The British Journal of Psychiatry最新文献

{"title":"Linking prolonged childhood and adolescent loneliness to schizophrenia spectrum disorders: results from EU-GEI study.","authors":"Álvaro Andreu-Bernabeu,Javier González-Peñas,Alberto Mora,Miguel Bernardo,Gisela Mezquida,Silvia Amoretti,Julio Bobes,Pilar A Saiz,Maria Paz García-Portilla,Julio Sanjuan,José Luis Santos,Estela Jiménez-López,Manuel Arrojo,Angel Carracedo,Mara Parellada,Nadja P Maric,Cem Atbaşoğlu,Alp Üçok,Köksal Alptekin,Meram Can Saka,Lotta-Katrin Pries,Michael O'Donovan,Jim van Os,Bart P F Rutten,Philippe Delespaul,Sinan Guloksuz,Celso Arango,Covadonga M Díaz-Caneja","doi":"10.1192/bjp.2025.100","DOIUrl":"https://doi.org/10.1192/bjp.2025.100","url":null,"abstract":"BACKGROUNDProlonged childhood and adolescent loneliness (CAL) is linked to various adverse mental health outcomes, yet its impact on schizophrenia spectrum disorders (SSD) has been understudied. While loneliness is associated with psychosis and worsens symptoms in SSD, few studies have explored the long-term effects of early loneliness on SSD risk. Understanding how CAL interacts with genetic liability to schizophrenia is essential for identification of high-risk individuals.AIMSThis study evaluated whether prolonged CAL is associated with increased SSD risk and examined the interaction between CAL and genetic liability for schizophrenia. Gender differences in these associations were also explored.METHODData from the European Gene-Environment Interactions in Schizophrenia (EU-GEI) study were analysed, including 1261 individuals with SSD, 1282 unaffected siblings and 1525 healthy controls. CAL was retrospectively assessed for periods before age 12 years and age 12-16 years. Genetic risk was measured using polygenic risk scores for schizophrenia. Logistic regression models and the Relative Excess Risk due to Interaction (RERI) method were used to examine gene-environment interactions, with stratification by gender.RESULTSProlonged CAL was associated with higher odds of SSD (odds ratio [95% CI] = 5.20 [3.85-7.01] for loneliness before age 12; odds ratio [95% CI] = 7.26 [5.63-9.38] for loneliness during adolescence). The interaction between CAL and genetic risk was strongest during adolescence (RERI [95% CI] = 23.46 [10.75-53.53]). Females showed a greater effect (odds ratio [95 %CI] = 10.04 [6.80-14.94]) than males (odds ratio [95% CI] = 5.50 [3.95-7.66]). Incorporating CAL and genetic interaction increased predictive values to 17% for SSD risk - rising to 22.5% in females - compared with 2.6 and 2.8%, respectively, for genetic risk alone.CONCLUSIONSProlonged CAL significantly increases SSD risk, particularly in females. The inclusion of CAL alongside genetic risk substantially enhances predictive accuracy. Early identification of CAL could inform preventive strategies, especially in genetically vulnerable populations.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"42 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144296011","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":"Neurosteroids and premenstrual dysphoric disorder","authors":"Marie Bixo, Louise Stiernman, Torbjörn Bäckström","doi":"10.1192/bjp.2025.103","DOIUrl":"https://doi.org/10.1192/bjp.2025.103","url":null,"abstract":"<span>Background</span><p>Premenstrual dysphoric disorder (PMDD) is common, with at least 3% of the female population affected by one or more of the typical mood symptoms of depression, irritability, mood swings and anxiety. The cyclicity and close relationship to the luteal phase of the menstrual cycle is characteristic for this syndrome and positive allosteric modulators (PAMs) on the GABA<span>A</span> receptor, especially allopregnanolone, are believed to be involved in the symptomatology.</p><span>Aim</span><p>To summarise the research on the role of PAMs and other neuroactive steroids in the pathophysiology of PMDD.</p><span>Method</span><p>PubMed was searched for articles including the terms Premenstrual syndrome, AND neurosteroids OR allopregnanolone OR GABA OR oestradiol. Many additional publications were previously known to the authors and basic animal research was covered in a secondary step through reference lists.</p><span>Results</span><p>There is evidence that allopregnanolone, like other PAMs of the GABA<span>A</span> receptor, is sedative in high concentrations and, in a minor proportion of the population, causes anxiety and irritability at lower levels, pointing to an inter-individual difference in sensitivity. In research comparing women with PMDD and healthy controls, differences in brain function and subcomposition of GABA<span>A</span> receptors related to levels of allopregnanolone have been found. Also, the varying levels of neuroactive steroids in general seem to worsen the symptoms. Supressed ovulation is effective but add-back hormones are necessary to prevent severe side-effects and could cause adverse mood in these individuals.</p><span>Conclusions</span><p>There is yet no effective treatment for PMDD available. Allopregnanolone seems to be a key provocateur of PMDD symptoms in susceptible individuals. Future research should focus on interventions that interfere with the effects of neurosteroids or the plasticity of the GABA<span>A</span> receptor itself.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144296091","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":"Predicting clinical and functional trajectories in individuals with first-episode psychosis by baseline deviations in grey matter volume.","authors":"Manuel Muñoz-Caracuel,Claudio Alemán-Morillo,Natalia García-San-Martín,Nathalia Garrido-Torres,María Alemany-Navarro,Richard A I Bethlehem,Lena Dorfschmidt,Jakob Seidlitz,Rosa Ayesa-Arriola,Javier Vázquez-Bourgon,Miguel Ruiz-Veguilla,,Benedicto Crespo-Facorro,Rafael Romero-García","doi":"10.1192/bjp.2025.105","DOIUrl":"https://doi.org/10.1192/bjp.2025.105","url":null,"abstract":"BACKGROUNDPredicting long-term outcome trajectories in psychosis remains a crucial and challenging goal in clinical practice. The identification of reliable neuroimaging markers has often been hindered by the clinical and biological heterogeneity of psychotic disorders and the limitations of traditional case-control methodologies, which often mask individual variability. Recently, normative brain charts derived from extensive magnetic resonance imaging (MRI) data-sets covering the human lifespan have emerged as a promising biologically driven solution, offering a more individualised approach.AIMSTo examine how deviations from normative cortical and subcortical grey matter volume (GMV) at first-episode psychosis (FEP) onset relate to symptom and functional trajectories.METHODWe leveraged the largest available brain normative model (N > 100 000) to explore normative deviations in a sample of over 240 patients with schizophrenia spectrum disorders who underwent MRI scans at the onset of FEP and received clinical follow-up at 1, 3 and 10 years.RESULTSOur findings reveal that deviations in regional normative GMV at FEP onset are significantly linked to overall long-term clinical trajectories, modulating the effect of time on both symptom and functional outcome. Specifically, negative deviations in the left superior temporal gyrus and Broca’s area at FEP onset were notably associated with a more severe progression of positive and negative symptoms, as well as with functioning trajectories over time.CONCLUSIONSThese results underscore the potential of brain developmental normative approaches for the early prediction of disorder progression, and provide valuable insights for the development of preventive and personalised therapeutic strategies.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"43 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295670","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":"Transdermal oestradiol and testosterone therapy for menopausal depression and mood symptoms: retrospective cohort study.","authors":"Sarah Glynne,Aini Kamal,Lynsey McColl,Louise Newson,Daniel Reisel,Eveline Mu,Olivia Hendriks,Pooja Saini,Caroline Gurvich,Jayashri Kulkarni","doi":"10.1192/bjp.2025.101","DOIUrl":"https://doi.org/10.1192/bjp.2025.101","url":null,"abstract":"BACKGROUNDPsychological symptoms in perimenopause and early menopause are common. The impact of menopausal hormone therapy (MHT) on menopausal mood symptoms is unclear.AIMSTo assess the impact of 17β-oestradiol ± micronised progesterone or the levonorgestrel-releasing intrauterine device, and/or transdermal testosterone, on depressive and anxiety symptoms in peri- and postmenopausal women.METHODA real-world retrospective cohort study set in the largest specialist menopause clinic in the UK. The Meno-D questionnaire measured mood-related symptoms.RESULTSThe study included 920 women: 448 (48.7%) perimenopausal, and 435 (47.3%) postmenopausal. Following initiation/optimisation of MHT, mean Meno-D scores decreased by 44.59% (95% CI -46.83% to -42.34%, P < 0.001) after average 107 days follow-up. Mood symptoms significantly improved (P < 0.01 per symptom). Improvement occurred in peri- and postmenopausal women. All MHT regimens improved mental health including both progestogen types (body-identical progesterone and levonorgestrel-releasing intrauterine device), MHT initiation strategy (oestradiol ± a progestogen versus oestradiol ± a progestogen and testosterone, 45.38 v. 48.53%, respectively, P = 0.47) and MHT optimisation strategy (MHT users treated with a higher oestradiol dose versus testosterone added versus both a higher oestradiol dose and testosterone, 34.70, 43.93 and 43.25%, respectively, P = 0.38).CONCLUSIONSUse of menopausal hormone therapy was associated with significant improvement in mood in peri- and postmenopausal women. Prospective studies and randomised clinical trials are needed to assess the effects of different regimens in different patient populations over longer time periods.","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"13 9 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144296014","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":"Subjective, behavioural and physiological correlates of stress in women using hormonal contraceptives","authors":"Zoé Bürger, Charlotte Kordowich, Julia Kübbeler, Carolin Müllerschön, Ann-Christin S. Kimmig, Min Su, Michael Lämmerhofer, Julia Sacher, Melanie Henes, Erika Comasco, Birgit Derntl, Lydia Kogler","doi":"10.1192/bjp.2025.7","DOIUrl":"https://doi.org/10.1192/bjp.2025.7","url":null,"abstract":"<span>Background</span><p>Stress, a major risk factor for mental health problems, is influenced by hormonal fluctuations from the menstrual cycle and hormonal oral contraceptives (OC). Despite widespread use, the impact of hormonal intrauterine devices (IUDs) on stress is limited to one study.</p><span>Aims</span><p>This study examines psychoendocrine stress responses in women using IUDs, OCs and women with a natural, regular menstrual cycle (NC) to better understand how endogenous and exogenous hormones influence stress.</p><span>Method</span><p>Using a repeated-measures design, we investigated stress responses in IUD and OC users and NC women. The Maastricht Acute Stress Task and its control task were applied twice within 4 months to assess subjective, endocrine and physiological stress correlates. Detailed endogenous and exogenous hormonal profiles were obtained, and women completed a 7-day diary (via ecological momentary assessment) after each appointment.</p><span>Results</span><p>Based on subjective, physiological and cortisol responses, stress induction was successful in all groups. IUD users reported higher subjective stress, negative affect and anxiety and lower positive affect compared to NC women. OC users exhibited a blunted cortisol response and higher heart rate but reported less acute stress and negative emotions than the other groups in the 7-day diary. Oestradiol and progesterone were suppressed in OC and IUD users compared with NC women. Progesterone, testosterone and oestradiol were differently associated with skin conductance, socio-emotional stress and negative affect.</p><span>Conclusions</span><p>IUD and OC use distinctly affect stress response, possibly because of their diverging metabolic pathways and hormone levels. IUD users showed higher emotional reactivity to stress in both lab and daily life, while OCs influenced physiological correlates. These findings highlight that exogenous hormone administration, previously thought to have limited systemic effects, affects women’s psychological well-being, underscoring the need for further research into stress-related disorders among women using hormonal contraceptives.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278497","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":"Methodological obstacles in studies linking hormonal contraception and depression","authors":"Søren Vinther Larsen, Vibe G. Frokjaer, Brice Ozenne","doi":"10.1192/bjp.2025.119","DOIUrl":"https://doi.org/10.1192/bjp.2025.119","url":null,"abstract":"<p>This editorial describes common methodological obstacles, including the healthy user bias, that are encountered in research studying the link between hormonal contraceptive use and depression and provides considerations for future directions.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"585 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144260294","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":"One size does not fit all: how type of menopause and hormone therapy matters for brain health","authors":"Laura L. Gravelsins, Liisa A. M. Galea","doi":"10.1192/bjp.2025.52","DOIUrl":"https://doi.org/10.1192/bjp.2025.52","url":null,"abstract":"<span>Background</span><p>Menopause is an inflection point in the ageing trajectory. Independent of chronological age, menopause is associated with the biological ageing of several body systems. In this review, we highlight the importance of considering the influence of menopause – its types, symptoms and interventions – on brain health. Supplementing the loss of ovarian hormones with menopausal hormone therapy (MHT) may be key for supporting the healthy brain ageing of females. MHT has been associated with reduced risk of several neurodegenerative diseases; however, its benefits are not always observed on brain health.</p><span>Aims</span><p>This narrative review highlights often overlooked MHT factors that influence its effects to produce positive or negative effects on brain health, cognition and neurodegenerative disease risk. These factors include the many varieties of MHT, including formulation, administration route and dosing schedule, as well as individual characteristics, particularly the presence of vasomotor symptoms and apolipoprotein ε4 (APOE4) genotype.</p><span>Method</span><p>PubMed and Scopus were used to identify articles with relevant search terms.</p><span>Results</span><p>Menopause factors, including age, abruptness and symptoms, influence brain ageing. MHT influences brain health, with transdermal MHT showing more positive effects on brain ageing, but its effectiveness may depend on individual factors such as genotype, reproductive and lifestyle factors.</p><span>Conclusions</span><p>To develop effective and individualised MHT treatments, further research is needed. Preclinical models must consider the type of human menopause and MHT. To achieve the greatest dementia prevention in females, more menopause education and care is needed that extends beyond 60 years of age, or 10 years postmenopause.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144238144","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 value of mental science: we publish what matters","authors":"Gin S. Malhi, Katherine Adlington, Adam Al-Diwani, Shehzad Ali, Rina Arya, David S. Baldwin, Prathiba Batley, Erica Bell, German Berrios, Allan Beveridge, Mohan Bhat, Dinesh Bhugra, Asit Biswas, Sarah Byford, Colin Campbell, Hilary Cass, Rakesh K. Chadda, Samuel R. Chamberlain, Astrid Chevance, Erika Comasco, John Cookson, Harry Costello, Hugo D. Critchley, Pim Cuijpers, Angharad N. de Cates, Riccardo De Giorgi, Claire de Oliveira, Colin Drummond, Jianfeng Feng, Tamsin Ford, Andrew Forrester, John R. Geddes, Judith R. Harrison, Joseph F. Hayes, Scott Henderson, Cyrus S.H. Ho, Philipp Homan, Neil Horn, Konstantinos Ioannidis, Edgar Jones, Eirini Karyotaki, Kenneth R. Kaufman, Ivan Koychev, Veena Kumari, Marinos Kyriakopoulos, Stephen M. Lawrie, William Lee, Anikó Lovik, Philip McGuire, Kwame McKenzie, Edoardo G. Ostinelli, Femi Oyebode, Sarah Peters, Eva Petkova, Michael R. Phillips, Mariana Pinto da Costa, Thomas J. Reilly, Emmert Roberts, Joanne Rodda, A. John Rush, Rob Saunders, Thomas G. Schulze, Frauke Schultze-Lutter, Sukhwinder S. Shergill, Gurubhaskar Shivakumar, Dan Siskind, G. Mustafa Soomro, Ramya Srinivasan, Athula Sumathipala, Kinga Szymaniak, Eric Tan, Leila Tarokh, Derek Tracy, Stuart Watson, Richard Williams, Jingwei Wu, Allan H. Young, Yaara Zisman-Ilani, Emilio Fernandez-Egea","doi":"10.1192/bjp.2025.118","DOIUrl":"https://doi.org/10.1192/bjp.2025.118","url":null,"abstract":"<p>Recent changes to US research funding are having far-reaching consequences that imperil the integrity of science and the provision of care to vulnerable populations. Resisting these changes, the <span>BJPsych Portfolio</span> reaffirms its commitment to publishing mental science and advancing psychiatric knowledge that improves the mental health of one and all.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"97 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144238145","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":"Premenstrual exacerbation of psychiatric symptoms: from misdiagnosis to management","authors":"Jayashri Kulkarni, Eveline Mu","doi":"10.1192/bjp.2024.295","DOIUrl":"https://doi.org/10.1192/bjp.2024.295","url":null,"abstract":"<p>Premenstrual exacerbation of existing mental illnesses (PME) is a condition where symptoms of mental disorders worsen during the luteal phase. Unlike premenstrual syndrome or premenstrual dysphoric disorder, PME is poorly recognised, with misdiagnoses and inadequate treatment. Understanding the brain impact of gonadal hormone fluctuations in PME is crucial.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218882","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":"Translational perspectives on women’s mental health","authors":"Liisa A. M. Galea","doi":"10.1192/bjp.2025.35","DOIUrl":"https://doi.org/10.1192/bjp.2025.35","url":null,"abstract":"<p>Preclinical and clinical research have devoted limited attention to women’s health. Animal models centred on female-specific factors will improve our understanding of mental health disorders. Exploring the heterogeneity of mental health disorders, in concert with attention to female-specific factors, will accelerate the discovery of efficacious treatments for mental health disorders.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218863","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}