BJPsych Open最新文献

{"title":"Future directions for brain health clinics.","authors":"Jerry H K Tan, Ivan Koychev","doi":"10.1192/bjo.2025.62","DOIUrl":"10.1192/bjo.2025.62","url":null,"abstract":"<p><p>Brain Health Services are second-generation memory clinics that aim to reduce the risk of progression to dementia in at-risk individuals. We describe the rationale for such a service, and comment on its novel implementation by Venkataraman and colleagues that integrates digital technologies and biomarker testing. We describe the advantages and possible limitations of such an approach, then investigate areas for further work - namely, the need to account for multiple pathologies in biomarker testing and to formulate standards for genetic counselling.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 3","pages":"e98"},"PeriodicalIF":3.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953668","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":"Individual-level brain phenotypes in first-episode mania: normative modelling of brain morphometry and brainAGE.","authors":"Kevin Yu, Ruiyang Ge, Yuetong Yu, Shalaila Haas, Nicole Sanford, Lakshmi N Yatham, Sophia Frangou, Trisha Chakrabarty","doi":"10.1192/bjo.2025.28","DOIUrl":"10.1192/bjo.2025.28","url":null,"abstract":"<p><strong>Background: </strong>Brain morphological alterations in bipolar disorder are well documented, particularly in chronic cases. This study focuses on first-episode mania (FEM) to quantify neuroanatomical changes at early stages of the disorder.</p><p><strong>Aims: </strong>To assess deviations from normative brain morphometry and age-related brain changes in patients with FEM.</p><p><strong>Method: </strong>Pretrained models, based on large, independent healthy samples, were applied to structural brain images from FEM patients (<i>n</i> = 83) and healthy individuals (<i>n</i> = 61). Normative deviation <i>z</i>-scores were computed for regional brain morphometry, along with global and voxel-level brain-age-gap estimates (G-brainAGE and L-brainAGE, respectively). The proportions of infranormal (<i>z</i> < -1.96) and supranormal (<i>z</i> > 1.96) deviations were measured for both groups. Ridge regression and support vector machine models were used to evaluate whether <i>z</i>-scores predicted symptom severity, IQ or diagnosis. Case-control differences in L-brainAGE and correlations between G-brainAGE and clinical features were analysed.</p><p><strong>Results: </strong>Both FEM and healthy individuals showed similar proportions of infra- and supranormal deviations in regional measures. Morphometric data, whether observed or normative, did not significantly predict clinical outcomes or diagnosis. Mean G-brainAGE in FEM was -1.04 (s.d. 3.26) years and negatively correlated with age of onset, while L-brainAGE did not differ significantly between groups.</p><p><strong>Conclusions: </strong>Regional morphometry and local brain-ageing metrics in FEM patients aligned with normative ranges, suggesting minimal abnormalities in early bipolar disorder. However, subtle delays in global brain ageing may reflect variation based on the age of onset, highlighting a potential area for further exploration.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 3","pages":"e95"},"PeriodicalIF":3.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062136","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 ketogenic diet and metabolic treatments for neuropsychiatric disorders.","authors":"Christopher M Palmer","doi":"10.1192/bjo.2025.50","DOIUrl":"10.1192/bjo.2025.50","url":null,"abstract":"<p><p>The ketogenic diet, initially developed for epilepsy treatment, has gained attention as a potential intervention for neuropsychiatric disorders. A groundbreaking study by Campbell et al highlights its feasibility and potential efficacy in bipolar disorder, shedding light on shared mechanisms across neuropsychiatric disorders and the promise of metabolic treatment approaches.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 3","pages":"e94"},"PeriodicalIF":3.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953990","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":"Mortality and its predictors among people with dementia receiving psychiatric in-patient care.","authors":"Oriane E Marguet, Shanquan Chen, Emad Sidhom, Emma Wolverson, Gregor Russell, George Crowther, Simon R White, Jonathan Lewis, Rebecca Dunning, Shahrin Hasan, Benjamin R Underwood","doi":"10.1192/bjo.2025.40","DOIUrl":"10.1192/bjo.2025.40","url":null,"abstract":"<p><strong>Background: </strong>Although dementia is a terminal condition, palliation can be a challenge for clinical services. As dementia progresses, people frequently develop behavioural and psychological symptoms, sometimes so severe they require care in specialist dementia mental health wards. Although these are often a marker of late disease, there has been little research on the mortality of people admitted to these wards.</p><p><strong>Aims: </strong>We sought to describe the mortality of this group, both on-ward and after discharge, and to investigate clinical features predicting 1-year mortality.</p><p><strong>Method: </strong>First, we conducted a retrospective analysis of 576 people with dementia admitted to the Cambridgeshire and Peterborough National Health Service (NHS) Foundation Trust dementia wards over an 8-year period. We attempted to identify predictors of mortality and build predictive machine learning models. To investigate deaths occurring during admission, we conducted a second analysis as a retrospective service evaluation involving mental health wards for people with dementia at four NHS trusts, including 1976 admissions over 7 years.</p><p><strong>Results: </strong>Survival following admission showed high variability, with a median of 1201 days (3.3 years). We were not able to accurately predict those at high risk of death from clinical data. We found that on-ward mortality remains rare but had increased from 3 deaths per year in 2013 to 13 in 2019.</p><p><strong>Conclusions: </strong>We suggest that arrangements to ensure effective palliation are available on all such wards. It is not clear where discussions around end-of-life care are best placed in the dementia pathway, but we suggest it should be considered at admission.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 3","pages":"e92"},"PeriodicalIF":3.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975230","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":"Randomised controlled feasibility trial of online group acceptance and commitment therapy for functional cognitive disorder.","authors":"Norman Poole, Sarah Cope, Serena Vanzan, Aimee Duffus, Tatiana Williams, Nadia Mantovani, Jared G Smith, Barbara Barrett, Martin Scicluna, Sarah Beardmore, Mark J Edwards, Robert Howard","doi":"10.1192/bjo.2025.33","DOIUrl":"10.1192/bjo.2025.33","url":null,"abstract":"<p><strong>Background: </strong>Functional cognitive disorder is an increasingly recognised subtype of functional neurological disorder for which treatment options are currently limited. We have developed a brief online group acceptance and commitment therapy (ACT)-based intervention.</p><p><strong>Aims: </strong>To assess the feasibility of conducting a randomised controlled trial of this intervention versus treatment as usual (TAU).</p><p><strong>Method: </strong>The study was a parallel-group, single-blind randomised controlled trial, with participants recruited from cognitive neurology, neuropsychiatry and memory clinics in London. Participants were randomised into two groups: ACT + TAU or TAU alone. Feasibility was assessed on the basis of recruitment and retention rates, the acceptability of the intervention, and signal of efficacy on the primary outcome measure (Acceptance and Action Questionnaire II (AAQ-II)) score, although the study was not powered to demonstrate this statistically. Outcome measures were collected at baseline and at 2, 4 and 6 months post-intervention, including assessments of quality of life, memory, anxiety, depression and healthcare use.</p><p><strong>Results: </strong>We randomised 44 participants, with a participation rate of 51.1% (95% CI 40.8-61.5%); 36% of referred participants declined involvement, but retention was high, with 81.8% of ACT participants attending at least four sessions, and 64.3% of ACT participants reported being 'satisfied' or 'very satisfied' compared with 0% in the TAU group. Psychological flexibility as measured using the AAQ-II showed a trend towards modest improvement in the ACT group at 6 months. Other measures (quality of life, mood, memory satisfaction) also demonstrated small to modest positive trends.</p><p><strong>Conclusions: </strong>It has proven feasible to conduct a randomised controlled trial of ACT versus TAU.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 3","pages":"e91"},"PeriodicalIF":3.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978320","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":"Effect of improving food security on parenting practices and caregiver-adolescent relationships: qualitative findings of an income-generating agricultural intervention in rural Kenya - CORRIGENDUM.","authors":"Maricianah A Onono, Lila Sheira, Edward A Frongilio, Gladys Odhiambo, Pauline Wekesa, Amy Conroy, Elizabeth A Bukusi, Craig R Cohen, Sheri D Weiser","doi":"10.1192/bjo.2025.38","DOIUrl":"https://doi.org/10.1192/bjo.2025.38","url":null,"abstract":"","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 3","pages":"e90"},"PeriodicalIF":3.9,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953386","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 era of digital mental health interventions: we know they can be effective but are they also safe?","authors":"Urska Arnautovska, Alyssa Milton","doi":"10.1192/bjo.2025.42","DOIUrl":"https://doi.org/10.1192/bjo.2025.42","url":null,"abstract":"<p><p>Over the past two decades, digital mental health interventions (DMHIs) have seen a surge in studies with people experiencing mental ill-health, whether this be via web-based platforms, smartphone applications, text messages or other digital devices. Although DMHIs already demonstrate evidence of their acceptability and some of their effectiveness among different populations, the information about their safety is less clear. This Editorial reflects on a Delphi study by Taher and colleagues that explored the regulation of DMHIs and generated ten safety recommendations. We discuss these recommendations in the context of existing relevant literature and provide suggestions for further steps to advance research and policy on DMHIs in the UK and globally. Further dialog is needed, including the views and experiences of all key stakeholders, and particularly of people with lived experience, to ensure DMHIs are not only an acceptable and potentially effective treatment approach, but also safe for those that use them.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 3","pages":"e89"},"PeriodicalIF":3.9,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963187","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":"Diverging cognitive benefits from education between rural and urban middle-aged and older adults in the USA.","authors":"Roger Wong, Amer Mansour","doi":"10.1192/bjo.2025.45","DOIUrl":"https://doi.org/10.1192/bjo.2025.45","url":null,"abstract":"<p><strong>Background: </strong>Subjective cognitive decline (SCD) is defined as self-reported increase in confusion or memory loss. There is limited research on the interplay between rural-urban residence and education on SCD.</p><p><strong>Aims: </strong>Examine rural-urban differences in SCD, and whether education moderates this relationship.</p><p><strong>Method: </strong>Respondents aged ≥45 years were queried about SCD in the 2022 Behavioral Risk Factor Surveillance System data, creating a sample size of 63 890. A logistic regression analysed the association between rural-urban residence and SCD, and moderation was tested by an interaction with education.</p><p><strong>Results: </strong>SCD was more common among rural (12.0%) compared with urban (10.7%) residents. Rural residence was associated with 9% significantly higher odds of SCD compared with urban residence after adjusting for sociodemographic and health covariates (adjusted odds ratio (aOR) = 1.09, <i>P</i> = 0.01). There was a negative relationship between education level and SCD, including the association of college degree with 15% lower odds of SCD compared with less than high school degree (aOR = 0.85, <i>P</i> < 0.01). Education was a significant moderator, with higher education associated with lower odds of SCD for urban, but not rural, residents.</p><p><strong>Conclusions: </strong>Rural setting and lower education were associated with higher odds of SCD, but higher education was protective for only urban residents. These results indicate that higher education may be a gateway for more opportunities and resources in urban settings, with cascading impacts on cognition. Future research should examine reasons for the diverging cognitive benefits from education depending on rural-urban residence.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 3","pages":"e88"},"PeriodicalIF":3.9,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953666","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":"Psychopathology in Dutch women with terrorist behaviours: empirical case series study.","authors":"Sadaf Rakhshandehroo, Nils Duits, Lieke van Emmeriek, Elise Pullen, Robbert-Jan Verkes, Maaike Kempes","doi":"10.1192/bjo.2025.9","DOIUrl":"10.1192/bjo.2025.9","url":null,"abstract":"<p><strong>Background: </strong>Current empirical understanding of the relationship between psychopathology and terrorist behaviours in women is limited, because most research focuses on male perpetrators and relies on secondary sources. Addressing this gap is crucial, particularly given previous research that highlights significant differences in mental health problems between women and men involved in non-terrorist violent activities.</p><p><strong>Aims: </strong>To empirically examine the presence of psychopathology in women exhibiting terrorist behaviours, as well as its potential role in these behaviours.</p><p><strong>Method: </strong>A case series study of 14 Dutch female convicts associated with the (so-called) Islamic State of Iraq and Syria (ISIS), examining the occurrence and types of mental disorders, psychopathological problems and pathological personality traits, and exploring their potential role in terrorist behaviours based on forensic mental health reports from psychiatrists and psychologists.</p><p><strong>Results: </strong>Half of the women (<i>n</i> = 7) exhibited mental disorders during terrorist activities, primarily personality disorders. Psychopathological problems included susceptibility to influence (71%, <i>n</i> = 10), identity problems (64%, <i>n</i> = 9), feelings of inferiority (57%, <i>n</i> = 8) and naivety (50%, <i>n</i> = 7). A significant link between terrorism and mental disorders, psychopathological problems or pathological personality traits was identified in almost half of the women (43%, <i>n</i> = 6).</p><p><strong>Conclusions: </strong>Psychopathology is present in some women involved in terrorist behaviours, influencing their involvement, but is absent or irrelevant in others. Identifying psychopathology in women with terrorist tendencies is essential for early prevention and should be a core competency for psychiatrists.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 3","pages":"e87"},"PeriodicalIF":3.9,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966489","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":"Machine learning for prediction of childhood mental health problems in social care.","authors":"Ryan Crowley, Katherine Parkin, Emma Rocheteau, Efthalia Massou, Yasmin Friedmann, Ann John, Rachel Sippy, Pietro Liò, Anna Moore","doi":"10.1192/bjo.2025.32","DOIUrl":"https://doi.org/10.1192/bjo.2025.32","url":null,"abstract":"<p><strong>Background: </strong>Rates of childhood mental health problems are increasing in the UK. Early identification of childhood mental health problems is challenging but critical to children's future psychosocial development. This is particularly important for children with social care contact because earlier identification can facilitate earlier intervention. Clinical prediction tools could improve these early intervention efforts.</p><p><strong>Aims: </strong>Characterise a novel cohort consisting of children in social care and develop effective machine learning models for prediction of childhood mental health problems.</p><p><strong>Method: </strong>We used linked, de-identified data from the Secure Anonymised Information Linkage Databank to create a cohort of 26 820 children in Wales, UK, receiving social care services. Integrating health, social care and education data, we developed several machine learning models aimed at predicting childhood mental health problems. We assessed the performance, interpretability and fairness of these models.</p><p><strong>Results: </strong>Risk factors strongly associated with childhood mental health problems included age, substance misuse and being a looked after child. The best-performing model, a gradient boosting classifier, achieved an area under the receiver operating characteristic curve of 0.75 (95% CI 0.73-0.78). Assessments of algorithmic fairness showed potential biases within these models.</p><p><strong>Conclusions: </strong>Machine learning performance on this prediction task was promising. Predictive performance in social care settings can be bolstered by linking diverse routinely collected data-sets, making available a range of heterogenous risk factors relating to clinical, social and environmental exposures.</p>","PeriodicalId":9038,"journal":{"name":"BJPsych Open","volume":"11 3","pages":"e86"},"PeriodicalIF":3.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972639","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}