Bakolis,Rachel Davis,Maria Baldellou Lopez,Anthony J Woods,Nikki Crane,Manonmani Manoharan,Alexandra Burton,Hannah Dye,Tim Osborn,Lorna Greenwood,Rosie Perkins,Paola Dazzan,Daisy Fancourt,Carmine M Pariante","doi":"10.1192/bjp.2025.10377","DOIUrl":"https://doi.org/10.1192/bjp.2025.10377","url":null,"abstract":"BACKGROUNDPostnatal depression (PND) affects up to one in four mothers. However, they may experience barriers to access to conventional treatments, indicating a need for alternatives such as arts-based interventions. A previous trial showed that a 10-week singing intervention could alleviate symptoms of PND.AIMSTo evaluate, in a larger sample and across a longer timeframe than previously, the clinical effectiveness, implementation effectiveness and cost-effectiveness of the Melodies for Mums (M4M) singing intervention for symptoms of PND.METHODOne-hundred and ninety-nine mothers experiencing symptoms of PND (Edinburgh Postnatal Depression Scale score ≥10) and their babies were randomised to 10 weeks of in-person singing sessions (M4M, n = 133) or an active control (existing community-based mother-baby activities, n = 66). Mothers were re-assessed at weeks 6, 10, 20 and 36 for depression, healthcare use for themselves and their babies, and health-related quality of life according to the EQ5D-3. The perceived acceptability (Acceptability of Intervention Measure), appropriateness (Intervention Appropriateness Measure) and feasibility (Feasibility of Intervention Measure) of the activity were also assessed at week 6. Trial registration number: NCT04834622.RESULTSMothers in both groups experienced attenuation of depressive symptoms by week 10; however, those in the singing group maintained lower EPDS scores than those in the control group at week 20 (10.7 v. 12.2 (mean difference 95% CI [-2.96, -0.22]), P = 0.023) and week 36 (9.85 v. 11.4 [-2.93, -0.19], P = 0.026). Mothers in the singing group were also more likely to remain in the study (77 v. 57%, χ2(1) = 12.92, P < 0.001) and found their programme more acceptable (4.75 v. 4.0 [0.25, 0.83], U = 2436.5, P < 0.001), appropriate (4.25 v. 3.88 [0.12, 0.62], U = 2241.5, P < 0.001) and feasible (4.75 v. 4.0 [0.41, 0.91], U = 2568.0, P < 0.001). Finally, M4M was associated with 15 extra days of health and was found to be cost-effective (£126-539 per dyad).CONCLUSIONM4M had a long-lasting effect on symptoms of PND and was perceived to be more suitable than existing activities; thus, M4M represents a worthwhile investment for healthcare systems as an intervention for mothers experiencing symptoms of PND.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"8 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145288614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of stroke associated with risperidone in dementia with and without comorbid cardiovascular disease: population-based matched cohort study.","authors":"Joshua Choma,Alys Griffiths,William Henley,Christoph Mueller,Nefyn Williams,Clive Ballard,Rhian Hopkins,Katherine G Young,John M Dennis,Byron Creese","doi":"10.1192/bjp.2025.10419","DOIUrl":"https://doi.org/10.1192/bjp.2025.10419","url":null,"abstract":"BACKGROUNDAgitation and aggression occur in up to half of people living with dementia over the course of the disease. Although non-pharmacological interventions are used as first-line treatment strategies, antipsychotics may be indicated in severe cases. A major adverse effect of antipsychotics in dementia is stroke; the mechanism of action of atypical antipsychotic risperidone has been linked to cardiovascular disease (CVD) biological pathways in preclinical studies.AIMSTo evaluate the risk of stroke associated with risperidone across different patient subgroups defined by stroke and CVD history.METHODAnonymised primary care data from the UK-based Clinical Practice Research Datalink were used to identify individuals diagnosed with dementia after the age of 65 years between 2004 and 2023. Risk of stroke over 1 year was compared between individuals initiating risperidone and propensity-score-matched controls across subgroups with and without history of stroke and any CVD.RESULTSIn the overall cohort (28 403 risperidone users and 136 324 mtatched controls), risperidone was associated with increased risk of stroke (adjusted hazard ratio: 1.28; 95% CI: 1.20-1.37). In the risperidone user group, the incidence rate of stroke was substantially higher in those with a prior history of stroke (incidence rate: 222 per 1000 person-years) and CVD (incidence rate: 94.1 per 1000 person-years) than in the overall cohort (incidence rate: 53.3 per 1000 person-years). Relative risks related to risperidone were similar across all CVD and stroke subgroup comparisons (hazard ratios between 1.23 and 1.44).CONCLUSIONSPeople with dementia with a prior history of CVD are at a significant increased risk of stroke, and risperidone further exacerbates this risk. Moreover, risperidone increases risk of stroke in patients without a prior history of CVD. This quantification of stroke risk across subgroups with and without history of CVD may help with communication of risk and aid more judicious prescribing.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"128 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary consensus on prevention, screening and monitoring of clozapine-associated myocarditis and clozapine rechallenge after myocarditis: commentary, de Leon.","authors":"Jose de Leon","doi":"10.1192/bjp.2025.10430","DOIUrl":"https://doi.org/10.1192/bjp.2025.10430","url":null,"abstract":"","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"106 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of 96 cases of apparent clozapine-induced severe neutropenia","authors":"Phoebe Wallman, Risha Govind, Cecilia Casetta, Eromona Whiskey, Shreyans Gandhi, Amelia Jewell, James MacCabe, David Taylor","doi":"10.1192/bjp.2025.10423","DOIUrl":"https://doi.org/10.1192/bjp.2025.10423","url":null,"abstract":"<span>Background</span><p>Clozapine remains underused despite its unparalleled efficacy in treatment-refractory schizophrenia. One of the reasons for its underuse is the fear of severe neutropenia and its consequences.</p><span>Aims</span><p>To scrutinise the association between severe neutropenia and clozapine in a cohort of patients clinically diagnosed with clozapine-induced severe neutropenia.</p><span>Method</span><p>We used data from the South London and Maudsley National Health Service Foundation Trust’s anonymised case register, known as the Clinical Record Interactive Search. We extracted details of cases where clozapine use was associated with two consecutive neutrophil counts below 1.5 × 10<span>9</span>/L. A panel of clinicians independently assessed each case. Agreement was reached on which cases clozapine was the likely or definite cause of the severe neutropenia, the risk to life and whether or not rechallenge with clozapine could be attempted.</p><span>Results</span><p>There were 96 cases where two consecutive neutrophil counts below 1.5 × 10<span>9</span>/L were registered. The panel judged that 9 (9.4%) were definitely caused by clozapine and a further 11 (11.5%) were probably caused by clozapine. Overall, 18 (18.8%) patients should be precluded from ever receiving clozapine again according to the panel (all from the 20 cases where clozapine was the definite or probable cause). Of the remaining 76 cases of severe neutropenia the cause could not be determined in 60 cases, but in 11 cases the cause was benign ethnic neutropenia, in 2 others the cause was cancer chemotherapy, in 2 it was infections and in 1 it was laboratory error. In almost 80% of cases, clozapine was not the clear cause of the neutropenia observed.</p><span>Conclusions</span><p>The large majority of severe neutropenia episodes mandating cessation of clozapine may not be caused by clozapine. Threshold-based monitoring systems cause unnecessary stopping of clozapine because they lack the necessary specificity for clozapine-related blood disorders.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145241877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clozapine-associated pulmonary embolism: presenting features and outcomes, UK pharmacovigilance data, 1990–2022","authors":"Susanna Every-Palmer, Rupert Nelson, Alice Hyun Min Kim, Simon Alfred Handley, Charlotte James, Lilly Wells, Alister Neill, Robert James Flanagan","doi":"10.1192/bjp.2025.10422","DOIUrl":"https://doi.org/10.1192/bjp.2025.10422","url":null,"abstract":"<span>Background</span><p>Pulmonary embolism is said to be more common in clozapine-treated patients than either in patients treated with other antipsychotics or in the general population.</p><span>Aims</span><p>To explore clinical features and outcomes of clozapine-related pulmonary embolism in the UK.</p><span>Method</span><p>We studied UK Yellow Card reports recorded as clozapine-related respiratory, thoracic and mediastinal disorders, 1990–2022.</p><span>Results</span><p>Of 474 unique reports of people with clozapine-associated pulmonary embolism, 339 (59% male) remained after applying strict exclusion criteria. Of these, 164 patients (48%) died. The mean clozapine dose was 336.7 (range 25–1000) mg d<span>−1</span> (<span>N</span> = 126). There was no difference in dose between the fatal and non-fatal outcomes. The median age at onset of pulmonary embolism was 45 years (range 21–82 years; <span>N</span> = 309). The median duration of clozapine treatment until onset was 2.9 years (range 2 days–22.7 years; <span>N</span> = 306). Sixty-five (39%) non-fatal and 36 (22%) fatal emboli occurred within 1 year of treatment. People who died were more likely to be obese (adjusted odds ratio 2.61; 95% CI 1.44–4.91) and to be noted as sedentary (adjusted odds ratio 6.07; 95% CI 1.58, 39.9). The 3 year moving average of cases was 0–5 per year, 1990–1999, 26 in 2010 and 16 in 2022. There was no change in the proportion of deaths by year of report (<span>p</span> = 0.41).</p><span>Conclusions</span><p>Clozapine-related pulmonary embolism is a significant concern with a high fatality rate. This risk necessitates a proactive approach to not only prevention, but also early recognition and management.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"64 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145235419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physician-assisted suicide research: the importance of integrating lived experience and neural science.","authors":"Gin S Malhi,Anneloes Hofstede","doi":"10.1192/bjp.2025.10417","DOIUrl":"https://doi.org/10.1192/bjp.2025.10417","url":null,"abstract":"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.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"214 1","pages":"661-663"},"PeriodicalIF":0.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145209151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The drama of fulfilment: reflection on Walter Benjamin's 'Fate and character' (1921).","authors":"George Ikkos,Giovanni Stanghellini,Antigone Ikkos-Serrano","doi":"10.1192/bjp.2024.274","DOIUrl":"https://doi.org/10.1192/bjp.2024.274","url":null,"abstract":"","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"114 1","pages":"736"},"PeriodicalIF":0.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145209150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accelerated ageing unfolds along the sensorimotor-association cortical axis in schizophrenia: multi-site study.","authors":"Haonan Pei,Sisi Jiang,Changyue Hou,Hechun Li,Zhihuan Yang,Roberto Rodriguez-Labrada,Mingjun Duan,Dezhong Yao,Cheng Luo","doi":"10.1192/bjp.2025.10364","DOIUrl":"https://doi.org/10.1192/bjp.2025.10364","url":null,"abstract":"BACKGROUNDSchizophrenia is associated with a reduced average lifespan due to accelerated ageing. Early studies have predominantly focused on the global brain age gap, limiting our understanding of region-specific ageing. Moreover, the relationship between accelerated ageing and schizophrenia disease progression has not been directly examined.AIMSOur aim was to investigate the cortical spatiotemporal patterns in ageing and disease progression in schizophrenia.METHODUsing multi-site, resting-state functional magnetic resonance imaging data, we analysed intrinsic activity fluctuations in 2353 healthy controls and 546 subjects with schizophrenia. We assessed normative models of ageing trajectories in brain activities in healthy controls, and examined the developmental trajectory of deviations from normative reference ranges with disease progression in schizophrenia.RESULTSThe ageing trajectories of both groups demonstrated spatiotemporal variability unfolding along the sensorimotor-association cortical axis, characterised by a rapid decline in transmodal association cortices at younger ages and followed by an accelerated decline in primary cortices at older ages. However, schizophrenia exhibited a more rapid rate of decline across the entire cerebral cortex, particularly during the short-duration stage. Further analysis revealed that the spatial variability of disease-induced ageing deviations persisted along the sensorimotor-association cortical axis throughout disease progression. The premature involvement of neurotransmitter systems, including dopamine and serotonin, may underlie accelerated ageing.CONCLUSIONSOur work uncovers regional ageing trajectories organised along the sensorimotor-association cortical axis, and provides new insights into the mechanisms of atypical ageing and disease progression in schizophrenia.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"93 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145195001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fit for whose future? A critical omission of people with intellectual disability in the 2025 NHS 10 Year Health Plan for England.","authors":"Rohit Shankar,Inder Sawhney,Samuel Tromans,Sujeet Jaydeokar,Mahesh Oodiyor,Rory Sheehan,Bhathika Perera,Amy Blake,Jana de Villers,Kiran Purandare,Jane McCarthy,Raja Anindya Sekhar Mukerjee,Richard A Laugharne,Angela Hassiotis,Andre Strydom,Regi Alexander,Ashok Roy","doi":"10.1192/bjp.2025.10428","DOIUrl":"https://doi.org/10.1192/bjp.2025.10428","url":null,"abstract":"The NHS 2025 Health Plan aims for radical reform but overlooks people with intellectual disability. This editorial highlights critical omissions in policy, services, research and rights protections. Without intentional inclusion, digital and community shifts risk deepening inequality. True progress demands co-produced strategies to ensure equitable care for this vulnerable population.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"100 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145140044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}