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

{"title":"Comment on 'The vulnerability paradox in global mental health and its applicability to suicide'.","authors":"Akinola Adebisi","doi":"10.1192/bjp.2020.185","DOIUrl":"https://doi.org/10.1192/bjp.2020.185","url":null,"abstract":"to a decline in blood pressure? Furthermore, an exciting study in amyloid precursor protein transgenic mice found that noradrenaline depletion results in microglia dysfunction together with an increase in extracellular β-amyloid deposition, which can be rescued pharmacologically. It remains to be seen whether this finding can be translated into noradrenaline-based therapies for patients with dementia (for example noradrenaline reuptake inhibitors). Conceivably, the neuroprotective effects of noradrenaline may even extend beyond a single cellular mechanism or disease entity. Understanding the alterations in central noradrenaline signalling preceding overt dementia may create a powerful new window of opportunity for identifying both preclinical dementia stages and developing novel treatments targeting the locus coeruleus circuitry.","PeriodicalId":520791,"journal":{"name":"The British journal of psychiatry : the journal of mental science","volume":" ","pages":"653-654"},"PeriodicalIF":10.5,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/bjp.2020.185","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38629556","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":"Post-traumatic stress disorder as a risk factor for dementia: systematic review and meta-analysis.","authors":"Mia Maria Günak,&nbsp;Jo Billings,&nbsp;Emily Carratu,&nbsp;Natalie L Marchant,&nbsp;Graziella Favarato,&nbsp;Vasiliki Orgeta","doi":"10.1192/bjp.2020.150","DOIUrl":"https://doi.org/10.1192/bjp.2020.150","url":null,"abstract":"<p><strong>Background: </strong>Post-traumatic stress disorder (PTSD) has been identified as a potential risk factor for developing dementia. There are currently, however, no meta-analyses quantifying this risk.</p><p><strong>Aims: </strong>To systematically review and quantify the risk of future dementia associated with PTSD across populations. PROSPERO registration number CRD42019130392.</p><p><strong>Method: </strong>We searched nine electronic databases up to 25 October 2019 for longitudinal studies assessing PTSD and risk of dementia. We used random- and fixed-effects meta-analyses to pool estimates across studies.</p><p><strong>Results: </strong>PTSD was associated with a significant risk for all-cause dementia: pooled hazard ratio HR = 1.61 (95% CI 1.43-1.81, I2= 85.8%, P < 0.001; n = 1 693 678; 8 studies). Pooled HR was 1.61 (95% CI 1.46-1.78; I2= 80.9%, P < 0.001; n = 905 896; 5 studies) in veterans, and 2.11 (95% CI 1.03-4.33, I2= 91.2%, P < 0.001; n = 787 782; 3 studies) in the general population. The association between PTSD and dementia remained significant after excluding studies with high risk of bias (HR = 1.55, 95% CI 1.39-1.73, I2= 83.9%, P < 0.001; n = 1 684 928; 7 studies). Most studies included were retrospective and there was evidence of high heterogeneity.</p><p><strong>Conclusions: </strong>This is the first meta-analysis quantifying the association of PTSD and risk of dementia showing that PTSD is a strong and potentially modifiable risk factor for all-cause dementia. Future studies investigating potential causal mechanisms, and the protective value of treating PTSD are needed.</p>","PeriodicalId":520791,"journal":{"name":"The British journal of psychiatry : the journal of mental science","volume":" ","pages":"600-608"},"PeriodicalIF":10.5,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/bjp.2020.150","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38385910","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":"Further evidence for a role for the locus coeruleus in the aetiopathogenesis of dementia.","authors":"Elizabeta Blagoja Mukaetova-Ladinska,&nbsp;Joern Steinert,&nbsp;John Maltby,&nbsp;Golo Kronenberg","doi":"10.1192/bjp.2020.175","DOIUrl":"https://doi.org/10.1192/bjp.2020.175","url":null,"abstract":"Bebbington & McManus are to be thanked and congratulated for keeping this important and popular, but slippery, statistic under regular review and close-examination. Their summary is likely to lead most readers to continue using the now well-known and oftquoted ‘1 in 4’ headline statistic for the overall prevalence of psychiatric disorders. They also rightly point out the twin dangers of overand under-egging the statistic, risking lack of credibility and lack of impact, respectively. However, I would suggest that the data presented comfortably allows for a new, revised ‘1 in 3’ headline. This would not be overstating the case, but would simply accurately describe their findings. Their current ‘1 in 4’ summary headline explicitly excludes ‘personality and other disorders’, as well as ‘substance use disorders’ and ‘developmental disorders’ ...including them takes the true statistic to (very nearly) ‘1 in 3’ (31.6%, to be precise). There is now a long history of evidence and campaigning to have personality disorders recognised as ‘bona-fide’ mental disorders, with services developed and provided to match. Calls range from the 2003 National Institute for Mental Health in England ‘Personality Disorder: no longer a diagnosis of exclusion’, through to the more recent 2018 consensus statement on personality disorder and the freshly released 2020 Royal College of Psychiatrists Position statement, ‘Services for People Diagnosable with Personality Disorder’. They have always been in the ICD10. Similar arguments and evidence could be made (ethically, on the grounds of stigma/parity, and scientifically) for the inclusion of the substance use disorders and developmental disorders that bring the final statistic to 1 in 3. Presenting a new ‘1 in 3’ headline would not be over-egging the evidence, but simply presenting the full findings of carefully conducted up-to-date research, thus promoting accurate, evidencebased societal perceptions of mental disorder, and subsequent policy decision-making. This is especially important given the limited traction so far gained in closing the gap between rhetoric and action with regard to ‘parity of esteem for mental health’. The NHS Long Term Plan for Mental Health carries the potential for hope, but nothing should be taken for granted until it materialises. In the meantime, we should advocate not excluding people with personality disorder (or substance use and developmental disorders) from the headline statistics generated by good-quality research; statistical parity of esteem for all those with mental disorders would justify a new, revised, evidence-based and accurate ‘1 in 3’ summary headline, which would be neither under-egged, nor over-egged, but ‘just(-ly) right’.","PeriodicalId":520791,"journal":{"name":"The British journal of psychiatry : the journal of mental science","volume":" ","pages":"652-653"},"PeriodicalIF":10.5,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/bjp.2020.175","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38629557","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":"Imagery rescripting and eye movement desensitisation and reprocessing as treatment for adults with post-traumatic stress disorder from childhood trauma: randomised clinical trial.","authors":"Katrina L Boterhoven de Haan,&nbsp;Christopher W Lee,&nbsp;Eva Fassbinder,&nbsp;Saskia M van Es,&nbsp;Simone Menninga,&nbsp;Marie-Louise Meewisse,&nbsp;Marleen Rijkeboer,&nbsp;Margriet Kousemaker,&nbsp;Arnoud Arntz","doi":"10.1192/bjp.2020.158","DOIUrl":"https://doi.org/10.1192/bjp.2020.158","url":null,"abstract":"<p><strong>Background: </strong>Investigation of treatments that effectively treat adults with post-traumatic stress disorder from childhood experiences (Ch-PTSD) and are well tolerated by patients is needed to improve outcomes for this population.</p><p><strong>Aims: </strong>The purpose of this study was to compare the effectiveness of two trauma-focused treatments, imagery rescripting (ImRs) and eye movement desensitisation and reprocessing (EMDR), for treating Ch-PTSD.</p><p><strong>Method: </strong>We conducted an international, multicentre, randomised clinical trial, recruiting adults with Ch-PTSD from childhood trauma before 16 years of age. Participants were randomised to treatment condition and assessed by blind raters at multiple time points. Participants received up to 12 90-min sessions of either ImRs or EMDR, biweekly.</p><p><strong>Results: </strong>A total of 155 participants were included in the final intent-to-treat analysis. Drop-out rates were low, at 7.7%. A generalised linear mixed model of repeated measures showed that observer-rated post-traumatic stress disorder (PTSD) symptoms significantly decreased for both ImRs (d = 1.72) and EMDR (d = 1.73) at the 8-week post-treatment assessment. Similar results were seen with secondary outcome measures and self-reported PTSD symptoms. There were no significant differences between the two treatments on any standardised measure at post-treatment and follow-up.</p><p><strong>Conclusions: </strong>ImRs and EMDR treatments were found to be effective in treating PTSD symptoms arising from childhood trauma, and in reducing other symptoms such as depression, dissociation and trauma-related cognitions. The low drop-out rates suggest that the treatments were well tolerated by participants. The results from this study provide evidence for the use of trauma-focused treatments for Ch-PTSD.</p>","PeriodicalId":520791,"journal":{"name":"The British journal of psychiatry : the journal of mental science","volume":" ","pages":"609-615"},"PeriodicalIF":10.5,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/bjp.2020.158","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38350448","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":"Challenges to welcoming people with mental illnesses into faith communities.","authors":"Patrick W Corrigan","doi":"10.1192/bjp.2020.83","DOIUrl":"https://doi.org/10.1192/bjp.2020.83","url":null,"abstract":"<p><p>Faith communities are important to the psychiatric care of people with mental illness. I distinguish the effects of two principles of becoming welcoming communities: compassion, in which the community accommodates members with mental illnesses so they are fully included, and dignity, which rests on the essential worth of everyone.</p>","PeriodicalId":520791,"journal":{"name":"The British journal of psychiatry : the journal of mental science","volume":" ","pages":"595-596"},"PeriodicalIF":10.5,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/bjp.2020.83","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37885500","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":"Kaleidoscope.","authors":"Derek K Tracy,&nbsp;Dan W Joyce,&nbsp;Dawn N Albertson,&nbsp;Sukhwinder S Shergill","doi":"10.1192/bjp.2020.186","DOIUrl":"https://doi.org/10.1192/bjp.2020.186","url":null,"abstract":"Among the criticisms of diagnostic systems is ‘diagnostic inflation’: with time criteria relax, the number of conditions expands and everything is pathologised. It is a common refrain, with the release of DSM-5 attracting particular notoriety. But, is it actually true? Fabiano & Haslam reviewed 123 studies in which a research sample was concurrently diagnosed using two consecutive DSM editions. Meta-analysis determined the average of 476 risk ratios was 1.0: namely, neither diagnostic inflation nor deflation from DSM-III to DSM-5. The overall stringency has been stable over time. This infers that, in general, any reported changes in population prevalences of illnesses are not because diagnostic systems altered ‘capture’ but are either the result of genuine change in numbers or their better detection. However, that is not to say all conditions were the same, with the altered criteria resulting in increases and decreases in prevalence of certain disorders across editions. It might not surprise you that attention-deficit hyperactivity disorder, autism spectrum disorder, eating disorders and substance use disorders showed inflation with time. One imagines that for these, there will be considerable debate as to whether this is just better recognition and detection. Nevertheless, the authors conclude that the notion of ‘concept creep’ across diagnostic systems has been overstated, and is not supported by the evidence.","PeriodicalId":520791,"journal":{"name":"The British journal of psychiatry : the journal of mental science","volume":" ","pages":"657-658"},"PeriodicalIF":10.5,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/bjp.2020.186","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38629558","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":"David Curtis","doi":"10.1192/bjp.2020.173","DOIUrl":"https://doi.org/10.1192/bjp.2020.173","url":null,"abstract":"to a decline in blood pressure? Furthermore, an exciting study in amyloid precursor protein transgenic mice found that noradrenaline depletion results in microglia dysfunction together with an increase in extracellular β-amyloid deposition, which can be rescued pharmacologically. It remains to be seen whether this finding can be translated into noradrenaline-based therapies for patients with dementia (for example noradrenaline reuptake inhibitors). Conceivably, the neuroprotective effects of noradrenaline may even extend beyond a single cellular mechanism or disease entity. Understanding the alterations in central noradrenaline signalling preceding overt dementia may create a powerful new window of opportunity for identifying both preclinical dementia stages and developing novel treatments targeting the locus coeruleus circuitry.","PeriodicalId":520791,"journal":{"name":"The British journal of psychiatry : the journal of mental science","volume":" ","pages":"653"},"PeriodicalIF":10.5,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/bjp.2020.173","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38629559","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":"Antti Mustonen,&nbsp;Solja Niemelä,&nbsp;Tanja Nordström,&nbsp;Graham K Murray,&nbsp;Erika Jääskeläinen,&nbsp;Jouko Miettunen","doi":"10.1192/bjp.2020.28","DOIUrl":"https://doi.org/10.1192/bjp.2020.28","url":null,"abstract":"We read, with great interest, the article by Antti Mustonen et al entitled ‘Adolescent cannabis use, baseline prodromal symptoms and the risk of psychosis’, it is a tremendous study and is well conceptualised. We would like to make certain comments. In theMethod section, under the subheading of Psychosis diagnoses, ICD diagnoses have been mentioned as (F22-F29, F302, F312...) whereas the fourth character in ICD-10 codes is always a ‘dot’. Second, the codes F302 and F312 are also mentioned under the category of psychosis. If these codes refer to F30.2 and F31.2, respectively then these fall in the category of affective disorder without psychosis. These errors in reporting make the article quite difficult to follow. There is also a mismatch between the figures and the text in the article. In the Results section, Figure 2, explaining the cumulative incidences of psychosis in four groups with and without cannabis use and prodromal symptoms in the Northern Finland Cohort 1986 is not self-explanatory as the figures (n = 13/134, 5/134...) has not been explained in the text and I found it difficult to understand the origin and meaning of these figures. Similarly, while mentioning the association between adolescent cannabis use and subsequent psychosis (on page 230 in the first paragraph of the Associations between adolescent cannabis use and subsequent psychosis subsection) the authors state that 18 out of 375 (4.8%) cannabis users received a diagnosis of psychosis during the 15-year follow-up (4 narrow-defined schizophrenia, 4 schizophrenia spectrum disorder, 0 bipolar disorder with psychotic features, 7 major depression with psychotic features, 3 other psychosis). As 7 out of 18 participants had major depression with psychotic features, which is a mood disorder, inclusion of it in the criteria would lead to inaccurate results. If these 7 participants are excluded, there would be 11 participants who had psychosis. There should have been more participants for a better exploration of the hypothesis formulated for the study. It would be of great help if the authors could clarify these points. Thank you.","PeriodicalId":520791,"journal":{"name":"The British journal of psychiatry : the journal of mental science","volume":" ","pages":"458"},"PeriodicalIF":10.5,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38202120","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":"Determinants of mental and physical health treatment-seeking among military personnel.","authors":"Thomas W Britt,&nbsp;Maurice L Sipos,&nbsp;Zachary Klinefelter,&nbsp;Amy B Adler","doi":"10.1192/bjp.2019.155","DOIUrl":"https://doi.org/10.1192/bjp.2019.155","url":null,"abstract":"<p><strong>Background: </strong>Although research has documented factors influencing whether military personnel seek treatment for mental health problems, less research has focused on determinants of treatment-seeking for physical health problems.</p><p><strong>Aims: </strong>To explicitly compare the barriers and facilitators of treatment-seeking for mental and physical health problems.</p><p><strong>Method: </strong>US soldiers (n = 2048) completed a survey with measures of barriers and facilitators of treatment-seeking for mental and physical health problems as well as measures of somatic symptoms and mental health.</p><p><strong>Results: </strong>The top barrier for both mental and physical health treatment-seeking was a preference for handling problems oneself. The top facilitators for both symptom types were related to treatment improving quality of life. Differential endorsement of barriers occurred for treatment of mental versus physical health symptoms. In contrast, facilitators were endorsed more for physical than for mental health treatment. While there were few gender differences, officers reported more barriers and facilitators than did enlisted personnel. Screening positive for mental or physical health problems was associated with greater endorsement of both barriers and facilitators for physical and mental health treatment, respectively.</p><p><strong>Conclusions: </strong>The leading barriers and facilitators for seeking treatment for mental health and physical problems are relatively similar, suggesting that health education should consider decision-making in seeking both mental and physical healthcare. Interventions should be tailored to reduce barriers for officers and improve facilitators for junior enlisted personnel, and address barriers and facilitators for service members screening positive for a mental or physical health problem.</p>","PeriodicalId":520791,"journal":{"name":"The British journal of psychiatry : the journal of mental science","volume":" ","pages":"420-426"},"PeriodicalIF":10.5,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/bjp.2019.155","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37383101","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":"Coronavirus disease 2019: achieving good mental health during social isolation.","authors":"Rowan Diamond,&nbsp;John Willan","doi":"10.1192/bjp.2020.91","DOIUrl":"https://doi.org/10.1192/bjp.2020.91","url":null,"abstract":"<p><p>The coronavirus disease 2019 pandemic has led to unprecedented disruption to the normal way of life for people around the globe. Social distancing, self-isolation or shielding have been strongly advised or mandated in most countries. We suggest evidence-based ways that people can maintain or even strengthen their mental health during this crisis.</p>","PeriodicalId":520791,"journal":{"name":"The British journal of psychiatry : the journal of mental science","volume":" ","pages":"408-409"},"PeriodicalIF":10.5,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1192/bjp.2020.91","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37896305","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}