The British Journal of Psychiatry最新文献

{"title":"Factors associated with self-harm in patients with substance use disorders who died by suicide: national hybrid questionnaire registry study","authors":"Martin Ø. Myhre, Fredrik A. Walby, Ole Klungsøyr, Jørgen G. Bramness, Lars Mehlum","doi":"10.1192/bjp.2025.22","DOIUrl":"https://doi.org/10.1192/bjp.2025.22","url":null,"abstract":"<span>Background</span><p>Self-harm, self-poisoning or self-injury, irrespective of the motivation, is a central risk factor for suicide. Still, there is limited knowledge of self-harm among patients with substance use disorders (SUDs) who die by suicide.</p><span>Aims</span><p>We aimed to describe the prevalence of a history of self-harm and identify the factors associated with self-harm, comparing individuals who died by suicide with and without SUDs.</p><span>Method</span><p>We used data from the Norwegian Surveillance System for Suicide in Mental Health and Substance Use Services, which is based on a national linkage between the Norwegian Cause of Death Registry and the Norwegian Patient Registry, to identify individuals who died by suicide within 1 year after last contact with mental health or substance use services (<span>n</span> = 1140). A questionnaire was retrieved for 1041 (91.3%) of these individuals. We used least absolute shrinkage and selection operator (LASSO) regression to select variables and compared patients with and without SUDs. Conditional selective inference was used to improve 90% confidence intervals and <span>p</span>-values.</p><span>Results</span><p>The prevalence of self-harm was 55% in patients with SUDs and 52.6% in patients without SUDs. Suicidal ideation (odds ratio 2.98 (95% CI 1.74–5.10)) emerged as a factor shared with patients without SUDs, while personality disorders (odds ratio 1.96 (1.12–3.40)) and a history of violence (odds ratio 1.86 (1.20–2.87)) were unique factors for patients with SUDs.</p><span>Conclusions</span><p>A history of self-harm is prevalent in patients with SUDs who die by suicide and is associated with suicidal ideation, a history of violence and personality disorders in patients with SUDs.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712775","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 extent to which child- and parent-report Revised Children’s Anxiety and Depression Scale, short Mood and Feeling Questionnaire, Strength and Difficulty Questionnaire and child-report KIDSCREEN identify the same young people as at risk of mental health conditions","authors":"Nazneen Nazeer, Jenny Parker, Lauren Cross, Sophie Epstein, Jessica Penhallow, Tamsin Newlove-Delgado, Johnny Downs, Tamsin Ford","doi":"10.1192/bjp.2025.5","DOIUrl":"https://doi.org/10.1192/bjp.2025.5","url":null,"abstract":"<span>Background</span><p>We rely heavily on cut-off points of brief measures of psychological distress in research and clinical practice to identify those at risk of mental health conditions; however, few studies have compared the performance of different scales.</p><span>Aim</span><p>To determine the extent to which the child- and parent-report Strength and Difficulty Questionnaire (SDQ), Revised Children’s Anxiety and Depression Scale (RCADS), short Mood and Feeling Questionnaire (sMFQ) and child-report KIDSCREEN correlated and identified the same respondents above cut-off points and at risk of mental health conditions.</p><span>Method</span><p>A cross-sectional survey was conducted among 231 children aged 11–16 years and 289 parents who completed all the above measures administered via a mobile app, MyJournE, including the SDQ, RCADS and sMFQ.</p><span>Results</span><p>The psychopathology measures identified similar proportions of young people as above the cut-off point and at risk of depression (child report 14.7% RCADS, 19.9% sMFQ, parent report 8.7% RCADS, 12.1% sMFQ), anxiety (child report 24.7% RCADS, 26.0% SDQ-Emotional subscale, parent report 20.1% RCADS, 26% SDQ-Emotional subscale) and child-report internalising problems (26.8% RCADS, 29.9% SDQ). Despite strong correlations between measures (child report 0.77–0.84 and parent report 0.70–0.80 between the SDQ, sMFQ and RCADS) and expected directions of correlation with KIDSCREEN and SDQ subscales, kappa values indicate moderate to substantial agreement between measures. Measures did not consistently identify the same children; half (<span>n</span> = 36, 46%) of those on child report and a third (<span>n</span> = 30, 37%) on parent report, scoring above the cut-off point for the SDQ-Emotional subscale, RCADS total or sMFQ, scored above the cut-off point on all of them. Only half (<span>n</span> = 46, 54%) of the children scored above the cut-off point on child report by the SDQ-Internalising and RCADS total scales.</p><span>Conclusion</span><p>This study highlights the risk of using a screening test to ‘rule out’ potential psychopathology. Screening tests should not be used diagnostically and are best used together with broad assessment.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"93 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143703177","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":"Cognitive and clinical profiles in first-episode psychosis and their relationship with functional outcomes","authors":"Megan Cowman, Jo Hodgekins, Siân Lowri Griffiths, Emma Frawley, Karen O’Connor, David Fowler, Max Birchwood, Gary Donohoe","doi":"10.1192/bjp.2025.3","DOIUrl":"https://doi.org/10.1192/bjp.2025.3","url":null,"abstract":"<span>Background</span><p>While cognitive impairment is a core feature of psychosis, significant heterogeneity in cognitive and clinical outcomes is observed.</p><span>Aims</span><p>The aim of this study was to identify cognitive and clinical subgroups in first-episode psychosis (FEP) and determine if these profiles were linked to functional outcomes over time.</p><span>Method</span><p>A total of 323 individuals with FEP were included. Two-step hierarchical and <span>k</span>-means cluster analyses were performed using baseline cognitive and clinical variables. General linear mixed models were used to investigate whether baseline cognitive and clinical clusters were associated with functioning at follow-up time points (6–9, 12 and 15 months).</p><span>Results</span><p>Three distinct cognitive clusters were identified: a cognitively intact group (<span>N</span> = 59), a moderately impaired group (<span>N</span>= 77) and a more severely impaired group (<span>N</span>= 122). Three distinct clinical clusters were identified: a subgroup characterised by predominant mood symptoms (<span>N</span> = 76), a subgroup characterised by predominant negative symptoms (<span>N</span>= 19) and a subgroup characterised by overall mild symptom severity (<span>N</span> = 94). The subgroup with more severely impaired cognition also had more severe negative symptoms at baseline. Cognitive clusters were significantly associated with later social and occupational function, and associated with changes over time. Clinical clusters were associated with later social functioning but not occupational functioning, and were not associated with changes over time.</p><span>Conclusions</span><p>Baseline cognitive impairments are predictive of both later social and occupational function and change over time. This suggests that cognitive profiles offer valuable information in terms of prognosis and treatment needs.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143703176","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 role of impairment in the diagnosis of autism","authors":"Jack Hollingdale, Emma Woodhouse, Quinton Deeley","doi":"10.1192/bjp.2025.12","DOIUrl":"https://doi.org/10.1192/bjp.2025.12","url":null,"abstract":"<span>Summary</span><p>Within the medical model, ‘impairment’ is required for a diagnosis of autism. However, the diagnostic manuals provide limited guidance as to how to interpret impairment, which can impact diagnostic rates and the provision of support. Impairment is discussed within the context of the medical model and current sociocultural landscape.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143703179","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":"Isotretinoin use, mood changes and suicidality. What is the link?","authors":"Cecilia Samamé","doi":"10.1192/bjp.2025.26","DOIUrl":"https://doi.org/10.1192/bjp.2025.26","url":null,"abstract":"<p>For over four decades, isotretinoin has shown unparalleled efficacy in the management of severe recalcitrant acne. However, controversies exist about its psychiatric safety profile. This editorial discusses the alleged causal role of isotretinoin in the development of psychiatric adverse events in light of the best available evidence.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"97 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677917","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":"From autism to the plural ‘autisms’: evidence from differing aetiologies, developmental trajectories and symptom intensity combinations","authors":"Paul Whiteley, Kevin Carr, Paul Shattock, Malcolm Hooper, Carol Stott, Karl Hardy, Ben Marlow","doi":"10.1192/bjp.2024.281","DOIUrl":"https://doi.org/10.1192/bjp.2024.281","url":null,"abstract":"<p>Autism spectrum disorder is defined by the presence of sustained problems in areas of social cognition and social understanding alongside repetitive and/or restricted patterns of behaviour. Behavioural presentations and developmental trajectories in autism are highly heterogeneous. For most, characteristics variably continue across the lifespan, and, for many, they overlap with numerous overrepresented comorbid combinations spanning behavioural, psychiatric and somatic domains. The current autism diagnostic systems (DSM-5, ICD-11) reflect this heterogeneity, focusing on discerning different assistance needs and symptom severity combinations. An emerging view on the pluralisation of autism – ‘the autisms’ – based on different severity levels and different developmental trajectories is gaining popularity, bolstered by the introduction of the grouping ‘profound autism’ and observations of non-persistence of autism for some. We advance the case for expanding the definition of the plural autisms based also on the numerous different aetiological routes that can lead to autism. Various genetic conditions, susceptibility to infectious agents, non-infectious environmental exposures and immune-mediated occurrences have all been observed to culminate in a diagnosis of autism. As a triad, aetiology, presentation intensity and developmental trajectory offer new ways to classify the autisms, with potentially important implications for research and practice.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"93 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143666383","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":"Biological research on mental pain, social pain and other pains not primarily felt in the body: methodological systematic review","authors":"Etienne K. Duranté, Alexandre Ribeiro, Lucie Gaspard-Boulinc, Isabelle Boutron, Chantal Henry, Anne-Cecile Petit, Josselin Houenou, Cedric Lemogne, Astrid Chevance","doi":"10.1192/bjp.2024.292","DOIUrl":"https://doi.org/10.1192/bjp.2024.292","url":null,"abstract":"<span>Background</span><p>Researchers explore the biology of painful experiences not primarily felt in the body (‘non-physical pain’), sometimes referred to as mental, social or emotional pain. A critical challenge lies in how to operationalise this subjective experience for biological research, a crucial process for translating findings into clinical practice.</p><span>Aims</span><p>To map studies investigating biological features of non-physical pain, focusing on their conceptual features (i.e. terms and definitions of non-physical pain) and methodological characteristics (e.g. experimental paradigms and measures).</p><span>Method</span><p>This methodological systematic review searched reports of primary research on the biological features of non-physical pain across Embase, MEDLINE and Web of Science. Using a meta-research approach, we synthetised results on terms, definitions, populations, experimental paradigms, confounders, measures of non-physical pain and investigation methods (e.g. functional magnetic resonance imaging).</p><span>Results</span><p>We identified 92 human studies, involving 7778 participants. Overall, 59.1% of the studies did not report any definition of non-physical pain, and 82% of studies did not use a specific measure. Regarding the possibility of translating results to clinical settings, most of the human studies involved only healthy participants (71.7%) and the seven different experimental paradigms used to induce non-physical pain had unknown external validity. Confounders were not considered by 32.4% of the experimental studies. Animal studies were rare, with only four rodent studies.</p><span>Conclusions</span><p>Biomedical studies of non-physical pain use heterogeneous concepts with unclear overlaps and methods with unknown external validity. As has been done for physical pain, priority actions include establishing an agreed definition and measurement of non-physical pain and developing experimental paradigms with good external validity.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143666375","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 identity of people of colour: deflecting the racialised lens","authors":"Rina Arya","doi":"10.1192/bjp.2025.17","DOIUrl":"https://doi.org/10.1192/bjp.2025.17","url":null,"abstract":"<p>A persistent problem that exists when considering minority groups – here conceived of as ethnic minorities – is the over-emphasis of an aspect of identity to represent the whole. In the west people of colour are seen through the lens of their colour and apparent racial difference. This is potentially limiting not only to their autonomy or right to shape their identity in their own terms but also within the therapeutic encounter. This article examines how misrepresentation of this kind occurs and what can be done to encourage a more empowering account of identity that advocates for the individual’s right to shape their identity and for the possibilities of a fuller perspective of identity that goes beyond racialised difference.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143666378","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 digital divide in people with severe mental illness: lessons learned and challenges lying ahead","authors":"Panagiotis Spanakis, Alice Mathers, Lauren Walker, Peter Huxley, Emily Peckham","doi":"10.1192/bjp.2025.47","DOIUrl":"https://doi.org/10.1192/bjp.2025.47","url":null,"abstract":"<p>In the post-COVID-19 pandemic era, a ‘digital-first’ agenda is being adopted in health/social care services, while digital exclusion has not been fully addressed. People with severe mental illness face profound inequalities at many levels (i.e. social, financial and health). Digital exclusion may further exacerbate some of these inequalities.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143666376","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":"Hype or hope? The developing evidence base for psychedelic treatment of addiction disorders","authors":"Emmert Roberts","doi":"10.1192/bjp.2025.19","DOIUrl":"https://doi.org/10.1192/bjp.2025.19","url":null,"abstract":"<p>There has been substantial recent renewed interest and investment to assess the therapeutic potential of psychedelic compounds in addiction disorders. This editorial discusses the available evidence from randomised trials and future research directions in the field, together with potential implications for patients, professionals and the wider addiction treatment system.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143666377","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}