The British Journal of Psychiatry最新文献

{"title":"Hyper-scanning and hyper-pursuit define eye movement biomarkers of anxiety disorders.","authors":"Dan Zhang,Yu Li,Lihua Xu,Yangyang Xu,Xu Liu,Wensi Zheng,Yawen Hong,Jinyang Zhao,Yanyan Wei,Huiru Cui,Haichun Liu,Tianhong Zhang,Jijun Wang","doi":"10.1192/bjp.2026.10626","DOIUrl":"https://doi.org/10.1192/bjp.2026.10626","url":null,"abstract":"BACKGROUNDAnxiety disorders are highly prevalent yet lack objective biomarkers. Whereas threat-related attentional biases are well documented, less is known about broader eye movement alterations that may characterise anxiety.AIMSTo characterise multi-paradigm eye movement profiles in anxiety disorders and evaluate their potential as behavioural markers for disorder differentiation.METHODEye movements were recorded in 91 patients with anxiety disorders, 118 with depressive disorders and 98 healthy controls during free viewing of neutral-stimuli, smooth-pursuit and fixation-stability tasks. Principal component analysis was applied to derive latent eye movement dimensions, which were then tested for group differences, associations with symptom severity and classification performance.RESULTSCompared with both patients with depression and healthy controls, patients with anxiety disorders exhibited hyper-scanning during free viewing, characterised by increased saccade frequency and path length, and hyper-pursuit during smooth pursuit, reflected in increased velocity gain, fewer intrusive saccades and more catch-up saccades. Principal component analysis identified six latent components, among which active visual exploration, pupillary arousal and smooth-pursuit control demonstrated robust group differences. Machine learning models trained on 6 components yielded areas under the receiver operating characteristic curve of 0.82 for anxiety versus healthy controls, 0.83 for depression versus healthy controls and 0.61 for anxiety versus depression.CONCLUSIONSHyper-scanning and hyper-pursuit emerge as defining eye movement signatures of anxiety, linking core mechanisms of vigilance and prediction with measurable behavioural markers. These insights position eye-tracking as a promising behavioural modality for mechanism-informed differentiation across affective disorders.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"4 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751438","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":"Looking for valid markers of anxiety.","authors":"Matthew Garner","doi":"10.1192/bjp.2026.10634","DOIUrl":"https://doi.org/10.1192/bjp.2026.10634","url":null,"abstract":"","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"5 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751417","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":"Tell me lies, tell me sweet little lies: power calculations in clinical trials.","authors":"Michael Berk,Ravi Iyer,Andrew Mackinnon,Sue Cotton","doi":"10.1192/bjp.2026.10642","DOIUrl":"https://doi.org/10.1192/bjp.2026.10642","url":null,"abstract":"","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"26 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751435","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":"Psychiatry and Human Nature: Classic and Romantic Perspectives By Gareth S. Owen. Cambridge University Press, 2025. £29.99 (pb). 210 pp. ISBN 978-1009212533 - ERRATUM.","authors":"Brendan D Kelly","doi":"10.1192/bjp.2026.10660","DOIUrl":"https://doi.org/10.1192/bjp.2026.10660","url":null,"abstract":"","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"11 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751418","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":"Investigating inequalities in children and young people's mental healthcare and outcomes: prospective longitudinal analysis from the STADIA trial.","authors":"Kapil Sayal,Grace Holt,Christopher Partlett,Laura Wyatt,Anupam Bhardwaj,Julia Gledhill","doi":"10.1192/bjp.2026.10617","DOIUrl":"https://doi.org/10.1192/bjp.2026.10617","url":null,"abstract":"BACKGROUNDMany children and young people (CYP) with significant mental health difficulties face barriers to accessing care from mental health services, impacting their clinical outcomes and recovery. Sociodemographic and socioeconomic factors may contribute to inequalities in access and outcomes.AIMSTo investigate the roles of sociodemographic, socioeconomic and clinical factors in influencing access to services, receipt of clinical care or diagnoses and clinical outcomes.METHODUsing data from a large, nationally representative, randomised controlled trial in England (STADIA), 1225 children aged 5-17 years and with emotional difficulties referred to child and adolescent mental health services (CAMHS) were followed up over 18 months post-referral to investigate predictors of referral acceptance, receipt of care and their clinical outcomes.RESULTSOlder CYP (for each 1-year increase in age, odds ratio 1.07, 95% CI: 1.02, 1.11) and those living in the least deprived neighbourhoods (deprivation index, least versus most deprived quintile: odds ratio 1.60, 95% CI: 1.05, 2.43) were more likely to have their referral accepted by CAMHS. Clinical severity (i.e. scoring above cut-off for symptoms and/or impact) was not associated with receipt of a clinical diagnosis or treatment/intervention. At 12-month post-referral, 61% met mental health 'caseness' criteria (v. 67% at baseline). CYP living in less deprived neighbourhoods had better clinical outcomes at 12-month follow-up (least versus most deprived quintile: odds ratio 0.49, 95% CI: 0.30, 0.81, for meeting caseness criteria, i.e. the presence of clinically significant symptoms and impairment). Females were more likely than males to have clinically significant levels of depression at 12-month follow-up (odds ratio 1.77, 95% CI: 1.28, 2.45).CONCLUSIONSThere appear to be sociodemographic and socioeconomic inequalities in access to care and outcomes for clinically referred CYP with emotional mental health difficulties, with limited improvements in clinical outcomes 1 year following referral to CAMHS. CYP living in more deprived areas and younger children appear less likely to receive help, hampering earlier intervention efforts even in help-seeking populations.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"13 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751434","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 pharmacological rationale for amiloride nasal spray: potentially a portable and rapid acting treatment for panic disorder: commentary, Fagan.","authors":"Harry A Fagan","doi":"10.1192/bjp.2026.10635","DOIUrl":"https://doi.org/10.1192/bjp.2026.10635","url":null,"abstract":"","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"15 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147735169","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":"Response to 'Beyond the biopsychosocial: why psychiatry needs anthropology'.","authors":"Daniel James Redfearn,Aditi Joshi,Jerry Yi Chang","doi":"10.1192/bjp.2026.10639","DOIUrl":"https://doi.org/10.1192/bjp.2026.10639","url":null,"abstract":"","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"65 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147735209","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":"Alice in AI-Wonderland: digital dyad, distorted reality.","authors":"Cortney Husodo,Gurubhaskar Shivakumar","doi":"10.1192/bjp.2026.10641","DOIUrl":"https://doi.org/10.1192/bjp.2026.10641","url":null,"abstract":"","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"325 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147735171","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":"Schizophrenia and accelerated ageing: systematic review and future research directions.","authors":"Emilio Fernandez-Egea,Clemente Garcia-Rizo,Brian Kirkpatrick","doi":"10.1192/bjp.2026.10606","DOIUrl":"https://doi.org/10.1192/bjp.2026.10606","url":null,"abstract":"BACKGROUNDSchizophrenia has been proposed to be a disorder of accelerated ageing, characterised by a mismatch between biological and chronological age. Evidence accumulated over the past 15 years has examined this model using molecular, neuroimaging, cognitive and epidemiological markers.AIMSTo evaluate whether schizophrenia shows evidence of an accelerated or advanced ageing phenotype across biological systems and to assess the consistency of the underlying molecular mechanisms.METHODA systematic review (PROSPERO CRD42024574059) was conducted following PRISMA guidelines. PubMed and Google Scholar were searched for studies published after 2009 that cited the original accelerated ageing hypothesis publication or investigated ageing in the context of schizophrenia and/or psychosis. Evidence was synthesised narratively by domain, with emphases on meta-analyses and minimally treated, longitudinal cohorts.RESULTSA total of 923 manuscripts were identified, and a final 170 were included in the systematic review. Schizophrenia showed a reproducible ageing phenotype, as evidenced by in increased mortality, higher dementia risk, brain-predicted age elevation and cognitive decline. BrainAGE studies revealed mean age gaps of 3-4 years, often present at first episode. At the mechanistic level, meta-analyses reported consistent telomere shortening (standardised mean difference approximately -0.4 to -0.5) and modest acceleration of selected epigenetic clocks. Dysregulation of oxidative stress, inflammation, mitochondrial function and insulin-like growth factor-1 signalling were frequent and partly preceded antipsychotic exposure.CONCLUSIONSSchizophrenia is associated with a multisystem ageing phenotype underpinned by convergent biological mechanisms, most consistently involving telomere attrition and oxidative and/or inflammatory stress. The overall pattern supports a model of advanced rather than uniformly accelerated ageing, reflecting early biological deviation with parallel rather than steeper decline.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"5 1","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147731483","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":"Altered prefrontal effective connectivity during emotion regulation in social anxiety disorder.","authors":"Elisabeth Schrammen,Alec J Jamieson,Hannah Meinert,Joscha Böhnlein,Theresa M Slump,Roman A Vogler,Alicia Menze,Susanne Meinert,Jochen Bauer,Janik Goltermann,Dominik Grotegerd,Katharina Förster,Jonathan Repple,Nils Opel,Ronny Redlich,Lisa Sindermann,Udo Dannlowski,Ben J Harrison,Elisabeth J Leehr","doi":"10.1192/bjp.2026.10628","DOIUrl":"https://doi.org/10.1192/bjp.2026.10628","url":null,"abstract":"BACKGROUNDEmotion regulation relies on the interplay between prefrontal and limbic brain regions, with prefrontal regions implicated in the top-down modulation of the amygdala. In social anxiety disorder, disruptions in these networks have been reported, but most studies used undirected functional connectivity.AIMSDynamic causal modelling (DCM) was used to assess effective (i.e. directed) connectivity differences during emotion processing and regulation in individuals with social anxiety disorder compared with healthy controls.METHODA total of 102 participants (61 with social anxiety disorder, 41 healthy controls) performed a functional magnetic resonance imaging emotion regulation task under two conditions: viewing neutral/negative faces, and downregulating emotions using a self-chosen strategy. DCM was applied to model effective connectivity among the amygdala and key prefrontal regions. Connectivity patterns were characterised in healthy controls, and group comparisons tested how social anxiety disorder differed from this baseline model using parametric empirical Bayes. Leave-one-out cross-validation (LOOCV) evaluated whether connectivity differences predicted diagnostic group, symptom severity and emotion regulation difficulties.RESULTSIn healthy controls, observation of negative faces was characterised by reciprocal influences between the amygdala and prefrontal cortex (PFC), including increased amygdala-to-ventromedial PFC (vmPFC) connectivity and inhibitory vmPFC-to-amygdala connectivity. During emotion regulation, healthy controls showed negative modulation from the amygdala to all prefrontal regions. Patients with social anxiety disorder did not differ from controls in amygdala-prefrontal connectivity; their alterations were confined to prefrontal circuits, with inhibitory connectivity from the pre-supplementary motor area (preSMA) to dorsolateral PFC during observation and bidirectional excitatory connectivity between the preSMA and vmPFC during regulation. LOOCV indicated that connectivity differences predicted diagnostic group.CONCLUSIONSThe results support the idea that emotion processing and regulation influence connectivity between prefrontal areas and the amygdala in a complex, feedback-driven manner. Our findings suggest that aberrant emotion regulation in social anxiety disorder appears to be more closely linked to differences in intra-prefrontal circuits than deficits in amygdala-prefrontal connectivity.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"65 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147726068","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}