BJPsych Open最新文献

{"title":"Prevalence and factors associated with postpartum depressive symptoms among mothers who gave birth within the past 12 months in Ghana: mixed-method study.","authors":"Leticia Tornyevah, Samuel Bosomprah, Anjali Sharma, Ank De Jonge, Jens Henrichs","doi":"10.1192/bjo.2025.10857","DOIUrl":"10.1192/bjo.2025.10857","url":null,"abstract":"<p><strong>Background: </strong>Postpartum depressive symptoms (PPDS) are mental health concerns, characterised by sadness, anxiety and suicidal ideation.</p><p><strong>Aims: </strong>We aimed to estimate the prevalence of PPDS, identify its associated factors and explore the lived experiences of individuals with PPDS, to understand the psychosocial mechanisms involved.</p><p><strong>Method: </strong>We surveyed 400 women aged 18 years and above and conducted in-depth interviews among 19 women who screened positive for PPDS at two urban hospitals and one peri-urban polyclinic in Ho, Ghana. We used multivariable binomial generalised linear models to identify factors independently associated with PPDS. We used thematic analysis (qualitative) to identify themes that highlight pathways through which these factors influence PPDS.</p><p><strong>Results: </strong>Overall, 117 (29.3%) women screened positive for PPDS. Being unmarried (adjusted prevalence ratio (aPR) 1.33, 95% CI 1.02-1.72), lack of partner support (aPR 1.60, 95% CI 1.21-2.12), history of depressive or psychiatric disorders (aPR 2.44, 95% CI 1.84-3.25), unplanned pregnancy (aPR 1.63, 95% CI 1.18-2.25), low self-esteem (aPR 2.38, 95% CI 1.79-3.16) and low birth weight (aPR 1.87, 95% CI 1.33-2.65) were independently associated with PPDS. The thematic analysis revealed four key themes: (a) social isolation and limited support, (b) emotional stress and vulnerability, (c) self-image and identity challenges, and (d) resilience resources.</p><p><strong>Conclusions: </strong>PPDS were common in our sample and were significantly associated with modifiable factors such as prior mental health history and low self-esteem. These findings underscore the importance of prioritising maternal mental health through the integration of depression screening and psychosocial care into routine antenatal and postnatal services.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 6","pages":"e239"},"PeriodicalIF":3.5,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12529339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285523","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":"Depressive symptoms and hypoglycaemic risk in individuals with type 2 diabetes mellitus: insights from the ACCORD-HRQL study.","authors":"Wanying Hong, Yang Yang, Zhenhua Xing","doi":"10.1192/bjo.2025.10853","DOIUrl":"10.1192/bjo.2025.10853","url":null,"abstract":"<p><strong>Background: </strong>Depression in individuals with type 2 diabetes mellitus (T2DM) is associated with worse clinical prognosis; however, evidence regarding the relationship between depression and hypoglycaemic risk remains limited and inconclusive.</p><p><strong>Aim: </strong>Our study aimed to evaluate the association between depressive symptoms and hypoglycaemic events.</p><p><strong>Method: </strong>Depressive symptoms were assessed in participants of the ACCORD-HRQL study at baseline and during follow-up visits at 12, 36 and 48 months using the nine-item Patient Health Questionnaire (PHQ-9). Symptom severity was categorised into three levels: none (0-4 points), mild (5-9 points) or moderate to severe (10-24 points). The primary outcomes included hypoglycaemia requiring any assistance (HAA) and hypoglycaemia requiring medical assistance (HMA).</p><p><strong>Results: </strong>Over a median follow-up of 4.3 years, 220 individuals developed HAA (incidence rate: 27.0 per 1000 person-years) and 157 individuals experienced HMA (incidence rate: 18.8 per 1000 person-years). Depressive symptoms exhibited dynamic fluctuations during the study period, and participants with depression consistently demonstrated less effective glycaemic control compared to those without depression. However, each one-unit increase in PHQ-9 score was not associated with elevated risks of HAA (hazard ratio, 1.00; 95% CI, 0.97-1.03) or HMA (hazard ratio, 0.98; 95% CI, 0.95-1.02).</p><p><strong>Conclusions: </strong>Depressive symptoms in individuals with T2DM are dynamic and correlate with suboptimal glycaemic control. However, no significant association was observed between depression severity and increased hypoglycaemic events. These findings highlight the importance of integrated clinical strategies for continuous mental health monitoring and glucose management in T2DM individuals.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 6","pages":"e241"},"PeriodicalIF":3.5,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12529320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145279002","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 impact of loneliness on healthcare costs and service utilisation and the cost-effectiveness of loneliness interventions: systematic review.","authors":"Sharon Eager, Helen Baldwin, David McDaid, Paul McCrone, Phoebe Barnett, Theodora Stefanidou, Prisha Shah, Stephen Jeffreys, Antonio Rojas-García, Ruby Jarvis, Beverley Chipp, Brynmor Lloyd-Evans, Alexandra Pitman, Maria Ana Matias, Nikita Jacob, Sonia Johnson","doi":"10.1192/bjo.2025.10862","DOIUrl":"10.1192/bjo.2025.10862","url":null,"abstract":"<p><strong>Background: </strong>Loneliness is associated with several physical and mental health problems, yet its costs to the healthcare system remain unclear.</p><p><strong>Aims: </strong>The current study aimed to review literature on the health and social care impacts of loneliness, and review economic evaluations of loneliness interventions.</p><p><strong>Method: </strong>We conducted a systematic review of studies published from 2008 to April 2025 by searching five bibliographic databases, grey literature and reference lists of systematic reviews. Studies estimating health and social care cost/expenditure, and on health resource utilisation, were included to assess the impact of loneliness on the health system. Return on investment, social return on investment and cost-effectiveness evaluations were included to assess the economic impact of loneliness interventions. We conducted quality appraisal and narrative synthesis of results.</p><p><strong>Results: </strong>We included 53 studies. Eight estimated the healthcare cost/expenditure of loneliness, 33 reported healthcare resource use and 19 were economic evaluations of interventions. Findings relating to the cost/expenditure of loneliness and service use were inconsistent: some studies reported excess costs/expenditure and service use, whereas others found lower costs/expenditure and service use. Economic evaluation studies indicated that loneliness interventions can be cost-effective, but were not consistently cost-saving or effective in reducing loneliness.</p><p><strong>Conclusions: </strong>Findings on the impact of loneliness on the healthcare system and economic evaluations of loneliness interventions were varied. Therefore, we cannot derive confident conclusions from this review. To address evidence gaps, future research relating to social care, younger populations, direct healthcare costs of loneliness and randomised controlled trials with long-term follow-ups should be prioritised.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 6","pages":"e243"},"PeriodicalIF":3.5,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12529335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278943","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":"Healthcare for individuals with schizophrenia in Taiwan: 10-year national trend analysis.","authors":"Shen-Yu Tsai, Ming-Shiang Wu, Shi-Heng Wang, Shih-Cheng Liao, Wei J Chen, Chi-Shin Wu","doi":"10.1192/bjo.2025.10868","DOIUrl":"10.1192/bjo.2025.10868","url":null,"abstract":"<p><strong>Background: </strong>Significant changes in Taiwan's psychiatric services over recent decades include expansion of community-based clinics and implementation of the Schizophrenia Pay-for-Performance programme.</p><p><strong>Aims: </strong>This study aimed to assess the trend of the quality of healthcare for individuals with schizophrenia, using various indicators of the treatment process and outcomes between 2010 and 2019.</p><p><strong>Method: </strong>Individuals with schizophrenia were identified using Taiwan's National Health Insurance claims database. The quality of healthcare for individuals with schizophrenia was assessed using treatment process and outcome indicators, including antipsychotic types, medication adherence, daily dose for antipsychotics and concurrent use of other psychotropic agents. Outcome indicators included all-cause mortality, suicide deaths, psychiatric hospitalisation, emergency department visits and employment status.</p><p><strong>Results: </strong>Antipsychotic medication usage has shifted towards second-generation antipsychotics (SGAs) and long-acting injectable antipsychotics (LAIs), with declines in first-generation antipsychotics. The percentage of medication adherence declined, while that of individuals with an adequate daily dose increased. Concurrently, anticholinergic and benzodiazepine use decreased while antidepressant and mood stabiliser use increased. Outcome indicators showed no significant change in all-cause mortality or suicide rates over time, but there were reductions in psychiatric hospitalisations and emergency department visits. Employment rates increased overall, particularly in urban areas.</p><p><strong>Conclusions: </strong>The quality of healthcare for individuals with schizophrenia, as measured by treatment process and outcome indicators, improved alongside changes in Taiwan's psychiatric services; however, causality cannot be inferred from our findings. Future research should evaluate the effectiveness of psychiatric service policies and continuously monitor healthcare quality to further enhance the lives of individuals with schizophrenia.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 6","pages":"e244"},"PeriodicalIF":3.5,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12529334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278952","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 natural language-processing application for LGBTQ+ status in mental health records.","authors":"Margaret Heslin, Jaya Chaturvedi, Anne Marie Bonnici Mallia, Ace Taaca, Diogo Pontes, Charvi Saraswat, Charlotte Woodhead, Katharine A Rimes, David Chandran, Jyoti Sanyal, Ruimin Ma, Robert Stewart, Angus Roberts","doi":"10.1192/bjo.2025.10855","DOIUrl":"10.1192/bjo.2025.10855","url":null,"abstract":"<p><strong>Background: </strong>Lesbian, gay, bisexual, transgender, queer and related community (LGBTQ+) individuals have significantly increased risk for mental health problems. However, research on inequalities in LGBTQ+ mental healthcare is limited because LGBTQ+ status is usually only contained in unstructured, free-text sections of electronic health records.</p><p><strong>Aims: </strong>This study investigated whether natural language processing (NLP), specifically the large language model, Bi-directional Encoder Representations from Transformers (BERT), can identify LGBTQ+ status from this unstructured text in mental health records.</p><p><strong>Method: </strong>Using electronic health records from a large mental healthcare provider in south London, UK, relevant search terms were identified and a random sample of 10 000 strings extracted. Each string contained 100 characters either side of a search term. A BERT model was trained to classify LGBTQ+ status.</p><p><strong>Results: </strong>Among 10 000 annotations, 14% (1449) confirmed LGBTQ+ status while 86% (8551) did not. These other categories included LGBTQ+ negative status, irrelevant annotations and unclear cases. The final BERT model, tested on 2000 annotations, achieved a precision of 0.95 (95% CI 0.93-0.98), a recall of 0.93 (95% CI 0.91-0.96) and an F1 score of 0.94 (95% CI 0.92-0.97).</p><p><strong>Conclusion: </strong>LGBTQ+ status can be determined using this NLP application with a high success rate. The NLP application produced through this work has opened up mental health records to a variety of research questions involving LGBTQ+ status, and should be explored further. Additional work should aim to extend what has been done here by developing an application that can distinguish between different LGBTQ+ groups to examine inequalities between these groups.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 6","pages":"e242"},"PeriodicalIF":3.5,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12529341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278971","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":"Health professional education in autism and intellectual disability: systematic review.","authors":"Catherine Franklin, Sinead Green, Katie Brooker, Ruby de Greef, Carla Meurk, Edward Heffernan","doi":"10.1192/bjo.2025.10842","DOIUrl":"10.1192/bjo.2025.10842","url":null,"abstract":"<p><strong>Background: </strong>Health and mental health professionals often lack knowledge and confidence to provide quality healthcare to people with intellectual disability and those on the autism spectrum. Educational interventions are proposed as solutions, but their effectiveness and optimal characteristics remain unclear.</p><p><strong>Aims: </strong>To evaluate the effectiveness of educational interventions in improving health professionals' knowledge, skills, attitudes, confidence and/or self-efficacy in providing care to people with intellectual disability and those on the autism spectrum.</p><p><strong>Method: </strong>A mixed-methods systematic review was conducted searching six major databases, adhering to PRISMA guidelines (PROSPERO CRD42022309194). Studies were included if they assessed outcomes of educational interventions aimed at improving health professionals' capacity to provide care to people with intellectual disability and/or those on the autism spectrum.</p><p><strong>Results: </strong>We identified 34 studies: five focused on intellectual disability, two on intellectual and developmental disabilities, and 27 on autism. All reported positive findings, although heterogeneity of measures limited synthesis. Most studies (30 out of 34) employed single group pre-test/post-test designs, with only nine using validated outcome measures. Only eight studies reported co-design or co-delivery involving people with lived experience.</p><p><strong>Conclusions: </strong>Educational interventions demonstrate positive effects on heath professionals' capacity to provide care. Significant gaps include limited evidence for adult-focused interventions, uncertainty about optimal delivery modes and duration, and minimal inclusion of people with lived experience in intervention design and delivery. Future interventions should involve people with lived experience in design and delivery, and incorporate validated outcome measures to enhance evidence quality.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 6","pages":"e238"},"PeriodicalIF":3.5,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12529344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257212","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":"Audit of Appointment Non-Attendance in Leeds Child and Young Person Learning Disability Psychiatry Clinic - CORRIGENDUM.","authors":"Amy Greener, Martha Sayer, Eleanor Morris, Konstantopoulou Kalliopi","doi":"10.1192/bjo.2025.10889","DOIUrl":"10.1192/bjo.2025.10889","url":null,"abstract":"","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 6","pages":"e236"},"PeriodicalIF":3.5,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12529330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257193","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":"VR for Mental Health Interventions at Home: Feasibility and Guiding Principles for success - CORRIGENDUM.","authors":"William Benjamin Clare, Shamita Suresh, Bhavana Thummala, Nimath Sumaithaa Shadhuly, Kashir Ahmed Raza, Bhone Hein Kyaw","doi":"10.1192/bjo.2025.10886","DOIUrl":"10.1192/bjo.2025.10886","url":null,"abstract":"","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 6","pages":"e235"},"PeriodicalIF":3.5,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12529342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257251","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":"Effectiveness of Behavioural Modification Techniques in children Having Intellectual Disability Pre and Post Evaluation - CORRIGENDUM.","authors":"Samreen Afzal, Irum Siddique, Imtiaz Ahmed Dogar, Waqar Azeem","doi":"10.1192/bjo.2025.10890","DOIUrl":"10.1192/bjo.2025.10890","url":null,"abstract":"","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 6","pages":"e237"},"PeriodicalIF":3.5,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12529316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145249614","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":"Criterion Validity of the Problematic Khat Use Screening Tool (PKUST-17) in Ethiopia.","authors":"Awoke Mihretu, Solomon Teferra, Yohannes Gebreegziabhere, Kassahun Habtamu, Abebaw Fekadu","doi":"10.1192/bjo.2025.10852","DOIUrl":"10.1192/bjo.2025.10852","url":null,"abstract":"<p><strong>Background: </strong>The use of amphetamine-type stimulants such as khat has been spreading quickly in eastern parts of Africa, the Arabian region and Asia. However, screening for the provision of early intervention has been inadequate, primarily because of the lack of culturally acceptable and valid screening tools.</p><p><strong>Aims: </strong>To evaluate the the accuracy of the Problematic Khat Use Screening Tool (PKUST-17) in screening for khat use disorder against the DSM-5 criteria for substance use disorder.</p><p><strong>Method: </strong>A cross-sectional validation study was conducted in Ethiopia from February to December 2018, among a randomly selected sample of 506 individuals. The study subsample comprised 236 participants. We used the DSM-5 criteria for stimulant use disorders as the standard for determining the criterion validity and optimal cut-off score for the PKUST-17, using the receiver operating characteristic (ROC) curve. The DSM-5 criteria for substance use disorders were examined by researchers in a subsample of 232 participants. The PKUST-17 uses a five-point Likert scale (0-4), with total scores ranging from 0 to 68. At the optimal cut-off scores, sensitivity and specificity were determined. In addition, we conducted multivariate logistic regression analysis to evaluate potential convergent validity of the tool.</p><p><strong>Results: </strong>The area under the ROC curve showed good performance of the PKUST-17 (0.78, 95% CI 0.70-0.85, <i>P</i> < 0.001). A cut-off score above 17 demonstrated a sensitivity of 72% and specificity of 73%. The positive predictive value was 77.6% and the negative predictive value was 65.8% in identifying stimulant use disorder, as per the DSM-5 criteria. Among others, problematic khat use was significantly associated with higher World Health Organization Disability Assessment Schedule 2.0 scores (adjusted odds ratio 1.78, 95% CI 1.04-3.03, <i>P</i> < 0.01) and more depressive symptoms (adjusted odds ratio 4.10, 95% CI 2.36-7.12, <i>P</i> < 0.05).</p><p><strong>Conclusions: </strong>We found that the PKUST-17 is a valid tool for screening for khat use disorder against the DSM-5 criteria for substance use disorder, and identifying high-risk problematic khat users.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 6","pages":"e232"},"PeriodicalIF":3.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12529311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145249638","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}