BJPsych Open最新文献

{"title":"The cost-effectiveness of predictive algorithm guided primary antidepressant treatment: economic evaluation of the multinational PReDicT randomised controlled trial.","authors":"Nataša Perić, Susanne Mayer, Timea Helter, Jürgen Deckert, Philip Gorwood, Victor Perez, Andreas Reif, Henricus G Ruhe, Dick J Veltman, Anneke van Schaik, Richard Keith Morriss, Amy Beckenstrom, Gerard R Dawson, Colin T Dourish, Rebecca Dias, Jonathan Kingslake, Michael Browning, Judit Simon","doi":"10.1192/bjo.2026.11021","DOIUrl":"10.1192/bjo.2026.11021","url":null,"abstract":"<p><strong>Background: </strong>The PReDicT study showed that predictive algorithm-guided antidepressant treatment reduces anxiety and improves functioning in patients with depression.</p><p><strong>Aims: </strong>To estimate the costs, outcomes and cost-effectiveness of the PReDicT test compared with treatment as usual (TAU) for primary depression care in five European countries.</p><p><strong>Method: </strong>Within-trial economic analysis was conducted over 24 weeks from the health/social care and societal perspectives alongside the PReDicT trial (NCT02790970) in France, Germany, The Netherlands, Spain, and the UK, according to Consolidated Health Economic Evaluation Reporting Standards guidelines. We calculated quality-adjusted life-years (QALYs) based on the EQ-5D-5L, capability-weighted life-years based on the Oxford Capabilities Questionnaire - Mental Health (OxCAP-MH) (Germany and UK only), and costs for 2018 (€). Multiple imputation for missing data, multivariable regression for cost and outcome differences, and bootstrapping and sensitivity analyses for uncertainty were conducted.</p><p><strong>Results: </strong>There were significant outcome improvements (EQ-5D-5L PRedicT: +0.139; TAU: +0.140) and societal cost reductions (PRedicT: -€2589; TAU: -€2602) in both groups (<i>N</i> = 913) between the before and during trial periods. In the UK and Germany (<i>n</i> = 619), the PReDicT group showed significant additional capability well-being gains (OxCAP-MH: +2.127, <i>p</i> = 0.021). Cost-effectiveness probabilities ranged from 46 to 59% at trial level, but exceeded 80% in the UK. Results remained stable across different sensitivity analyses, with societal cost-effectiveness improved for those (self-)employed.</p><p><strong>Conclusions: </strong>We observed potentially meaningful health and economic benefits of closely monitored antidepressant treatment, as implemented in both treatment and control arms of the PReDicT trial. The PReDicT test itself had some added benefits in improved capabilities and productivity, however, with great uncertainty and country-level variations in cost-effectiveness.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 3","pages":"e107"},"PeriodicalIF":3.5,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670226","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":"'Since people who have mental illness are stigmatised, their service is also stigmatised. You get a massive hospital building and there is no mental health facility': exploring perceptions of mental health, stigma of mental illness, care-seeking and service use in the Somali Regional State of Ethiopia.","authors":"Nasir Warfa, Charlotte Hanlon, Elyas Abdulahi, Mohamed Abdi Wali, Abdifetah Abdullahi Sheikh, Medhin Selamu, Mussie Abdosh Hassen, Fowsia Abdulkadir Hashi, Abdulahi Hussein, Bashir Abdulahi, Ahmed M Abdinasir, Abdikarim M Abdi, Mustafa al'Absi, Roxanne Keynejad, Solomon Teferra, Chris Willott","doi":"10.1192/bjo.2026.11016","DOIUrl":"10.1192/bjo.2026.11016","url":null,"abstract":"<p><strong>Background: </strong>There are few mental health services in the Somali Regional State (SRS) of Ethiopia, and many people with mental health conditions turn to traditional healing. Also, little is known about perspectives on mental ill health and care in this sociocultural context.</p><p><strong>Aims: </strong>The study explores the experiences and manifestations of mental health-related stigma in the SRS, to inform the development of mental healthcare systems.</p><p><strong>Method: </strong>We conducted 16 semi-structured interviews with health workers, aspirational leaders, users of mental health services and carers in Jigjiga and Kabridahar, two cities in the SRS, between April and July 2024. Translated transcripts were imported into NVIVO version 14 for coding and were then analysed using the thematic analysis method. We identified three main themes: (a) mental health stigma, (b) societal neglect and (c) misunderstanding of mental ill health.</p><p><strong>Results: </strong>Participants suggested that most people in the SRS view mental health in binary terms, in which a person is either 'mad' or sane; a corollary is that only severe conditions with overt behavioural manifestations were viewed as mental illness. Most people viewed mental health conditions as having spiritual causes. Mental health stigma was reportedly widespread and severe. These barriers contribute to care-seeking that is delayed and initially focused on faith-based providers.</p><p><strong>Conclusions: </strong>Any intervention to improve the provision of mental health services and the development of mental health systems must take into account the perspectives of service users and carers, and address the widespread stigma and lack of knowledge around mental illness.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 3","pages":"e106"},"PeriodicalIF":3.5,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670176","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":"Audio Visual Assisted Therapy Aid for Refractory Auditory Hallucinations (AVATAR) therapy for voice hearers: systematic review and meta-analysis.","authors":"Felix Opper, Sebastian Henges, Pawel Weinstein, Dana Arnheim, Laura Fässler, Olivier Percie du Sert, Izabela Stefaniak, Michel Sabé, Louise Birkedal Glenthøj, Neil Thomas, Chih-Sung Liang, Brendon Stubbs, Kerem Böge","doi":"10.1192/bjo.2026.11014","DOIUrl":"10.1192/bjo.2026.11014","url":null,"abstract":"<p><strong>Background: </strong>Auditory verbal hallucinations (AVHs) are common and distressing symptoms across a range of psychiatric disorders, including schizophrenia spectrum disorders. Audio Visual Assisted Therapy Aid for Refractory Auditory Hallucinations (AVATAR) is an innovative therapeutic approach that facilitates dialogue with a digital avatar representing the voices that patients hear.</p><p><strong>Aims: </strong>This systematic review and meta-analysis aimed to assess the efficacy, tolerability and acceptability of AVATAR therapy in reducing voice-related symptoms.</p><p><strong>Method: </strong>Following preregistration, we conducted a systematic review and meta-analysis of controlled trials of AVATAR therapy in samples primarily diagnosed with schizophrenia spectrum disorders. PubMed, CINAHL, Embase, PsycInfo, ClinicalTrials.gov, ISRCTN and Web of Science were searched in March 2025. We assessed bias and certainty with the Cochrane Risk-of-Bias 2 tool and the GRADE approach. Random-effects models were used to synthesise outcomes.</p><p><strong>Results: </strong>Eight AVATAR trials (<i>N</i> = 978) were included. Compared with usual treatment, waitlist and active control groups, AVATAR therapy decreased the primary outcome of AVH severity at post-treatment (Hedges' <i>g</i> = -0.40, 95% CI -0.54 to -0.25) and short-term follow-up (Hedges' <i>g</i> = -0.25, 95% CI -0.40 to -0.10). AVH subscales showed small significant effect sizes at post-treatment (frequency: Hedges' <i>g</i> = -0.38, 95% CI -0.52 to -0.24; distress: Hedges' <i>g</i> = -0.32, 95% CI -0.46 to -0.18), which were maintained at short-term follow-up. The certainty of evidence was rated moderate for AVH severity at post-treatment. AVATAR therapy was largely tolerable and acceptable, with adverse events mostly unrelated to the treatment and a comparable drop-out rate to control groups.</p><p><strong>Conclusions: </strong>Findings suggest that AVATAR therapy is effective at reducing AVH symptoms. Considering heterogeneous control groups and less clear evidence for secondary outcomes and longer follow-ups, further research is warranted.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 3","pages":"e104"},"PeriodicalIF":3.5,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670182","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 career concerns and opportunities for UK-based early career researchers working in the field of eating disorders: Delphi study.","authors":"Emy Nimbley, Marie-Christine Opitz, Michelle Sader, Emily Newman, Helen Sharpe, Karri Gillespie-Smith, Fiona Duffy","doi":"10.1192/bjo.2026.11003","DOIUrl":"10.1192/bjo.2026.11003","url":null,"abstract":"<p><strong>Background: </strong>Although there may be common challenges and opportunities for early career researchers (ECRs), those working in the field of eating disorders may face unique barriers and require tailored support.</p><p><strong>Aims: </strong>The current study sought to explore consensus on career concerns and opportunities in eating disorder ECRs.</p><p><strong>Method: </strong>A three-stage Delphi model was conducted. Round 1 involved participants rating career concern and opportunity statements, with free-text responses. Researchers then generated a list of Delphi statements, which were shared in round 2, and participants were asked to indicate their level of agreement. A final round was shared, with median ratings from round 2 and the option to change or further expand on responses. Final consensus was calculated as percentage agreement.</p><p><strong>Results: </strong>Career concerns reaching consensus included timeline pressures, personal sacrifices for roles, unclear career trajectories, job insecurity, funding concerns, fears of being pushed out of the field and pressures to publish. There was no consensus on a range of other concerns (work/life balance, isolation, mental health and well-being and power imbalances), suggestive of context-dependent experiences. Participants agreed that almost all the presented career opportunities were of importance to eating disorder ECRs.</p><p><strong>Conclusions: </strong>Findings suggest that eating disorder ECRs face significant barriers toward remaining in the field. Although many concerns reflect broader ECR experience (limited research funding, associated job insecurity), some appear to be particularly exacerbated for ECRs working in the eating disorder field. Further research is needed to inform directions for tailored support strategies, such as peer support, mentoring schemes and increased funding from governing bodies.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 3","pages":"e105"},"PeriodicalIF":3.5,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670190","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":"Communicating the risk of psychiatric in-patient or enhanced community care in dementia.","authors":"Maja Swirska, Sabina London, Emma Wolverson, Benjamin R Underwood","doi":"10.1192/bjo.2026.11011","DOIUrl":"10.1192/bjo.2026.11011","url":null,"abstract":"<p><strong>Background: </strong>Around 10% of people living with dementia (PLWD) will experience a deterioration in their condition that will require urgent ('crisis') community support or an in-patient psychiatric admission. We have previously shown that people at high risk of a crisis event can be identified at the point of diagnosis. How the idea that someone is at increased risk of experiencing a crisis event in their care is best communicated is not known. Here, we describe the analysis of interviews with clinicians and PLWD, to understand their perspective and the co-production of tools designed to support risk communication.</p><p><strong>Aims: </strong>To explore multistakeholder perspectives (healthcare professionals, carers, PLWD; <i>n</i> = 12) on the communication of risk of future in-patient psychiatric admission or enhanced 'crisis' community care and develop tools to support communication.</p><p><strong>Method: </strong>This pilot study used an experience-based, co-design approach. Reflexive thematic analysis was used to analyse transcripts, leading to co-development of draft educational materials.</p><p><strong>Results: </strong>We identified five themes that inform how risk should be communicated. Participants underlined the importance of timing, setting and follow-up appointments. Digital tools were considered essential, but they were not seen as a substitute to face-to-face appointments. Individual preferences varied, highlighting the need for patient-centred communication. The findings led to the co-development of clinician guidelines and educational materials.</p><p><strong>Conclusions: </strong>Risk communication in dementia is complex and must be personalised to be most effective. Our findings may have relevance for the communication of other areas of risk in dementia beyond risk of care crises.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 3","pages":"e102"},"PeriodicalIF":3.5,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627000","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 compulsory community treatment across Australian jurisdictions: insights from three different data sources.","authors":"Claudia Bull, Anoushka Gaekwad, Jessica Madyson Layton, Bobbak Makooie, Alyshia Guan, Nithyashree Narayanan, Edwina Light, Steve Kisely","doi":"10.1192/bjo.2026.11019","DOIUrl":"10.1192/bjo.2026.11019","url":null,"abstract":"<p><strong>Background: </strong>Compulsory Community Treatment (CCT) is any intervention that mandates community psychiatric care. Despite Australia's high use of CCT compared to other countries, there is no standardised national reporting framework, limiting transparency and comparability across jurisdictions.</p><p><strong>Aims: </strong>To determine rates of CCT orders per 100 000 population, individuals subject to CCT per 100 000 population and the proportion of all community mental healthcare contacts that were involuntary between 2016-2017 and 2023-2024. We also sought to identify and document differences in reporting practices across CCT reporting bodies.</p><p><strong>Method: </strong>Publicly available data were extracted from annual reports of state and territory Mental Health Review Tribunals or Civil and Administrative Tribunals, Offices of the Chief Psychiatrist and the Australian Institute of Health and Welfare. Rates of CCT orders per 100 000 population, individuals subject to CCT per 100 000 population and the proportion of all community mental healthcare contacts that were involuntary were calculated and compared across jurisdictions.</p><p><strong>Results: </strong>Marked differences were identified in CCT terminology, reporting scope and data completeness across jurisdictions and reporting bodies. Only three jurisdictions reported the number of individuals subject to CCT and none reported incidence data. Rates of CCT increased in most jurisdictions, except Western Australia, which showed a decline and the lowest rate of all jurisdictions. The proportion of involuntary community contacts ranged from 3 to 26% nationally.</p><p><strong>Conclusions: </strong>Australia's fragmented CCT reporting landscape impedes accurate national monitoring. A standardised national CCT data-set that incorporates prevalence and incidence indicators is urgently needed to enable transparent, comparable reporting.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 3","pages":"e103"},"PeriodicalIF":3.5,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627124","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":"Implementing Problem Management Plus (PM+) in Haiti: qualitative study.","authors":"Michela Marchetti, Ana Carolina Molina, Marcio Gagliato, Orso Muneghina, Pernille Hansen, Faimy Carmelle Loiseau, Giuliana Mazzoni, Corrado Barbui, Marianna Purgato","doi":"10.1192/bjo.2026.11008","DOIUrl":"10.1192/bjo.2026.11008","url":null,"abstract":"<p><strong>Background: </strong>Haiti is experiencing a severe humanitarian crisis characterised by political instability and economic and security hardship. These adversities contribute to significant mental health challenges, which are also exacerbated by poor access to psychological support due to a shortage of specialised professionals. Problem Management Plus (PM+), a scalable and low-intensity intervention developed by the World Health Organization, is based on a task-sharing approach to address the treatment gap by training non-specialist helpers to provide psychosocial support.</p><p><strong>Aims: </strong>This study aimed to explore the implementation process of PM+ in Haiti, focusing on the barriers and facilitators that influenced its delivery. Specifically, the study focused on understanding the contextual factors affecting intervention accessibility, participant experiences and potential adaptations to enhance its effect.</p><p><strong>Method: </strong>A qualitative study was conducted across three Haitian cities, where trained helpers delivered PM+. Data were collected through the PSYCHLOPS tool with end-users and via cognitive interviews with stakeholders. Thematic analysis was conducted incorporating Lund's social determinants of mental health model and Bronfenbrenner's ecological systems theory to interpret findings.</p><p><strong>Results: </strong>Sixteen end-users and five stakeholders participated in the study. Key barriers to implementation and its success mainly included economic constraints and safety concerns. Facilitating factors included strong community engagement, adaptive implementation strategies (such as flexible scheduling, remote supervision and culturally responsive adjustments), alongside strong organisational support. End-users described substantial difficulties in managing everyday problems and emotional distress, as reported during pre-intervention qualitative assessments.</p><p><strong>Conclusions: </strong>PM+ appeared feasible in the Haitian context from an implementation perspective; however, its implementability depends on cultural adaptations, economic considerations and sustained support for facilitators. Addressing systemic barriers and integrating task-sharing interventions within existing health structures could enhance the long-term impact.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 3","pages":"e101"},"PeriodicalIF":3.5,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627173","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":"Attentional bias in paranoia: systematic review and meta-analysis.","authors":"Laura Eid, Chloe Hampshire, George Vamvakas, Pamela Jacobsen, Daniel Stahl, Jenny Yiend","doi":"10.1192/bjo.2026.10993","DOIUrl":"10.1192/bjo.2026.10993","url":null,"abstract":"<p><strong>Background: </strong>Paranoia is a transdiagnostic symptom and is associated with cognitive and social impairments. Attentional bias toward threat is thought to maintain paranoia.</p><p><strong>Aims: </strong>Despite many studies, attentional biases in paranoia have not been systematically summarised, which was the aim of the current work.</p><p><strong>Method: </strong>We conducted a systematic review and meta-analysis, identifying 10 964 studies, of which 35 met inclusion criteria for review and 15 for meta-analysis.</p><p><strong>Results: </strong>Findings showed a significant negative attentional bias (average standardised effect size 0.26; 95% CI 0.01-0.52; <i>p</i> = 0.046). Preliminary indications suggested bias was strongest for paranoia-related stimuli (average effect size 0.30; 95% CI 0.03-0.57; <i>p</i> = 0.027) and stronger for words than faces (average effect size 0.41; 95% CI 0.05-0.77; <i>p</i> = 0.027), but more data is needed to confirm these effects. Limitations were primarily statistical and included likely underestimation of the overall effect size of the association between negative attentional bias and paranoia and a lack of sufficient studies to robustly examine moderators.</p><p><strong>Conclusions: </strong>Summarising this literature provides a rationale for existing and new interventions for paranoia that target biased attentional mechanisms.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 3","pages":"e100"},"PeriodicalIF":3.5,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621410","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":"Childhood socioemotional development and growth mindset preceding schizophrenia: case-control study using prospectively collected data.","authors":"Javiera Vasquez-Nuñez, José Conejeros, Camila Díaz-Dellarrossa, Cristian Mena, Juan Undurraga, Alfonso Gonzalez-Valderrama, Ruben Nachar, Susana Claro, Eduardo A Undurraga, Nicolas A Crossley","doi":"10.1192/bjo.2026.11004","DOIUrl":"10.1192/bjo.2026.11004","url":null,"abstract":"<p><strong>Background: </strong>Understanding premorbid socioemotional trajectories in schizophrenia is crucial for early identification and potential primary prevention. Studies in adults with schizophrenia suggest similar socioemotional premorbid difficulties, but are limited by their retrospective design.</p><p><strong>Aims: </strong>To contribute new insights into the premorbid socioemotional characteristics of schizophrenia, beyond the biases of retrospective studies, this research investigates three educational socioemotional dimensions in children who later developed the disorder.</p><p><strong>Method: </strong>We conducted a case-control study using prospectively collected data, examining childhood differences in perceived parental support, self-esteem and school motivation, and growth mindset (intelligence can improve through effort) among individuals who later developed schizophrenia (<i>n</i> = 341) and their classmates (<i>n</i> = 20 567). We constructed <i>z</i>-normalised indicators based on standardised national tests administered in fourth, eighth and tenth grades in Chile. Mixed linear models accounted for repeated measures and adjusted for educational level, gender, grade point average, school and year.</p><p><strong>Results: </strong>Children later diagnosed with schizophrenia reported less parental educational support compared with their classmates (<i>β</i> = -0.276, 95% CI -0.388 to -0.163). Only girls who later developed schizophrenia reported lower self-esteem and school motivation than their peers (<i>β</i> = -0.290, 95% CI -0.498 to -0.131). Contrary to our hypothesis, children who later developed schizophrenia showed a higher growth mindset (<i>β</i> = 0.287, 95% CI 0.077-0.497).</p><p><strong>Conclusions: </strong>Our results suggest that premorbid socioemotional characteristics in schizophrenia are detectable in childhood and may vary by gender. These findings highlight the potential of educational settings as platforms for preventive interventions aimed at enhancing parental support and monitoring students' psycho-emotional well-being, while acknowledging gender-specific developmental trajectories and heterogeneity in premorbid functioning.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 3","pages":"e99"},"PeriodicalIF":3.5,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621448","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":"Concordance of positive, negative and disorganised psychotic syndromes in five twin samples.","authors":"Alastair G Cardno, E Jane Marshall, Timothea Toulopoulou, Eugenia Kravariti, Edward J Pepper, Frühling V Rijsdijk, Judith Allardyce, Robin M Murray, Evangelos Vassos","doi":"10.1192/bjo.2026.11017","DOIUrl":"10.1192/bjo.2026.11017","url":null,"abstract":"<p><strong>Background: </strong>Schizophrenia and psychosis have high twin heritability (approximately 80%), but these general estimates may hide aetiological variation. This can be investigated by using syndromes based on key psychotic symptom combinations.</p><p><strong>Aims: </strong>To investigate concordance, and heritability where calculable, of psychotic syndromes in multiple schizophrenia and psychosis twin samples.</p><p><strong>Method: </strong>We investigated concordance for positive, negative and disorganised psychotic syndromes, based on lifetime symptom ratings, in three classical schizophrenia twin samples (Fischer, Kringlen and Slater) and two psychosis samples (Maudsley register and non-register), the first four being systematically ascertained (total 317 monozygotic and 145 dizygotic probandwise pairs). We assessed concordance differences with logistic regression in generalised linear mixed models, and heritability from twin-modelling in the Maudsley register sample.</p><p><strong>Results: </strong>The positive syndrome, comprising delusions plus hallucinations, had 37.7-41.4% monozygotic and 6.0-6.3% dizygotic concordance, and heritability of 0.81 or 81% (95% CI 0.58-0.88), with similar results for negative and disorganised syndromes. In the systematically ascertained samples, delusions and hallucinations occurring without disorganised symptoms had nominally lower monozygotic twin concordance than when disorganised symptoms were also present (in the three schizophrenia samples: 89 pairs, odds ratio 3.47 (95% CI 1.04-1.54), <i>p</i> = 0.043; and the Maudsley register psychosis sample: 70 pairs, odds ratio 7.68 (95% CI 1.49-39.70), <i>p</i> = 0.016).</p><p><strong>Conclusions: </strong>In schizophrenia and psychosis, the syndrome of delusions plus hallucinations has high twin heritability overall. Positive symptoms without disorganised symptoms may indicate relatively high environmental influences, and positive symptoms with disorganised symptoms, relatively high familial and probably genetic influences, but further confirmation is needed.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"12 3","pages":"e98"},"PeriodicalIF":3.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13106995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147589903","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}