BMJ mental health最新文献

{"title":"Universal, selective and indicated parenting interventions to prevent the development of adverse mental health outcomes in youth: a meta-review of systematic reviews.","authors":"Meredith X Han, Edward Chesney, Valerie Ng, Joanna Bright, Yashna K Sagar, Ellie Baker, Michael J Meaney, Evelyn C Law","doi":"10.1136/bmjment-2025-301613","DOIUrl":"https://doi.org/10.1136/bmjment-2025-301613","url":null,"abstract":"<p><strong>Background: </strong>Preventive interventions in the form of parenting support can reduce the risk of mental disorders in children. Summarising the effectiveness of parenting interventions across different levels of prevention can inform the prioritisation of the intervention.</p><p><strong>Objectives: </strong>We conducted a meta-review of systematic reviews and meta-analyses on universal, selective and indicated parenting interventions to prevent adverse mental health outcomes in youth.</p><p><strong>Study selection and analysis: </strong>PubMed, Ovid, Embase and PsycNet were searched. Systematic reviews consisting of randomised controlled trials of preventative parenting interventions were included. We provided a narrative synthesis of the results and assessed the quantity and quality of evidence for each level of prevention (ie, universal, selective, indicated) and mental health outcome.</p><p><strong>Findings: </strong>We identified 32 systematic reviews and meta-analyses, which included 354 randomised controlled trials, consisting of over 74 558 children and adolescents. Universal parenting interventions were effective in delaying the initiation of alcohol and cannabis use, but did not have consistent findings in preventing disruptive behaviour and mood disorders. Selective interventions were predominantly beneficial for disruptive behavioural problems across a variety of risk factors. Indicated interventions found substantial and consistent evidence for reducing problems in children with behavioural problems. Caution is warranted when interpreting findings, as the overall confidence rating of most reviews was very low, especially in the reporting of study selection and justifying exclusions in the AMSTAR-2.</p><p><strong>Conclusions: </strong>Our findings highlight the need for robust evidence synthesis. Despite the limitations of the current evidence base, parenting interventions hold promise for preventing mental health disorders.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565490","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":"Emergency colon cancer diagnosis in people with mental health conditions: a population-based cohort study in northern Italy.","authors":"Flavia Pennisi,Carlotta Buzzoni,Federico Gervasi,Antonio Giampiero Russo,Cristina Renzi","doi":"10.1136/bmjment-2025-301733","DOIUrl":"https://doi.org/10.1136/bmjment-2025-301733","url":null,"abstract":"BACKGROUNDIndividuals with mental health conditions may experience disparity in cancer diagnosis and health outcomes. This study aims to examine diagnostic pathways and mortality in patients with colon cancer with pre-existing mental health conditions.METHODSA population-based cohort study on colon cancer cases diagnosed in 2014-2020 in the provinces of Milan and Lodi, using linked cancer registration and health data. We examined cancer diagnostic pathways (screening, emergency presentation (EP), inpatient/outpatient visits) and short-term mortality in patients with and without pre-existing mental health conditions, accounting for physical comorbidities and sociodemographic factors. Mental health conditions were systematically categorised into distinct groups according to the International Classification of Diseases, 10th Revision.RESULTSOut of 11 429 patients with colon cancer, 16.2% had a pre-existing mental health condition. Individuals with mental health conditions versus those without had a higher risk of cancer diagnosis following EP: 43.8% versus 33.8%, adjusted OR (aOR) 1.32, 95% CI 1.19 to 1.47. EP risk was higher for patients with diagnoses of dementia and related cognitive conditions (aOR 1.69, 95% CI 1.41 to 2.03), substance use/behavioural syndromes/personality-related conditions (aOR 1.92, 95% CI 1.34 to 2.75) and anxiety (aOR 1.44, 95% CI 1.16 to 1.79). The likelihood of screening-detected cancer was lower (4.6% vs 9.1%; aOR 0.78, 95% CI 0.60 to 0.99), especially for dementia and related cognitive conditions (aOR 0.27, 95% CI 0.08 to 0.86). Short-term mortality was higher in patients with cancer with mental health conditions than in those without.CONCLUSIONMental health conditions were associated with a lower likelihood of screening and a higher risk of emergency cancer diagnosis. Tailored strategies are warranted to enhance cancer diagnosis for the non-negligible group of individuals with mental health conditions.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533337","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":"Prognostic predictions in psychosis: exploring the complementary role of machine learning models.","authors":"Violet van Dee, Seyed M Kia, Caterina Fregosi, Wilma E Swildens, Anne Alkema, Albert Batalla, Coen van den Berg, Danko Coric, Edwin van Dellen, Lotte G Dijkstra, Arthur van den Doel, Livia S Dominicus, John Enterman, Frank L Gerritse, Marte Z van der Horst, Fedor van Houwelingen, Charlotte S Koch, Lisanne E M Koomen, Marjan Kromkamp, Michelle Lancee, Brian E Mouthaan, Diane F van Rappard, Eline J Regeer, Raymond W J Salet, Metten Somers, Jorgen Straalman, Marjolein H T de Vette, Judith Voogt, Inge Winter-van Rossum, Rene S Kahn, Wiepke Cahn, Hugo G Schnack","doi":"10.1136/bmjment-2025-301594","DOIUrl":"https://doi.org/10.1136/bmjment-2025-301594","url":null,"abstract":"<p><strong>Background: </strong>Predicting outcomes in schizophrenia spectrum disorders is challenging due to the variability of individual trajectories. While machine learning (ML) shows promise in outcome prediction, it has not yet been integrated into clinical practice. Understanding how ML models (MLMs) can complement psychiatrists' predictions and bridge the gap between MLM capabilities and practical use is key.</p><p><strong>Objective: </strong>This vignette study aims to compare the performance of psychiatrists and MLMs in predicting short-term symptomatic and functional remission in patients with first-episode psychosis and explore whether MLMs can improve psychiatrists' prognostic accuracy.</p><p><strong>Method: </strong>24 psychiatrists predicted symptomatic and functional remission probabilities at 10 weeks based on written baseline information from 66 patients in the OPtimization of Treatment and Management of Schizophrenia in Europe (OPTiMiSE) trial. ML-generated predictions based on these vignettes were then shared with psychiatrists, allowing them to adjust their estimates.</p><p><strong>Findings: </strong>The predictive accuracy of the MLM was low but comparable to that of psychiatrists for symptomatic remission (MLM: 0.50, psychiatrists: 0.52) and comparable to that of psychiatrists for functional remission (MLM: 0.72, psychiatrists: 0.79). Inter-rater agreement was low but comparable for psychiatrists and the MLM. Although the MLM did not improve overall predictive accuracy, it showed potential in aiding psychiatrists with difficult-to-predict cases. However, psychiatrists struggled to recognise when to rely on the model's output, and we were unable to determine a clear pattern in these cases based on their characteristics.</p><p><strong>Conclusions: </strong>MLMs may have the potential to support psychiatric decision-making, particularly in difficult-to-predict cases, but at present, their effectiveness remains limited due to constraints in predictive accuracy and the ability to identify when to rely on the model's output. Addressing these issues is crucial to improve the utility of MLMs and foster their integration into clinical practice.</p><p><strong>Clinical implications: </strong>MLMs are best suited as supplementary tools, providing a second opinion while psychiatrists retain decision-making autonomy. Integrating predictions from both sources may help reduce individual biases and improve accuracy. This approach leverages the strengths of MLMs without compromising clinical responsibility.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509810","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":"Prognostic predictions in psychosis: exploring the complementary role of machine learning models.","authors":"Violet van Dee,Seyed M Kia,Caterina Fregosi,Wilma E Swildens,Anne Alkema,Albert Batalla,Coen van den Berg,Danko Coric,Edwin van Dellen,Lotte G Dijkstra,Arthur van den Doel,Livia S Dominicus,John Enterman,Frank L Gerritse,Marte Z van der Horst,Fedor van Houwelingen,Charlotte S Koch,Lisanne E M Koomen,Marjan Kromkamp,Michelle Lancee,Brian E Mouthaan,Diane F van Rappard,Eline J Regeer,Raymond W J Salet,Metten Somers,Jorgen Straalman,Marjolein H T de Vette,Judith Voogt,Inge Winter-van Rossum,Rene S Kahn,Wiepke Cahn,Hugo G Schnack","doi":"10.1136/bmjment-2025-301594","DOIUrl":"https://doi.org/10.1136/bmjment-2025-301594","url":null,"abstract":"BACKGROUNDPredicting outcomes in schizophrenia spectrum disorders is challenging due to the variability of individual trajectories. While machine learning (ML) shows promise in outcome prediction, it has not yet been integrated into clinical practice. Understanding how ML models (MLMs) can complement psychiatrists' predictions and bridge the gap between MLM capabilities and practical use is key.OBJECTIVEThis vignette study aims to compare the performance of psychiatrists and MLMs in predicting short-term symptomatic and functional remission in patients with first-episode psychosis and explore whether MLMs can improve psychiatrists' prognostic accuracy.METHOD24 psychiatrists predicted symptomatic and functional remission probabilities at 10 weeks based on written baseline information from 66 patients in the OPtimization of Treatment and Management of Schizophrenia in Europe (OPTiMiSE) trial. ML-generated predictions based on these vignettes were then shared with psychiatrists, allowing them to adjust their estimates.FINDINGSThe predictive accuracy of the MLM was low but comparable to that of psychiatrists for symptomatic remission (MLM: 0.50, psychiatrists: 0.52) and comparable to that of psychiatrists for functional remission (MLM: 0.72, psychiatrists: 0.79). Inter-rater agreement was low but comparable for psychiatrists and the MLM. Although the MLM did not improve overall predictive accuracy, it showed potential in aiding psychiatrists with difficult-to-predict cases. However, psychiatrists struggled to recognise when to rely on the model's output, and we were unable to determine a clear pattern in these cases based on their characteristics.CONCLUSIONSMLMs may have the potential to support psychiatric decision-making, particularly in difficult-to-predict cases, but at present, their effectiveness remains limited due to constraints in predictive accuracy and the ability to identify when to rely on the model's output. Addressing these issues is crucial to improve the utility of MLMs and foster their integration into clinical practice.CLINICAL IMPLICATIONSMLMs are best suited as supplementary tools, providing a second opinion while psychiatrists retain decision-making autonomy. Integrating predictions from both sources may help reduce individual biases and improve accuracy. This approach leverages the strengths of MLMs without compromising clinical responsibility.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504614","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":"Coping strategies for climate change anxiety: a perspective on building resilience through psychological capital.","authors":"Thomas Kwame Osei Atta Nimo,Hansen Akoto-Baako,Ebenezer Oduro Antiri,Edward Wilson Ansah","doi":"10.1136/bmjment-2024-301421","DOIUrl":"https://doi.org/10.1136/bmjment-2024-301421","url":null,"abstract":"As the global impacts of climate change become more apparent, there is a corresponding increase in the psychological effects of the phenomenon, including climate change anxiety, stress and helplessness or hopelessness. Positive psychology provides a promising approach for tackling these mental health challenges by consolidating mental strength and building resilience. In this article, we consider how positive psychological coping mechanisms can lessen the negative impacts of climate change on mental health, especially in vulnerable populations. Based on evidence-based concepts such as psychological capital, positive psychology interventions seek to empower individuals, bolstering their capacity for optimism, self-efficacy and problem solving. By transforming anxiety into proactive behaviour, interventions such as mindfulness, cognitive reframing and encouraging environmental engagement could assist individuals in navigating the emotional toll of climate change. Although these strategies are not a solution to the climate crisis itself, they are adaptative strategies that equip individuals and communities with the means to cope with climate-related challenges more effectively and take positive actions. This perspective note also addresses the significance of incorporating these techniques into public health educational initiatives and policy-making, highlighting the necessity of accessible interventions that can be tailored to various cultural and socioeconomic contexts. Accordingly, we specifically discuss how positive psychology can be leveraged to foster resilience and hope, providing insight into how these concepts can support mental health and well-being in an era of climate change crisis.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504628","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":"Use of GLP-1 receptor agonists and risks of suicide attempts or self-harm in patients with type 2 diabetes: a multicountry self-control case series study.","authors":"Zi-Yang Peng, Vincent Ka Chun Yan, Vincent Kai Chung Wong, Ian Chi Kei Wong, Esther Wai Yin Chan, Eric Yuk Fai Wan, Huang-Tz Ou","doi":"10.1136/bmjment-2025-301635","DOIUrl":"https://doi.org/10.1136/bmjment-2025-301635","url":null,"abstract":"<p><strong>Background: </strong>Inconclusive findings regarding the association between suicidal ideation/suicide attempt and glucagon-like peptide-1 receptor agonists (GLP-1RAs) have been recently revealed in a small number of studies.</p><p><strong>Methods: </strong>This was a multinational self-controlled case series analysis using Hong Kong's Clinical Data Analysis and Reporting System (2008-2023), Taiwan's National Health Insurance Research Database (2012-2020) and the UK's IQVIA Medical Research Database with The Health Improvement Network (2000-2021). A total of 642 suicide attempt or self-harm cases with GLP-1RA use were included to assess pooled incident rate ratios (IRRs) of suicide attempts or self-harm associated with GLP-1RA treatment versus non-treatment with their 95% CIs.</p><p><strong>Results: </strong>The pooled IRR (95% CI) of suicide attempts or self-harm associated with GLP-1RA treatment versus non-treatment was 0.67 (0.51 to 0.88). The suicide attempt or self-harm risk varied with the time window of GLP-1RA use, with pooled IRRs (95% CIs) of 1.94 (0.86 to 4.37), 0.61 (0.23 to 1.63), 0.72 (0.37 to 1.41), 0.60 (0.32 to 1.09) and 0.63 (0.49 to 0.87) for the pretreatment period and Days 1-30, Days 31-90, Days 91-180 and Days>180 of GLP-1RA treatment, respectively. Subgroup analyses by age, sex and individual GLP-1RAs and sensitivity analyses showed no significant increase in the suicide attempt or self-harm risk associated with GLP-1RA use. The point estimate and CI of the E-value for suicide attempts or self-harm were 2.35 and 1.53, respectively.</p><p><strong>Conclusions: </strong>We found no increase in the risks of suicide attempts or self-harm following GLP-1RA treatment, and even in the long-term use of GLP-1RAs. Close monitoring of potential suicide attempts or self-harm and ensuring treatment tolerability during treatment initiation are required, and well-controlled or pragmatic trials remain warranted to validate our findings.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509811","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":"Coping strategies for climate change anxiety: a perspective on building resilience through psychological capital.","authors":"Thomas Kwame Osei Atta Nimo, Hansen Akoto-Baako, Ebenezer Oduro Antiri, Edward Wilson Ansah","doi":"10.1136/bmjment-2024-301421","DOIUrl":"10.1136/bmjment-2024-301421","url":null,"abstract":"<p><p>As the global impacts of climate change become more apparent, there is a corresponding increase in the psychological effects of the phenomenon, including climate change anxiety, stress and helplessness or hopelessness. Positive psychology provides a promising approach for tackling these mental health challenges by consolidating mental strength and building resilience. In this article, we consider how positive psychological coping mechanisms can lessen the negative impacts of climate change on mental health, especially in vulnerable populations. Based on evidence-based concepts such as psychological capital, positive psychology interventions seek to empower individuals, bolstering their capacity for optimism, self-efficacy and problem solving. By transforming anxiety into proactive behaviour, interventions such as mindfulness, cognitive reframing and encouraging environmental engagement could assist individuals in navigating the emotional toll of climate change. Although these strategies are not a solution to the climate crisis itself, they are adaptative strategies that equip individuals and communities with the means to cope with climate-related challenges more effectively and take positive actions. This perspective note also addresses the significance of incorporating these techniques into public health educational initiatives and policy-making, highlighting the necessity of accessible interventions that can be tailored to various cultural and socioeconomic contexts. Accordingly, we specifically discuss how positive psychology can be leveraged to foster resilience and hope, providing insight into how these concepts can support mental health and well-being in an era of climate change crisis.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509809","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":"Associations of adolescent mental health and parental education with healthcare use: a cohort study based on data from the Young-HUNT study, Norway.","authors":"Kirsti Wahlberg,Karoline Louise Imingen Selvik,Tonje Braaten,Kirsti Kvaløy,Gunnhild Åberge Vie,Ottar Bjerkeset,Kristine Pape","doi":"10.1136/bmjment-2024-301508","DOIUrl":"https://doi.org/10.1136/bmjment-2024-301508","url":null,"abstract":"BACKGROUNDAdolescent mental health problems and mental health help-seeking have increased in the later decades. We aimed to assess to which extent adolescents with high mental health symptom loads received help in general practice or specialist mental health services, and whether parental education influenced the association.METHODSThis cohort study included 7554 Norwegian adolescents who participated in the population-based Young-HUNT4 Survey (2017-2019). They reported their mental health by the Strengths and Difficulties Questionnaire (SDQ), measuring both internalising and externalising symptoms, summed up to a Total Difficulties score. During 1 year after participation, data on contacts with and diagnoses from general practice and specialist mental health services were collected from national registries. We used generalised linear models to analyse the probability of contact with general practice and specialist mental health services by low, moderate and high SDQ scores. We evaluated effect measure modification using interaction terms.RESULTSAmong adolescents with high total, internalising or externalising SDQ scores, 29-31% of females and 19-21% of males consulted a general practitioner for mental health problems, compared with 9-10% and 6-7% among those with low scores. Males and females with high internalising scores had a nine times increased risk of specialist mental health service contacts with internalising diagnoses, and similar associations were found for externalising scores and contacts/diagnoses. The associations were largely independent of parental education level.CONCLUSIONAdolescents' mental health symptom loads were positively associated with health service use in general practice and specialist mental health services and largely independent of parental education.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504612","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":"Associations of adolescent mental health and parental education with healthcare use: a cohort study based on data from the Young-HUNT study, Norway.","authors":"Kirsti Wahlberg, Karoline Louise Imingen Selvik, Tonje Braaten, Kirsti Kvaløy, Gunnhild Åberge Vie, Ottar Bjerkeset, Kristine Pape","doi":"10.1136/bmjment-2024-301508","DOIUrl":"https://doi.org/10.1136/bmjment-2024-301508","url":null,"abstract":"<p><strong>Background: </strong>Adolescent mental health problems and mental health help-seeking have increased in the later decades. We aimed to assess to which extent adolescents with high mental health symptom loads received help in general practice or specialist mental health services, and whether parental education influenced the association.</p><p><strong>Methods: </strong>This cohort study included 7554 Norwegian adolescents who participated in the population-based Young-HUNT4 Survey (2017-2019). They reported their mental health by the Strengths and Difficulties Questionnaire (SDQ), measuring both internalising and externalising symptoms, summed up to a Total Difficulties score. During 1 year after participation, data on contacts with and diagnoses from general practice and specialist mental health services were collected from national registries. We used generalised linear models to analyse the probability of contact with general practice and specialist mental health services by low, moderate and high SDQ scores. We evaluated effect measure modification using interaction terms.</p><p><strong>Results: </strong>Among adolescents with high total, internalising or externalising SDQ scores, 29-31% of females and 19-21% of males consulted a general practitioner for mental health problems, compared with 9-10% and 6-7% among those with low scores. Males and females with high internalising scores had a nine times increased risk of specialist mental health service contacts with internalising diagnoses, and similar associations were found for externalising scores and contacts/diagnoses. The associations were largely independent of parental education level.</p><p><strong>Conclusion: </strong>Adolescents' mental health symptom loads were positively associated with health service use in general practice and specialist mental health services and largely independent of parental education.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509808","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":"Use of GLP-1 receptor agonists and risks of suicide attempts or self-harm in patients with type 2 diabetes: a multicountry self-control case series study.","authors":"Zi-Yang Peng,Vincent Ka Chun Yan,Vincent Kai Chung Wong,Ian Chi Kei Wong,Esther Wai Yin Chan,Eric Yuk Fai Wan,Huang-Tz Ou","doi":"10.1136/bmjment-2025-301635","DOIUrl":"https://doi.org/10.1136/bmjment-2025-301635","url":null,"abstract":"BACKGROUNDInconclusive findings regarding the association between suicidal ideation/suicide attempt and glucagon-like peptide-1 receptor agonists (GLP-1RAs) have been recently revealed in a small number of studies.METHODSThis was a multinational self-controlled case series analysis using Hong Kong's Clinical Data Analysis and Reporting System (2008-2023), Taiwan's National Health Insurance Research Database (2012-2020) and the UK's IQVIA Medical Research Database with The Health Improvement Network (2000-2021). A total of 642 suicide attempt or self-harm cases with GLP-1RA use were included to assess pooled incident rate ratios (IRRs) of suicide attempts or self-harm associated with GLP-1RA treatment versus non-treatment with their 95% CIs.RESULTSThe pooled IRR (95% CI) of suicide attempts or self-harm associated with GLP-1RA treatment versus non-treatment was 0.67 (0.51 to 0.88). The suicide attempt or self-harm risk varied with the time window of GLP-1RA use, with pooled IRRs (95% CIs) of 1.94 (0.86 to 4.37), 0.61 (0.23 to 1.63), 0.72 (0.37 to 1.41), 0.60 (0.32 to 1.09) and 0.63 (0.49 to 0.87) for the pretreatment period and Days 1-30, Days 31-90, Days 91-180 and Days>180 of GLP-1RA treatment, respectively. Subgroup analyses by age, sex and individual GLP-1RAs and sensitivity analyses showed no significant increase in the suicide attempt or self-harm risk associated with GLP-1RA use. The point estimate and CI of the E-value for suicide attempts or self-harm were 2.35 and 1.53, respectively.CONCLUSIONSWe found no increase in the risks of suicide attempts or self-harm following GLP-1RA treatment, and even in the long-term use of GLP-1RAs. Close monitoring of potential suicide attempts or self-harm and ensuring treatment tolerability during treatment initiation are required, and well-controlled or pragmatic trials remain warranted to validate our findings.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"2 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504613","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}