BMJ mental health最新文献

{"title":"Do illness beliefs predict uptake of depression treatment after web-based depression screening? A secondary analysis of the DISCOVER RCT.","authors":"Matthias Klee,Franziska Sikorski,Bernd Loewe,Sebastian Kohlmann","doi":"10.1136/bmjment-2025-301666","DOIUrl":"https://doi.org/10.1136/bmjment-2025-301666","url":null,"abstract":"BACKGROUNDOnly a minority of those with depressive disorder receive treatment. Besides system-level factors, individual factors could account for the gap between detection and treatment of depression in so far unreached but affected populations.OBJECTIVEThis study tests the predictive value of illness beliefs (IB) for the uptake of depression treatment 6 months after web-based depression screening.METHODSThis is a secondary analysis of the randomised controlled Germany-wide DISCOVER trial that investigated the effects of automated results feedback following web-based depression screening in untreated participants with at least moderate depression severity (Patient Health Questionnaire ≥10 points). IB were examined as predictors of depression treatment uptake. Eligible participants were at least 18 years old, reported proficiency in German language, and provided informed consent. IB were assessed at the time of screening (baseline) with an adapted version of the Brief Illness Perception Questionnaire. Uptake of depression treatment was operationalised as self-reported initialisation of psychotherapy and/or antidepressant medication 6 months after baseline. Analyses were adjusted for study arm.FINDINGSData from N=871 participants of the DISCOVER trial providing follow-up data were analysed. IB denoting more consequences (OR (95% CI) 1.12 (1.00 to 1.26)), higher treatment control (OR (95% CI) 1.19 (1.11 to 1.29)) and a depression-conforming illness identity (OR (95% CI) 1.65 (1.15 to 2.36)) were associated with up to 56.8% relative increase in predicted probability of depression treatment uptake 6 months after baseline.CONCLUSIONSResults suggest considerable effects of IB for depression treatment uptake in untreated populations.CLINICAL IMPLICATIONSIB could reflect relevant barriers in access to depression care and, concurrently, intervention targets to foster health service utilisation in untreated populations.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144720252","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":"Indigenous mental health research in the context of climate change: methodological reflections on language and barriers to cultural practice.","authors":"Samrawit Gougsa, Victoria Pratt, Daniel Kobei, Sylvia Kokunda, Siwakorn Odochao, Jenni Laiti, Babitha George, Jessica Sim, Nicole Redvers","doi":"10.1136/bmjment-2025-301856","DOIUrl":"10.1136/bmjment-2025-301856","url":null,"abstract":"<p><p>Climate change creates unique forms of psychological distress for Indigenous Peoples whose identities and cultural practices are often intrinsically connected to ancestral lands, yet research on culturally appropriate methodologies for studying Indigenous mental health in the context of climate change remains limited. This perspective paper presents methodological reflections from Land Body Ecologies research collective, which collaborates with Ogiek (Kenya), Batwa (Uganda), Iruliga (India), Pgak'yau (Thailand) and Sámi (Sápmi) Indigenous Peoples to explore climate change-related mental health impacts through the lens of solastalgia. Through participatory dialogues conducted during in-person gatherings, team members reflected on three years of community-based participatory research and identified two critical methodological challenges underexplored in the existing literature: (1) language and concept translation difficulties, where terms such as 'mental health' and 'climate change' lack direct cultural equivalents and may carry stigmatising connotations and (2) barriers to cultural practices, where climate change and conservation-related legislation restricts Indigenous Peoples' access to ancestral lands and traditional practices essential for well-being. These challenges reflect deeper epistemological tensions between conventional research approaches and Indigenous holistic worldviews that understand land, body and ecosystems as interconnected. It concludes that meaningful mental health research with Indigenous Peoples demands active recognition of Indigenous cultural rights and self-determination, collaborative approaches that honour Indigenous knowledge systems and systemic changes that normalise Indigenous timelines, relationality and knowledge sovereignty within research institutions.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"28 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719233","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":"Safer opioid supply clients' values and preferences: a systematic review and thematic synthesis of qualitative research.","authors":"Frishta Nafeh, Lucas Martignetti, Gillian Kolla, Matthew Bonn, Shahryar Moradi Falah Langeroodi, Karen Urbanoski, Bernie Pauly, Dan Werb, Mohammad Karamouzian","doi":"10.1136/bmjment-2025-301629","DOIUrl":"10.1136/bmjment-2025-301629","url":null,"abstract":"<p><strong>Question: </strong>What are the values and preferences of safer opioid supply clients?</p><p><strong>Study selection and analysis: </strong>We conducted a systematic review of qualitative studies on safer opioid supply client experiences published between January 2016 and August 2024. Searches were conducted across seven databases-MEDLINE, Embase, PsycINFO, CINAHL, EBM Reviews, Web of Science and Scopus-and supplemented with searches in Google Scholar and relevant repositories. Study quality was assessed using the Critical Appraisal Skills Programme. Data analysis was guided by Thomas and Harden's thematic synthesis approach and confidence in review findings was evaluated using Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative research. The review was registered with PROSPERO (CRD42022384447).</p><p><strong>Findings: </strong>Our thematic synthesis included 19 peer-reviewed original research articles involving 459 study participants from British Columbia and Ontario, of whom 60.1% were men and 36.1% were women. Our findings centred on four cross-cutting analytic themes: (1) client-relevant goals and outcomes (withdrawal management, pain management, socioeconomic improvements), (2) the right medications to optimise client-relevant outcomes (multiple medication and formulation options, flexible dosage), (3) supportive, client-centred care environment (safe, welcoming and non-judgmental spaces, coordinating access to health and social support services, shared decision-making) and (4) complex adaptive systems approach to clinical policies (understanding the complexity of clients' living circumstances, flexible dose schedules, non-punitive policies). Confidence in findings ranged from moderate to high.</p><p><strong>Conclusions: </strong>Safer opioid supply's success depends on providing individualised opioid medications, fostering person-centred care and implementing adaptive clinical policies. A supportive and flexible model enhances client satisfaction, sustains programme participation and optimises client-relevant outcomes.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"28 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719234","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":"Development and evaluation of prompts for a large language model to screen titles and abstracts in a living systematic review.","authors":"Ava Homiar,James Thomas,Edoardo G Ostinelli,Jaycee Kennett,Claire Friedrich,Pim Cuijpers,Mathias Harrer,Stefan Leucht,Clara Miguel,Alessandro Rodolico,Yuki Kataoka,Tomohiro Takayama,Keisuke Yoshimura,Ryuhei So,Yasushi Tsujimoto,Yosuke Yamagishi,Shiro Takagi,Masatsugu Sakata,Đorđe Bašić,Eirini Karyotaki,Jennifer Potts,Georgia Salanti,Toshi A Furukawa,Andrea Cipriani","doi":"10.1136/bmjment-2025-301762","DOIUrl":"https://doi.org/10.1136/bmjment-2025-301762","url":null,"abstract":"BACKGROUNDLiving systematic reviews (LSRs) maintain an updated summary of evidence by incorporating newly published research. While they improve review currency, repeated screening and selection of new references make them labourious and difficult to maintain. Large language models (LLMs) show promise in assisting with screening and data extraction, but more work is needed to achieve the high accuracy required for evidence that informs clinical and policy decisions.OBJECTIVEThe study evaluated the effectiveness of an LLM (GPT-4o) in title and abstract screening compared with human reviewers.METHODSHuman decisions from an LSR on prodopaminergic interventions for anhedonia served as the reference standard. The baseline search results were divided into a development and a test set. Prompts guiding the LLM's eligibility assessments were refined using the development set and evaluated on the test set and two subsequent LSR updates. Consistency of the LLM outputs was also assessed.RESULTSPrompt development required 1045 records. When applied to the remaining baseline 11 939 records and two updates, the refined prompts achieved 100% sensitivity for studies ultimately included in the review after full-text screening, though sensitivity for records included by humans at the title and abstract stage varied (58-100%) across updates. Simulated workload reductions of 65-85% were observed. Prompt decisions showed high consistency, with minimal false exclusions, satisfying established screening performance benchmarks for systematic reviews.CONCLUSIONSRefined GPT-4o prompts demonstrated high sensitivity and moderate specificity while reducing human workload. This approach shows potential for integrating LLMs into systematic review workflows to enhance efficiency.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693379","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":"Agreeing a set of biopsychosocial variables for collection across the UK Eating Disorders Clinical Research Network: a consensus study using adapted nominal group technique.","authors":"Tom Jewell,Iona Smith,James Downs,Anna Carnegie,Saakshi Kakar,Laura Meldrum,Lu Qi,Una Foye,Chelsea M Malouf,Suzanne Baker,Hope Virgo,Marilyn Okoro,Jessica Griffiths,Daniel Munblit,Moritz Herle,Ulrike Schmidt,Sarah Byford,Sabine Landau,Clare Llewellyn,Dasha Nicholls,Agnes Ayton,Sheryllin McNeil,Stephen Anderson,Gerome Breen,Karina L Allen","doi":"10.1136/bmjment-2025-301760","DOIUrl":"https://doi.org/10.1136/bmjment-2025-301760","url":null,"abstract":"BACKGROUNDEating disorders are serious psychiatric disorders associated with high levels of co-occurring physical and mental health conditions and poor treatment outcomes. The collection of standardised, routinely collected data within clinical services holds promise to improve patient care.OBJECTIVETo agree on a set of biopsychosocial variables for routine data collection within eating disorder services in the UK.METHODSTwo online workshops were conducted using an adapted nominal group technique to agree on priorities for data collection in adult and child/adolescent eating disorder services. Workshop participants (n=43) consisted of people with lived experience, carers, clinicians and researchers. Two researchers independently conducted a reflexive thematic analysis of the workshop transcripts to identify qualitative priorities for data collection. Descriptive statistics were used to analyse the results of online voting.FINDINGSThematic analysis identified four superordinate themes for data collection in eating disorder services: (1) a mutually valued and beneficial collaboration; (2) a holistic approach; (3) a balance between standardisation and individualisation; (4) doing no harm. Quantitative analysis of voting identified priorities across a range of domains, leading to a proposed biopsychosocial dataset.CONCLUSIONSThis project agreed on a set of biopsychosocial variables for routine data collection in the UK Eating Disorders Clinical Research Network. Further research should evaluate the implementation success of these variables.CLINICAL IMPLICATIONSPatients, caregivers and clinicians support routine data collection in eating disorder services so long as the measures used are considered meaningful, not overly burdensome, non-stigmatising and collected in collaboration between patients and treatment providers.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"276 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669312","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":"Transdiagnostic early warning score for psychiatric hospitalisation: development and evaluation of a prediction model.","authors":"Maxime Taquet,Seena Fazel,A John Rush","doi":"10.1136/bmjment-2025-301622","DOIUrl":"https://doi.org/10.1136/bmjment-2025-301622","url":null,"abstract":"BACKGROUNDThe lack of an early warning score for psychiatric hospitalisation means that the decision to initiate preventative interventions is based solely on clinical judgement, which is prone to bias.OBJECTIVEThe objective is to develop and externally validate a transdiagnostic score that predicts psychiatric hospitalisation.METHODSIn this retrospective cohort study using deidentified electronic health records from 20 healthcare organisations in the NeuroBlu Data, we identified all patients with any of seven major psychiatric disorders with at least five Clinical Global Impressions of Severity and five Global Assessment of Functioning measured over a period of 6 consecutive months before any hospitalisation. From these measurements, metrics of clinical severity and instability and functional severity and instability were derived and incorporated into a score predicting the 6-month risk of incident psychiatric hospitalisation. Discrimination and calibration of this score were validated in an external sample. The transdiagnostic validity of the score was evaluated and its performance was compared between white and non-white people.FINDINGSAltogether, 37 049 individuals (531 incident hospitalisations) were included. The predictive model showed good discrimination in the training (optimism-adjusted c-index: 0.74, 95% CI 0.72 to 0.76) and external validation (c-index: 0.80, 95% CI 0.78 to 0.82) samples, with adequate calibration. Discrimination improved with adjustment for organisation-level hospitalisation rates (c-index: 0.80, 95% CI 0.78 to 0.82 and 0.84, 95% CI 0.82 to 0.86 in the derivation and validation samples). Good discrimination was also achieved for each diagnostic category (c-index: 0.71-0.82 and 0.64-0.75 with/without adjustment for organisation-level hospitalisation rates, respectively). There was no significant difference in model performance between white and non-white people.DISCUSSIONA transdiagnostic early warning system based on simple longitudinal measurements can reliably and robustly predict psychiatric hospitalisation. It will help target preventative interventions to individuals most at risk.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"89 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of ADHD traits, sleep/circadian factors, depression and quality of life.","authors":"Siddhi Nair,Neha Deshpande,Catherine Hill,Samuele Cortese,Eus J W Van Someren,Sarah Laxhmi Chellappa","doi":"10.1136/bmjment-2025-301625","DOIUrl":"https://doi.org/10.1136/bmjment-2025-301625","url":null,"abstract":"BACKGROUNDIndividuals with attention deficit hyperactivity disorder (ADHD) are at a higher risk of depression and lower quality of life (QoL); however, it is unclear whether disrupted sleep and circadian rhythms mediate this increased risk.OBJECTIVESWe investigated whether disruption of self-reported sleep and circadian factors mediate the associations of ADHD traits with depression symptom severity and QoL.METHODS1364 participants (mean: 51.86 (SD=0.37) years, 75% women) from a large-scale cross-sectional online survey (Netherlands Sleep Registry) completed a sociodemographic questionnaire, the Adult ADHD Rating Scale, Hospital Anxiety and Depression Scale, Satisfaction With Life Scale (SLS) and Cantril Ladder (CL) (QoL measures), Insomnia Severity Index, Pittsburgh Sleep Quality Index and Munich Chronotype Questionnaire.FINDINGSHigher ADHD traits were significantly associated with depression symptom severity (p=0.03), lower QoL (p<0.001), insomnia severity (p<0.001), lower sleep quality (p<0.001) and later chronotype (p=0.01). No sleep or circadian factor significantly mediated the association of the severity of symptoms of ADHD and depression (all p>0.1). Conversely, only insomnia severity significantly mediated the association of ADHD traits and QoL (SLS: standardised β=-0.10, 95% CI (-0.12 to -0.04); CL: standardised β=0.103, 95% CI (0.04 to 0.16)).CONCLUSIONADHD traits were associated with lower QoL and it was partially mediated by insomnia severity. Future studies targeting insomnia complaints in this population may help mitigate their depression complaints and improve their QoL.CLINICAL IMPLICATIONSOur results may help current clinical guidelines that do not typically link sleep/circadian complaints to QoL in ADHD assessment.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"108 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144630462","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":"Association of hyperactivity-impulsivity and inattention symptom profiles with suicide attempt: an 18-year population-based cohort study.","authors":"Michel Spodenkiewicz,Ayla Inja,Samuele Cortese,Cedric Galera,Isabelle Ouellet-Morin,Sylvana M Côté,Michel Boivin,Frank Vitaro,Mara Brendgen,Ginette Dionne,Johanne Renaud,Richard E Tremblay,Gustavo Turecki,Marie-Claude Geoffroy,Massimilano Orri","doi":"10.1136/bmjment-2025-301725","DOIUrl":"https://doi.org/10.1136/bmjment-2025-301725","url":null,"abstract":"BACKGROUNDAttention-deficit/hyperactivity disorder (ADHD) symptomatology in childhood is associated with a high risk of suicide attempt later in life. However, symptom presentation in ADHD is heterogeneous, and little is known about how suicide risk varies according to different profiles of ADHD symptoms and sex.OBJECTIVEThe aim was to investigate the longitudinal associations between childhood profiles of ADHD symptoms (ie, hyperactivity-impulsivity and inattention) and youth suicide attempt in males and females, separately.METHODSThis population-based cohort study used data from three longitudinal cohorts: the Quebec Longitudinal Study of Child Development (QLSCD), the Quebec Longitudinal Study of Kindergarten Children (QLSKC) and the Quebec Newborn Twin Study (QNTS) for a total of 4399 participants (1490 from the QLSCD, 2134 from the QLSKC and 775 from the QNTS; 50% females) followed up from ages 6-23 years. Symptoms of hyperactivity-impulsivity and inattention were assessed by teachers five times from ages 6-12 years. Suicide attempt in adolescence and young adulthood (by age 23) was self-reported. Multitrajectory modelling was used to identify profiles of ADHD symptoms, and regression analysis was used to test their association with suicide attempt, adjusting for childhood socioeconomic and clinical characteristics.FINDINGSWe identified four ADHD symptom profiles with distinct associations with suicide attempt for males and females. Compared with those with persistently low symptoms, females with persistently high inattention and hyperactivity-impulsivity (OR: 2.54, CI 1.39 to 4.63) or high inattention and low hyperactivity-impulsivity (OR: 1.81, CI 1.21 to 2.70) were at higher risk of suicide attempt, while, among males, only those with decreasing hyperactivity-impulsivity and inattention over time (OR: 2.23, CI 1.20 to 4.13) were at higher risk of suicide attempt.CONCLUSIONSRisk of suicide attempt in children with ADHD symptoms varies according to both symptom profile and sex, the highest risk being for females with high inattention symptoms (with or without hyperactivity), and males with decreasing symptoms.CLINICAL IMPLICATIONSTaking into account differences in both sex and ADHD symptoms profile may be relevant to more accurately identify and manage suicide risk in individuals with high ADHD symptoms, though caution is needed when generalising our population-based findings to clinical populations.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144613027","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":"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}