BMJ mental health最新文献

{"title":"Increased prevalence of urticarial diseases and antihistamine/corticosteroid consumption in patients with attention-deficit/hyperactivity disorder.","authors":"Eli Magen,Eugene Merzon,Akim Geishin,Shai Ashkenazi,Iris Manor,Shlomo Vinker,Ilan Green,Avivit Golan-Cohen,Abraham Weizman,Ariel Israel","doi":"10.1136/bmjment-2025-301588","DOIUrl":"https://doi.org/10.1136/bmjment-2025-301588","url":null,"abstract":"OBJECTIVESThis nationwide cohort study investigated the association between attention-deficit/hyperactivity disorder (ADHD) and various types of urticarial diseases.METHODSWe conducted a population-based cohort study using data from Leumit Health Services (LHS), a health maintenance organisation in Israel. The study population consisted of all members of LHS between 1 January 2002 and 30 November 2022 aged 5-18 years. Diagnoses of ADHD and urticarial diseases were based on International Classification of Diseases, 9th Edition codes. The study group consisted of subjects with ADHD, while matched controls were randomly selected non-ADHD subjects (2:1 ratio).FINDINGSDemographic characteristics of ADHD (n=18 558) and control (n=37 116) groups were well-matched, with no significant socio-demographic differences. A significantly higher prevalence of various subtypes of urticarial diseases was found in the ADHD group compared with the control group. Specifically, urticaria (5.00% vs 4.22%, OR (95% CI) 1.19 (1.10 to 1.30), p<0.001), allergic urticaria (3.26% vs 2.73%, OR (95% CI) 1.20 (1.08 to 1.33), p<0.001). Inducible forms of urticaria did not show significant differences between the groups. The ADHD group had a higher use of systemic and topical antihistamines and systemic corticosteroids.CONCLUSIONSVarious urticarial diseases are more prevalent in individuals with ADHD, possibly due to shared genetic factors, immune system dysfunction, or environmental triggers.CLINICAL IMPLICATIONSThis study suggests an association between ADHD and some urticaria subtypes. Physicians should be aware of this association and its public health implications.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857281","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":"Access to treatment protocols and manuals for evidence-based psychological interventions for severe mental disorders: a survey of randomised trials included in network meta-analyses.","authors":"Chrysanthi Blithikioti, Giuliano Tomei, Fabrizio Visconti, Lorena Pizzocri, Camilla Cadorin, Irene Gómez-Gómez, Ioana Alina Cristea","doi":"10.1136/bmjment-2025-301578","DOIUrl":"10.1136/bmjment-2025-301578","url":null,"abstract":"<p><strong>Background: </strong>Evidence-based psychological interventions for mental disorders are described in treatment protocols and manuals, which detail treatment components and conditions of application. Systematic evaluations of the accessibility of treatment protocols and manuals across multiple mental disorders are absent.</p><p><strong>Objective: </strong>We assessed whether treatment protocols or manuals for psychological interventions for severe mental disorders are accessible and publicly available.</p><p><strong>Study selection and analysis: </strong>We surveyed randomised controlled trials (RCTs) from six large network meta-analyses of psychological interventions for severe mental disorders (psychotic, borderline personality, substance use, bipolar, anorexia and bulimia nervosa). Between January 2024 and February 2025, we retrieved protocols and manuals of psychological intervention arms using a multipronged approach (published protocol, trial registries, author contact, commercial availability). We report the proportion of trials and intervention arms for which protocols or manuals were (1) Accessible, that is, retrievable by any method, and (2) Publicly versus commercially available.</p><p><strong>Findings: </strong>We included 260 RCTs, with 422 active intervention arms. We retrieved published protocols for 20 RCTs (8%, 95% CI 5% to 12%) and contacted 450 authors for the remaining 240. Authors shared protocols for 43/240 trials (18%, 95% CI 13% to 23%), refused to share for 73 (30%, 95% CI 25% to 37%) and did not respond for 101 (42%, 95% CI 36% to 49%). Protocols or manuals were retrievable for 364 psychological intervention arms (86%, 95% CI 83% to 89%), with 191 available commercially (45%, 95% CI 40% to 50%) and 106 (25%, 95% CI 21% to 30%) publicly.</p><p><strong>Conclusions and clinical implications: </strong>Retrieving detailed descriptions of psychological interventions used in trials, crucial for identifying treatment components, was challenging, resource-intensive and required multiple methods. Reliance on public availability and author sharing enabled access to about 40% of protocols or manuals.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065375","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":"Psychotherapies for adults with complex presentations of PTSD: a clinical guideline and five systematic reviews with meta-analyses.","authors":"Julie Perrine Schaug,Lise Møller,Nina Reinholt,Dyveke Bové Illum,Frida Lau Græbe,Line Bang Mikkelsen,Stephen Fitzgerald Austin,Nina Nørrelykke Paulsen,Adrian Maria Tremel Porsing,Sophie Juul,Oliver Rumle Hovmand,Mie Sedoc Jørgensen,Ida-Marie Terese Pereira Arendt,Maria Quistgaard,Magnus Tang Kristensen,Sidsel Christine Buskbjerg Døssing,Bent Rosenbaum,Nicole Gremaud Rosenberg,Sidse Marie Arnfred,Ole Jakob Storebø","doi":"10.1136/bmjment-2024-301158","DOIUrl":"https://doi.org/10.1136/bmjment-2024-301158","url":null,"abstract":"OBJECTIVETo develop a clinician-guided, research-based guideline for adult outpatient psychotherapy for complex presentations of post-traumatic stress disorder (PTSD).METHODSWe used state-of-the-art methods to develop clinical guideline recommendations and conduct systematic reviews with meta-analyses for five research questions: (Q1) When treating adults with PTSD, should trauma-focused psychotherapy include exposure? Which psychotherapies are effective for PTSD with co-occurring: (Q2) personality disorder; (Q3) depression; and (Q4) dissociative disorder? (Q5) for complex PTSD (C-PTSD)?RESULTS(Q1) We found no evidence of a difference between trauma-focused psychotherapies with or without exposure on PTSD symptoms (standardised mean difference (SMD) 0.02, 95% CI -0.11 to 0.15, p=0.75, I2=64%). (Q2) Dialectical behaviour therapy (DBT-for-PTSD) showed beneficial effects over cognitive processing therapy (CPT) on co-occurring borderline personality disorder (BPD) symptoms (mean difference (MD) -0.58, 95% CI -0.94 to -0.22, p=0.003). (Q3) Mindfulness and body-focused psychotherapies, prolonged exposure (PE), narrative exposure therapy (NET) and CPT showed beneficial effects on symptoms of PTSD and co-occurring depression. Results for present-centred therapy (PCT) were uncertain. (Q4) No statistically significant differences were found among psychotherapies for PTSD with co-occurring dissociation. (Q5) Skills training appeared promising for C-PTSD.CONCLUSIONWeak clinical recommendations were reached for trauma-focused therapies with or without exposure for PTSD; DBT-for-PTSD for PTSD with co-occurring BPD; CPT, NET, PE and Mindfulness and body-focused psychotherapies for PTSD with co-occurring depression; and Skills training for C-PTSD. A weak recommendation was reached against PCT for PTSD with co-occurring depression. It is good practice to include interventions targeting dissociation for PTSD with co-occurring dissociation. Overall, the certainty of evidence was low; high-quality trials are needed to strengthen the recommendations.PROSPERO REGISTRATION NUMBERCRD42022376117.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143841189","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":"Leveraging artificial intelligence in the prediction, diagnosis and treatment of depression and anxiety among perinatal women in low- and middle-income countries: a systematic review.","authors":"Uchechi Shirley Anaduaka,Ayomide Oluwaseyi Oladosu,Samantha Katsande,Clinton Sekyere Frempong,Success Awuku-Amador","doi":"10.1136/bmjment-2024-301445","DOIUrl":"https://doi.org/10.1136/bmjment-2024-301445","url":null,"abstract":"AIMThe adoption of artificial intelligence (AI) tools is gaining traction in maternal mental health (MMH) research. Despite its growing usage, little is known about its prospects and challenges in low- and middle-income countries (LMICs). This study aims to systematically review articles on the role of AI in addressing MMH in LMICs.METHODSThis systematic review adopts a patient and public involvement approach to investigate the role of AI in predicting, diagnosing or treating perinatal depression and anxiety (PDA) among perinatal women in LMICs. Seven databases were searched for studies that reported on AI tools/methods for PDA published between January 2010 and July 2024. Eligible studies were identified and extracted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using Covidence, and the data were synthesised using thematic analysis.RESULTSOut of 2203 studies, 19 studies across eight countries were deemed eligible for extraction and synthesis. The review revealed that the supervised machine learning method was the most common AI approach and was used to improve the early detection of depression and anxiety among perinatal women. Additionally, postpartum depression was the most frequently investigated MMH condition in this study. Further, the review revealed only three conversational agents (CAs)/chatbots used to deliver psychological treatment.CONCLUSIONSThe findings underscore the potential of AI-based methods in identifying risk factors and delivering psychological treatment for PDA. Future research should investigate the underlying mechanisms of the effectiveness of AI-based chatbots/CAs and assess the long-term effects for diagnosed mothers, to aid the improvement of MMH in LMICs.PROSPERO REGISTRATION NUMBERCRD42024549455.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143841057","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":"Risk of hospitalisation for first-onset psychosis or mania within a year of ADHD medication initiation in adults with ADHD.","authors":"Ragna Kristin Gudbrandsdottir,Engilbert Sigurdsson,Þorsteinn Ivar Albertsson,Halldora Jonsdottir,Oddur Ingimarsson","doi":"10.1136/bmjment-2024-301521","DOIUrl":"https://doi.org/10.1136/bmjment-2024-301521","url":null,"abstract":"BACKGROUNDThe prevalence of attention-deficit hyperactivity disorder (ADHD) drug treatment for youth and adults has been rising exponentially in Iceland over the past 15 years. The efficacy of ADHD drugs is not as strongly supported for adults as for children and adolescents, and adult use has been reported to increase the risk of psychosis or mania.OBJECTIVETo assess the absolute risk of hospitalisation for first-onset psychosis or mania in adults diagnosed with ADHD within 1 year of being prescribed ADHD drugs and to examine the proportional attributable risk.METHODSThis study included all adults prescribed ADHD drugs in Iceland between 1 January 2010 and 31 December 2022. Records from the Icelandic Prescription Drug Register were linked to the Hospital Discharge Register to identify individuals who were admitted due to psychosis or mania. This risk was compared with the risk of all other first-onset hospitalisations for psychosis, mania or mixed episodes between 1 January 2018 and 31 December 2020.FINDINGS16 125 individuals aged 18 or older initiated ADHD drug therapy during the study period. Of those, 61 were hospitalised due to first-onset psychosis or mania within a year. This corresponds to an absolute risk of 0.38% for such an admission. The general population risk for all other first-onset hospitalisations for psychosis or mania from 2018 through 2020 for Icelanders aged 18-67 was 0.048%. The estimated relative risk was 7.99 (95% CI 6.06, 10.54), the proportional attributable risk 87.5% and the number needed to harm 302 (95% CI 271, 340). Within 1 year of hospital discharge, 69% (42/61) had been represcribed their ADHD medication, and 26.2% (11/42) of these had to be readmitted for psychosis or mania CONCLUSIONS: The risk of hospitalisation for psychosis or mania with prescription ADHD drugs is small but real among adults, and represcription is strongly associated with readmission.CLINICAL IMPLICATIONSClinicians and adults diagnosed with ADHD should be aware of the association between ADHD drugs and the risk of developing psychosis or mania requiring hospitalisation in adults with ADHD.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143827104","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":"Predicting the incidence of depression in adolescence using a sociodemographic risk score: prospective follow-up of the IDEA-RiSCo study.","authors":"Jader Piccin,Claudia Buchweitz,Pedro H Manfro,Rivka Barros Pereira,Fernanda Rohrsetzer,Laila Souza,Anna Viduani,Arthur Caye,Brandon A Kohrt,Valeria Mondelli,Johnna R Swartz,Helen L Fisher,Christian Kieling","doi":"10.1136/bmjment-2024-301207","DOIUrl":"https://doi.org/10.1136/bmjment-2024-301207","url":null,"abstract":"BACKGROUNDAdolescence constitutes a critical window for preventing depression, but efforts have mostly targeted single risk factors. The Identifying Depression Early in Adolescence Risk Score (IDEA-RS) integrates easily obtainable sociodemographic variables and has been able to predict future depression across diverse populations. However, its performance within a prospective cohort remains untested.OBJECTIVETo evaluate the performance of the IDEA-RS in a prospective sample of adolescents participating in the IDEA Risk Stratified Cohort.METHODSUsing the IDEA-RS, we screened 7720 adolescents aged 14-16 years in 101 public schools in Porto Alegre, Brazil, and recruited 50 low-risk (LR) and 50 high-risk (HR) participants without depression. The incidence of depressive disorders over 3 years was assessed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children. Statistical analysis involved Poisson regression with robust variance to estimate incidence rate ratios (IRRs) for depression onset.FINDINGSIn the HR group, 14/45 developed depression, in comparison to 5/43 in the LR group. Poisson regression analysis confirmed a higher probability of developing depression in the HR group compared with the LR group (IRR of 2.68, 95% CI 1.05 to 6.79, p=0.04).CONCLUSIONIn a prospective cohort of Brazilian adolescents, the IDEA-RS effectively distinguished between those at HR and LR for developing depression.CLINICAL IMPLICATIONSThese results support the usefulness of an easy-to-administer sociodemographic composite risk score for stratifying the probability of developing depression among adolescents, a promising tool to be used in a variety of global contexts, including resource-limited settings.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143827105","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":"Methodological quality in randomised clinical trials of mental health apps: systematic review and longitudinal analysis.","authors":"Jake Linardon,Qiang Xie,Caroline Swords,John Torous,Shufang Sun,Simon B Goldberg","doi":"10.1136/bmjment-2025-301595","DOIUrl":"https://doi.org/10.1136/bmjment-2025-301595","url":null,"abstract":"QUESTIONThis study investigated the methodological rigour of randomised controlled trials (RCTs) of mental health apps for depression and anxiety, and whether quality has improved over time.STUDY SELECTION AND ANALYSISRCTs were drawn from the most recent meta-analysis of mental health apps for depression and anxiety symptoms. 20 indicators of study quality were coded, encompassing risk of bias, participant diversity, study design features and app accessibility measures. Regression models tested associations between year of publication and each quality indicator.FINDINGS176 RCTs conducted between 2011 and 2023 were included. Methodological concerns were common for several quality indicators (eg, <20% were replication trials, <35% of trials reported adverse events). Regression models revealed only three significant changes over time: an increase in preregistration (OR=1.27; 95% CI 1.10, 1.46) and reporting of adverse events (OR=1.32; 95% CI 1.11, 1.56), and a decrease in apps reported to be compatible with iOS and/or Android (OR=0.78; 95% CI 0.64, 0.96). Results were unchanged when excluding outliers. Results were similar when excluding three high-quality studies published between 2011 and 2013, with additional evidence for an increase in modern missing data methods (OR=1.22; 95% CI 1.04, 1.42) and studies reporting intention-to-treat analysis (OR=1.20; 95% CI 1.03, 1.39).CONCLUSIONSFindings provide minimal evidence of improvements in the quality of clinical trials of mental health apps, highlighting the need for higher methodological standards in future research to ensure the reliability and generalisability of evidence for these digital tools.","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"112 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143827102","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":"Climate change worry and the association with future depression and anxiety: cross-national analysis of 11 European countries.","authors":"Aminah Collery, Claire L Niedzwiedz","doi":"10.1136/bmjment-2024-301318","DOIUrl":"10.1136/bmjment-2024-301318","url":null,"abstract":"<p><strong>Background: </strong>Climate change affects people's mental health directly and indirectly. Climate anxiety, characterised by persistent worry and distress about environmental changes, is increasingly recognised as a factor affecting mental well-being. This study focused on potential implications of climate change worry for mental health.</p><p><strong>Objective: </strong>To assess whether climate change worry is associated with an increased risk of depression, anxiety and sleep disturbance across European countries.</p><p><strong>Methods: </strong>The study used longitudinal data from the European Social Survey-10 (2020-2022) and the follow-up CROss-National Online Survey 2 wave 4 (2022). A total of 5155 participants across 11 European countries were included in the analysis. Logistic regression models were used to examine the relationship between climate change worry and mental health outcomes (anxiety, depression and sleep), adjusting for potential confounding factors. Stratified analyses were conducted to assess variations between countries.</p><p><strong>Findings: </strong>Climate change worry was associated with increased risk of anxiety (OR: 1.38, 95% CI: 1.13 to 1.68), but not depression (OR: 1.10, 95% CI: 0.94 to 1.29), or sleep disturbance (OR: 1.08, 95% CI: 0.92 to 1.27), in pooled analyses across countries. Country-specific analyses revealed notable differences, with the strongest associations between climate worry and anxiety observed in Slovenia and Italy.</p><p><strong>Conclusions: </strong>These findings suggest that the psychological impact of climate change worry is not uniform across Europe and may be influenced by national policies, environmental risks and sociocultural factors. Given the varying effects across countries, policy-makers should consider contextual factors when designing strategies to address climate anxiety. Integrating mental health considerations into climate policies may enhance public engagement and resilience in the face of environmental challenges.</p><p><strong>Clinical implications: </strong>Traditional therapeutic approaches may not fully capture the unique distress associated with environmental worries, necessitating the development of specialised interventions that validate individuals' concerns while equipping them with coping mechanisms.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804984","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":"Single-session intervention with and without video support to prevent the worsening of emotional distress among healthcare workers during the SARS-CoV-2 pandemic: a randomised clinical trial.","authors":"Giovanni Abrahão Salum, Lucas Spanemberg, Marianna de Abreu Costa, André Rafael Simioni, Natan Pereira Gosmann, Livia Hartmann de Souza, Pim Cuijpers, Daniel Samuel Pine, Andre Russowsky Brunoni, Natan Katz, Roberto Nunes Umpierre, Christian Haag Kristensen, Gisele Gus Manfro, Marcelo Pio Fleck, Carolina Blaya Dreher","doi":"10.1136/bmjment-2024-301416","DOIUrl":"10.1136/bmjment-2024-301416","url":null,"abstract":"<p><strong>Background: </strong>The SARS-CoV-2 pandemic was a major stressful event that significantly affected healthcare providers.</p><p><strong>Objective: </strong>To evaluate the efficacy of a single-session intervention (SSI), with and without weekly personalised prerecorded videos, in preventing emotional distress worsening.</p><p><strong>Methods: </strong>Nationwide randomised clinical trial conducted in Brazil from 19 May 2020 to 31 December 2021. We included healthcare professionals with anxiety, depression or irritability scores below a T-score of 70, measured by the Patient-Reported Outcomes Measurement Information System. Participants were randomised to SSI or SSI plus weekly personalised prerecorded videos for 4 weeks (SSI-ET). The primary outcome was the proportion of participants with a significant escalation of symptoms (ie, T-score above 70).</p><p><strong>Findings: </strong>From 3328 assessed for eligibility, 1112 participants were randomised (SSI=549; SSI-ET=563). The cumulative proportion of incident cases at 6 months was 17.5% (95% CI: 13.1% to 21.6%) for SSI and 15% (95% CI: 10.9% to 18.8%) for SSI-ET, with no difference between groups (HR=0.81, 95% CI: 0.83 to 1.79). Both groups showed significant symptom reductions at 1 month follow-up, maintained at 3 and 6 months (Cohen's d=0.68-1.08).</p><p><strong>Conclusions: </strong>Adding asynchronous videos to SSI provided no additional benefit. While symptom improvements occurred over time, the lack of a control group limits conclusions about intervention efficacy.</p><p><strong>Clinical implications: </strong>Given its simplicity and scalability, the synchronous component, which includes core mental health support elements, such as active listening, validation, and empathic care, may represent a feasible way to assist healthcare professionals in crisis settings, even though further research is needed to determine its specific impact.</p><p><strong>Trial registration number: </strong>NCT04632082.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804990","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":"Measuring social environment factors of inpatients and outpatients with depression in Germany: a cross-sectional study.","authors":"Petra Schoenweger, Julia Eder, Lisa Pfeiffer, Peter Falkai, Michaela Kirschneck, Maria S Simon, Claudia Ditzen-Janotta, André R Brunoni, Michaela Coenen, Mark Sen Dong, Jochen Gensichen, Catherine Glocker, Nikolaos Koutsouleris, Richard Musil, Andrea Schmitt, Caroline Jung-Sievers","doi":"10.1136/bmjment-2024-301359","DOIUrl":"10.1136/bmjment-2024-301359","url":null,"abstract":"<p><strong>Background: </strong>Social environment characteristics, including social relationships and cultural milieus, may influence the occurrence, course and management of depression. Effective questionnaires are needed to measure these factors and improve disease management.</p><p><strong>Objective: </strong>We aimed to (1) evaluate the social environment, such as social isolation, social disability and social cohesion of depressed inpatients and outpatients, and (2) discuss the suitability of standardised questionnaires measuring it.</p><p><strong>Methods: </strong>This cross-sectional study included adult patients with unipolar depression from a psychiatric hospital and general practitioner (GP) practices in Bavaria, Germany. Social isolation, disability and cohesion were measured using the <i>Lubben Social Network Scale</i> (LSNS), the <i>WHO Disability Assessment Schedule</i> (WHODAS) and the <i>Social Cohesion and Trust Scale</i> (SCTS), respectively. The suitability of these questionnaires was assessed with a context-specific quality appraisal.</p><p><strong>Findings: </strong>Among 282 included patients (mean age 38.8 years, SD=13.3), 69.5% were inpatients and 30.5% were outpatients. Social isolation prevalence was 52.5%. Social disability was higher in our cohort than in the general population (p<0.001). LSNS and WHODAS showed no differences between inpatients and outpatients, and suggest good clinical suitability. The SCTS showed shortcomings in applicability and comparability.</p><p><strong>Conclusion: </strong>People with depression, whether treated in psychiatric hospitals or in GP practices, reported more social isolation and social disability than the general population.</p><p><strong>Clinical implications: </strong>Researchers and clinicians should monitor social aspects as potential intervention targets to support patient management. Social environment questionnaires should be selected carefully, ideally guided by guidelines or medical associations, to enhance the understanding, comparability and implementation.</p>","PeriodicalId":72434,"journal":{"name":"BMJ mental health","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789448","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}