BJPsych Bulletin最新文献

{"title":"How do we treat a child who kills? A pragmatic consideration of the prosecution of young children.","authors":"Enys Delmage, Pamela J Taylor, Heidi Hales","doi":"10.1192/bjb.2026.10225","DOIUrl":"https://doi.org/10.1192/bjb.2026.10225","url":null,"abstract":"<p><p>Despite being a rare phenomenon, children who kill galvanise extraordinary amounts of conversation about why they did it, how to deal with them and how to prevent recurrences. The debate quickly becomes polarised and occasionally politicised, often without nuanced consideration of the benefits and costs of proceeding in one direction or another. A scientific approach would begin with the question: 'what do we actually want the outcomes to be?', which might assist in relinquishing the less helpful desire for natural justice or revenge and move towards a more evidence-informed and inclusive approach to children who have committed very serious crimes.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-4"},"PeriodicalIF":2.0,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147363916","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":"Patients' experiences of sexual violence in psychiatric in-patient care: systematic review and synthesis of qualitative studies.","authors":"Yue Deng, Joanne Butler, Sian Oram","doi":"10.1192/bjb.2026.10222","DOIUrl":"https://doi.org/10.1192/bjb.2026.10222","url":null,"abstract":"<p><strong>Background: </strong>Sexual violence in psychiatric in-patient care has received increasing attention following persistent evidence of sexual violence and harassment on wards. However, patients' subjective experiences remain under-examined, limiting the evidence base to inform safeguarding, gender-sensitive design and trauma-informed practice.</p><p><strong>Aims: </strong>To synthesise qualitative evidence on patients' experiences of sexual violence and perceived risk within psychiatric in-patient settings.</p><p><strong>Method: </strong>We conducted a systematic review and qualitative synthesis following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines (PROSPERO registration no. CRD42024595945). MEDLINE, Embase and PsycINFO were searched from inception to October 2024, supplemented by reference list screening and citation tracking. Inclusion criteria were peer-reviewed qualitative studies reporting patients' first-hand accounts of sexual violence or perceived sexual safety in psychiatric in-patient care. The quality of the included studies was assessed using the Critical Appraisal Skills Programme checklist, and data were analysed by thematic synthesis.</p><p><strong>Results: </strong>Six studies published between 1998 and 2025 met the inclusion criteria, with most focusing on female patients in mixed-gender wards. Three overarching themes were developed: (a) 'a culture of permissiveness and dismissal' - patients downplayed harassment and abuse and staff routinely dismissed concerns; (b) 'everyday fear, hypervigilance and resistance' - the constant threat of harm generated chronic distress, with safeguarding responsibility shifted onto the patients; and (c) 'gendered power dynamics in open or mixed-gender spaces' - open ward layouts, inadequate boundaries and legal detention compounded vulnerability to harm.</p><p><strong>Conclusions: </strong>Sexual violence in psychiatric in-patient care is enabled by ward cultures that normalise harm, weak safeguarding and gendered power imbalances. Urgent action is needed to implement trauma-informed, gender-sensitive practices and secure spatial boundaries and consistent incident responses, alongside policies that enable safe disclosure and accountability.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-8"},"PeriodicalIF":2.0,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147353711","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":"Characteristics of mental health service users attending Recovery Colleges in England: baseline findings from Recovery Colleges Characterisation and Testing (RECOLLECT).","authors":"Simon Lawrence, Amy Ronaldson, Thomas Allen, Merly McPhilbin, Simran K Takhi, Agnieszka Kapka, Jonathan Simpson, Riddhi Daryanani, Daniel Hayes, Tesnime Jebara, Danielle Dunnett, Mariam Namasaba, Yasuhiro Kotera, Oliver Skipper, Sara Meddings, Jane Rennison, Vanessa Lawrence, Ioannis Bakolis, Richard Emsley, Rachel A Elliott, Katy Stepanian, Katherine Barrett, Daniel Elton, Claire Henderson, Mike Slade","doi":"10.1192/bjb.2026.10220","DOIUrl":"https://doi.org/10.1192/bjb.2026.10220","url":null,"abstract":"<p><strong>Aims and method: </strong>Recovery Colleges are adult education initiatives supporting personal recovery for individuals with mental health difficulties. We characterised a national (England) inception cohort of mental health service users, students from the Recovery Colleges Characterisation and Testing 2 programme, and compared those attending different Recovery College types on sociodemographic, clinical, service use and student-reported outcomes over the 4 months prior to enrolment. Mixed-effects regression models were used to assess differences.</p><p><strong>Results: </strong>The cohort comprised 498 students from 36 Recovery Colleges across England; 77.7% attended strengths-oriented Recovery Colleges. Mean age was 39 years (s.d. 12); most were female (72.1%) and White (81.5%). Common diagnoses were mood (31.3%) and anxiety disorders (29.7%). No significant differences were found between students attending strengths- versus community-oriented Recovery Colleges.</p><p><strong>Clinical implications: </strong>Strengths- and community-oriented Recovery Colleges have similar service user student populations. Certain groups that may be underrepresented in Recovery Colleges and Recovery College research include older adults, men, those with developmental disorders and ethnic minority populations.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-10"},"PeriodicalIF":2.0,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147353657","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":"Associations between recorded treatment non-adherence and clinical outcomes in schizophrenia.","authors":"Shayan Fassih, Kerr Hartop, Jyoti Sanyal, Robert Stewart","doi":"10.1192/bjb.2026.10223","DOIUrl":"https://doi.org/10.1192/bjb.2026.10223","url":null,"abstract":"<p><strong>Aims and method: </strong>Treatment non-adherence is a well-established predictor of relapse in schizophrenia, yet its broader clinical impact remains unclear. This study examines the association between clinician-recorded treatment non-adherence and clinical outcomes during the first year following a schizophrenia diagnosis. Using a bespoke natural language processing algorithm applied to anonymised electronic health records, we classified the recorded treatment adherence status of 2667 patients. Multivariable and Poisson regression analyses were conducted to assess associations of recorded treatment non-adherence with clinical outcomes.</p><p><strong>Results: </strong>Compared with the remainder, those classified as non-adherent had greater increases in recorded symptoms and higher frequency and duration of in-patient admissions and crisis care episodes. They were also prescribed a greater number of different antipsychotics and developed a greater number of recorded physical health comorbidities.</p><p><strong>Clinical implications: </strong>Treatment non-adherence is associated with markedly poorer clinical outcomes, emphasising the importance of early identification and targeted interventions to support adherence.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-7"},"PeriodicalIF":2.0,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324521","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":"Reforming medical training for psychiatry of intellectual disability: from margins to mandate.","authors":"Rohit Shankar, Niall O'Kane, Indira Vinjamuri, Nicole Eady, Bhathika Perera","doi":"10.1192/bjb.2026.10221","DOIUrl":"https://doi.org/10.1192/bjb.2026.10221","url":null,"abstract":"<p><p>In its 2025 medical training review, National Health Service (NHS) England highlighted the urgent need to modernise postgraduate medical education in England to meet NHS population needs while supporting doctors' professional aspirations. The psychiatry of intellectual disability, a subspecialty marked by declining recruitment, uneven service provision and limited research capacity, provides a critical test case for these reforms. This article applies the 11 recommendations from the review to doctors training in this subspecialty. Drawing on recent evidence, it advocates for equitable, flexible and academically grounded reforms that embed psychiatry of intellectual disability within mainstream medical education, workforce planning and national health policy transformation.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-5"},"PeriodicalIF":2.0,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147301620","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":"Assisted death for prisoners and forensic patients: Complexity and controversy illustrated by four recent cases - CORRIGENDUM.","authors":"Roland M Jones, Alexander I F Simpson","doi":"10.1192/bjb.2026.10226","DOIUrl":"https://doi.org/10.1192/bjb.2026.10226","url":null,"abstract":"","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1"},"PeriodicalIF":2.0,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147275595","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":"Modernising the Mental State Examination: embedding eating and nutritional assessment into the 21st-century MSE.","authors":"Edwin Birch, James Downs, Agnes Ayton","doi":"10.1192/bjb.2026.10213","DOIUrl":"https://doi.org/10.1192/bjb.2026.10213","url":null,"abstract":"<p><strong>Aims and method: </strong>The Mental State Examination (MSE) is a core component of psychiatric assessment and medical training, yet it was developed before feeding or eating disorders (FEDs) were widely recognised. FEDs are now common, clinically severe and frequently missed in routine assessments. We conducted a narrative review of the historical development of the MSE, current UK medical education standards and relevant literature, supplemented by a lived-experience perspective, to examine whether the MSE adequately captures eating behaviour, nutritional status and body image disturbance.</p><p><strong>Results: </strong>We identified no published studies examining the explicit inclusion of FED-related psychopathology within the MSE. Current frameworks lack systematic prompts for eating behaviours and nutrition, contributing to under-recognition. Contributing factors include historical MSE design, limited curriculum coverage, clinician uncertainty and patient non-disclosure.</p><p><strong>Clinical implications: </strong>Embedding brief, semi-structured prompts into the MSE is a feasible training-aligned approach to improve detection, support curriculum modernisation and enhance patient safety.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"1-6"},"PeriodicalIF":2.0,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147269791","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":"The menopause transition: a call for a holistic approach.","authors":"Rachel Gibbons","doi":"10.1192/bjb.2025.17","DOIUrl":"10.1192/bjb.2025.17","url":null,"abstract":"<p><strong>Summary: </strong>This paper advocates for a holistic approach to the menopause transition and challenges the current dominant narrative that frames this transition primarily in biological terms. It examines the psychological, social and cultural dimensions, addresses the stigma faced by older women and advocates for the vital role psychiatrists have to play in supporting postmenopausal women.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"62-64"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699225","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":"Reporting of oral chemical restraint in the Mental Health Services Monthly Statistics for England.","authors":"Thomas Cranshaw, Harry Matchette-Downes, Keith Reid","doi":"10.1192/bjb.2025.10","DOIUrl":"10.1192/bjb.2025.10","url":null,"abstract":"<p><strong>Aims and method: </strong>This study examines more than 5.8 million bed days of data from private and National Health Service care providers who contribute to the Mental Health Services Monthly Statistics in the UK. The use of oral chemical restraint is compared with provider size, and the relative use of oral chemical restraint as opposed to seclusion is investigated.</p><p><strong>Results: </strong>The data-set has large amounts of missing data. The use of oral chemical restraint is proportional to provider size in terms of bed days. Analysis of those providers who reliably submit data demonstrates patterns of reported use of oral chemical restraint versus use of seclusion.</p><p><strong>Clinical implications: </strong>Further research is required into the institutional characteristics that are correlated with increased use of oral chemical restraint. Efforts to investigate the use of restrictive interventions in mental health settings are frustrated by inconsistent reporting.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"26-30"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647092","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":"Psychiatric poetics: mental healthcare and Giovanni Stanghellini's 'Logics of Discovery'.","authors":"George Ikkos, Alastair Morgan","doi":"10.1192/bjb.2024.115","DOIUrl":"10.1192/bjb.2024.115","url":null,"abstract":"<p><p>The importance of art and humanities in mental health is widely recognised, and consumption and creation of poetry, prose, drama and the plastic arts are now considered to be relevant knowledge-generating and therapeutic activities. However, literary and art criticism remain at the margins. By contrast, in his two 'Logics of Discovery' papers, psychiatrist, psychopathologist and psychotherapist Giovanni Stanghellini brings to bear on clinical discovery and the healing alliance cultural historian Aby Warburg's approach to images (specifically, his <i>Atlas of Mnemosyne</i>) and philosopher Giorgio Agamben's analysis of the linguistic phenomenon of parataxis in Friedrich Hölderlin's poetry. Both Warburg and Hölderlin experienced severe mental disorders, and Stanghellini's analysis is notable for its potential to contribute to co-creation in a wide range of clinical settings. We suggest that this work may help to address some key sources of dissatisfaction among mental health patients and thus improve patient experience and clinical outcomes. We also comment on issues regarding implementation of Stanghellini's proposals and conclude with discussion of an example of the severe loosening of associations originally reported by Eugen Bleuler.</p>","PeriodicalId":8883,"journal":{"name":"BJPsych Bulletin","volume":" ","pages":"72-77"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142943740","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}