BMJ mental health最新文献

{"title":"Mental health in university students: an umbrella review grading the evidence for psychosocial interventions.","authors":"Giulia Muriago, Andrea Chiccoli, Davide Papola, Beatrice Compri, Giulia Turrini, Michela Nose, Corrado Barbui","doi":"10.1136/bmjment-2025-302323","DOIUrl":"https://doi.org/10.1136/bmjment-2025-302323","url":null,"abstract":"<p><strong>Question: </strong>Psychological distress is increasingly prevalent among university students, raising concerns about their mental health. This review aimed to assess the strength and credibility of evidence on the efficacy of psychosocial interventions for improving mental health in this population.</p><p><strong>Study selection and analysis: </strong>We conducted an umbrella review of systematic reviews (SRs) with meta-analyses of randomised controlled trials assessing psychosocial interventions among university students. Searches were performed in Medline, PubMed, Cochrane Central, PsycINFO, CINAHL, Epistemonikos and Campbell Collaboration from 1 January 2014 to 1 February 2026. Data on intervention type, comparator, outcome and study-level effect sizes were analysed using inverse-variance random-effects models with restricted maximum likelihood estimation of between-study heterogeneity (τ²). Strength of associations was evaluated according to umbrella review criteria, reporting quality using A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR-2) and certainty of evidence using Grading of Recommendations Assessment, Development and Evaluation (GRADE).</p><p><strong>Findings: </strong>A total of 34 SRs were identified. After excluding overlapping syntheses, 28 unique meta-analyses from 12 SRs were included. Mindfulness-based interventions versus inactive controls for distress (standardised mean difference (SMD) -0.40; 95% CI -0.53 to -0.28) showed highly suggestive evidence (class II; GRADE: low; AMSTAR: high). Seven associations provided suggestive evidence (Class III): mindfulness-based interventions versus inactive controls for anxiety (SMD -0.54; 95% CI -0.81 to -0.27) and depression (SMD -0.52; 95% CI -0.65 to -0.39); cognitive-based interventions versus inactive controls for anxiety (SMD -0.48; 95% CI -0.62 to -0.34) and depression (SMD -0.60; 95% CI -0.75 to -0.45); cognitive-based interventions versus active controls for well-being (SMD -0.30; 95% CI -0.42 to -0.18); positive psychology interventions versus inactive controls for distress (SMD -0.22; 95% CI -0.35 to -0.10); and multimodal interventions versus inactive controls for distress (SMD -0.85; 95% CI -1.32 to -0.87). The remaining associations were weak or non-significant, generally supported by low or very low certainty and mostly low or very low reporting quality.</p><p><strong>Conclusions: </strong>The most robust evidence emerged for mindfulness and cognitive-based interventions, with some support also for positive psychology approaches. These interventions appear to improve depression, anxiety, distress and well-being among university students, though further rigorous research is needed.</p><p><strong>Prospero registration number: </strong>CRD42023493618.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"29 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857837","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":"Cognition and future depression: associations with risk in those with and without a history of depression.","authors":"Angharad N de Cates, Angeline Lee, Laura Winchester, Klaus P Ebmeier, Paris Lalousis, Rachel Upthegrove, Susannah E Murphy, Catherine J Harmer, Thomas Nichols, Anya Topiwala","doi":"10.1136/bmjment-2025-302332","DOIUrl":"10.1136/bmjment-2025-302332","url":null,"abstract":"<p><strong>Background: </strong>Cognitive impairments are common in depression and often persist beyond mood resolution. However, the relationship between cognitive performance, its neurological underpinnings, and future depression risk is unclear, limiting strategies for primary and secondary prevention.</p><p><strong>Objective: </strong>Our objective was to determine whether cognition associates with subsequent depression, both relapse and first-episode occurrences.</p><p><strong>Methods: </strong>1862 UK Biobank participants with a history of International Classification of Diseases (ICD)-10-defined depression in remission (RD) (mean (SD) age: 52.7 (7.13) years) were age-matched and sex-matched to 1862 participants without depression history or current antidepressant use. Cognitive scores were compared between groups at the composite (z-score), domain and task levels. MRI-derived phenotypes assessed brain network structure and functional connectivity. Longitudinal associations with future depression were assessed using logistic regression models and a Cox proportional hazards model controlling for key confounders.</p><p><strong>Findings: </strong>Participants with RD had a higher risk of future depression (33%) than controls (13%), including when we accounted for temporal differences in longitudinal assessment (HR=3.16 (95% CI 2.71 to 3.67), global proportional hazard assumption p=0.07). Composite cognitive performance in controls was inversely associated with future depression risk (risk estimated marginal means: 0.25% at -1SD, 0.20% at mean, 0.15% at +1 SD). In RD, this relationship was reversed (0.74% at -1SD, 0.90% at mean, 1.10% at +1 SD). Executive functioning, processing speed and reasoning task scores all contributed. Higher grey matter in default mode network regions was associated with better concurrent cognitive performance across all participants, but not with future depression risk. Other MRI findings were limited.</p><p><strong>Conclusions: </strong>RD carried a threefold higher risk of future depression than controls. Cognitive performance was a risk marker for future depression in both groups but in opposing directions. Neuroimaging metrics provided little predictive value.</p><p><strong>Clinical implications: </strong>Personalised risk factor assessment for depression is likely to be dependent on depression history. Those without previous history of diagnosed depression are at higher risk of future depression when cognitive performance is lower at baseline. RD is a high-risk group for future depression, and those with relatively higher cognitive performance may be more likely to report future depressive symptoms.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"29 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846872","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":"'It is just a prediction; it's, like, not fact': youth attitudes towards risk prediction tools and personalised preventive interventions for depression and anxiety.","authors":"Nina Higson-Sweeney, Anna Peycheva, Josefien J F Breedvelt","doi":"10.1136/bmjment-2025-302327","DOIUrl":"10.1136/bmjment-2025-302327","url":null,"abstract":"<p><strong>Background: </strong>Risk prediction tools may help identify youth who are at risk of developing depression or anxiety and allow personalised preventive interventions to be delivered. However, with concerns for implementation, it is important to directly engage with youth to understand their attitudes.</p><p><strong>Objective: </strong>To qualitatively explore UK-based youth attitudes towards risk prediction tools and personalised preventive interventions for depression and anxiety.</p><p><strong>Methods: </strong>Online semistructured interviews were conducted with a convenience sample of youth aged 16-25 years (n=25) and analysed using reflexive thematic analysis.</p><p><strong>Findings: </strong>Analysis generated four themes: (1) <i>Helpful or harmful: risk prediction as a 'double-ended sword'</i> explores the potential benefits and consequences of risk scores; (2) '<i>Taken with a grain of salt': are risk prediction models the way forward?</i> focuses on participants' scepticism towards risk prediction tools, including ethics and privacy; (3) '<i>It really depends on the person': respecting the individual in prevention</i> emphasises the importance of personal choice and individual differences and (4) '<i>You still need like a person in the process': the importance of human involvement</i> encapsulates participants' belief regarding human involvement in development and implementation.</p><p><strong>Conclusions: </strong>While youth appear open to risk prediction tools and personalised preventive interventions, they highlighted concerns that must be addressed before implementation, including ethics, accuracy, privacy and feasibility.</p><p><strong>Clinical implications: </strong>Going forward, researchers should prioritise stakeholder involvement, using active collaboration to identify ways in which these concerns can be addressed, which may increase acceptability and uptake. Human contact, alongside agency and choice, are further factors to consider.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"29 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846890","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":"Functional near-infrared spectroscopy assessment of the effects of transcranial direct current stimulation combined with transcranial magnetic stimulation on dynamic functional networks in patients with chronic insomnia: randomised, double-blind, parallel-group, controlled clinical trial.","authors":"Qi Zhou, Zhiwang Liu, Chang Li, Qiao Wang, Tianming Zheng, Dong-Sheng Zhou, Haihang Yu, Chang Yu","doi":"10.1136/bmjment-2025-302410","DOIUrl":"10.1136/bmjment-2025-302410","url":null,"abstract":"<p><strong>Background: </strong>Evidence suggests that transcranial direct current stimulation (tDCS) combined with repetitive transcranial magnetic stimulation (rTMS) is more effective than either modality alone. However, the underlying neural mechanisms remain unclear.</p><p><strong>Objective: </strong>To explore the effects of combined tDCS-rTMS on cortical functional networks and neural regulation processes in chronic insomnia.</p><p><strong>Methods: </strong>In this randomised, double-blind, sham-controlled trial, 111 adults with chronic insomnia were allocated to real tDCS+real rTMS or sham tDCS+real rTMS. Participants received 20 weekday sessions over 4 weeks. Of these, 106 completed treatment and 103 provided functional near-infrared spectroscopy (fNIRS) data meeting predefined quality criteria. fNIRS measured oxygenated haemoglobin (Oxy-Hb) responses in prefrontal and temporal regions during a verbal fluency task (VFT) before and after treatment. The primary outcome was haemodynamic activation; secondary outcomes were functional connectivity and sleep quality.</p><p><strong>Findings: </strong>Sleep quality improved in both groups, with significantly greater reduction in Pittsburgh Sleep Quality Index (PSQI) scores in the real tDCS+real rTMS group (p<0.05). No between-group differences were observed in VFT performance. However, the combined stimulation group showed significantly increased Oxy-Hb responses across multiple fronto-temporal channels, particularly in bilateral temporal regions, and greater enhancement in mean functional connectivity (p<0.05). Both interventions were well tolerated, with no serious adverse events.</p><p><strong>Conclusions: </strong>This study provides neuroimaging evidence that combined tDCS and rTMS may improve chronic insomnia by enhancing activation of fronto-temporal cortices and strengthening inter-regional functional connectivity. These findings offer objective support for the clinical efficacy of the combined stimulation protocol, link neurophysiological changes to treatment optimisation and suggest potential advantages of this approach for neuromodulation-based therapeutic strategies.</p><p><strong>Clinical implications: </strong>These findings suggest that tDCS combined with rTMS may represent a feasible and well tolerated non-pharmacological strategy for chronic insomnia, with potential advantages over rTMS alone at both clinical and neurophysiological levels.</p><p><strong>Trial registration number: </strong>This study was registered as a clinical trial with the China Clinical Trial Registration Centre (ChiCTR2100052681).</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"29 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13141000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790649","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":"Using electronic health records to evaluate a children and young people's social prescribing service: challenges and implications for research and practice.","authors":"Jessica K Bone,Feifei Bu,Daisy Fancourt,Daniel Hayes","doi":"10.1136/bmjment-2025-302442","DOIUrl":"https://doi.org/10.1136/bmjment-2025-302442","url":null,"abstract":"BACKGROUNDPreliminary evidence indicates that social prescribing (SP) can improve children and young people's (CYP) well-being but is limited by small non-representative samples and often relies on descriptive statistics. Given the wide implementation of SP in the UK, administrative records provide a unique opportunity to understand current practice and assess impacts on well-being.OBJECTIVES(1) To understand the quality of data captured in SP administrative records. (2) To explore which CYP are currently receiving SP and what SP entails in practice. (3) To assess the impact of SP on well-being.METHODSWe used administrative records from one CYP SP service in England. Records were extracted from Joy, an online platform for managing SP. Over 18 months, 770 age-eligible CYP were referred to SP, 203 of whom were successfully discharged and completed two pre-post measures of well-being (the short Warwick-Edinburgh Mental Wellbeing Scale; SWEMWBS) at least 7 days apart. We used descriptive statistics, a paired t-test to assess changes in well-being and linear regressions with interactions to test effect modification.FINDINGSMissing data was the largest issue, with ethnicity missing for 94% of CYP. A lack of detail and inconsistent recording for both individual characteristics and SP practices also presented challenges. Despite this, we identified that most CYP were referred by their GP, followed by their school, with 97% referred because of their mental health. The most common pathway was to receive SP for around 90 days, with 10-15 link worker contacts and 6 contact hours. Following SP, SWEMWBS scores improved by 3.72 points (t(202)=17.50, 95% CI 3.30 to 4.14, p<0.001), a 20% relative increase. Exploratory analyses suggested that this increase was greater for those with lower baseline well-being.CONCLUSIONSDespite numerous challenges with missing data and data quality, we found that CYP well-being increases following SP (as it is currently implemented). The moderate effect size was consistent with larger studies of adults.CLINICAL IMPLICATIONSFurther development of online platforms is needed to monitor access to, nature of and efficacy of SP. For those working in SP, we recommend more training, implementation of standardised guidelines and designated time to update records.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147738996","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":"De-implementing treatments from the healthcare system: trauma-focused versus non-trauma-focused therapy of post-traumatic stress disorder as an example.","authors":"Falk Leichsenring,Barbara Milrod,Patrick Luyten","doi":"10.1136/bmjment-2026-302505","DOIUrl":"https://doi.org/10.1136/bmjment-2026-302505","url":null,"abstract":"Recently, a proposal was made to de-implement ineffective or harmful psychotherapeutic treatments from the healthcare system. Given the potential wide-ranging implications of this proposal, a critical review is warranted. As an example of an 'implementation failure', the authors of the proposal discussed non-trauma-focused treatments of post-traumatic stress disorder (PTSD). For this reason, we reviewed the evidence for non-trauma-focused psychotherapies compared with trauma-focused or exposure-based psychotherapies of PTSD in adults, published in the recent 7 years. We focused on efficacy and safety as the central criteria for potential (de-)implementation. The majority of meta-analytical results showed non-trauma-focused psychotherapies to be non-inferior to trauma-focused psychotherapies. In only a few analyses, non-inferiority was not found or exposure therapy achieved statistically significantly better effect sizes, which, however, were small and not clinically significant. Furthermore, non-trauma-focused psychotherapies were found to be safe and well-tolerated with low dropout. Hence, key criteria for de-implementation are not met. The results question the claim that non-trauma-focused therapies constitute an implementation failure. Thus, the example of trauma-focused versus non-trauma-focused psychotherapy of PTSD highlights fundamental problems associated with the proposal to de-implement specific treatments from the healthcare system. The reviewed results suggest that researcher allegiance may have an important impact on (de-)implementation decisions and needs to be rigidly controlled for. Several open questions remain, including consented criteria on which de-implementation decisions would be based, who decides about the actors responsible for making these decisions and, crucially, the mechanisms by which those in positions of authority are held accountable.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"21 5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147641320","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":"Congenital malformation risk following prenatal antipsychotic exposure: a systematic safety surveillance approach.","authors":"Loreen Straub,Shirley V Wang,Sonia Hernandez-Diaz,Brian T Bateman,Seanna M Vine,Massimiliano Russo,Yanmin Zhu,Lee Cohen,Carolyn E Cesta,Kathryn J Gray,Krista F Huybrechts","doi":"10.1136/bmjment-2025-302270","DOIUrl":"https://doi.org/10.1136/bmjment-2025-302270","url":null,"abstract":"BACKGROUNDMedication safety studies in pregnancy typically focus on selected or composite outcomes (eg, any malformation) to test specific hypotheses or verify suspected safety signals, potentially overlooking or masking other clinically significant associations (eg, individual malformations or malformation types).OBJECTIVETo conduct a comprehensive, systematic screening for potential teratogenic safety alerts associated with first-trimester exposure to individual antipsychotics, using a tree-based scan statistic (TBSS) approach for simultaneous evaluation of a broad range of specific malformations and malformation groupings.METHODSUsing a US-nationwide cohort of >4.2 million mother-child dyads (2000-2020), pregnancies with ≥1 first-trimester antipsychotic dispensing were compared with antipsychotic-unexposed pregnancies. Individual congenital malformations were identified via International Classification of Diseases codes, grouped into increasingly aggregated higher-level clinically related categories. Leveraging this hierarchical classification tree, TBSS was used to scan for associations with individual malformation codes and code categories while tightly controlling type 1 error. Confounding was adjusted for via propensity score fine-stratification, and relative risks (RRs) were estimated using an unconditional Poisson scan statistic. The p-values were used to prioritise alerts for further investigation, and follow-up analyses were conducted to refine the understanding of statistical alerts.FINDINGSExposed pregnancies ranged from 68 (fluphenazine) to 18 366 (prochlorperazine). Antipsychotic-exposed versus antipsychotic-unexposed women tended to be older and to have a higher comorbidity burden and more healthcare encounters. Alerts for an increased risk (with p<0.1) were observed for skin anomaly after haloperidol (RR=1.88) and polydactyly after ziprasidone (RR=3.06) exposure. Results were consistent in sensitivity analyses. The data in the two external data sources were too sparse to confirm a safety alert.CONCLUSIONSTBSS identified two potential alerts previously unreported for prenatal antipsychotic exposure. Importantly, no alerts for severe or life-threatening malformations were detected. Findings from this screening-based approach, therefore, align with existing evidence suggesting that antipsychotics are unlikely to be major teratogens.CLINICAL IMPLICATIONSThe potential risk increase observed for some less-severe malformations and some antipsychotics needs to be weighed against the high potential for relapse and mental health deterioration following treatment discontinuation. While no consistent patterns suggesting a strong teratogenic effect have emerged thus far for newer antipsychotics, continued monitoring of these medications is important.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635852","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":"Factors associated with the mental health of parents during and after their child's hospitalisation: an international longitudinal prospective cohort study.","authors":"Renee Mehra, Thomas J Hoffmann, Dave Graham-Squire, Amy J Lisanti, Caryl Gay, Christine Hodgson, Jennifer Rienks, Michelle Pavlik, Sufiya Manju, Nitya Turaga, Michael Clay, Linda S Franck","doi":"10.1136/bmjment-2025-302231","DOIUrl":"10.1136/bmjment-2025-302231","url":null,"abstract":"<p><strong>Background: </strong>A child's hospitalisation may have long-term influences on parental mental health, which can affect child health.</p><p><strong>Objective: </strong>To describe the prevalence of and examine factors associated with parents' depression and anxiety symptoms over time.</p><p><strong>Methods: </strong>This prospective cohort study in 14 countries measured parent mental health during their child's hospitalisation, at discharge and 3 months postdischarge (2023-2024). We included parents ≥18 years staying at a Ronald McDonald House^® during their child's hospitalisation. Exposures were parent, family and child psychosocial and health factors and hospital experiences. Outcomes were parental depression and anxiety symptoms. We used mixed-effects logistic regression.</p><p><strong>Findings: </strong>3350 parents, including 2594 (78.6%) mothers, 616 (18.1%) fathers and 131 (3.3%) other caregivers, participated during hospitalisation; 1751 (52%) at discharge, and 2395 (71%) postdischarge. Prevalence of depression and anxiety symptoms was high during hospitalisation (49.7% and 69.0%, respectively) and decreased modestly at discharge (44.6% and 59.5%, respectively), and postdischarge (42.8% and 59.2%, respectively). Over time, probabilities of depression symptoms decreased among those with high, moderate and low levels of social support (50%, 27%, 5%, respectively), and self-care (29%, 27% and 22%, respectively). Probabilities of depression symptoms decreased among those with high or moderate perceived levels of family-centred care (high: 20% decrease; moderate: 11% decrease, compared with low). In contrast, probabilities of depression symptoms increased among those with high or moderate levels of unmet basic needs (high: 18% increase; moderate: 8% increase, compared with low) and poorer ratings of their child's health (high: 68% increase; moderate: 32% increase, compared with low (healthier)). These trends were similar for anxiety symptoms.</p><p><strong>Conclusions: </strong>Prevalence of depression and anxiety symptoms is high among parents and only decreases modestly postdischarge.</p><p><strong>Clinical implications: </strong>Routine screening and ongoing services may lower the risk of prolonged parental mental health symptoms, but more research is needed.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"29 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147617277","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":"Automatically detecting trends and open questions from mental health publications: a Wellcome-funded GALENOS project.","authors":"Janna Hastings,Marie Wosny,Jaycee Kennett,Ava Homiar,Gin S Malhi,Toshi A Furukawa,Jennifer Potts,James Thomas,Andrea Cipriani","doi":"10.1136/bmjment-2025-302379","DOIUrl":"https://doi.org/10.1136/bmjment-2025-302379","url":null,"abstract":"BACKGROUNDMore effective and better tolerated treatments are urgently needed for people with mental health disorders, such as anxiety, depression and psychosis. However, the rate of translation of positive results from early phase studies into clinically validated treatments remains painstakingly slow. The scientific literature on mental health preclinical and early interventions is burgeoning at pace, making it difficult for researchers, practitioners and policymakers to identify and track new developments.OBJECTIVEAs part of the Wellcome-funded Global Alliance of Living Evidence for aNxiety, depressiOn and pSychosis project, we aimed to develop and evaluate an automated approach to track the evolution of mental health research over time, detect emerging trends and suggest open questions.METHODSOur approach used topic modelling, large language models and time-series forecasting in combination. We applied our approach to a corpus of 182 747 titles and abstracts extracted from the OpenAlex database for 2015-2025. Using topic modelling to identify topics and then tracking topic mentions over time, we built a time series predictive model and predicted 'trendiness' based on sustained increased mentions above baseline expected from model predictions. We evaluated our approach retrospectively using a blinded expert study of a randomly selected sample of trending and not trending topics. Finally, we developed a novel topic-augmented generation approach to suggest open questions in trendy topics and evaluated the approach by comparison to baseline-generated questions without topic augmentation.FINDINGSOur approach detected 973 topics and predicted 165 (17%) of those as trending. Key topics that the model predicted as trending included 'ketamine for treatment-resistant depression', 'student mental health in academia' and 'COVID-19 psychosis'. We found that domain experts largely agreed with the model's predictions of trendiness. Topic-augmented generated questions were more specific than baseline generated questions.CONCLUSIONSOur approach enables identification of new developments and open questions. Future work will improve temporal pattern tracking and use full texts.CLINICAL IMPLICATIONSOur approach can support all stakeholders to gain an overview of the published literature, assess temporal patterns, identify trends and rank open questions.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147599390","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":"Identifying postpartum depression subtypes using natural language processing and clinical notes.","authors":"Prakash Adekkanattu,Veer Vekaria,Yiye Zhang,Braja Gopal Patra,Priscilla Liang,Marianne Sharko,Natalie Benda,Meghan Reading Turchioe,Andrea Temkin-Yu,Alison Hermann,Jyotishman Pathak","doi":"10.1136/bmjment-2025-302066","DOIUrl":"https://doi.org/10.1136/bmjment-2025-302066","url":null,"abstract":"BACKGROUNDPostpartum depression (PPD) remains vastly underdiagnosed, and its clinical heterogeneity is not well understood. Diagnosis codes in electronic health records (EHRs) alone may not identify all PPD cases, highlighting a need for novel detection approaches.OBJECTIVETo develop a transformer-based natural language processing (NLP) method to identify patients with PPD from clinical notes in EHRs and to examine demographic and clinical heterogeneity among identified cases.METHODSClinical notes from 64 426 patients who gave birth between 2010 and 2023 at a major US academic medical centre were used to develop and evaluate the NLP method. By augmenting the NLP output with International Classification of Diseases (ICD-9/10) diagnosis codes, three subgroups of individuals with PPD were identified: patients identified by ICD only (PPD-ICD), NLP only (PPD-NLP) and both ICD and NLP (PPD-BOTH). Demographics, mental health and substance use disorders (SUDs), antidepressant treatment, behavioural therapy and healthcare utilisation were compared across PPD subgroups and a non-PPD control group. Longitudinal associations of depression and anxiety were also examined.FINDINGSThe NLP method identified an additional 29.6% of patients whose clinical notes indicated symptoms suggestive of PPD but who lacked an ICD diagnosis. Significant variation was observed among PPD subgroups in comorbid psychiatric disorders, SUDs, treatment patterns and healthcare utilisation. During the 24 months post-delivery, the PPD-BOTH subgroup exhibited the highest rates of anxiety disorder diagnoses (vs PPD-ICD: OR 1.69, 95% CI 1.49 to 1.93; vs PPD-NLP: OR 4.46, 95% CI 3.82 to 5.22), antidepressant prescriptions (vs PPD-ICD: OR 1.95, 95% CI 1.71 to 2.22; vs PPD-NLP: OR 5.98, 95% CI 5.11 to 7.01) and mental health outpatient visits (vs PPD-ICD: OR 1.45, 95% CI 1.24 to 1.7; vs PPD-NLP: OR 4.94, 95% CI 3.9 to 6.31), suggesting higher symptom severity (all p<0.001). Comorbid depression and anxiety diagnoses were most prevalent during the postpartum period and declined over time.CONCLUSIONSAugmenting NLP-based identification with ICD codes yielded more individuals with distinct demographic and clinical profiles, demonstrating the method's ability to improve case detection and characterise heterogeneity.CLINICAL IMPLICATIONSGiven that PPD is underdiagnosed and undertreated, this novel approach demonstrates further potential for NLP in healthcare settings to capture more cases, enabling earlier and more personalised interventions that reach patients who may otherwise be overlooked.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147502197","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}