The British Journal of Psychiatry最新文献

{"title":"The interface of autism and (borderline) personality disorder","authors":"Orestis Zavlis, Peter Tyrer","doi":"10.1192/bjp.2024.80","DOIUrl":"https://doi.org/10.1192/bjp.2024.80","url":null,"abstract":"<span>Summary</span><p>Prominent clinical perspectives posit that the interface of autism and (borderline) personality disorder manifests as either a misdiagnosis of the former as the latter or a comorbidity of both. In this editorial, we integrate these disparate viewpoints by arguing that personality difficulties are inherent to the autistic spectrum.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"201 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142276973","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":"Towards a unified theory of the aetiology of schizophrenia","authors":"Yuchao Jiang, Xiao Chang, Jianfeng Feng","doi":"10.1192/bjp.2024.65","DOIUrl":"https://doi.org/10.1192/bjp.2024.65","url":null,"abstract":"<p>We emphasise the existence of two distinct neurophysiological subtypes in schizophrenia, characterised by different sites of initial grey matter loss. We review evidence for potential neuromolecular mechanisms underlying these subtypes, proposing a biologically based disease classification approach to unify macro- and micro-scale neural abnormalities of schizophrenia.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142276965","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":"Early detection and intervention through the lens of the neurodevelopmental framework: the salience of developmental years and related services","authors":"Andrea Raballo, Michele Poletti, Antonio Preti","doi":"10.1192/bjp.2024.146","DOIUrl":"https://doi.org/10.1192/bjp.2024.146","url":null,"abstract":"<p>Broadening prediction efforts from imminent psychotic symptoms to neurodevelopmental vulnerabilities can enhance the accuracy of diagnosing severe mental disorders. Early interventions, especially during adolescence, are vital as these disorders often follow a long prodromal phase of neurodevelopmental disturbances. Child and adolescent mental health services should lead a developmentally-sensitive model for timely, effective detection and intervention.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"190 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142276948","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":"Clozapine, relapse, and adverse events: a 10-year electronic cohort study in Canada","authors":"Lloyd Balbuena, Shawn Halayka, Andrew Lee, A.G. Ahmed, Tamara Hinz, Nathan Kolla, Jenna Pylypow","doi":"10.1192/bjp.2024.140","DOIUrl":"https://doi.org/10.1192/bjp.2024.140","url":null,"abstract":"<span>Background</span><p>Clozapine is the most effective medication for treatment-resistant psychoses, but the balance of benefits and risks is understudied in real-world settings.</p><span>Aims</span><p>To examine the relative re-hospitalisation rates for mental health relapse and adverse events associated with clozapine and other antipsychotics in adult and child/youth cohorts.</p><span>Method</span><p>Data were obtained from the Canadian Institute of Health Information for adults (<span>n</span> = 45 616) and children/youth (<span>n</span> = 1476) initially hospitalised for mental health conditions in British Columbia, Manitoba and Saskatchewan from 2008 to 2018. Patient demographics and hospitalisations were linked with antipsychotic prescriptions dispensed following the initial visit. Recurrent events survival analysis for relapse and adverse events were created and compared between clozapine and other antipsychotics.</p><span>Results</span><p>In adults, clozapine was associated with a 14% lower relapse rate versus other drugs (adjusted hazard ratio: 0.86, 95% CI: 0.83–0.90) over the 10-year follow-up. In the first 21 months, the relapse rate was higher for clozapine but then reversed. Over 1000 person-months, clozapine-treated adults could be expected to have 38 relapse hospitalisations compared with 45 for other drugs. In children/youth, clozapine had a 38% lower relapse rate compared with other antipsychotic medications (adjusted hazard ratio: 0.62, 95% CI: 0.49–0.78) over the follow-up period. This equates to 29 hospitalisations for clozapine and 48 for other drugs over 1000 person-months. In adults, clozapine had a higher risk for adverse events (hazard ratio: 1.34, 95% CI: 1.18–1.54) over the entire follow-up compared with other antipsychotics. This equates to 1.77 and 1.30 hospitalisations over 1000 person-months for clozapine and other drugs, respectively.</p><span>Conclusions</span><p>Clozapine was associated with lower relapse overall, but this was accompanied by higher adverse events for adults. For children/youth, clozapine was associated with lower relapse all throughout and had no difference in adverse events compared with other antipsychotics.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142236258","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":"Electroconvulsive therapy response and remission in moderate to severe depressive illness: a decade of national Scottish data","authors":"David M. Semple, Szabolcs Suveges, J. Douglas Steele","doi":"10.1192/bjp.2024.126","DOIUrl":"https://doi.org/10.1192/bjp.2024.126","url":null,"abstract":"<span>Background</span><p>Despite strong evidence of efficacy of electroconvulsive therapy (ECT) in the treatment of depression, no sensitive and specific predictors of ECT response have been identified. Previous meta-analyses have suggested some pre-treatment associations with response at a population level.</p><span>Aims</span><p>Using 10 years (2009–2018) of routinely collected Scottish data of people with moderate to severe depression (<span>n</span> = 2074) receiving ECT we tested two hypotheses: (a) that there were significant group-level associations between post-ECT clinical outcomes and pre-ECT clinical variables and (b) that it was possible to develop a method for predicting illness remission for individual patients using machine learning.</p><span>Method</span><p>Data were analysed on a group level using descriptive statistics and association analyses as well as using individual patient prediction with machine learning methodologies, including cross-validation.</p><span>Results</span><p>ECT is highly effective for moderate to severe depression, with a response rate of 73% and remission rate of 51%. ECT response is associated with older age, psychotic symptoms, necessity for urgent intervention, severe distress, psychomotor retardation, previous good response, lack of medication resistance, and consent status. Remission has the same associations except for necessity for urgent intervention and, in addition, history of recurrent depression and low suicide risk. It is possible to predict remission with ECT with an accuracy of 61%.</p><span>Conclusions</span><p>Pre-ECT clinical variables are associated with both response and remission and can help predict individual response to ECT. This predictive tool could inform shared decision-making, prevent the unnecessary use of ECT when it is unlikely to be beneficial and ensure prompt use of ECT when it is likely to be effective.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142236214","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":"BJP volume 224 issue 6 Cover and Back matter","authors":"","doi":"10.1192/bjp.2024.92","DOIUrl":"https://doi.org/10.1192/bjp.2024.92","url":null,"abstract":"","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"6 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141099283","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":"BJP volume 224 issue 6 Cover and Front matter","authors":"","doi":"10.1192/bjp.2024.91","DOIUrl":"https://doi.org/10.1192/bjp.2024.91","url":null,"abstract":"","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"7 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141099140","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":"Interaction between mental disorders and social disconnectedness on mortality: a population-based cohort study","authors":"Lisbeth Mølgaard Laustsen, Linda Ejlskov, Danni Chen, Mathias Lasgaard, Jaimie L. Gradus, Søren Dinesen Østergaard, Marie Stjerne Grønkjær, Oleguer Plana-Ripoll","doi":"10.1192/bjp.2024.68","DOIUrl":"https://doi.org/10.1192/bjp.2024.68","url":null,"abstract":"<span>Background</span><p>Despite the recognised importance of mental disorders and social disconnectedness for mortality, few studies have examined their co-occurrence.</p><span>Aims</span><p>To examine the interaction between mental disorders and three distinct aspects of social disconnectedness on mortality, while taking into account sex, age and characteristics of the mental disorder.</p><span>Method</span><p>This cohort study included participants from the Danish National Health Survey in 2013 and 2017 who were followed until 2021. Survey data on social disconnectedness (loneliness, social isolation and low social support) were linked with register data on hospital-diagnosed mental disorders and mortality. Poisson regression was applied to estimate independent and joint associations with mortality, interaction contrasts and attributable proportions.</p><span>Results</span><p>A total of 162 497 individuals were followed for 886 614 person-years, and 9047 individuals (5.6%) died during follow-up. Among men, interaction between mental disorders and loneliness, social isolation and low social support, respectively, accounted for 47% (95% CI: 21–74%), 24% (95% CI: −15 to 63%) and 61% (95% CI: 35–86%) of the excess mortality after adjustment for demographics, country of birth, somatic morbidity, educational level, income and wealth. In contrast, among women, no excess mortality could be attributed to interaction. No clear trends were identified according to age or characteristics of the mental disorder.</p><span>Conclusions</span><p>Mortality among men, but not women, with a co-occurring mental disorder and social disconnectedness was substantially elevated compared with what was expected. Awareness of elevated mortality rates among socially disconnected men with mental disorders could be of importance to qualify and guide prevention efforts in psychiatric services.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140845118","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":"LGI1-antibody encephalitis: how to approach this highly treatable dementia mimic in memory and mental health services","authors":"Sophie N. M. Binks, Adam Al-Diwani, Adam E. Handel, Tomasz Bajorek, Sanjay Manohar, Masud Husain, Sarosh R. Irani, Ivan Koychev","doi":"10.1192/bjp.2024.72","DOIUrl":"https://doi.org/10.1192/bjp.2024.72","url":null,"abstract":"<p>Leucine-rich glioma-inactivated 1-antibody-encephalitis is a treatable and potentially reversible cause of cognitive and psychiatric presentations, and may mimic cognitive decline, rapidly progressive dementia and complex psychosis in older patients. This aetiology is of immediate relevance given the alternative treatment pathway required, compared with other conditions presenting with cognitive deficits.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"222 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140821206","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":"Global, regional and national burdens of depression in adolescents and young adults aged 10–24 years, from 1990 to 2019: findings from the 2019 Global Burden of Disease study","authors":"Cheng-hao Yang, Jia-jie Lv, Xiang-meng Kong, Feng Chu, Zhi-bin Li, Wei Lu, Xin-yu Li","doi":"10.1192/bjp.2024.69","DOIUrl":"https://doi.org/10.1192/bjp.2024.69","url":null,"abstract":"<span>Background</span><p>Depression is a significant mental health concern affecting the overall well-being of adolescents and young adults. Recently, the prevalence of depression has increased among young people. Nonetheless, there is little research delving into the longitudinal epidemiology of adolescent depression over time.</p><span>Aims</span><p>To investigate the longitudinal epidemiology of depression among adolescents and young adults aged 10–24 years.</p><span>Method</span><p>Our research focused on young people (aged 10–24 years) with depression, using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019. We explored the age-standardised prevalence, incidence and disability-adjusted life-years (DALYs) of depression in different groups, including various regions, ages, genders and sociodemographic indices, from 1990 to 2019.</p><span>Results</span><p>The prevalence, incidence and DALYs of depression in young people increased globally between 1990 and 2019. Regionally, higher-income regions like High-Income North America and Australasia recorded rising age-standardised prevalence and incidence rates, whereas low- or middle-income regions mostly saw reductions. Nationally, countries such as Greenland, the USA and Palestine reported the highest age-standardised prevalence and incidence rates in 2019, whereas Qatar witnessed the largest growth over time. The burden disproportionately affected females across age groups and world regions. The most prominent age effect on incidence and prevalence rates was in those aged 20–24 years. The depression burden showed an unfavourable trend in younger cohorts born after 1980, with females reporting a higher cohort risk than males.</p><span>Conclusions</span><p>Between 1990 and 2019, the general pattern of depression among adolescents varied according to age, gender, time period and generational cohort, across regions and nations.</p>","PeriodicalId":22495,"journal":{"name":"The British Journal of Psychiatry","volume":"100 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140642733","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}