BJPsych Open最新文献

{"title":"'I would have killed myself had it not been for this service': qualitative experiences of NHS and third sector crisis care in the UK.","authors":"Laura Sambrook, Anna Balmer, Jackie Tait, Peter Ashley-Mudie, Jason C McIntyre, Amrith Shetty, Rajan Nathan, Pooja Saini","doi":"10.1192/bjo.2025.30","DOIUrl":"10.1192/bjo.2025.30","url":null,"abstract":"<p><strong>Background: </strong>More people than ever are receiving support for mental health crises, and instances of suicide continue to grow. Mental health funding has recently increased, focusing on improving services that provide an alternative to emergency departments, such as urgent helplines and crisis cafés. However, there is a lack of literature examining the efficacy of these services, despite research suggesting they may be associated with lower hospital admission rates.</p><p><strong>Aims: </strong>We aimed to evaluate the perspectives of people with lived experience of accessing a variety of mental health crisis services in the UK.</p><p><strong>Method: </strong>One-to-one interviews were conducted with 25 individuals as part of a qualitative grounded theory analysis.</p><p><strong>Results: </strong>The following themes were identified as important for recovery: more than a diagnosis (a need for person-centred care); instilling hope for the future (access to creative spaces and community); and a safe space for recovery (out-of-hours crisis cafés). Many have credited crisis cafés with saving their lives and felt there should be increased funding provided for collaboration between the National Health Service (NHS) and the third sector. Participants highlighted the need for interim support for those awaiting therapy via the NHS and continuity of care as key areas for improvement.</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 and an over-reliance on the third sector. While crisis cafés are currently provided at a low cost and appear to result in satisfaction, policymakers must ensure they receive adequate funding and do not become overburdened.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 3","pages":"e107"},"PeriodicalIF":3.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972700","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":"Exploring perspectives on how to improve psychological treatment for women from minoritised ethnic communities: qualitative study with psychological therapists.","authors":"Laura-Louise Arundell, Rob Saunders, Phoebe Barnett, Judy Leibowitz, Joshua E J Buckman, Felicity Woodcock, Stephen Pilling","doi":"10.1192/bjo.2025.36","DOIUrl":"10.1192/bjo.2025.36","url":null,"abstract":"<p><strong>Background: </strong>Women from minoritised ethnic communities experience inequalities in access, experience and outcomes of psychological therapy. Understanding the factors associated with these inequalities could inform improvements to mental health services.</p><p><strong>Aims: </strong>To explore therapists' experiences of providing treatment to women from minoritised ethnic communities, including insights on adaptations made at the delivery, content and wider organisation levels, and to gather suggestions about potential treatment improvements.</p><p><strong>Method: </strong>Semi-structured interviews were conducted with 13 therapists working in two National Health Service Talking Therapies for anxiety and depression services and who had experience of treating women from minoritised ethnic communities. Data were analysed using thematic analysis.</p><p><strong>Results: </strong>Three high-order themes were identified: incorporating ethnicity and culture in the delivery of psychological therapies, challenges associated with delivering therapeutic interventions to women from minoritised ethnic groups and improvements to services that could support better access, engagement and outcomes for women from minoritised ethnic groups.</p><p><strong>Conclusions: </strong>Findings indicate that therapists viewed cultural adaptation and cultural sensitivity as important to the delivery of appropriate care for minoritised ethnic women. Challenges to appropriate care included limited service resources, communication and language barriers, stigma and existing access and engagement inequalities. Therapists suggested that, to deliver high-quality care and optimise outcomes, improvements are required in cultural sensitivity training, flexibility of service delivery, outreach work with communities to encourage uptake and reduce stigma, support for staff and workforce diversity.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 3","pages":"e104"},"PeriodicalIF":3.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978304","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":"Time trends in life expectancy of people with severe mental illness in Scotland, 2000-2019: population-based study.","authors":"Kelly J Fleetwood, Raied Alotaibi, Stine H Scheuer, Daniel J Smith, Sarah H Wild, Caroline A Jackson","doi":"10.1192/bjo.2025.49","DOIUrl":"10.1192/bjo.2025.49","url":null,"abstract":"<p><strong>Background: </strong>People with severe mental illness (SMI) have a higher risk of premature mortality than the general population.</p><p><strong>Aims: </strong>To investigate whether the life expectancy gap for people with SMI is widening, by determining time trends in excess life-years lost.</p><p><strong>Method: </strong>This population-based study included people with SMI (schizophrenia, bipolar disorder and major depression) alive on 1 January 2000. We ascertained SMI from psychiatric hospital admission records (1981-2019), and deaths via linkage to the national death register (2000-2019). We used the Life Years Lost (LYL) method to estimate LYL by SMI and sex, compared LYL to the Scottish population and assessed trends over 18 3-year rolling periods.</p><p><strong>Results: </strong>We included 28 797 people with schizophrenia, 16 657 with bipolar disorder and 72 504 with major depression. Between 2000 and 2019, life expectancy increased in the Scottish population but the gap widened for people with schizophrenia. For 2000-2002, men and women with schizophrenia lost an excess 9.4 (95% CI 8.5-10.3) and 8.2 (95% CI 7.4-9.0) life-years, respectively, compared with the general population. In 2017-2019, this increased to 11.8 (95% CI 10.9-12.7) and 11.1 (95% CI 10.0-12.1). The life expectancy gap was lower for bipolar disorder and depression and unchanged over time.</p><p><strong>Conclusions: </strong>The life expectancy gap in people with SMI persisted or widened from 2000 to 2019. Addressing this entrenched disparity requires equitable social, economic and health policies, healthcare re-structure and improved resourcing, and investment in interventions for primary and secondary prevention of SMI and associated comorbidities.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 3","pages":"e103"},"PeriodicalIF":3.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972642","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 national survey of current discharge planning and aftercare arrangement practices for those returned to prison from secure psychiatric services in England and Wales.","authors":"Sarah Leonard, Jana Bowden, Matilda Minchin, Ruth McDonald, Neil Allen, Jane Senior, Jennifer Shaw","doi":"10.1192/bjo.2025.26","DOIUrl":"10.1192/bjo.2025.26","url":null,"abstract":"<p><strong>Background: </strong>Little is known about the transition process for those returned to prison following treatment in secure psychiatric services. This study is the first internationally to explore the process of discharge/aftercare planning for this population.</p><p><strong>Aim: </strong>To identify the current national discharge and aftercare planning procedures for people returned to prison in England and Wales.</p><p><strong>Methods: </strong>A national survey of current service discharge planning and aftercare arrangement practices in low- and medium-secure psychiatric services and prison mental health teams in England and Wales.</p><p><strong>Results: </strong>We had a 72% response rate across prison-based and secure mental health services. A summative contents analysis highlighted that outstanding priority areas for improvement, include (a) relationship building to improve communication and understanding between secure psychiatric services, prison mental health services, and the prison estate and (b) significant reform and additional resources to achieve the expected standard of care and to provide people returned to prison with a care package tailored to meet their specific needs.</p><p><strong>Conclusion: </strong>Effective care planning and management of return to prison from secure psychiatric services has the potential to improve patient health and well-being in prison and up to and beyond their subsequent prison release, with far-reaching effects on prevention of relapse, hospital readmission, reoffending and other adverse events.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 3","pages":"e105"},"PeriodicalIF":3.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062126","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 assessment of self-harm as a window of opportunity for addressing domestic abuse: invited editorial on Knipe et al.","authors":"Vishal Bhavsar, Anne M Doherty","doi":"10.1192/bjo.2025.46","DOIUrl":"10.1192/bjo.2025.46","url":null,"abstract":"<p><p>Domestic abuse harms children and families. Self-harm is associated with exposure to and perpetration of domestic abuse, but research on health service responses to self-harm in the context of domestic abuse is limited. We discuss recent work examining the response of mental health professionals to domestic abuse in the emergency department by Knipe and colleagues. Thematic analysis of interviews with 15 mental health professionals working in consultation and liaison settings helped to construct themes including a fear of deeper exploration and tensions between identification and response ('between knowing and acting'). The paper raises important issues for quality improvement in responses to self-harm in liaison settings, including balancing time and resources across different management needs (including domestic abuse response) and professional perceptions of their own actions in clinical settings, such as acknowledging harmful behaviour. The paper demonstrates opportunities for strengthening responses to domestic abuse in professional training.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 3","pages":"e102"},"PeriodicalIF":3.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969855","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 perceived levels of stress, anxiety and depression among family caregivers of patients undergoing haemodialysis and their association with quality of life.","authors":"Aisha Al Maqbali, Omar Al Omari, Loai Abu Sharour, Zakariya Al-Naamani, Mahmood Al Khatri, Hala Mohamed Sanad, Iman Al Hashmi, Abdullah Alkhawaldeh, Mohammad Al Qadire, Domam Al Omari","doi":"10.1192/bjo.2025.44","DOIUrl":"10.1192/bjo.2025.44","url":null,"abstract":"<p><strong>Background: </strong>Acknowledging the impact of chronic kidney disease on caregivers' quality of life (QoL) and psychological well-being has become a global priority, highlighting the need for supportive interventions specifically aimed at caregivers.</p><p><strong>Aims: </strong>This study aimed to assess the prevalence of stress, anxiety and depression among family caregivers of Omani patients undergoing haemodialysis and to explore its association with QoL.</p><p><strong>Method: </strong>The study employed a cross-sectional design. A sample of 326 participants completed the study's surveys, including the Depression Anxiety Stress Scale, WHOQOL-BREF scale and a demographic scale.</p><p><strong>Results: </strong>The survey indicated that 68.4% of the participant caregivers experienced varying degrees of depression. In addition, 48.4% of caregivers reported experiencing stress levels ranging from mild to extremely severe. For anxiety, 65.6% (<i>n</i> = 214) of caregivers noted varying levels, from mild to extremely severe anxiety. Significant negative associations were found among caregiver age, number of chronic illnesses, number of medications, daily hours spent on caregiving, physical health, stress, anxiety and depression, on the one hand, and the physical domain of QoL, on the other hand. Regarding the psychological domain of QoL, significant negative associations were observed with daily caregiving hours, physical health, stress, anxiety and depression.</p><p><strong>Conclusion: </strong>This study highlights the significant psychological burden faced by caregivers of patients undergoing haemodialysis. Systematic screening and practical interventions, such as support groups and mental health programmes, are essential to improve caregiver well-being. Future research should explore the effectiveness of these interventions and the long-term impact of caregiving.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 3","pages":"e100"},"PeriodicalIF":3.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968602","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":"Association of risk factors with mental illness in a rural community: insights from machine learning models.","authors":"Firoj Al-Mamun, Mohammed A Mamun, Md Emran Hasan, Moneerah Mohammad ALmerab, Johurul Islam, Mohammad Muhit","doi":"10.1192/bjo.2025.47","DOIUrl":"10.1192/bjo.2025.47","url":null,"abstract":"<p><strong>Background: </strong>Mental health conditions, particularly depression and anxiety, are highly prevalent and impose substantial health burdens globally. Despite advancements in machine learning, there is limited application of these methods in predicting common mental illnesses within community populations in low-resource settings.</p><p><strong>Aims: </strong>This study aims to examine the prevalence and associated risk factors of common mental illnesses collectively (depression and anxiety) in a rural Bangladeshi community using machine learning models.</p><p><strong>Method: </strong>This cross-sectional study surveyed 490 adults aged 18-59 in a rural Bangladeshi community. Depression and anxiety were assessed using the Patient Health Questionnaire (PHQ-2) and Generalised Anxiety Disorder (GAD-2) scales. Machine learning models, including Categorical Boosting, the support vector machine, the random forest and XGBoost (eXtreme Gradient Boosting), were trained on 80% of the data-set and tested on 20% to evaluate predictive accuracy, precision, F1 score, log-loss and area under the receiver operating characteristic curve (AUC-ROC).</p><p><strong>Results: </strong>Some 20.4% of participants experienced at least one common mental illness. Feature importance analysis identified house type, age group and educational status as the most significant predictors. SHAP (Shapley Additive exPlanations) values highlighted their influence on model outputs, and the XGBoost gain metric confirmed the importance of marital status and house type, with gains of 0.76 and 0.73, respectively. XGBoost delivered the best performance, achieving an F1 score of 71.01%, precision of 71.58%, accuracy of 71.15% and the lowest log-loss value of 0.56. The random forest had an accuracy of 78.21% and an AUC-ROC of 0.90.</p><p><strong>Conclusions: </strong>The findings of this study suggest targeted interventions addressing housing and social determinants could improve mental health outcomes in similar rural settings. Further studies should consider longitudinal data to explore causal relationships.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 3","pages":"e96"},"PeriodicalIF":3.9,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971594","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 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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089809/pdf/","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":"OA","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089807/pdf/","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":"OA","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089803/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}