BJPsych Open最新文献

{"title":"The effect of the quality of the national health security systems in 12 countries on the prevalence of suicide crisis syndrome during the COVID-19 pandemic.","authors":"Ferdinand Bortenschlager, Maximilian Lutz, Judith Streb, Claudia I Astudillo-García, Shira Barzilay, Ksenia Chistopolskaya, Elif Çinka, Sergey N Enikolopov, Muhammad Ishrat Husain, Oskar Kuśmirek, Vikas Menon, Jefté Peper-Nascimento, Megan L Rogers, Samira S Valvassori, Fatma Kantaş Yilmaz, Sungeun You, Manuela Dudeck, Igor Galynker","doi":"10.1192/bjo.2025.58","DOIUrl":"https://doi.org/10.1192/bjo.2025.58","url":null,"abstract":"<p><strong>Background: </strong>Limited access to health services and overwhelmed healthcare systems created a challenging environment for those in need of mental health support during the COVID-19 pandemic, and the pandemic impacted suicide risk in several ways.</p><p><strong>Aims: </strong>The present study aimed to analyse how the quality of the health security systems in 12 countries affected suicide crisis syndrome (SCS) during the pandemic. We hypothesised that countries with robust health systems were better able to respond to the increased demand for (mental) health support, resulting in fewer cases of SCS.</p><p><strong>Method: </strong>From June 2020 to September 2021, 11 848 participants from 12 different countries took part in an online survey. Besides asking about sociodemographic information, the survey assessed the severity of SCS with the Suicide Crisis Inventory (SCI). The Global Health Security Index and the Legatum Prosperity Health Index were used to operationalise the quality of the national health systems. Multilevel analyses were performed to evaluate the impact of health system quality and COVID-19-associated factors on SCI scores.</p><p><strong>Results: </strong>SCS was more prevalent among participants with COVID-19 symptoms and in countries with high rates of COVID-19-associated deaths. Multilevel analyses revealed a significant interaction effect of COVID-19 symptoms and national health indices. SCS occurred significantly less frequently in participants with COVID-19 symptoms living in countries with good health security systems.</p><p><strong>Conclusions: </strong>The challenges posed by the pandemic highlight the necessity to promote accessible and affordable health services to mitigate the negative impact of the pandemic on suicidal ideation and behaviour.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 3","pages":"e99"},"PeriodicalIF":3.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969684","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}

{"title":"A longitudinal study of changes in depressive symptoms and risk factors for congestive heart failure.","authors":"Julia Gallucci, Justin Ng, Maria T Secara, Brett D M Jones, Colin Hawco, M Omair Husain, Nusrat Husain, Imran B Chaudhry, Aristotle N Voineskos, M Ishrat Husain","doi":"10.1192/bjo.2025.41","DOIUrl":"https://doi.org/10.1192/bjo.2025.41","url":null,"abstract":"<p><strong>Background: </strong>Depression is prevalent among patients with congestive heart failure (CHF) and is associated with increased mortality and healthcare use. However, most research on this association has focused on high-income countries, leaving a gap in knowledge regarding the relationship between depression and CHF in low-to-middle-income countries.</p><p><strong>Aims: </strong>To identify changes in depressive symptoms and potential risk factors for poor outcomes among CHF patients.</p><p><strong>Methods: </strong>Longitudinal data from 783 patients with CHF from public hospitals in Karachi, Pakistan, were analysed. Depressive symptom severity was assessed using the Beck Depression Inventory. Baseline and 6-month follow-up Beck Depression Inventory scores were clustered using Gaussian mixture modelling to identify separate depressive symptom subgroups and extract trajectory labels. Further, a random forest algorithm was used to determine baseline demographic, clinical and behavioural predictors for each trajectory.</p><p><strong>Results: </strong>Four separate patterns of depressive symptom changes were identified: 'good prognosis', 'remitting course', 'clinical worsening' and 'persistent course'. Key factors related to these classifications included behavioural and functional factors such as quality of life and disability, as well as the clinical severity of CHF. Specifically, poorer quality of life and New York Heart Association (NYHA) class 3 symptoms were linked to persistent depressive symptoms, whereas patients with less disability and without NYHA class 3 symptoms were more likely to exhibit a good prognosis.</p><p><strong>Conclusions: </strong>By examining the progression of depressive symptoms, clinicians can better understand the factors influencing symptom development in patients with CHF and identify those who may require closer monitoring and appropriate follow-up care.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 3","pages":"e93"},"PeriodicalIF":3.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975333","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}

{"title":"Contributions of common and rare genetic variation to different measures of mood and anxiety disorder in the UK Biobank.","authors":"Ioanna K Katzourou, Inês Barroso, Lauren Benger, Andrés Ingason, Daniel Stow, Ruby Tsang, Megan Wood, George Kirov, James Walters, Michael J Owen, Peter Holmans, Marianne B M van den Bree","doi":"10.1192/bjo.2025.43","DOIUrl":"https://doi.org/10.1192/bjo.2025.43","url":null,"abstract":"<p><strong>Background: </strong>Mood and anxiety disorders co-occur and share symptoms, treatments and genetic risk, but it is unclear whether combining them into a single phenotype would better capture genetic variation. The contribution of common genetic variation to these disorders has been investigated using a range of measures; however, the differences in their ability to capture variation remain unclear, while the impact of rare variation is mostly unexplored.</p><p><strong>Aims: </strong>We aimed to explore the contributions of common genetic variation and copy number variations associated with risk of psychiatric morbidity (P-CNVs) to different measures of internalising disorders.</p><p><strong>Method: </strong>We investigated eight definitions of mood and anxiety disorder, and a combined internalising disorder, derived from self-report questionnaires, diagnostic assessments and electronic healthcare records (EHRs). Association of these definitions with polygenic risk scores (PRSs) of major depressive disorder and anxiety disorder, as well as presence of a P-CNV, was assessed.</p><p><strong>Results: </strong>The effect sizes of both PRSs and P-CNVs were similar for mood and anxiety disorder. Compared to mood and anxiety disorder, internalising disorder resulted in higher prediction accuracy for PRSs, and increased significance of associations with P-CNVs for most definitions. Comparison across the eight definitions showed that PRSs had higher prediction accuracy and effect sizes for stricter definitions, whereas P-CNVs were more strongly associated with EHR- and self-report-based definitions.</p><p><strong>Conclusions: </strong>Future studies may benefit from using a combined internalising disorder phenotype, and may need to consider that different phenotype definitions may be more informative depending on whether common or rare variation is studied.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 3","pages":"e97"},"PeriodicalIF":3.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960226","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}

{"title":"Future directions for brain health clinics.","authors":"Jerry H K Tan, Ivan Koychev","doi":"10.1192/bjo.2025.62","DOIUrl":"https://doi.org/10.1192/bjo.2025.62","url":null,"abstract":"<p><p>Brain Health Services are second-generation memory clinics that aim to reduce the risk of progression to dementia in at-risk individuals. We describe the rationale for such a service, and comment on its novel implementation by Venkataraman and colleagues that integrates digital technologies and biomarker testing. We describe the advantages and possible limitations of such an approach, then investigate areas for further work - namely, the need to account for multiple pathologies in biomarker testing and to formulate standards for genetic counselling.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 3","pages":"e98"},"PeriodicalIF":3.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953668","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}

{"title":"Individual-level brain phenotypes in first-episode mania: normative modelling of brain morphometry and brainAGE.","authors":"Kevin Yu, Ruiyang Ge, Yuetong Yu, Shalaila Haas, Nicole Sanford, Lakshmi N Yatham, Sophia Frangou, Trisha Chakrabarty","doi":"10.1192/bjo.2025.28","DOIUrl":"https://doi.org/10.1192/bjo.2025.28","url":null,"abstract":"<p><strong>Background: </strong>Brain morphological alterations in bipolar disorder are well documented, particularly in chronic cases. This study focuses on first-episode mania (FEM) to quantify neuroanatomical changes at early stages of the disorder.</p><p><strong>Aims: </strong>To assess deviations from normative brain morphometry and age-related brain changes in patients with FEM.</p><p><strong>Method: </strong>Pretrained models, based on large, independent healthy samples, were applied to structural brain images from FEM patients (<i>n</i> = 83) and healthy individuals (<i>n</i> = 61). Normative deviation <i>z</i>-scores were computed for regional brain morphometry, along with global and voxel-level brain-age-gap estimates (G-brainAGE and L-brainAGE, respectively). The proportions of infranormal (<i>z</i> < -1.96) and supranormal (<i>z</i> > 1.96) deviations were measured for both groups. Ridge regression and support vector machine models were used to evaluate whether <i>z</i>-scores predicted symptom severity, IQ or diagnosis. Case-control differences in L-brainAGE and correlations between G-brainAGE and clinical features were analysed.</p><p><strong>Results: </strong>Both FEM and healthy individuals showed similar proportions of infra- and supranormal deviations in regional measures. Morphometric data, whether observed or normative, did not significantly predict clinical outcomes or diagnosis. Mean G-brainAGE in FEM was -1.04 (s.d. 3.26) years and negatively correlated with age of onset, while L-brainAGE did not differ significantly between groups.</p><p><strong>Conclusions: </strong>Regional morphometry and local brain-ageing metrics in FEM patients aligned with normative ranges, suggesting minimal abnormalities in early bipolar disorder. However, subtle delays in global brain ageing may reflect variation based on the age of onset, highlighting a potential area for further exploration.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 3","pages":"e95"},"PeriodicalIF":3.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062136","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}

{"title":"The ketogenic diet and metabolic treatments for neuropsychiatric disorders.","authors":"Christopher M Palmer","doi":"10.1192/bjo.2025.50","DOIUrl":"https://doi.org/10.1192/bjo.2025.50","url":null,"abstract":"<p><p>The ketogenic diet, initially developed for epilepsy treatment, has gained attention as a potential intervention for neuropsychiatric disorders. A groundbreaking study by Campbell et al highlights its feasibility and potential efficacy in bipolar disorder, shedding light on shared mechanisms across neuropsychiatric disorders and the promise of metabolic treatment approaches.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 3","pages":"e94"},"PeriodicalIF":3.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953990","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}

{"title":"Mortality and its predictors among people with dementia receiving psychiatric in-patient care.","authors":"Oriane E Marguet, Shanquan Chen, Emad Sidhom, Emma Wolverson, Gregor Russell, George Crowther, Simon R White, Jonathan Lewis, Rebecca Dunning, Shahrin Hasan, Benjamin R Underwood","doi":"10.1192/bjo.2025.40","DOIUrl":"https://doi.org/10.1192/bjo.2025.40","url":null,"abstract":"<p><strong>Background: </strong>Although dementia is a terminal condition, palliation can be a challenge for clinical services. As dementia progresses, people frequently develop behavioural and psychological symptoms, sometimes so severe they require care in specialist dementia mental health wards. Although these are often a marker of late disease, there has been little research on the mortality of people admitted to these wards.</p><p><strong>Aims: </strong>We sought to describe the mortality of this group, both on-ward and after discharge, and to investigate clinical features predicting 1-year mortality.</p><p><strong>Method: </strong>First, we conducted a retrospective analysis of 576 people with dementia admitted to the Cambridgeshire and Peterborough National Health Service (NHS) Foundation Trust dementia wards over an 8-year period. We attempted to identify predictors of mortality and build predictive machine learning models. To investigate deaths occurring during admission, we conducted a second analysis as a retrospective service evaluation involving mental health wards for people with dementia at four NHS trusts, including 1976 admissions over 7 years.</p><p><strong>Results: </strong>Survival following admission showed high variability, with a median of 1201 days (3.3 years). We were not able to accurately predict those at high risk of death from clinical data. We found that on-ward mortality remains rare but had increased from 3 deaths per year in 2013 to 13 in 2019.</p><p><strong>Conclusions: </strong>We suggest that arrangements to ensure effective palliation are available on all such wards. It is not clear where discussions around end-of-life care are best placed in the dementia pathway, but we suggest it should be considered at admission.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 3","pages":"e92"},"PeriodicalIF":3.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975230","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}

{"title":"Randomised controlled feasibility trial of online group acceptance and commitment therapy for functional cognitive disorder.","authors":"Norman Poole, Sarah Cope, Serena Vanzan, Aimee Duffus, Tatiana Williams, Nadia Mantovani, Jared G Smith, Barbara Barrett, Martin Scicluna, Sarah Beardmore, Mark J Edwards, Robert Howard","doi":"10.1192/bjo.2025.33","DOIUrl":"https://doi.org/10.1192/bjo.2025.33","url":null,"abstract":"<p><strong>Background: </strong>Functional cognitive disorder is an increasingly recognised subtype of functional neurological disorder for which treatment options are currently limited. We have developed a brief online group acceptance and commitment therapy (ACT)-based intervention.</p><p><strong>Aims: </strong>To assess the feasibility of conducting a randomised controlled trial of this intervention versus treatment as usual (TAU).</p><p><strong>Method: </strong>The study was a parallel-group, single-blind randomised controlled trial, with participants recruited from cognitive neurology, neuropsychiatry and memory clinics in London. Participants were randomised into two groups: ACT + TAU or TAU alone. Feasibility was assessed on the basis of recruitment and retention rates, the acceptability of the intervention, and signal of efficacy on the primary outcome measure (Acceptance and Action Questionnaire II (AAQ-II)) score, although the study was not powered to demonstrate this statistically. Outcome measures were collected at baseline and at 2, 4 and 6 months post-intervention, including assessments of quality of life, memory, anxiety, depression and healthcare use.</p><p><strong>Results: </strong>We randomised 44 participants, with a participation rate of 51.1% (95% CI 40.8-61.5%); 36% of referred participants declined involvement, but retention was high, with 81.8% of ACT participants attending at least four sessions, and 64.3% of ACT participants reported being 'satisfied' or 'very satisfied' compared with 0% in the TAU group. Psychological flexibility as measured using the AAQ-II showed a trend towards modest improvement in the ACT group at 6 months. Other measures (quality of life, mood, memory satisfaction) also demonstrated small to modest positive trends.</p><p><strong>Conclusions: </strong>It has proven feasible to conduct a randomised controlled trial of ACT versus TAU.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 3","pages":"e91"},"PeriodicalIF":3.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978320","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}

{"title":"Effect of improving food security on parenting practices and caregiver-adolescent relationships: qualitative findings of an income-generating agricultural intervention in rural Kenya - CORRIGENDUM.","authors":"Maricianah A Onono, Lila Sheira, Edward A Frongilio, Gladys Odhiambo, Pauline Wekesa, Amy Conroy, Elizabeth A Bukusi, Craig R Cohen, Sheri D Weiser","doi":"10.1192/bjo.2025.38","DOIUrl":"https://doi.org/10.1192/bjo.2025.38","url":null,"abstract":"","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 3","pages":"e90"},"PeriodicalIF":3.9,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953386","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 era of digital mental health interventions: we know they can be effective but are they also safe?","authors":"Urska Arnautovska, Alyssa Milton","doi":"10.1192/bjo.2025.42","DOIUrl":"https://doi.org/10.1192/bjo.2025.42","url":null,"abstract":"<p><p>Over the past two decades, digital mental health interventions (DMHIs) have seen a surge in studies with people experiencing mental ill-health, whether this be via web-based platforms, smartphone applications, text messages or other digital devices. Although DMHIs already demonstrate evidence of their acceptability and some of their effectiveness among different populations, the information about their safety is less clear. This Editorial reflects on a Delphi study by Taher and colleagues that explored the regulation of DMHIs and generated ten safety recommendations. We discuss these recommendations in the context of existing relevant literature and provide suggestions for further steps to advance research and policy on DMHIs in the UK and globally. Further dialog is needed, including the views and experiences of all key stakeholders, and particularly of people with lived experience, to ensure DMHIs are not only an acceptable and potentially effective treatment approach, but also safe for those that use them.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 3","pages":"e89"},"PeriodicalIF":3.9,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963187","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}