BMJ mental health最新文献

{"title":"Discontinuation and reinitiation of pharmacological treatment for ADHD among individuals with ADHD and substance use disorder.","authors":"Andrea J Capusan,Le Zhang,Henrik Larsson,Isabell Brikell,Diana Martinez,Brian M D'Onofrio,Paul Lichtenstein,Ralf Kuja-Halkola,Zheng Chang","doi":"10.1136/bmjment-2025-302138","DOIUrl":"https://doi.org/10.1136/bmjment-2025-302138","url":null,"abstract":"BACKGROUNDAttention-deficit/hyperactivity disorder (ADHD) and substance use disorder (SUD) often coexist. ADHD complicates the course of disease in SUD. While recommended in guidelines, ADHD medication for those with comorbid SUD remains controversial.OBJECTIVEThis study aims to explore how comorbid SUD affects ADHD medication discontinuation and reinitiation in individuals with ADHD.METHODSUsing a matched cohort design, we identified 9283 individuals with ADHD and SUD in Sweden between 2006 and 2020, who had ongoing ADHD medication at the time of their first SUD-related event. Controls with ADHD medication but no SUD (n=46 401) were matched 5:1 on sex and birth year. HRs for treatment discontinuation within 1 year from first SUD, and for treatment reinitiation within 1 year from the first discontinuation, were estimated using stratified Cox models.FINDINGSIndividuals with ADHD and SUD were nearly two times as likely to discontinue ADHD treatment within 1 year (HR: 1.99, 95% CI 1.92 to 2.07) and less likely to re-initiate ADHD treatment (HR: 0.82, 95% CI 0.76 to 0.89) compared with controls. Several factors, including male sex, adolescent to young adult age and lower stimulant medication dose, were associated with increased risk for treatment discontinuation, but only adolescent to young adult age was significantly associated with treatment reinitiation in those with ADHD and SUD.CONCLUSIONSThe results suggest less treatment continuity and access for those with ADHD and comorbid SUD.CLINICAL IMPLICATIONSTreatment providers need to consider the specific needs of individuals with ADHD and comorbid SUD, especially in young males, to improve treatment outcomes for vulnerable groups.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147502198","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":"International Depression Questionnaire and International Anxiety Questionnaire: validation of brief ICD-11 measures for depression and generalised anxiety disorder.","authors":"Johanna Schröder,Leonhard Kratzer,Thanos Karatzias,Anamaria Semm,Stefan Tschöke,Sarah Biedermann,Eva Schäflein,Julia König,Matthias Knefel,Philip Hyland,Mark Shevlin","doi":"10.1136/bmjment-2025-302389","DOIUrl":"https://doi.org/10.1136/bmjment-2025-302389","url":null,"abstract":"BACKGROUNDThe 11th revision of the International Classification of Diseases (ICD-11) introduced revised diagnostic criteria for a depressive episode (DE) and generalised anxiety disorder (GAD). The International Depression Questionnaire (IDQ) and the International Anxiety Questionnaire (IAQ) are the first self-report measures developed to assess and screen these disorders according to the ICD-11 diagnostic rules.OBJECTIVEThis study aims to validate the IDQ and the IAQ in clinical and community samples, examining internal consistency, factorial validity and construct validity.METHODSThe cross-sectional, observational multicentre validation study applied internal consistency testing, confirmatory factor analyses and item response theory (IRT) in a clinical sample (n=569; age 18-73; 417 females, 118 males, 34 diverse) and a sample representative of the German general population (n=1001) by age, education and gender (500 females, 499 males, 2 diverse). Factorial and IRT model fit of the IDQ and IAQ as well as concordance with the Patient Health Questionnaire-9 (PHQ-9) and the Generalised Anxiety Disorder-7 (GAD-7) was tested.RESULTSBoth questionnaires showed excellent internal consistency (ω=0.96 each) and strong factor loadings. A three-factor IDQ model and a one-factor IAQ model provided the best fit. In the clinical sample, 39.7% met ICD-11 DE criteria and 51.0% GAD criteria (overlap 32.2%). In the general population, prevalence was 5.9% for DE and 9.3% for GAD. Concordance with PHQ-9 and GAD-7 was partial, suggesting differences between ICD-11-based and established screening tools.CONCLUSIONSThe IDQ and IAQ are psychometrically robust self-report measures for ICD-11 DE and GAD. They are reliable, valid, brief, easy to administer, cost-free and suitable for use in primary care and research across diverse clinical and research settings. Their availability supports standardised screening of depression and GAD in both clinical and community settings.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147502199","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":"Reduced risk of cause-specific hospitalisations and all-cause hospitalisation/mortality during treatment with attention-deficit/hyperactivity disorder medications in the course of bipolar disorder: a Swedish registry-based within-subject cohort study.","authors":"Cagatay Ermis,Antti Tanskanen,Olivier Corbeil,Johannes Lieslehto,Eduard Vieta,Christoph U Correll,Ellenor Mittendorfer-Rutz,Jari Tiihonen,Heidi Taipale","doi":"10.1136/bmjment-2025-302159","DOIUrl":"https://doi.org/10.1136/bmjment-2025-302159","url":null,"abstract":"BACKGROUNDComorbid attention-deficit/hyperactivity disorder (ADHD) increases the burden in bipolar disorder (BD). Concerns about the risk/benefit balance of ADHD treatment have been raised.OBJECTIVEThis study aimed to investigate the association between hospital admissions and add-on ADHD medications to antipsychotics and/or mood-stabilisers (APs/MSs) compared with AP/MS alone in BD.METHODSIndividuals with BD prescribed ADHD medications in Sweden during 2006-2021 were identified from national registers of inpatient care, specialised outpatient care, sickness absence and disability pension. ADHD treatment was defined as stimulants (mostly methylphenidate and lisdexamfetamine, rarely amphetamine, dexamphetamine) and non-stimulants (atomoxetine, modafinil). Add-on ADHD treatment to concomitant AP/MS was compared with treatment periods with AP/MS without ADHD treatment, using within-individual models where individuals acted as their own control. Adjusted HRs (aHRs) and CIs (95% CIs) were calculated for the primary outcome of psychiatric hospitalisation, and for the secondary outcomes: substance-use-related, somatic or mania-related hospitalisations, and all-cause hospitalisation/mortality.RESULTSAltogether, 17 971 individuals (mean age=32.0±11.6 years, males=37.6%, ADHD=88.9%, follow-up=8.9±4.4 years) with BD who used any ADHD treatment were included. compared with the use of AP/MS alone, add-on stimulant use was related to a lower risk of psychiatric hospitalisations (aHR=0.89, 95% CI 0.85 to 0.93), substance-related hospitalisations (aHR=0.75, 95% CI 0.70 to 0.81) and all-cause hospitalisations/mortality (aHR=0.90, 95% CI 0.87 to 0.93), but was not associated with increased risk for somatic (aHR=1.00, 95% CI 0.90 to 1.12) or mania-related hospitalisations (aHR=0.93, 95% CI 0.72 to 1.20). Of commonly used specific ADHD medications, add-on lisdexamfetamine (aHR=0.81, 95% CI 0.75 to 0.87) and methylphenidate (aHR=0.92, 95% CI 0.88 to 0.97) were associated with decreased risk of psychiatric hospitalisations while add-on atomoxetine was not. Findings on substance-use-related hospitalisations were significant only for stimulants, specifically lisdexamfetamine (aHR=0.70, 95% CI 0.61 to 0.79) and methylphenidate (aHR=0.80, 95% CI 0.74 to 0.86).CONCLUSIONSAmong individuals with BD who received ADHD medications, add-on lisdexamfetamine and methylphenidate were associated with lower risks of psychiatric and substance-use-related hospital admissions, compared with AP/MS use alone. No significant association was found between ADHD medication use and mania-related hospitalisations or somatic admissions when these medications were used together with AP/MS. Larger samples are needed to reach adequate statistical power and conclusive findings on atomoxetine, dexamfetamine and modafinil.CLINICAL IMPLICATIONSThe findings of this study suggested that the treatment of comorbid ADHD could be considered after adequate mood-stabilisation in patients with BD.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483327","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":"Sex differences in familial risk and genetic components of suicide attempts: a register-based cohort study in Sweden.","authors":"Thuy-Dung Nguyen,Tong Gong,Kejia Hu,Ralf Kuja-Halkola,Karen Borges,Agnieszka Butwicka,Isabell Brikell,James J Crowley,Zheng Chang,Brian M D'Onofrio,Henrik Larsson,Paul Lichtenstein,Christian Rück,Cynthia Bulik,Fang Fang,Patrick Sullivan,Yi Lu","doi":"10.1136/bmjment-2025-302082","DOIUrl":"https://doi.org/10.1136/bmjment-2025-302082","url":null,"abstract":"BACKGROUNDSuicidal behaviour shows notable sex differences, and understanding whether genetic factors contribute to these differences is critical for identifying at-risk individuals and prevention.OBJECTIVEWe aim to investigate the genetic contribution to suicide attempts and examine whether genetics account for sex differences in incidence.METHODSThis population-based cohort study includes 3.1 million individuals born 1963-1998 and followed through Swedish National Registers, including hospitals and specialist outpatient diagnoses and cause of death data. Suicide attempts were identified using ICD codes, indicating intentional self-harm, self-harm using lethal methods or leading to hospitalisation, or resulting in death. Familial aggregation, coaggregation, pedigree heritability and genetic correlations were estimated using genealogical data. For sex-specific analyses, we examined mother-daughter, female sibling, father-son and male sibling pairs, separately.FINDINGSSuicide attempts were more common among females than males (3.3% vs 2.6%). In both sexes, risk aggregated within families (ORs ranged 1.6-3.4 across relative types) and was higher in first-degree than second-degree relatives. Familial aggregation was stronger in females than in males, and in same-sex first degree relatives compared with cross-sex pairs. Pedigree heritability was 41.9% (95% CI 36.0 to 48.4%) and did not differ significantly by sex (female 51.4% (95% CI 40.1% to 58.6%), male 45.1% (95% CI 32.3% to 52.5%), Bootstrap p value 0.40). Suicide attempt showed moderate to high pedigree genetic correlations with psychiatric disorders, strongest with substance use disorders (SUD, rg=0.85 (95% CI 0.83 to 0.96)), with no significant sex differences. The genetic correlation between female and male suicide attempts was high (0.85 (95% CI 0.80 to 0.99)), suggesting a substantial genetic overlap.CONCLUSIONSSuicide attempt has a moderate heritable component that largely overlaps between females and males and with other psychiatric disorders, particularly SUD. Stronger familial aggregation in females and in same-sex pairs highlights the potential role of sex-specific environmental or social factors. Future research should focus on non-genetic contributors and their potential interaction with genetic factors to better understand and address sex disparities in suicidal behaviour CLINICAL IMPLICATIONS: Genetic risk for suicide attempt is substantial but does not fully explain sex differences in incidence. Clinicians should, therefore, consider non-genetic, including sex-specific environmental and social factors, alongside family history and psychiatric comorbidity when assessing suicidal risk.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"84 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147383498","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":"Levels of evidence supporting American, European and international guidelines in psychiatry, 2014-2024: a systematic review with quantitative synthesis.","authors":"Troels Boldt Rømer,Signe N Andersson,Michael Eriksen Benros","doi":"10.1136/bmjment-2025-302194","DOIUrl":"https://doi.org/10.1136/bmjment-2025-302194","url":null,"abstract":"QUESTIONTo what extent are psychiatry guidelines supported by high-level evidence?STUDY SELECTION AND ANALYSISGuidelines from the American Psychiatric Association, European Psychiatric Association, WHO and World Federation of Societies for Biological Psychiatry (2014-2024) were selected. Recommendations were graded by guideline authors' levels of evidence (LOE) appraisal (standardised to the Grading of Recommendations, Assessment, Development and Evaluations framework (high, moderate, low, very low)) and by the highest-level study referenced (meta-analysis, randomised controlled trial (RCT), observational study, expert opinion, etc.).FINDINGS24 guidelines, containing 545 recommendations, were included. Of 82 guidelines screened, 29 (35%) had not been updated in a decade. 63 (11.6%) recommendations were rated by guideline authors as based on high LOE. The proportion was the highest for pharmacotherapies (41/281 (14.6%)) and the lowest for somatic assessment (0/13 (0%)). The proportion of high LOE recommendations varied between publishers (European Psychiatric Association: 20 %, WHO: 1.6 %). For high LOE recommendations, only those concerning pharmacotherapies cited meta-analyses based on double-blind studies using adequate controls. A large proportion (n=241 (44.2%)) of recommendations cited either a meta-analysis of RCTs (n=155 (28.4%)) or ≥two RCTs (n=86 (15.8 %)). There were few recommendations primarily addressing self-harm (n=2), autism (n=3), attention-deficit/hyperactivity disorder (n=3), prevention (n=3), patient involvement (n=3) or discontinuation (n=6).CONCLUSIONSClinical guidelines in psychiatry frequently cite RCTs, but the evidence is often downgraded by guideline authors, highlighting the need for better quality trials. LOE varies across areas, with pharmacotherapies supported by the highest quality evidence. Organisations should commit to a timely update of guidelines covering all areas of psychiatry.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147383222","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":"Effects of smartphone cognitive behavioural therapy on social functioning in non-depressive and subthreshold depressive adults: a secondary analysis of the RESiLIENT trial.","authors":"Aran Tajika,Rie Toyomoto,Masatsugu Sakata,Yan Luo,Tatsuo Akechi,Masaru Horikoshi,Kosuke Inoue,Hisashi Noma,Pim Cuijpers,Toshi A Furukawa","doi":"10.1136/bmjment-2025-302303","DOIUrl":"https://doi.org/10.1136/bmjment-2025-302303","url":null,"abstract":"BACKGROUNDDepression is a leading cause of global disability, and subthreshold cases contribute substantially to the burden. Cognitive behavioural therapy (CBT) is effective for depressive symptoms, but its impact on social functioning in subthreshold depression remains unclear.OBJECTIVEThis study evaluated the effects of smartphone-based CBT on social functioning and personal health records among individuals with subthreshold depression and examined whether a personalised and optimised therapy (POT) algorithm enhanced these outcomes.METHODSWe performed a secondary analysis of the RESiLIENT trial (n=5361). Participants were stratified by baseline Patient Health Questionnaire-9 (PHQ-9) scores (0-4 and 5-14) and randomised to nine CBT app groups or a self-check group. Outcomes included social functioning and health records. A mixed-effects model for repeated measures was used to analyse the outcomes. The POT algorithm selected CBT skills tailored to individual characteristics.FINDINGSDepressive symptoms improved in both PHQ-9 groups compared with those of the self-check group, but gains in social functioning were modest, observed mainly in the PHQ-9 score ≤4 group. No consistent benefits were seen for health behaviours, job resignation, sick leave or healthcare costs. However, in a simulated randomised comparison using 10-fold cross-validated datasets, the POT algorithm had potentially beneficial effects for productivity (standardised mean difference (SMD)=0.16, 95% CI 0.03 to 0.29) and social adjustment (SMD=-0.13, 95% CI -0.26 to 0.00).CONCLUSIONSSmartphone CBT effectively reduced depressive symptoms but showed limited impact on social functioning and healthcare costs. Personalised optimisation may modestly improve productivity and adjustment, suggesting its promise for enhancing social outcomes.CLINICAL IMPLICATIONSPersonalised tailoring of CBT skills may strengthen the effects of digital interventions on social functioning.TRIAL REGISTRATION NUMBERUMIN000047124.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147350631","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":"Are all risks equal? Understanding the differential mechanism linking early environmental risk and obesity via the interplay of mental health and lifestyle factors.","authors":"Hongyi Sun,Janet Kiri,Valerie Brandt,Dennis Golm","doi":"10.1136/bmjment-2025-302211","DOIUrl":"https://doi.org/10.1136/bmjment-2025-302211","url":null,"abstract":"BACKGROUNDThe mechanisms linking early environmental risk (EER) and obesity via the interplay of mental health and lifestyle factors in the early life stage remain unclear.OBJECTIVETo examine whether EER was associated with later mental health, lifestyle factors and obesity and to identify the mediating roles of mental health and lifestyle in these relationships.METHODUsing data from the Millennium Cohort Study (valid n=5401), we longitudinally assessed the relationship between EER (prenatal risks, neonatal risks, low socioeconomic status, maternal psychological problems and harsh parenting; 9 months to age 3 years), mental health problems in childhood (internalising and externalising problems; age 7 years), lifestyle factors in early adolescence (diet, exercise, smoking and drinking; age 11 years) and obesity in late adolescence (age 14-17 years). Structural equation modelling was used to test proposed pathways.FINDINGSThe proposed model showed an acceptable fit (Comparative Fit Index=0.926, Tucker-Lewis Index=0.875, root mean square error of approximation=0.034, standardised root mean square residual=0.046). EER was significantly associated with later mental health problems, lifestyle factors (ie, diet, exercise, smoking) and obesity. Higher EER was modestly associated with higher obesity risk via the interplay of externalising problems and drinking (β=0.01, p=0.036). The sex-stratified model results indicated differences between males and females.CONCLUSIONBy highlighting the importance of EER and the mediating role of lifestyle factors in mental health and later obesity risk, our findings provide evidence of shared risk mechanisms linking mental and physical health.CLINICAL IMPLICATIONSThese findings suggest that integrating mental health assessment (especially externalising symptoms) with routine screening for adolescent alcohol use and other risk factors could inform more targeted obesity prevention in clinical and public health settings.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147346446","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":"How can we make interventions more 'acceptable' in mental health?","authors":"Thomas Kabir","doi":"10.1136/bmjment-2025-302337","DOIUrl":"10.1136/bmjment-2025-302337","url":null,"abstract":"<p><p>Are we properly assessing the acceptability of mental health interventions from a service user's point of view? A treatment can be efficacious and effective but still not acceptable to a service user. For example, someone with psychosis may find a treatment that improves symptoms but causes significant weight gain and sedation unacceptable. Despite significant progress being made in developing safe and effective interventions for mental health problems, a notable proportion of people remain in need. The reasons for this are complex. Part of the problem could be an inadequate focus on how 'acceptable' interventions really are to service users given their views and specific circumstances.Treatment acceptability has been a rather poorly defined concept. This has led to researchers using several methods to assess their own ideas about what service user acceptability is. This can include methods such as using recruitment and withdrawal data. But such data may not be true markers of acceptability to a service user.Current approaches to assessing acceptability need improvement. Existing acceptability questionnaire measures are not widely used and are often developed for specialist settings. Crucially, very few have had any stated involvement of people with mental health conditions in their development. This approach risks not listening to service users' voices fully.Developing better ways of understanding and assessing service users' views of treatment acceptability in mental health could have many benefits-including empowering individual service users to identify interventions that they can and cannot accept. It is time to better understand what 'acceptable' really means in mental health.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"29 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12959063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147319151","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 admission in female survivors of childhood and young adult cancer: a whole population retrospective study.","authors":"W Hamish B Wallace, Tom W Kelsey, David S Morrison, Katie Fm Marwick, Richard Anderson","doi":"10.1136/bmjment-2025-301683","DOIUrl":"10.1136/bmjment-2025-301683","url":null,"abstract":"<p><strong>Background: </strong>The last 40 years have seen a substantial improvement in overall survival from cancer in children and young people. There is limited information on psychiatric wellbeing in female survivors of cancer at a young age.</p><p><strong>Objective: </strong>In this 40-year population-based linkage study, we set out to determine the incidence of first psychiatric admission compared with a non-exposed age-matched control.</p><p><strong>Methods: </strong>Scottish cancer registry records from 1981 to 2012 were linked to psychiatric admissions, maternity and death records from January 1981 to September 2018 using the unique personal Community Health Index number allocated to each person in Scotland. For each exposed subject, three age and deprivation matched controls from the population were selected. The primary exposed group was all females with a cancer diagnosis at age <25 years and no previous pregnancy and no psychiatric admission before cancer diagnosis. The main outcome measure is admission to a psychiatric hospital with a mental health diagnosis.</p><p><strong>Findings: </strong>Female cancer survivors had a significantly lower cumulative incidence of first psychiatric admissions than matched controls over the 38 years of follow-up for the cohort (p<0.05). The relative risk of a first psychiatric admission at 25 years from cancer diagnosis was 0.72 (0.56-0.89).</p><p><strong>Conclusion: </strong>Overall, we have shown that young cancer survivors are less likely than age-matched controls to have a psychiatric admission after cancer diagnosis. In particular, psychiatric admissions for mood disorders, neuroses, personality disorders and substance use are significantly less likely in the cancer survivors.</p><p><strong>Clinical implications: </strong>The experience of cancer treatment and survival in young females may reduce the risk of psychiatric admission in later life.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"29 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12958883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313151","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":"Cannabis use, cognitive function and dementia risk in older adults: observational and genetic analyses.","authors":"Saba Ishrat, Daniel F Levey, Joel Gelernter, Klaus P Ebmeier, Anya Topiwala","doi":"10.1136/bmjment-2025-302290","DOIUrl":"10.1136/bmjment-2025-302290","url":null,"abstract":"<p><strong>Background: </strong>The cognitive effects of cannabis use in older adults remain unclear, despite increasing use for medical and recreational purposes in this age group.</p><p><strong>Objective: </strong>To investigate associations between cannabis use, cognitive performance and dementia risk in older individuals, using large population cohorts and Mendelian randomisation (MR) to explore potential causal relationships.</p><p><strong>Methods: </strong>Observational analyses were conducted using the UK Biobank (UKB) and the US Million Veteran Program (MVP). In UKB, cross-sectional and longitudinal cognitive performance across five domains was compared between lifetime cannabis users (up to 18 975 participants) and non-users (up to 60 598 participants). In MVP, cannabis use disorder (CanUD; n=12 222) was examined in relation to incident all-cause dementia using Cox proportional hazards models. MR analyses assessed potential bidirectional causal relationships between cannabis use, cognitive function and dementia.</p><p><strong>Findings: </strong>At baseline, cannabis users performed modestly better on tests of numeric memory (beta=0.07, 95% CI 0.06 to 0.09, p<0.001) and fluid intelligence (beta=0.12, 95% CI 0.10 to 0.13, p<0.001), but no significant differences were observed in longitudinal cognitive change. In MVP, CanUD was not significantly associated with dementia risk (HR=1.11, 95% CI 0.97 to 1.26, p=0.12). MR analyses provided no evidence of a causal relationship between cannabis use and either cognitive performance or dementia risk.</p><p><strong>Conclusions: </strong>Cannabis use was not linked to longitudinal cognitive decline or dementia risk. Within the limits of these cohorts, we found no evidence that cannabis use contributes substantially to cognitive ageing or dementia risk in older adults. Further research with detailed exposure assessment and longer follow-up is warranted to confirm these findings.</p><p><strong>Clinical implications: </strong>Cannabis use in older adults does not appear linked to faster cognitive decline or higher dementia risk. Occasional or prior use may not substantially affect cognitive ageing, though safety at higher doses or prolonged use remains uncertain. Clinicians should inquire about cannabis history and consider cognitive screening in routine care.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"29 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12958891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313034","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}