BMJ mental health最新文献

{"title":"Co-prescription of metformin and antipsychotics in severe mental illness: a UK primary care cohort study.","authors":"Luiza Farache Trajano, Joseph F Hayes, Naomi Launders, Neil M Davies, David P J Osborn, Alvin Richards-Belle","doi":"10.1136/bmjment-2024-301505","DOIUrl":"10.1136/bmjment-2024-301505","url":null,"abstract":"<p><strong>Background: </strong>Metformin is a pharmacological candidate to mitigate second-generation antipsychotic (SGA)-induced weight gain in patients diagnosed with severe mental illnesses (SMI).</p><p><strong>Objective: </strong>To determine the incidence, prevalence and demographic patterns of metformin co-prescription among patients diagnosed with SMI initiating SGAs. To estimate the impact of metformin co-prescription on weight over 2 years post-SGA initiation.</p><p><strong>Methods: </strong>A cohort study of patients diagnosed with SMI initiating aripiprazole, olanzapine, quetiapine or risperidone in 2005-2019 using primary care data from Clinical Practice Research Datalink. We estimated cumulative incidence and period prevalences of co-prescription and explored prescribing differences by demographic and clinical factors. We compared weight change among patients prescribed an SGA-only versus an SGA plus metformin, accounting for confounders using linear regression.</p><p><strong>Findings: </strong>Among 26 537 patients initiating SGAs, 4652 were ever prescribed metformin and 21 885 were not. The two-year incidence of first metformin prescription was 3.3%. The SGA plus metformin group were more ethnically diverse, had greater social deprivation, more comorbidities and higher baseline weight (mean 90.4 vs 76.8 kg). By 2 years post-SGA initiation, mean weight in the SGA-only group had changed by +4.16% (95% CI -1.26 to +9.58) compared with -0.65% (95% CI -4.26 to +2.96) in the SGA plus metformin group. After confounder adjustment, the 2-year mean difference in weight with metformin co-prescription was -1.48 kg (95% CI -4.03 to 1.07) among females and -1.84 kg (95% CI -4.67 to 0.98) among males.</p><p><strong>Conclusion: </strong>Metformin is infrequently co-prescribed, despite apparent efficacy and guidelines.</p><p><strong>Clinical implications: </strong>Primary and secondary care collaboration should be strengthened and barriers to co-prescribing addressed.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774769","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":"Effect of the LifeSpan suicide prevention model on self-harm and suicide in four communities in New South Wales, Australia: a stepped-wedge, cluster randomised controlled trial.","authors":"Fiona Shand, Michelle Torok, Andrew Mackinnon, Alexander Burnett, Lisa N Sharwood, Philip J Batterham, Alison L Calear, Jiahui Qian, Stephanie Zeritis, Grant Sara, Andrew Page, Henry Cutler, Myfanwy Maple, Brian Draper, Lauren McGillivray, Matthew Phillips, Demee Rheinberger, Isabel Zbukvic, Helen Christensen","doi":"10.1136/bmjment-2024-301429","DOIUrl":"10.1136/bmjment-2024-301429","url":null,"abstract":"<p><strong>Background: </strong>There have been few rigorous evaluations of population, multi-strategy, suicide prevention programmes, despite increasing global recognition that such approaches are needed to reduce suicide.</p><p><strong>Objective: </strong>To examine the effects of a multi-strategy suicide prevention model on age-standardised rates of hospital presenting self-harm and suicide after 24 months of implementation.</p><p><strong>Methods: </strong>A stepped-wedge cluster randomised trial was conducted in four sites across New South Wales (NSW), Australia, from 2016 to 2020. Sites were randomised to a starting order and implemented the same set of interventions over a 24-month period. Changes in rates of hospital presenting self-harm and suicide deaths were measured using linked administrative health data sets of persons aged 10 or older.</p><p><strong>Results: </strong>Negative binomial regression models adjusted for linear trends and seasonality showed that LifeSpan was associated with a 13∙8% (incident response rate 0.86; 95% CI 0.79 to 0.94) reduction in hospital-presenting self-harm rates over the intervention period, compared with preintervention. These effects were not observed in the rest of NSW. There were statistically non-significant changes in suicide death rates during the intervention across all sites.</p><p><strong>Conclusions: </strong>Locally implementing a multi-strategy suicide prevention model can reduce rates of hospital presentations for self-harm, but longer implementation and evaluation periods may be required to realise the full impacts of interventions for suicide, as a more intractable outcome.</p><p><strong>Clinical implications: </strong>Our findings can inform policy at all levels of government to invest in actions that may build cross-sectoral capacity in local communities to detect and respond to suicide risk.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756143","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":"Decline in striatal binding ratio associated with accelerated decline in performance on symbol digit modality but not MoCA in Parkinson's Disease Psychosis.","authors":"Sara Pisani, Latha Velayudhan, Dag Aarsland, Kallol Ray Chaudhuri, Clive Ballard, Dominic Ffytche, Sagnik Bhattacharyya","doi":"10.1136/bmjment-2024-301430","DOIUrl":"10.1136/bmjment-2024-301430","url":null,"abstract":"<p><strong>Background: </strong>Cognitive deficits and reduced dopamine transporter (DAT) binding ratio have been reported in Parkinson's disease psychosis (PDP). However, it remains unclear whether DAT striatal binding ratio (SBR) may contribute to worsening cognitive performance in PDP.</p><p><strong>Objectives: </strong>We examined this using data from the Parkinson's Progression Markers Initiative.</p><p><strong>Methods: </strong>We analysed data from 392 PD patients, from baseline to year 4 follow-up, and classified patients into PD with psychosis (PDP) and without psychosis (PDnP). DAT SBR was available from ¹²³I-FP-CIT-SPECT [(123) I-2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane single photon emission computed tomography] imaging. We examined all cognitive measures assessed at each time point; sociodemographic characteristics, neuropsychiatric and PD-specific symptoms were entered as covariates of interest.</p><p><strong>Findings: </strong>PDP patients had lower DAT SBR compared with PDnP patients (b=-0.092, p=0.035) over all time points, which remained significant after controlling for age, sex and ethnicity. PDP patients also reported worse trajectory of task performance on the Montreal Cognitive Assessment (MoCA) (b=-0.238, p=0.001) and symbol digit modality (b=-0.534, p=0.016) compared with PDnP patients. Declining performance in symbol digit modality (Group×Time×DAT SBR interaction, b=0.683, p=0.028) but not MoCA was differentially associated with the decline in DAT SBR over time. MoCA scores declined more in PDP compared with PDnP patients over all timepoints (Group×Time interaction, b=-0.284, p=0.016).</p><p><strong>Conclusions: </strong>Decline in striatal presynaptic dopamine function may specifically underlie longitudinal decline in performance in the symbol digit modality task that engages processing speed, associative learning and working memory in PD psychosis. Whether striatal presynaptic dopamine changes explain accelerated longitudinal decline in other cognitive domains in people with PDP remains to be tested.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756137","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":"Prevention of mental disorders after exposure to natural hazards: a meta-analysis.","authors":"Ahlke Kip, Luca Weigand, Silvia Valencia, Mark Deady, Pim Cuijpers, Lasse B Sander","doi":"10.1136/bmjment-2024-301357","DOIUrl":"10.1136/bmjment-2024-301357","url":null,"abstract":"<p><strong>Question: </strong>Mental health complaints are increased in survivors of natural hazards and disaster responders. This meta-analysis assessed the efficacy of psychological and psychosocial interventions for the prevention of mental disorders after exposure to natural hazards.</p><p><strong>Study selection and analysis: </strong>We searched Web of Science, PsycINFO and MEDLINE for peer-reviewed randomised controlled trials evaluating preventive interventions targeting symptoms of post-traumatic stress disorder, depression and anxiety. Trials conducted in both, civilians and disaster responders, were included. Random-effect meta-analyses were conducted to assess the efficacy of interventions relative to active and passive control conditions.</p><p><strong>Findings: </strong>The results from 10 included studies (5068 participants) did not find preventive interventions to be superior compared with active or passive control conditions regarding symptoms of post-traumatic stress disorder (<i>g</i>=0.08 and <i>g</i>=0.05) and depression (<i>g</i>=0.13 and <i>g</i>=0.32, respectively). Effects on anxiety symptoms remain unclear. Aggregated effects for all outcomes were significant at follow-up compared with passive controls, but the interpretability is limited by the low number of studies. Intervention effects were not significantly associated with intervention type (psychotherapy vs psychosocial), age or delivery mode (online vs face-to-face). The risk of bias across studies was high.</p><p><strong>Conclusions: </strong>The current evidence does not allow for any recommendations regarding prevention programmes in the aftermath of natural hazards. A larger body of high-quality research is needed to develop effective and evidence-based preventive interventions for disaster survivors and responders.</p><p><strong>Study registration: </strong>https://osf.io/4es65.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743908","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":"Crosswalk between HRSD and MADRS outcomes for rTMS in patients with depression.","authors":"Xiao Chen, Daniel M Blumberger, Chao-Gan Yan, Jonathan Downar, Fidel Vila-Rodriguez, Zafiris J Daskalakis, Tyler S Kaster","doi":"10.1136/bmjment-2024-301451","DOIUrl":"10.1136/bmjment-2024-301451","url":null,"abstract":"<p><strong>Background: </strong>The Hamilton Rating Scale for Depression (HRSD) and the Montgomery-Åsberg Depression Rating Scale (MADRS) are the two most common clinician-rated scales to quantify depression symptom change in repetitive transcranial magnetic stimulation (rTMS) trials. However, it is unclear how the values of one scale translate to the other. Being able to translate scores between these scales could allow for aggregating rTMS clinical trial data.</p><p><strong>Methods: </strong>Clinical data from two randomised rTMS clinical trials (FOURD and CARTBIND, total N=380) were pooled. We used five crosswalk models: (1) a pharmacotherapy equipercentile model, (2) an rTMS equipercentile model, (3) a linear regression model, (4) a random forest (RF) regression model and (5) a support vector regression (SVR) model. Model performance was benchmarked using the root mean square error (RMSE).</p><p><strong>Results: </strong>The linear regression model demonstrated the best performance (RMSE: 2.66-4.82), though the SVR model's performance was slightly worse but comparable (RMSE: 2.69-5.32). The RF regression model generally performed worst (RMSE: 2.70-5.20). The rTMS equipercentile model's performance was intermediate (RMSE: 2.69-5.32) in the primary analysis but achieved superior performance and demonstrated less bias in the additional analysis.</p><p><strong>Interpretation: </strong>MADRS and HRSD scores from rTMS trials can be accurately converted between each other. The optimal model was the newly developed equipercentile model, though the results of the SVR model were promising. Nevertheless, independent external replication is required to demonstrate the external validity of these findings.</p><p><strong>Trial registration number: </strong>FOURD: NCT02998580; CARTBIND: NCT02729792.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743821","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":"Prevalence and predictors of healthcare use for psychiatric disorders at 9 years after a first episode of psychosis: a Swedish national cohort study.","authors":"Donna van Deursen, Ellenor Mittendorfer-Rutz, Heidi Taipale, Emma Pettersson, Philip McGuire, Paolo Fusar-Poli, Dan W Joyce, Nikolai Albert, Annette Erlangsen, Meredete Nordentoft, Carsten Hjorthøj, Simon Cervenka, Alexis E Cullen","doi":"10.1136/bmjment-2024-301248","DOIUrl":"10.1136/bmjment-2024-301248","url":null,"abstract":"<p><strong>Background: </strong>Psychotic disorders are known to exhibit heterogeneity with regards to illness course and prognosis, yet few studies have examined long-term healthcare use.</p><p><strong>Objective: </strong>To determine the prevalence and predictors of healthcare use for psychiatric disorders at 9 years after the first episode of psychosis (FEP).</p><p><strong>Methods: </strong>National registers were used to identify all Swedish residents aged 18-35 years with FEP between 2006 and 2013. The 12-month period-prevalence of secondary healthcare use was determined at each year of the 9-year follow-up, categorised according to main diagnosis (psychotic disorder vs other psychiatric disorder vs none vs censored). Multinomial logistic regression models were used to examine associations between baseline characteristics and healthcare use at 9 years and derive predicted probabilities and 95% CIs for the four outcome groups, for each predictor variable.</p><p><strong>Findings: </strong>Among 7733 individuals with FEP, 31.7% were treated in secondary healthcare for psychotic disorders at the 9-year follow-up, 24.1% were treated for other psychiatric disorders, 35.7% did not use healthcare services for psychiatric disorders and 8.5% were censored due to death/emigration. Having an initial diagnosis of schizophrenia was associated with the highest probability of secondary healthcare use for psychotic disorder at 9 years (0.50, 95% CI (0.46 to 0.54)] followed by inpatient treatment at first diagnosis (0.37, 95% CI (0.35 to 0.38)).</p><p><strong>Conclusion: </strong>Although 56% of individuals with FEP were treated for psychiatric disorders in secondary healthcare 9 years later, a substantial proportion were treated for non-psychotic disorders.</p><p><strong>Clinical implications: </strong>Individuals with an initial diagnosis of schizophrenia, who received their first diagnosis in inpatient settings, may need more intensive treatment to facilitate remission and recovery.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733402","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":"Capacity-building strategy for next-generation mental health research: embedding a national network infrastructure to grow mental health researcher capabilities and mental health lived-experience research leaders.","authors":"Dana Jazayeri, Michelle Banfield, Caley Tapp, Caroline Tjung, Tegan Stettaford, Victoria Stewart, Giulietta Valuri, Terence Chong, Patricia Cullen, Martina McGrath, Rebecca Cooper, Amanda J Wheeler, Amanda L Neil, Steve Kisely, Jill Bennett, David Preen, Sandra Eades Ao, Lena Sanci, Emma Baker, Victoria J Palmer","doi":"10.1136/bmjment-2025-301554","DOIUrl":"10.1136/bmjment-2025-301554","url":null,"abstract":"<p><p>Internationally, capacity building for mental health implementation and translation research has lagged. A review of literature found initiatives since 2008 indicating limited dedicated attention to growing capabilities of early-to-mid-career mental health researchers, and little reporting of tailored career pathways and skills growth. Significant gaps in capacity building thus exist. This perspective article describes a networked infrastructure for a capacity building strategy of the Australian-based ALIVE National Centre for Mental Health Research Translation. The Centre was funded as a special initiative in mental health with an initial five-year investment. In 2022, the Centre established the first national, cross-disciplinary mental health Next Generation Researcher Network, including a tailored Lived-Experience Research Collective with the aim to grow future research leaders and establish career pathways embedded within the research activities of the Centre. After three years of operation, membership is upward of 280 people in the Next Generation Researcher Network and more than 250 people for the Collective. Specific components implemented as part of the strategy include a central coordination hub, coleadership approaches, coresearch models, tailored traineeships, skills-building through short courses and learning events, cocreation of resources, an online peer discussion platform and annual seed funding schemes. A continuous capacity-building strategy is critical for advancing global research agendas to improve mental health implementation and translation outcomes. Success requires network infrastructure to ensure research methodologies advance, and research addresses the priorities of people most impacted, and early and mid-career researcher capabilities across all research settings connected with universities and service sectors grow.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712162","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":"Systematic review with qualitative meta-synthesis of parents' experiences and needs in relation to having a child or young person with a mental health difficulty.","authors":"Faith Martin, Dania Dahmash, Sarah Wicker, Sarah Glover, Charlie Duncan, Andrea Anastassiou, Lucy Docherty, Sarah Halligan","doi":"10.1136/bmjment-2024-301518","DOIUrl":"10.1136/bmjment-2024-301518","url":null,"abstract":"<p><strong>Question: </strong>What are the experiences and needs of parents of children and young people (CYP) aged 5-18 with diagnosed mental health difficulties, particularly in relation to the parents' own well-being?</p><p><strong>Study selection and analysis: </strong>A systematic review with thematic meta-synthesis was conducted, including qualitative studies published in English. Seven databases were searched (MEDLINE, PsycINFO, CINAHL Ultimate, AMED, EMBASE, Web of Science and Cochrane Library) from inception to September 2024. Studies focused on parents of CYP aged 5-18 years, where the CYP had a confirmed mental health diagnosis.</p><p><strong>Findings: </strong>Of 75 862 screened studies, 46 met inclusion criteria. Six overarching themes were identified: support needs and gaps; impact on everyday life; altered family dynamics; parental worries and fears; emotional experience of caregivers and self-care paradox. Parents face significant challenges, including unmet support needs from healthcare and education systems, substantial impacts on daily life and altered family dynamics. Emotional experiences such as worry, guilt and stigma were pervasive, compounded by systemic gaps in information and resources. Parents often prioritise their child's needs over their own, creating barriers to self-care. These challenges were consistent across diagnoses but heightened in cases of life-threatening conditions like eating disorders and depression.</p><p><strong>Conclusions: </strong>The findings highlight support needs for parents of CYP with mental health difficulties. Tailored interventions, better professional training and family centred care are needed. Future research should focus on developing theoretical models of parental distress to guide interventions and inform support mechanisms that mitigate these broad impacts on parents' well-being.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712165","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":"Psychiatric morbidity in people with autoimmune arthritides as a model of inflammatory mechanisms in mental disorders.","authors":"Tomáš Formánek, Karolína Mladá, Pavel Mohr, Mao Fong Lim, Marta Olejárová, Karel Pavelka, Petr Winkler, Emanuele Felice Osimo, Peter B Jones, Markéta Hušáková","doi":"10.1136/bmjment-2024-301506","DOIUrl":"10.1136/bmjment-2024-301506","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis (RA) and axial spondyloarthritis (axSpA) are autoimmune illnesses characterised by chronic inflammation demonstrating differential associations with psychiatric conditions.</p><p><strong>Objective: </strong>In this matched-cohort study, we aimed to investigate whether the associations between these inflammatory illnesses and mental disorders are predominantly the consequence of the burden of the former or whether common causes might underpin the susceptibility to both.</p><p><strong>Methods: </strong>Using Czech national inpatient care data, we identified individuals with RA or axSpA during the years 1999-2012. We investigated the occurrence of psychiatric outcomes up to 2017 using stratified Cox proportional hazards models. In evidence triangulation, we assessed the potential moderation by age at inflammatory illness, the associations relative to counterparts with other similarly burdensome chronic illnesses and the temporal ordering of conditions.</p><p><strong>Findings: </strong>Both RA and axSpA were associated with mood and anxiety disorders and behavioural syndromes. In evidence triangulation, the associations with depression showed a decreasing age-at-inflammatory-illness gradient in RA; the association between RA and depression was stronger than that between other chronic illnesses and depression; and excluding prevalent depression attenuated the RA-depression association. RA showed consistent inverse associations with schizophrenia and Alzheimer's disease.</p><p><strong>Conclusions: </strong>Common aetiologies might be involved in increasing the risk of developing both RA and depression. The consistent inverse associations between RA and schizophrenia and between RA and Alzheimer's disease suggest that at least part of these associations might also be a consequence of shared aetiologies as well as potential medication effects.</p><p><strong>Clinical implications: </strong>People with autoimmune arthritides are more likely to experience mood and anxiety disorders, even relative to counterparts with other similarly burdensome chronic illnesses.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694592","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":"Quantifying ecological intelligence: building metrics for the green brain capital model-a systematic review.","authors":"Omnia Mahmoud Abdelraheem, Burcin Ikiz, Sungsoo Chun, Harris Eyre, Mohamed Salama","doi":"10.1136/bmjment-2024-301317","DOIUrl":"10.1136/bmjment-2024-301317","url":null,"abstract":"<p><strong>Question: </strong>The Green Brain Capital Model emphasises the bidirectional relationship between brain health and the environment, making it an environmentally focused type of brain capital. This work represents the initial stage of conceptualising the Green Brain Capital Model, which is essential to avoid ambiguity and misinterpretation while developing a quantitative model. Ecological intelligence (EI) is identified as a key component of the model in the literature. Therefore, the objective of this review was to systematically review the literature to define EI, its features and quantitative assessment tools, to develop comprehensive metrics for Green Brain Capital.</p><p><strong>Study selection and analysis: </strong>We conducted a search in Scopus, ScienceDirect and Scopus secondary literature and identified 11 articles that provide definitions of EI and quantitative tools to assess it.</p><p><strong>Findings: </strong>The study revealed that EI is a multifaceted concept with cognitive, affective and behavioural domains. Seven quantitative tools for measuring EI were identified, with the Ecological Intelligence Measurement Tool by Okur-Berberoglu and the Ecological Intelligence Scale by Akkuzu, demonstrating strong theoretical grounding, reliability and validity. Additionally, our review included searching open-access databases provided by reputable organisations, but no indicators for the assessment of EI were found in these databases.</p><p><strong>Conclusions: </strong>All the available tools were designed to assess EI at the individual level and for research purposes within certain cultural contexts. There is a lack of global indicators reflecting countries' EI development status and global positioning. Establishing country-level indicators across EI domains is essential for policymaking and public awareness.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652365","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}