The British Journal of Psychiatry最新文献

{"title":"Longitudinal changes in the mental health of those affected by the 2017 Manchester Arena attack: 3-year follow-up of adults seeking support from the Resilience Hub.","authors":"Louise Hussey,Matthew Gittins,Anna Hedges,Kate Allsopp,Neharika Puligundla,Alan Barrett,Gill Szafranski,Prathiba Chitsabesan,Paul French","doi":"10.1192/bjp.2025.10342","DOIUrl":"https://doi.org/10.1192/bjp.2025.10342","url":null,"abstract":"BACKGROUNDThe Resilience Hub was established to support people in need of psychological/psychosocial support following the 2017 Manchester Arena terrorist attack.AIMSTo use mental health screening measures over 3 years following the Arena event to examine the variation in symptoms reported by adults registered with the Hub, and whether this was associated with treatment access characteristics.METHODAdults engaging with Hub services were separated into eight cohorts depending on when they registered post-incident. Participants completed screening measures for symptoms of trauma, depression, generalised anxiety and work/social functioning. Baseline and follow-up scores over 3 years were compared among the eight admission groups. All types of appointment were recorded in terms of the number of minutes of clinical 'contact time' involved, to explore associations with time taken to register.RESULTSOverall, baseline screening scores increased as time to register post-event increased. Over the 3 years of follow-up, a decrease in scores was observed for all 4 screening measures, indicating improvement in mental well-being. Those taking longer to register had higher follow-up scores. However, they showed a slightly stronger decrease in average change of score per follow-up month. Mean contact time per month was greater (apart from the 18-months admission group) in individuals delaying registration. Increased contact time was associated with decreased follow-up screening scores for depression and anxiety.CONCLUSIONSPeople who registered earlier were less symptomatic, suggesting there may be a potential beneficial impact of early engagement with support services following traumatic events. All who registered showed improvement in symptoms, including those delaying registration, with increased contact time being beneficial. This reinforces the benefits of encouraging early and sustained engagement with services as soon as possible post-incident.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"41 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145140043","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":"Remembering Lysenko: when ideology and science meet","authors":"Rob Poole","doi":"10.1192/bjp.2025.10418","DOIUrl":"https://doi.org/10.1192/bjp.2025.10418","url":null,"abstract":"<p>Lysenko was a powerful Soviet pseudoscientist, whose theories cost millions of lives. He died 50 years ago, but his legacy is highly salient. Anti-science and ideology come together slowly, and UK pseudoscience has had unforeseen consequences. Pseudoscience must be challenged even when this has repercussions for those who speak up.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133575","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 relationship between placement instability and mental health among care-experienced children and young people: UK systematic review and meta-analysis","authors":"Cody Varnish, Alice R. Phillips, Shailaja Tallam Laxman, Nina Maxwell, Sarah L. Halligan, Katherine S. Button","doi":"10.1192/bjp.2025.10375","DOIUrl":"https://doi.org/10.1192/bjp.2025.10375","url":null,"abstract":"<span>Background</span><p>Children in care who experience frequent placement changes face an increased risk of negative mental health outcomes. Emerging evidence suggests a bidirectional relationship, where placement instability can both predict and result from mental health difficulties. Understanding the strength and direction of this relationship is crucial for informing policy and practice, yet UK-based evidence remains unconsolidated.</p><span>Aims</span><p>To conduct the first systematic review and meta-analysis examining the relationship between placement instability and mental health in the UK care system.</p><span>Method</span><p>This review was prospectively registered on the International Prospective Register of Systematic Reviews (PROSPERO; CRD42024493617). We searched five databases (up to August 2024) for peer-reviewed UK studies that included a care-experienced sample, measured placement (in)stability, measured mental health, and quantitatively examined the relationship between placement instability and mental health. A random-effects meta-analysis was conducted, and study quality was assessed using the Newcastle–Ottawa Scale.</p><span>Results</span><p>Fifteen studies (<span>N</span> = 6905) were included, with twelve studies (<span>n</span> = 5536) contributing to the meta-analysis. Children with unstable placements were more than twice as likely to experience mental health difficulties compared to those with stable placements (odds ratio 2.07, 95% CI 1.65–2.59). However, evidence on the causal direction of this relationship was limited.</p><span>Conclusion</span><p>Placement instability doubles the risk of mental health difficulties for care-experienced children, who already face elevated rates of mental disorders. Further research is urgently needed to clarify the bidirectional nature of this relationship and guide targeted intervention. Meanwhile, policymakers should prioritise collaborations between mental health services and local authorities to prevent the cycle of instability and mental health deterioration.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133574","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":"Attitudes towards mental health professionals in social media: infodemiology study: commentary, Shahbaz et al.","authors":"Aized Raza Shahbaz,Marta Corti,Ben Gray","doi":"10.1192/bjp.2025.10416","DOIUrl":"https://doi.org/10.1192/bjp.2025.10416","url":null,"abstract":"","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"85 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134084","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":"Determining essential dimensions for the clinical approximation of personality disorder severity: multi-method study.","authors":"André Kerber,Caroline Macina,Ludwig Ohse,Leonie Kampe,Oliver Busch,Michael Rentrop,Christine Knaevelsrud,Johannes Wrege,Susanne Hörz-Sagstetter","doi":"10.1192/bjp.2025.10347","DOIUrl":"https://doi.org/10.1192/bjp.2025.10347","url":null,"abstract":"BACKGROUNDDecades of research on the dimensional nature of personality disorder have led to the replacement of categorical personality disorder diagnoses by a dimensional assessment of personality disorder severity (PDS) in ICD-11, which essentially corresponds to personality functioning in the alternative DSM-5 model for personality disorders. Besides advancing the focus in the diagnosis of PD on impairments in self- and interpersonal functioning, this shift also urges clinicians and researchers worldwide to get familiar with new diagnostic approaches.AIMSThis study investigated which PDS dimensions among different assessment methods and conceptualisations have the most predictive value for overall PDS.METHODUsing semi-structured interviews and self-reports of personality functioning, personality organisation and personality structure in clinical samples of different settings in Switzerland and Germany (n = 534), we calculated a latent general factor for PDS (g-PDS) by applying a correlated trait correlated (method - 1) model (CTC(M-1)).RESULTSOur results showed that four interview-assessed PDS dimensions: defence mechanisms, desire and capacity for closeness, sense of self, and comprehension and appreciation of others' experiences and motivations account for 91.1% of variance of g-PDS, with a combination of either two of these four dimensions already explaining between 81.8 and 91.3%. Regarding self-reports, the dimensions depth and duration of connections, self-perception, object perception and attachment capacity to internal objects predicted 61.3% of the variance of a latent interview-based score, with all investigated self-reported dimensions together adding up to 65.2% variance explanation.CONCLUSIONSTaken together, our data suggest that focusing on specific dimensions, such as intimacy and identity, in time-limited settings might be viable in determining PDS efficiently.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"58 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145127027","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":"Severe alcohol withdrawal symptoms and the risk of suicidal acts in patients treated for alcohol use disorder.","authors":"Clément Vansteene,Caroline Dubertret,Henri-Jean Aubin,Philippe Batel,Daphnée Poupon,Philip Gorwood","doi":"10.1192/bjp.2025.10386","DOIUrl":"https://doi.org/10.1192/bjp.2025.10386","url":null,"abstract":"BACKGROUNDAlcohol use disorder (AUD) increases the likelihood of suicide attempts. The characteristics of AUD that increase suicide attempt risk remain unclear.AIMSTo identify factors associated with a history of suicide attempts and with suicidal acts occurring within a 2-year follow-up in patients with AUD.METHODThis multicentre, prospective cohort study included patients with AUD within 1 week of admission to in-patient care for alcohol withdrawal management. Sociodemographic and clinical data were collected during a face-to-face clinician interview at baseline. Follow-up telephone interviews were conducted up to 24 months post-inclusion to assess the primary end-point: the occurrence of a suicidal act (suicide attempt or completed suicide). To identify factors associated with past suicide attempts, Student's t-tests, chi-squared tests and logistic regression were performed. Univariate survival analyses and a multivariate Cox model were computed to identify predictors of suicidal acts occurring during the follow-up period.RESULTSOf the 779 patients included in the study, 337 (43.3%) had a history of suicide attempts. This was significantly associated with a history of major depressive disorder, female gender and higher levels of suicidal ideation and hopelessness. Regarding the prospective analysis, suicidal acts occurred in 90 (11.5%) patients. A history of severe alcohol withdrawal symptoms, defined as delirium tremens or seizures (adjusted hazard ratio (aHR) 2.38, 95% CI 1.38-4.10, P = 0.002), and a history of suicide attempts (aHR 1.84, 95% CI 1.14-2.99, P = 0.013), were associated with higher occurrence of suicidal acts, while living alone (0.47, 95% CI 0.28-0.78, P = 0.004) was a protective factor.CONCLUSIONSWhile a history of suicide attempts is a well-established risk factor for future suicidal acts, a history of severe alcohol withdrawal symptoms emerges as an even stronger predictor. Further studies are necessary to generalise this finding and use it to identify patients at higher risk of suicidal acts.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"1 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103515","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":"Reflections on the manifestation of attention-deficit hyperactivity disorder in girls from young adults with lived experiences: a qualitative study.","authors":"Tamara Williams,Isabella Barclay,Rhys Bevan-Jones,Lucy A Livingston,Sharifah Shameem Agha,Tamsin Ford,Ann John,Kapil Sayal,Anita Thapar,Joanna Martin","doi":"10.1192/bjp.2025.10376","DOIUrl":"https://doi.org/10.1192/bjp.2025.10376","url":null,"abstract":"BACKGROUNDAttention-deficit/hyperactivity disorder (ADHD) is more commonly missed or diagnosed later in females than in males. One explanation is that diagnostic criteria have been informed by research primarily based on male samples and may not adequately capture the female presentation of ADHD.AIMSThis study used a qualitative approach to better understand female ADHD in childhood, from the perspective of young women and non-binary adults with ADHD.METHODTwelve young adults (10 women and 2 non-binary individuals assigned female at birth, aged 18-25 years) with ADHD were interviewed to describe their lived experiences of ADHD throughout childhood. Interviews were transcribed verbatim and qualitatively analysed using the framework method, a codebook approach to thematic analysis.RESULTSParticipants reported experiencing a range of ADHD symptoms, some of which are not included in current diagnostic criteria. Four core themes were identified: (a) socially oriented and internalised symptoms, (b) social impacts, (c) masking and compensation and (d) the importance of context. Theme one describes how girls with ADHD may experience symptoms as more socially oriented (e.g. losing track of thoughts in a conversation), non-disruptive (e.g. doodling) and internalised (e.g. feeling frustrated) than those described by current diagnostic criteria. Theme two highlights the importance of social impacts of ADHD on friends, home and school. Theme three describes the desire to 'fit in' socially, behaviours and strategies used to mask symptoms and associated unfavourable consequences. Theme four highlights variability in symptoms across different environmental contexts.CONCLUSIONSThis study suggests that the presentation of ADHD symptoms in girls may be socially oriented, internalised and especially influenced by the social context. Also, female ADHD symptoms may be less visible due to scaffolding, masking and context. Future research should consider whether current ADHD diagnostic criteria require adjustment, to aid earlier recognition and diagnosis of ADHD in children and young people, especially in females.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"1 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103456","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 factors associated with PTSD in a paediatric population exposed to the 14 July 2016, Nice terrorist attack: results from a 2-year longitudinal study.","authors":"Morgane Gindt,Philippe Auby,Philippe Robert,Radia Zeghari,Nicolas Bodeau,Florence Askenazy,Arnaud Fernandez","doi":"10.1192/bjp.2025.10378","DOIUrl":"https://doi.org/10.1192/bjp.2025.10378","url":null,"abstract":"BACKGROUNDThe risk factors for post-traumatic stress disorder (PTSD) in children and adolescents following mass violence incidents, such as terrorist attacks, remain incompletely understood. In the aftermath of the 14 July 2016, terrorist attack in Nice, France, a dedicated paediatric consultation centre was established at the Children's University Hospital, the Nice Pediatric Psychotrauma Center (NPPC).AIMSThis 2-year longitudinal study aims to identify and understand the influence of pre-trauma, trauma-related and post-trauma risk factors associated with the development of PTSD in children and adolescents following the 2016 terrorist attack in Nice.METHODParticipants under 18 years of age at the time of the attack were recruited from the NPPC over 2 years, between 21 November 2017 and 22 November 2019. Assessments included semi-structured diagnostic interviews with children and/or parents, standardised clinical questionnaires for both parents and children and cognitive tests exclusively for children.RESULTSTwo hundred and seventy-one children (mean age 8.10 years; 48.7% female) directly impacted by the terrorist attack, were assessed. Pre-traumatic factors (age, gender assigned at birth and cognitive functioning) failed to predict PTSD. Two trauma-related factors, subjective fear intensity and lifetime number of traumatic events emerged as significant predictors. Concerning post-trauma factors, maternal symptoms (anxiety, depression and PTSD), child somatic symptoms and comorbid DSM-5 diagnoses played a crucial role in child PTSD. The final regression model demonstrated an 84% accuracy in predicting PTSD in children and adolescents (χ2[3] = 2.4, P < 0.001).CONCLUSIONSThese findings highlight the importance of assessing specific risk factors for PTSD in children and adolescents to deliver specialised and targeted care to young people and their parents following a terrorist attack.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"88 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083624","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 impact of trauma and PTSD on social functioning in refugees and asylum seekers post-migration: systematic review.","authors":"Alexandra Perkins,Julia Michalek,Lisa Dikomitis,Sukhi Shergill,Isabelle Mareschal","doi":"10.1192/bjp.2025.10385","DOIUrl":"https://doi.org/10.1192/bjp.2025.10385","url":null,"abstract":"BACKGROUNDRefugees and asylum seekers often experience trauma, leading to high rates of post-traumatic stress disorder (PTSD). However, the extent to which trauma and PTSD impacts social functioning, such as social relationships or engaging with community activities in new environments, remains unclear.AIMSThis systematic review aims to identify key areas of social functioning influenced by trauma and PTSD, with additional analyses stratified by trauma type.METHODA comprehensive search of five databases, grey literature sources, and reference lists was conducted in February 2025. Included papers explored the impact of trauma or PTSD on social functioning in adult displaced populations post-migration, within the last 30 years. Studies' risk of bias was assessed using the Mixed Methods Appraisal Tool and the Authority, Accuracy, Coverage, Objectivity, Date, Significance checklist. Data were extracted on associations between trauma, PTSD and social functioning outcomes.RESULTSOf the studies, encompassing 15 394 participants, 38 met the inclusion criteria. Our analysis indicated that trauma and PTSD have an impact on multiple domains of social functioning, including post-migration living difficulties, everyday functioning, acculturation and integration, social relationships, and employment and education. War-related trauma predominantly affected psychosocial functioning and integration, whereas interpersonal trauma had a greater impact on social relationships. While most findings indicated a negative influence of trauma and PTSD on these areas, some evidence suggested the potential for post-traumatic growth.CONCLUSIONSThe findings underscore the challenges displaced groups face, alongside the possibility of post-traumatic growth. Future research should focus on identifying factors that facilitate positive adaptation, informing interventions to support social integration in these vulnerable groups.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"22 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083585","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":"Blending low- and high-intensity cognitive-behavioural therapy in NHS Talking Therapies for anxiety and depression: preliminary evaluation.","authors":"Graham R Thew,Luke O'Reilly,Alexander Andrews,Dave Brignull,Jade Burton,Krishna Chauhan,Andrew Humphrey,Nevonne Lewis,Charlotte Stride,Caitlyn Teeney,Florence Vaughan-Burleigh,Christina Webb,Martyn Bradshaw,Laurien Broadley,Gabriella Clarke,Natalie Holmes,Edward Rennie,Samantha Sadler,Josef Landsberg,John Pimm,Peggy Postma,Joanne Ryder,Alison Salvadori,David M Clark","doi":"10.1192/bjp.2025.10374","DOIUrl":"https://doi.org/10.1192/bjp.2025.10374","url":null,"abstract":"BACKGROUNDA stepped care approach to treating anxiety and depression is common in mental health services. Low-intensity interventions, typically based on cognitive behavioural principles, are offered first, followed by high-intensity therapy if required. In the English National Health Service Talking Therapies (NHS TT) programme, different types of therapists deliver low- and high-intensity interventions. 'Stepping up' therefore involves changing therapist, and often an additional wait, which could both disrupt treatment flow.In NHS TT, many low-intensity therapists subsequently train at high intensity. Once dual-trained, they typically deliver only high-intensity treatment. With both skillsets, they could theoretically deliver a full stepped care pathway, avoiding potential disruption linked to stepping up.AIMSTo explore a blended treatment approach, where dual-trained therapists move between low- and high-intensity flexibly based on patient need.METHODTen dual-trained therapists across 4 services treated 43 patients. Patients with clinical complexities more likely to eventually require high-intensity support were selected. Propensity score matching was used to identify matched control groups from a pool of patients who received stepped care. Treatment characteristics and clinical outcomes were compared. Feedback was obtained from patients, therapists and supervisors.RESULTSCompared with matched controls, who received low- then high-intensity treatment, blended treatment required four fewer sessions on average, saving a third of therapist time and was completed 121 days sooner. The reliable recovery rate (54.1%) was 9% higher than the stepped care group (44.7%), which is clinically, although not statistically, significant. Blended treatment showed a non-significantly higher reliable deterioration rate. Patient feedback was positive. Therapists and supervisors highlighted advantages alongside practical challenges.CONCLUSIONSThe blended approach showed promise as an efficient and effective method to deliver therapy when clinicians are dual-trained. Larger-scale studies, and consideration of implementation challenges, are needed. However, results suggest that this approach could potentially offer more flexible and seamless care delivery.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"28 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083618","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}