BJPsych Open最新文献

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Psychiatrists and non-psychiatrists' attitudes to psychotropic optimisation for people with intellectual disabilities and/or autism: cross-sectional comparison study. 精神科医生和非精神科医生对智力残疾和/或自闭症患者的精神药物优化的态度:横断面比较研究。
IF 3.5 3区 医学
BJPsych Open Pub Date : 2025-10-23 DOI: 10.1192/bjo.2025.10875
Samuel J Tromans, Shoumitro Deb, Hassan Mahmood, Paraskevi Triantafyllopoulou, Tony Jamieson, Gill Gookey, Paul Bassett, Zayed Malak, Indermeet Sawhney, Laura Korb, Danielle Adams, Rory Sheehan, Rohit Shankar
{"title":"Psychiatrists and non-psychiatrists' attitudes to psychotropic optimisation for people with intellectual disabilities and/or autism: cross-sectional comparison study.","authors":"Samuel J Tromans, Shoumitro Deb, Hassan Mahmood, Paraskevi Triantafyllopoulou, Tony Jamieson, Gill Gookey, Paul Bassett, Zayed Malak, Indermeet Sawhney, Laura Korb, Danielle Adams, Rory Sheehan, Rohit Shankar","doi":"10.1192/bjo.2025.10875","DOIUrl":"https://doi.org/10.1192/bjo.2025.10875","url":null,"abstract":"<p><strong>Background: </strong>Off-licence psychotropic use in people with intellectual disability and/or autism, in the absence of psychiatric illness, is a major public health concern in England.</p><p><strong>Aims: </strong>To ascertain and compare views of psychiatrists and non-psychiatrists working with people with intellectual disability and/or autism on psychotropic medication optimisation for this population.</p><p><strong>Method: </strong>A cross-sectional survey of 13 questions was disseminated online among psychiatrists and other health professionals working with people with intellectual disability and/or autism across England, using a non-discriminatory exponential snowballing technique leading to non-probability sampling. The questionnaire covered demographic characteristics, perceived barriers/benefits of psychotropic optimisation (including ethnicity) and views on implementation of a national medicine optimisation programme. Quantitative analysis used chi-squared, Mann-Whitney and unpaired <i>t</i>-tests, with significance taken as <i>P</i> < 0.05. Thematic analysis of free-text responses was undertaken with Braun and Clarke's methodology.</p><p><strong>Results: </strong>Of 219 respondents, significant differences in attitudes to most issues emerged between psychiatrists (<i>n</i> = 66) and non-psychiatrists (<i>n</i> = 149). Psychiatrists had less optimism of a successful national medication optimisation programme if commissioned, or achieving 50% reduction in psychotropic overprescribing and inappropriate psychotropic prescribing generally. Perceived barriers to reducing overmedication differed significantly between the psychiatrists and non-psychiatrists, Thematic analysis identified five themes (system issues, resources, medication challenges, family and carers, and training and alternatives/structure).</p><p><strong>Conclusions: </strong>This is the first study to highlight important differences between psychiatrists and non-psychiatrists' attitudes to psychotropic optimisation despite respondents overall being broadly supportive of its need. A major finding is the hitherto unquantified concerns of patient ethnicity and its impact on psychotropic optimisation principles.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 6","pages":"e249"},"PeriodicalIF":3.5,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Outcomes in end-stage renal disease dialysis patients with depression. 终末期肾病透析伴抑郁患者的预后
IF 3.5 3区 医学
BJPsych Open Pub Date : 2025-10-23 DOI: 10.1192/bjo.2025.10872
I-Ning Yang, Chin-Li Lu, Jhi-Joung Wang, Ming-Chuan Hung, Chih-Chiang Chien
{"title":"Outcomes in end-stage renal disease dialysis patients with depression.","authors":"I-Ning Yang, Chin-Li Lu, Jhi-Joung Wang, Ming-Chuan Hung, Chih-Chiang Chien","doi":"10.1192/bjo.2025.10872","DOIUrl":"https://doi.org/10.1192/bjo.2025.10872","url":null,"abstract":"<p><strong>Background: </strong>Depression is the most common psychiatric disorder among patients with end-stage renal disease (ESRD), yet the risk factors for mortality in this population remain unclear.</p><p><strong>Aims: </strong>To identify risk factors for mortality in ESRD patients with depression and assess the incidence of suicide attempts.</p><p><strong>Method: </strong>We used Taiwan's National Health Insurance Research Database to identify adult patients who initiated maintenance dialysis between 1997 and 2012. Two ESRD cohorts were established at a depression-to-non-depression ratio of 1:8, matched by age and gender (<i>n</i> = 3289 with depression; <i>n</i> = 26 312 without depression). Outcomes included all-cause mortality and suicide attempts, with additional subgroup analyses by baseline depression severity.</p><p><strong>Results: </strong>ESRD patients with depression had a higher mortality risk (hazard ratio 1.15, 95% CI: 1.10-1.21) than those without. Risk factors for mortality included male gender, older age, diabetes and cardiovascular disease. Patients with depression also had a higher risk of suicide attempts (hazard ratio 3.02, 95% CI: 1.68-5.42). ESRD patients with severe depression had a significantly higher rate of hospital admissions for depression compared to those with non-severe depression (incidence rate ratio (IRR): 1.82, 95% CI: 1.14-2.93). Furthermore, patients with severe depression were associated with a significantly higher mortality rate compared to those without depression (IRR: 1.42, 95% CI: 1.15-1.76).</p><p><strong>Conclusions: </strong>Depression is linked to poor survival in ESRD patients, with underlying comorbidities playing a key role in mortality. Given the increased risk of mortality, suicide attempts and hospital admissions, these high-risk patients require enhanced medical attention, particularly those with severe depression.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 6","pages":"e250"},"PeriodicalIF":3.5,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The clinical and psychosocial journey of young people engaging with early intervention psychosis services: qualitative study. 年轻人参与早期干预精神病服务的临床和心理社会之旅:定性研究。
IF 3.5 3区 医学
BJPsych Open Pub Date : 2025-10-23 DOI: 10.1192/bjo.2025.10848
Patrick Caldwell, Nicholas Glozier, Tacita Powell, Katrina Conn, Rochelle Einboden, Niels Buus, Ellie Brown, Isabella Choi, Alyssa Milton
{"title":"The clinical and psychosocial journey of young people engaging with early intervention psychosis services: qualitative study.","authors":"Patrick Caldwell, Nicholas Glozier, Tacita Powell, Katrina Conn, Rochelle Einboden, Niels Buus, Ellie Brown, Isabella Choi, Alyssa Milton","doi":"10.1192/bjo.2025.10848","DOIUrl":"https://doi.org/10.1192/bjo.2025.10848","url":null,"abstract":"<p><strong>Background: </strong>Early Intervention Psychosis Services (EIPS) provide multimodal interventions for young people who are at risk of, or have experienced, a first episode of psychosis. Although recent studies have begun to examine this critical period in a young person's personal recovery in more depth, little is known about how young people experience EIPS in general, and its influences on their clinical and psychosocial recovery in particular.</p><p><strong>Aims: </strong>This study aimed to explore young people's experience of EIPS, specifically the factors that have affected their (a) clinical and (b) psychosocial recovery.</p><p><strong>Method: </strong>This study purposively sampled 27 young people from a range of backgrounds at 6 community-based EIPS in Australia. Audio-recorded, semi-structured interviews were conducted and reflexive thematic analysis was used to analyse this data-set.</p><p><strong>Results: </strong>Four themes of how EIPS enabled recovery were identified. The first three - a safe space, unconditional support and active involvement - were foundational to a fourth theme of gradual self-management. In earlier-stage self-management, participants relied on practical supports to make connections and find education and employment opportunities. By later-stage self-management, they had developed the tools to do these things for themselves. Participants' movement between earlier- and later-stage self-management was connected to their overall EIPS engagement and, for some, to their engagement with peer support.</p><p><strong>Conclusions: </strong>Providing a safe space, unconditional support and active involvement for clients and their families created the foundational conditions for improved clinical and psychosocial recovery. Peer support programmes, increasing engagement when situational changes such as employment occur and the provision of culturally sensitive care appeared valuable to this process.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 6","pages":"e252"},"PeriodicalIF":3.5,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Changes in mental health stigma and well-being: knowledge, attitudes and behavioural intentions among Hong Kong residents between 2021 and 2023. 心理健康污名与幸福感的变化:2021至2023年香港居民的知识、态度及行为意向
IF 3.5 3区 医学
BJPsych Open Pub Date : 2025-10-23 DOI: 10.1192/bjo.2025.10865
Stephanie Ng, Odile Thiang, Young Suk Oh
{"title":"Changes in mental health stigma and well-being: knowledge, attitudes and behavioural intentions among Hong Kong residents between 2021 and 2023.","authors":"Stephanie Ng, Odile Thiang, Young Suk Oh","doi":"10.1192/bjo.2025.10865","DOIUrl":"https://doi.org/10.1192/bjo.2025.10865","url":null,"abstract":"<p><strong>Background: </strong>Previous research has demonstrated that the COVID-19 pandemic led to a global increase in mental distress. However, few studies have examined the impact of the pandemic on mental health stigma.</p><p><strong>Aims: </strong>To investigate changes in measures of mental health stigma, including knowledge, attitudes and behavioural intentions, in 2021 and 2023 in Hong Kong; to examine the mediating role of attitudes on the relationship between knowledge and behavioural intentions; and to explore how disclosure of mental illness contributes to enhanced overall well-being.</p><p><strong>Method: </strong>Data were collected as part of a larger research project focusing on mental well-being in Hong Kong. A total of 1010 and 1014 participants were surveyed in 2021 and 2023, respectively. The participants were Hong Kong residents aged 18 years and above.</p><p><strong>Results: </strong>Our findings demonstrate that all measures of mental health stigma showed increases in severity between 2021 and 2023. In addition, our mediation analyses observed both full and partial mediation effects of attitudes on the relationship between knowledge and behavioural intentions. The results also showed that mental illness disclosure was associated with higher well-being; however, despite these benefits, there was a decrease in willingness to disclose in 2023 compared with 2021.</p><p><strong>Conclusions: </strong>This study highlights the ongoing issue of mental health stigma in Hong Kong. Future mental health programmes and interventions should aim to address various facets of mental health knowledge, including symptom recognition, access to support resources and the deleterious consequences of mental health stigma.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 6","pages":"e248"},"PeriodicalIF":3.5,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Excess mortality in people with schizophrenia: 8-year population-based study in southern China. 精神分裂症患者的高死亡率:中国南方8年基于人群的研究
IF 3.5 3区 医学
BJPsych Open Pub Date : 2025-10-23 DOI: 10.1192/bjo.2025.10866
Shaoling Zhong, Zihua Pan, Jinghua Su, Xiaoling Duan, Yanan Chen, Liang Zhou
{"title":"Excess mortality in people with schizophrenia: 8-year population-based study in southern China.","authors":"Shaoling Zhong, Zihua Pan, Jinghua Su, Xiaoling Duan, Yanan Chen, Liang Zhou","doi":"10.1192/bjo.2025.10866","DOIUrl":"https://doi.org/10.1192/bjo.2025.10866","url":null,"abstract":"<p><strong>Background: </strong>Schizophrenia is associated with premature mortality, but most evidence comes from high-income regions.</p><p><strong>Aims: </strong>This study aimed to estimate the excess mortality associated with schizophrenia in southern China.</p><p><strong>Method: </strong>We linked register data from a nationwide information system for psychosis to death registers. Individuals diagnosed with schizophrenia and residing in Guangzhou between 2014 and 2021 were included. Standardised mortality ratios (SMRs) were calculated to compare the mortality of people with schizophrenia with that of the general population. Life expectancy, potential years of life lost (PYLL) and years of life lost (YLL) were estimated for all-cause mortality and specific causes of death. Gender difference in these metrics was examined.</p><p><strong>Results: </strong>There were 3684 deaths (11.3%) during the study period. The leading causes of death were circulatory, neoplastic and respiratory diseases. The mortality rate among people with schizophrenia was twofold greater than in the general population, with a greater risk associated with unnatural causes than natural causes. The risk of mortality due to suicide was 15-fold higher than that of the general population. The life expectancy in schizophrenia was around 60 years, which is 21 years shorter than that for the general population. Schizophrenia was associated with substantial premature mortality burden, showing greater impact in men than women.</p><p><strong>Conclusions: </strong>Schizophrenia is associated with increased premature mortality, reduced life expectancy and substantial PYLL. The enduring disparity in mortality underscores an imminent call for targeted interventions aimed at suicide prevention and enhancement of the physical well-being of people with schizophrenia.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 6","pages":"e251"},"PeriodicalIF":3.5,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Feasibility and acceptability of remote technologies for the treatment of trauma- and stressor-related disorders in adults: mixed-methods systematic review. 成人创伤和应激相关疾病远程治疗技术的可行性和可接受性:混合方法系统评价
IF 3.5 3区 医学
BJPsych Open Pub Date : 2025-10-22 DOI: 10.1192/bjo.2025.10832
Marjolaine Rivest-Beauregard, Justine Fortin, Élyse Gauthier, Michelle Lonergan, Alain Brunet, Manuela Ferrari
{"title":"Feasibility and acceptability of remote technologies for the treatment of trauma- and stressor-related disorders in adults: mixed-methods systematic review.","authors":"Marjolaine Rivest-Beauregard, Justine Fortin, Élyse Gauthier, Michelle Lonergan, Alain Brunet, Manuela Ferrari","doi":"10.1192/bjo.2025.10832","DOIUrl":"https://doi.org/10.1192/bjo.2025.10832","url":null,"abstract":"<p><strong>Background: </strong>Trauma- and stressor-related disorders (TSRD) are debilitating mental health conditions. Given the barriers to traditional services, remote and online technologies are increasingly used in treating TSRD.</p><p><strong>Aims: </strong>This mixed-methods systematic review aimed to identify remote technologies and assessed their feasibility and acceptability in treating adults with post-traumatic stress disorder (PTSD), acute stress disorder and adjustment disorder (AjD).</p><p><strong>Method: </strong>The databases MEDLINE, CINAHL, Embase, PsycInfo, PubMed and the Cochrane Library were screened to identify studies investigating the feasibility and acceptability of remote interventions for PTSD, acute stress disorder and AjD in adults. Studies that obtained poor-quality ratings on critical appraisal tools were excluded. Results were synthesised using a narrative review approach.</p><p><strong>Results: </strong>In total, there were 74 studies evaluating 27 remote interventions for TSRD: online interventions (<i>k</i> = 47, 63.51%), mobile applications (<i>k</i> = 17, 22.97%), video conferencing (<i>k</i> = 9, 12.16%) and message-based systems <i>(k</i> = 1, 1.35%). Findings from the review showed higher feasibility and acceptability for interventions with an interactive clinician-patient component. Among self-directed interventions, only two applications and eight online interventions provided a clinician component. Most studies targeted PTSD, with few targeting other diagnoses.</p><p><strong>Conclusions: </strong>Recommendations related to remote interventions for TSRDs should be broadened to include AjD and other underrepresented diagnoses, and tailored to individual patients' profiles, including their ability to sustain engagement and clinical needs, using a stepped-care approach.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 6","pages":"e247"},"PeriodicalIF":3.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Beyond vision: economic toll of untreated mental health disorders in ophthalmic patients. 超越视力:眼科患者未经治疗的精神健康障碍的经济代价。
IF 3.5 3区 医学
BJPsych Open Pub Date : 2025-10-17 DOI: 10.1192/bjo.2025.10870
Cansu Yüksel Elgin, Ceyhun Elgin
{"title":"Beyond vision: economic toll of untreated mental health disorders in ophthalmic patients.","authors":"Cansu Yüksel Elgin, Ceyhun Elgin","doi":"10.1192/bjo.2025.10870","DOIUrl":"https://doi.org/10.1192/bjo.2025.10870","url":null,"abstract":"<p><strong>Background: </strong>Mental health disorders such as depression and anxiety are highly prevalent among ophthalmic patients, particularly those with progressive vision impairment. Despite the strong interconnection between mental health and vision-related disabilities, mental health support remains underintegrated into ophthalmic care. The economic burden of untreated mental health conditions in visually impaired patients is understudied, particularly in middle-income countries such as Turkey and Bulgaria.</p><p><strong>Aims: </strong>This study aims to examine the economic impact of untreated mental health disorders among ophthalmic patients, focusing on financial burden, healthcare access disparities and quality of life outcomes. In addition, the study compares barriers to mental healthcare across ophthalmic conditions and between Turkey and Bulgaria.</p><p><strong>Method: </strong>A qualitative study was conducted using structured surveys and in-depth interviews with 214 ophthalmic patients (107 in Turkey, 107 in Bulgaria). Mental health symptoms were assessed using the Patient Health Questionnaire-9 (for depression) and Generalized Anxiety Disorder-7 (for anxiety) scales. Thematic analysis was applied to qualitative responses.</p><p><strong>Results: </strong>Over 50% of participants exhibited moderate-to-severe depression and anxiety, with diabetic retinopathy and retinal disease patients experiencing the highest distress levels. Financial barriers were more pronounced in Bulgaria, whereas long psychiatric wait times disproportionately affected retinal patients. Mental health stigma was higher in Bulgaria, limiting care access.</p><p><strong>Conclusions: </strong>Findings underscore the urgent need for integrating mental health services into ophthalmic care. Policy interventions should focus on financial support, stigma reduction and improved interdisciplinary care models to enhance mental health outcomes for visually impaired individuals.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 6","pages":"e246"},"PeriodicalIF":3.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145306870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Benzodiazepine use in physicians: retrospective 5-year nationwide study in Taiwan. 医师使用苯二氮卓类药物:台湾5年全国性回顾性研究。
IF 3.5 3区 医学
BJPsych Open Pub Date : 2025-10-17 DOI: 10.1192/bjo.2025.10869
Wan-Ju Cheng, Yin-Chieh Chuang, Hsuan-Ching Wang, Hei-Tung Yip, Cheng-Li Lin, Cynthia Wei-Sheng Lee
{"title":"Benzodiazepine use in physicians: retrospective 5-year nationwide study in Taiwan.","authors":"Wan-Ju Cheng, Yin-Chieh Chuang, Hsuan-Ching Wang, Hei-Tung Yip, Cheng-Li Lin, Cynthia Wei-Sheng Lee","doi":"10.1192/bjo.2025.10869","DOIUrl":"https://doi.org/10.1192/bjo.2025.10869","url":null,"abstract":"<p><strong>Background: </strong>Benzodiazepine use among physicians is an important public health issue related to physicians' well-being and patient safety.</p><p><strong>Aims: </strong>This study aimed to evaluate the patterns and correlates of benzodiazepine use in physicians by comparing the characteristics of heavy users with those of low-dose users.</p><p><strong>Method: </strong>We identified 4844 physicians with a history of benzodiazepine use as the benzodiazepine cohort from 32 080 physicians from the population-based Taiwan National Health Insurance Research Database from 2014 to 2020. Benzodiazepine users were divided into low-dose, intermediate and heavy users based on their yearly equivalent dosage of <20, 20-150 and >150 defined daily dose (DDD) per year, respectively. Differences in demographic characteristics and specialities between the benzodiazepine and control cohorts were compared via univariate and multivariate logistic regression models. A generalised estimating equation was used to investigate the relationship between benzodiazepine use and comorbidities.</p><p><strong>Results: </strong>Among all of the physicians, 15.1% used benzodiazepine. Male physicians were more likely to use benzodiazepines and become heavy users. Older age, sleep disorders and depression were significantly associated with heavy benzodiazepine use. Regarding physician specialities, the highest prevalence of benzodiazepine use was observed in otorhinolaryngology (19.8%), followed by family medicine (19.1%). Odds of benzodiazepine use were 2.20 and 2.90 times greater in physicians with sleep disorders and depression, respectively.</p><p><strong>Conclusions: </strong>Comorbidities of depression and sleep disorders are associated with increased probability of benzodiazepine use. Providing stress-coping strategies and appropriate treatment for mental disorders is recommended to support the overall well-being of physicians.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 6","pages":"e245"},"PeriodicalIF":3.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145306856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
(Es)ketamine as a treatment for depressive episodes with psychotic features: systematic review. 氯胺酮治疗伴有精神病性特征的抑郁发作:系统综述。
IF 3.5 3区 医学
BJPsych Open Pub Date : 2025-10-14 DOI: 10.1192/bjo.2025.10830
Henrique Castro Santos, Alexandra Rodrigues, Tiago Machado, Manuel Gonçalves-Pinho, Allan H Young, Mario F Juruena
{"title":"(Es)ketamine as a treatment for depressive episodes with psychotic features: systematic review.","authors":"Henrique Castro Santos, Alexandra Rodrigues, Tiago Machado, Manuel Gonçalves-Pinho, Allan H Young, Mario F Juruena","doi":"10.1192/bjo.2025.10830","DOIUrl":"10.1192/bjo.2025.10830","url":null,"abstract":"<p><strong>Background: </strong>Psychotic symptoms in depression are linked to worse outcomes, and treatment options are limited. Ketamine and esketamine are effective antidepressants, yet most studies have excluded patients with a history of psychotic symptoms.</p><p><strong>Aims: </strong>To evaluate by systematic review the efficacy and safety of ketamine and esketamine in treating patients with unipolar or bipolar depressive episodes with psychotic features.</p><p><strong>Method: </strong>A comprehensive search of the PubMed, Ovid and Web of Science databases was conducted up to 2 November 2023. We included any study that reported the use of ketamine or esketamine in patients with depressive episodes with psychotic symptoms. The primary outcomes assessed were variations in depressive and psychotic symptoms and the incidence of adverse events. The protocol was preregistered in PROSPERO (CRD42023488524).</p><p><strong>Results: </strong>Ten studies were included, encompassing 60 patients with unipolar depression with psychotic symptoms and 19 patients with bipolar depression with psychotic symptoms. Treatment with (es)ketamine showed mean score changes on the Montgomery-Åsberg Depression Rating Scale ranging from -13.7 to -18.2 points in open-label studies of patients with unipolar depression with psychotic symptoms. Up to 50% of participants achieved remission. The largest study with patients with bipolar depression with psychotic symptoms reported a mean Montgomery-Åsberg Depression Rating Scale score change of -14.9 points. Adverse events were mostly mild and transient. There were no reports of switches to (hypo)mania or deterioration of psychotic symptoms, and in six studies there was substantial improvement of the latter.</p><p><strong>Conclusions: </strong>The available evidence suggests that (es)ketamine shows antidepressant effects in patients with depressive episodes with psychotic features and has a reasonable safety profile. However, the heterogeneity of the studies included in this review and the high risk of bias warrant caution in interpreting the findings and underscore the need for further trials to confirm these preliminary results.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 6","pages":"e240"},"PeriodicalIF":3.5,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12529312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285522","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}
引用次数: 0
Prevalence and factors associated with postpartum depressive symptoms among mothers who gave birth within the past 12 months in Ghana: mixed-method study. 加纳过去12个月内分娩的母亲产后抑郁症状的患病率及相关因素:混合方法研究
IF 3.5 3区 医学
BJPsych Open Pub Date : 2025-10-14 DOI: 10.1192/bjo.2025.10857
Leticia Tornyevah, Samuel Bosomprah, Anjali Sharma, Ank De Jonge, Jens Henrichs
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