BMJ mental health最新文献

{"title":"Guidelines and practice on antipsychotics prescribing and physical health monitoring in children and young people: a cohort study using primary care data.","authors":"Yana Vinogradova,Ruth H Jack,Vibhore Prasad,Carol Coupland,Richard Morriss,Chris Hollis","doi":"10.1136/bmjment-2024-301287","DOIUrl":"https://doi.org/10.1136/bmjment-2024-301287","url":null,"abstract":"BACKGROUNDAntipsychotic treatments require physical health monitoring (PHM), especially among children and young people (CYP).OBJECTIVEFor CYP aged 5-17, to investigate recorded indications for antipsychotics prescribing and first-treatment durations, and, for psychosis, bipolar disorder, autism spectrum disorder (ASD) and Tourette's syndrome, recorded levels of PHM for CYP with antipsychotics prescriptions and those without.METHODSAll CYP registered with QResearch English general practices between 2006 and 2021 were considered. To quantify PHM, 2158 CYP with antipsychotics prescriptions and 22 151 CYP with a condition but no prescriptions were followed for 2 years.FINDINGS47% (2363) of CYP with antipsychotics prescriptions had a recorded mental health condition of interest (of which 62% were ASD). 19% (921) had no relevant indication. For patients with ASD and Tourette syndrome, top quartiles for initial exposure to antipsychotics were >10 months. Recorded PHM was generally low, with over 50% of CYP showing no blood test during the 2-year follow-up.CONCLUSIONSCoverage of best practice is uneven across the condition-related national CYP guidelines, and this requires improvement. However, we suspect some apparently poor adherence to best practice also derives from treatment complexities and associated data flows leading to gaps in the encoded general practice data. To audit more exactly clinical practice against guidelines, we propose qualitative studies, targeted to cover the full range of local circumstances, nationally.CLINICAL IMPLICATIONSGeneral practices should be encouraged to prioritise encoding of all treatment data. Development of one central gold-standard set of recommendations for antipsychotics use could encourage better adherence levels across conditions.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"688 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586622","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":"ImproviNg Tic services in EnglaND: a multi-method study to explore existing healthcare service provision for children and young people with tics and Tourette syndrome.","authors":"Nikita R Rattu,Sophie S Hall,Charlotte L Hall,Tara Murphy,Joseph Kilgariff,Nadya James,Emma McNally,Alexia Jeayes,Kareem Khan,Suzanne Rimmer,Louise Thomson,Madeleine Jane Groom","doi":"10.1136/bmjment-2025-301599","DOIUrl":"https://doi.org/10.1136/bmjment-2025-301599","url":null,"abstract":"BACKGROUNDTimely access to diagnostic assessment and treatment is essential to improve function and mitigate the risk of poor long-term outcomes in children and young people (CYP) with tics.OBJECTIVEThis study aimed to explore (i) how tic services for CYP in England are currently organised, including access to assessment and treatment and (ii) healthcare professionals' (HCPs) experiences of assessing and treating tics.METHODSTwo methodologies were used to examine tic service provision. First, two freedom of information (FOI) requests were sent to Integrated Care Boards (FOI1) and service providers (FOI2) to gather data on referral and assessment processes, and treatments offered. Second, a national survey of HCPs explored their experiences and training needs when assessing and treating tics.FINDINGSFOI responses indicated that 12 of 62 services (19.4%), primarily located in the London area, offered a full pathway for the referral, assessment and treatment of tics in CYP.The national survey sample (n=184) included psychologists, paediatricians, neurologists and mental health nurses. Most described services as poorly structured and reported a need for additional resources and training in the assessment and treatment of tics.CONCLUSIONSInconsistent and underfunded tic service provision across England limits HCPs' ability to support CYP with tics effectively. There is an urgent need to develop clear service pathways offering both assessment and treatment, and to equip HCPs with sufficient training and resources to provide appropriate care.CLINICAL IMPLICATIONSCurrent tic service provision does not meet the healthcare needs of CYP in England. Without improvements, CYP are at increased risk of poorer long-term outcomes.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144578597","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":"Premenstrual disorders and risk of sick leave and unemployment: a prospective cohort study of 15 857 women in Sweden.","authors":"Hang Yu, Yihui Yang, Elgeta Hysaj, Alicia Nevriana, Sara Hägg, Unnur Anna Valdimarsdóttir, Elizabeth Bertone-Johnson, Donghao Lu","doi":"10.1136/bmjment-2025-301550","DOIUrl":"10.1136/bmjment-2025-301550","url":null,"abstract":"<p><strong>Background: </strong>Premenstrual disorders (PMDs) are prevalent and impair women's quality of life, but their long-term influence on work capacity is unclear. Understanding the association between PMDs and subsequent sick leave and unemployment could inform interventions and policies.</p><p><strong>Objective: </strong>We hypothesised that women with PMDs have an increased risk of future sick leave and unemployment compared with those without PMDs.</p><p><strong>Methods: </strong>We conducted a prospective cohort study involving 15 857 women aged 15-60 years who were employed at baseline in the LifeGene Study, with linkage to population and health registers in Sweden. PMDs were identified from clinical diagnoses and symptom questionnaires; sick leave and unemployment data were obtained from national registers. Poisson regression estimated incidence rate ratios (IRRs) for sick leave and unemployment in women with versus without PMDs.</p><p><strong>Findings: </strong>A total of 2585 (16.3%) women (mean age 32.5 years) had probable PMDs. Over a median 9.17-year follow-up, 6741 (42.5%) and 1485 (9.4%) experienced at least one sick leave or unemployment, respectively. Compared with women without PMDs, those with PMDs had a 40% higher risk of sick leave (IRR 1.40, 95% CI 1.31 to 1.49) and a 27% higher risk of unemployment (IRR 1.27, 95% CI 1.10 to 1.46). Risk elevations were pronounced for sick leave≥90 days (IRR 1.69, 95% CI 1.50 to 1.91) and depression-related sick leave (IRR 1.41, 95% CI 1.27 to 1.56).</p><p><strong>Discussion: </strong>Women with PMDs are at increased risk of sick leave and unemployment, suggesting significant long-term socioeconomic burden associated with PMDs.</p><p><strong>Clinical implications: </strong>This study underscores the need for greater awareness of PMDs in clinical practice. Healthcare providers should recognise the potential impairment at work associated with PMDs, especially in women with recurrent symptoms or comorbidities like anxiety or depression.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585751","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":"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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565490","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":"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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509811","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":"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}