The British Journal of Psychiatry最新文献

{"title":"Lamotrigine treatment of mental health problems during the perinatal period.","authors":"Holly A Austin,David S Baldwin","doi":"10.1192/bjp.2025.10307","DOIUrl":"https://doi.org/10.1192/bjp.2025.10307","url":null,"abstract":"Lamotrigine is beneficial in bipolar disorder and is often prescribed to patients during their period of reproductive potential. We summarise aspects of the pharmacology of lamotrigine, highlight its uses in psychiatric practice, drawing attention to recent findings relating to potential hazards arising from lamotrigine exposure in utero, and make some suggestions for clinical management.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"12 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533571","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 Mental Health Bill (2025) for England and Wales: professional and carer consensus statement summarising concerns and unintended consequences from proposed changes to autism and learning disability","authors":"Peter Beazley, Regi T. Alexander, John L. Taylor, Bharat Velani, Helen Dewson, Rohit Shankar, Samuel J. Tromans, Mahesh M. Odiyoor, Angela Hassiotis, Ashok Roy, Iain McKinnon, Asif Zia, Andre Strydom, Patrick Keown, Bhathika Perera, Mohsin Khan, Jane McCarthy, Michael Butler, Verity Chester, Lucy Fitton, Kenny Chiu, Andrea Bew, Tadhgh Lane, Tricia Gay, Bob Gay","doi":"10.1192/bjp.2025.10324","DOIUrl":"https://doi.org/10.1192/bjp.2025.10324","url":null,"abstract":"<p>The Mental Health Bill, 2025, proposes to remove autism and learning disability from the scope of Section 3 of the Mental Health Act, 1983 (MHA). The present article represents a professional and carer consensus statement that raises concerns and identifies probable unintended consequences if this proposal becomes law. Our concerns relate to the lack of clear mandate for such proposals, conceptual inconsistency when considering other conditions that might give rise to a need for detention and the inconsistency in applying such changes to Part II of the MHA but not Part III. If the proposed changes become law, we anticipate that detentions would instead occur under the less safeguarded Deprivation of Liberty Safeguards framework, and that unmanaged risks will eventuate in behavioural consequences that will lead to more autistic people or those with a learning disability being sent to prison. Additionally, there is a concern that the proposed definitional breadth of autism and learning disability gives rise to a risk that people with other conditions may unintentionally be unable to be detained. We strongly urge the UK Parliament to amend this portion of the Bill prior to it becoming law.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"653 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144521157","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 overview effect and patient care in psychiatry","authors":"Dinesh Bhugra, Antonio Ventriglio, Gin S. Malhi","doi":"10.1192/bjp.2025.116","DOIUrl":"https://doi.org/10.1192/bjp.2025.116","url":null,"abstract":"<p>The ‘overview effect’ was described by astronauts who saw the earth from space and found this gave them a very different perspective. This effect is a shift in worldview, and it has been suggested that politicians be sent to space to change their narrow perspectives. In a similar vein, it is crucial that psychiatrists have an overview of their patients so that their perspectives on patient care enable them to deal with the patient from different angles. In this editorial, the overview effect is described in the context of clinical care.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144515619","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":"Effectiveness of peer support for people with severe mental health conditions in high-, middle- and low-income countries: multicentre randomised controlled trial.","authors":"Bernd Puschner,Juliet Nakku,Ramona Hiltensperger,Philip Wolf,Inbar Adler Ben-Dor,Faith Bugeiga,Ashleigh Charles,Lion Gai Meir,Paula Garber-Epstein,Yael Goldfarb,Alina Grayzman,Shimri Hadas-Grundman,Maria Haun,Imke Heuer,Bahati Iboma,Jasmine Kalha,Lydia Kamwaga,Palak Korde,Yasuhiro Kotera,Silvia Krumm,Arti Kulkarni,Eric Kwebiiha,Jennifer Kyara,Max Lachman,Candelaria Mahlke,Benjamin Mayer,Galia Moran,Richard Mpango,Rachel Mtei,Annabel Müller-Stierlin,Roseline Nanyonga,Fileuka Ngakongwa,Jackline Niwemuhwezi,Rebecca Nixdorf,Lena Nugent,Soumitra Pathare,Mary Ramesh,Grace Ryan,Gwen Schulz,Maria Wagner,Tamara Waldmann,Lisa Wenzel,Donat Shamba,Mike Slade","doi":"10.1192/bjp.2025.10299","DOIUrl":"https://doi.org/10.1192/bjp.2025.10299","url":null,"abstract":"BACKGROUNDSome trials have evaluated peer support for people with mental ill health in high-income, mainly English-speaking countries, but the quality of the evidence is weak.AIMSTo investigate the effectiveness of UPSIDES peer support in high-, middle- and low-income countries.METHODThis pragmatic multicentre parallel-group wait-list randomised controlled trial (registration: ISRCTN26008944) with three measurement points (baseline and 4 and 8 months) took place at six study sites: two in Germany, and one each in Uganda, Tanzania, Israel and India. Participants were adults with long-standing severe mental health conditions. Outcomes were improvements in social inclusion (primary) and empowerment, hope, recovery, health and social functioning (secondary). Participants allocated to the intervention group were offered UPSIDES peer support.RESULTSOf the 615 participants (305 intervention group), 337 (54.8%) identified as women. The average age was 38.3 (s.d. = 11.2) years, and the mean illness duration was 14.9 (s.d. = 38.4) years. Those allocated to the intervention group received 6.9 (s.d. = 4.2) peer support sessions on average. Intention-to-treat analysis showed effects on two of the three subscales of the Social Inclusion Scale, Empowerment Scale and HOPE Scale. Per-protocol analysis with participants who had received three or more intervention sessions also showed an effect on the Social Inclusion Scale total score (β = 0.18, P = 0.031, 95% CI: 0.02-0.34).CONCLUSIONSPeer support has beneficial impacts on social inclusion, empowerment and hope among people with severe mental health conditions across diverse settings. As social isolation is a key driver of mental ill health, and empowerment and hope are both crucial for recovery, peer support can be recommended as an effective component of mental healthcare. Peer support has the potential to move global mental health closer towards a recovery- and rights-based orientation.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"2 3 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504607","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":"Critical components of 'Early Intervention in Psychosis': national retrospective cohort study.","authors":"Ryan Williams,Ed Penington,Veenu Gupta,Alan Quirk,Apostolos Tsiachristas,Michelle Rickett,Carolyn A Chew-Graham,David Shiers,Paul French,Belinda Lennox,Alex Bottle,Mike J Crawford","doi":"10.1192/bjp.2025.126","DOIUrl":"https://doi.org/10.1192/bjp.2025.126","url":null,"abstract":"BACKGROUNDPsychotic disorders are severe mental health conditions frequently associated with long-term disability, reduced quality of life and premature mortality. Early Intervention in Psychosis (EIP) services aim to provide timely, comprehensive packages of care for people with psychotic disorders. However, it is not clear which components of EIP services contribute most to the improved outcomes they achieve.AIMSWe aimed to identify associations between specific components of EIP care and clinically significant outcomes for individuals treated for early psychosis in England.METHODThis national retrospective cohort study of 14 874 EIP individuals examined associations between 12 components of EIP care and outcomes over a 3-year follow-up period, by linking data from the National Clinical Audit of Psychosis (NCAP) to routine health outcome data held by NHS England. The primary outcome was time to relapse, defined as psychiatric inpatient admission or referral to a crisis resolution (home treatment) team. Secondary outcomes included duration of admissions, detention under the Mental Health Act, emergency department and general hospital attendances and mortality. We conducted multilevel regression analyses incorporating demographic and service-level covariates.RESULTSSmaller care coordinator case-loads and the use of clozapine for eligible people were associated with reduced relapse risk. Physical health interventions were associated with reductions in mortality risk. Other components, such as cognitive-behavioural therapy for psychosis (CBTp), showed associations with improvements in secondary outcomes.CONCLUSIONSSmaller case-loads should be prioritised and protected in EIP service design and delivery. Initiatives to improve the uptake of clozapine should be integrated into EIP care. Other components, such as CBTp and physical health interventions, may have specific benefits for those eligible. These findings highlight impactful components of care and should guide resource allocation to optimise EIP service delivery.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"55 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144488290","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":"Evidence-based clinical practice guidelines for prevention, screening and treatment of peripartum depression.","authors":"Sandra Nakić Radoš,Ana Ganho-Ávila,Maria F Rodriguez-Muñoz,Rena Bina,Sarah Kittel-Schneider,Mijke P Lambregtse-van den Berg,Ilaria Lega,Angela Lupattelli,Greg Sheaf,Alkistis Skalkidou,Ana Uka,Susanne Uusitalo,Laurence Bosteels-Vanden Abeele,Mariana Moura-Ramos","doi":"10.1192/bjp.2025.43","DOIUrl":"https://doi.org/10.1192/bjp.2025.43","url":null,"abstract":"BACKGROUNDPeripartum depression (PPD) is a prevalent mental health disorder in the peripartum period. However, a recent systematic review of clinical guidelines relating to PPD has revealed a significant inconsistency in recommendations.AIMSThis study aimed to collect up-to-date evidence on the effectiveness of interventions and provide recommendations for prevention, screening and treating PPD.METHODA series of umbrella reviews on the effectiveness of PPD prevention, screening and treatment interventions was conducted. A search was performed in five databases from 2010 until 2023. The guidelines were developed according to the GRADE framework and AGREE II Checklist recommendations. Public stakeholder review was included.RESULTSOne hundred and forty-five systematic reviews were included in the final analysis and used to form the guidelines. Forty-four recommendations were developed, including recommendations for prevention, screening and treatment. Psychological and psychosocial interventions are strongly recommended for preventing PPD in women with no symptoms and women at risk. Screening programmes for depression are strongly recommended during pregnancy and postpartum. Cognitive-behavioural therapy is strongly recommended for PPD treatment for mild to severe depression. Antidepressant medication is strongly recommended for treating severe depression in pregnancy. Electroconvulsive therapy is strongly recommended for therapy-resistant and life-threatening severe depression during pregnancy. Other recommendations are offered to healthcare professionals, stakeholders and researchers in managing PPD in different contexts.CONCLUSIONTreatment recommendations should be implemented after carefully considering clinical severity, previous history, risk-benefit for mother and foetus/infant and women's values and preferences. Implementation of evidence-based clinical practice guidelines within country-specific contexts should be facilitated.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"141 1","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144488289","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":"Oral glucocorticoids and risk of psychiatric and suicidal behaviour outcomes: population-based cohort study.","authors":"Tyra Lagerberg,Tapio T Gustafsson,Yasmina Molero,Julian Forton,Amir Sariaslan,Zheng Chang,Henrik Larsson,Paul Lichtenstein,Seena Fazel","doi":"10.1192/bjp.2025.128","DOIUrl":"https://doi.org/10.1192/bjp.2025.128","url":null,"abstract":"BACKGROUNDDespite evidence of associations between glucocorticoid treatment and adverse psychiatric and suicidal behaviour outcomes, large-scale observational evidence for serious outcomes is lacking.AIMSTo assess the risk of psychiatric and suicidal behaviour outcomes during glucocorticoid treatment.METHODUsing Swedish population registers, we identified 1 105 964 individuals aged 15-54 years who collected a glucocorticoid prescription in oral form between 2006 and 2020. We investigated associations with a range of psychiatric outcomes: unplanned specialist healthcare contacts due to depressive, bipolar, anxiety or schizophrenia-spectrum disorders; and deaths by suicide or unplanned specialist healthcare contacts due to self-harm ('suicidal behaviour'). We estimated hazard ratios from Cox proportional hazards models in a medication-only cohort by comparing outcome rates during and outside treated periods within individuals. We further identified individuals with an autoimmune or gastrointestinal autoimmune disorder diagnosis and compared hazards of the outcomes between those who did and did not initiate a glucocorticoid using a target trial emulation approach.RESULTSWe found increased risks for psychiatric outcomes, with within-individual hazard ratios ranging from 1.08 (95% CI, 1.00-1.16) for depressive disorders to 1.23 (95% CI, 1.12-1.36) for bipolar disorder and 1.25 (95% CI, 1.20-1.31) for anxiety disorders. We found no clear association with suicidal behaviour (hazard ratio: 1.06; 95% CI, 0.96-1.17). These findings were similar when stratified by age and gender. Within-individual associations were attenuated in those diagnosed with an autoimmune disorder. The risk of anxiety and bipolar disorder outcomes appeared particularly elevated in the first weeks of treatment. Absolute rates were modestly elevated during treatment, and higher in those with a history of psychiatric disorders.CONCLUSIONSGlucocorticoid treatment is associated with elevated risks of serious psychiatric outcomes, including the onset and relapse of common psychiatric disorders. Individuals with psychiatric histories may require additional monitoring during glucocorticoid treatment.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"20 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478919","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":"What are the implications of investigator positionality for mental health services research?","authors":"Patrick W. Corrigan, Miranda Twiss","doi":"10.1192/bjp.2025.114","DOIUrl":"https://doi.org/10.1192/bjp.2025.114","url":null,"abstract":"<p>Recent attention to diversity, equity and inclusion (DEI) has led to positionality wherein investigators and authors disclose their identity and social position, allowing readers to interpret findings through the lens of authors’ biases. This article describes positionality via meanings of identity and impact of positionality on readers and authors themselves.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"105 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144341083","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":"Insulin resistance and poorer treatment outcomes in depression: evidence from UK Biobank primary care data","authors":"Giuseppe Fanelli, Janita Bralten, Barbara Franke, Nina Roth Mota, Anna Rita Atti, Diana De Ronchi, Alessio Maria Monteleone, Luigi Grassi, MNESYS – Mood and Psychosis Sub-Project (Spoke 5), Alessandro Serretti, Chiara Fabbri","doi":"10.1192/bjp.2025.82","DOIUrl":"https://doi.org/10.1192/bjp.2025.82","url":null,"abstract":"<span>Background</span><p>Major depressive disorder (MDD) and insulin resistance-related conditions are major contributors to global disability. Their co-occurrence complicates clinical outcomes, increasing mortality and symptom severity.</p><span>Aims</span><p>In this study, we investigated the association of insulin resistance-related conditions and related polygenic scores (PGSs) with MDD clinical profile and treatment outcomes, using primary care records from UK Biobank.</p><span>Method</span><p>We identified MDD cases and insulin resistance-related conditions, as well as measures of depression treatment outcomes (e.g. resistance) from the records. Clinical-demographic variables were derived from self-reports, and insulin resistance-related PGSs were calculated using PRS-CS. Univariable analyses were conducted to compare sociodemographic and clinical variables of MDD cases with (IR+) and without (IR−) lifetime insulin resistance-related conditions. Multiple regressions were performed to identify factors, including insulin resistance-related PGSs, potentially associated with treatment outcomes, adjusting for confounders.</p><span>Results</span><p>Among 30 919 MDD cases, 51.95% were IR+. These had more antidepressant prescriptions and classes utilisation and longer treatment duration than patients without insulin resistance-related conditions (<span>P</span> &lt; 0.001). IR+ participants showed distinctive depressive profiles, characterised by concentration issues, loneliness and inadequacy feelings, which varied according to the timing of MDD diagnosis relative to insulin resistance-related conditions. After adjusting for confounders, insulin resistance-related conditions (i.e. cardiovascular diseases, hypertension, non-alcoholic fatty liver disease, obesity/overweight, prediabetes and type 2 diabetes mellitus) were associated with antidepressant non-response/resistance and longer treatment duration, particularly when MDD preceded insulin resistance-related conditions. No significant PGS associations were found with antidepressant treatment outcomes.</p><span>Conclusions</span><p>Our findings support an integrated treatment approach, prioritising both psychiatric and metabolic health, and public health strategies aimed at early intervention and prevention of insulin resistance in MDD.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144341081","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":"Mortality and hospital admissions in people with eating disorders: longitudinal cohort study in secondary care-linked English primary care records","authors":"Annie Jeffery, Joseph F. Hayes, Naomi Launders, Glyn Lewis, David Osborn, Helen Bould, Naomi Warne, Francesca Solmi","doi":"10.1192/bjp.2025.69","DOIUrl":"https://doi.org/10.1192/bjp.2025.69","url":null,"abstract":"<span>Background</span><p>Research on mortality and admissions for physical health problems across eating disorder diagnoses in representative settings is scarce. Inequalities in these outcomes across a range of sociodemographic characteristics have rarely been investigated.</p><span>Aims</span><p>We investigated whether people with eating disorders had greater all-cause mortality and physical health-related in-patient admissions compared with those without eating disorders, and whether associations varied by sex, ethnicity, deprivation, age and calendar year at diagnosis.</p><span>Method</span><p>Using primary care Clinical Research Practice Datalink linked to Hospital Episode Statistics, we matched people with an incident eating disorder diagnosis (any, anorexia nervosa, bulimia nervosa, eating disorders not otherwise specified, generic eating disorder or a referral code) from primary care Read codes to four people without eating disorders (1:4 matching) on year of birth, sex, primary care practice, year of registration and index date. We used univariable and multivariable Cox (mortality) and Poisson (admissions) models, and fitted interactions to investigate whether associations varied by sociodemographic characteristics.</p><span>Results</span><p>We included 58 735 people (90.1% female, 91.6% White). People with any eating disorders had higher all-cause mortality (hazard ratio: 2.15, 95% CI: 1.73–2.67). Anorexia nervosa had the highest mortality (hazard ratio: 3.49, 95% CI: 2.43–5.01). People with any eating disorders had higher rates of planned (incidence rate ratio (IRR): 1.80, 95% CI: 1.4–1.87) and emergency admissions for physical health problems (IRR: 2.35. 95% CI: 2.35–2.46) and emergency admissions for injuries, accidents and substance misuse (IRR: 5.26, 95% CI: 5.24–5.29). Mortality and admission rate ratios were greater in males.</p><span>Conclusions</span><p>People with eating disorders have high rates of mortality and physical health-related admissions. Observed inequalities call for an understanding of why such inequalities exist. These findings highlight the need for prompt and effective treatment for eating disorders, and for improved guidance on primary care management of people with eating disorders.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144341082","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}