BMJ mental health最新文献

{"title":"Dose-dependent effects of oral cannabidiol and delta-9-tetrahydrocannabinol on serum anandamide and related N-acylethanolamines in healthy volunteers.","authors":"Timothy A Couttas, Carola Boost, Franziska Pahlisch, Eliska B Sykorova, Juliane K Mueller, Beverly Jieu, Judith E Leweke, Inga Dammann, Anna E Hoffmann, Martin Loeffler, Oliver Grimm, Frank Enning, Herta Flor, Andreas Meyer-Lindenberg, Dagmar Koethe, Cathrin Rohleder, F Markus Leweke","doi":"10.1136/bmjment-2024-301027","DOIUrl":"10.1136/bmjment-2024-301027","url":null,"abstract":"<p><strong>Background: </strong>The mental health benefits of cannabidiol (CBD) are promising but can be inconsistent, in part due to challenges in defining an individual's effective dosage. In schizophrenia, alterations in anandamide (AEA) concentrations, an endocannabinoid (eCB) agonist of the eCB system, reflect positively on treatment with CBD. Here, we expanded this assessment to include eCBs alongside AEA congeners, comparing phytocannabinoids and dosage in a clinical setting.</p><p><strong>Methods: </strong>Liquid chromatography-tandem mass spectrometry quantified changes in serum levels of AEA, 2-arachidonoylglycerol (2-AG), alongside AEA-related compounds oleoylethanolamide (OEA) and palmitoylethanolamide (PEA), which were attained from two independent, parallel-designed, clinical trials investigating single, oral CBD (600 or 800 mg), delta-9-tetrahydrocannabinol (Δ⁹-THC, 10 or 20 mg) and combination administration (CBD|800 mg+Δ⁹-THC|20 mg) in healthy volunteers (HVs, n=75). Concentrations were measured at baseline (t=0), 65 and 160 min post administration.</p><p><strong>Results: </strong>CBD-led increases in AEA (1.6-fold), OEA and PEA (1.4-fold) were observed following a single 800 mg (p_corr<0.05) but not 600 mg dosage. Declining AEA was observed with Δ⁹-THC at 10 mg (-1.3-fold) and 20 mg (-1.4-fold) but restored to baseline levels by 160 min. CBD+Δ⁹-THC yielded the highest increases in AEA (2.1-fold), OEA (1.9-fold) and PEA (1.8-fold) without reaching a maximal response.</p><p><strong>Conclusion: </strong>CBD-administered effects towards AEA, OEA and PEA are consistent with phase II trials reporting clinical improvement for acute schizophrenia (CBD≥800 mg). Including Δ⁹-THC appears to enhance the CBD-induced response towards AEA and its congeners. Our results warrant further investigations into the potential of these lipid-derived mediators as metabolic measures for CBD dose prescription and co-cannabinoid administration.</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/PMC11409355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057476","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":"Target mechanisms of mindfulness-based programmes and practices: a scoping review.","authors":"Shannon Maloney, Merle Kock, Yasmijn Slaghekke, Lucy Radley, Alba Lopez-Montoyo, Jesus Montero-Marin, Willem Kuyken","doi":"10.1136/bmjment-2023-300955","DOIUrl":"10.1136/bmjment-2023-300955","url":null,"abstract":"<p><strong>Question: </strong>Mindfulness-based programmes (MBPs) and practices have demonstrated effects in mental health and well-being, yet questions regarding the target mechanisms that drive change across the population remain unresolved.</p><p><strong>Study selection and analysis: </strong>Five databases were searched for randomised controlled trials that evaluate the indirect effects (IEs) of an MBP or mindfulness practice in relation to mental health and well-being outcomes through psychological mechanisms.</p><p><strong>Findings: </strong>27 eligible studies were identified, with only four exploring mechanisms in the context of specific mindfulness practices. Significant IEs were reported for mindfulness skills, decentering and attitudes of mindfulness (eg, self-compassion) across different outcomes, population samples, mental health strategies and active comparators. Evidence gap maps and requirements for testing and reporting IEs are provided to help guide future work.</p><p><strong>Conclusions: </strong>Mindfulness skills, decentering and attitudes of mindfulness may be key intervention targets for addressing the mental health of whole populations. However, future work needs to address significant knowledge gaps regarding the evidence for alternative mechanisms (eg, attention and awareness) in relation to unique outcomes (eg, well-being), mental health strategies (ie, promotion) and active comparators. High-quality trials, with powered multivariate mediation analyses that meet key requirements, will be needed to advance this area of work.</p><p><strong>Trial registration number: </strong>10.17605/OSF.IO/NY2AH.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11344521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057478","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":"Psychological well-being and needs of parents and carers of children and young people with mental health difficulties: a quantitative systematic review with meta-analyses.","authors":"Faith Martin, Dania Dahmash, Sarah Wicker, Sarah-Lou Glover, Charlie Duncan, Andrea Anastassiou, Lucy Docherty, Sarah Halligan","doi":"10.1136/bmjment-2023-300971","DOIUrl":"10.1136/bmjment-2023-300971","url":null,"abstract":"<p><strong>Question: </strong>For parents of children and young people (CYP) with diagnosed mental health difficulties, what are the levels of parents' well-being and psychological need?</p><p><strong>Study selection and analysis: </strong>Medline, PsycINFO, EMBASE, AMED, CINAHL, Web of Science and Cochrane Library of Registered Trials were searched from inception to June 2023.</p><p><strong>Inclusion criteria: </strong>parents of CYP aged 5-18 years with formal mental health diagnosis. Data were extracted from validated measures of well-being or psychological needs with established cut-off points or from a controlled study.</p><p><strong>Findings: </strong>32 of the 73 310 records screened were included. Pooled means showed clinical range scores for one measure of depression, and all included measures of anxiety, parenting stress and general stress. Meta-analyses showed greater depression (g=0.24, 95% CI 0.11 to 0.38) and parenting stress (g=0.34, 95% CI 0.20 to 0.49) in parents of CYP with mental health difficulties versus those without. Mothers reported greater depression (g=0.42, 95% CI 0.18 to 0.66) and anxiety (g=0.73, 95% CI 0.27 to 1.18) than fathers. Narrative synthesis found no clear patterns in relation to CYP condition. Rates of parents with clinically relevant levels of distress varied. Typically, anxiety, parenting stress and general stress scored above clinical threshold. Quality appraisal revealed few studies with a clearly defined control group, or attempts to control for important variables such as parent gender.</p><p><strong>Conclusions: </strong>The somewhat mixed results suggest clinical anxiety, parenting and general stress may be common, with sometimes high depression. Assessment and support for parents of CYP with mental health problems is required. Further controlled studies, with consideration of pre-existing parental mental health difficulties are required.</p><p><strong>Prospero registration number: </strong>CRD42022344453.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11298743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894999","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":"'There's more to life than staring at a small screen': a mixed methods cohort study of problematic smartphone use and the relationship to anxiety, depression and sleep in students aged 13-16 years old in the UK.","authors":"Ben Carter, Najma Ahmed, Olivia Cassidy, Oliver Pearson, Marilia Calcia, Clare Mackie, Nicola Jayne Kalk","doi":"10.1136/bmjment-2024-301115","DOIUrl":"10.1136/bmjment-2024-301115","url":null,"abstract":"<p><strong>Background: </strong>Depression and anxiety are common in adolescents and have increased over the last decade. During that period, smartphone usage has become ubiquitous.</p><p><strong>Objectives: </strong>The study aim was to assess the association between problematic smartphone usage (PSU) and anxiety.</p><p><strong>Methods: </strong>Using a prospective mixed methods cohort study design, students aged 13-16 year old from two schools were enrolled regarding their smartphone use, mood and sleep via a semistructured questionnaire at baseline and week 4. The primary outcome was symptoms of anxiety (Generalised Anxiety Disorder Questionnaire, GAD-7) and exposure was PSU (Smartphone Addiction Scale Short Version). A linear regression was fitted to assess the change in anxiety. Thematic analysis of free-text responses was conducted.</p><p><strong>Findings: </strong>The sample included 69 participants that were enrolled and followed up between 28 March and 3 June 2022. Of those with PSU, 44.4% exhibited symptoms of moderate to severe anxiety compared with 26.4% of those without PSU. There was a linear association between change in symptoms of anxiety and PSU β=0.18 (95% CI 0.04 to 0.32, p=0.013). Several themes were found: both positive and negative effects of smartphones on relationships; negative effects on school performance and productivity; mixed effects on mood; a desire to reduce the amount of time spent on smartphones.</p><p><strong>Conclusions: </strong>Increased anxiety, depression and inability to sleep were seen in participants as their PSU score increased over time. Participants reported both positive and negative effects of smartphones and almost all used strategies to reduce use.</p><p><strong>Clinical implications: </strong>Interventions need to be developed and evaluated for those seeking support.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11293406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861798","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":"Potential dopaminergic deficit in patients with geriatric psychiatric disorders as revealed by DAT-SPECT: a cross-sectional study.","authors":"Shintaro Takenoshita, Seishi Terada, Katsuhide Kojima, Naoto Nishikawa, Tomoko Miki, Osamu Yokota, Masaki Fujiwara, Manabu Takaki","doi":"10.1136/bmjment-2024-301042","DOIUrl":"10.1136/bmjment-2024-301042","url":null,"abstract":"<p><strong>Background: </strong>It has been reported that patients with geriatric psychiatric disorders include many cases of the prodromal stages of neurodegenerative diseases. Abnormal ¹²³I-2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane dopamine transporter single-photon emission computed tomography (DAT-SPECT) reveals a nigrostriatal dopaminergic deficit and is considered useful to detect dementia with Lewy bodies and Parkinson's disease as well as progressive supranuclear palsy and corticobasal degeneration. We aimed to determine the proportion of cases that are abnormal on DAT-SPECT in patients with geriatric psychiatric disorders and to identify their clinical profile.</p><p><strong>Methods: </strong>The design is a cross-sectional study. Clinical findings of 61 inpatients aged 60 years or older who underwent DAT-SPECT and had been diagnosed with psychiatric disorders, but not neurodegenerative disease or dementia were analysed.</p><p><strong>Results: </strong>36 of 61 (59%) had abnormal results on DAT-SPECT. 54 of 61 patients who had DAT-SPECT (89%) had undergone ¹²³I-metaiodobenzylguanidine myocardial scintigraphy (¹²³I-MIBG scintigraphy); 12 of the 54 patients (22.2%) had abnormal findings on ¹²³I-MIBG scintigraphy. There were no cases that were normal on DAT-SPECT and abnormal on ¹²³I-MIBG scintigraphy. DAT-SPECT abnormalities were more frequent in patients with late-onset (55 years and older) psychiatric disorders (69.0%) and depressive disorder (75.7%), especially late-onset depressive disorder (79.3%).</p><p><strong>Conclusion: </strong>Patients with geriatric psychiatric disorders include many cases showing abnormalities on DAT-SPECT. It is suggested that these cases are at high risk of developing neurodegenerative diseases characterised by a dopaminergic deficit. It is possible that patients with geriatric psychiatric disorders with abnormal findings on DAT-SPECT tend to show abnormalities on DAT-SPECT first rather than on ¹²³I-MIBG scintigraphy.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11293386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141857282","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":"Efficacy, acceptability and tolerability of second-generation antipsychotics for behavioural and psychological symptoms of dementia: a systematic review and network meta-analysis.","authors":"Wenqi Lü, Fangzhou Liu, Yuwei Zhang, Xiance He, Yongbo Hu, Huifang Xu, Xin Yang, Jin Li, Weihong Kuang","doi":"10.1136/bmjment-2024-301019","DOIUrl":"10.1136/bmjment-2024-301019","url":null,"abstract":"<p><strong>Background: </strong>Behavioural and psychological symptoms of dementia (BPSD) are highly prevalent in people living with dementia. Second-generation antipsychotics (SGAs) are commonly used to treat BPSD, but their comparative efficacy and acceptability are unknown.</p><p><strong>Methods: </strong>The standard mean difference (SMD) was used to pool the fixed effects of continuous outcomes. We calculated ORs with corresponding 95% credible intervals (CI) for the categorical variable. Efficacy was defined as the scores improved on the standardised scales. Acceptability was defined as the all-cause dropout rate. Tolerability was defined as the discontinuation rate due to adverse effects (AEs). The relative treatment rankings were reported with the surface under the cumulative curve. The AE outcomes included mortality, cerebrovascular adverse events (CVAEs), falls, sedation, extrapyramidal symptoms and urinary symptoms.</p><p><strong>Results: </strong>Twenty randomised controlled trials with a total of 6374 individuals containing 5 types of SGAs (quetiapine, olanzapine, risperidone, brexpiprazole and aripiprazole) with intervention lengths ranging from 6 weeks to 36 weeks were included in this network meta-analysis. For the efficacy outcome, compared with the placebo, brexpiprazole (SMD=-1.77, 95% CI -2.80 to -0.74) was more efficacious, and brexpiprazole was better than quetiapine, olanzapine and aripiprazole. Regarding acceptability, only aripiprazole (OR=0.72, 95% CI 0.54 to 0.96) was better than the placebo, and aripiprazole was also better than brexpiprazole (OR=0.61, 95% CI 0.37 to 0.99). In terms of tolerability, olanzapine was worse than placebo (OR=6.02, 95% CI 2.87 to 12.66), risperidone (OR=3.67, 95% CI 1.66 to 8.11) and quetiapine (OR=3.71, 95% CI 1.46 to 9.42), while aripiprazole was better than olanzapine (OR=0.25, 95% CI 0.08 to 0.78). Quetiapine presented good safety in CVAE. Brexpiprazole has better safety in terms of falls and showed related safety in sedation among included SGAs.</p><p><strong>Conclusion: </strong>Brexpiprazole showing great efficacy in the treatment of BPSD, with aripiprazole showing the highest acceptability and olanzapine showing the worst tolerability. The results of this study may be used to guide decision-making.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11293415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141857281","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":"Parkinson's disease psychosis associated with accelerated multidomain cognitive decline.","authors":"Sara Pisani, Luca Gosse, Dag Aarsland, K Ray Chaudhuri, Clive Ballard, Dominic Ffytche, Latha Velayudhan, Sagnik Bhattacharyya","doi":"10.1136/bmjment-2024-301062","DOIUrl":"10.1136/bmjment-2024-301062","url":null,"abstract":"<p><strong>Background: </strong>Cognitive deficits are associated with poor quality of life and increased risk of development of dementia in patients with Parkinson's disease (PD) psychosis. The trajectory of cognitive decline in PD psychosis remains however unclear.</p><p><strong>Objective: </strong>We examined this using data from the Parkinson's Progression Markers Initiative study.</p><p><strong>Methods: </strong>We analysed data from patients with drug-naïve PD (n=676) and healthy controls (HC, n=187) over 5 years, and examined all cognitive measures assessed at each time point. We classified patients with PD into those who developed psychosis over the course of the study (PDP) and those without psychosis throughout (PDnP) using the Movement Disorders Society Unified Parkinson's Disease Rating Scale part I hallucinations/psychosis item. We used linear mixed-effect models with restricted maximum likelihood. Age, sex, ethnicity, education and neuropsychiatric and PD-specific symptoms were entered as covariates of interest.</p><p><strong>Findings: </strong>There were no baseline cognitive differences between PD patient groups. There were differences in cognitive performance between PD and HC across the majority of the assessments.Patients with PDP exhibited greater cognitive decline over 5 years compared with PDnP across most domains even after controlling for sociodemographics, depression, sleepiness, rapid eye movement sleep behaviour disorder and motor symptom severity (immediate recall, b=-0.288, p<i>=</i>0.003; delayed recall, b=-0.146, p<i>=</i>0.003; global cognition, Montreal Cognitive Assessment, b=-0.206, p<i><</i>0.001; visuospatial, b=-0.178, p<i>=</i>0.012; semantic fluency, b=-0.704, p<i>=</i>0.002; processing speed, b=-0.337, p<i>=</i>0.029).</p><p><strong>Conclusions: </strong>Patients with PD psychosis exhibited decline in semantic aspects of language, processing speed, global cognition, visuospatial abilities and memory, regardless of sociodemographic characteristics, neuropsychiatric and motor symptoms. These cognitive domains, particularly semantic aspects of language may therefore play an important role in PD psychosis and warrant further investigation.</p><p><strong>Trial registration number: </strong>NCT01141023.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"27 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11268075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753513","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":"Brighter future for light therapy: harmonising the reporting of light interventions in psychiatry.","authors":"Manuel Spitschan, Laura Kervezee, Renske Lok, Elise McGlashan, Raymond P Najjar","doi":"10.1136/bmjment-2024-301060","DOIUrl":"10.1136/bmjment-2024-301060","url":null,"abstract":"","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"27 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11284921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141763056","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":"Prioritised research questions in serious mental illness: a priority setting based on evidence gaps.","authors":"Mussie Msghina, Lise-Lotte Bergerlind, Ulla-Karin Schön, Christian Dahlström, Åsa Konradsson Geuken, Sara Fundell, Lena Wallgren, Sofia Tranaeus, Malin Höistad","doi":"10.1136/bmjment-2024-301082","DOIUrl":"10.1136/bmjment-2024-301082","url":null,"abstract":"","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11288138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592255","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":"Exploring early discontinuation of mental health outpatient treatment: language, demographics and clinical characteristics among migrant populations in Japan.","authors":"Janice Y Tsoh, Youji Takubo, Eriko Fukui, Ayaka Suzuki, Momoko Iwai, Hisaaki Saito, Naohisa Tsujino, Takashi Uchino, Naoyuki Katagiri, Takahiro Nemoto","doi":"10.1136/bmjment-2024-301059","DOIUrl":"10.1136/bmjment-2024-301059","url":null,"abstract":"<p><strong>Background: </strong>The fast-growing migrant population in Japan and globally poses challenges in mental healthcare, yet research addressing migrants' mental health treatment engagement remains limited.</p><p><strong>Objective: </strong>This study examined language proficiency, demographic and clinical characteristics as predictors of early treatment discontinuation among migrants.</p><p><strong>Methods: </strong>Electronic health record data from 196 adult migrants, identified from 14 511 patients who received mental health outpatient treatment during 2016 and 2019 at three central hospitals in the Tokyo-Yokohama metropolitan region of Japan, were used. We conducted multivariable regression models to identify predictors of early discontinuation within 3 months.</p><p><strong>Findings: </strong>The study cohort (65% women, age range: 18-90 years, from 29 countries or regions) included 23% non-Japanese speakers. Japanese and non-Japanese speakers had similar discontinuation rates (26% vs 22%). Multivariable models revealed younger age (OR=0.97; 95% CI: 0.95, 0.99; p=0.016) and those with a primary diagnosis other than a schizophrenia spectrum disorder (OR=3.99; 95% CI: 1.36, 11.77; p=0.012) or a neurotic, stress-related and somatoform disorder (OR=2.79; 95% CI: 1.14, 6.84; p=0.025) had higher odds of early discontinuation. These effects were more pronounced among the Japanese speakers with significant language-by-age and language-by-diagnoses interactions.</p><p><strong>Conclusion: </strong>Younger age and having a primary diagnosis other than a schizophrenia spectrum disorder or a neurotic, stress-related and somatoform disorder increased vulnerability for discontinuing mental health treatment early in Japanese-speaking migrants but not for migrants with limited Japanese proficiency.</p><p><strong>Clinical implications: </strong>Understanding language needs within a context of mental health treatment should go beyond assumed or observed fluency. Unmet language needs might increase vulnerability for treatment disengagement among migrants. Targeted clinical efforts are crucial for enhancing early treatment engagement and informing health practices in Japan and countries with growing migrant populations.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11227775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499773","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}