The British Journal of Psychiatry最新文献

{"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":"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":"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 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}

{"title":"Use of a violence risk prediction tool (Oxford Mental Illness and Violence) in early intervention in psychosis services: mixed methods study of acceptability, feasibility and clinical role","authors":"Daniel Whiting, Margaret Glogowska, Sue Mallett, Daniel Maughan, Belinda Lennox, Seena Fazel","doi":"10.1192/bjp.2024.293","DOIUrl":"https://doi.org/10.1192/bjp.2024.293","url":null,"abstract":"<span>Background</span><p>Scalable assessment tools for precision psychiatry are of increasing clinical interest. One clinical risk assessment that might be improved by such approaches is assessment of violence perpetration risk. This is an important adverse outcome to reduce for some people presenting to services for first-episode psychosis. A prediction tool (Oxford Mental Illness and Violence (OxMIV)) has been externally validated in these services, but clinical acceptability and role need to be examined and developed.</p><span>Aims</span><p>This study aimed to understand clinical use of the OxMIV tool to support violence risk management in early intervention in psychosis services in terms of acceptability to clinicians, patients and carers, practical feasibility, perceived utility, impact and role.</p><span>Method</span><p>A mixed methods approach integrated quantitative data on utility and patterns of use of the OxMIV tool over 12 months in two services with qualitative data from interviews of 20 clinicians and 12 patients and carers.</p><span>Results</span><p>The OxMIV tool was used 141 times, mostly in new assessments. Required information was available, with only family history items scored unknown to any notable degree. The OxMIV tool was deemed helpful by clinicians in most cases, especially if there were previous risk concerns. It was acceptable practically, and broadly for the service, for which its concordance with clinical judgement was important. Patients and carers thought it could improve openness. There was some limited impact on plans for clinical support.</p><span>Conclusions</span><p>The OxMIV tool met an identified clinical need to support clinical assessment for violence risk. Linkage to intervention pathways is a research priority.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143661186","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":"Freedom is (still today) therapeutic: centenary and continuing relevance of Franco Basaglia","authors":"Angelo Fioritti, Graham Ash, George Ikkos, Tommaso Squeri","doi":"10.1192/bjp.2024.294","DOIUrl":"https://doi.org/10.1192/bjp.2024.294","url":null,"abstract":"<p>Franco Basaglia (1924–1980) has a particular relevance to psychiatry today as he combined social critique with psychiatric reform. In the new ‘metacommunity’ era in psychiatry, his radical and critical thinking provides important tools, as does his enduring message that ‘freedom is (still today) therapeutic’.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143653461","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":"Network analysis of functional disabilities and their association with mental well-being in children and adolescents: multi-country study across low- and middle-income countries","authors":"Shanquan Chen, Emilio Fernandez-Egea, Sara Rotenberg, Rudolf N. Cardinal, Daiane Borges Machado, Tracey Smythe, Tamsin J. Ford, Hannah Kuper","doi":"10.1192/bjp.2024.278","DOIUrl":"https://doi.org/10.1192/bjp.2024.278","url":null,"abstract":"<span>Background</span><p>To develop effective mental health interventions for children and adolescents, it is essential to understand the intricate link between functional disability and mental well-being in this group.</p><span>Aims</span><p>To explore the network connections between various aspects of functional disability and mental well-being in young people with disabilities.</p><span>Method</span><p>We analysed data from the Multiple Indicator Cluster Surveys in 47 low- and middle-income countries, tracking progress towards health-related sustainable development goals. Our focus was on children and adolescents aged 5–17 with functional disabilities. Mental well-being was gauged using carer-reported signs of depression, anxiety and disability on the Child Functioning Module. Network-analysis techniques were used to examine links between mental well-being and functional disability domains.</p><span>Results</span><p>The study included 32 669 eligible children aged 5–17 with functional disabilities (14 826 females and 17 843 males). The core domains of disability with the strongest connections to poor mental well-being were difficulties in accepting change, making friends, behavioural control (controlling own behaviour) and remembering/concentrating. These associations remained largely consistent across different genders and developmental stages. However, there were notable gender differences and age-related shifts in the relationships between specific disabilities and mental well-being. In particular, signs of anxiety in males and depression in females were most associated with functional disability overall, while signs of depression had the closest links to disability in adolescents.</p><span>Conclusions</span><p>The network perspective may enable the design of tailored interventions and support services that consider age and gender differences. Further research should continue to explore these complex relationships, incorporating novel methodologies like network-analysis to enhance the understanding of these associations.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143653323","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":"Hidden suicides: focus on England and Wales – comparison with other nations","authors":"John Snowdon","doi":"10.1192/bjp.2025.20","DOIUrl":"https://doi.org/10.1192/bjp.2025.20","url":null,"abstract":"<p>Most deaths around the world are certified, registered and then ‘coded’ for statistical purposes. Misclassified (‘hidden’) suicides are deaths assigned an ICD code that is either erroneous or that should never be specified as a cause of death. Public health strategies depend on provision of accurate mortality statistics. Suicides are under-counted, largely through misattribution to natural disease, accident, ill-defined or unknown cause (code R99) or an event of undetermined intent. Proportions of suicides misclassified to each of these codes vary between nations. It is recommended that psychological or verbal autopsies be used when investigating external deaths of uncertain cause or intention, and some R99 deaths. This applies in Britain and wherever unusual patterns of deaths could signal hidden suicides – exemplified by high rates of drug deaths in North America.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143653322","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}