BJPsych Open最新文献

{"title":"Youth peer-based mental health programmes and supports in low- and middle-income countries: rapid review.","authors":"Joseph H Puyat, Mana Mohebbian, Erin Kwak, Jaime A Manalo, Mehar Mago, Mark Andre Blanco, John Ismael J Medina, Ursula Ellis, Llewelyn Issa B Dela Cruz, Carolina Uno-Rayco, Mendiola Teng-Calleja, Carla T Hilario, Raymond W Lam, Rosemin Kassam","doi":"10.1192/bjo.2026.11030","DOIUrl":"10.1192/bjo.2026.11030","url":null,"abstract":"<p><strong>Background: </strong>Youth in low- and middle-income countries (LMICs) bear a disproportionate burden of mental health conditions, alongside low health-seeking behaviours and limited access to services. These gaps underscore the need for accessible strategies such as youth peer-based mental health programmes and supports (Y-PBMHPS).</p><p><strong>Aims: </strong>To examine whether Y-PBMHPS can help address the mental health needs of LMIC youth.</p><p><strong>Method: </strong>We conducted a rapid review of peer-reviewed literature, searching Medline, PsycINFO, CINAHL, CAB Global Health, Science Citation Index and Social Sciences Citation Index for studies of Y-PBMHPS in LMICs published in English between 1 January 2002 and 19 September 2025. Two review authors performed title/abstract screening and full-text review. Study quality was assessed by one review author using Joanna Briggs Institute critical appraisal tools. The primary outcome was change in mental health status, expressed in standardised difference units.</p><p><strong>Results: </strong>Of 6105 unique records identified, 329 studies were reviewed in full and 34 were included. All studies were conducted in Asia or Africa; 17 were quantitative studies (including randomised controlled trials), 9 were qualitative studies and 8 used quantitative designs with qualitative findings. Y-PBMHPS included counselling, psychotherapy, psychoeducation and self-help groups, with peers acting as leaders, facilitators, educators or service providers. Quantitative studies most frequently assessed anxiety and depression, reporting negligible to moderate effects. Qualitative findings indicated good fidelity, adherence and acceptability, alongside some feasibility challenges.</p><p><strong>Conclusions: </strong>Y-PBMHPS can broaden youth mental health support and services in LMICs. Clearer guidelines on peer selection, training and supervision and further research in other LMICs, including cost-effectiveness evaluations, would strengthen the evidence base.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 3","pages":"e126"},"PeriodicalIF":3.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between cognitive complaints and burden of non-cognitive symptoms in multiple sclerosis.","authors":"Stefanie Roberts, Valeriya Kuznetsova, Fiore D'Aprano, Carmen J Zheng, Tomas Kalincik, Charles B Malpas","doi":"10.1192/bjo.2026.11041","DOIUrl":"10.1192/bjo.2026.11041","url":null,"abstract":"<p><strong>Background: </strong>Cognitive complaints are common in multiple sclerosis, but their relationship to non-cognitive symptoms such as fatigue, sleep dysfunction and psychopathology has not been systematically examined in patients referred for specialist cognitive evaluation. These potentially modifiable symptoms may warrant attention in a clinical context.</p><p><strong>Aims: </strong>This study aimed to characterise common patterns of cognitive and non-cognitive symptoms in a referred patient cohort and determine whether cognitive complaints are associated with clinically significant fatigue, sleep dysfunction and psychopathology.</p><p><strong>Method: </strong>Cognitive complaints were captured using (a) a binary classification derived from clinical impression and (b) a severity rating from a self-report instrument. Objective cognitive performance was measured across five cognitive domains. Patients also completed self-report measures of fatigue, sleep dysfunction and psychopathology.</p><p><strong>Results: </strong>Fifty-one patients were included. Although 98% had cognitive complaints, only 29% had objective cognitive impairment. Most (90%) had significant non-cognitive symptoms, primarily fatigue (86%), sleep dysfunction (28%) and depression (26%). Pattern analysis revealed that the most common symptom phenotype was cognitive complaints with significant non-cognitive symptoms, occurring in the absence of objective cognitive impairment. More severe cognitive complaints were associated with greater psychopathology (<i>r</i> = 0.57, <i>BF</i>₁₀ = 2188.48), fatigue (<i>r</i> = 0.53, <i>BF</i>₁₀ = 366.44) and sleep dysfunction (<i>r</i> = 0.47, <i>BF</i>₁₀ = 69.27).</p><p><strong>Conclusions: </strong>Cognitive complaints in multiple sclerosis may reflect broader non-cognitive symptom burden rather than objective cognitive impairment, even among patients referred for specialist evaluation. Their presence should prompt consideration of fatigue, sleep disturbance and psychopathology as potential targets for intervention.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 3","pages":"e127"},"PeriodicalIF":3.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a patient decision aid prototype on the decision to continue, reduce or discontinue antipsychotic medication following remission of first-episode psychosis.","authors":"Laurent Béchard, Olivier Corbeil, Maxime Huot-Lavoie, Olivier Roy, Sébastien Brodeur, Emmanuelle Bouchard, Joanne Martel, Natalie Pavey, Amélie M Achim, Matthew Menear, Marc-André Roy, Sophie Lauzier, Marie-France Demers","doi":"10.1192/bjo.2026.11034","DOIUrl":"10.1192/bjo.2026.11034","url":null,"abstract":"<p><strong>Background: </strong>Shared decision-making is essential to patient-centred care, but remains underutilised in psychiatry, particularly when deciding whether to continue, reduce or stop antipsychotic medication after remission from first-episode psychosis (FEP). Existing decision aids do not fully address recovery goals such as autonomy, identity and social reintegration.</p><p><strong>Aims: </strong>To co-develop a patient decision aid (PDA) prototype that supports individuals in making the decision to continue, reduce or stop antipsychotics following remission from FEP.</p><p><strong>Method: </strong>We used a patient-centred design process informed by International Patient Decision Aid Standards (IPDAS), User Centered Design (UCD-11) and the CHIME framework. A multidisciplinary steering group - including individuals with lived experience, clinicians, and researchers - co-developed the PDA. Iterative feedback was collected from an external advisory group of patient partners, caregivers and healthcare providers (<i>n</i> = 7). Acceptability was evaluated with structured questionnaires.</p><p><strong>Results: </strong>The final prototype, structured into five sections (decision overview, personal values, risks and benefits, planning and real-life experiences), demonstrated strong acceptability across stakeholders. Ratings improved with each iteration, with version 3 receiving near-perfect scores on clarity, usefulness and balance. Users described the tool as relatable and empowering. The inclusion of real-life stories and visual decision exercises were particularly valued. However, some clinicians expressed concerns about time constraints and workflow integration.</p><p><strong>Conclusions: </strong>This recovery-oriented PDA prototype offers a practical, evidence-based resource to facilitate shared decision-making with respect to continuing, reducing or stopping antipsychotics after FEP. Although early feedback is promising, pilot testing is needed to evaluate its impact on decision quality, satisfaction and treatment outcomes.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 3","pages":"e125"},"PeriodicalIF":3.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of early intervention in psychosis in Latin America: economic evaluation of Chilean services.","authors":"David Aceituno, Nicolas A Crossley, Huajie Jin, Carlos Balmaceda, Eduardo A Undurraga, Alfonso Gonzalez-Valderrama, Paul McCrone, Matthew Prina, Mark W Pennington","doi":"10.1192/bjo.2026.11033","DOIUrl":"10.1192/bjo.2026.11033","url":null,"abstract":"<p><strong>Background: </strong>International evidence suggests that Early Intervention for Psychosis (EIP) services are both effective and cost-effective. Such evidence, however, comes almost exclusively from high-income countries.</p><p><strong>Aims: </strong>Our aim was to estimate the cost-effectiveness of EIP services in a Latin American setting.</p><p><strong>Method: </strong>We compared EIP services against community mental health teams (CMHT) from the Chilean health system perspective. We developed a six-state Markov model to estimate the costs, benefits (measured as quality-adjusted life-years (QALYs)) and incremental cost-effectiveness ratio (ICER) for a 10-year time horizon. The model was populated with data from a Chilean EIP cohort, published literature and expert opinion. We characterised uncertainty through probabilistic sensitivity analysis and calculated the value of information to reduce such uncertainty.</p><p><strong>Results: </strong>In the base case analysis, EIP was cost-effective compared with CMHT, with an ICER of 5 550 044 Chilean pesos per QALY (USD 13 742 adjusted for purchasing power parity). Uncertainty analysis revealed an 80% probability of EIP services being the most cost-effective option at a willingness-to-pay threshold of one gross domestic product per capita (USD 15 923). Sensitivity analysis showed that the results were sensitive to parameters such as intervention effectiveness and cost, suggesting that a new trial might be worthwhile to reduce uncertainty.</p><p><strong>Conclusions: </strong>This model suggests that implementing EIP services in Chile may cost more, but it is likely to be cost-effective. Nonetheless, more evidence about affordability, equity and broader perspectives is needed to improve the economic case of implementing EIP services in less-resourced settings, such as in Latin America.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 3","pages":"e124"},"PeriodicalIF":3.5,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NICE guidance, eating disorders and older people.","authors":"Suzanne Heywood-Everett, Louisa J Shirley, Noor Aqsa, Kate Fitzgerald, Ryan Horsfall","doi":"10.1192/bjo.2026.11006","DOIUrl":"10.1192/bjo.2026.11006","url":null,"abstract":"<p><strong>Background: </strong>The treatment of eating disorders by the National Health Service in England and Wales adheres to the National Institute for Health and Care Excellence (NICE) guidelines, which were informed by an experimental evidence base.</p><p><strong>Aims: </strong>As the presentation and treatment of eating disorders have been shown to vary on the basis of age, we aimed to review the representation of older people in the evidence base for the NICE guidelines.</p><p><strong>Method: </strong>The evidence base was reviewed by identification of participant ages and the recruitment methods used in the experimental literature. The use of clinician referral was of particular interest, owing to the age-dependent risk of eating disorders being misdiagnosed in older adults.</p><p><strong>Results: </strong>The results highlighted low participant ages across the evidence base, most notably in anorexia nervosa samples. In accordance with the age data, a high frequency of clinician referral was used to recruit participants, with the highest rate identified in anorexia nervosa samples.</p><p><strong>Conclusions: </strong>NICE guidance fails to consider the economic, social, political and health contexts around onset or chronological development of an eating disorder, with no reference to comorbidities which are commonly reported with older people or how this might affect diagnosis, formulation and treatment recommendations. Research is urgently required to inform clinical recommendations for older adults.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 3","pages":"e123"},"PeriodicalIF":3.5,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147761685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Youth visiting the emergency department after a suicide attempt, suicidal ideation or non-suicidal self-injury: trends, repeat visits and costs.","authors":"Naomi van der Linden, Leona Hakkaart-van Roijen, Kinke Lommerse, Merel van Loon-van Gaalen, Shanna van der Linden, Yvonne Bal, Christien van der Linden","doi":"10.1192/bjo.2026.11031","DOIUrl":"https://doi.org/10.1192/bjo.2026.11031","url":null,"abstract":"<p><strong>Background: </strong>In The Netherlands, it is unknown whether the number of youth suicide-related emergency department visits has changed over time. Also, insight is needed in the hospital costs for managing these patients, as a first step toward the economic evaluation of suicide prevention measures.</p><p><strong>Aims: </strong>This study examines (a) changes in emergency department-recorded suicide attempts, suicidal ideation and non-suicidal self-injury in youth, including repeat emergency department visits; and (b) related hospital costs for these patients, from a health insurer perspective.</p><p><strong>Method: </strong>In this cross-sectional study, data from various sources was combined to identify all youth aged ≤27 years visiting a Dutch inner-city emergency department between 2016 and 2023 for a suicide attempt, suicidal ideation or non-suicidal self-injury. Hospital records were reviewed manually to determine inclusion. Ambiguities were discussed within an expert panel and descriptive analyses, Poisson regression and logistic regression analyses were performed. For a subset of 30 patients, invoiced costs were determined.</p><p><strong>Results: </strong>The number of suicide attempts increased by approximately 5% annually, peaking in 2022 (<i>n</i> = 172); there were significantly more female patients (71%), and the median age was 21 years. Cases of suicidal ideation showed a similar trend, whereas the number of recorded non-suicidal self-injuries reduced. A total of 28.5% of all patients (<i>n</i> = 281) had one or multiple repeat visits for the above reasons. Median suicide attempt-related costs per case were €930, range €385-€33 473.</p><p><strong>Conclusions: </strong>Since 2016, an increasing number of youth visited the emergency department of a Dutch hospital after a suicide attempt, but this increase does not seem to continue after 2022. Hospital-invoiced costs differ substantially between patients.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 3","pages":"e117"},"PeriodicalIF":3.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147761672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric and qualitative assessment of the Client Satisfaction Questionnaire-8 (CSQ-8) among Syrian mental health and psychosocial support service users.","authors":"Michael McGrath, Ahmed El-Vecih, Gülşah Kurt, Salah Addin Lekkeh, Wael Yasaki, Ammar Beetar, Simon Rosenbaum, Ruth Wells","doi":"10.1192/bjo.2026.11013","DOIUrl":"https://doi.org/10.1192/bjo.2026.11013","url":null,"abstract":"<p><strong>Background: </strong>Patient satisfaction is an important indicator of mental healthcare quality. The Client Satisfaction Questionnaire-8 (CSQ-8) is widely used, but its psychometric performance and contextual relevance have not been examined in humanitarian settings.</p><p><strong>Aims: </strong>To assess the reliability and validity of the CSQ-8 in a sample of displaced and conflict-affected Syrian mental health and psychosocial support (MHPSS) service users.</p><p><strong>Method: </strong>Structured telephone interviews were conducted with Syrian MHPSS service users in North-West Syria. Psychometric analysis assessed the internal consistency and construct validity of the CSQ-8. Convergent validity with therapeutic alliance was examined using the Working Alliance Inventory Short Revised. Item comprehension and contextual relevance were examined using open-ended qualitative responses.</p><p><strong>Results: </strong>Among 337 participants, the CSQ-8 demonstrated strong internal consistency (<i>ω</i> = 0.92), but suboptimal model fit (comparative fit index 0.922; Tucker-Lewis index 0.890; root mean square error of approximation 0.132). Convergent validity with therapeutic alliance confirmed the importance of service user-practitioner relationships to satisfaction. Item 4 ('Would you recommend the service?') and item 8 ('Would you return to the service?') showed large ceiling effects and weaker psychometric properties. Qualitative data indicated responses to these items were shaped by community stigma, low expectations and a lack of alternative services, rather than satisfaction. A secondary analysis of the CSQ-4 showed good reliability (<i>ω</i> = 0.81) and improved model fit (comparative fit index 0.993; Tucker-Lewis index 0.980; root mean square error of approximation 0.065).</p><p><strong>Conclusions: </strong>In this humanitarian setting, items about a willingness to recommend and intent to return to a service may lack conceptual validity and should be used cautiously. Shorter forms such as the CSQ-4 may be a useful alternative.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 3","pages":"e121"},"PeriodicalIF":3.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147761725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SMART: preliminary efficacy, feasibility and acceptability of a theory-informed digital intervention for metabolic health in people with schizophrenia and related disorders.","authors":"Urska Arnautovska, Gabrielle Ritchie, Nicole Korman, Anish Menon, Alyssa Milton, Marlien Varnfield, Jaimon Kelly, Pieter Jansen, Andrea Baker, Steve Kisely, Anthony Russell, Dan Siskind, Mike Trott","doi":"10.1192/bjo.2026.11032","DOIUrl":"https://doi.org/10.1192/bjo.2026.11032","url":null,"abstract":"<p><strong>Background: </strong>People with schizophrenia spectrum disorders (SSD) experience high rates of type 2 diabetes (T2D), mainly due to antipsychotic medication side-effects and lifestyle factors (e.g. suboptimal nutrition and physical inactivity). Digital technologies may reduce T2D risk by complementing face-to-face and pharmacological treatments, through the provision of flexible and personalised psychoeducation and behavioural prompts tailored to end-users.</p><p><strong>Aims: </strong>This study tested the preliminary efficacy of the Schizophrenia and diabetes Mobile-Assisted Remote Trainer (SMART), a co-designed text message-facilitated intervention, designed to reduce the risk and/or improve self-management of T2D, along with its acceptability and feasibility.</p><p><strong>Method: </strong>Using an uncontrolled pre-post design, 29 out-patients of an endocrinology mental health clinic and two community-based rehabilitation mental health facilities used SMART for 12 weeks. The primary outcome was patient activation, measured using the Patient Activation Measure. Secondary outcomes were combined objective cardiometabolic and self-reported health and mental health indicators. Pre-post changes were analysed with a linear mixed model, accounting for within-participant variation.</p><p><strong>Results: </strong>Significant improvements (<i>p</i> < 0.05) were detected in patient activation, confidence in diabetes self-management and general health management, health literacy and mental health recovery. High levels of acceptability and feasibility were confirmed, with recruitment, retention and adherence rates of 67.4, 92.9 and 93.0%, respectively.</p><p><strong>Conclusions: </strong>SMART is a world-first digital intervention aimed at improving metabolic health in individuals with SSD. This study provides evidence of its preliminary efficacy in self-management of metabolic health while confirming its high acceptability and feasibility, supporting expansion towards a sufficiently powered controlled trial to assess its clinical effectiveness.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 3","pages":"e122"},"PeriodicalIF":3.5,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147761715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-traumatic stress symptom trajectories following exposure to population-level trauma: findings from the COVID-19 Healthcare Staff Wellbeing Survey.","authors":"Kevin F W Dyer, Niamh Hurst, Ciaran Shannon, Julie-Ann Jordan","doi":"10.1192/bjo.2026.11027","DOIUrl":"https://doi.org/10.1192/bjo.2026.11027","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has been described as a prolonged societal trauma providing new understanding of long-term post-traumatic stress reactions, both generally and in specific at-risk populations.</p><p><strong>Aims: </strong>The present study examined the longitudinal course of post-traumatic stress disorder (PTSD) symptoms within one of the most high-profile risk groups (i.e. healthcare staff).</p><p><strong>Method: </strong>The sample comprised 439 healthcare staff who completed the Northern Ireland longitudinal COVID-19 Staff Wellbeing Survey on a minimum of 3 out of 4 distribution time points. The survey was administered repeatedly over 4 years, spanning both peri- and post-pandemic periods (2020-2023), and contained the Impact of Event Scale-Revised, as well as bespoke items on COVID-19, demographics, occupational issues and support factors.</p><p><strong>Results: </strong>Three distinct classes emerged from a three-class, latent class growth analysis model. A 'resilient' group (74%) displayed symptoms that remained below cut-offs for clinically significant moderate-severe post-traumatic stress throughout the pandemic, whereas a 'recovering' group (23%) exhibited moderate-severe symptoms during the pandemic, which then decreased to subthreshold levels post-pandemic. A key at-risk group was the 'chronic' class (4%), which had moderate-severe post-traumatic stress symptoms peri-pandemic that continued to increase post-pandemic. Significant predictors of the 'recovering' and 'chronic' classes included perception of poor communication within the healthcare organisation; increased exposure to COVID-19 outside their work; and increased personal health risk factors for COVID-19.</p><p><strong>Conclusions: </strong>Post-pandemic PTSD monitoring and support for healthcare staff may be warranted alongside the development of internal communication strategies within healthcare systems to protect staff and services going forward.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 3","pages":"e120"},"PeriodicalIF":3.5,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147761740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and determinants of diabetes-related psychological distress in a tertiary care setting in Tamil Nadu, India: cross-sectional study.","authors":"Gowri Aravind, Lawrence Soosai Nathan, Senthil R Kumar, Aravindakumar Subramanium, Karthikeyan Aravindakumar Gowri, Dhasaratharaman Thirunavukkarasu, Samuel J Tromans, Rohit Shankar","doi":"10.1192/bjo.2026.11020","DOIUrl":"https://doi.org/10.1192/bjo.2026.11020","url":null,"abstract":"<p><strong>Background: </strong>Diabetes distress, whereby people with diabetes experience distressing psychological symptoms associated with living with their condition, is an emerging problem in India. Diabetes distress leads to self-care deficits, suboptimal glycaemic control (which can lead to increasing risks of complications) and impaired quality of life.</p><p><strong>Aims: </strong>To determine the burden of diabetes distress and its associated factors in an Indian tertiary care centre in Trichy, Tamil Nadu, India, covering a population of 1.25 million.</p><p><strong>Method: </strong>This prospective observational study involved a structured questionnaire covering demographic and clinical details, which was given to patients. The Diabetes Distress Scale 17 (DDS-17) was used to assess diabetes distress levels. The DDS-17 also measures four subdomains: emotional burden, physician-related distress, regimen-related distress and diabetes-related interpersonal distress. Patients were divided into two groups based on their DDS-17 score: no diabetes distress (DDS-17 score <2) versus diabetes distress (DDS-17 score ≥2) and compared. Correlation analysis, chi-squared tests and <i>t</i>-tests were used, with <i>P</i> < 0.05 considered statistically significant.</p><p><strong>Results: </strong>Of 1019 respondents (mean age 56 years; 59.6% male, 40.4% female), diabetes distress was reported in 24.4% (<i>n</i> = 249). Factors significantly associated with higher DDS-17 scores were younger age (<45 years) (<i>P <</i> 0.0001), long-standing diabetes (>10 years) (<i>P <</i> 0.0001), and smoking and alcohol (<i>P <</i> 0.05). Significant protective factors for diabetes distress included working, daily exercise, no comorbidities and medical insurance cover (<i>P <</i> 0.05). Significant positive correlation between DDS-17 score and all four subdomains was observed (<i>P <</i> 0.0001).</p><p><strong>Conclusions: </strong>Our findings highlight the need for routine psychological screening and holistic management strategies in diabetes care, to improve patient outcomes and quality of life.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 3","pages":"e119"},"PeriodicalIF":3.5,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147761707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}