BMJ mental health最新文献

{"title":"Identifying postpartum depression: Using key risk factors for early detection.","authors":"Mette-Marie Zacher Kjeldsen, Kathrine Bang Madsen, Xiaoqin Liu, Merete Lund Mægbæk, Thalia Robakis, Veerle Bergink, Trine Munk-Olsen","doi":"10.1136/bmjment-2024-301206","DOIUrl":"10.1136/bmjment-2024-301206","url":null,"abstract":"<p><strong>Background: </strong>Personal and family history of psychiatric disorders are key risk factors for postpartum depression (PPD), yet their combined contribution has been understudied.</p><p><strong>Objective: </strong>To examine personal and family psychiatric history, alone and combined, and their effect on absolute risk and relative risk (RR) of mild/moderate or severe PPD.</p><p><strong>Methods: </strong>In this cohort study, we used data from 142 064 childbirths with PPD screenings from 2015 to 2021 merged with population registers. Exposures were personal and family psychiatric history defined as a psychiatric hospital contact or psychotropic prescription fills by index mothers and their parents prior to delivery. Outcomes were mild/moderate PPD (Edinburgh Postnatal Depression Scale, cut-off: ≥11 within 12 weeks post partum) and severe PPD (antidepressant fill or depression diagnosis within 6 months post partum). We calculated absolute risks and RRs using Poisson regression models adjusted for parity, education, maternal age, and calendar year.</p><p><strong>Findings: </strong>Of the 142 064 participants, 23.4% had no psychiatric history, 47.4% had only family history, 6.0% had only personal history, and 23.2% had both. The latter group had the highest risk of PPD: absolute risk of mild/moderate PPD was 11.7% (95% CI 11.5%; 11.8%), and adjusted RR: 2.35 (95% CI 2.22; 2.49). Alone, personal psychiatric history was the most potent risk factor. Dose-response relationship based on severity of personal and family psychiatric history was found.</p><p><strong>Discussion: </strong>Our study documents a substantial association between personal and family psychiatric history and PPD risk.</p><p><strong>Clinical implications: </strong>Evaluating combinations of risk factors is important to improve risk assessment.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11448151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using the South African Depression Scale (SADS) to measure depressive symptoms in a UK sample.","authors":"Arish Mudra Rakshasa-Loots, Goabaone Diteko, Jaime H Vera","doi":"10.1136/bmjment-2024-301257","DOIUrl":"10.1136/bmjment-2024-301257","url":null,"abstract":"","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11440181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333571","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 and meta-analysis of interventions to improve outcomes for parents or carers of children with anxiety and/or depression.","authors":"Anthony Tsang,Dania Dahmash,Gretchen Bjornstad,Nikki Rutter,Aleem Nisar,Francesca Horne,Faith Martin","doi":"10.1136/bmjment-2024-301218","DOIUrl":"https://doi.org/10.1136/bmjment-2024-301218","url":null,"abstract":"QUESTIONDepression and anxiety are common among children and young people and can impact on the well-being of their parents/carers. Dominant intervention approaches include parent training; however, this approach does not directly address parents' well-being. Our objective was to examine the effect of interventions, with at least a component to directly address the parents' own well-being, on parents' well-being outcomes, including stress, depression and anxiety.STUDY SELECTION AND ANALYSISA systematic search was performed in the following: MEDLINE, EMBASE, CINAHL, AMED, PsycINFO, Scopus, CENTRAL, Web of Science Core Collection (six citation indexes) and WHO ICTRP from inception to 30 December 2023. Interventions that aimed to support parents/carers managing the impact of their child's/young person's mental health were eligible. EPHPP (Effective Public Health Practice Project) was used to quality appraise the included studies. A meta-analysis of relevant outcomes was conducted.FINDINGSFifteen studies were eligible comprising 812 parents/carers. Global methodological quality varied. Seven outcomes (anxiety, depression, stress, burden, self-efficacy, quality of life and knowledge of mood disorders) were synthesised at post-intervention. A small reduction in parental/carer anxiety favouring intervention was indicated in one of the analyses (g=-0.26, 95% CI -0.44 to -0.09, p=0.02), when excluding an influential case. Three outcomes were synthesised at follow-up, none of which were statistically significant.CONCLUSIONSInterventions directly addressing the well-being for parents of children with anxiety and/or depression appear not to be effective overall. Clearer conceptualisation of factors linked to parental distress is required to create more targeted interventions.PROSPERO REGISTRATION NUMBERCRD42022344453.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142325027","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":"Cumulative ADHD medication use and risk of type 2 diabetes in adults: a Swedish Register study.","authors":"Zihan Dong,Le Zhang,Lin Li,Shengxin Liu,Isabell Brikell,Ralf Kuja-Halkola,Brian M D'Onofrio,Agnieszka Butwicka,Soffia Gudbjornsdottir,Henrik Larsson,Zheng Chang,Ebba Du Rietz","doi":"10.1136/bmjment-2024-301195","DOIUrl":"https://doi.org/10.1136/bmjment-2024-301195","url":null,"abstract":"BACKGROUNDLittle is known about the impact of cumulative attention-deficit/hyperactivity disorder (ADHD) medication use on the risk of type 2 diabetes (T2D).OBJECTIVEThe objective is to examine the association between cumulative use of ADHD medication and risk of incident T2D.METHODSA nested case-control study was conducted in a national cohort of individuals aged 18-70 years with incident ADHD (n=138 778) between 2007 and 2020 through Swedish registers. Individuals with incident T2D after ADHD were selected as cases (n=2355) and matched with up to five controls (n=11 681) on age at baseline, sex and birth year. Conditional logistic regression models examined the association between cumulative duration of ADHD medication use and T2D.FINDINGSCompared with no use, a decreased risk of T2D was observed for those on cumulative use of ADHD medications up to 3 years (ORs: 0<duration≤1 year, 0.79 (95% CI, 0.69 to 0.91); 1<duration≤3 years, 0.80 (95% CI, 0.69 to 0.92); duration>3 years, 0.97 (95% CI, 0.84 to 1.12)). When investigating medication types separately, methylphenidate showed results similar to main analyses, lisdexamfetamine showed no association with T2D, whereas long-term (>3 years) use of atomoxetine was associated with an increased risk of T2D (OR: 1.44 (95% CI, 1.01 to 2.04)).CONCLUSIONCumulative use of ADHD medication does not increase the risk for T2D, with the exception of long-term use of atomoxetine.CLINICAL IMPLICATIONSFindings suggest that clinicians should be aware of the potential risk of T2D associated with the cumulative use of atomoxetine among patients with ADHD; however, further replication is strongly needed.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"120 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142325025","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":"Prevalence of spontaneous movement disorders (dyskinesia, parkinsonism, akathisia and dystonia) in never-treated patients with chronic and first-episode psychosis: a systematic review and meta-analysis.","authors":"Arturas Kalniunas, Katie James, Sofia Pappa","doi":"10.1136/bmjment-2024-301184","DOIUrl":"10.1136/bmjment-2024-301184","url":null,"abstract":"<p><strong>Background: </strong>The aim of this systematic review and meta-analysis is to evaluate and compare the prevalence rates of spontaneous movement disorders (SMDs), including dyskinesia, parkinsonism, akathisia and dystonia, in antipsychotic-naïve individuals with chronic psychosis and first-episode psychosis (FEP) and gain a more nuanced understanding of factors influencing their presence.</p><p><strong>Methods: </strong>Several literature databases were systematically searched and screened based on predetermined eligibility criteria. Included articles underwent risk of bias assessment. The prevalence rates of SMDs were calculated using a random-effects model.</p><p><strong>Results: </strong>Out of 711 articles screened, 27 were included in this meta-analysis. The pooled prevalence of spontaneous dyskinesia was 7% (3% FEP and 17% chronic schizophrenia) across 24 studies (95% CI 3 to 11; I²=94%, p<0.01) and 15% for spontaneous parkinsonism (14% FEP and 19% chronic schizophrenia) in 21 studies (95% CI 12 to 20; I²=81%, p<0.01). A meta-regression analysis found a significant positive correlation between age (p<0.05) and duration of untreated psychosis (DUP) (p<0.05) with dyskinesia but not parkinsonism prevalence. Akathisia and dystonia appear to be both less studied and less frequent in occurrence with a pooled prevalence of 4% (95% CI: 3 to 6; I²=0%, p=0.65) for akathisia in eight studies and a mean prevalence of 6% (range 0%-16%) for dystonia in five studies.</p><p><strong>Conclusion: </strong>The presence of varying degrees of neurodysfunction in antipsychotic-naïve patients with schizophrenia underscores the need for individualised treatment approaches that consider each patient's unique predisposition and neuromotor profile. Further research is warranted into the role of specific SMDs and risk factors including sex, race and diagnostic variations.</p><p><strong>Prospero registration number: </strong>CRD42024501951.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309249","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 pharmacological treatment of attention-deficit/hyperactivity disorder on later psychiatric comorbidity: a population-based prospective long-term study.","authors":"Ingvild Lyhmann,Tarjei Widding-Havneraas,Ingvar Bjelland,Simen Markussen,Felix Elwert,Ashmita Chaulagain,Arnstein Mykletun,Anne Halmøy","doi":"10.1136/bmjment-2024-301003","DOIUrl":"https://doi.org/10.1136/bmjment-2024-301003","url":null,"abstract":"BACKGROUNDPsychiatric comorbidity is frequent among persons with attention-deficit/hyperactivity disorder (ADHD). Whether pharmacological treatment of ADHD influences the incidence of psychiatric comorbidity is uncertain.OBJECTIVETo investigate associations and causal relations between pharmacological treatment of ADHD and incidence of subsequent comorbid psychiatric diagnoses.METHODSWe employed registry data covering all individuals aged 5-18 years in Norway who were diagnosed with ADHD during 2009-2011 (n=8051), followed until 2020. We used linear probability models (LPM) and instrumental variable (IV) analyses to examine associations and causal effects, respectively, between pharmacological treatment and subsequent comorbidity.FINDINGSFrom time of ADHD diagnosis to 9 years of follow-up, 63% of patients were registered with comorbid psychiatric disorders. For males, LPM showed associations between ADHD medication and several incident comorbidities, but strength and direction of associations and consistency over time varied. For females, no associations were statistically significant. IV analyses for selected categories isolating effects among patients 'on the margin of treatment' showed a protective effect for a category of stress-related disorders in females and for tic disorders in males for the first 2 and 3 years of pharmacological treatment, respectively.CONCLUSIONSOverall, LPM and IV analyses did not provide consistent or credible support for long-term effects of pharmacological treatment on later psychiatric comorbidity. However, IV results suggest that for patients on the margin of treatment, pharmacological treatment may initially reduce the incidence of certain categories of comorbid disorders.CLINICAL IMPLICATIONSClinicians working with persons with ADHD should monitor the effects of ADHD medication on later psychiatric comorbidity.TRIAL REGISTRATION NUMBERISRCTN11891971.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142275314","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":"Emotion regulation profiles in Syrian refugees and migrants in Germany: self-efficacy, resilience and well-being comparisons.","authors":"Dana Churbaji,Pascal Schlechter,Angela Nickerson,Nexhmedin Morina","doi":"10.1136/bmjment-2024-301099","DOIUrl":"https://doi.org/10.1136/bmjment-2024-301099","url":null,"abstract":"BACKGROUNDEmotion regulation (ER) plays a central role in psychopathology. Understanding person-centred patterns of ER strategies is crucial for prevention and intervention strategies. However, there is a paucity of research on ER profiles and their psychological correlates in forcibly displaced people (FDP).OBJECTIVEThis study aimed to identify habitual ER profiles and to examine the predictive role of different psychological variables on these profiles in Syrian FDP in Germany.METHODIn a sample of 991 individuals, we conducted a latent profile analysis (LPA) to assess habitual reappraisal and suppression of emotion as ER strategies, as well as self-efficacy, resilience, well-being comparisons, trauma exposure and International Classification of Diseases 11th Revision post-traumatic stress disorder (PTSD) symptoms as potential predictors of ER profile membership.RESULTSLPA identified four distinct ER profiles: high regulators (12.8%), low regulators (20.6%), reappraisal regulators (25.1%) and suppressive regulators (41.5%). In multinomial regression analysis, self-efficacy, resilience, appetitive well-being comparisons and trauma exposure were significantly associated with profile membership, while PTSD and aversive well-being comparisons showed no significant association. High regulators exhibited the highest levels of self-efficacy, resilience and appetitive well-being comparisons, followed by reappraisal, suppressive and low regulators. Additionally, high regulators reported the highest number of traumatic events, followed by suppressive and low regulators.CONCLUSIONSOur results indicate a higher adaptiveness in high regulation ER profiles as opposed to low regulation ER profiles.CLINICAL IMPLICATIONSGiven that most FDP in our sample relied predominantly on one ER strategy, developing interventions that focus on cultivating a broad repertoire of ER strategies may be beneficial.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142273561","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 between psychological resilience and all-cause mortality in the Health and Retirement Study.","authors":"Aijie Zhang, Liqiong Zhou, Yaxian Meng, Qianqian Ji, Meijie Ye, Qi Liu, Weiri Tan, Yeqi Zheng, Zhao Hu, Miao Liu, Xiaowei Xu, Ida K Karlsson, Sara Hägg, Yiqiang Zhan","doi":"10.1136/bmjment-2024-301064","DOIUrl":"10.1136/bmjment-2024-301064","url":null,"abstract":"<p><strong>Background: </strong>Psychological resilience refers to an individual's ability to cope with and adapt to challenging life circumstances and events.</p><p><strong>Objective: </strong>This study aims to explore the association between psychological resilience and all-cause mortality in a national cohort of US older adults by a cross-sectional study.</p><p><strong>Methods: </strong>The Health and Retirement Study (2006-2008) included 10 569 participants aged ≥50. Mortality outcomes were determined using records up to May 2021. Multivariable Cox proportional hazards models were used to analyse the associations between psychological resilience and all-cause mortality. Restricted cubic splines were applied to examine the association between psychological resilience and mortality risk.</p><p><strong>Findings: </strong>During the follow-up period, 3489 all-cause deaths were recorded. The analysis revealed an almost linear association between psychological resilience and mortality risk. Higher levels of psychological resilience were associated with a reduced risk of all-cause mortality in models adjusting for attained age, sex, race and body mass index (HR=0.750 per 1 SD increase in psychological resilience; 95% CI 0.726, 0.775). This association remained statistically significant after further adjustment for self-reported diabetes, heart disease, stroke, cancer and hypertension (HR=0.786; 95% CI 0.760, 0.813). The relationship persisted even after accounting for smoking and other health-related behaviours (HR=0.813; 95% CI 0.802, 0.860).</p><p><strong>Conclusions: </strong>This cohort study highlights the association between psychological resilience and all-cause mortality in older adults in the USA.</p><p><strong>Clinical implications: </strong>Psychological resilience emerges as a protective factor against mortality, emphasising its importance in maintaining health and well-being.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11409260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127544","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":"Brief Educational Workshops in Secondary Schools Trial (BESST): a cluster randomised controlled trial. Secondary analysis in those with elevated symptoms of depression.","authors":"Stephen Lisk, Kirsty James, James Shearer, Sarah Byford, Paul Stallard, Jessica Deighton, David Saunders, Jynna Yarrum, Peter Fonagy, Timothy Weaver, Irene Sclare, Crispin Day, Claire Evans, Ben Carter, June Brown","doi":"10.1136/bmjment-2024-301192","DOIUrl":"10.1136/bmjment-2024-301192","url":null,"abstract":"<p><strong>Background: </strong>Depression and anxiety are increasingly prevalent in adolescents. The Brief Educational Workshops in Secondary Schools Trial investigated the effectiveness of a brief self-referral stress workshop programme for sixth-form students aged 16-18 years old.</p><p><strong>Objective: </strong>This study conducted a secondary analysis on the outcomes of participants with elevated depressive symptoms at baseline.</p><p><strong>Methods: </strong>This is an England-wide, multicentre, cluster randomised controlled trial to evaluate the clinical effectiveness and cost-effectiveness of a brief cognitive-behavioural therapy workshop (DISCOVER) compared with treatment-as-usual (TAU) (1:1). The primary outcome was depression symptoms (Mood and Feelings Questionnaire (MFQ)) at 6-month follow-up, using the intention-to-treat (ITT) population and analysed with a multilevel linear regression estimating a between-group adjusted mean difference (aMD). Cost-effectiveness, taking a National Health Service (NHS) and personal social services perspective, was explored using quality-adjusted life years (QALYs).</p><p><strong>Findings: </strong>Between 4 October 2021 and 10 November 2022, 900 adolescents at 57 schools were enrolled. 314 students were identified as having elevated symptoms of depression at baseline (>27 on MFQ). In this prespecified subgroup, the DISCOVER arm included 142 participants and TAU included 172. ITT analysis included 298 participants. Primary analysis at 6 months found aMD to be -3.88 (95% CI -6.48, -1.29; Cohen's d=-0.52; p=0.003), with a similar reduction at 3 months (aMD=-4.00; 95% CI -6.58, -1.42; Cohen's d=0.53; p=0.002), indicating a moderate, clinically meaningful effect in the DISCOVER arm. We found an incremental cost-effectiveness ratio of £5255 per QALY, with a probability of DISCOVER being cost-effective at between 89% and 95% compared with TAU.</p><p><strong>Conclusions and clinical implications: </strong>DISCOVER is clinically effective and cost-effective in those with elevated depressive symptoms. This intervention could be used as an early school-based intervention by the NHS.</p><p><strong>Trial registration number: </strong>ISRCTN90912799.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115570","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":"Putting person-centred psychosocial diabetes care into practice: two psychosocial care pathways based on outcome preferences of people with diabetes and healthcare professionals.","authors":"Ann-Kristin Porth, Yuki Seidler, Preston Alexander Long, Tanja Stamm, Anouk S Huberts, Kathryn Hamilton, Alexandra Kautzky-Willer","doi":"10.1136/bmjment-2024-301061","DOIUrl":"10.1136/bmjment-2024-301061","url":null,"abstract":"<p><strong>Background: </strong>Diabetes increases the risk of psychosocial health problems. Person-centred psychosocial care is therefore advocated. However, several barriers to implementation exist, including uncertainty about how to approach psychosocial problems in consultations.</p><p><strong>Objective: </strong>We aimed to explore which psychosocial outcomes patients and healthcare professionals consider important and whether certain characteristics are associated with this. We propose strategies for facilitating psychosocial diabetes care on this basis.</p><p><strong>Methods: </strong>The results of an international Delphi study aimed at achieving multi-stakeholder consensus on a diabetes outcome set were analysed. We compared the importance ratings of the two stakeholder groups for each psychosocial outcome. A multivariable linear regression analysis tested whether certain characteristics would predict the importance attributed to outcomes that were not generally considered important.</p><p><strong>Findings: </strong>Patients and healthcare professionals agreed on the importance of regularly assessing psychological well-being, diabetes distress and diabetes-specific quality of life, while they regarded it as less important to monitor depression, anxiety, eating problems, social support and sexual health. Being a woman, younger and living with type 1 diabetes were associated with considering it important to assess eating problems.</p><p><strong>Conclusions: </strong>We propose two psychosocial care pathways that reflect the outcome preferences of patients and healthcare providers. They follow a stepped approach, starting with the assessment of psychological well-being and quality of life and proceeding from there.</p><p><strong>Clinical implications: </strong>Adopting this approach can facilitate the implementation of person-centred psychosocial diabetes care by reducing the burden and making psychosocial issues more accessible. This approach should be tested for feasibility, safety and effectiveness.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11409268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057477","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}