BJPsych Open最新文献

{"title":"Sustained mood improvement with laughing gas exposure (SMILE): a randomised, placebo-controlled pilot trial of nitrous oxide for treatment-resistant depression.","authors":"Karim S Ladha, Jiwon Lee, Gabriella F Mattina, Janneth Pazmino-Canizares, Duminda N Wijeysundera, Fatemeh Gholamali Nezhad, Vanessa K Tassone, Fathima Adamsahib, Wendy Lou, Sidney Kennedy, Venkat Bhat","doi":"10.1192/bjo.2025.10823","DOIUrl":"10.1192/bjo.2025.10823","url":null,"abstract":"<p><strong>Background: </strong>Nitrous oxide may possess antidepressant effects; however, limited data exist on repeated administrations and active placebo-controlled studies in treatment-resistant depression (TRD).</p><p><strong>Aims: </strong>We aimed to test the feasibility of a randomised controlled trial examining a 4-week course of nitrous oxide or midazolam, an active placebo.</p><p><strong>Method: </strong>In this randomised, active, placebo-controlled pilot trial, 40 participants with TRD were assigned either a 1-h inhalation of 50% nitrous oxide plus intravenous saline (<i>n</i> = 20) or a 1-h inhalation of 50% oxygen plus intravenous midazolam (0.02 mg/kg, up to 2 mg; <i>n</i> = 20) once weekly, for 4 weeks. Feasibility was assessed by examining rates of recruitment, withdrawal, adherence, missing data and adverse events. The main measure of clinical efficacy was the change in depression severity (Montgomery-Åsberg Depression Rating Scale (MADRS)) score from baseline to day 42.</p><p><strong>Results: </strong>The recruitment rate was 22.3% (95% CI 16.9-29.0). Withdrawal rates were 10% (95% CI 2.8-30.1) in both groups and adherence rates were 100.0% (95% CI 82.4-100) in the nitrous oxide group and 94.4% (95% CI 74.2-99.0) in the placebo group. There were no missing primary clinical outcome data in either group (0.0%, 95% CI 0.0-17.6). MADRS score changed by -20.5% (95% CI -39.6 to -1.3) in the nitrous oxide group and -9.0% (95% CI -22.6 to 4.6) in the placebo group. Nearly all adverse events were mild to moderate and transient.</p><p><strong>Conclusions: </strong>The findings support the feasibility and necessity of conducting a full-scale trial comparing nitrous oxide and midazolam in patients with TRD.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 5","pages":"e208"},"PeriodicalIF":3.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039069","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":"'A community in crisis': staff qualitative experiences of NHS and third sector mental healthcare in England.","authors":"Laura Sambrook, Jason C McIntyre, Rajan Nathan, Jackie Tait, Peter Ashley-Mudie, Matthew Humphreys, Peter Wilson, Pooja Saini","doi":"10.1192/bjo.2025.10826","DOIUrl":"10.1192/bjo.2025.10826","url":null,"abstract":"<p><strong>Background: </strong>More people than ever are receiving support for mental health issues, and instances of suicide continue to grow. Although mental health funding has increased, UK government figures evidence that the National Health Service (NHS) does not have the resources required to respond to such growth in demand. The experiences of staff working in mental health services can offer insight into the efficacy of current provision and assist in service evaluation; however, research examining this issue outside of the COVID-19 pandemic, and in the context of community mental health, is lacking.</p><p><strong>Aims: </strong>We aimed to explore the perspectives of staff working in a variety of mental health services in North-West England, to elucidate the current standard of care provided and highlight areas for improvement.</p><p><strong>Method: </strong>One-to-one interviews were conducted with 26 staff members as part of a qualitative grounded theory analysis.</p><p><strong>Results: </strong>Findings portrayed a community in crisis, consisting of the following themes: stabilisation not recovery, inefficient pathways and barriers to collaboration.</p><p><strong>Conclusions: </strong>NHS services are struggling to meet the mental health needs of the population, resulting in lengthy waiting times for therapy, a lack of intervention-focused care and an over-reliance on the third sector. While crisis cafés are provided at low cost and result in satisfaction, policy-makers must ensure that these receive adequate funding and do not become overburdened. Staff reported that collaboration between clinical and non-clinical services would improve care pathways and reduce strain on the NHS, but judgemental attitudes and inflexible service development must be challenged to achieve this.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 5","pages":"e210"},"PeriodicalIF":3.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039100","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":"Correlations between receptor occupancy change and mental state in patients using long-acting injectable antipsychotics: MIDILIA pilot study.","authors":"James R O'Neill, Christopher Wilson, Mark A Horowitz, Samantha L McLean, Muhammad Faisal, Michael Dixon, Lewis Couchman, Katie Lawlor, George Crowther","doi":"10.1192/bjo.2025.10831","DOIUrl":"10.1192/bjo.2025.10831","url":null,"abstract":"<p><strong>Background: </strong>The rate at which psychosis drugs can be reduced in dose remains unclear. Anecdotal reports exist of people experiencing worsening of mental state before their next dose of long-acting injectable antipsychotic. No research has previously explored this phenomenon, but understanding this may advise on the rate of receptor occupancy change that provokes the emergence of psychotic symptoms.</p><p><strong>Aims: </strong>Exploring the relationship between psychotic symptoms and variations in plasma concentration (and calculated receptor occupancy) of long-acting injectable antipsychotics.</p><p><strong>Method: </strong>This longitudinal study monitored mental state variation within dosing cycles of people taking depot flupentixol and zuclopenthixol. The Positive and Negative Syndrome Scale (PANSS) monitored global mental state changes, and was stratified into domains according to a five-factor model. Plasma assays at maximal and minimal concentrations allowed prediction of striatal D₂ occupancy from published data. We examined correlations between receptor occupancy and the emergence of psychotic symptoms.</p><p><strong>Results: </strong>Preliminary results from ten participants with psychotic disorders suggest that global mental state deterioration may correlate with increased rate of D₂ occupancy reduction. Increased rate of D₂ occupancy reduction led to deterioration in 'positive' (<i>r</i> = 0.637 [CI: 0.013, 0.904], <i>P</i> = 0.047) and 'resistance' (<i>r</i> = 0.726 [CI: 0.177, 0.930], <i>P</i> = 0.018) PANSS clinical domains at minimal concentrations. PANSS score differences were not related to absolute reduction in D₂ occupancy.</p><p><strong>Conclusions: </strong>Our novel observational study design has been demonstrated to be feasible and practicable. Faster reductions in D₂ occupancy may increase the risk of increased positive psychotic symptoms and irritability. Slower reductions may minimise this effect. Further recruitment is required before this can be confirmed.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 5","pages":"e211"},"PeriodicalIF":3.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039044","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":"Establishing accountability and promoting rights: the WHO QualityRights contribution to mental health, recovery and community inclusion.","authors":"Julian Eaton","doi":"10.1192/bjo.2025.10835","DOIUrl":"10.1192/bjo.2025.10835","url":null,"abstract":"<p><p>Attention to human rights as a central pillar of global mental health work has shifted from a focus on the right to healthcare to a deeper examination of the quality of care received, and to the way in which people with mental health conditions are treated in all aspects of life. The QualityRights programme is the World Health Organization's flagship guidance for promotion of rights-based approaches to mental healthcare, and a means of holding service providers to account for quality of care provided. A recent evaluation of the QualityRights e-training package demonstrates promising impact on attitude change of participants, raising the prospect of an efficient scale-up of efforts to improve dignity in services and reduce stigma and discrimination.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 5","pages":"e212"},"PeriodicalIF":3.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039056","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":"Developing theory-informed implementation strategies to embed a suicide safety planning intervention app into a psychiatric emergency department: co-design study using the Behaviour Change Wheel.","authors":"Hwayeon Danielle Shin, Gillian Strudwick, John Torous, Keri Durocher, Juveria Zaheer","doi":"10.1192/bjo.2025.10824","DOIUrl":"10.1192/bjo.2025.10824","url":null,"abstract":"<p><strong>Background: </strong>Safety planning is a commonly used, evidence-based intervention for suicide prevention. There is a need for continuous engagement with safety plans post-discharge, and the improvement of safety plan portability has been discussed within our mental health organisation. This has led to the development of an app, called the Hope App. This study aims to implement this app into routine practice in a Canadian psychiatric emergency department.</p><p><strong>Aims: </strong>We aimed to describe a collaborative, theoretically driven approach to co-design implementation strategies to elicit behaviour change among emergency department clinicians; co-develop a set of tailored, theory-informed, multifaceted implementation strategies for embedding an app into a psychiatric emergency department; and describe engagement evaluation received by the co-design team.</p><p><strong>Method: </strong>Co-design approaches and the Behaviour Change Wheel were used to develop implementation strategies with clinicians, patients and care partners. The co-design team consisted of 12 members, and we held four design sessions. Design sessions were iterative in nature and organised such that the findings of each session fed into the next session.</p><p><strong>Results: </strong>We identified 11 implementation strategies encompassing different combinations of intervention functions and behaviour change techniques, targeting barriers and leveraging facilitators identified in our previous work.</p><p><strong>Conclusions: </strong>The tailored implementation strategies developed in this study have the potential to fill existing gaps in integrating digital technology. A key strength of this study is its use of behaviour change theories and a collaborative approach. The strategies are designed to align with the needs and preferences of clinicians, patients and care partners.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 5","pages":"e209"},"PeriodicalIF":3.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039086","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":"Risk factors and trajectories for self-harm, neurodevelopmental disorders and mental health conditions in pupils in alternative education provision in Wales: population-based electronic cohort study.","authors":"Olivier Y Rouquette, Marcos Del Pozo Baños, Sze Chim Lee, Ann John","doi":"10.1192/bjo.2025.10827","DOIUrl":"10.1192/bjo.2025.10827","url":null,"abstract":"<p><strong>Background: </strong>Pupils in alternative education provision, known as 'Educated in Other Than At School' (EOTAS) in Wales, UK, are among the most vulnerable learners and who, for reasons such as mental health or behavioural challenges, do not attend a mainstream or special school.</p><p><strong>Aims: </strong>We compared self-harm, neurodevelopmental disorders and mental health conditions between EOTAS pupils and controls with similar characteristics, before and after being in EOTAS provision.</p><p><strong>Method: </strong>This population-based electronic cohort study included pupils in Wales aged 7-18 years, from the academic years 2010-11 to 2018-19. We linked data from Education Wales to primary and secondary healthcare records within the Secure Anonymised Information Linkage (SAIL) Databank. Individuals included in the EOTAS data-set were identified as cases. Controls were pseudo-randomly selected based on equivalent age and academic year distribution.</p><p><strong>Results: </strong>This study included 8056 pupils in EOTAS and 224 247 controls. Higher levels of deprivation, childhood maltreatment, self-harm, neurodevelopmental disorders and mental health conditions before EOTAS entry were linked to higher odds of being in EOTAS. Pupils in EOTAS provision had increased incidence of self-harm, neurodevelopmental disorders and mental health conditions, from 1 year after entering EOTAS provision up to 24 years of age, than pupils with similar characteristics not in EOTAS provision.</p><p><strong>Conclusion: </strong>While EOTAS provision plays an important role, our findings indicate that it is not sufficient on its own to meet pupils' social, emotional, behavioural and mental health needs. Additional support and better integration with health and social services are required.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 5","pages":"e205"},"PeriodicalIF":3.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032814","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":"Safe and soothed: randomised clinical pilot study on the subjective and psychophysiological impact of a new physiotherapeutic intervention in patients with dissociative disorders.","authors":"Lea Stief, Heribert Sattel, Karin Paschinger, Martin Sack, Eva Schäflein","doi":"10.1192/bjo.2025.10072","DOIUrl":"10.1192/bjo.2025.10072","url":null,"abstract":"<p><strong>Background: </strong>Dissociative disorders frequently co-occur with post-traumatic stress disorder (PTSD), yet many individuals lack adequate treatment. Existing interventions often prioritise reducing arousal over promoting safety and self-soothing, tending to neglect the bodily experience.</p><p><strong>Aims: </strong>This randomised clinical within-person pilot study examined the effects of the nest position, a physiotherapeutic intervention designed to enhance safety and self-soothing, on patients with dissociative disorders and healthy controls (German Clinical Trials Register No.: DRKS00030669).</p><p><strong>Method: </strong>Eighteen patients with dissociative disorders and 18 healthy controls alternated between the nest position and a neutral supine position across two rounds of a measurement session. The order of the experimental conditions (nest position or supine only) was randomised for each participant. We assessed self-reported distress and comfort (Subjective Units of Distress and Comfort) and autonomic nervous system activity during three baseline phases and imagination of stressful and comforting situations.</p><p><strong>Results: </strong>Both patients and healthy controls experienced lower distress and greater comfort in the nest position. Heart rate and sympathetic tone decreased, particularly in the healthy controls. There were no significant changes in parasympathetic tone in both groups. Linear mixed models revealed a significant effect of the nest position on distress, comfort and sympathetic tone.</p><p><strong>Conclusions: </strong>The nest position is a potentially promising additional intervention for highly dissociative patients. Our findings help to better understand the importance of self-soothing and safety in these individuals and to address the research gap in physiotherapy within in-patient mental health care.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 5","pages":"e198"},"PeriodicalIF":3.5,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145028915","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":"Music therapy for patients with depression: systematic review and meta-analysis of randomised controlled trials.","authors":"Youn Joo Lee, Seog Ju Kim, Jihyun Yoon, Jung Hwan Lee","doi":"10.1192/bjo.2025.10822","DOIUrl":"10.1192/bjo.2025.10822","url":null,"abstract":"<p><strong>Background: </strong>Depression is one of the most common mental diseases, leading to a decline in both psychiatric and physical functions. One non-pharmacological therapeutic strategy for the management of psychiatric disorders is music therapy.</p><p><strong>Aims: </strong>To assess the clinical effectiveness of music therapy and its various subscales for managing depressive symptoms (primary outcome) and related problems (secondary outcome) in comparison with other conventional treatments.</p><p><strong>Method: </strong>A comprehensive search of MEDLINE, Embase, Cochrane Review, CINAHL, PsyInfo and KMbase was conducted to identify randomised controlled trials published up to 31 August 2023. Studies assessing the clinical effectiveness of music therapy for individuals with depression were included, and data on participants, music therapy and clinical measurement scores were extracted. This study was registered with PROSPERO (no. CRD42023466833).</p><p><strong>Results: </strong>Music therapy was significantly more effective than controls in reducing depressive symptoms (standardised mean difference (SMD) -0.97 [95% CI: -1.23 to -0.71], <i>P</i> < 0.01). This benefit was consistent regardless of music therapy types, delivery methods or provider professionalism. In addition, music therapy was significantly better than controls in improving quality of life (SMD 0.51 [95% CI: 0.19-0.83], <i>P</i> < 0.01) and sleep quality (SMD -0.61 [95% CI: -1.03 to -0.19], <i>P</i> < 0.01), although it showed only a non-significant trend towards reducing anxiety (SMD -0.98 [95% CI: -2.01 to 0.06], <i>P</i> = 0.06). The evidence level was very low due to high risk of bias, inconsistency due to high heterogeneity and imprecision.</p><p><strong>Conclusions: </strong>Despite the very low evidence level, music therapy may be recommended with weak strength for patients with depression, considering the results of the meta-analysis and the high accessibility and broad applicability of music.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 5","pages":"e201"},"PeriodicalIF":3.5,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022749","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":"Formal and informal mental health support in young adults with recurrently depressed parents.","authors":"Rhys Bevan-Jones, Bryony Weavers, Tessa Lomax, Emma Meilak, Olga Eyre, Victoria Powell, Becky Mars, Frances Rice","doi":"10.1192/bjo.2025.10819","DOIUrl":"10.1192/bjo.2025.10819","url":null,"abstract":"<p><strong>Background: </strong>A family history of mental illness, particularly parental depression, is a risk factor for mental health difficulties in young people, with this heightened risk extending into adulthood. Evidence suggests low rates of formal mental health support in children/adolescents with depressed parents, but it is unknown whether this pattern persists into adulthood and applies to informal support.</p><p><strong>Aims: </strong>We examined the prevalence of formal and informal mental health support accessed by young adults with recurrently depressed parents. We identified factors associated with access to different support, and report satisfaction with support.</p><p><strong>Method: </strong>The sample included 144 young adults (mean age 23 years, range 18-28 years) who completed psychiatric assessments and reported on their use of mental health support in a cross-sectional analysis of a longitudinal cohort study (wave 4). Regression analyses explored predictors for support.</p><p><strong>Results: </strong>Young adults accessed a range of formal (29%) and informal (56%) support. Among those with a psychiatric disorder, nearly half had not accessed formal support and a fifth had not accessed any support. Predictors of support included psychiatric disorder, severity indicators (e.g. self-harm/suicidal thoughts, impairment) and demographic factors (e.g. education, gender). Predictors varied by type of support. Most participants reported satisfaction with support.</p><p><strong>Conclusions: </strong>Young adults at high risk of mental disorders accessed various mental health support. However, many did not access/receive support when needed. Further work is required to improve access to tailored support.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 5","pages":"e200"},"PeriodicalIF":3.5,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022769","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":"Understanding the role of cannabis in patients with suicidal ideation presenting to the emergency department: systematic chart review.","authors":"Maria Simmons, Candice E Crocker, Derek Fisher, Sherry H Stewart, Jason G Emsley, Sabina Abidi, Alix Carter, Cynthia Calkin, Igor Yakovenko, Kirk Magee, Philip G Tibbo","doi":"10.1192/bjo.2025.10776","DOIUrl":"10.1192/bjo.2025.10776","url":null,"abstract":"<p><strong>Background: </strong>The association between cannabis use and suicidality has been established, but details on impacts of legalisation, as well as long-term service use, have had limited attention.</p><p><strong>Aims: </strong>To examine if changes are present in suicide presentations with access to legal cannabis.</p><p><strong>Method: </strong>This study employed administrative database and medical record reviews to identify two cohorts of patients presenting with suicidal ideation/attempts and cannabis use to emergency departments, for two periods: 17 October 2018 to 30 April 2019, and 17 October 2020 to 30 April 2021. Demographic and clinical outcome data were obtained, and emergency department healthcare usage for 2 years before and 2 years after index encounter were compared, to further understand emergency department presentations for the same complaint.</p><p><strong>Results: </strong>Number of emergency department encounters following the index visit and number of emergency department encounters specifically relating to suicidality following the index visit were significantly different between cohorts (<i>t</i> = 2.05, <i>P</i> = 0.042; <i>t</i> = 2.23, <i>P</i> = 0.027, respectively), with the immediate post-cannabis legalisation period demonstrating greater numbers of subsequent emergency department visits for suicidality. Additional associations were found between personality disorders and repeat emergency department visits related to cannabis use.</p><p><strong>Conclusions: </strong>There appears to be stability in the patient profile of those presenting to the emergency department with a complaint relating to suicide while reporting cannabis use from the period directly following legalisation in Canada, to a similar time frame 2 years later despite reported increased use of cannabis in the general population over this period. Despite the rising potency and access to legal cannabis, suicide risk remains stable, although concerning.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 5","pages":"e199"},"PeriodicalIF":3.5,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022758","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}