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Beyond a false choice: categories and dimensions in psychiatric diagnosis. 超越错误的选择：精神病诊断的范畴和维度。
IF 2.9
BJPsych Bulletin Pub Date : 2026-09-25 DOI: 10.1192/bjb.2026.10296
Valentin Radoi, Mark L Ruffalo
{"title":"Beyond a false choice: categories and dimensions in psychiatric diagnosis.","authors":"Valentin Radoi, Mark L Ruffalo","doi":"10.1192/bjb.2026.10296","DOIUrl":"https://doi.org/10.1192/bjb.2026.10296","url":null,"abstract":"<p><p>Debates about psychiatric diagnosis are often framed as a choice between categorical and dimensional models. This editorial argues that dimensional approaches may enrich formulation but do not necessarily replace categorical diagnosis. The challenge is not to choose one over the other <i>a priori</i>, but to evaluate the evidence for a given condition and to clarify the distinct work each approach performs.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-3"},"PeriodicalIF":2.9,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036223","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
AI and the clinical blind spot: why psychiatry should be part of the conversation about artificial intelligence and human behaviour. 人工智能和临床盲点：为什么精神病学应该成为人工智能和人类行为对话的一部分。
IF 2.9
BJPsych Bulletin Pub Date : 2026-09-24 DOI: 10.1192/bjb.2026.10290
Hina Tahseen
{"title":"AI and the clinical blind spot: why psychiatry should be part of the conversation about artificial intelligence and human behaviour.","authors":"Hina Tahseen","doi":"10.1192/bjb.2026.10290","DOIUrl":"https://doi.org/10.1192/bjb.2026.10290","url":null,"abstract":"<p><p>Artificial intelligence (AI) systems that model human behaviour are built on data humans generate about themselves, yet the assumption that this data is reliable remains largely unexamined. Psychiatry's evidence base directly challenges it. Self-report is shaped by cognitive distortions, the gap between clinical presentation and underlying experience, and conditions that make accurate self-report impossible. The populations most affected by AI-driven decisions can be the least represented in training data. Clinical expertise in the reliability of human data, which psychiatry holds and practises daily, is largely absent from AI development. This omission is correctable, but psychiatry must enter the conversation.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-3"},"PeriodicalIF":2.9,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029613","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
Not fit for purpose: the Mental Capacity Act cannot serve as a safeguard for assisted dying. 不符合目的：《精神能力法》不能作为协助死亡的保障。
IF 2.9
BJPsych Bulletin Pub Date : 2026-09-18 DOI: 10.1192/bjb.2026.10289
Joseph Gough
{"title":"Not fit for purpose: the Mental Capacity Act cannot serve as a safeguard for assisted dying.","authors":"Joseph Gough","doi":"10.1192/bjb.2026.10289","DOIUrl":"https://doi.org/10.1192/bjb.2026.10289","url":null,"abstract":"<p><p>The Mental Capacity Act 2005 was not designed to, and is not fit to, provide safeguards for assisted dying. The impairment requirement puts interpersonal pressure beyond the scope of the Act. The criteria included in the Act struggle to deal with the effects of affect and motivation on decision-making even for its intended purposes and within its intended scope. The use of the Act in the Terminally Ill Adults (End of Life) Bill presents an opportunity for reform.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-3"},"PeriodicalIF":2.9,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987623","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
Whose business is autism? Exploring the intersecting roles of developmental paediatrics and child and adolescent mental health services. 自闭症是谁的事？探索发展儿科和儿童和青少年心理健康服务的交叉作用。
IF 2.9
BJPsych Bulletin Pub Date : 2026-09-18 DOI: 10.1192/bjb.2026.10281
Yasser Saeed Khan, Mohamed Adil Shah Khoodoruth, Nazim Abdel Aati
{"title":"Whose business is autism? Exploring the intersecting roles of developmental paediatrics and child and adolescent mental health services.","authors":"Yasser Saeed Khan, Mohamed Adil Shah Khoodoruth, Nazim Abdel Aati","doi":"10.1192/bjb.2026.10281","DOIUrl":"https://doi.org/10.1192/bjb.2026.10281","url":null,"abstract":"<p><p>This opinion article looks at how autism services for children and young people are organised within child development and child and adolescent mental health services. Although both play vital roles, their responsibilities often overlap, which can lead to delays and uncertainty for families. Rising demand, limited resources and differing pathways have added further pressure, especially since the COVID-19 pandemic. The article highlights key challenges, including age cut-offs, gaps in continuity, the need for a collaborative integrated model, the impact of stigma and the difficulties faced by children whose main needs relate to developmental delay. It argues for clearer pathways and more coordinated care.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-5"},"PeriodicalIF":2.9,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987671","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
Integrating pharmacovigilance, pharmacokinetics and clinical outcomes in clozapine safety science. 整合氯氮平安全性科学的药物警戒、药代动力学和临床结果。
IF 2.9
BJPsych Bulletin Pub Date : 2026-09-17 DOI: 10.1192/bjb.2026.10284
Carlos De Las Cuevas
{"title":"Integrating pharmacovigilance, pharmacokinetics and clinical outcomes in clozapine safety science.","authors":"Carlos De Las Cuevas","doi":"10.1192/bjb.2026.10284","DOIUrl":"https://doi.org/10.1192/bjb.2026.10284","url":null,"abstract":"<p><p>Clozapine remains the most effective treatment for treatment-resistant schizophrenia, yet its use is constrained by concerns about safety and preventable adverse outcomes. Evidence on clozapine safety remains fragmented and methodologically heterogeneous, limiting translation into clinical practice. Pharmacovigilance, therapeutic drug monitoring, pharmacokinetics and pharmacogenetics provide complementary information that is rarely considered together. This editorial argues that integrating these approaches within a coherent clinical framework may improve prediction and individualisation of risk while acknowledging current methodological limitations. Progress may therefore depend less on generating additional isolated evidence than on connecting the data already available.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-3"},"PeriodicalIF":2.9,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148981912","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
From medical school to foundation training: supporting autistic doctors in early medical careers. 从医学院到基础培训：支持自闭症医生早期的医疗事业。
IF 2.9
BJPsych Bulletin Pub Date : 2026-09-17 DOI: 10.1192/bjb.2026.10282
Chloë Groenewald
{"title":"From medical school to foundation training: supporting autistic doctors in early medical careers.","authors":"Chloë Groenewald","doi":"10.1192/bjb.2026.10282","DOIUrl":"https://doi.org/10.1192/bjb.2026.10282","url":null,"abstract":"<p><strong>Aims and method: </strong>To explore existing knowledge on autism in medical education and early clinical training, examine the lived experiences of autistic doctors, review relevant National Health Service policies and legal frameworks, and propose a practical framework for improving inclusion. This study comprised a narrative review of the published literature on autism in medical education, foundation training and healthcare settings, supplemented by a positionality statement informed by the author's clinical experience.</p><p><strong>Results: </strong>Common barriers include the hidden curriculum of clinical placements, neurotypical templates in communication assessment, sensory demands of clinical environments, significant risks associated with disclosure and inadequate supervisor awareness. Masking imposes substantial psychological costs, including risk of autistic burnout. Legal frameworks exist but are inconsistently applied in practice. The SUPPORT framework is proposed as a structured model: Structured learning environments, Understanding neurodiversity, Predictability, Practical adjustments, Open culture, Relationships and mentorship, and Trainee well-being.</p><p><strong>Clinical implications: </strong>Autistic doctors bring valuable strengths to clinical practice. The barriers they face during the transition from medical school to clinical practice are documented and preventable. Despite legal protections and growing awareness of neurodiversity, National Health Service training frameworks do not consistently address the needs of autistic clinicians. The SUPPORT framework provides a practical, low-resource approach to addressing these barriers, with implementation requiring greater awareness and institutional commitment. These findings identify the need for medical training to move past recognition of neurodiversity and towards creating clinical environments in which autistic doctors can thrive.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-9"},"PeriodicalIF":2.9,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148981974","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
Lethal discrimination and prejudice: a systems failure? Commentary on… How the 'Big, Black and Dangerous' stereotype still shapes psychiatry. 致命的歧视和偏见：制度失灵？评论……“又大又黑又危险”的刻板印象如何影响着精神病学。
IF 2.9
BJPsych Bulletin Pub Date : 2026-09-17 DOI: 10.1192/bjb.2026.10291
Kamaldeep S Bhui
{"title":"Lethal discrimination and prejudice: a systems failure? Commentary on… How the 'Big, Black and Dangerous' stereotype still shapes psychiatry.","authors":"Kamaldeep S Bhui","doi":"10.1192/bjb.2026.10291","DOIUrl":"https://doi.org/10.1192/bjb.2026.10291","url":null,"abstract":"<p><p>Meju argues that the 'Big, Black and Dangerous' stereotype is still alive in psychiatry and leads to coercive care and deaths. This brief commentary considers the wider social and structural influences, clinical-decision making and circumstances in which bias might arise. Reducing bias requires adequate training and service capacity, good team functioning and further research to evaluate outcomes.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-3"},"PeriodicalIF":2.9,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148981977","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
Sex differences in mental health disorders among autistic men and women: retrospective service audit of a random cohort - CORRIGENDUM. 自闭症男性和女性心理健康障碍的性别差异：随机队列的回顾性服务审计-勘误。
IF 2.9
BJPsych Bulletin Pub Date : 2026-09-16 DOI: 10.1192/bjb.2026.10292
Charlotte Cliffe, Henrietta Rees, Howard Childs, Rebecca Day, Elizabeth Shade, Luke Simmons, Jo Jennison, Clare Allely, Raja Anindya Sekhar Mukherjee
{"title":"Sex differences in mental health disorders among autistic men and women: retrospective service audit of a random cohort - CORRIGENDUM.","authors":"Charlotte Cliffe, Henrietta Rees, Howard Childs, Rebecca Day, Elizabeth Shade, Luke Simmons, Jo Jennison, Clare Allely, Raja Anindya Sekhar Mukherjee","doi":"10.1192/bjb.2026.10292","DOIUrl":"https://doi.org/10.1192/bjb.2026.10292","url":null,"abstract":"","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1"},"PeriodicalIF":2.9,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975645","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
Are we missing obsessive-compulsive disorder in children with severe intellectual disability? 我们是否忽略了严重智力障碍儿童的强迫症？
IF 2.9
BJPsych Bulletin Pub Date : 2026-09-14 DOI: 10.1192/bjb.2026.10285
Annie Swanepoel
{"title":"Are we missing obsessive-compulsive disorder in children with severe intellectual disability?","authors":"Annie Swanepoel","doi":"10.1192/bjb.2026.10285","DOIUrl":"https://doi.org/10.1192/bjb.2026.10285","url":null,"abstract":"<p><p>Obsessive-compulsive disorder (OCD) is being missed in children with severe intellectual disability. Their compulsive behaviours are routinely attributed to autism spectrum disorder or dismissed as challenging behaviour, without systematic consideration of OCD. I argue that this misattribution is predictable, consequential and correctable. The key diagnostic tool is the ego-dystonic/ego-syntonic distinction: OCD rituals are distressing to the child and a change from their baseline, whereas autistic repetitive behaviours are typically comforting. When this distinction is applied, and OCD is treated with modified exposure and response prevention and selective serotonin reuptake inhibitors, outcomes can be transformative. A dedicated evidence base for this population is urgently needed.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-4"},"PeriodicalIF":2.9,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963354","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
Precision without participation: why precision psychiatry needs Collaborative/Therapeutic Assessment. 没有参与的精确：为什么精确精神病学需要协作/治疗性评估。
IF 2.9
BJPsych Bulletin Pub Date : 2026-09-07 DOI: 10.1192/bjb.2026.10278
Filippo Aschieri, Qiwu Sun, Stephen E Finn
{"title":"Precision without participation: why precision psychiatry needs Collaborative/Therapeutic Assessment.","authors":"Filippo Aschieri, Qiwu Sun, Stephen E Finn","doi":"10.1192/bjb.2026.10278","DOIUrl":"https://doi.org/10.1192/bjb.2026.10278","url":null,"abstract":"<p><p>Contemporary psychiatry often assumes that more precise diagnosis will yield more effective care. Biomarkers, digital phenotyping, artificial intelligence and related tools promise better diagnosis, treatment selection and outcomes. Yet this expectation is clinically incomplete: objectively valid information may not improve treatment when patients experience it as impersonal, imposed or disconnected from their concerns. Collaborative/Therapeutic Assessment (C/TA) complements precision psychiatry by engaging patients as partners in meaning-making rather than passive recipients of expert conclusions. It can transform technically precise findings into personally useful knowledge, making diagnosis more likely to foster engagement and meaningful change instead of merely producing refined classification.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-4"},"PeriodicalIF":2.9,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900166","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
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