BJPsych Open最新文献

{"title":"Comparative risk of QTc prolongation induced by second-generation antipsychotics in the real world: retrospective cohort study based on a hospital information system.","authors":"Luyao He, Wenjuan Yu, Huiqing Song, Lujin Li, Yifeng Shen, Lei Zhang, Huafang Li","doi":"10.1192/bjo.2024.871","DOIUrl":"https://doi.org/10.1192/bjo.2024.871","url":null,"abstract":"<p><strong>Background: </strong>Second-generation antipsychotics (SGAs) can cause corrected QT interval (QTc) prolongation as a side-effect. This may limit their clinical use and pose safety concerns for patients.</p><p><strong>Aims: </strong>To analyse the risk of QTc prolongation associated with eight second-generation antipsychotics and observe the timing characteristics of QTc prolongation events and subsequent changes in medication strategies.</p><p><strong>Methods: </strong>Using data from the hospital information system of a large mental health centre, this retrospective cohort study included 5130 patients (median follow-up: 141.2 days) treated between 2007 and 2019. A marginal structural Cox model was used to compare the hazard ratios for QTc prolongation associated with various SGAs.</p><p><strong>Results: </strong>The mean age of the cohort was 35.54 years (s.d. = 14.22), and 47.8% (<i>N</i> = 2454) were male. Ziprasidone, amisulpride and olanzapine were the only SGAs associated with QTc prolongation. Ziprasidone presented the highest risk (hazard ratio 1.72, 95% CI: 1.03-2.85, adjusted <i>P</i> = 0.03), followed by amisulpride (hazard ratio 1.56, 95% CI: 1.04-2.34, adjusted <i>P</i> = 0.03) and olanzapine (hazard ratio 1.40, 95% CI: 1.02-1.94, adjusted <i>P</i> = 0.04).</p><p><strong>Conclusion: </strong>Ziprasidone, amisulpride and olanzapine are associated with increased risk of QTc prolongation. Regular electrocardiogram monitoring is recommended when clinicians prescribe such drugs.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 2","pages":"e42"},"PeriodicalIF":3.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584626","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":"Clinical characteristics and prevalence of adolescent self-harm before, during and after the COVID-19 pandemic: retrospective cross-sectional database study.","authors":"Patricia Zavaleta-Ramírez, Marcos Rosetti, Lilia Albores-Gallo, Emmanuel Sarmiento-Hernández","doi":"10.1192/bjo.2025.4","DOIUrl":"https://doi.org/10.1192/bjo.2025.4","url":null,"abstract":"<p><strong>Background: </strong>Evidence indicates that the COVID-19 pandemic has led to an increase in self-harm among adolescents; however, little is known about the trends in prevalence after the end of the pandemic.</p><p><strong>Aims: </strong>This retrospective cross-sectional database study evaluates changes in the prevalence and clinical characteristics of self-harm among adolescents who sought attention from the emergency service of the largest children's psychiatric hospital in Mexico before, during and after the COVID-19 pandemic.</p><p><strong>Method: </strong>After comparing the clinical characteristics of self-harm between the three periods, we calculated the monthly prevalence of self-harm among patients (<i>n</i> = 3520) visiting the hospital's emergency psychiatric services over a period of 58 months. Using joinpoint regression, we evaluated temporal trends in self-harm prevalence.</p><p><strong>Results: </strong>Affective disorders and hitting as a method of self-harm were more frequent during and after the pandemic in comparison with the pre-pandemic period. The prevalence of self-harm diminished from March 2019 to March 2023, a trend followed by an increase coinciding with the end of the pandemic and the return to normal activities.</p><p><strong>Conclusions: </strong>The significant increase in prevalence observed after the end of the pandemic suggests a long-term impact on mental health of adolescents. This underscores the need for monitoring this population during post-pandemic years to provide timely interventions.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 2","pages":"e41"},"PeriodicalIF":3.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584625","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":"Associations between oral hormonal contraceptives and internalising problems in adolescent girls.","authors":"Nadie H M Bosmans, Milan Zarchev, Leonie Berges, Astrid M Kamperman, Eline M P Poels, Witte J G Hoogendijk, Nina H Grootendorst-van Mil","doi":"10.1192/bjo.2024.859","DOIUrl":"https://doi.org/10.1192/bjo.2024.859","url":null,"abstract":"<p><strong>Background: </strong>Oral contraceptive pills (OCP) have received increased critical attention recently owing to their perceived link with mental health, especially among adolescent girls. The empirical literature, however, includes mixed findings on whether OCP use is associated with poorer mental health.</p><p><strong>Aims: </strong>To examine the association between the use of OCP and internalising problems in adolescent girls.</p><p><strong>Methods: </strong>This study was embedded in the iBerry study, a population-based cohort of adolescents oversampled for behavioural and emotional problems from the greater Rotterdam area, The Netherlands. In 372 girls, internalising problems were measured using the Youth Self Report, and use of OCP was determined by parental interview and self-report questionnaire across two subsequent waves (mean ages 14.9 and 17.9 years, respectively). Multiple regression analyses were performed to determine the association. Analyses were adjusted for various sociodemographic factors and adjusted for previous internalising problems assessed at a mean age of 14.9 years.</p><p><strong>Results: </strong>In total, 204 girls (54.8%) used OCP. OCP use was associated with fewer internalising problems in adolescent girls compared with non-use (adjusted β = -2.22, 95% CI [-4.24, -0.20]; <i>P</i> = 0.031).</p><p><strong>Conclusions: </strong>In this research, we found that adolescent girls using OCP reported fewer internalising problems compared with non-users. This association was most prominent for girls with pre-existing internalising problems. Although healthy user bias may have a role, our observations suggest a potential therapeutic benefit for those with greater baseline challenges.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 2","pages":"e40"},"PeriodicalIF":3.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539792","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":"Neuropsychiatry as a paradigm propelling neurology and psychiatry into the future.","authors":"Jay A Salpekar, Marco Mula, Niruj Agrawal, Kenneth R Kaufman","doi":"10.1192/bjo.2024.864","DOIUrl":"https://doi.org/10.1192/bjo.2024.864","url":null,"abstract":"<p><p>Neurology and psychiatry have long been divided as subspecialities of medicine. However, the symptom overlap in central nervous system illness is unmistakable. Medical science has evolved, necessitating a neuropsychiatric approach that is more comprehensive. This editorial briefly outlines the history of neurology and psychiatry and the movement towards a new paradigm.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 2","pages":"e38"},"PeriodicalIF":3.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536446","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 systematic review and meta-analysis of the traumatogenic phenotype hypothesis of psychosis: commentary, Alameda.","authors":"Luis Alameda","doi":"10.1192/bjo.2024.863","DOIUrl":"https://doi.org/10.1192/bjo.2024.863","url":null,"abstract":"<p><p>Onyeama et al have examined the clinical profile of individuals with psychosis and childhood trauma using a stringent approach that yielded selective evidence, affecting power and insight into the specific and differential roles of abuse and neglect in the clinical profile. This commentary puts the findings into a broader meta-analytical context.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 2","pages":"e39"},"PeriodicalIF":3.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536542","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":"Developing an algorithm to identify individuals with psychosis in secondary care in England: application using the Mental Health Services Data Set.","authors":"Claire de Oliveira, Maria Ana Matias, María José Aragon Aragon, Misael Anaya Montes, David Osborn, Rowena Jacobs","doi":"10.1192/bjo.2024.853","DOIUrl":"https://doi.org/10.1192/bjo.2024.853","url":null,"abstract":"<p><strong>Background: </strong>There is currently no definitive method for identifying individuals with psychosis in secondary care on a population-level using administrative healthcare data from England.</p><p><strong>Aims: </strong>To develop various algorithms to identify individuals with psychosis in the Mental Health Services Data Set (MHSDS), guided by national estimates of the prevalence of psychosis.</p><p><strong>Method: </strong>Using a combination of data elements in the MHSDS for financial years 2017-2018 and 2018-2019 (mental health cluster (a way to describe and classify a group of individuals with similar characteristics), Health of the Nation Outcome Scale (HoNOS) scores, reason for referral, primary diagnosis, first-episode psychosis flag, early intervention in psychosis team flag), we developed 12 unique algorithms to detect individuals with psychosis seen in secondary care. The resulting numbers were then compared with national estimates of the prevalence of psychosis to ascertain whether they were reasonable or not.</p><p><strong>Results: </strong>The 12 algorithms produced 99 204-138 516 and 107 545-134 954 cases of psychosis for financial years 2017-2018 and 2018-2019, respectively, in line with national prevalence estimates. The numbers of cases of psychosis identified by the different algorithms differed according to the type and number (3-6) of data elements used. Most algorithms identified the same core of patients.</p><p><strong>Conclusions: </strong>The MHSDS can be used to identify individuals with psychosis in secondary care in England. Users can employ several algorithms to do so, depending on the objective of their analysis and their preference regarding the data elements employed. These algorithms could be used for surveillance, research and/or policy purposes.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 2","pages":"e37"},"PeriodicalIF":3.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514252","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":"Impact of introducing a capacity-based mental health law in Norway: qualitative exploration of multi-stakeholder perspectives.","authors":"Jacob Jorem, Reidun Førde, Tonje Lossius Husum, Jørgen Dahlberg, Reidar Pedersen","doi":"10.1192/bjo.2024.810","DOIUrl":"https://doi.org/10.1192/bjo.2024.810","url":null,"abstract":"<p><strong>Background: </strong>Decision-making capacity (DMC) is key to capacity-based mental health laws. In 2017, Norway introduced a lack of DMC as an additional criterion for involuntary care and treatment to strengthen patient autonomy and reduce involuntary care. Health registry data reveal an initial reduction followed by rising involuntary care and treatment rates post-2017. Despite jurisdictions moving towards capacity-based mental health laws, little is known about their impact.</p><p><strong>Aims: </strong>To explore the impact of introducing a capacity-based mental health law governing involuntary care and treatment.</p><p><strong>Method: </strong>Semi-structured interviews and focus groups were conducted in 2018 with 60 purposively sampled stakeholders, including patients, families, health professionals and lawyers. Of these, 26 participated in individual follow-up interviews in 2022-23. The transcribed interviews were thematically analysed following Braun and Clarke.</p><p><strong>Results: </strong>Four themes emerged: (a) increased awareness of patient autonomy and improved patient involvement; (b) altered thresholds for involuntary admission and discharge and more challenging to help certain patient groups; (c) more responsibility for primary health services; and (d) increased family responsibility but unchanged involvement by health services.</p><p><strong>Conclusions: </strong>Introducing a capacity-based mental health law appears to raise awareness of patient autonomy, but its impact depends on an interplay of complex health, social and legal systems. Post-2017 changes, including rising involuntary care and treatment rates, higher thresholds for admissions and increased pressure on primary health services and families, may be influenced by several factors. These include implementation of decision-making capacity, legal interpretations, formal measures for care of non-resistant incompetent individuals, reduced in-patient bed availability, inadequate voluntary treatment options and societal developments. Further research is needed to better understand these changes and their causes.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 2","pages":"e35"},"PeriodicalIF":3.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490472","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 pilot study of a ketogenic diet in bipolar disorder: clinical, metabolic and magnetic resonance spectroscopy findings.","authors":"Iain H Campbell, Nicole Needham, Helen Grossi, Ivana Kamenska, Saturnino Luz, Shane Sheehan, Gerard Thompson, Michael J Thrippleton, Melissa C Gibbs, Joana Leitao, Tessa Moses, Karl Burgess, Benjamin P Rigby, Sharon A Simpson, Emma McIntosh, Rachel Brown, Ben Meadowcroft, Frances Creasy, Maja Mitchell-Grigorjeva, John Norrie, Ailsa McLellan, Cheryl Fisher, Tomasz Zieliński, Giulia Gaggioni, Harry Campbell, Daniel J Smith","doi":"10.1192/bjo.2024.841","DOIUrl":"https://doi.org/10.1192/bjo.2024.841","url":null,"abstract":"<p><strong>Background: </strong>Preliminary evidence suggests that a ketogenic diet may be effective for bipolar disorder.</p><p><strong>Aims: </strong>To assess the impact of a ketogenic diet in bipolar disorder on clinical, metabolic and magnetic resonance spectroscopy outcomes.</p><p><strong>Method: </strong>Euthymic individuals with bipolar disorder (<i>N</i> = 27) were recruited to a 6- to 8-week single-arm open pilot study of a modified ketogenic diet. Clinical, metabolic and MRS measures were assessed before and after the intervention.</p><p><strong>Results: </strong>Of 27 recruited participants, 26 began and 20 completed the ketogenic diet. For participants completing the intervention, mean body weight fell by 4.2 kg (<i>P</i> < 0.001), mean body mass index fell by 1.5 kg/m² (<i>P</i> < 0.001) and mean systolic blood pressure fell by 7.4 mmHg (<i>P</i> < 0.041). The euthymic participants had average baseline and follow-up assessments consistent with them being in the euthymic range with no statistically significant changes in Affective Lability Scale-18, Beck Depression Inventory and Young Mania Rating Scale. In participants providing reliable daily ecological momentary assessment data (<i>n</i> = 14), there was a positive correlation between daily ketone levels and self-rated mood (<i>r</i> = 0.21, <i>P</i> < 0.001) and energy (<i>r</i> = 0.19 <i>P</i> < 0.001), and an inverse correlation between ketone levels and both impulsivity (<i>r</i> = -0.30, <i>P</i> < 0.001) and anxiety (<i>r</i> = -0.19, <i>P</i> < 0.001). From the MRS measurements, brain glutamate plus glutamine concentration decreased by 11.6% in the anterior cingulate cortex (<i>P</i> = 0.025) and fell by 13.6% in the posterior cingulate cortex (<i>P</i> = <0.001).</p><p><strong>Conclusions: </strong>These findings suggest that a ketogenic diet may be clinically useful in bipolar disorder, for both mental health and metabolic outcomes. Replication and randomised controlled trials are now warranted.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 2","pages":"e34"},"PeriodicalIF":3.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490518","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":"Interrater reliability of the DSM-5 and ICD-11 Criterion A for PTSD and complex PTSD in parents of children with autism using the Life Events Checklist.","authors":"Kylie Hinde, Gert Martin Hald, David Hallford, Theis Lange, Mikkel Christoffer Berg B Arendt, Silvia Pavan, David Austin","doi":"10.1192/bjo.2024.848","DOIUrl":"https://doi.org/10.1192/bjo.2024.848","url":null,"abstract":"<p><strong>Background: </strong>Parents of children with autism demonstrate elevated traumatic stress symptoms, but seldom receive diagnoses of post-traumatic stress disorder (PTSD) or complex PTSD. An accurate assessment of Criterion A is essential for a valid diagnosis of these disorders, yet it is uncertain whether Criterion A, as defined by the two primary international diagnostic systems (DSM-5-TR and ICD-11), yields consistent interrater reliability, when psychologists rely solely on self-report from these parents for assessing PTSD or complex PTSD.</p><p><strong>Aims: </strong>This study aims to investigate interrater reliability across psychologists when assessing Criterion A events against the ICD-11 and DSM-5-TR.</p><p><strong>Method: </strong>Ten Australian psychologists rated parents' self-reported traumatic events related to parenting, using the Life Events Checklist for DSM-5-TR and ICD-11 Criterion A. Data from 200 randomly selected parents of children, all meeting symptom thresholds for PTSD or complex PTSD, were analysed. Bootstrapping calculated kappa coefficients, differences between ICD-11 and DSM-5-TR criteria, and self-reports of threat/no threat, with 95% confidence intervals for these differences.</p><p><strong>Results: </strong>Interrater reliability varied from poor to moderate. The ICD-11 had significantly higher reliability than the DSM-5-TR for Criterion A (<i>κ</i>_difference = 0.105, 95% CI 0.052-0.153, <i>P</i> < 0.001). The interrater reliability was lower when parents reported life threat, serious injury or death (<i>κ</i>_difference = 0.096, 95% CI 0.019-0.176, <i>P</i> = 0.007).</p><p><strong>Conclusions: </strong>This study highlights challenges in assessing PTSD and complex PTSD Criterion A in parents of children with autism, using DSM-5-TR and ICD-11 criteria with the Life Events Checklist, revealing less than adequate interrater reliability.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 2","pages":"e34"},"PeriodicalIF":3.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466530","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":"Assessment attendance and treatment engagement with talking and internet-enabled therapies of people with and without a long-term physical health condition: analysis of Talking Therapies service data.","authors":"Emma Jenkinson, Ruth A Hackett, Rona Moss-Morris, Grace Wong, Jon Wheatley, Mirko Cirkovic, Joanna Hudson","doi":"10.1192/bjo.2024.846","DOIUrl":"https://doi.org/10.1192/bjo.2024.846","url":null,"abstract":"<p><strong>Background: </strong>Research indicates that treatment outcomes are poorer for people with long-term physical health conditions (LTCs) in Talking Therapies services (formerly known as Improving Access to Psychological Therapies). However, the impact of having an LTC on attendance at assessment and treatment appointments within Talking Therapies remains unclear. Internet-enabled therapies may be one way to overcome barriers to treatment engagement in Talking Therapies. However, their effect on engagement and the influence of LTC status on receipt of internet-enabled therapies is unknown.</p><p><strong>Aims: </strong>To explore the association between LTC status and assessment attendance, treatment engagement and internet-enabled therapy receipt within Talking Therapies services, and whether receipt of internet-enabled treatment bolsters engagement.</p><p><strong>Method: </strong>We used anonymous patient-level data from two inner London Talking Therapies services during January to December 2022 (<i>n</i> = 17 095 referrals). Binary logistic regression models were constructed to compare differences between LTC and non-LTC groups on (a) assessment attendance, (b) engagement and (c) internet-enabled therapy receipt. In our regression models, we controlled for key clinical and demographic covariates.</p><p><strong>Results: </strong>There were no differences between patients with or without an LTC in assessment attendance or treatment engagement, after controlling for covariates. Across the whole sample, receiving internet-enabled treatment increased engagement. People with an LTC were less likely to receive an internet-enabled treatment.</p><p><strong>Conclusions: </strong>Having an LTC does not negatively affect assessment attendance and engagement with talking therapies. However, receiving an internet-enabled treatment bolstered engagement in our regression models. People with an LTC were less likely to receive internet-enabled treatment.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 2","pages":"e31"},"PeriodicalIF":3.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390004","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}