The British journal of psychiatry : the journal of mental science最新文献

{"title":"Bipolar villanelle and Lithium - Extra poems.","authors":"Rebecca Lawrence","doi":"10.1192/bjp.2021.193","DOIUrl":"https://doi.org/10.1192/bjp.2021.193","url":null,"abstract":"","PeriodicalId":520791,"journal":{"name":"The British journal of psychiatry : the journal of mental science","volume":" ","pages":"424"},"PeriodicalIF":10.5,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39998730","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":"Healthcare resource use and costs for people with type 2 diabetes mellitus with and without severe mental illness in England: longitudinal matched-cohort study using the Clinical Practice Research Datalink.","authors":"Han-I Wang,&nbsp;Lu Han,&nbsp;Rowena Jacobs,&nbsp;Tim Doran,&nbsp;Richard I G Holt,&nbsp;Stephanie L Prady,&nbsp;Simon Gilbody,&nbsp;David Shiers,&nbsp;Sarah Alderson,&nbsp;Catherine Hewitt,&nbsp;Jo Taylor,&nbsp;Charlotte E W Kitchen,&nbsp;Sue Bellass,&nbsp;Najma Siddiqi","doi":"10.1192/bjp.2021.131","DOIUrl":"https://doi.org/10.1192/bjp.2021.131","url":null,"abstract":"<p><strong>Background: </strong>Approximately 60 000 people in England have coexisting type 2 diabetes mellitus (T2DM) and severe mental illness (SMI). They are more likely to have poorer health outcomes and require more complex care pathways compared with those with T2DM alone. Despite increasing prevalence, little is known about the healthcare resource use and costs for people with both conditions.</p><p><strong>Aims: </strong>To assess the impact of SMI on healthcare resource use and service costs for adults with T2DM, and explore the predictors of healthcare costs and lifetime costs for people with both conditions.</p><p><strong>Method: </strong>This was a matched-cohort study using data from the Clinical Practice Research Datalink linked to Hospital Episode Statistics for 1620 people with comorbid SMI and T2DM and 4763 people with T2DM alone. Generalised linear models and the Bang and Tsiatis method were used to explore cost predictors and mean lifetime costs respectively.</p><p><strong>Results: </strong>There were higher average annual costs for people with T2DM and SMI (£1930 higher) than people with T2DM alone, driven primarily by mental health and non-mental health-related hospital admissions. Key predictors of higher total costs were older age, comorbid hypertension, use of antidepressants, use of first-generation antipsychotics, and increased duration of living with both conditions. Expected lifetime costs were approximately £35 000 per person with both SMI and T2DM. Extrapolating nationally, this would generate total annual costs to the National Health Service of around £250 m per year.</p><p><strong>Conclusions: </strong>Our estimates of resource use and costs for people with both T2DM and SMI will aid policymakers and commissioners in service planning and resource allocation.</p>","PeriodicalId":520791,"journal":{"name":"The British journal of psychiatry : the journal of mental science","volume":" ","pages":"402-409"},"PeriodicalIF":10.5,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39837260","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":"Rates of treatment-resistant schizophrenia from first-episode cohorts: systematic review and meta-analysis.","authors":"Dan Siskind,&nbsp;Stacy Orr,&nbsp;Surabhi Sinha,&nbsp;Ou Yu,&nbsp;Bhavna Brijball,&nbsp;Nicola Warren,&nbsp;James H MacCabe,&nbsp;Sophie E Smart,&nbsp;Steve Kisely","doi":"10.1192/bjp.2021.61","DOIUrl":"https://doi.org/10.1192/bjp.2021.61","url":null,"abstract":"<p><strong>Background: </strong>Treatment-resistant schizophrenia (TRS) is associated with high levels of functional impairment, healthcare usage and societal costs. Cross-sectional studies may overestimate TRS rates because of selection bias.</p><p><strong>Aims: </strong>We aimed to quantify TRS rates by using first-episode cohorts to improve resource allocation and clozapine access.</p><p><strong>Method: </strong>We undertook a systematic review of TRS rates among people with first-episode psychosis and schizophrenia, with a minimum follow-up of 8 weeks. We searched PubMed, PsycINFO, EMBASE, CINAHL and the Cochrane Database of Systematic Reviews, and meta-analysed TRS rates from included studies.</p><p><strong>Results: </strong>Twelve studies were included, totalling 11 958 participants; six studies were of high quality. The rate of TRS was 22.8% (95% CI 19.1-27.0%, P < 0.001) among all first-episode cohorts and 24.4% (95% CI 19.5-30.0%, P < 0.001) among first-episode schizophrenia cohorts. Subgroup sensitivity analyses by location of recruitment, TRS definition, study quality, time of data collection and retrospective versus prospective data collection did not lead to statistically significant differences in heterogeneity. In a meta-regression, duration of follow-up and percentage drop-out did not significantly affect the overall TRS rate. Men were 1.57 times more likely to develop TRS than women (95% CI 1.11-2.21, P = 0.010).</p><p><strong>Conclusions: </strong>Almost a quarter of people with first-episode psychosis or schizophrenia will develop TRS in the early stages of treatment. When including people with schizophrenia who relapse despite initial response and continuous treatment, rates of TRS may be as high as a third. These high rates of TRS highlight the need for improved access to clozapine and psychosocial supports.</p>","PeriodicalId":520791,"journal":{"name":"The British journal of psychiatry : the journal of mental science","volume":" ","pages":"115-120"},"PeriodicalIF":10.5,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39835584","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":"Why electroconvulsive therapy still carries a stigma.","authors":"Joel Paris","doi":"10.1192/bjp.2021.135","DOIUrl":"https://doi.org/10.1192/bjp.2021.135","url":null,"abstract":"<p><p>Electroconvulsive therapy is a highly effective treatment in psychiatry but still carries a stigma. One possible explanation is that it can be seen as a threat to personal autonomy.</p>","PeriodicalId":520791,"journal":{"name":"The British journal of psychiatry : the journal of mental science","volume":" ","pages":"113-114"},"PeriodicalIF":10.5,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39835069","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":"Investigating default mode network connectivity disruption in children of mothers with depression.","authors":"Maor Zeev-Wolf,&nbsp;Yair Dor-Ziderman,&nbsp;Maayan Pratt,&nbsp;Abraham Goldstein,&nbsp;Ruth Feldman","doi":"10.1192/bjp.2021.164","DOIUrl":"https://doi.org/10.1192/bjp.2021.164","url":null,"abstract":"<p><strong>Background: </strong>Exposure to maternal major depressive disorder (MDD) bears long-term negative consequences for children's well-being; to date, no research has examined how exposure at different stages of development differentially affects brain functioning.</p><p><strong>Aims: </strong>Utilising a unique cohort followed from birth to preadolescence, we examined the effects of early versus later maternal MDD on default mode network (DMN) connectivity.</p><p><strong>Method: </strong>Maternal depression was assessed at birth and ages 6 months, 9 months, 6 years and 10 years, to form three groups: children of mothers with consistent depression from birth to 6 years of age, which resolved by 10 years of age; children of mothers without depression; and children of mothers who were diagnosed with MDD in late childhood. In preadolescence, we used magnetoencephalography and focused on theta rhythms, which characterise the developing brain.</p><p><strong>Results: </strong>Maternal MDD was associated with disrupted DMN connectivity in an exposure-specific manner. Early maternal MDD decreased child connectivity, presenting a profile typical of early trauma or chronic adversity. In contrast, later maternal MDD was linked with tighter connectivity, a pattern characteristic of adult depression. Aberrant DMN connectivity was predicted by intrusive mothering in infancy and lower mother-child reciprocity and child empathy in late childhood, highlighting the role of deficient caregiving and compromised socio-emotional competencies in DMN dysfunction.</p><p><strong>Conclusions: </strong>The findings pinpoint the distinct effects of early versus later maternal MDD on the DMN, a core network sustaining self-related processes. Results emphasise that research on the influence of early adversity on the developing brain should consider the developmental stage in which the adversity occured.</p>","PeriodicalId":520791,"journal":{"name":"The British journal of psychiatry : the journal of mental science","volume":" ","pages":"130-139"},"PeriodicalIF":10.5,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39697729","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":"Letter to the Editor about 'Mental health difficulties across childhood and mental health service use: findings from a longitudinal population-based study'.","authors":"Isha Batra,&nbsp;Avni Gupta,&nbsp;Kajal Taneja,&nbsp;Aparna Goyal","doi":"10.1192/bjp.2021.77","DOIUrl":"https://doi.org/10.1192/bjp.2021.77","url":null,"abstract":"Letter to the Editor about ‘Mental health difficulties across childhood and mental health service use: findings from a longitudinal population-based study’ We read with great interest the article published by Mulraney et al in the July 2020 issue. This was an extensive study and targeted a very vulnerable group of our society. The study was followed up longitudinally and pointed to the deficits in utilisation of mental health services. Although this study provided great insights, we had some reservations that we would like to discuss. The authors have clearly described the take up of the data from the Longitudinal Study of Australian Children cohort. Clearly defined inclusion and exclusion criteria with a description of the recruitment process and how contact was made or how the questionnaire was applied, would have made the study design easier to follow. The recruitment process was difficult to infer especially for non-English-speaking readers. The authors mentioned that children excluded from the analysis were likely to have less educated parents, more mental health problems and disturbed family dynamics but we think that these are one of the most vulnerable groups, who need a higher level of care. The risk of underrepresentation of these subpopulations probably skewed the data, as those with higher unmet needs were left out of the study. Also, lack of mention of statistically significant values for the Vuong-Lo-Mendell-Rubin likelihood ratio test made it a little hard to interpret the results. The authors have very rightly projected four trajectories – low symptoms, high decreasing, moderate increasing and high increasing – but while following the tables in the supplementary data with the trajectories and individual specialist contact or in different waves, it was difficult to follow through. The authors have reported an attrition of 3764 participants, which was not reflected in these tables. Also, the reason for drop-out of participants from 4348 at end of the wave 1 to 3764 at the end of wave 6 would have made it more informative. Other factors like dual or referred consultation, changes in outcome, ease of accessibility and presence of required services in the defined postcode could play a role in the proposed conclusions. Probably the ratio of children who benefited with or without an adequate number of visits could have provided insights into the study. What actually is of real concern is that psychiatrists and psychologists are the least consulted ones for mental health issues. A possible role of stigmatised views, of parents and society, towards mental health cannot be overlooked. There areminor typographical errors thatwenoticed thatweremisleading like ‘Supplementary Fig. 1 shows’ in the results, while no such figure has been provided in the supplementary material or in Figure 1 of the article; age has been defined from 4 to 14 years, but in the graph that follows, age ‘10’ has been followed by ‘15’ and then by ‘14’. It would be a grea","PeriodicalId":520791,"journal":{"name":"The British journal of psychiatry : the journal of mental science","volume":" ","pages":"163"},"PeriodicalIF":10.5,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39647493","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":"Author's reply.","authors":"Melissa Mulraney","doi":"10.1192/bjp.2021.78","DOIUrl":"https://doi.org/10.1192/bjp.2021.78","url":null,"abstract":"Letter to the Editor about ‘Mental health difficulties across childhood and mental health service use: findings from a longitudinal population-based study’ We read with great interest the article published by Mulraney et al in the July 2020 issue. This was an extensive study and targeted a very vulnerable group of our society. The study was followed up longitudinally and pointed to the deficits in utilisation of mental health services. Although this study provided great insights, we had some reservations that we would like to discuss. The authors have clearly described the take up of the data from the Longitudinal Study of Australian Children cohort. Clearly defined inclusion and exclusion criteria with a description of the recruitment process and how contact was made or how the questionnaire was applied, would have made the study design easier to follow. The recruitment process was difficult to infer especially for non-English-speaking readers. The authors mentioned that children excluded from the analysis were likely to have less educated parents, more mental health problems and disturbed family dynamics but we think that these are one of the most vulnerable groups, who need a higher level of care. The risk of underrepresentation of these subpopulations probably skewed the data, as those with higher unmet needs were left out of the study. Also, lack of mention of statistically significant values for the Vuong-Lo-Mendell-Rubin likelihood ratio test made it a little hard to interpret the results. The authors have very rightly projected four trajectories – low symptoms, high decreasing, moderate increasing and high increasing – but while following the tables in the supplementary data with the trajectories and individual specialist contact or in different waves, it was difficult to follow through. The authors have reported an attrition of 3764 participants, which was not reflected in these tables. Also, the reason for drop-out of participants from 4348 at end of the wave 1 to 3764 at the end of wave 6 would have made it more informative. Other factors like dual or referred consultation, changes in outcome, ease of accessibility and presence of required services in the defined postcode could play a role in the proposed conclusions. Probably the ratio of children who benefited with or without an adequate number of visits could have provided insights into the study. What actually is of real concern is that psychiatrists and psychologists are the least consulted ones for mental health issues. A possible role of stigmatised views, of parents and society, towards mental health cannot be overlooked. There areminor typographical errors thatwenoticed thatweremisleading like ‘Supplementary Fig. 1 shows’ in the results, while no such figure has been provided in the supplementary material or in Figure 1 of the article; age has been defined from 4 to 14 years, but in the graph that follows, age ‘10’ has been followed by ‘15’ and then by ‘14’. It would be a grea","PeriodicalId":520791,"journal":{"name":"The British journal of psychiatry : the journal of mental science","volume":" ","pages":"163-164"},"PeriodicalIF":10.5,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39647494","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":"Clinical and cost-effectiveness of social recovery therapy for the prevention and treatment of long-term social disability among young people with emerging severe mental illness (PRODIGY): randomised controlled trial.","authors":"Clio Berry, Joanne Hodgekins, Paul French, Tim Clarke, Lee Shepstone, Garry Barton, Robin Banerjee, Rory Byrne, Rick Fraser, Kelly Grant, Kathryn Greenwood, Caitlin Notley, Sophie Parker, Jon Wilson, Alison R Yung, David Fowler","doi":"10.1192/bjp.2021.206","DOIUrl":"10.1192/bjp.2021.206","url":null,"abstract":"<p><strong>Background: </strong>Young people with social disability and severe and complex mental health problems have poor outcomes, frequently struggling with treatment access and engagement. Outcomes may be improved by enhancing care and providing targeted psychological or psychosocial intervention.</p><p><strong>Aims: </strong>We aimed to test the hypothesis that adding social recovery therapy (SRT) to enhanced standard care (ESC) would improve social recovery compared with ESC alone.</p><p><strong>Method: </strong>A pragmatic, assessor-masked, randomised controlled trial (PRODIGY: ISRCTN47998710) was conducted in three UK centres. Participants (n = 270) were aged 16-25 years, with persistent social disability, defined as under 30 hours of structured activity per week, social impairment for at least 6 months and severe and complex mental health problems. Participants were randomised to ESC alone or SRT plus ESC. SRT was an individual psychosocial therapy delivered over 9 months. The primary outcome was time spent in structured activity 15 months post-randomisation.</p><p><strong>Results: </strong>We randomised 132 participants to SRT plus ESC and 138 to ESC alone. Mean weekly hours in structured activity at 15 months increased by 11.1 h for SRT plus ESC (mean 22.4, s.d. = 21.4) and 16.6 h for ESC alone (mean 27.7, s.d. = 26.5). There was no significant difference between arms; treatment effect was -4.44 (95% CI -10.19 to 1.31, P = 0.13). Missingness was consistently greater in the ESC alone arm.</p><p><strong>Conclusions: </strong>We found no evidence for the superiority of SRT as an adjunct to ESC. Participants in both arms made large, clinically significant improvements on all outcomes. When providing comprehensive evidence-based standard care, there are no additional gains by providing specialised SRT. Optimising standard care to ensure targeted delivery of existing interventions may further improve outcomes.</p>","PeriodicalId":520791,"journal":{"name":"The British journal of psychiatry : the journal of mental science","volume":" ","pages":"154-162"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7612415/pdf/EMS140540.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39963530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Offspring's risk for suicidal behaviour in relation to parental death by suicide: systematic review and meta-analysis and a model for familial transmission of suicide.","authors":"Mara Calderaro,&nbsp;Christopher Baethge,&nbsp;Felix Bermpohl,&nbsp;Stefan Gutwinski,&nbsp;Meryam Schouler-Ocak,&nbsp;Jonathan Henssler","doi":"10.1192/bjp.2021.158","DOIUrl":"https://doi.org/10.1192/bjp.2021.158","url":null,"abstract":"<p><strong>Background: </strong>Exposure to parental suicide has been associated with increased risk for suicide and suicide attempts, although the strength of this association is unclear as evidence remains inconsistent.</p><p><strong>Aims: </strong>To quantify this risk using meta-analysis and identify potential effect modifiers.</p><p><strong>Method: </strong>A systematic search in PubMed, PsycInfo and Embase databases to 2020 netted 3614 articles. Inclusion criteria were: observation of history of parental death by suicide, comparison with non-exposed populations and definition of suicide and suicide attempt according to standardised criteria. We focused on population-based studies. The primary outcome was the pooled relative risk (RR) for incidence of suicide attempt and suicide in offspring of a parent who died by suicide compared with offspring of two living parents. Additionally, we compared the RR for attempted and completed suicide after parental suicide with the RR for attempted and completed suicide after parental death by other causes.</p><p><strong>Results: </strong>Twenty studies met our inclusion criteria. Offspring exposed to parental suicide were more likely to die by suicide (RR = 2.97, 95% CI 2.50-3.53) and attempt suicide (RR = 1.76, 95% CI 1.58-1.96) than offspring of two living parents. Furthermore, their risk of dying by or attempting suicide was significantly higher compared with offspring bereaved by other causes of death.</p><p><strong>Conclusions: </strong>The experience of losing a parent to suicide is a strong and independent risk factor for suicidal behaviour in offspring. Our findings highlight the need for prevention strategies, outreach programmes and support interventions that target suicide-related outcomes in the exposed population.</p>","PeriodicalId":520791,"journal":{"name":"The British journal of psychiatry : the journal of mental science","volume":" ","pages":"121-129"},"PeriodicalIF":10.5,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39837255","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":"Groups 4 Health versus cognitive-behavioural therapy for depression and loneliness in young people: randomised phase 3 non-inferiority trial with 12-month follow-up.","authors":"Tegan Cruwys,&nbsp;Catherine Haslam,&nbsp;Joanne A Rathbone,&nbsp;Elyse Williams,&nbsp;S Alexander Haslam,&nbsp;Zoe C Walter","doi":"10.1192/bjp.2021.128","DOIUrl":"https://doi.org/10.1192/bjp.2021.128","url":null,"abstract":"<p><strong>Background: </strong>Depression treatments are typically less effective for young people than for adults. However, treatments rarely target loneliness, which is a key risk factor in the onset, maintenance and development of depression.</p><p><strong>Aims: </strong>This study evaluated the efficacy of a novel loneliness intervention, Groups 4 Health (G4H), relative to the best-practice treatment of cognitive-behavioural therapy (CBT) in reducing loneliness and depression over a 12-month period (Australian New Zealand Clinical Trial Registry: ACTRN12618000440224).</p><p><strong>Method: </strong>The study was a phase 3 randomised non-inferiority trial comparing G4H with dose-controlled group CBT. Participants were 174 people aged 15-25 years experiencing loneliness and clinically significant symptoms of depression, who were not in receipt of adjunct treatment. Participants were recruited from mental health services in Southeast Queensland, Australia. Randomisation was conducted using computer software. Follow-up assessments and statistical analyses were masked to allocation. Both interventions consisted of five 75 min group-based psychotherapy sessions. The primary outcomes were depression and loneliness, with a non-inferiority margin of 2.20 for depression.</p><p><strong>Results: </strong>The trial enrolled 174 participants between 24 April 2018 and 25 May 2019, with 84 in the G4H condition and 90 in the CBT condition. All randomised participants were included in the intention-to-treat analyses (n = 174). The pre-post effect sizes for depression were dG4H = -0.71 and dCBT = -0.91. For loneliness, they were dG4H = -1.07 and dCBT = -0.89. At 12-month follow-up, the absolute difference between groups on depression was 1.176 (95% CI -1.94 to 4.29) and on loneliness it was -0.679 (95% CI -1.43 to 0.07). No adverse effects were observed.</p><p><strong>Conclusions: </strong>G4H was non-inferior to CBT for depression and showed a slight advantage over CBT for loneliness that emerged after treatment completion.</p>","PeriodicalId":520791,"journal":{"name":"The British journal of psychiatry : the journal of mental science","volume":" ","pages":"140-147"},"PeriodicalIF":10.5,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39835396","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}