BJPsych Bulletin最新文献

Clozapine, suicide prevention and risk perception in psychiatry. 氯氮平，精神病学自杀预防和风险感知。

IF 2.9

BJPsych Bulletin Pub Date : 2026-10-19 DOI: 10.1192/bjb.2026.10317

Carlos De Las Cuevas

引用次数: 0

'But the patient doesn't seem borderline': some observations on a common diagnostic error. “但病人似乎并不处于边缘”：对一个常见诊断错误的一些观察。

IF 2.9

BJPsych Bulletin Pub Date : 2026-10-15 DOI: 10.1192/bjb.2026.10313

Mark L Ruffalo

引用次数: 0

Suicide in South Wales: comprehensive review of suicides reported to the South Wales Central Coroner's Service, 2016-2023. 南威尔士的自杀：2016-2023年向南威尔士中央验尸官服务报告的自杀事件的全面审查。

IF 2.9

BJPsych Bulletin Pub Date : 2026-10-13 DOI: 10.1192/bjb.2026.10297

Sarah-Jane Richards, Stephen B Dunnett, Graeme D Hughes

{"title":"Suicide in South Wales: comprehensive review of suicides reported to the South Wales Central Coroner's Service, 2016-2023.","authors":"Sarah-Jane Richards, Stephen B Dunnett, Graeme D Hughes","doi":"10.1192/bjb.2026.10297","DOIUrl":"https://doi.org/10.1192/bjb.2026.10297","url":null,"abstract":"Aims and method: An analysis of coronial inquest data provides contextual information rarely available in routine surveillance systems, including a nuanced understanding of proximal circumstances preceding death of value to mental health services. Inquest records of more than 750 suicides occurring within the South Wales Central Coroner's jurisdiction between 2016 and 2023 were reviewed, including the COVID-19 pandemic years, to assess the effects of lockdown and social isolation. Detailed information was extracted, including medical records, toxicology, police reports, witness statements and suicide notes.Results: Several patterns emerged relating to age, gender, method of death, trigger factors, local authority area, and engagement with mental health services. Hanging was the predominant method, particularly among men. Depression was the most common trigger factor, followed by relationship problems, alcohol/drug misuse, health concerns, psychotic illness and bereavement.Clinical implications: Key structural and psychosocial risk factors identified highlighted the need for tailored, context-specific suicide-prevention strategies, with circumstances preceding suicide integrated into public health planning.","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-9"},"PeriodicalIF":2.9,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164031","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}

引用次数: 0

Long-term outcomes of daridorexant in those with comorbid insomnia. daridorexant对合并症失眠患者的长期疗效。

IF 2.9

BJPsych Bulletin Pub Date : 2026-10-13 DOI: 10.1192/bjb.2026.10298

Soumya Saladi, Hatem Jouda, Teck Yong, Kirstie N Anderson

{"title":"Long-term outcomes of daridorexant in those with comorbid insomnia.","authors":"Soumya Saladi, Hatem Jouda, Teck Yong, Kirstie N Anderson","doi":"10.1192/bjb.2026.10298","DOIUrl":"https://doi.org/10.1192/bjb.2026.10298","url":null,"abstract":"Aims and method: Daridorexant is a dual orexin receptor antagonist recently licensed for chronic insomnia disorder. Guidelines recommend it as a second-line treatment for insomnia, after cognitive-behavioural therapy. Initial trials excluded common comorbidities despite comorbid insomnia being the norm, not the exception. The long-term benefit from daridorexant remains unclear, with few long-term trials. We aimed to assess long-term outcomes in those with comorbid insomnia.This was a retrospective analysis of 38 patients with insomnia who commenced daridorexant. Mental health disorders were common in those referred. Adverse events and a range of insomnia outcomes were assessed.Results: The mean follow-up period was 10.5 months. Of the 38 patients in the study, 95% had comorbid insomnia; 55% experienced benefit from the daridorexant, but 24% discontinued because of side-effects, including vivid dreams, fatigue and worsening anxiety. Three patients experienced worsening mood, one of which included suicidality.Clinical implications: Daridorexant can be effective for those with comorbid insomnia, but side-effects may be more common than previously reported.","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-6"},"PeriodicalIF":2.9,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168715","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}

引用次数: 0

Rising demand, robust triage? Service evaluation of the triage process in a young-onset dementia service. 需求上升，分类稳健？服务评估的分诊过程在一个年轻的发病痴呆症服务。

IF 2.9

BJPsych Bulletin Pub Date : 2026-10-13 DOI: 10.1192/bjb.2026.10280

Amna Khalil, Timona Chetty, Elizabeta B Mukaetova-Ladinska, Matthew Critchfield

{"title":"Rising demand, robust triage? Service evaluation of the triage process in a young-onset dementia service.","authors":"Amna Khalil, Timona Chetty, Elizabeta B Mukaetova-Ladinska, Matthew Critchfield","doi":"10.1192/bjb.2026.10280","DOIUrl":"https://doi.org/10.1192/bjb.2026.10280","url":null,"abstract":"Aims and method: To evaluate referrals to our local Young Onset Dementia Assessment Service (YODAS), analyse referral trends and re-referral patterns between 2020 and 2024, and review reasons for non-acceptance of referrals at triage. A retrospective review of electronic referral records was undertaken using descriptive analysis.Results: Referrals to YODAS almost doubled over the study period, while non-acceptance rates remained relatively stable, rising from 52.6% in 2020 to 57.3% in 2024. Among 760 patients whose referrals were not accepted, the most common reasons for non-acceptance were: absence of features suggestive of neurodegeneration, cognitive symptoms better explained by mental health conditions, and insufficient referral information. Over one-quarter were re-referred, with two-thirds subsequently accepted. Only 6% of individuals whose referrals were initially not accepted later received a dementia diagnosis, indicating effective triage.Clinical implications: A rise in the demand for dementia assessment from a younger patient population requires a careful triage to ensure the individuals with possible features of neurodegeneration are appropriately assessed, and cases where alternative explanations are more likely are directed to more appropriate pathways.","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-7"},"PeriodicalIF":2.9,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164723","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}

引用次数: 0

'Life changer as a general adult psychiatrist': delivering a National Autism Training Programme for Psychiatrists. “作为普通成人精神病医生改变生活”：为精神病医生提供国家自闭症培训计划。

IF 2.9

BJPsych Bulletin Pub Date : 2026-10-10 DOI: 10.1192/bjb.2026.10286

Conor Davidson, Karen Quinton, Abdul Raoof, Verity Westgate, Regi T Alexander

引用次数: 0

Lessons from the history of antipsychotic discovery: part 3 - muscarinic mechanisms. 抗精神病药物发现史的教训：第3部分-毒蕈碱机制。

IF 2.9

BJPsych Bulletin Pub Date : 2026-10-08 DOI: 10.1192/bjb.2026.10267

Jeremy Hall

{"title":"Lessons from the history of antipsychotic discovery: part 3 - muscarinic mechanisms.","authors":"Jeremy Hall","doi":"10.1192/bjb.2026.10267","DOIUrl":"https://doi.org/10.1192/bjb.2026.10267","url":null,"abstract":"After more than seven decades in which antipsychotic drug development has been dominated by dopaminergic mechanisms, the recent emergence of a muscarinic receptor-based treatment represents a conceptual shift in the pharmacotherapy of psychosis. This article reviews the history and development of the first clinically effective non-dopaminergic antipsychotic, tracing its origins to unexpected behavioural effects observed during trials of muscarinic agonists developed for Alzheimer's disease. Early studies of the muscarinic agonist xanomeline demonstrated antipsychotic efficacy, but were limited by poor tolerability due to peripheral cholinergic adverse effects. Subsequent progress depended on the dissociation of central therapeutic effects from peripheral side-effects, through the combination of xanomeline with the peripherally restricted muscarinic antagonist trospium. The development of this treatment highlights several broader lessons for psychiatric drug discovery, including the value of revisiting previously abandoned compounds, the benefits of leveraging existing human safety data on the importance of early-phase translational research and the role of innovative companies.","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-4"},"PeriodicalIF":2.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126641","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}

引用次数: 0

Lessons from the history of antipsychotic discovery: part 1 - initial insights. 抗精神病药物发现史的教训：第一部分-初步见解。

IF 2.9

BJPsych Bulletin Pub Date : 2026-10-08 DOI: 10.1192/bjb.2026.10250

Jeremy Hall

引用次数: 0

Lessons from the history of antipsychotic discovery: part 2 - dopaminergic diversification. 抗精神病药物发现史的教训：第二部分-多巴胺能多样化。

IF 2.9

BJPsych Bulletin Pub Date : 2026-10-08 DOI: 10.1192/bjb.2026.10266

Jeremy Hall

引用次数: 0

Investigating risk assessment and management processes. 调查风险评估和管理过程。

IF 2.9

BJPsych Bulletin Pub Date : 2026-10-02 DOI: 10.1192/bjb.2026.10283

Heather Tolland, Emma Drysdale, Paula McCahon, Alan Mackenzie, Fiona Mohammad, Scott Rae, Kay Sunderland, Pamela Swift, Tonya Sheridan, Hollie Walker, Brian Gillatt

{"title":"Investigating risk assessment and management processes.","authors":"Heather Tolland, Emma Drysdale, Paula McCahon, Alan Mackenzie, Fiona Mohammad, Scott Rae, Kay Sunderland, Pamela Swift, Tonya Sheridan, Hollie Walker, Brian Gillatt","doi":"10.1192/bjb.2026.10283","DOIUrl":"https://doi.org/10.1192/bjb.2026.10283","url":null,"abstract":"Background: Risk assessment and management are key elements of clinical practice in mental health. Existing literature on risk assessment in mental health has focused more on the predictive validity of tools and less on the clinical utility of tools in daily practice.Aims: To explore risk assessment and management processes, and how clinicians use risk tools in daily practice, across a single health board.Method: This was a large mixed-methods study in a health authority responsible for the care of 1.3 million people covering a wide range of settings. Data collection involved multiple approaches including staff surveys, focus groups, non-participant observations of team meetings, case-file audits and reviews of incident reports.Results: Although risk was routinely discussed in team meetings, the risk tool was rarely used to inform decision-making. Barriers to meaningful use of the tool included time constraints, lack of training and perceived lack of relevance. Both staff and carers reported limited involvement of patients and families in risk assessment processes. Case-file audits showed high completion rates of the risk tool but little evidence that it influenced decision-making.Conclusions: This study demonstrates a significant challenge for services, with clinical teams discussing risk but not using the mandated formulation-based risk tool to do so. This is set against the need for health authorities to demonstrate consistent standards in risk management across specialties and settings and to have a format that makes risk management plans easily available to clinicians unfamiliar with the patient. Further research is required to develop a method of recording risk mitigation strategies that is collaborative and can be easily completed in a clinical setting.","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-14"},"PeriodicalIF":2.9,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103872","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}

引用次数: 0